Long term difference between Suboxone and abstinence?

Anything about buprenorphine that doesn't fit somewhere above, fit it here!
Post Reply
Fortune Cookie
New Poster
New Poster
Posts: 1
Joined: Fri Jul 12, 2019 8:04 pm

Long term difference between Suboxone and abstinence?

Post by Fortune Cookie » Fri Jul 12, 2019 8:08 pm

Hi, I am a recovering addict and I have a couple questions for the people here. From my understanding, after a couple weeks of being on buprenorphine at a stable dose there is no detectable opioid effect due to tolerance. Am I wrong about that? If you can't "feel" anything from the medicine, what's the benefit in using it? Wouldn't you feel exactly the same being abstinent? Also, if your body has grown tolerant to the ceiling level of buprenorphine, then how does it kill cravings? Please help steer me in the right direction here because I can't figure this one out. Thanks!

User avatar
razor55
Moderator
Moderator
Posts: 1284
Joined: Tue Mar 11, 2014 9:48 pm

Re: Long term difference between Suboxone and abstinence?

Post by razor55 » Sat Jul 13, 2019 2:10 pm

First and formost, taking this medication give you a feeling of well being, not a high. A normal feeling after stablizing. There is no high when taken correctly. Maybe in the begining there may be a Feeling but at a regular everyday dose there isnt a high. Your not suppose to feel anything but well being. All hopelessness goes away, no chaising . So there is a difference than abstinent, this is much more than a phy feeling as an addict. we feel protected. we feel strouger, theres less to no depression. My drinking days were also taken away by this medication. Craving killing is mostly a mental thing after reaching ceiling level or above. You get on a dose of 6 to 8mgs or above, depending on each persons toterance then phy you shouldnt have cravings. Are you thinking of going on Suboxone? Total abstinent is great but people with oud need to look at this long term. These are my opinons after 8 and a half years on this med and no relapes on Anything else..... May I suggest you go over to Dr Junigs Talkzone blog. Use the search box and do some reading, all the answers ae there... RR..

User avatar
Amy-Work In Progress
Moderator
Moderator
Posts: 4816
Joined: Thu Feb 23, 2012 2:42 am

Re: Long term difference between Suboxone and abstinence?

Post by Amy-Work In Progress » Mon Jul 15, 2019 8:42 pm

Those with Opioid Use Disorder will feel intense cravings, mental health effects such as depression, and lingering withdrawal symptoms if they are completely abstinent. Unfortunately, abstinence does not feel "normal" to us. For us, the feelings of normality come from taking a stable, therapeutic dose of buprenorphine.

Or you can think of it this way. Would there be an epidemic of opioid addiction and overdose death if those who are addicted could just simply stay abstinent?

Amy
Done is better than perfect!

User avatar
jennjenn
Moderator
Moderator
Posts: 3092
Joined: Mon Sep 15, 2014 6:15 pm
Location: Tennessee

Re: Long term difference between Suboxone and abstinence?

Post by jennjenn » Tue Jul 16, 2019 10:34 am

Amen to that!
Jennifer

BlueLight
Super-Duper Poster
Super-Duper Poster
Posts: 341
Joined: Wed Jan 09, 2019 2:05 pm

Re: Long term difference between Suboxone and abstinence?

Post by BlueLight » Thu Jul 18, 2019 4:01 am

Fortune Cookie wrote:Hi, I am a recovering addict and I have a couple questions for the people here. From my understanding, after a couple weeks of being on buprenorphine at a stable dose there is no detectable opioid effect due to tolerance. Am I wrong about that? If you can't "feel" anything from the medicine, what's the benefit in using it? Wouldn't you feel exactly the same being abstinent? Also, if your body has grown tolerant to the ceiling level of buprenorphine, then how does it kill cravings? Please help steer me in the right direction here because I can't figure this one out. Thanks!
Buprenorphine is an opioid. A partial agonist opioid vs a full agonist opioid. My physical body most certainly reacts to having buprenorphine in my system, but my brain cannot “feel” it, because there is no euphoria, pleasure, or “rush”, from using like there is on full agonist opioids like Oxycodone or heroin.

The way my addiction doctor describes it, is that buprenorphine allows my brain to begin to heal itself from the psychological effects of addiction, while I work on my life via recovery programs to find new coping strategies and finding stress reduction tools. It’s nearly impossible to beat opioid addiction when you’re in the throws of the obsession and compulsion cycle of active addiction with finding and using ways and means to get more and more drugs.

docm2
Long Time Member
Long Time Member
Posts: 679
Joined: Thu Aug 08, 2013 4:40 pm

Re: Long term difference between Suboxone and abstinence?

Post by docm2 » Thu Jul 18, 2019 10:44 am

I am a recovering addict
Another one and done, trolling?
I assume you are in recovery and abstinent from Opiates?
If so, good for you. However, the numbers are not with you. I have a couple of people that have done so with support and comfort meds but it seems touch and go every month.
I am aware that there are people in long term recovery that do not use methadone, buprenorphine or naloxone. If you are doing well, why the curiosity?

incessant_chatter
Average Poster
Average Poster
Posts: 17
Joined: Thu Jun 07, 2018 4:49 pm
Location: NYS

Re: Long term difference between Suboxone and abstinence?

Post by incessant_chatter » Sun Dec 08, 2019 12:23 pm

The other factor I feel is important is that Bupe blocks the euphoria one gets from other opiates. If I want to get high I would have to stop taking my bupe and start to go into withdrawl before I felt much of anything from a full agonist... so it gives me time to think about what I'm doing. I can't just decide on a whim that I want to get high, I'd have to plan it ahead of time
John...

User avatar
TeeJay
Long Time Member
Long Time Member
Posts: 1146
Joined: Sat Aug 04, 2012 10:02 pm

Re: Long term difference between Suboxone and abstinence?

Post by TeeJay » Sun Dec 08, 2019 2:09 pm

OP does make a fair point regarding the a flaw in the rationale of taking maintenance. If a person who takes a regular dose of buprenorphine each day is in fact completely tolerant to its "feel good" effect, how is it different to being abstinent and how does it curb cravings?

I've experienced "early recovery" doing the abstinent approach a few times now, and I tell you there's something that hasn't been factored into this discussion. That is the reality that a person who is newly abstinent off opioids and in the first couple of years of recovery actually doesn't feel "normal" at all. They experience ongoing cravings. One way to describe it is that, especially in the first year, they feel a dose of opioids below "normal". This is why abstinence is particularly difficult to achieve, as the first year or two of abstinence the brain will try to pull out every trick in the book to get the person to re-introduce opioids to make it feel "normal" once again. Only after an extremely slow, gradual normalisation over a couple of years does the brain's opioid receptors return to a state close to that of a person who never was addicted.

Taking maintenance buprenorphine (or methadone for that matter) basically prevents the brain from playing tricks in order to return to using, as the maintenance dose satiates / fills the receptors just enough to keep them happy but without falling back into the cycle of saturating the receptors then leaving them bare multiple times a day like in addiction. This is the cycle that perpetuates obsession and addiction associated with the shorter half-life opioids (heroin, morphine, oxycodone etc).

I personally don't place much emphasis on the partial agonist property of buprenorphine when it comes to this discussion. The main benefit of partial agonism is the ceiling effect, which is useful as it makes overdose on buprenorphine a lot harder than say, for methadone. Doctors therefore have much less of an issue with patients taking a whole month's supply home.

I've been on methadone too which is a full agonist, and that too didn't get me "high" as long as I took a dose I was stable on. However something about methadone just made me look like shit compared to me on buprenorphine.

Another oft understated benefit of taking buprenorphine over abstinence is that people on maintenance reduce their chance of fatal overdose by 80% if they do lapse or relapse on their opioid-of-choice. This is HUGE. Imagine for a second there's a cemetary with headstones for every opioid overdose since the beginning of the US opioid epidemic. Then imagine the possible scenario that up to 80% of those headstones could have disappeared, and 80% of those lives potentially saved, if they had been on maintenance. Even if they weren't taking it as prescribed, and were skipping doses, or getting it off the street. Simply having a bit of an opioid tolerance on board could have been what saved them.

User avatar
Amy-Work In Progress
Moderator
Moderator
Posts: 4816
Joined: Thu Feb 23, 2012 2:42 am

Re: Long term difference between Suboxone and abstinence?

Post by Amy-Work In Progress » Sat Dec 14, 2019 11:51 am

incessant_chatter wrote:
Sun Dec 08, 2019 12:23 pm
The other factor I feel is important is that Bupe blocks the euphoria one gets from other opiates. If I want to get high I would have to stop taking my bupe and start to go into withdrawl before I felt much of anything from a full agonist... so it gives me time to think about what I'm doing. I can't just decide on a whim that I want to get high, I'd have to plan it ahead of time
Good point, John!

In fact, this thread has many great points about the difference between buprenorphine and abstinence.

Amy
Done is better than perfect!

Post Reply