Addiction Recovery :: Day One - Suboxone

So I made the big plunge yesterday and went through with something I'd been tossing around in my head the last couple months. I went to a clinic and got a prescription for Suboxone.

Since I'm a school teacher, one of my biggest worries was actually walking into a Suboxone clinic and someone recognizing me. It would come as quite a shock to some (in my mind) to see Mr. B____, the local English teacher, lined up to get a prescription for his opiate addiction. Just goes to show that addiction doesn't pick and choose whom it affects. But I overcame my ridiculous fears and went on in today.

There are actually two clinics in the small city where I live (at least nearby). One clinic as open on Saturday, looked to be a nicer looking facility, but they don't take insurance. It would have cost $500 for the first visit, without even considering the cost of the drug itself. So I went with other clinic that did take my insurance, and I was only out 35 dollars (My prescription copay was to be $40 for the name brand strips, but the clinic gave me a discount card that took care of my copay, which was a pleasant surprise...this wasn't a one time deal...it will cover my copay each time I get the med). Being a teacher with a wife and three kids...every dollar helps for me. For those interested, the card will help those who are either pay in cash or use have insurance other than Medicare. The card pays up to $50.

The clinic is only open two hours (two days a week), so I was a little curious how they handled so many patients in so little time. The answer came to me as I was shuffled through the clinic cattle at a sale barn. Though there was a thick stack of papers to sign, some of which asked detailed questions about my addiction and health history, I got the feeling I was getting a product wrapped up and sold for the masses, not for me as an individual. It is sad for me to think of those who don't have the ability to educate themselves on what it is they are taking. Even I, after months of research on the internet, am still confused on quite a few contradictory opinions and ideals regarding Suboxone.

The clinic is located in a less than desirable part of town, and the waiting room did not exactly make one feel comfortable. It was hot, and everyone in there looked pretty miserable. I was comforted, though, by the fact that there were no familiar faces. It also gave me comfort knowing that we were all there for the same reason, and none of us had anything to hide. I could go into more detail about this experience, but I have jabbered too much already.

Long story short, I peed in a cup, the results of which I was not told. I knew coming into the clinic that there was no dispensing medication at the clinic, so there was no worry for me to stay clean for 24-48 hours. I took 40mg of hydrocodone at 7:00 the night before, so I wasn't completely miserable at the time of the appointment.

Strangely, my vitals or any other normal "clinic" methods were practiced. I went straight from peeing in a cup to talking to the doctor who was sitting behind this big beaten up wooden desk in a stale smelling office. The doctor thumbed through my file and asked basic questions about how much I was using and where I was getting it. I was in and out of his office in less than 5 minutes.

I didn't lie about my drug use, and I was prepared to share much more. I pretty much told him that I got hooked on opiate painkillers after multiple operations that required them. Also, I have had two DVT blood clots that required me to be on blood thinners, and thus not able to take most standard OTC painkillers such as naproxen or ibuprofen. I had been fed hydrocodone for years with few questions asked. My problem is that I like the way they make me feel and have spent the past ten years trying to get my hands on enough to manage my pain and feed my addiction.

I believe it us by the grace of God that I have not found myself in a worse predicament than I currently find myself. I have never injected anything, but I suppose that would have been the next stop for me. I had been doctor and pharmacy shopping for years and I knew how to work the system pretty well. Even in my heyday though I wasn't able to get my hands on quite enough. I was always counting pills and worrying about when I would run out. I soon found myself "borrowing" from my mother and other friends. I found myself doing things I never imagined I'd be doing. Shameful things to feed my habit. My wife discovered my problem years ago as and threatened to leave me more than once. To lose her and my children would have devastated me. One would think that I would turn my back on the pills considering all I had to lose. But that was not enough to stop me. I guess if my wife didn't love me (a lot) she would have left me tears ago.

I was fine while on my hydros,though, but when I ran out and became sick from withdrawals, I was miserable. I felt miserable , and I was miserable to be around. I made and broke more promises than I can count to my wife, mother, and father, friends, and family.

I have had many of those moments of enlightenment where it became clear that I could no longer go on with this. There have been months at a time where I was able to stay clean. But some kind of life event always drove me back to the pills. I would have a surgery or other physical problem, or life would become so stressful that I would choose to hit the exit door and insulate myself from the world around me by delving into the world of pills.

There is another component yo my story that is important to share. In 1995 I had a bad auto accident that broke several of my bones and kept me in the hospital about a week. Worse than the physical wounds, however, I found myself battling emotional wounds. By the time I turned 22 I found myself battling terrible panic attacks that marked the beginning of my struggle with chronic depression that has lasted until now (I'm now 41). I have tried. nearly every antidepressant known to man. In the end I settled good old Prozac and Klonopin. Neither of which has done a great deal to relieve my depressive symptoms. I currently take 40 mg of Prozac and 2 mg of Klonopin in the morning and 2 mg at night. No, I have never abused Klonopin in the way I have hydrocodone. I don't feel blissful on either medication. I only notice them in their absence. I have tried to quit both and have experienced hellish withdrawals with each. My sub doctor indicated that he would like to see me come off of both quickly. I understand that taking benzos with Suboxone is a dangerous combination, but quitting cold turkey, especially with the Klonopin can be equally dangerous. He said he would like to see me off of both within six months. I don't see this happening but maybe Suboxone will allow it?

Getting to my main point. I have not been drawn to opiates because of recreational use. They were, as I've written, prescribed for physical pain. But the best aspect about opiates to me was their positive effect on the symptoms of my depression. Nothing I've taken comes close to making me feel "normal" as do opiates.

Hydrocodone, oxycodone etc... do make me feel "not depressed" but they are a kind of fools gold. My body and mind quickly build up a tolerance for them, and I find myself taking more and more to feel "not depressed". So when I started reading more and more about Suboxone, I became very interested. The medicine might be able to help me break the cycle of pill addiction, and help me as a type of antidepressant.

There seem to be two opposing camps on this issue. Some believe it is ridiculous to even consider Suboxone as a long term treatment for depression. Some might say I'm making the same mistake as I did with hydrocodone...expecting a band aid to heal a much deeper disease. There others who see Suboxone as a type of synergistic agent that might be legitimate weapon to combat depression. I can understand the viewpoints from both sides, but as for me, I'm willing to at the very least give Suboxone a few days to see how it makes me feel. I can tell you this, that I can already feel the positive effects of the Suboxone on my depression. There was an initial semi state of euphoria a couple of hours after I took my first strip, but I don't exactly feel " high". I feel rather normal capable of doing things that I would ordinarily struggle with (like typing this ridiculously long post that most people won't have the patience to read!)

I'm not sure how things will go from here. I'm not sure how I will sleep tomorrow or how I will feel with my next dose. But I will say that it feels good to have some hope. I have been worrying all summer how I would be able to gut out another year in the classroom with my raging depression and addiction cycles. I don't know how it will end, but at the end of the day it is nice to be able to look back and say that I did the right thing, that I tried to make the right choice.