Is Suboxone A Good Thing for My Loved One?

mom101 is overwhelmed by all the conflicting information and stances on Suboxone. Her 40-year-old son has struggled for 15 years with opioids and other drugs, and his new treatment plan includes Suboxone. Is this a good thing?

“Hello friends, It’s been a while since I commented or posted. Life is definitely a roller coaster ride here. I am surrounded by addiction. I wondered if I could find out all there is to know about “suboxone”. My son recently detoxed at a center and decided to do IOP a few days a week as well as seeing a doctor who counsels and prescribes suboxone. I am a bit concerned because I am not sure how long he is supposed to do this and I can’t seem to get an idea of the plan from him. He is a 40 year old…………….. so I have absolutely no rights to information unless he wants to share.

He has been an addict off and on for at least 15 years. His drug of choice is opioids, fentanyl, oxy, benzos (?) don’t know what these are…. and lately a bit of alcohol…….. (to try to get thru the detox at home). That was AWFUL! He purchased suboxone from dealers and tried for months to self-detox on weekends using alcohol to numb the sick feelings. It never worked. To add to this, his wife is also having addiction issues. Hers seems to be more on the alcoholism but opioids also played a part. She also went into treatment and is going for inpatient a bit longer than he did.

I want to be supportive but I can’t do that without knowing more about suboxone. He thinks that he can stay on this long-term but I doubt that is what he is supposed to do. He is afraid of feeling sick and of not being able to sleep (which he is not doing much of anyway). He is a wonderful and caring son but he thinks that he can manage his care on his terms. I KNOW that I am not in control. I KNOW that I need to set limits. I also know that I love these two more than the world and I want to help. I want information regarding suboxone, but there is SO much on the internet and I have no idea what is valid and what is not.

Also I would like to do a family counseling type of meeting. Does anyone have information on how to find a good person?

And is there a “sober-retreat” in the Massachusetts area that might be a good ‘getaway’ for them as a couple.

I appreciate all of the info and comments that you can give. I got a book that I just began reading and I am finding it helpful, “It takes a family”. I’m hoping for insight and new methods for helping and supporting.

I am in a very sad and numb place and I can’t imagine feeling any other way until things get ‘healthier’. Thanks for listening. Mom101… 🙁

Hi Mom101,

Boy, oh boy! I can really relate to your comment. I also had concerns and questions when my son was exploring Suboxone as a part of his treatment plan, and my lack of information led to feelings of anxiety. When I look back now, I know I was also hearing a lot of myths and advice that were based on stigma and misinformation, and which contributed to my own apprehension towards Medically Assisted Recovery (MAR).

It’s always helpful to identify the positives in a seemingly hopeless situation

First, I want to point out some incredible positives in your situation that may help relieve a little of your distress and help you to realize there is a foundation to build on:

1.  Your son is being open and honest with you about his struggles with cravings and informing you that his treatment plan will include Suboxone;

2.  Your son (and his wife) are not in denial. It sounds as if he’s trying multiple methods to boost his recovery. He has attempted detox at home, then went into detox, attended an IOP and is seeing a Suboxone provider. I am not sure if you’re aware, but your son will also have to fulfill certain requirements in order to continue with his Suboxone prescription, like: testing negative for certain substances, attending monthly meetings, meeting with a counselor, etc.;

3.  Your son moved away from illicit use of Suboxone and is now in the care of a doctor or nurse practitioner.

Misinformation about Suboxone can present a real obstacle

When my Loved One (LO) first started on Suboxone, I, too, had fears and worries, mostly because of my lack of knowledge about MAR and some of the misinformation I had heard from others.

I, personally, find it comforting to become educated and learn all I can about a new situation/challenge. What I found out about Suboxone helped me feel more confident that MAR could be a major pillar in my LO’s recovery.

I decided to block out and stop listening to all the noise about MAR — people in support groups, information on social media, articles in the news (journalists who have no idea what they are talking about), even professionals in the field that give advice (without evidence) based on an anti-MAR stance.

For my job and volunteer work, I have access to Suboxone providers, researchers and nurse practitioners and have had one-on-one conversations, heard speakers on panels and read a lot of what they’ve written on the subject. Here are some of the professionals whose expertise I have read/listened to/leaned on:

• Dr. Josiah Rich (Dr. Rich also was very supportive of my son and helped in a difficult time with access to his meds) and Dr. Traci Green — both are epidemiologists and researchers who have done extensive work and research on prescription medicines involved with Substance Use Disorder (SUD) and among other amazing credentials, work at Brown University;

• Dr. James McDonald, Medical Director for the Rhode Island Department of Health — he has spoken on Suboxone and other meds used to treat SUD.

A treatment plan should be tailored to the individual’s needs

I learned through discussions, and hearing these professionals speak, that a treatment plan should be designed around the individual’s needs. Each person is different. Some don’t need meds, some are prescribed meds short-term, some are prescribed long-term and some people may need meds for their whole life.

Just like with other illnesses, medications and treatment plans should be driven by the patient’s needs and overseen by a doctor. It is important to note here that there may be adjustments needed, and that medicines work differently for each individual. For example, my son tried Vivitrol but could not tolerate it. Some people experience side effects with Suboxone that may be intolerable and make it impossible for them to continue. Each treatment plan should be individualized.

I, too, had doubts but vowed to support his use of Suboxone

When my LO first went on Suboxone, I decided I was going to support any decisions he made for himself, as long as he was moving towards recovery and an improved life. He had struggled for quite a while, chronically relapsing, and hadn’t ever been prescribed meds, outside of detox.

He was also telling me he didn’t think he’d be able to maintain non-use without a way to stop the craving, and I needed to listen to what he was telling me. It is his recovery after all, and he was learning through a long process of trial and error what would work for him (maybe this is what managing his own care on his terms looks like? Learning about himself and becoming empowered with what will help, and what won’t?). He already knew what wasn’t working.

I committed to support, rather than discourage, any and all of his attempts at recovery, regardless of my own uneasiness. I have to tell you: I’m really glad that I did!

Another influence in my own life, that helped me support my LO’s going on Suboxone, is I have a cousin that was going through a similar experience with her son only a year ahead of my family. Her LO had been prescribed Suboxone and we all saw the progress he was making in his life. It was the first time he had made any steady, positive improvement.

The atmosphere of Suboxone clinics can feel prohibitive

When my son first started Suboxone I gave him rides and waited in the waiting room during his appointments. I had often heard how horrible these clinics were: they were packed with people, everyone was very nervous and anxious, and people had visible symptoms of drug use. I can attest that this was indeed the case. It’s exactly what I saw and experienced, but I started to filter my thoughts and perceptions about my visits to the clinic through a new lens. Yes, the clinic was jam-packed, people looked visibly stressed and some were nodding off, but here they were! ASKING FOR HELP! A lot of them, anyway. Isn’t that a good thing? Something we must take care not to judge or shame, but which instead merits our support.

Over a two-and-a-half-year period of bringing my LO to the clinic, I saw some people come and go, but many more stayed steady with their appointments. I had the privilege to witness the transformation of so many. People went from anxiety-ridden to calm. In the waiting room I heard about new jobs, saw physical transformations (I don’t know about your LO but when my LO stops using he often put on weight and looked a lot healthier), and saw a group of people that were starting to live life. It was slow progress but it was progress and it was also happening with my son.

He progressed on Suboxone but it was up and down

It was not easy progress, as NOTHING with SUD is. It was very up and down, and in his early recovery (by early, I mean for the first 1.5 – 2 years), he was in a vulnerable place. There was not much support outside of his family and program. In fact, a lot of the stigmatizing and judgment he experienced came from within the recovery community. This just drove us to offer as much support as we could, so he could gain the confidence and strength he would need to keep working on his recovery.

It took months for his body to adjust to the Suboxone; he had side effects like fatigue. With support from the nurse practitioners, his family and the staff at his IOP, he just kept going. As we all know, recovery is not a straight-line process; there were plenty of times that he waivered, and even times where he lapsed.

But, with support, he got right back on track. I have heard it can take an average of 6 tries with meds to reach some stability, I believe that this number would be reduced if there was a lot less discouragement and as much support and encouragement for MAR as there is for other forms of recovery!  I was not giving up on him being prescribed Suboxone. He had been successful and I was witnessing improvement.

Looking back on our journey, Suboxone was gift. Through the years, he has been able to attend college and get his degree. He is now married and actually living in another country! He is no longer prescribed Suboxone (this is a whole other post: why he stopped being prescribed Suboxone, how I became very uneasy about him stopping … but I had to keep quiet as it is his recovery not mine), and how easy and smooth a transition it was, thanks to a new method of weaning off). He is living life!

Momma, as much as you can, block out all of the noise that is based on opinion. Stay focused on what the doctors and professionals who research and work with SUD medicines are saying. Their work is rigorously scrutinized, peer-reviewed and has improved the lives of many. We don’t hear enough from those who have benefitted from this treatment — they experience a lot of stigma in an already highly-stigmatized population.

Also, know that there’s always new research and information being released on the medicines used to treat SUD. Did you know that once a person is stable for a time on Suboxone, their dose can be reduced to a very small amount and the effect is the same? Did you know that Buprenorphine, the molecule in Suboxone that decreases craving, now comes in a 30-day shot called Sublocade? And that Sublocade is a tool that can significantly reduce withdrawal symptoms for those weaning off?

Regarding your questions about family therapy and recovery getaways

To address the other questions in your post:

1) I have found that going to a family counselor and looking together at my plan has been helpful. I let the counselor know that we were using CRAFT (I provide the Allies in Recovery website url if they’ve never heard of CRAFT) and let them know I do not believe in “tough love.” We let the therapist know that we were there to learn to communicate better with each other.

2) Some other books you might want to read are “Get Your Loved One Sober,” and “Beyond Addiction.”

3) There are many retreats that focus on recovery that involve meditation and yoga. What about asking them if they’d be interested in one and letting them choose? There is a lot of information on Boston Dharma Punx that offers a lot of options.

I hope this response is helpful and I wish for continued healing for you, your son and his wife. They really have a wonderful, strong, and loving support in their corners. Please keep us updated on your family’s journey. We are here for you.

Laurie MacDougall