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BonsaiGuy
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Default Feb 16, 2019 at 06:30 AM
 
Quote:
Originally Posted by Sammyfivesix View Post
I was on suboxone for a short while, I'm off now. Obviously just doing heroin, but I'm broke and homeless and don't even have a safe spot to do my shots. I wanted to know if you guys would recommend suboxone or Methadone? Which would you say is better? What are the pros and cons of each?

I can't seem to decide and I really need to because it will determine where I go for my treatment.
Thank you for bringing me in on this, @sarahsweets!

@Sammyfivesix, I'm really grateful that you reached out. It takes a lot to seek help from others and I am really proud of you for doing it. I am a recovering drug addict with chronic Substance Use Disorder. It seems like only yesterday I was down and out, spending every single dime I had on heroin or fentanyl. At the end, I wasn't even getting high. I had overdosed three times in a single month and knew if I kept going, I was going to die. I was at my lowest low when I had the thought "I'm going to get help right now." Literally the next morning, I woke up a 3AM and went to the Methadone clinic near me. They took me in and dosed me that day following my extensive intake. I have not taken a single drug since.

Simply put, I have my life back. I have a happy marriage, a good job, a house, disposable income.. I have a personal recovery program that works for me. I know you can find the same light.

As for MAT (medication assisted treatment), I have tried all three medications (the third one being a once a month Vivitrol shot that is an opiate blocker). Here is my experience with each one...

Suboxone and Methadone in my experience have very similar physical and mental effects. However, where Suboxone is a partial antagonist (meaning it has less effect than full antagonists like heroin but will block your opiate receptors from the introduction of other opiates), Methadone is not. In my experience though, I really never had any desire to stack more opiates on my methadone dose once I got to the dose that worked for me. As far as feeling goes, you really wont find and major euphoria in any of these medications. They simply fulfill your body's need for opiates and allow you to focus on getting clean without constantly looking for the next hit. They basically regulate your body and then when you're ready, you will very slowly lower your dose over time.

Given that there are minor physical and mental effect differences between Methadone and Suboxone (some may disagree but for the sake of my point let's go with it), what you need to look at is the structure of program that comes alongside the medication. The differences that I have seen are as followed...

Methadone: At the start, I was required to go to the clinic every day except Sunday's to receive my dose. This may sound like a hassle but it was CRUCIAL to my recovery. The visits don't take long. Mostly, you're in and out. I have a job that requires me to open a store early and I never once have been late because of dosing or missed my dose because of work. This gave me a routine and accountability that were I desperately needed. Over the course of treatment you will "earn" the right to have "take-homes" up to two weeks in advance. This will take quite some time before you get this privilege. They do this for multiple reasons but the main one is if you give an addict that much Methadone before any structure is established, you're simply begging for an overdose. You will have some time in the beginning where dirty drug screens are acceptable but after around 2 months (give or take) you are required to have clean drug screens. One thing I cannot stress enough is that YOU CANNOT CONSUME ANY ALCOHOL, SEDATIVES, BARBITURATES, OR BENZODIAZEPINES WHILE ON METHADONE! This is so incredibly important. I've heard some say "I've been drinking/ using for years. I can handle it!" You most certainly cannot handle it and YOU WILL OVERDOSE. This is their biggest no-no. If any of these come up positive on a urine screen, the liability is so high that you might be dropped as a patient. Also, it is very important to have reliable daily transportation. The last thing you want it to start treatment and then rapidly stop treatment because of a transportation issue. Because of this, most clinic will offer transportation resources. You also are usually require to attend a few groups and individual counseling each month. Again, structure. I actually really look forward to these and they have really helped with my mental health. Most clinics will also have the ability to diagnose and prescribe medication for mental health issues.

If you have any more questions about Methadone, PM me. I am not expert by any means, but I do have a lot of insight and experience with this.

Suboxone: This medication seems to have a little bit of a quicker onset than Methadone. If you are worried about having the desire to continue to use while on MAT, this may be a good option for you. Also, with most Suboxone programs, you earn privileges more frequently than with Methadone (take-homes, less counseling requirements, less group requirements, etc). Suboxone is a lot safer as far as overdose is concerned. What it comes down to most of the time with these different treatments are the program preferences.For me, the medications seem to provide a similar result.

Also, something to keep in mind is that most clinics will allow you to try one of these medications for a few weeks and if it's not working for you, you can usually switch to the other with minimal discomfort. In my experience, however, Suboxone to Methadone is a much easier transition than the opposite due to the fact that you have to have all opiates completely out of your system before you take Suboxone due to the risk of precipitated withdrawal.

Vivitrol: Look at this as a very long acting Naloxone shot. This medication is my least favorite. This is simply my preference due to the fact that I had some side effects that were very undesired. I'll leave it to you to research, but it affects your pleasure centers in your brain in a way that I didn't like. This is great for combating urges, but it also will diminish the pleasure received from most other things (like sex or working out). It also made it so that I couldn't really fully taste food or smell as well as I used to be able to. The benefit to this however is you get a shot once a month and that's it. You are left to create a recovery program at that point, but as far as requirements from the clinic go, they are very minimal. It's mostly show up once a month,get your shot, and off you go. Very easy.

Overall, everything I mentioned is simply from my experience. I am not a medical professional. I do enjoy sharing my experience because I want to inform others and to try to give them hope. It sounds like you are motivated to get clean. That's a great start. Think about it, I used to get my drugs every single day, without fail, no matter what. If I put even half of that effort into my recovery, then I am on a very good track.

Please reach out to me if you have any questions at all. You have no idea of the wonderful life that awaits you on the other side of the hell of addiction. It is absolutely wonderful bliss and totally worth fighting for.

I am proud of you and I believe in you. Good luck!

__________________
Recovering from the past. Growing in the present. Planting seeds for the future.

Dx: Bi-Polar II, PTSD, ADHD, SUD
Rx: Methadone 100mg, Lamictal 300mg, Abilify 10mg, Buspar 40mg, Clonadine 0.3mg, Trazodone 50mg, Nexium 20mg, Allegra 180mg
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