Valeria’s recent post on dealing with triggers in recovery got me thinking about my own triggers, and the ways I’ve learned to diffuse them since I’ve been in Suboxone treatment.

One of my biggest triggers is pain. Pain is probably a major reason why a lot of us started taking opiates in the first place, and I know that pain is one of the biggest triggers of relapse. So what do you do when you’re in recovery but you still have pain?

First of all, I should probably point out that Suboxone is not approved for the treatment of pain and is not recommended for chronic-pain patients who need opiate medication to manage their pain. Readers of my blog probably know that I have fibromyalgia. I have chronic pain, but my doctors never agreed to treat my pain with opiod medication. They all said that the kind of pain I have doesn’t respond well to opioids.

Eventually I began using pain meds that I obtained illicitly in an attempt to self-medicate. This worked for a while, but as many of us know, treating chronic pain with opioids has a downside. My tolerance grew quickly, and it was difficult for me to obtain the drugs that I was now dependent on. Because the drugs masked my pain so well in the begining, I often pushed myself too hard and caused myself more pain, which required more drugs…a cycle that soon became incredibly difficult to break.

Suboxone helped me break this cycle, and it does help manage my pain. I’m fortunate in this, because Suboxone doesn’t work that way for everyone. But while it does help, it doesn’t take away my pain completely and I still have many days where my pain level is high enough to significantly affect my life. So what do I do now that I can’t (and don’t want to) turn to  pills?

My biggest coping mechanism is exercise (and I admit this grudgingly, as I am truly lazy). In my quest for greater physical and mental health, I’ve gone from being basically for sedentary to taking Tai Chi, Yoga, and Dance (Nia), plus swimming and walking. Some days require a monumental struggle with myself to get my butt to the gym, but it’s always worth it. I’m getting stronger and more flexible, and I feel better.

Exercise has another benefit, in that it increases the natural endorphins in our brains. Opiate addiction can cause our bodies to decrease or stop making endorphins, so anything that helps jump-start endorphin production seems like a good idea to me. I do believe it’s working too, because I feel so much happier when I’m exercising regularly.

Getting enough rest, eating right, spending time with friends and watching funny movies are other things that I can do for myself to help minimize my pain. I’m also learning to recognize my limits and how to ask for help when I need it. These habits keep me mentally strong and stable, so that I can deal with pain when it comes. I’m amazed at how much better I can deal with a flare-up when I’m well-rested and I’ve been enjoying life.

Examining my attitude towards my pain helped me a lot too. I realized that I could accept a certain amount of physical pain in my life and still be ok. I don’t have to be “comfortably numb” all the time any more. I also became more open to alternative ways of dealing with pain, instead of holding fast to my belief that only morphine would make me feel better. These days I use meditation, massage, ibuprofin, and cold or heat therapy to help me cope, and I’m looking into accupuncture.

Learning to deal with physical pain in my recovery hasn’t always been easy, and I’m certainly not perfect at it. During my active addiction, I got out of the habit of taking care of myself, and creating new habits takes time. Sometimes I do just wish I could take a pill and feel better, but that happens less and less the longer I’m in recovery. When it does happen, I’ve been able to use one of my new coping tools to get me through.

Of course, I have other triggers as well. I will write about how I cope with those in another post.

So lots of questions have popped up on this blog about different aspects of Suboxone and its effects that haven’t been touched upon in different posts. In an effort to answer those questions, I’ve compiled a list of frequently asked questions below.

Does Suboxone have side effects?

Yes. Just like other opiates, Subutex and Suboxone has side effects, not the least of which is withdrawal symptoms if taken too soon in an attempt to detox off of other opiate medications or heroin, especially for people who are addicted to a high dose of other opiates. Nausea and vomiting as well as constipation are most often reported to varying degrees. Withdrawal symptoms are like that associated with all opiates: muscle aches and cramps, sweating, runny nose, diarrhea and stomach cramps, low fever and chills, irritability and an inability to sleep or eat.

Can Suboxone be abused?

Yes, it sure can. Especially if you’re not addicted to opiates, you can get high by taking bupe. It doesn’t have the same euphoric effects that other opiates provide and there’s a ceiling to what little amount of a “high” it will provide, so it’s not a drug that is commonly abused but it certainly is possible. The naloxone in Suboxone prevents it from being abused by injection.

Is Suboxone a pain reliever?

No. It is only prescribed for opiate addiction treatment and not for pain. If you are addicted to pain pills and suffer from chronic pain then your pain will return if you detox off of your medication with Suboxone.

Is Suboxone better than methadone?

No. It’s different, and some people should not take buprenorphine for drug addiction treatment but should take methadone instead. For example, pregnant women and those who suffer from chronic pain should not take Suboxone or Subutex and will fare much better on methadone maintenance treatment. Suboxone works best for to help those who became addicted to prescription pain medication after a short-term bout with pain.

Why do I have to get sick before I can take Suboxone?

The best way to explain it is to show you, and the online buprenorphine training at buprenorphineCME.com explains very clearly how buprenorphine binds to receptors and why it can cause withdrawal. Plus, it has pictures!

Do you have any questions about Suboxone or how it works?

Well! It’s been a while since I’ve made a post here, and I have missed y’all something terrible, but I can’t think of a better reason to break my writer’s block than this:

This week marks the six-month anniversaryof me beginning Suboxone treatment! Woot!

I can hardly believe that a half of a year has already passed, and so it seems like a good time to take a moment to reflect on where I came from, and where I am now.

Six months ago I was a huge mess. I was in constant pain, physically and emotionally. I’d been using opiates nearly every day for the previous year, progressing from hydrocodone to morphine and dilaudid. My life slowly and steadily constricted around me as I let go of people and activities I cared about because all I had energy for was getting high.

I dropped out of school, telling myself I’d take the quarter off to rest and get my health back - but that quarter stretched to another and another. Work wasn’t going well. I was unmotivated, lethargic and frankly, my attitude was total crap. Home life wasn’t much better - even my beloved daughter was starting to feel more like a burden to me than a joy. The worst, though, was the way I felt about myself.

I knew I was out of control. I put off paying bills because I needed drugs to stave off the dopesickness that constantly threatened to take me down. My tolerance grew so much over the previous summer that I couldn’t even get pain relief any longer, and getting high was out of the question. Over and over I tried to quit and suffered through the pain of withdrawals for days, sometimes even a week or more, only to use again at the first chance I had. Still, some twisted sense of pride kept me from admitting that I was in over my head and I needed help.

During this low-point, I became aware of this new drug called Suboxone, and it’s great potential to help people like me - opiate addicts. Did I call for help the first time I heard about it? Oh, no way. I was scared, and embarassed. But I was also intrigued, so I sought out information online. And the more stories I read, the more I became convinced that this drug could help me too.

So I finally made the call, and got into a treatment program and started taking Subxone. That was six months ago, and while it hasn’t always been smooth sailing, I definitely stopped my ship from sinking and steered it to safer waters. (to torture a metaphor, sorry!)

What does my life look like, six months into treatment? Well, I’m glad you asked, because things are great!

Because I chose, based on my substance abuse history and other mental-health issues, to go with a longer-term replacement type treatment with Subxone, I still take Suboxone every day. I’ve decreased my dose quite a bit, with an eye toward tapering off completely in the next six to eight months. I also go to therapy once a week, and I have a “recovery plan” that keeps me involved in activities that are healthy and fun - like yoga, dance, swimming, writing, and blogging.

Family life is so much better. The best thing is that I can now handle the inevitable rough-patches without turning to drugs, and sometimes I even manage to hold on to my peace of mind during the hard times. I’ve navigated some serious health issues lately without completely losing my balance, and I’m quite proud of that. I’m doing better at work too, and have been given new responsibilites that have made my job fun again.

The thing I’m most proud of, though, is that I returned to school for the Spring quarter and if all goes well, I will finally complete my Associate of Arts degree after only 15 years!!! Well, not that I was in school for that whole time, LOL, but it did take me a while. The class I’m taking this quarter should complete my degree, and I can transfer to University next year. I can not tell you how incredibly good it feels to be getting on with my life.

And, more than just getting on with life, I have goals again. Addiction steals our goals, our hopes and dreams, sometimes to the point that the only thing we’re living for is the next opportunity to get high. That is such an incredibly painful way to live, so I’m beyond happy to have found that I don’t have to live that way anymore. Nobody has to live like that - there’s help for us all.

Suboxone didn’t do all the work for me, but I doubt I could have come this far this quickly without it. If you’ve been thinking about calling, wondering if this drug could help you too - all I can say is Make The Call. I sincerely believe you won’t regret it.