Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: Opiate Detox Recovery

To Use Suboxone, Or Not To Use Suboxone?

A reader writes:

Hi G,

I know there is no magic bullet or simple answer, but I thought you may have a suggestion for me. I’ve been taking perc or ox for five years, for the first 3 it was only 30-50mg/day but now it’s between 150 and 180.

Suboxone scares the shit out of me, but at the same time, every time I try to taper, I fail and I’m starting to go broke. I lost my health insurance.

I go to meetings 4 or 5 times a week, all helpful, but the physical part keeps me hooked.

I heard suboxone may be ok if used very briefly (like a month or less), as when taken for longer, the withdrawal is way worse than the oxy itself. I wish I could go to a 7-day detox or something, but I just don’t have the money and I don’t have insurance. I also freelance so I need to be able to work and I can’t lose more than a few days. 

Anyway, I started trying to find low-income or sliding scale suboxone programs in NYC, but it’s slow going and I don’t want to just get hooked on something else. I have read long term effects of suboxone are bad too.

I guess my Qs are:

if I were to do suboxone briefly, a few weeks, would I just then have the same withdrawal as I would going cold-turkey from the oxy anyway?

is there something else in my area (or anywhere) where someone could go for opiate detox that costs nothing or very little?

I want to be clean so bad, but every time I try to taper I just fail.

Any thoughts/suggestions appreciated – I know you’re not a doctor or professional, you just seem to have a lot of info and I know how we like to help each other. 

Thanks in advance.

B

Dear B,

There is no magic bullet, but in my experience there are simple answers.

The first was to know that I wanted to get clean. (Which you say you do.) First problem solved: I was telling myself the truth. The truth was, I was willing to do what it takes. And It Takes What It Takes.

The second was to ask for help. (Which you have. Keep doing it.) Nobody, but nobody, does this on his own. Even the people I know who don’t go to meetings have put together communities of other people trying to stay sober.

The third was to use my willingness and my growing community to decide on a path, and walk the walk.

For some people, Suboxone is the solution. They’ll tell you they don’t mind eating an opioid for the rest of their lives—it’s “like a diabetic taking insulin.”

In my opinion the diabetes analogy is worn out. I wanted my solution to be real freedom. When I reached out for help I met people who had shot heroin and who had gone bankrupt buying drugs over the Internet and who had drunk themselves into blackouts—people who drank and used to the excess I had, or worse—who were clean and sober. I wanted to break ties with all drugs that cause physical and psychological dependence. For me taking drugs is signing on for slavery. Just my reality.

I really wanted to go to rehab but I knew I couldn’t leave my kid for that long.

Here’s how I decided on a Suboxone taper.

I knew I couldn’t detox off full-agonists like oxy. Too alluring. (More truth-telling.) I needed to change all my habits. So I asked for help—I found a detox doctor who was willing to oversee a Suboxone taper for me.

I told him at the outset that I wanted to taper. When my resolve flagged, he reminded me that the project was to get free.

I put the taper in his control. I never had more than one week’s worth of drugs in my possession. He wrote out the taper, I wrote out the check, we shook hands. I waved the white flag and gave up.

I did what he and a bunch of other people—Dani, Allgood, Sluggo, Bonita, all online friends; and my new real-life sponsor and community—told me to do. I put my faith in the people who were sober and who told me I could be, too. I burned a script for more drugs. I went to meetings and opened my mouth and let myself cry on people. I kept collecting sober people around me.

Several weeks later I was drug-free for the first time in years.

And yeah, I ain’t a doctor, but I’ll offer this anecdotal caveat: if you’re taking 180mg Oxy, they’ll try to start you out at 8-12mg Suboxone (or maybe even more). But that would be increasing your tolerance. If you really want to get clean, you’ll start at 4mg and taper to 3mg within two days. You could do a 2-week taper, cutting to 1/4mg—the equivalent of 1 Percocet—at the end and have a relatively smooth landing.

Post-acute withdrawal.

I ain’t gonna kid you: staying clean was a slog. Tapering off suboxone was not nearly as bad as detoxing cold-turkey from fentanyl or oxy, but it wasn’t painless—I shivered, I kicked in my sleep, I sneezed 20 times in a row. Keep in mind, my tolerance was more than twice yours, and I’m probably a little smaller than you. I spent each day telling myself if I made it to bed without having stolen drugs (because yes: I used to steal drugs) or used anything, including alcohol, I was a success.

The best treatment for drug-cravings was vigorous exercise. It helps the body produce its private supply of morphine and dopamine. Dr. Steve Scanlan told me research shows people who exercise cut their recovery time in half. I made playlists that helped me drag my body around the neighborhood. Walk, run, cycle. Do pushups. Lift weights. Start small and grow bigger. I exercised, and my body and mind recovered.

Healthy. (Mostly.)

Healthy. (Mostly.)

A 180mg oxy habit is totally beatable. With a stick, my friend. Dude, if I can get clean, you can. I was on more than twice that and I’m free today. And I did not use insurance to get clean. But I paid what it took—the first of several critical investments I’ve made in myself over the past few years. Paying that doctor made me realize that, for a long time, maybe all my life, I’d withdrawn a great deal without putting very much back.

 

The most important information here: Get to a meeting. Tell them you want to get clean. Ask them to help you.

If you feel you need inpatient or other professional help, try Phoenix House, a large NYC-based treatment system with detox facilities in Long Island City. Or try the “free and affordable” resources listed on this website.

Getting Sober Online Or In Real Life

Can you get sober online? or does it have to be IRL?

More and more people are using the Internet to look for help with their addictions. I’m getting mail every day from people who are desperate for help. We heard from the American woman staying in a little town overseas with no meetings; according to the comment she wrote this morning, she cannot put down the booze, and she’d like some help.

Where can she get help?

Here are some other examples:

I’m a single mom, divorcing an abusive alcoholic husband, I have a pill problem and started Suboxone and can’t get off, I’m afraid of depression; what should I do?

I tried tapering off pills and went from 90mg to 15mg but now I’m up to 60mg again, is any benefit I got from tapering lost now that I’ve gone back up, I don’t know where to turn for help; what should I do?

I love an alcoholic who is artistic and sensitive and intense and highly self-aware, here’s the situation: he’s stopped drinking but he still smokes weed every day, and I’m not sure whether his weed thing matters, I just wish he’d place a higher value on himself, I also wish he’d love me more, because I love him so much, I see so many beautiful things inside him that he doesn’t even see; what should I do?

//

Caveat: This blog has its limitations. It is strictly a place where I share personal experience, strength and hope. I’m not a professional, I don’t have all the answers. Quite often I don’t have even one answer. I’m just another addict trying to stay sober today.

But I do know how I got sober.

The first place I reached out was online, at Opiate Detox Recovery. (Fantastic resource for anyone dealing with an opioid drug problem; excellent moderators who protect the community; please check in if you’re trying to quit painkillers or dope.) I was two days into an outpatient medically-overseen detox, I was sick, I was (quite literally) kicking, and I had a shitload of stuff to get done. My first post was all about how I was a pain patient and trying to make my life manageable by reducing my tolerance a bit and how I was in the middle of painting the dining room, how it was Labor Day and I had a bunch of people coming for dinner, I had to cook, I had to clean, I had to take care of my kid and my husband and maybe I’d fucked up my brain chemistry forever with drugs, and blah blah blah poor me, please please please help me.

I got replies right away. Within 20 minutes, in fact. From Jay, who told me yes, I’d fucked up my brain chemistry, but that if I got off drugs it would heal, and from Arlene who told me to drop the fuckin superwoman act.

“It will only lead to continued rationalization to use,” she wrote.

“I don’t know what you mean by the superwoman act,” I wrote back, all high and mighty.

It took me three more weeks to accept the truth in her statement and admit to myself and to one other person that I was an addict. And that person was a person who lives in my city, who met with me in the flesh, whose brown eyes and calm voice conveyed concern and care.

I started going to meetings.

Meanwhile Gettingbetter and Allgood and Sluggo and OnMyWay and a bunch of other awesome people had started writing. Also Bonita, who was detoxing at the same time and who “jumped” (quit taking drugs) on my birthday that year, a couple days ahead of me. My Jump Buddy: we were paratroopers into the Land of the Clean and Sober. (Rough landing for both of us, but we’re both still alive, and both sober.)

Sluggo wrote me a taper schedule that I followed, along with the doctor’s supervision. The doctor, of course, was IRL, and in real life he did not take insurance, so he was expensive.

But how much is my life worth? how much money? how much time? I paid him about $700 to detox me. Cheap at the price.

I’m alive today.

It was after I jumped that the online support became important and ingrained in my daily life. I jumped Nov. 1, 2008, and that Thanksgiving Day I went upstairs every hour or so to write posts to those folks, because I had five house guests and because I felt draggy, restless, irritable and discontent, I had very little recovery, I had no faith, and those online folks answered. Same with Christmas. Same when my first sponsor relapsed; same when my second sponsor ditched me. I could always go to those people, and I’d always get an answer.

//

So in April, while visiting New York, I met OnMyWay, still sober, living in Brooklyn, working in Midtown. It’s ALWAYS amazing to see the faces of people with whom I have shared an online connection. Her face was round and sweet; her eyes were like large peaceful ponds in the fall, after the leaves have dropped and the sun shines into the water and the surface of the water is calm.

Then just before Memorial Day I met Allgood.

Allgood and Dani on either side of G.

Two days ago I drove from Kingston to Providence to meet Gettingbetter, also known as Dani, along with Allgood, who live near each other. They drove two hours to see me, and two hours home. I knew Dani was one tough fellow beeyotch whose backbone had hauled my sorry ass through some difficult shit after detox. In my mind she had grown into a kind of super-neohippie-wisewoman; despite the fact that I’d seen photos of her, I had given her long Joni-Mitchell-style hair, only brown, and lots of suede, maybe even fringes and beads. In real life, Dani is about my height, about 8 years younger than I, and smooth-faced, with eyes the color of yellow topaz, or cat’s eye sapphire. She wore jeans and a T-shirt. She’s fit and strong and healthy and sober.

Allgood kept pushing plates of food my way (his family and mine come from opposite sides of the Adriatic; the custom is to feed those you love), but I just wanted to sit there and look at their faces and listen to their voices and soak it all up. Same with a few others I’ve met IRL who I first met online.

What can I say? They saved my life, man. They keep saving it.

So do the many real-life people in my sober community. It takes an entire village to get sober.

//

Can you get sober online? The answer for me was yes and no. Online support is a real bonus for people getting sober these days. But I need to see real people to be sober. I need to hold someone’s hand; I need to hear someone’s voice; I need to see the whites of their eyes as they help me get honest. We have bodies for a reason, after all.

Now I need to meet Sluggo.

More and More Mail: How To Quit A Small Oxy Habit

Ran four miles in the Rhode Island countryside this morning. No place in Rhode Island is very far from the coast and the light here is different from home, somehow both brighter and more gentle. Using it to paint:

Henry, age 2. Almost done.

More mail from a young guy in the Pacific Northwest:

I am battling with an addiction from Oxycodone. Approximately 15-60mg a day, and I had a few questions for you. My first question was, how hard and how long do you think I will withdraw for? I have been using for about 9 months, and just finished college and would like to get my life started. Second, I was wondering if you think it would be a bad idea for me to get about 2-3 8mg Suboxone pills, and cut them into quarters, use those for about a week, and get off them to help me skip the physical withdrawal symptoms. Please, respond as soon as you can as I am desperate for help.

Last week I attended a regional prescription drug abuse summit in my town. The U.S. Attorney’s office and the DEA and Obama’s drug-control policy people were there, and they made a big deal about two drugs: oxycodone and Opana—chemical name oxymorphone, metabolite of oxycodone. It’s twice as strong as oxycodone and is said to be three or to eight times stronger than morphine (though most sources cite oxycodone as being 1.5 times stronger than morphine, so these equivalencies don’t make sense). At any rate Opana is stronger than its parent drug.

Oxycodone is a short-acting drug—its half-life is 3-4 hours, which means within 24 hours it pretty much clears the system.

Suboxone, on the other hand, has a 37-hour half-life. Which means it takes days and days to clear the body.

First thing to consider: one milligram of suboxone is equivalent to 30mg morphine, or about 20mg oxycodone. The reader wants to “get” 8mg tablets and cut them into 2mg pieces, which would be upregulating the opioid receptors: he’d be taking the equivalent of 40mg oxycodone, but if he doses every 24 hours, he’d be stacking up the drug in his blood because it takes 37 hours for half a dose to clear the body.

Second, “getting” a prescription drug is problematic (criminal, a felony in my state, actually) unless it’s prescribed. Don’t buy on the street, OK, dude? … Number one, addicts are powerless over drugs. I couldn’t have trusted myself to “get” Suboxone and use it responsibly. Suboxone is a kickass substance and the only way I could have used it successfully for any purpose was under a reliable doctor’s hawkeye supervision.

My experience:

  1. A 60mg/day oxycodone habit is beatable through quitting cold-turkey or tapering. The acute withdrawal will involve about 10-14 days of sweating it out and feeling like you’ve got the flu; after that, maybe another month of feeling like life is a drag, but aerobic exercise can work wonders to cut down on insomnia, restless legs, etc. … I know 60mg feels like a huge amount. But hear this: I used Suboxone because I was on 100mcg fentanyl per hour, which is equivalent to about 400mg oxycodone per day. I don’t mean to minimize your experience, but using Suboxone for a 15-60mg/day habit is, to use my lay buprenorphine expert friend Jay’s analogy, like shooting an anthill with an atom bomb. … When I first took Suboxone I was tempted to stay on it for life because at first I felt so super-well, but that feeling changed within a matter of weeks. And I can’t tell you how many emails I’ve had and posts I’ve read from folks who used Suboxone to get off drugs and now can’t get off Suboxone. Your decision, of course, but just sharing experience.
  2. Log onto Opiate Detox Recovery and find others who have quit and are trying to quit short-acting painkillers. ODR has a wealth of reliable information and real-life experience and was an enormous support to me when I was trying to get sober.

One last piece of experience: face-to-face help is so important. Go to a meeting of people trying to quit drugs, any drugs—alcohol, painkillers, cocaine, whatever. Get phone numbers, call the people you meet, ask for help. It’s impossible to quit alone. To that end, I hope others will weigh in on all this.

The summer after graduating college is a great time to get sober and “get your life started.” Getting sober and starting your life are the same thing, and better to do it now than later. I’m in awe of folks who quit in their teens or 20s. You have your entire life ahead of you to find out who you are and be that, instead of using drugs to hide. If you ask for help, you will meet people who will tell you that you CAN do this. Let me be the first.

Thanks for helping me stay sober today.

Back to the palette.

In Real Life: Meeting Allgood.

Have you ever met anyone online who means a whole lot to you—you’d take their middle-of-the-night calls, you’d give them food or shelter, you love them, but you’ve never seen their face?

//

A couple weeks ago I get this Facebook message:

Hey, so I’ll be driving through your state next week. I’ll be on I-80 heading east… could we meet for lunch? I would like that. Let me know. Love

It is “Allgood” writing.

Mid-30s, Mark Wahlberg-ish accent, former heroin addict, one of my mainstays when I was first getting sober. “Allgood” is his screen name.

Stoked to try to work this out. End of school year; teaching, writing, driving the boy around; schedule has been impossible. But this dude was one of the first and most dependable folks I met when I started looking for sober people online. He tells it like it is. He was so honest and direct that he freaked me out. He’s kind, and he’s no-bullshit: two qualities I admire in anyone. (Sometimes the no-bullshit comes before the kindness; sometimes vice-versa, as with anyone, right?)

//

I met Allgood on Opiate Detox Recovery, the place where I became Guinevere, when I was in detox in 2008. Allgood is a former East Coast stocks trader and IV addict who has been sober since spring 2008. Just before I detoxed, he was Getting It after many, many, many tries. He had been looking at jail time. He picked sobriety instead.

How he stays sober: he helps other people. He has written almost 5,000 posts to people (including myself) trying to kick drugs of one kind or another. He is busy changing his work and moving across the country so he can help more people.

And the people online who helped him?—they were telling him their stories, they were giving him their numbers, they were offering to take his dog while he went to rehab, for chrissake. The help just goes around and around.

//

It’s in the back of my mind: Allgood will be here in a couple days, he’s coming in north of my town and this is a bridge-and-tunnel city, I never venture into the suburbs, so I kind of wait for some burst of inspiration about a meeting place till I’m sitting at a soccer match last week and my phone lights up with a text:

Is our gathering happening, G?

Yes, dammit. It is. I sit there at dusk in the dewy skeeter-ridden grass and watch my kid score a goal, then I use an app to nail down a place. I text him the address so in case he has GPS he can plug it in. He writes:

Sweet! Can’t wait!!! See u there

//

It’s 85 degrees at 5 p.m. in the shady parking lot of this restaurant, and I am on the phone with a 20-something woman in the program when I see him open his car door. He has already warned me he’s in “super-duper driving-cross-country casual dress” and I see that he’s wearing three or four days’ growth of black beard and black flip-flops. He tells me to take my time with this girl and my conversation winds down, and then Allgood is standing in front of me, and I put my arms around him, and it was like the time my son and I hugged one of the redwoods in Marin County. We just leaned in.

In Marin County with my boy, four months out of detox.

Marin County and the redwoods—that was three years ago, March 2009.

Allgood was steady.

When I relapsed in January 2010, I told my friends on the forum. A lot of people were surprised and some expressed shock, disappointment, and even feeling “doomed” if Someone Like G could relapse (for godsake). Because I can talk a good talk, I sounded most of the time as though I were doing real well. (I’m still learning how to apply the principle of rigorous honesty to my relationship with myself, and also how to ask for help and then to accept it.)

Allgood’s boat wasn’t rocked. Allgood had tried to quit and had relapsed many times himself. Here’s what he wrote (in Post No. 999 on my thread) to the people who were disappointed and to me:

We are never “cured” from this disease of alcoholism and drug addiction. What we have is a daily reprieve contingent on our spiritual condition.

Sure, this is disappointing to hear. Am I surprised? Certainly not…

G—what was missing in your program this time? Are we willing to move forward and seek more this time? I’m hand in hand with you my friend. Much love

//

“So, in my family we just kind of order, and share everything,” Allgood told me as we looked at the dinner menu. “Is that cool with you?”

I’m, like, hardly ever really hungry. I didn’t care much about the food. I wanted to see him smile. (It’s impossible to see someone smiling while writing to them over the Internet.) He told me some of his story I hadn’t heard before. I was having a very, very tough week last week, and he listened with deep attention and asked me questions about my experience.

I’d spoken to Allgood over the phone before and his years out West had taken the edge off his Marky-Mark accent. I ordered a crab cake on salad and he had scallops and salmon and at the end we split a funnel cake with cream on top, and we shared stories, and it was all good.

//

I’ve met other sober people In Real Life who I’d first met online. Two in particular mean a lot to me, and they both live in New York. There are one or two on Long Island I’d like to meet. There’s another one in Jersey who I’ve never met but for whom I’ve made some art, and another in New Hampshire I want to make a date with in July. (These two have helped save my life.) There’s a guy in Iowa I wish I could connect with, a former fentanyl addict whose every post I read for several years before I even logged on as Guinevere. There’s one in L.A., one in San Diego, and one in Washington, D.C.

Have you ever met a sober person in real life who has helped you online? Are there sober people you know only online who are part of your sober community? Would you be willing to tell us about them?

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