I was looking around the other day for information about what happens when you mess around with your Suboxone prescription or try and take it other than prescribed. We’ve talked a little bit about the effects of Suboxone and how the naloxone sends you into opiate withdrawal if you try to dissolve the tablet and inject it. But here’s a case of the same result—opiate withdrawal—when someone tried to skip a few days and stockpile their buprenorphine pills then take them all at once to get high. Here’s a quote from the discussion at the Medical Journal of Australia:

The Buprenorphine-Spawned Opiate Withdrawal Incident

By diverting his dispensed medication, our patient collected 11 buprenorphine tablets (8 mg each), which he took in one day. The result was not respiratory depression, but instead severe opiate withdrawal lasting four days — this scenario has not previously been reported. This case highlights features of the unique pharmacology of buprenorphine and some key issues for its use in the management of heroin dependence.

Yikes. No bueno. But I can understand his logic behind it. Usually backing off your drug of choice for a few days can help you feel it a little stronger when you take it again, right? Especially if you take it in such a large dose. But bupe ain’t your average opiate, apparently. I’m completely intrigued by what they call buprenorphine’s “unique pharmacology.”

The Burning Question of Buprenorphine-Caused Opiate Withdrawal

Now, I’m assuming that this person took Suboxone and not Subutex and that the naloxone must have kicked in for some reason. I’m also assuming that he took that as per usual, that is letting them dissolve under his tongue rather than injecting the drug. Because if he injected it, there is no mystery. Or if he took other opiates (heroin was his drug of choice and apparently there were some relapse incidents, though it doesn’t say how many days passed between relapse and restarting his buprenorphine regimen) and then took Suboxone without waiting for the detox to begin, that makes sense, too. But if they were Suboxone pills and he took them as prescribed or if they were Subutex pills and he took them in any form at any time after relapse, then I simply must know why this happened.

What Do You Think?

Anyone have any ideas? Theories? Perhaps experiences of your own that may illuminate this quandary?

Incidentally, the person in question was transferred to methadone treatment and his withdrawal subsided when buprenorphine wouldn’t ease his symptoms. Just goes to show that buprenorphine isn’t right for everyone and that methadone and other opiate detox methods are still viable and valuable.

For parents, there are few things worse than discovering that their child is addicted to opiates. But there’s one thing that few parents realize: there are few things worse for your child to discover about him or herself as well. As the anti-drug commercials put it, “No one ever said, ‘When I grow up, I want to be a junkie,’” and for your child, finding themselves in the tortuous position of physical addiction can be terrifying. As the parent, you may be the only person who can really help him or her to get through this experience and come out on the other side a happier, more well-adjusted person. Here are some 5 tips to help you along the way.

Stay Calm

Fear often manifests in the form of anger, but this is a case when screaming and yelling will only serve to worsen the situation and your child’s feelings about him or herself. If you suspect that your child is using, be prepared for a volatile reaction when he or she is confronted. Their fear of getting caught and concern for their own physical safety will likely turn emotional. It is your job to take a breath, pursue the conversation and help them defuse so that you two can have a conversation that is productive and goal (not blame) oriented.

Ask Questions

Are you using every day? How much are you using? How do you feel when you don’t use? If you find opiate painkillers, ask how they are taking them (no need to offer multiple choice answers, but crushing and shooting the drug is significantly more dangerous than swallowing the pill whole and knowing the answer to this question will help you find the right drug rehab facility for them, even if they give you a sarcastic answer).

It’s not immediately important who they are using with, where they are getting the drugs or if they were high at such-and-such event. Pointing out addictive behavior like lying and stealing won’t serve your first purpose: helping your child accept the fact that he or she is addicted to opiates and needs drug treatment.

Listen

It may seem intuitive, but after you ask your questions, wait and listen to the answers. Bombarding your child with questions won’t yield anything but frustration. If you don’t understand the answer or feel like he or she is being indirect, you can always ask more questions later, but give your child a chance to speak his or her mind.

Offer Solution Options

Berating your child or handing down punishments isn’t appropriate at this time. Certainly, you want the addictive behavior and using to stop, but the best way for this to happen is to give them solutions: inpatient treatment, medical detox, outpatient treatment. Talk to them about what is available, and let them know that you will stand by them through it all.

Let Them Know That You Love Them No Matter What

This is crucial. Even though you may be scared to death, angry and overwhelmingly disappointed and sad, you must communicate to your child that you will be right there as the two of you work through this together. Let your child know that you love him or her and that you will make sure to provide the necessary help to get them back on their feet so that both of you can move forward.

You’ve gotten through the roughest parts of opiate detox. You’re at home and you continue on your maintenance schedule according to the treatment plan that you’ve created with your doctor. You get up every morning and take your medication, be it Suboxone or methadone. If you have a job, then you head there and if you have small children, then you spend time with them. If not, maybe a meeting, out for coffee, take care of the house…. What are you supposed to do all day?

One of the problems with opiate detox is that it’s boring. I’ve heard so many people say that they ended up relapsing because they didn’t have anything to do. TV got old and they just weren’t getting any ideas about how to spend their time. The opportunity arose to get loaded, and so they did. This is where chaos comes in.

Chaos and Opiate Detox

It may seem counterintuitive, but just like you have to ingest some fats while you’re trying to lose weight, you also need a certain amount of chaos in your life in order to successfully navigate an opiate detox. Yes, you need to stay away from the negative elements and stressors that put you in a position to use in the first place, but you can’t bury yourself at home and hide for the rest of your life, either. Humans crave contact and contact breeds chaos. And a little chaos can help you fight off the boredom that may drive you to relapse.

Where to Find Chaos

Maybe a friend of yours is having issues with her boyfriend or husband and needs someone to listen. Maybe you have a niece or nephew who could use a little “auntie” time. You can always find someone who needs something at meetings, whether it’s advice, companionship or a ride somewhere. The point? Controlled chaos can help you take your mind off yourself, get you out of the house, appreciate your situation and your newfound sobriety.

How do you create balance in your life during opiate detox?