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Buprenorphine and depression/anxiety
  1. #1
    encrypteddreams2010 is offline New Member
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    Exclamation Buprenorphine and depression/anxiety

    Hi all...
    I am new to this forum and have a topic i would like to hear some educated feedback on. I am an opiate addict, the problem is...i havent touched an opiate since December, 2008. I am on a court supervised drug program that is extremely intense, and requires weekly drug testing. I am on 8mg suboxone though, 20mg a day, and have been since august, 2009. The obvious delimma is, i was obviosly not in withdrawl in august, if i got clean in december. I am on suboxone maintenance for depression...it does help too. I have a very high stress level and suboxone gives me a little mood lift, gives me an appetite, and helps with sleep. I do not abuse my medication, although i have tried. Suboxone has a strange effect that makes me not crave the high so much, although i would like to smoke a joint now and then, but other than the suboxone i have been completely clean for 18 months, which is amazing to me. I do not go to any meetings or support groups, or do not take any other medications. I am prescribed 1mg clonazepam 3x daily, but am not allowed to take it so i dont even fill my script.
    I just want to know what others think about this situation, and also i dont want to be on it forever. Is it going to be just as difficult for me to stop taking bupe as it is for someone who goes straight to bupe maintenance from oxy or H or whatever? All feedback would be helpful, and feel free to ask any questions...
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  2. #2
    newyorkgal is offline Advanced Member
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    I am very sorry to say that you've been give sub for the wrong reasons. Sub is meant for people in active addiction so they won't suffer withdrawal symptoms. It is not meant to be used as an antidepressant. It is a highly addictive opiate. There are other ways to treat depression. In addition, you are on a crazy high dose. Sub has a ceiling effect which is about 4 mgs. so all that extra isn't even necessary. Problem is, doctors know very little about this drug as they only have to take a short online course in order to perscribe it. You are on too much and have been on too long. I know what I'm talking about as I've been on for over a year at a dose of under 1 mg. and still, I'm finding it very difficult to get off totally. If I were you, I'd start decreasing the dose immediately. When you get down to a reasonable dose, you can find ways to taper off on these threads. I still don't understand why they gave you sub when you were clean. Makes no sense.

  3. #3
    cferd is offline Member
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    I've read a few places where sub has been used off label to treat depression, sometimes it can be an effective treatment. I know there is more research being done on it and it may someday be approved for use in certain forms of depression. I don't agree with the 4 mg ceiling. From all the educational and research sources available it appears the ceiling is believed to be between 12-16 mgs. Although it could vary significantly for the individual. For every story I've read that it has helped someone with depression, there is also a story where the sub is believed to have caused depression, or increased pre-exsisting depression. I do agree with the dose being quite high that makes no sense, just as why someone would stay on any ORT longer than neccessary. It makes no sense that people are on a drug that is ment to help them get of drugs for years and even decades.
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  4. #4
    newyorkgal is offline Advanced Member
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    For most people, if Suboxone is taken correctly the flat part of the response (ceiling) occurs at about 2-4 mg of the drug. This is where I got the information saying 2-4 mgs. I have also read 8 mgs., 12 and 16.... In any case, 20 is never necessary. Next issue is why would someone take sub when they've been clean 8 months? Also, I would think even if it works off label as an antidepressent, because of the fact that its a HIGHLY addictive opiate, everything else should and would be tried first to treat the depression. Lastly, although you might not understand why anyone would stay on ORT longer than necessary (and what is the necessary time frame?), as you said, everyone is different. Some people find they can't get off, either because of fear, illness or continual relapse.
    Last edited by Anonymous; 05-10-2010 at 12:11 AM.

  5. #5
    encrypteddreams2010 is offline New Member
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    Sometimes i go 24 to 36 hours without taking a dose, and do just fine. i work 60 hours a week, and have for 3+ years. If you knew a little of my history and the reason for my stress levels, maybe you wouldnt be so quick to judge. especially considering the program i am on, i CANNOT take most medicines, and bupe does not show on a drug screen...Life is hard. not to use that as an excuse, but, sometimes you have to take something to stay out of the asylum. so if i am taking bupe that is prescibed by a doctor to keep me from doing something crazy...what is the problem with it???
    Last edited by Anonymous; 08-31-2013 at 03:29 PM.
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  6. #6
    cferd is offline Member
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    I don't think anyone can say what the right way to treat depression is for everybody. it's just too unique of a disease. if being on sub is preventing relapse/ a trip to the asylum then i agree, your better off taking a Dr prescibed med than he alternative.. The fact that eventually you will have to taper of suboxone is no different than if you were taking lexapro or an other SSRI, they too can give you wds and need to be tapered. Your Dr has is reasons for prescribing you sub, my only thoughts are on the size of the dose. Most people seem to be able to make large drops when on a higher dose. Then again, you are not most people, you are you, what works for "most people" may not for you. I agree with the suboxonetalkone having biased information, many sites due. You'll often find an individuals bad choices in life turned into a summariation of why sub is a horrible medication. There are some sites that are there to provide support solely for sub patients. The mods could probably provide my email if you want the info as I don't think I can post it here. I'm all for people using sub to break the chains of addiction, get on and get off is the ideal way. But I believe there are other cases where it can be used appropriately for longer. Hopefully your stress will lessen, you can find a way to manage it and won't need to stay on suboxone for the next twenty years.

  7. #7
    JunigMD is offline New Member
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    In answer to the issue of being biased at STZ... I have been an opiate addict for 18 years. I have been sober using the steps after going through treatment twice-- the second time after relapsing after seven years. I then went through 4 months of residential treatment, followed by six years of traditional aftercare. I am the medical director of a 50 bed residential treatment center that never uses buprenorphine. I have attended literally hundreds, probably thousands of AA, NA, and CA meetings over the past 15 years.

    I started prescribing buprenorphine about 5 years ago, and have treated over 450 patients with the medication. I eventually realized that the medication is a long-term med; something that has been verified since I started preaching about it a few years ago.

    Right now-- i.e. this minute-- I am in Washington DC at a summit between NIDA and SAMHSA. Since Monday morning I have listened to all of the 'big names' in addiction research and treatment-- and in government policy-- discuss buprenorphine. We have reviewed data from study after study, looking at different treatment paradigms, different patient populations (including adolescents, pregnant women, and older populations).

    At my blog and forum I discuss different ways to use buprenorphine. After all that I have seen, and all that I continue to see, I have opinions that are fairly strong. At one point is a person considered 'biased', and at what point is a person simply well educated? I do not have any links with Reckitt Benckiser, and I am closed to new patients for buprenorphine-- and have been closed for about a year. I have no reason to favor buprenorphine, and in fact would love to see the manufacturer fall on its face for the high price, that has been killing people.

    One thing that was clear from all of the data today is that buprenorphine is a long term medication, and it works better than any other treatment for opiate dependence. If anyone wants to compare data on either of those issues, I'll post your comments on my blog. In the past when I come here, I get deleted-- and yet y'all think I am biased!
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  8. #8
    cferd is offline Member
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    What would you say about the podcast that has become the source of some debate.Apparently a Dr in Florida, who is also a recoverying opiate addict insists that sub treatment should only be used for three weeks max basically saying that staying on it any longer creates a much bigger problem than the original addiction.
    It's his opinion, but he claims there is scientific evidence that the Bup. creates so many new receptor sites and it is worse than any other opaite out there. He even states he'd rather have to treat a patient with a herion addiction than a patient that's been on suboxone for a long period of time.
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  9. #9
    rockermom51 is offline Junior Member
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    Default Sub

    I wanted to stay on sub forever, after a 7 year addiction to opiates, heavy opiate use. And major depression. My addictionologist put me on 16mgs subutex daily for 5 yrs. My mood was good, I felt normal, did not crave opiates or any other drug or alcohol. My life was "normal". Til my insurance ran out and I could not afford the hundreds of dollars per month to remain on it.

    The withdrawal was pure hell. I cant even describe it. I suddenly ran out because I didn't know my insurance was cancelled. I had to use hydrocodone for the weaning process, and lots of clonazepam. I still battle depression and addiction and if the opportunity arises, I will again start the sub. It was saving my life and my sanity.

    Thanks,
    Sheryl
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  10. #10
    rockermom51 is offline Junior Member
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    The ceiling effect is 32mgs. I was given an initial dosage of 4mgs, each dose increased every few hours up to 32mgs. This was done in a hospital that treats mental illness and drug addiction and my doctor is an addictionologist with extensive training and research on suboxone and subutex. After adjusting my effective dosage, we decided on 16mgs daily. And he also informed me, after speaking and attending several seminars on the subject that sub does indeed treat major depression in some people. Hell, before I found him, I had a family doctor treatingmy depression with 50mgs of hydrocodone a day. And my tolerance got too high. My tolerance never got too high with sub. It makes perfect sense to me to allow two little tablets to dissolve under my tongue each day than to eat 30 to 40 norcos a day, which is what I was doing. I was killing myself.

    There is much info out there on this medication. Like I said, if I ever get the chance to have that treatment again, I will. I'm tired of battling depression. Im suicidal and have been hospitalized several times. Sick of it. Doctors should give us what works!.

    Sheryl
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  11. #11
    sailnfl is offline New Member
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    Default agree with JunigMD

    I have heard of it being used for depression. In Fl, a psychiatrist can write it for depression without the 8hr course. They can also get it made at a few pharmacies that make it themselves. I had it at two different rehabs. It is much cheaper since they use the liquid bup and put it on a wax type substance so it is not expensive at all. I also know ppl that get it prescribed for pain and inject it in the muscle for pain.Not a good pain med at all.
    I was on it after detoxing off a 6-year methadone habit and thought it would be the answer. Big mistake for me. After a year or so, I went to a rehab and went down to 1/2mg. I stopped and after the fifth day, I was more depressed than any experience I have had, methadone included. When I got out I did not sleep for about 30 days and just could not take it. I fount some old sublingual .2mgs subs I ordered from England a few years ago. I could not believe how good I felt from that .2mg.I ended up back on pain management with a higher tolerance than ever. Now at 240 30mg oxy and 90 40mg of oxycontin a month from 1 doctor I am praying for help. My blue cross will pay for subs or oxies so that is not the problem. The dose I am on along with my age (60) I now have to use a catheter and eat like a baby because of constipation. I have sought help but with my medical problems, not many detox or rehabs want to deal with me. It is now a life threatning situation. I went to a hospital that promised the world but my insurance stopped paying after 3 days. I was given 30 mg of oxy every 6hours along with a valium. I was very sick on that dose so they made the decision to get rid of me.
    Once again I am thinking of bup because I think?? It might be better for my constipation and bladder. Before I got on the high dose of oxy (dose is out of control). I am taking about 500 30's a month and while my kidneys and liver are still OK this cannot go on.My bodily functions are not working.
    I do put allot of blame on the doctor that first sold me on subutex (2002) but MY addiction is the real culprit here. Just as the original poster needs sound advice for his bup ordeal, I also am seeking any help or suggestions that anyone can offer.
    Thanks
    Sailnfl
    Last edited by Anonymous; 05-20-2010 at 02:11 PM. Reason: spell

  12. #12
    newyorkgal is offline Advanced Member
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    To Encrypted - I just got back to this thread and read where you accused me of being judgmental. I promise you, that was not my intent whatsoever. I was just concerned that sub, which is super addictive, would be used as a first choice for depression and at such a high dose but surely, I am anything but judgmental. I've been on sub for a year and 1/2 now after a long, long time on a methadone program after a 10 year >>>>>> addiction so who would I be to judge anyone else? I also apologize for the wrong info regarding the ceiling effect. I read it and jumped to post it before further research.

    Sailn, I'm in a similar situation except that my methadone addiction was over 30 years. I switched to subs. I had no problems doing that but for some reason, I thought I'd be able to get off subs also. I got down to .25 and had the most wicked RLS and restless arm syndrome (a new symptom for me, even with my extensive history and many times kicking)... I am on .5 now and here I stay. I guess Rocker has a point in saying sub might be a long term treatment for some, just as methadone is. I had hoped it wouldn't be though but after a 44 year addiction to opiates, it ain't easy, let me tell you. In this country, insurance sucks in a major way. How they can get rid of a 60 year old with health issues AND addiction issues because insurance runs out beats me. It's a sin. Greed rules.
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  13. #13
    encrypteddreams2010 is offline New Member
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    Quote Originally Posted by newyorkgal View Post
    To Encrypted - I just got back to this thread and read where you accused me of being judgmental. I promise you, that was not my intent whatsoever. I was just concerned that sub, which is super addictive, would be used as a first choice for depression and at such a high dose but surely, I am anything but judgmental. I've been on sub for a year and 1/2 now after a long, long time on a methadone program after a 10 year >>>>>> addiction so who would I be to judge anyone else? I also apologize for the wrong info regarding the ceiling effect. I read it and jumped to post it before further research.

    Sailn, I'm in a similar situation except that my methadone addiction was over 30 years. I switched to subs. I had no problems doing that but for some reason, I thought I'd be able to get off subs also. I got down to .25 and had the most wicked RLS and restless arm syndrome (a new symptom for me, even with my extensive history and many times kicking)... I am on .5 now and here I stay. I guess Rocker has a point in saying sub might be a long term treatment for some, just as methadone is. I had hoped it wouldn't be though but after a 44 year addiction to opiates, it ain't easy, let me tell you. In this country, insurance sucks in a major way. How they can get rid of a 60 year old with health issues AND addiction issues because insurance runs out beats me. It's a sin. Greed rules.
    So let me raise this question, since everyone who knows what they are talking about seems to be on the same page...what exactly would be the problem with bupe being a long term medication? I mean does it have any negative side effects when used long term? I am 22 years old now, and if i stayed on suboxone for the rest of my life what would be the problem with that? I mean take into consideration that i can afford it like i can now, and i have a doctor that is willing to prescribe it...Really the only problem with doing any opiate is running out. if you could buy 80mg oxy at walmart just like acetaminophen what would be the problem with doing it??? I know this all might seem a little absurd but think about it.
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  14. #14
    newyorkgal is offline Advanced Member
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    I think it's an individual choice. There are alot of people who will say being on any mind altering substance is no good period. I think if it's what a person wants, being on sub is a better alternative than doing illegal drugs. I suppose the best choice is to be clean but for reasons known to each individual, sometimes it's not an option. Sub is also not really mind altering for most people. It just keeps you from being able to get high on other opiates.

  15. #15
    Dano1501 is offline New Member
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    Default Suboxone

    I totally agree with you. Don't let anyone tell you different. If it works for you and you are supervised by a doctor, it is the same as taking an antidepressant such as Zoloft or Paxil. I have recently tried small doses of Suboxone for my anxiety and depression and it works awesome and if I stop I dont have withdrawls of any kind, the anxiety and depression just eventually comes back. When you suffer with a condition that effects your enjoyment in life, you will do whatever it takes to pull you out. I have never been addicted to any opiates but started suffering from OCD, depression and anxiety and tried everything until a friend suggested Suboxone and I am a true believer. My doctor said I will probably be on medication for the rest of my life to keep things in check. Why not stay on WHAT WORKS ??? People who live in glass houses should not throw stones, but be understanding that there are numerous reasons behind other peoples chemical imbalances or addictions. Rock on and great to read your post !!!

    Dan
    Last edited by Anonymous; 08-31-2013 at 03:29 PM.
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  16. #16
    Anonymous Guest

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    well that post is over a year and a half old, and you are going to get addicted to suboxone, so get used to it...
    its not an anti depressant at all. its an opiate.

    good luck with still not being addicted months or years down the track....

  17. #17
    TabithaNY is offline New Member
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    Quote Originally Posted by cheekysod View Post
    well that post is over a year and a half old, and you are going to get addicted to suboxone, so get used to it...
    its not an anti depressant at all. its an opiate.

    good luck with still not being addicted months or years down the track....
    I would rather be addicted to one drug, rather then the 4 drugs I'm on now.
    (Paxil, Klonopin, Serzone, Abilify) I have never taken Sub, but if it helped my depression I would take it in a heartbeat.
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  18. #18
    rvnew is offline New Member
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    Lightbulb I agree with JunigMD

    Changing one addiction for a another addiction that is just as bad or worse is not the best way to recover from an addicion. Using suboxone just long enough to withdraw from an addiction should be the goal unless you chose a maintenance program because for whatever reason you cannot or will not quit using drugs. I'm sure those who profit from our addictions would love to see us continue to use drugs whether legal or illegal.

  19. #19
    rvnew is offline New Member
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    Default Mistake; I agree with cferd

    I just made a reply saying I agree with JunigMD when I really meant that I agree with cferd about a short term treatment of suboxone for drug withdrawals. There are other ways of staying clean rather than switching additions.

  20. #20
    androidfreak is offline New Member
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    Contrary to certain posts it is used for depression and bipolar. After trying every normal medicine there is my psychiatrist threw this out as an option.
    For the first time in my life I do not think about suicide daily and my mood swings are not as often.

    As someone who has done done things that I thought would kill me but didn't, this has been a lifesaver .
    My family has noticed a huge difference. My Dr. is one of the top in the state and has only had to use this on Very very few patients. The term he used is "Treatment resistant bipolar depression".
    So anyone who who is at the end of their rope as I was and nothing worked, this is an option.
    And yes, my insurance covered it.
    It has been a blessing after years of suffering with no hope in sight.
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  21. #21
    anniecakes is offline New Member
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    [deleted - swearing]
    Last edited by Anonymous; 04-26-2015 at 11:19 PM.

  22. #22
    anniecakes is offline New Member
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    Exactly. Psychotropic drugs are meant for long term use and they usually have bad side effects, yet everyone pushes them. So, why can't sub be used indefinitely? What's the problem if it helps?

  23. #23
    chrissy2015 is offline New Member
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    Quote Originally Posted by androidfreak View Post
    Contrary to certain posts it is used for depression and bipolar. After trying every normal medicine there is my psychiatrist threw this out as an option.
    For the first time in my life I do not think about suicide daily and my mood swings are not as often.

    As someone who has done done things that I thought would kill me but didn't, this has been a lifesaver .
    My family has noticed a huge difference. My Dr. is one of the top in the state and has only had to use this on Very very few patients. The term he used is "Treatment resistant bipolar depression".
    So anyone who who is at the end of their rope as I was and nothing worked, this is an option.
    And yes, my insurance covered it.
    It has been a blessing after years of suffering with no hope in sight.
    You are right, and those who talked about how this medication should "never" be used for depression are simply ignorant of current medical thinking. There are drug trials finishing in 2016 that will lead to buprenorphine being prescribed "on label" for depression and anxiety.

    Doubters might want to Google ALKS 5461 and read about it for themselves. Meanwhile, there are a very few savvy psychiatrists who have experience with it for depression as it stands. This is not to be undertaken lightly, however, and no one should ever self medicate. Unfortunately, because few doctors are actually trained in using the drug this way, most don't know how to do it. That will change in the future, at which time many people with treatment resistant depression will finally get the help they deserve.

    Treatment resistant depression leads to endless suffering, sometimes for many years, and sometimes dire consequences for those who choose to end their lives. So people, please do NOT keep your closed minds and even begin to think you know all there is to know about either buprenorphine or how it can be applied to anything other than addiction therapy.
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  24. #24
    PersephonedeHades is offline New Member
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    Default I realize this is a dead thread now, but....

    Quote Originally Posted by cferd View Post
    I don't think anyone can say what the right way to treat depression is for everybody. it's just too unique of a disease. if being on sub is preventing relapse/ a trip to the asylum then i agree, your better off taking a Dr prescibed med than he alternative.. The fact that eventually you will have to taper of suboxone is no different than if you were taking lexapro or an other SSRI, they too can give you wds and need to be tapered. Your Dr has is reasons for prescribing you sub, my only thoughts are on the size of the dose. Most people seem to be able to make large drops when on a higher dose. Then again, you are not most people, you are you, what works for "most people" may not for you. I agree with the suboxonetalkone having biased information, many sites due. You'll often find an individuals bad choices in life turned into a summariation of why sub is a horrible medication. There are some sites that are there to provide support solely for sub patients. The mods could probably provide my email if you want the info as I don't think I can post it here. I'm all for people using sub to break the chains of addiction, get on and get off is the ideal way. But I believe there are other cases where it can be used appropriately for longer. Hopefully your stress will lessen, you can find a way to manage it and won't need to stay on suboxone for the next twenty years.
    I realize this is a dead thread at this point, but it pleases me to see information from a legitimate medical professional amongst all the he-said she-said internet nonsense. Thank you for posting, doctor.
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  25. #25
    Lyssiex3 is offline New Member
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    Default Sheryl

    Quote Originally Posted by rockermom51 View Post
    The ceiling effect is 32mgs. I was given an initial dosage of 4mgs, each dose increased every few hours up to 32mgs. This was done in a hospital that treats mental illness and drug addiction and my doctor is an addictionologist with extensive training and research on suboxone and subutex. After adjusting my effective dosage, we decided on 16mgs daily. And he also informed me, after speaking and attending several seminars on the subject that sub does indeed treat major depression in some people. Hell, before I found him, I had a family doctor treatingmy depression with 50mgs of hydrocodone a day. And my tolerance got too high. My tolerance never got too high with sub. It makes perfect sense to me to allow two little tablets to dissolve under my tongue each day than to eat 30 to 40 norcos a day, which is what I was doing. I was killing myself.

    There is much info out there on this medication. Like I said, if I ever get the chance to have that treatment again, I will. I'm tired of battling depression. Im suicidal and have been hospitalized several times. Sick of it. Doctors should give us what works!.

    Sheryl
    Hi Sheryl, I am new to this site but I couldn't resist helping you because I was in the same boat, desperate for a way out. You can easily get suboxone if you simply apply for Medicaid. Once you're approved you will probably have to spend only $100-200 per month and the Medicaid covers the prescription so it's free for the suboxone. Compared to the price of street drugs this miracle med saves lives and lots of money! You can even find a free doctor for suboxone if you look hard enough.. Hopefully this was a little bit helpful I wasn't sure if you were informed of the most inexpensive way to get it, so I had to put my two cents in lol good luck with everything!!

  26. #26
    mrowen is offline New Member
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    Hi, I quit using Percocet 11 weeks ago. The Percocet cured my anxiety and depression now I'm worse than ever!!!! I'm thinking of going back on Percocet just to get on suboxone Can you please help???

  27. #27
    58andsucky is offline New Member
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    I am on bups subutex and have been for 4 years. I was on painpills and it was an expensive habit run out buy some! I went to a pain Dr, I also suffered from a clinical depression shortly after loosing my job my home my sanity! I have tried every antidepressant and they don't work! My depression has kept me from living! Today I finally figure it out bups 4 mgs makes me feel good it's like a burst of energy! So now today I am questioning why the subutex makes me feel so good!
    I have research and subutex is used for depression. It's highly addictive and I know someone who got off it it was hell!
    Has anybody here ever been so depressed that u felt paralyzed?! I went off Paxil in the yr 2000. It took six months going off that and it wasn't fun I wanted to die, but I didn't! I have always loved life but being depressed?! I want to live again so is I have to take more I will!! What's the difference?! They are both hard to get off almost impossible some say about bups! Any feed back please, and positive as u can be as it's been a living hell!!! I really feel that my addiction to pain pills Caused damage to my dopamine! Any feed back please!! Thank you

  28. #28
    58andsucky is offline New Member
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    Hi,

    This is a older forum have u gone down on the bups?! Just curious. I take 8 mgs a day and it helps w my addiction as well but it helps with my depression! It is used for depression as well! If u get my message it would be nice to hear from you!

  29. #29
    qragland1203 is offline New Member
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    Quote Originally Posted by rockermom51 View Post
    I wanted to stay on sub forever, after a 7 year addiction to opiates, heavy opiate use. And major depression. My addictionologist put me on 16mgs subutex daily for 5 yrs. My mood was good, I felt normal, did not crave opiates or any other drug or alcohol. My life was "normal". Til my insurance ran out and I could not afford the hundreds of dollars per month to remain on it.

    The withdrawal was pure hell. I cant even describe it. I suddenly ran out because I didn't know my insurance was cancelled. I had to use hydrocodone for the weaning process, and lots of clonazepam. I still battle depression and addiction and if the opportunity arises, I will again start the sub. It was saving my life and my sanity.

    Thanks,
    Sheryl
    Sheryl. I took Subutex for five months and it worked perfectly. Now it has stopped. I take Prozac as well. Do you think that is what caused the Subutex to quit working. Quin

  30. #30
    Badgee is offline New Member
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    Posts
    3

    Default

    I am exactly the same. I am a hardcore atheist,and NA is disgusting. I would have to remove the reasoning lobe of my brain in order to become deluded in such nonsense! I take my subs 16 mgs a day for 3 years. I've been absolutely clean otherwise. It's amazing! If I ever stop taking suboxone I am 100% sure I will relapse in short order and once again contract hep-c that I am currently I. Remission from. So..... why think about stopping, this is sustainable, my back pain is gone
    I'm a new person.

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