Some kid complained about the length of this so here's your warning, it's what children might call "long".
As quickly as I can sum up my own life to give you all an idea of where I'm coming from I was given opiates by my doctor at age 11. That progressed to stronger ones like Oxycontin, and by age 12 another doctor added Adderall & Xanax to the concoction. I turned age 13 and began dating an 18 year old. I'm female by the way, so that makes it ew I know. Anyways everything changed when my doctors took me off of all those pills I began a horrible withdrawal.
I got onto AIM (AOL's version of FB messenger back in the day) asking people of they knew where to get any opiates. This 30 something year old friend of my adult bf, replied saying he could get heroin and began telling me how it's basically the same thing. I didn't even care I just knew if I got more I could stop feeling like that. Tom, the adult bf, and I used for 5 years we broke up I moved on once I was 18.

So began an almost sixteen year long hell in which I went through several boyfriend's each one I dated for a few years and each one was a drug relationship. In the one relationship my bf would run around scrapping for metal to support HIS habit I was often left without anything and always sick. He was a jerk. Anyways one day at the apartment we were being evicted from the landlord and sheriff showed up and I left. Bf wasn't coming to get his stuff. And somehow they thought a vibrator John made for me out of an MnM mini's tube was a pipe bomb so they had to detonate it. I also had misdemeanor warrants out for getting caught stealing something for like a dollar at a major retail store. I of course had already worn my welcome out at my parents with stealing their stuff and doing typical drug addict stuff. They had moved to Arizona while I was still in PA. I ended up lasting maybe a month more after that apartment and then was just sick of the life I was living. I found this girl that was good at stealing stuff, or just stupid enough to do it.

She took me to some literal dark places man. I'd have to take her to this black guys house who only had his body from his belly button up, and he'd do some awful sexual shit to her. Like some stuff you'd see out of a gore movie. So I said screw that, begged my parents to let me come straighten my life out (for the fifth time) and my mother finally caved and sent me the $ to drive out there.
I really thought things were going to be different I had every intention of doing well I was practically detoxed. Since that prostitute lady did mostly crack and only some heroin I was often dope sick. But it did help me get thru the worst of it. So with 1 Suboxone I drove through four days there and was doing great. Until I met Glen.
So stupid! Dumb! Argh! Can't believe I got into a relationship immediately. We were attached at the hip and infatuated with each other, one of the first things we did was get a bunch of cocaine. Eventually that lead to heroin. And so began the craziest time in my life so far...
For some stupid reason Glen & I were trying to have a baby the first week into knowing each other. We were doing meth and heroin daily, and sometimes cocaine on occasion. Things got worse than they ever had with my parents, I was returning their stuff to Walmart for cash, pawning my dad's tools, my mom's jewelry. Selling the catalytic converters off all our vehicles for $. As Glen and I got worse he began taking bolder moves. Breaking into houses, cars, stealing cars, taking from stores, it was insanity. He actually became addicted to the stealing. For almost a year we stayed out of legal trouble for the most part, but I became pregnant and he just kept on stealing.
Of course he was caught several times, I remember he had just made a rather impressive score of 3 flat screens, lots of gold jewelry, rare coins, computers, laptops, a credit card, and some high end cell phones and shoes. He ended up leaving that night to look for more and he finally got arrested trying to steal gold jewelry out of a case in JC Penny and then they found that stolen credit card. Once all of the items he stole from that one score were sold, every last dime went to bailing him out twice in a row. The second time, he was so dope sick and impatient even though I was headed toward him and was 60 miles away he decided to walk across the parking lot from the jail he was released at and he broke the wiper off of a Jeep and tried using it as a slim Jim. He was spotted doing that and immediately re-arrested less than an hour after being released. Once he went back I got him out on bond one last time...
I was trying so hard to get him to just spend time with me & not go steal. What do you think happened? Wrong! He actually didn't get caught stealing again, but got so twacked out on meth and was up for almost a week and we were on our way to his court hearing & he started messing with the car. He was on "tweaker time" &hadn't real conception of time so he missed it. He was eventually caught by the bondsman and spent the next 4 years in prison and I had to give birth to my child alone.
I was still using the entire time I was pregnant, I hadn't even been to the doctor to confirm the pregnancy. The only time time I had gone to the doctor at all during the pregnancy is when I was 15 minutes from delivering my miracle child..
My son had not much wrong with him considering the ordeal he had been through in the womb of an addict. He had a small tear in his lung, and when he was on his way out defecated inside me and breathed it in causing a minor infection they took care of. They also had to ween him off the opiates with baby morphine. He was premature by a month and was 5lbs 5oz. Beautiful baby boy, Connor. I lost custody of him, and unfortunately the paternal grandmother has him.
I say unfortunately because she's an awful person, after all my boyfriend Glen was an awful human being. She raised him. The way he spoke to people and has robbed people of at least a quarter million dollars in his criminal history even prior to meeting me. She also has some sort of delusion where she doesn't see behavior with her soon seems more on the lines of a partner, not a motheson relationship so I fear for my son.
Glen, the bf at that time has basically been in & out of prison since my son was born and he currently is in there. Now the grandma doesn't let me speak to him, nor does she say anything about my family to him. And I hate it! I don't even get to see pictures of him from recent or even talk to him. I do miss him, but I was thinking ready at that time to be a parent I still had to get sober.
After I had Connor, Glen was still in prison not getting out for years, my parents moved back to PA, and I was just so alone. I began to steal, I got down to 94lbs & would only eat once a week. My teeth began to rot, I just didn't care about my life anymore.
Then I was finally arrested on a warrant, I was sent to the infamous tent city jail in Phoenix. They didn't give me any medications for the withdrawal, and it took two long hellishly long months and I had no strength.
Once you are sentenced in a county jail, you're either going to prison or doing your time at the jail if it's under one year, but if you stay in the jail you are given a job. At first I worked in the kitchen on an assembly line putting together the breakfast sacks all of the inmates ate. I was too weak to even stand for a few hours! It was embarrassing, but with each job there was a perk for each job. For kitchen workers, we had an inmate cook that was allowed to cook us things while we worked. We ate amazing. Cooked polish sausage, delicious sides like baked potato, ice cream, and soda!
My time in tent City of course seemed to take forever, at this time I actually became pretty well acquainted with Jodi Arias, a murder who killed her ex bf in Mesa, AZ and overkill is an understatement. Watching her whole story go on was distracting for a bit. I switched jobs from kitchen to an intake trustee do that's how I became acquainted with her. I was able to roam freely in the inside part of the jail (tent city was just outside the jail) without handcuffs or escort, my job was to bring each jail tower whatever they needed for the inmates and there were other various odds and ends I had to do, but mainly I was working in the intake room, I'd always see the inmates that were coming or going, she had to go to court like everyday for years. Anyways after that 3 months in jail I was released.
I was so stupid, I immediately went back to using The good news is I stopped after 2 weeks after having to live in the homeless shelter. It was like 120°F outside and they kicked us out from 6am-4pm so I'd often be batteling heatstroke. I decided it was time to go to detox and a halfway house.
It was a boot camp style halfway house for all girls, that worked for like 4 months then I left & relapsed. My boss constantly glorified him getting high off heroin, so I ended up moving in with him and his GF then got back into heroin again real bad. After 6 months and being kicked out of where I was staying, I immediately went to that halfway house again. I had to go to detox though, for four days so I left.
I went through a week long medical detox, then was set up with a Suboxone taper, and was being set up with a coed halfway house. My house managers were a couple, and I got along amazingly with the guy Isaac. I spent the next 10 weeks tapering off Suboxone and hanging out with Isaac all the time, then I was moved to a higher level house, and the owner was such a dick to me I ended up leaving after 7 months.
I stupidly left with another guy, not Isaac, his name is Ben. He was an alcoholic and claimed to have a year clean, he relapsed the first day in our apartment. I relapsed shortly after and tried doing the Suboxone taper again, ended up relapsing again.
After a couple months living there we broke up, and our landlord relapsed and disappeared. He disappeared for 2.5 years. And during that time it was hell for me Ben kept stealing my stuff & harassing me. I called the police almost every day, he'd get so drunk then get violent. One of the times I had to call the police I watched his dumb drunk self make a move on an officer, so they beat the crap out of him and took him to jail. Unfortunately the assault on a police officer charge didn't stick, they poked his chest & they had their body cameras on so they decided not to even bother charging him with it.
That continued for a few years, then I moved out and got an apartment. I had to get a restraining order on Ben, I was single again but was loving it. There was really only one person I'd go back to at this point, and it's because it was my baby daddy and he and his mother had him. So if I could be with Glen, I could be with my son Connor.
Then Glen got out of prison and claimed he needed a place to sober up, he was even saying he wanted to bring my son to live there too I was like absolutely! He ended up coming out and he was very far from his side of town, and we didn't have any cars. I got him set up with transportation to his Methadone clinic. Yes this fiend was worried about getting dope sick yet he had methadone and medical marijuana at his disposal. He ended up not bringing my son out, at all. Glen went back for a weekend to be with Connor then just disappeared, I searched and found out he was in jail with a 2nd degree burglary which means with a weapon. Well he just ended up back in prison not even 30 days after talking to me again, so stupid of me. He was shooting up drugs in my bathroom, I felt like my safe space was violated. And Glen's institutionalized, and with his record it's nearly impossible to find a job or an apartment so he just continues robbing people.
Then after awhile in AZ I decided to move back in with my parents which meant I had to get my license reinstated. I also needed a car, my parents were amazing enough to ship on of theirs to me. I stupidly started talking to Isaac again, I even stopped to see him on my drive home from AZ to PA. We got along amazingly for those 48 hours. After 3 months of a long distance relationship,he quit his job with the post office and with his truck that was falling apart he moved out here. Into my parents home.
Now it's just like every relationship I've had before I feel so stuck. Him and I are always fighting it stresses my parents out, they're old. He also knows how desperately I want him to leave them alone, and my parents are lonely they'll talk and offer help to anyone.
I just wish and hope Isaac moves out soon, so I can continue with my life and doing things that make me happy. I also hope I've learned my lesson to stop going after the same type of guy, and make sure you're friends for awhile first.
So in the recent months I learned I'm addicted to being in a relationship, on top of the heroin addiction I went through.
Now things are slowly getting better, just celebrated 4 years relapse free back in October.
Now throughout the relationship with Ben my health started getting bad, quick. No doubt from all of the stress, I had an aneurysm in 2016. I also was Hepatitis C positive which wasn't a huge shocker, but my liver is already damaged from all of the chemicals I put in it. I ended up turning to medical marijuana.
Medical marijuana has easily saved my life, I even used it to help me get off the opiates. Cannabis has so many amazing uses.
Due to my criminal record, my health, and other circumstances I'm not able to work a normal job. So how does one become a productive member of society when they can't work? I began just being a cannabis activist and it feels like I'm right where I'm supposed to be.
I help the cannabis community by educating patients about all kinds of cannabis there is and the different products, I go to all of the meetings about cannabis law. Most recently a bill called HB50 that would allow for recreational cannabis. PA residents would be able to have six plants, three being in vegetative.
I'm also involved with a class action lawsuit for the opiate ordeal, against the pharmaceutical companies. So if anyone who had a legitimate prescription for any of the pain killers in the United States then became addicted afterwards with no signs of addiction prior to the prescription feel free to DM me and I'll help you.
Just remember, a very small percentage of heroin addicts recover. Something like 2%, but it is possible to quit! Especially with medication assisted treatment like Suboxone, Methadone, cannabis, halfway houses, and treatment centers.

Suboxone, All The Details You Need To Know.

Why is there no official medical protocol to detox addicts off of Suboxone? The Fix goes to the pharmaceutical companies for answers. trappedsub.jpg Shutterstock Maybe the headline in the press release for Bunavail says it all: First and Only FDA-Approved (Buccal Formulation) of Buprenorphine and Naloxone to compete in the $1.7 Billion and Growing U.S. Opioid Dependence Market.
$1.7 billion and growing, they got that part right. Heroin and prescription opiate addiction are massive, under treated and under reported conditions in the U.S. By 2013 estimates there are over 669,000 opiate addicts in the United States. It's jarring to see a press release referring to opiate addiction as a high competition market for pharmaceutical companies. That, however, is the case, and the heart of the issue when it comes to understanding why Big Pharma enthusiastically went after the market in 2002. That's when the first buprenorphine/naloxone combination (Suboxone, from Reckitt-Benckiser Pharmaceuticals) received FDA approval.
During the time before Reckitt-Benckiser Pharmaceuticals received the green light to bring Suboxone to market, the company was one busy bee. They lobbied congress to create the Drug Addiction Treatment Act of 2002 (DATA) and worked with the National Institute on Drug Abuse (NIDA) and FDA to lay the groundwork for the successful introduction of their product into a needy marketplace. DATA's passing created a waiver for physicians with specific certification to provide schedule III, IV or V narcotics for detox and ongoing treatment. Buprenorphine (the powerhouse ingredient in Suboxone) was developed back in 1969 by Reckitt & Coleman (now known as RBP). They were attempting to develop an opiate derivative, harnessing pain-killing properties and sidestepping its potential for addiction. This required ten years and millions of dollars to cultivate the formula and an additional 13 years to bring Suboxone to market.
The emergence of the most recent opiate derivative can be framed in a historic context. Since the synthesis of opium in 3400 BC, mankind has danced with the devil, attempting to utilize the drug's benefits and avoid getting burned. Morphine was created in 1817, codeine in 1832, and in 1874, heroin. For a time each of these compounds was thought to be a less addicting substance. By 1914 heroin became available only by prescription, and in 1924 was classified as an illegal narcotic. The narrative of today's heroin addict moved in tandem with the activities of pharmaceutical companies. Oxycontin came to the US in 1996 and was aggressively marketed as (guess what) a less habituating alternative to morphine. By 2001 it was number one with a bullet, the highest selling narcotic pain reliever. In 2010 the formula was altered making it more difficult to crush, snort or inject. The combination of high street prices for Oxycontin and the lower cost of heroin moved some prescription drug abusers to jump the fence.
Vermont Pulls the Covers on Heroin Addiction
The Governor of Vermont dedicated his entire 2014 State of the State speech to heroin addiction. The syndrome has a chokehold on his state. In the bucolic home of Ben and Jerry's ice cream, maple syrup and same sex marriage, the Governor’s entire narrative goes to opiate dependence? You can be sure the problem has gone mainstream. Heroin addiction has swung from being an inner city to a suburban and rural crisis. The demographic shift from young, poor and brown-skinned to post-collegiate suburban and white continues to shock the media.
Globally there are an estimated 9.2 million heroin users. According to the World Health Organization this is triple the figures from 1985. One of the difficulties in quantifying the scope of opiate addiction is that reporting tends to come from treatment centers and other institutions.
In the United States accurate data is also hard to come by. WHO estimates the number of opiate addicts (including heroin) to be two million. Figures from The National Alliance of Advocates for Buprenorphine Treatment (NAABT) puts that figure at 5.5 million. We don't need charts, graphs and annual reports to tell us that opiate addiction is a disaster. Communities around the country once naive to the consequences of active addiction have been thrust into the squall. The Center For Disease Control (CDC) reports opioid analgesic consumption increased 300% between 1999 and 2010, and death rates for poisoning involving opioid analgesics more than tripled between 2000 and 2010. In 2014 the skyrocketing number of 911 calls and overdoses related to heroin and prescription drugs are traumatizing communities they never touched before, and the problem is not going away.
The Scope of the Buprenorphine Market
According to RBP's 2013 annual report, Suboxone had sales of $1.2 billion. It is ranked at #39 of the top 100 drugs prescribed in the U.S., placing it above Viagra, Adderall and (generic) hydrocodone. To give this sum context, Suboxone revenue is three times that of Super Bowl advertiseprovocateur Go Daddy, and dwarfs brands including Urban Outfitters and Ameritrade. In the U.S. more revenue was generated by Suboxone sales than the entire digital music download business. Other companies have arrived or plan to enter the market including Orexo (Zubsolv) and BioDelivery Sciences (Bunavail).
Getting Off Suboxone
RBP created and dominates the buprenorphine/naloxone market. Some patients who have been prescribed the drug decide they want to discontinue it. The reasons vary, ranging from financial pressures arising out of the cost of doctor visits and medication to side effects, potential future side effects and finally, the patient who wants to be 100% drug free.
Regardless of the reason one has for ending replacement therapy, making the choice presents a whole new set of challenges. Suboxone is a hard drug to kick. The medication's long half-life combined with its tight adhesion to opiate receptors makes tapering particularly difficult. From anecdotal reports, the least disruptive way to achieve a Suboxone-free life is to cut down the amount used very slowly week by week until titration is complete.
This scenario is complicated by two facts:
The lowest strength Suboxone comes in is 2 mg. (”Jumping” from a 2 mg dose can be a drawn out and debilitating process that takes months to recover from); RBP warns against cutting Suboxone strips into smaller amounts, and maintains that the medication is not equally distributed in the preparation. If you ask the doctor who has been prescribing you the drug for months or years, you may find him/her woefully lacking in experience or a plan for tapering. Some physicians continue to murmur the mantra of RBP, that a majority (95%) of patients who go off the remedy will return to active addiction. The overall statistics on recovery from addiction reflect this same figure. The fact is that a high percentage of people who try to get clean fail. Some fail many times before achieving freedom, and some die. Confusing the rhetoric of a pharmaceutical company with studies on the outcome of addiction treatment is a mistake.
This perception is changing. Four doctors I spoke to while researching this article told me they have successfully tapered patients formerly on replacement therapy. A successful taper requires adopting a combination of daily cardio exercise and mindful nutrition to repair and rebuild body and brain. For some a spiritual program is central.
While there are lower strength formulations of buprenorphine on the market (that would make tapering a more simple and accurate process) they are created for pain management and are illegal to prescribe to recovering addicts. Physicians routinely prescribe medications for "off label" use, but there are many laws directed towards prescribers of buprenorphine and they have serious repercussions. A doctor could lose his/her license for prescribing a Butrans patch to help taper a patient off of Suboxone.
Getting certified to prescribe buprenorphine is remarkably easy. It requires completion of one eight hour online course. The amount of time in the course agenda dedicated to taking patients off off the drug is nil. No doctor I spoke with recalled the topic of withdrawal from Suboxone being mentioned during the certification process.
Many doctors have found that prescribing Suboxone is akin to installing an ATM in their waiting rooms. It’s the perfect storm. Patients are desperate when they come in, willing to pay significant sums of cash for services, and rarely shop around for the perfect fit between patient and practitioner. In many cities there is a waiting list to get in to see a doctor able to prescribe. No background in addiction medicine is required to take the course. This creates a wide berth for physicians who may be opportunists to cash in on the vast and growing population of opiate addicts frantic for a solution.
Wrestling with Big Pharma
The difficulty of compelling a pharmaceutical company to take suggestions from the public is directly related to the power Big Pharma wields in the United States. Pharmaceutical companies spent almost three billion dollars lobbying the U.S. Government in the last five years. Pharma is the largest of all 121 lobbying entities and donated over $90 million dollars to federal candidates and political parties.
Advocates for an exit strategy from Suboxone have the weight and effect of a single fly in the chardonnay of Big Pharma. There are some lobbying groups working on issues of addiction treatment, and the numbers of these groups are growing. New York, Florida and Pennsylvania have advocacy groups, but their efforts tend to be focused on broader stroke issues. With an entire health care system in transition, obtaining any treatment for addicts is the fight these groups are concentrated on.
Big Pharma's Inconvenient Truth
Pharmaceutical companies gross massive annual earnings; a whopping $950 billion dollars globally. It is an industry of Goliath momentum and political reach. Relying upon recipients of lobbying influence to look their gift horse in the mouth? In the battle of ethics and commerce, conscience rarely rears its inconvenient head. Like Jesse from Breaking Bad, we might ask “What about science, bitches"? Where are the impartial and sovereign scientists? The reality of scientific investigation means taking marching orders from drug companies. For more on this topic read Jacky Law’s examination in her book, Big Pharma - Exposing The Global Healthcare Agenda.
Knee Deep in the Muck
With these facts in mind, I reached out to RBP, Orexo, and BioScience Delivery International. My outreach to RBP is particularly pertinent, since they are both the creator of Suboxone and the market leader. It’s key to understand that the first company to bring a pharmaceutical product to market jumps through extra hoops in order to obtain first entrant advantage. The company had to work closely with the FDA and NIH to first prove that there was a need for the drug. They also worked together to establish dosage protocol, and in the case of Suboxone, on establishment of a certification program so that physicians could legally prescribe the drug (using a narcotic to treat narcotic addicts was against the law until DATA was created in 2002). The intimate relationship between RBP, the NIH, NIDA and the FDA raised a red flag in my mind.
The initial safety and dosage protocol studies created to bring Suboxone to market have not been revisited since 2002. Since the drug has been in the market for 12 years, it seems prudent to have a look at how people on long-term maintenance are faring.
There are no FDA regulations requiring re-evaluation of a drug and its side effects over time. In the past new studies were prompted by negative outcomes not identified during clinical trials. Post-marketing investigation uses a number of methods to check on the safety of drugs: reporting databases, prescription monitoring, electronic health records, patient registries, and linking records between databases. In the U.S. post-marketing surveillance is overseen by the FDA through MedWatch where doctors or the public can report adverse reactions to drugs.
You Can Check Out Anytime You Like But You Can Never Ever Leave
People who have taken Suboxone over time have begun asking questions that Big Pharma finds troubling. Incidences of adrenal imbalances, hair and tooth loss as well as a myriad of psychological issues ranging from dissociative disorders to anxiety have long been denied by the manufacturers of buprenorphine/naloxone medications.
Interestingly, the NAABT (National Alliance of Advocates for Buprenorphine Treatementt) has quietly begun posting questionnaires on their website forums about exactly these maladies. The relationship between NAABT and RBP goes back to well, the introduction of the drug onto the market by RBP. The website was launched with generous and anonymous donations some of which certainly came from RBP’s coffers. While the organization now counts Orexo and BioDelivery Sciences as partners in their mission, for many years it was only RBP.
In 2014 both physicians and patients find themselves in a bureaucratic catch-22 with Suboxone. Some recovering addicts are desperate to get off the medication, and sorely in need of assistance. To get a sense of the scope of the problem type the words “get off Suboxone” into search engines, and you’ll find over 900,000 results.
RBP has gone on since 2002 and obtained FDA approval for two higher strength dosages for the drug. Some patients are pleading for lower strengths to help them titrate off the medication, and this is something no one wants to deal with or talk about.
If you have any doubt about the power and reach of Big Pharma when it comes to Suboxone, you might be interested in the tale of Dr. Steven Scanlan. A Florida addiction specialist who runs the Palm Beach Outpatient Detox, Scanlan was asked to write his opinion on Suboxone maintenance in a 2010 article for a professional journal. It was described to him as a debate, where he took the “con” side. At that time he felt that maintenance on Suboxone was not a good idea, period. The response to this one article was staggering. He received over 2,000 vitriolic e-mails after his personal address was mistakenly (?) printed with the article. The other doctor (who was pro-maintenance) did not have his personal information revealed. Dr. Scanlan told me that in addition to receiving numerous death threats, he was falsely accused of nefarious actions, from violence towards his wife to abusing a young male patient in his care. He was tormented in hundreds of posts on websites and forums. The fallout from the position he took was so overwhelming that he prefers to keep a low profile these days. Scanlan does take on patients who want to get off Suboxone. He takes a maximum of five at any one time, and places strict conditions and terms around being a patient in the program. He has written an article detailing the experiences he has had with patients whom he has tapered off the drug. Before dedicating part of his practice to helping patients get off Suboxone he found that the lengthy withdrawal process associated with it led many patients to give up trying. He is working to change that.
I am not a conspiracy theorist by nature. I find obsessing on the infinite layers of potential actions and counter actions of institutions, governments and countries to be contrary to my mental health. In the case of Suboxone however, I have a lot of questions.
In particular, I want to know about RBP’s incestuous relationship with the NAABT, the development of FDA/NIDA guidelines, and the lack of any studies undertaken by RBP since the drug was approved in 2002. It’s a cozy and profitable world that’s been created, and rocking the boat is not on anyone’s agenda.
With these thoughts in mind I made inquiries with RBP, Orexo and BioDelivery Sciences International. My queries were as follows:
1) Is any company studying the long-term effects of Suboxone use?
2) Will any company debut lower dosages of buprenorphine/naloxone to help patients with the taper process?
3) Do pharmaceutical companies have an agenda to keep patients on buprenorphine/naloxone indefinitely?
Responses from Pharmaceutical Companies
As far as answers went, some common themes emerged from BSDI and Orexo:
Studies of Long Term Treatment with buprenorphine/naloxone:
RBP chose not to answer this question, which I can only presume means they are not studying long term use, or do not intend to reveal any perspective on the topic. To be fair, Orexo and BioSciences Delivery International have been in the market for under one year and do not have any data on their own products to study.
Regarding lower strength dosages of buprenophine/naloxone:
BDSI
“Formula strengths (of buprenorphine/naloxone combinations) are based on FDA, NIDA and NIH guidelines (established with help from RBP ) They are bound by the doses studied and approved by FDA. Creation of product lower than 1.4 or 2 mg have to be supported by clinical studies and a subsequent regulatory filing. BDSI (BioDelivery Science Industries) is studying buprenorphine at lower doses now for the treatment of chronic pain, where we believe there is also a very high unmet need. Many patients with dependence also suffer from chronic pain. Often, it’s the reason for their dependence.”
Orexo
“We recognize that there is little medical data for patients trying to discontinue buprenorphine therapy. We have recently launched a buprenorphine product approved for the same use (addiction), but we are a relatively new company and our product has only been available for about 10 months."
"We agree with your assessment on the lack of data, lower strength products, and investment in additional clinical studies by the manufacturers who have had a product approved for some time".
"We are currently evaluating the development of lower dose of our product to submit for FDA approval, but, at this time, we do not have a timetable for additional strengths of our product."
How do you frame theories that pharmaceutical companies have a vested interest in keeping patients on buprenorphine treatment indefinitely?
BDSI
“Our interest is solely in what’s in the best interest of the patient and what is demonstrated in the medical literature. The length of treatment is an individual decision between the physician and patient. Opioid dependence is a chronic medical condition. Like many chronic conditions, there isn’t a lot of evidence to support the most appropriate length of treatment, and often it is individualized to the patient. In the case of opioid dependence, I’m not certain there is fixed treatment duration suitable for all.”
Orexo
“We appreciate hearing the perspective of patients who are actually dealing with these issues and your (questions) match what we’ve heard from both patients and physicians. Orexo is a young company and, when we started, we were taken aback by the lack of investment in clinical studies to assist patients in recovery by the companies who have had a buprenorphine product on the market for a number of years".
"We do recognize this as an issue and are looking at both additional strengths of our product and clinical studies that could provide a roadmap for tapering off of the medication."
"Please be assured that your voice was heard and shared with the leadership, including the President, of Orexo. We are actively trying to develop a lower strength and are in discussions with the FDA on how best to do that."
And now for the voice of experience, market savvy and $1.3 billion dollars in the bank, Reckitt Benckiser speaks:
Has RBP written a protocol for titration off of the medication SUBOXONE® Film or SUBUTEX® (buprenorphine HCl) Sublingual Tablet? If not, why?
"No. Reckitt Benckiser Pharmaceuticals Inc. believes there is no “one-size-fits-all” approach to opioid dependence treatment, and the company is not aware of an established guideline or protocol for titration. The decision to discontinue therapy with SUBOXONE® Film after a period of maintenance should be made as part of a comprehensive treatment plan. Patients seeking to discontinue treatment for opioid dependence should be advised to work closely with their healthcare provider on a tapering schedule and should be apprised of the potential to relapse to illicit drug use associated with discontinuation of opioid agonist/partial agonist medication-assisted treatment."
Does RBP have the ability to request changes in the protocol around use of the drug e.g., adding an enhanced segment on tapering to the curriculum physicians have to complete to be able to prescribe the medication?
"The Substance Abuse and Mental Health Services Administration oversees the curriculum healthcare professionals must complete in order to prescribe the medication. In order to be certified under DATA 2000, prescription use of SUBOXONE® Film in the treatment of opioid dependence is limited to healthcare providers who meet certain qualifying requirements, and who have notified the Secretary of Health and Human Services of their intent to prescribe this product for the treatment of opioid dependence and have been assigned a unique identification number that must be included on every prescription."
"Reckitt Benckiser Pharmaceuticals Inc. also has proactive and open communication with DATA-waived healthcare professionals to educate them about SUBOXONE® Film as well as their role in minimizing potential abuse, misuse and diversion."
What would it take to influence your firm to bring a lower strength buprenorphine product (for treatment of opiate addiction) to the US market?
This is the topic RBP is not interested in. I did get off the record comments from a different company saying that they were not aware of data or studies that could support a lower dose. I was told that lower dosage protocols would require studies and an FDA filing/review. This will take a number of years.
One company representative (not RBP) told me that they are investing in a lower dose program for the treatment of chronic pain, and that their desire is to bring to market a product with a lower propensity for abuse and addiction.
Final Thoughts
The information gathered was helpful in understanding the power of RBP, who I began to refer to as "The Kaiser" to remember the correct pronunciation of the company name. The tag sure has a ring to it.
When you research Big Pharma you come away with one principal insight. Innovation is driven by competitive advantage, being the first provider in a new market. Once the initial patent on a drug expires and generics fill the channel, new formulations need to be developed in order to hit revenue goals. In the case of Suboxone those formulas all point one way, towards more potent and easier to absorb preparations.
The criticism is not of basic economic market theory. It speaks to the fact that time and again pharmaceutical companies have been slow to respond to anecdotal reports from patients of complications from a drug. From Thalidomide to Vioxx there are hundreds of examples of drugs that were aggressively marketed and touted as safe that ended up being banned. Unfortunately this occurs only after dire consequences and perhaps more pointedly, expensive litigation.
The following is clear to me:
RBP refuses to study the long term effects of buprenorphine maintenance; The company reflects an intolerance for the faction of buprenorphine patients who decide they want to discontinue replacement therapy; There is a dearth of information about Suboxone titration from Suboxone doctors making significant profit prescribing it; The lack of medical studies/recommendations on tapering has created Internet "experts" and websites posting unreliable information. The surge of heroin and prescription opiate addiction ensures that the companies who manufacture and distribute buprenorphine based products will have a burgeoning market of patients to buy their products for many years to come.
If you, or someone you know is on a program of buprenorphine/naloxone maintenance and wants to discontinue, it can be done. We are not victims. On some level we have volunteered for this. We have to advocate for ourselves. As addicts we are extraordinarily crafty and resourceful in getting what we want. If we want to be free of Suboxone we can do it. Unfortunately, for the most part we will be going it alone.
Resources/Links for Information on Tapering off Buprenorphine

Haven’t slept in months

Survey Results and Weekly Community Thread Voting!!

Thank you to everyone who completed our survey! For the full results, follow this link.

Here's our TLDR; of our comments and responses:

Please report rude, harassing, or unconstructive comments. All reports are reviewed by a human member of our mod team.
Steroid accusations are against the rules, and will be removed. Repeated offenders will be banned.
Digging through users post histories to attack them in progresspics is not acceptable.
Harassing users who post in support subreddits for eating disorders is also not allowed.
Linking to a GoneWild subreddit or suggesting that someone post in a GoneWild subreddit is also an example of being a pervert. Users who do this will be banned from progresspics, even if an individual posts NSFW progress pics. No exceptions. This includes suggesting that users post to nakedprogress or suggesting that a poster who follows a keto diet post to ketogonewild.
/progresspics is for users of any shape, size, race, ethnicity, and gender to display their progress. Progress comes in many forms, and as long as people follow our posting guidelines by including a visual before and after photo, they're welcome to post here. That can display weight loss, weight gain, or essentially any type of body transformation. Some less common transformations include gender reassignment, as well as recovery from drug or alcohol addiction. We want to make it amply clear that we welcome all of these posts on this subreddit.
Animal progress pictures remain against the rules for stand alone posts, BUT we plan to add a weekly themed thread where these pictures are welcome.

About Weekly Community Threads:

We have decided that we would like to move forward with weekly community threads featuring progress pics that meet particular themes. While we understand the requests for discussion of methods or community Q&As, these posts are more appropriate for LoseIt and many of these ideas already exist in the form of Wecipe Wednesday, Motivation Monday, the Daily Q&A and more.

Ideas for Weekly Community Threads:

Meal Share Monday (Pictures of meals and recipes.)
Training Tuesday (Before and after pictures specifically showing training/fitness advancements, for example, gym selfies, flexibility progress, weight lifting progress, muscle gains, end of race pictures, etc.)
Wardrobe Wednesday (Before and after pictures in the same clothes, showing how much you have shrank since your largest size)
On Track Thursdays (Space for individuals who wish to share weekly progress pictures for accountability)
Furball Friday (Animal progress pictures)
Seniors Saturday (A space for the elders of progresspics to celebrate their improvements!)
Selfies Saturday (Selfies and face focused progress pictures.)
Support and Sobriety Sunday (Progress pictures or discussion of mental health, addiction issues, and other general struggles.)
In the comments below, we will post these ideas as top level comments. Please upvote the thread ideas that you would be interested in seeing/participating in. If you have further suggestions, please post them here as well!

Without further ado, here’s a few comments/issues raised in the survey that we thought merited further discussion or response:

I would like to see you require or at least strongly suggest that people include the "how" along with their pics and stats. It blows my mind that people don't just provide that information because someone asks in every single post!

This was referenced by a couple of different people, but I’m also going to focus on something interesting about the survey.
80.3% of the respondents cited that they were actively working on weight loss, yet only 58.7% of the respondents participate in LoseIt.
ProgressPics is a photo based format and we don’t require pictures to have long explanations. In LoseIt (our sister subreddit which is moderated by the same team), we remove progress posts that do not have a full explanation generating discussion.
If you would like to see more text based posts about weight loss (techniques, Q&As, food suggestions, finding accountability buddies, team based challenges, etc.) LoseIt is the appropriate place to go.
If you’re new to LoseIt, we’d suggest checking out the rules, posting guidelines, and Quick Start Guide for important information.
We don’t plan to change the rules to require long explanations for how posters changed anytime soon.

Be more supportive of those with EDs. I’ve seen some people with ED post their photos and get absolutely destroyed in the comments. While I don’t think we should promote eating disorders, I think we could moderate those threads better to be more supportive. As someone with an ED myself, I’ve been very hesitant to post my own progress even though I’m proud of it.

Thank you for this feedback. Harassment is never acceptable in progresspics, regardless of what a poster may have said first. For people who may be concerned about pictures appearing to look unhealthy, the appropriate action is to report the post to our mod team so that we can manually review it and decide what, if any, action should be taken.
We absolutely do not want individuals with eating disorders to feel like they are not welcome to post in progresspics. We realize that individuals can be diagnosed with serious eating disorders and still need to lose weight, or learn how to eat in a healthy, sustainable manner. While we reserve the right to remove comments that provide dangerous advice (for example, encouraging an underage redditor to water fast for extended periods of time), we will also remove rude and/or harassing comments posted on progress pics.
That said, there is also a difference between someone who is recovering from a painful disorder working to improve their condition (while at a weight that they know is not healthy) and someone who is still in the grips of their eating disorder, at an unhealthy weight, and attempting to further lose weight. As moderators, we may remove posts if we decide that a post raises red flags about an unhealthy mindset and we have strong concerns about their health. In these situations, we will always explain our reasoning and suggest ways to get treatment in a tactful manner - we would love if posts that fall under this category were reported to our team.
This subreddit is a place for healthy, sustainable progress above all else. This does not mean that every post needs to be by someone who is as healthy as can be. We just want to be sure that this subreddit is inspiring individuals to continue making healthy progress, rather than feedback here leading to relapse or additional unhealthy restriction.
Please know that it is impossible to read every single post and comment as a moderator. If you see a comment that is rude, harassing, sexual, or otherwise breaks our rules, please report these comments.
Reports are anonymous, and every single report is reviewed by a living human who decides what action to take, if any. Thanks to our new moderators, our queue of reported comments and posts for progresspics and loseit is almost always at zero. There is almost always at least one moderator online and watching the queue.

More strictly police low BMI harassment. A poster gets within 1pt of underweight BMI, & it's a free license for people to go at it with posters and harass them about their goals. BMI is a population tool that was never meant to be used on an individual basis. Some people are outliers with small frames & can be perfectly healthy at low weight. Some definitely have issues, but the tack these crusaders take is anything but positive and supportive

As above, please report rude and harassing comments, and we will remove them, and ban the offenders if necessary. It is acceptable for users to express concern politely, but when users are not constructive nor supportive, that is against everything we stand for.
While BMI can be an imperfect tool, I do feel confident saying that if someone’s final goal is outside a healthy BMI, it’s worth having a conversation with a medical professional about their goals and their methods just to check in. However, there are a plethora of reasons a person with a non-normal BMI can still be in peak condition - bodybuilders, very short individuals, some ethnic groups, etc. The best advice we can give anyone who is concerned that someone is pursuing an unhealthy goal is to encourage them to speak to a doctor.
In order for us to more strictly police any threads, please report the offending comments. We frequently share posts in our moderator chat that we want the rest of the team to “keep an eye on.” You can also shoot us a modmail if you would like to provide additional detail about why you find a post or particular comments concerning.

I’ve noticed that for muscle gain progress pics there can sometimes be quite a few very negative comments about steroids. This could be moderated a bit better

Our moderation team is in firm agreement that we are not going to police whether someone uses steroids, and we’re certainly not going to allow users to harass people who they think took steroids. While overall, we’d prefer a policy of honesty regarding such matters, we understand why this is such a controversial subject.
Witch hunts of any sort are against the rules, and we do not take kindly to digging through users’ post histories in order to insult them. Please report these rude, harassing comments so that we can remove them and ban repeat offenders.

I think so many of the transgender participants are pretty amazing in the way that they’ve reshaped their bodies. However, it’s getting to be like mua. 🙄 imo there’s a chuck of the transgender posts that aren’t really weight loss/fitness transformations, just gender transformations.

As we have said several times now, progresspics are for ALL types of progress. Members of this community (transgender or otherwise) are not required to have weight loss or fitness transformations to post.

Fewer opinions on women’s bodies by male commenters would make this subreddit a more supportive place.

We try to remove those comments that we see. Please report those that we have not yet seen so that we can remove them and ban repeat offenders.
In case that’s not clear enough, comments about “real women have curves” and “I liked you better with the booty” are not appropriate. We almost always have a stickied post reminding users not to be perverts, such as this one. There’s a reminder on the text box before you post or comment saying “Be good to one another. Don’t be a pervert.” in red. We’ve tweaked filters to try to proactively prevent sexual/harassing comments.
We’re trying really dang hard to be proactive, and our new team members are really doing an amazing job ensuring that the mod queue is cleared at all times. When we added more moderators we specifically sought out mods who were available/living in different time zones from the rest of the team.
That said, we realize that it’s still a problem and we are doing all that we can to prevent and limit these creeps.

I once posted a progress photo and got a lot of flirtatious private messages that made me feel uncomfortable. Is there any way to prevent this?

Unfortunately, in a lot of ways this is out of our control. The type of messages they send violate reddit's TOS, but the situation needs to be escalated to a Reddit admin. We can't terminate another users accounts. We accept screenshots as evidence in /progresspics modmail so that we can ban these users from the subreddit.
If you receive perverted or harassing messages:

Report these messages to the admins!
Take screenshots and send the messages to modmail!
Block these users - DO NOT INTERACT WITH THEM AT ALL!

We will happily ban these users from /progresspics, but this won't prevent them from contacting other users.
This will simply prevent them from interacting on posts, such as commenting. It won't stop them from retrieving a user's information, or pictures. Your reports to the Reddit admin team are the only way these creeps will get their accounts banned.

Re:nsfw it's not really that it's too much or too little but the standards seem to be inconsistent. Sometimes bra/panties is labeled nsfw and sometimes not

The nature of a subreddit for body pics is that it is going to generate pictures of all states of undress. That said, the way that Reddit functions is that people who subscribe to progresspics and scroll through their homepage will have images pop up while scrolling on their phones on the subway or on their monitors at work, or in public places like the library - unless they are flaired NSFW.
The general rule that we use is whether or not a boss or HR director would have an issue with an image popping up on someone’s screen or phone. A NSFW flair really only means that a post won’t immediately reveal and requires you to click to the post to see the pictures. Generally, underwear pictures should be flagged NSFW.
Context can matter. Action shots of someone playing volleyball or posed at the beach may be less likely to receive a NSFW tag than traditional mirror shots, depending on what the picture looks like. Tightness can be a factor - a huge percentage of men basically post in the same shape of shorts, but there is a huge difference between a guy in basketball shorts lifting weights at the gym and a picture where you could trace the shape of someone’s genitals.
It’s always going to be subjective. I know that some users take it personally, but if we’re uncertain and a post gets reported, we are more likely to flair it than not. We don’t go out looking to flag pictures as NSFW and rely largely on the community to flair their pictures appropriately and report those that may be problematic. We don’t want anyone to get in trouble for looking at “inappropriate pictures” on a school library computer or at work. I think a lot of people have come to consider NSFW as meaning “porn” or “nudity” but the literal meaning of “not safe for work” goes beyond the question of “is this person naked?”
If your post gets flaired NSFW and you see other posts that should be flaired NSFW, please report those posts. It’s most likely that your post was reported, and a moderator manually decided it was worth flairing after viewing it in the modqueue.
We really, really don’t want to have to move to a system where posts have to be individually approved prior to being posted. Based on the polling, it seems like most people are generally satisfied. When you see posts that should be flaired NSFW, please report them.

Enforce proper sequence of pics - before on left, after on right.

Sorry, but no. We’re really not interested in policing this, and quite honestly it’s not usually that hard to tell the difference.

If someone loses like 10 lbs and we can't even notice it in the pictures, the moderators should delete the post. I hate when the first comment is like "which one is the aftebefore pic"?. That means we can't see any progress.

We’re not really a fan of policing users’ pictures and telling them “Sorry, you didn’t progress enough.” Everyone on the mod team has had their own moments of “the scale says that I’ve lost x pounds and I can’t tell at all.” We’re not going to put users down who are genuinely trying to share their journeys.

Limit individual pic submits to 1 per month max. Weekly updates really don't show anything and clog the feed.

We’ve discussed this, and presently do not plan to change the rules to limit the frequency that individuals are allowed to share. It would be a lot of work to police this and quite frankly our presence sense is that the community is divided between people who only want new content and people who want to provide support. As this is a support subreddit, we’re currently erring on the side of maintaining the current status quo.
If you dislike individuals posting too frequently, the up and down votes are powerful tools in curating what posts should be pushed to the top. We are also leaning towards one of the new weekly community threads being a thread where individuals can post weekly. We are hoping that this space would generate a better sense of support/community for those who do want to post regularly.

Flair search is still dreadful. For example, searching for the 4"11 (incl 150cm) flair will bring up anytime with "150lbs" because it has 150 as a title keyword. Very annoying when searching by height

Yeah, sorry about that. We will eventually be completely redoing the flair search, but as the redesign is still being completed, every time u/ClaytonRayG fixes the flair search an update occurs that breaks it again. There isn’t an easy fix, and the redesign has monumentally changed the ability to search flairs. We do not want to lose the flair search ability altogether, but we cannot guarantee that flair search will work properly anytime soon.

No animal pics ever please. There's plenty of other appropriate subs for that.
While I support adding an animal thread, I would prefer to see animal weight loss constantly allowed in this sub. It's nice to see animals getting healthy and losing weight just as much as it is to see humans!

Based on the replies, it appears that the community is rather split regarding animal progress pics. We will definitely be adding animal progress pics as a weekly thread, but other than that we will continue to enforce the rules: all standalone posts must feature before and after pictures of a human.

For the few individuals who read this far, thank you for your continued participation. You are what makes this community great. If you have additional thoughts or comments, please post them below or reach out through modmail.

My Nofap journey of the past two years.

Appeal for donations for Mattapan drug rehab program!

Telling peers, friends and family about nofapping or not

Started not fapping about two weeks ago. I don't count exact days, because I feel it's pointless to count "beans", when it's really just a decision about who you want to be.
For me, I'm 28 and I suspected that my addiction to porn and fapping wasn't healthy for many years. I came to this realization maybe at 17/18, when I already had fapped intensely for quite a few years, simply because my dick started to take damage.
The worst about it is, that this damage only got worse over the years and I never experienced any recovery, I even had some short streaks of not fapping of about a month a couple of times, and it did never lead to my penis getting back its natural awesomeness, it just kept being a beaten down loser no matter what, similar to myself in a way.
Basically after so many years of no sensitivity I've been at a point of giving up on sex completely for years now, it doesn't make any sense to me to go out and hook up with people or to seek a relationship, when I know I'm not going to please anyone sexually. Worse than not being able to please others is knowing that it will throw me down emotionally even more when another embarrassing event takes place in my life, so I'm avoiding situations that I don't think I can or want to take on.
My only hope sexually would be that sensitivity as I knew it from back in the days of puberty returns after a really long streak of leaving alone my junk without edging. Actually I'm not placing a lot of hope and expectations on that happening, because that would lead to even more depression when it eventually fails, and I'm currently betting that my dick is just a broken body part and my best chance for sexual normalcy is probably a future where dick replacement surgery will be possible.
Bottom line, I'm counting myself out of the sexual game entirely. Even when I'm constantly fapping, I'm only doing it for the O, because the O releases the Dopamine and gives me a slight and short relieve from constant pressure in life. You all know what I mean, there's constant relentless pressure on most people to make something out of their life, to deal with problems, to fit in, to have a partner, it's a different mix of problems and pressures for everybody, but we're all in this global competition with each other, like it or not. Wanking off lets me for a short while forget, similar to how some drugs do, this negative environment in which I live. It freed me for a just a few minutes each day from trying to be this correct being that is trying to cope with pressures and to be a respectable good human in every way possible.
If you want to stop fapping for real, you need to be really honest about what fapping is. I see a lot of talk on here about buzzwords like addiction and to be fair most of it is based in reality, of course it's an addiction.
But why is fapping so addictive, what is it in the process of fantasizing and simulating sexual intercourse with another person, while there's no other person there in actuality, that makes you horny, that makes you feel guilty pleasure, that makes you secretly like it even when your dick is already so desensitized like mine, that you barely feel anything until the very final stage where you will ejaculate in some sad way.
We all know this exactly of course, that's why we're addicts, but I want to recount those things to you anyhow. We like that we can imagine ourselves having sex with people that have no clue that we're in this moment having these nasty thoughts and we like to pretend that this isn't just imagination, no we believe for a couple of minutes that there is a real chance of all of this happening, if only we could be this man of our fantasy. We want to be this fantasy superhero porno superstar. We want to have sex with people we remember from a long time ago, who we adored, but couldn't tell them. We fantasize about sexual acts like group sex, which we're very unlikely to engage in in real life, and we're even very unlikely to even openly talk about the fantasy, although there's nothing wrong with such a fantasy. Society even in the west is still repressed in 2015, not everybody is, there are some exceptions, but I can tell you that I was feeling extremely repressed in my puberty, which started this whole fapping to the extreme thing in the first place. I'm pretty sure 99,49% of us aren't fapping to the image of a future bride in a white wedding dress, no we're constantly imagining new scenarios and bringing to life a sexual superhero in the same way fiction writers bring alive starship captains and trolls hiding under bridges.
There's a false belief that manifests in the beginning of the addiction, that one day you'll transform this sexual energy into real life, and that one day you'll be the alpha male that you always hoped you'd be. Of course you could also fantasize about being humiliated by a dominatrix, but even there applies the same rule, that while fapping nothing is off limits, unlike in real life.
Think about that, in real life most things that are desirable to a man or woman are pretty much off limit. You walk down a street and see your dreamcar, and in your dream you of course drive that car and not only that car, no in your dream you own a whole island and have a private race course on it, you're a billionaire who hasn't decided yet if he wants to run for president or not. That's not really my fantasy, I just made that up, in the same way all fantasies are made up.
When this world beats you down, when everything is looking dark and you're asking yourself why you're even there, isn't a little dream, a little fantasy, no matter how ridiculous, isn't that the last refuge a simple man or woman has.
Why are so many teenage girls dreaming about and adoring Justin Bieber? Because in their reality they already are his girlfriend, or at least his romance, in their wished upon reality he is singing about them and they're not merely fans, they're the princesses.
Humans are far from rational beings, which in many ways is a good thing, I'm very far from being rational myself, and I enjoy reading silly books and watching shows such as Game of Thrones is the greatest enjoyment to me. Humans consider Shakespeare, Goethe, Tolkien to be among the greatest examples of their species of all time. Someone using just a pen being able to create a whole fake reality is a strength in the eye of humanity, it's something to strive for not something to be ashamed of.
So why would sexual fantasy that will never come true in all likelihood, and emulating that fantasy through motions you perform on your own body parts be viewed in a negative way by society and why would that be something that's affecting your psychology negatively.
I don't think fapping is a problem and a bad addiction for all people, I just know that it destroyed my dick and my sexuality, I can't extrapolate to the whole world, I think it's wrong to categorically call masturbation bad. Just like categorically saying that drinking alcohol or enjoying some weed is bad, or eating junk food, or what not. As with everything, it's different for everybody. When you wank off you increase the likelihood of destroying the dick by a huge percentage, yet it doesn't happen to all people, and many still have a great sex life inspite of being addicted to porn. Just like when you smoke cigarettes it doesn't mean you'll get lung cancer after 30 years, but you've a 50% percent chance of dying of your addiction eventually, but it doesn't have to happen.
For this reason I don't feel comfortable to evangelize about not fapping, unless someone was to tell me about serious sexual problems and especially a loss of sensitivity or a loss of control over the compulsive drive to masturbate to porn.
I can assume that everyone reading this on the NoFap subreddit is here because in the process of being a porn and masturbation junkie a few things went wrong. If you're in this category, we're in the same category. For us this fapping story, is equivalent to the drinking story of an alcoholic, and to the smoking story of someone who just got diagnosed with cancer. Others can ignore the NoFap movement and what it has to say, only we already find ourselves in the middle of self-destruction and can't ignore.
By the time I was 18 like many people on here, I had already seen so many pictures of sexual intercourse on countless of web galleries and so many videos of banging and sucking and whatnot, that it started to get really hard to look forward to the next sensation.
Throw yourselves back at the beginning of what puberty was like. Didn't you get an erection of monumental proportions just by the slightest thoughts of sexual approaches. Didn't seeing even just the contours of girl's boobs or asses give you more pleasure than you could've expected just a couple of years before puberty hit. Suddenly without forewarning you had a rockhard rod in your pants and you feared someone might see it when you were walking. It happened to me countless times that I didn't dare to get up from a chair in school and first had to wait until the erection had cooled down. It's not even like we had the greatest looking girls of all time in my school, it's just that for whatever reason being horny in the extreme is a deeply inbuilt feature of the vast majority of humans going through puberty.
In a way I'm even glad now that I don't get aroused anymore by every display of tits, asses and hints of sexual acts. It was a prison of its own kind, especially as guy who never got any piece of the action in real life.
Everytime right after cumming we feel a weird mix of guilt, relieve and at the same time the hope for more. It's a toxic mix, you can't really enjoy the guilty pleasure, although the guilty component is a kind of pleasure in itself. Everything that you have to hide and has the aura of forbiddenness has a special appeal. I'm feeling in a rut in all my adult life and doing something that's breakout of the matrix experience, even if the breakout is just fake and takes place just for a couple of minutes, gives relieve, even if that relieve is just tiny.
Thank god modern western society is moving in the direction of less oppression, for example we can at least openly talk about this habit now and with each subsequent generation I believe there'll be less shame involved and hopefully getting real sex will not be the big deal it is now.
At least for me part of the reason why I got so badly addicted to fapping was the huge amount of insecurity I felt as a teenager around the possibilities of sex in real life. I was feeling like I was disgusting and almost no girl in the world would want to have sex with me. I wasn't even sure most girls liked, desired or wanted sex in any way. It seemed to me all girls just searched for the same James T Kirk type of guy, I didn't even notice when some of them actually showed a little interest in me, no this couldn't really be true, except for when I was masturbating, then I everything was possible.
I hope men and women will have to hide their real sexual selves less and less in the future. If you desire to live polygamous, to have group sex, to be dominated, to be dominating, to have sex with Asians, or whatever weird fantasies you may have (as long as it's legal, of course), I hope that you and I and everyone in the future will be able to be truthful and honest about those desires and fantasies and not to feel that senseless shame anymore.
For example, let's say you see some in your eyes beautiful and really sexy girl. In this society you have to dance around the fact that you want sex from her and if you don't dance around it you're a creep and may get immediately dismissed. You can't just go to her and say you really enjoy seeing her body and would love to have sex with her immediately. Think about it, that's really a huge compliment. It doesn't mean that you think she's unintelligent and all that she is good for is sex, it just means that you've opened your true self up to her and told her what you really think.
I imagine that even today there are many girls that would be attracted to that openness and honesty, although many would probably just slap you for this "disgusting" behaviour. I'm not even sure what I'm trying to say here, I'm probably trying to point out a double standard. We are supposed to be honest, and be just "who we are", we're supposed not to pretend and not to create a fake personality, but if you just tell someone on the street straight in the face that you're insanely attracted to the body and the initial impression it made on you, you're viewed as a weirdo. Well, of course, it should be totally appropriate to dismiss someone that approaches you that directly, I'm totally okay with that. My point is, that when you're also attractive to this person you're approaching you're pretty likely to get dismissed just on the basis of too much honesty. It's not my biggest gripe in the world and already taking up too much space in this text, just an observation about an illogical irrational human behaviour.
From previous goes I had at nofap I know that I wont last if I start to edge. I can't trust myself with porn, even though I'm looking at those images without any passion. I bombarded myself with enough moving pictures and images for a couple of lifetimes. If I wanted to, I could remember the tits, asses and sexual scenes from all those years of addiction for the rest of my life and I could just feed my addiction with those memories, there's no need for me to see even just one more tit or ass in whatever combination in whatever sexual scene. My hunger for those naughty pictures is filled for for at least a couple of lifetimes.
Seriously, jerking off was barely a fun activity for me in the last few years. There was a minimal thrill of doing the naughty and forbidden thing left, but the actual process of it just felt incredibly boring. It was just an autopilot flying the plane from A to B. Something triggered me, sex was mentioned somewhere in an online article, or I remembered a flirt from a couple of weeks ago, and without really thinking about it I made the horny decision to open up the incognito browser window. Next thing I know I'm seeing myself going to get some tissues, just like I'm a robot on a mission. Everything from there till cumming just seemed like it was programmed into my brain by years and years of practice. Enter search term. View pictures. Select your favorites. Start jerking off. Not good enough yet. Enter different term. Search favorite among pictures again. Press play. Jerk off some more. Eventually make sure you're coming into the tissues you placed next to yourself and not on the keyboard or some other not so great location. Then when you've come pretend like nothing happened and get rid of the evidence.
It frightened me to see myself in this robotic autopilot mode, it was literally beyond my control. That's when you know you might have a real problem. Besides I didn't get any real pleasure from it anyhow and I knew it for years, but just couldn't break the cycle.
I realized that on occasional streaks of not fapping I felt slightly better emotionally. It's not like I transformed into a infallible superhuman and got rid of all my problems, but I always had a slight increase in productivity and a slight stabilization of emotions.
It seems like this constant dopamine rollercoaster we fappers with real issues are on, is preventing us from getting grounded. That could happen with any addiction I guess, it could be eating, drinking, smoking, gaming, gambling and any combination of all those.
We addicts are especially vulnerable to the addiction when the sky seems to fall on our heads. I know I masturbated and engaged in all sorts of other addictions especially when I was between a rock and a hard place. When you don't know what to do, when you are just trying to get by somehow and have really no good solutions, then is the time when addictions strike the hardest.
There's no way I'm ever going to break this cycle when I'm not completely and 100% beyond the fapping lifestyle. It is a lifestyle, but unfortunately a totally shallow one. It's not good for creating real relationships and might even interfere with the ones you have. It takes away from your emotional health, it takes away from your trust in yourself. I mean I was basically a zombie whenever I watched porn and masturbated, I can't even call it anything else. This zombiesc autopilot out-of-control porn induced masturbation binging isn't that much different from what I assume a heroine junkie goes through with his respective addiction.
As I stated before, I've really known for a while that I don't desire any of those pictures/movies and fantasies anymore. I accept that this desire and this creation of fantasies is completely normal in the sense, that all humans are to an extend irrational beings living in their own little fantasy worlds. I don't want to chastise myself for what I've done, for all the fapping and the many thousands of people I've seen in naughty action without them knowing anything about it. I'm not feeling guilty about what I've done, and nobody here should feel any shame or guilt about their masturbation and porn problems. Guilt and shame are totally illogical and unnecessary emotions that are nevertheless deeply ingrained in the makeup of human societies and our brains. But it makes no sense, realize that almost every human that ever lived has masturbated and that none of them are better (or worse) than you.
It's an activity and a lifestyle that I'm personally through with for quite a while. But actually dissolving the attachment to it and actually resisting the robot inside myself isn't an easy task. That's why people relapse, they recognize what's bad about their habit, they inform themselves, but they aren't really through with their habit 100%. If you aren't through with masturbation and porn 100%, stopping it 100% is impossible, you could maybe aim for shrinking the habit, like when smokers claim they're now only smoking one cigarette per day instead of a pack a day, but unless you're really sure that porn has nothing to give you anymore and that masturbation is not a real meaningful release, unless you're sick and tired and you want to kill that zombie inside of you, you can't ever kill that zombie. You can shrink the zombie, but it might grow back even stronger and your next relapse will be as intense as any masturbation session ever was. If you're not ready to kill the zombie, don't even try it, then you're just repressing it and eventually it strikes back and the next time you're binging the guilt and shame of it will just increase. That was my experience when my previous nofap tries failed. It started with edging. Eventually I gave up and binge fapped to porn. For a while I even felt like I had missed it and that nofap was bullshit, but it's not, it's just that zombie sucking you in again. That zombie doesn't want to die, he'll do anything to get you back in the action, or else he'd be toast.
I'm killing it now, I'm not edging, I'm not even thinking about it at all. If I get an erection, I don't bother about it, it's normal, but an erection doesn't require an ejaculation. I'm just trying to focus on other stuff like playing chess, cooking myself some good food, practicing yoga or watching stupid videos on youtube. As long as I'm staying away from porn and fapping I know I'm fine, at least relative to how terrible I could potentially be. Like with my previous nofap streaks I can already feel that my emotions are becoming stabilized. It's not a huge groundbreaking experience, but it's enough that it's worth it. I don't expect to get more from it, I'm happy if those are all the positive results I'm getting. I was desperate to get of this rollercoaster and now I'm promising myself not to get on it ever again.
Maybe in 2 or 3 years my dick will recover and I can have a normal sex life and find a loving partner, who knows, I'm not even counting on it, I'll not fap even when this means I'll never have orgasms again in my life. To hell with it, I'd rather go into a monastery than fall back into my destructive lifestyle yet again. There's really no point at all in pretending that you're an amazingly great sexual animal when you're not. Just get over it. We don't all need to be sex symbols. Society tells us that you're worth nothing unless you're successful and attractive. I call bullshit. You my friend are worth a lot to me. You're reading this and this means I didn't write this for nothing, I love you because you're following my thoughts and you're showing that you're an intelligent being with worth that can't be imagined. Your worth comes from you being a real being that exists not in someone's fantasy, but in a world that is unlikely to exist, but somehow still manages to exist. It sounds corny, but the existence of you and me and everything is truly wonderful, it's beyond our capabilities to know how we were put here exactly, it's almost unreal. I may be a loser and sexually I'm giving up for now, but I refuse to believe that my self-worth comes from whatever society thinks about me and that "scoring" increases my worth.
Think about that, when you get a number and get laid we call that scoring. Why do we call it that? Do you rise in the world ranking of studs and is your eventual goal to get a highscore that is better than the one of your peers? This is a ridiculous delusional self-betraying game. No, your worth is preexisting any action that you can take. Your worth comes from you being in existence as a living and breathing creature that has feelings and thoughts. Your worth doesn't come from your bank account, it doesn't come from a karma bank either, it has nothing to do with how attractive you're to anyone, it has nothing to do with what the people are saying about you, it has nothing to do with what they'll say about you at your funeral, it has nothing to do with how much offspring you have, it has nothing to do with the level of your intelligence, worth is something you have to find inside of yourself and that nobody can take away from you. I don't want to get too spiritual here, but I really feel in my life how this realization that increased in me each year makes a giant difference to the way I view my own life, life in general, the whole world, the universe and everything. Stop worrying about perceptions, you are not here to please anyone else, you are also not here to self-pleasure yourself. There's no task that you have to complete in order for your life to be a success, there's nothing you can fail at that will make your life worthless. Stop all the nonsense, like irrational intense fapping, stop the self-hate, the self-destructive thinking, stop the whole madness of it all. Just relax and know that your worth can't be taken from you even if people spit on you. Just smile, just realize that this whole world around you is infested with madness. Do not engage the madness. When you're relapsing and going down the road of porn and masturbation, that's nothing but a celebrated form of madness. Madness is around us at all times, humanity is a huge hive of more or less mad animals that have occasional sparks of brightness among themselves. Accept that madness is there, but don't feel pressured to react to it.
I'm not dancing to anyone else's tune anymore, I don't care what they say, what they think is right or wrong. I don't care what they think I should or shouldn't be doing. I'm trying to live a healthy life while not bothering anyone else, that's all I'm trying to accomplish and I'm extremely happy with seeing that as my life from now on.
Maybe one day I'll find love, until then I'll be completely content with myself, I'll be completely content with a malfunctioning dick, I'll be completely content with barely having money, I'll be completely content with being perceived as a loser, I'll be completely content with not being the brightest man in my street, I'll be completely content with not "scoring", I'll be completely content with my reality.
My initial intention was to ask you, if talking about nofap to friends was a good idea. One of my fears was that they might laugh about the idea. I think I answered that question myself. Basically there's no reason to give a damn what they think about it or if they believe me about the benefits of nofap. I'm not going to evangelize about nofap, many people may not even chase that dragon like I used to do, that dragon has a different appearance for each human, it's annoying and not necessary to try to proselytize. Figure it out for yourself, or don't, but do not believe everyone else has your problems or must come to the same conclusions as you do. If someone asks me about it, I'll tell them everything they want to know, in every other case it's my own business.

[Table] I am a certified addiction counselor working with patients diagnosed with heroin/opiate dependency. AMA.

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Date: 2013-05-26
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Questions	Answers
What is your thoughts on weed being called a gateway drug?	I know this is a widely contested topic, but I will do my best to explain my position. I don't think marijuana is solely responsible for people using other substances. I like to take the stance that it is more about WHO an individual associates themselves with that causes them to want to try new illicit substances due to peer pressure, the need to fit in etc. I've come across many patients that have never used any other illicit substances other than marijuana so it is difficult for me to concede that it leads everyone to use harder drugs.
Thanks for the reply. Now I have another question. What's your favourite muffin?	Haha cranberry orange muffins are delicious.
Not Poppy seed muffins?	Ha. no but I do love poppy seed chicken.
Have you ever worked with people who are addicted to porn? If so, man, can you give me some advice? I got a porn addiction that keeps morphing into weirder and worse porn. What can I do?	PM me. I can definitely give you some information to point you in the right direction if you need/want to get help with your addiction.
	Edit: For clarification that I'm not feeding porn addictions.
What is your opinion on intervention? As someone clean from Meth for 11 years today, I think an addict has to hit rock bottom and want treatment in order for it to be effective. No one staged an intervention for me, but had they I would have just shut them out of my life.	First of all, congratulations on your long term success. That is a huge accomplishment. To answer your question, I think that it is important to understand that different approaches work for different individuals. While you had to get to a certain point before you were ready to receive treatment others may need that push. I think it is important that research is done about the individual to find out what method is most productive and beneficial to them.
Different strokes for different folks. Thanks for the answer and the encouragement.	You're more than welcome. Keep up the hard work!
Decriminalize all drugs or no? and why of course.	Whew, this one is a loaded question. I don't feel all drugs need to be decriminalized because there are some that have severe and dire consequences almost immediately and should they become decriminalized it puts these drugs into the hands of more unsuspecting people which could cause more traffic deaths, teen deaths, etc. In keeping things illegal I feel you almost eliminate a certain subset of people. However in decriminalizing it all it opens up curiosity that could prove to be dangerous. I know this is an argument that will continue to rage, but my personal belief is no, not all drugs should be decriminalized. I'd love to hear your perspective.
What is your opinion on Portugal's past decade+ of decriminalization? All data points to an overwhelming success. Drops in drug relates crime (obvious), drops in addiction rates, drops in overall drug use, etc.	I wouldn't necessarily say that decriminalization would lead to the down fall of rehab centers. As long as there are drugs there will be a need for centers to assist these individuals.
I realize that this may put an entire industry predicated on drug criminalization out of business (prisons, drug counselors, law enforcement, etc) so gets resistance in terms of policy making.	I can't really state how Portugal's past decade of decriminalization would compare to the US if we opted to do it simply because I haven't seen the data, but as far as my personal opinion on decriminalization it's posted a little ways toward the beginning of the AMA.
Thoughts on Ibogaine as a treatment for opioid addiction?	As with all medications in treating ANY form of addiction I feel as though it needs to be closely monitored. In the case of Methadone and Suboxone in our clinics we mandate a minimum of 2 counseling sessions each month and there are several safety precautions used to ensure that patients are handling this medication safely. I can only speak to what I know of Ibogaine from what I've read in your link as it is not as widely used as the afore mentioned medications. I have a hard time seeing how this substance could be regulated enabling it to be an effective treatment for opiate withdrawals. But, if it can be we should try it! Counseling in my opinion is the most crucial part of the recovery process as it allows for patients to begin to have a firmer understanding of what it is to be sober. To use a metaphor medication is a bandaid, counseling is the neosporin.
My younger sister is a recovering heroin addict and she is still going to support groups. Here there aren't a lot of NA groups around here, so she had been going to AA meetings as well and she tells me that sometimes those two communities clash a little because as she says, its not the same thing. Is this true? I also am also someone hesitant about going to meetings because I somewhat feel that putting her with more addicts could potentially give her more opportunities to get other drugs or the same kind she preferred. I know that she needs people that can understand what she is going through, so I can also see the benefit. Are these hazards real or am I getting myself worked up about nothing?	I've heard patients say the same thing about NA vs. AA but it is my understanding these communities have very similar standings. I think the issue at times with community based meetings is that people running them can provide a different message than intended, even slightly. I think there is also some resistance between alcoholics and narcotic users because one deems the other to be less intense than the other or vice versa.
What's the saddest thing you've witnessed?	Deaths of course are unfortunately common in our field and to me it is impossible to place one patients death over another so for respect for them I will not talk about a death of a patient as the saddest moment. For me I think the saddest things that can be witnessed are when a patient brings their family in for a family session, and for most of them, this is their first time in a room together with out yelling and screaming. So to watch a patient own up to their misdeeds because of their addiction and have a family continually tell them they're a "fuck up" or "worthless" is hard for me to watch. I had a mother tell her daughter that "she wished she had never been born", in a family session after the patient had been clean for 6 months. While I understand it has to be frustrating for families and at times unbearable I don't grasp the feeling of needing to belittle your child. Especially when she had done so well in treatment.
I am a recovering addict currently taking Suboxone in a setting much like you describe with the required counseling, etc. How many people do you see typically that have managed to hide their addiction from everyone in their lives? Or at least a bigger portion of the people in their lives?	I've heard this a lot from patients, the fact that they have "hidden" their addiction from their family and that their friends have no idea. However, in most settings with family or friends it comes out that although they may not know exactly what was going on with the individual they knew something was up. Money is missing, time together is infrequent, etc. In this regard I don't feel patients are very successful in hiding it. To this point, I think it is wildly important to involve family and friends (if healthy relationships can be maintained) throughout the course of treatment because not only is the patient learning how to live a sober lifestyle, but family and friends are also having to learn to live with an individual in recovery. Education is important on both sides. I wish you the best in your recovery, it's a long, difficult road, but the end results are worth it!
What is the relapse rate, and what sort of success rate can be expected in getting relapsers to quit? I'm always glad when I hear of someone getting out of the tunnel, but a part of me always wonders how long until they're back in.	You have a point in your skepticism it is all too common that individuals relapse a number of times after exiting treatment. It is hard to say with certainty and EXACT percentage of success due to it being a largely objective topic. However, the patients that successfully complete our program (i.e. 2+ years of treatment, complete weening of of medications, negative UDS results, and compliance with counseling) have an exponentially better chance of remaining sober due to the fact that they are entitled to 1 year of free aftercare with their families and support groups It is important to note that patients that do not complete the program successfully based on our standards, also meet success in terms that they may have stable employment, avoided new legal issues, etc. However, relapse is higher with these patients than those that successfully complete the program.
I was seated next to an opiate researcher on my last flight who suggested that "meth mouth" and the skeletonizing effects of meth we see in those pictures are a myth - not supported by evidence. Can you confirm, deny, educate?	All I can say is that I cannot 100% agree with everything this individual has told you. I have seen several patients with cross addictions, including methamphetamine and due to what methamphetamine does to an individual's metabolism and the chemicals used in making it, which are typically inhaled I can't see HOW this couldn't be a contributing factor. The other part to consider is that most of these individuals do not prioritize dental and medical health to their addiction which could also be part of the issue.
How hereditary do you think that addictions are? My ex-husband became a meth addict. We left him when she was still a tiny baby, and she has never been exposed to it, but I still worry daily about my daughter having to deal with addictions when she's grown.	While research shows that there are some correlations between addiction and genetics, I tend to take the stance that environmental and behavioral factors weigh more into addiction than heredity. Our sense of right and wrong is deemed from what you see on a daily basis, and for children most times, that is their family. So lets say "John" has an alcoholic father and sees his father drink when he is upset, stressed, etc. "John" is then more likely IMO to have learned the response of drinking or some other sort of deflection of handling his emotions is more appropriate than handling them rationally. The best thing I can tell you is to always have open and honest communication with your daughter, so should she slip up, she feels comfortable discussing the issue with you.
How do patients with dependencies handle life outside of counseling and addiction centers? Are taking up healthier habits to be addicted to encouraged, like exercise?	Absolutely! Addiction recovery isn't simply sitting in an office and taking prescribed medications. We encourage all patients to begin pursuing healthier activities to fill the "boredom factor" which is a trigger for most to use. We work with patients to identify things they once enjoyed and encourage them (if healthy, of course) to do these things. Exercise is a big one for a majority of our patients as well as playing music, playing sports, etc.
Hi, I've never tried drugs, but I have a serious addiction to food. I'm serious. Food is like a drug to me. Is there any way for me to overcome it?	I would recommend seeking out specialized professionals in your area that could assist you with in this problem. If you genuinely want to overcome this addiction it will be hard work but if you can genuinely approach this problem with 100% effort I have complete faith that you can over come it.
Are there ever people who are 'hopeless'? Or can EVERYONE be helped?	Are there times where it's frustrating and it feels that way? sure. When there are severe difficulties surrounding a patient or they don't feel they can be successful, it can feel that way However, not to sound overly P.C. here but I believe that anyone can get sober if they want to be. There has to be a large shift in their thought process, life style and social environment. If these things can change then I feel everyone has the same chance to do it. I have faith in all of my patients.
I used opiates, including heroin, for about 4 years and have been clean for about 8 months or so. My question is how do you deal with people who have philosophical triggers, so to speak? For example, someone who has a well thought out world view which is less than optimistic would require an insane amount of debate and evidence to refute their life of experiences. Do you think the level of work required to help that person exceeds the capability of a counselor? I had plenty of conversations like this with counselors in the past and they can go on indefinitely. It inevitably leads to both of us conceding that the world isn't fair, and for some people to be happy they have to be ignorant. How would you deal with someone with such a strong view of reality?	I tend to take the approach with my patients that although recovery is difficult the concept of recovery is pretty basic: Identify the triggers and do not use drugs. I think a lot of patients tend to over think the process because they have to have a sense of "why did this happen?" rather than simply identifying triggers. I encourage my patients to focus on "what can I do to ensure I don't end up in the same spot again" rather than the afore mentioned. Does this answer your question?
Do you have experience with drug addiction yourself? if not why did you choose this career.	I have some drug addiction in my family but none personally. I got into the field to help people that had a hard time believing in themselves. I have a "slightly" optimistic world view and if I can be part of making it better than why not do it?
I respect what you're doing. theres so much predice towards drug addicts and not enough people that acknowledge addiction as a real problem. in my experience at least.	I think a lot of people think these people WANT this lifestyle. However in the 250ish patients I have sat down with in my career so far, I can assure you that none of their life goals were to be a drug addict. I simply try to help get them were they want to be.
How did you end up in this career? What did you study, etc?	I studied Psychology throughout undergrad and applied for the job because I wanted to help make a difference. I also completed 2 years of on-the-job training and received a CADC II certification while working.
Could you elaborate more on your take on marijuana? I understand the dependency factor and the negative effects that it can cause, but that can be dependency on anything, not necessarily mind-altering chemical compounds, dependency on anything to a certain extent can be bad for you. If abuse was minimized, do you believe counseling would still be necessary, if so, why? or do you believe marijuana to be overreacted to? If so, How? Why? Thank you for your time and responses!!!	My opinion on counseling is really geared toward the patients suffering with opiate dependence. However, I think that should a person want to discontinue the use of any substance and are finding it difficult a little out side perspective never hurts.
I'm on a suboxone program at the moment, 2mg/day now, down from 12mg/day. Any advice for somebody about to attempt the jump to no suboxone?	First off all it was very smart tapering down completely from Suboxone. The biggest piece of advice I can give you is two fold:
	Ensure you have a solid after care plan worked out with family, friends, counselors, etc.
	Remember that you did all the hard work to remain sober and the medication was a small part of the success you have. You need to own the success of your recovery!
	Congrats!
What drugs, if any, have you tried?	I smoked weed a handful of times. Never really did anything for me.
What are your thoughts on people who where only addicted to opiates drinking alcohol? Do you push 12 step programs on your patients?	I don't push anything on my patients that they don't feel comfortable doing. I tell patients that if they feel it necessary to attend 12 step programs then by all means do. However, I would never force my patients to attend 12 step programs.
	I have to say that I do alert patients taking methadone/suboxone the dangers of mixing alcohol and the opioid replacers. It is also important to know whether alcohol would be a trigger for a patient to relapse. If this is the case, we work on replacing activities that trigger use with productive healthy activities.
Does it seem to you that since oxycontin was made "tamper proof" there's been a rise in heroin use in rural areas?	Oh god yes! It's also cheaper in a lot of areas making it more popular with those addicted to it. Opiate addiction is a MAJOR problem that I feel that in the US most people are naive to it, as a whole that is.
Do you ever see the bad side of having the rehab industry grow independent on the judicial system for patients, and what can be done to stop it? Case in point, drug court = good. Sending spouse of medical cannabis patient in a illegal state =bad.	I may be missing something here but I'm not clear on your question. Break it down for me again?
It's no secret that rehabs have become independent on the judicial system for patients. According to Addiction experts only one in eleven adults who use cannabis are addicted, yet courts are placing all adults who are caught into some sort of treatment which allows rehabs to have patients that they would not normally have. I see the good of this relationship, drug courts helping people who are truly addicted get the help they need, without a permanent record, but the bad means people who are not using (in my case my husband was using cannabis to deal will pain from chronic pain) or not addicted are forced into a rehab program taking up valuable space. Have you seen this personally, and if so what steps can a person take to stop this?	Okay, we're on the same page now. The clinics I have worked had a policy of only taking patients who voluntarily wanted to enter treatment. These patients also had to meet DSM-IV criteria for opiate dependence, not abuse. So to answer your question, I feel that court placing people in rehabilitation programs for instances for which you referred, is simply due to courts not being educated on the terms of what the difference between recreational, abuse, and dependency so they lump them all in to one sector. That of course being rehab programs. At the same time I think it is up to the staff of the rehab center to truly assess the patients needs in regards for treatment. Meaning if the center believes there is no reason for them to be there then the court should take this into account and offer up a different sentencing.
Have you ever had a situation where someone tried to stick a needle in your arm so "you could feel what they feel" or something similar?	No I can't say that I have. However I can say that most patients are apprehensive about having blood drawn after a year in treatment because they're afraid of it giving them old feelings.
Do you think different drugs affect people differently. I know people who do it once twice and leave it while others get addicted instantly. It it external factors only or a person's physiology has to do something with it ? Thanks for the AMA!	I feel this is one of those i fall on the fence for this issue. While I am more of a proponent for a behavioralist approach it is difficult to deny the fact that physiology also plays a role in addiction as well. I feel as though both have a footing in the development of addiction hence why I like to apply a holistic approach to treatment progress.
How many rich white people do you get? From what I know, the number one indicator of drug use within a community is poverty.	With the high volume of prescription medication in households nowadays, it is more common to see wealthier people in our office than it would've been say 15-20 years ago. But on a firm number I would say that roughly 10% of our patients make more than $80,000 while the vast majority make less than $30,000.
What advice can you give to someone like me when damn near everyone I know is addicted to percs...dones...heroin...lortabs. They don't think they have a problem. So many friends of mine..it breaks my heart. How can I help them?	These individuals have to want to accept the help. I know it is hard to be surrounded friends and watching them "ruin themselves." The only advice I have is to set firm bottom lines letting them know that you love them but you will no longer enable the behavior. Which at times can mean having to break off friendships. It is tough but until they are willing to commit to stopping opiate use it may be in your best interest to remove yourself from the situation.
I was in jail for two months once, before the charges against me were dropped due to lack of evidence. Anyways while I was their what shocked me was that at least 75% maybe more of the other people in their were Heroin addicts, I had no idea it was so common, hell I had never even met someone who had done Heroin before my brief incarceration. My question how prevalent is it for your, patients to have criminal records and what crimes are they usually charged with?	I think it is safe to say that around 40 % of incoming patients have had legal issues with the past 30 days prior to entering treatment. More often then not the legal issues consisted of drug charges, theft, and DUI. Very seldom although not completely absent are there patients with violent crimes in their history.
Kurt Cobain, Did you come across his Case and review why a man that was on the right track to recovery, just off himself?	Link to kurtcobainssuicidenote.com
	Maybe there was relapse. maybe a deeper seeded issue, but it is always unfortunate when someone takes their own life.
Do you see lots of abscesses or MRSA?	I chuckled to myself when this was asked because the first patient I ever sat in with showed her counselor an abscess on her leg and asked if she should get it checked out. From there I would say I've seen 3 or 4 cases of it.
What are your feelings on drug court?	In what regard?
Do you think it's an effective approach or no? And why?	It can be if the legal system you're working with truly believes in rehabilitation. If a more punitive approach is taken, I see a lot more pressure on a patient which can lead to triggers of relapse.
So, I went to rehab for heroin about 7 months ago. I relapsed once about a month after I got out, then again about a month ago. My life got so much better in the time that I was clean, I felt happy, etc. However I can't seem to get the urge to use out of my head ... I haven't been able to figure out what triggers it. I will be fine for weeks and then it will suddenly pop into my head and I can't get rid of the thought, even though I know all the bad consequences. What can I do to get through that?	Whenever I have patients that are having difficulties identifying triggers I have them write down the exact place, feeling, time, and people(if any), were around at the time of the relapse. I know it sounds incredibly basic but it can help you identify things that you may not have noticed before. It is also INCREDIBLY important to ensure you're changing the environment around you to ensure you're not falling into old habits. Much like smoking must drug use revolves around a certain level of ritualistic behavior. Identify these and you'll be on your way. Also it may help you to engage in counseling to assist you with these urges as well.
What sort of schooling did you acquire before becoming a counselor and how did you become certified in addiction counseling?	I got a bachelor's degree in Psychology prior to getting my job. I was lucky enough to get hired by a company that paid for me to get continuous education throughout my patient contact hours. There are several classes you have to take every year like patient confidentiality, motivational counseling etc. Then I was certified through an organization called IC/RC after 2 years and roughly 4800 patient contact hours I took a written certification exam.
Do your patients qualify for SSDI?	Some do, however, most of the SSDI patients we have have it stemming from injuries or MH diagnosis, not being diagnosed as opiate dependent.
What is your opinion on A/A and N/A?	If it works for the individual than great, but I don't believe that it is the only solution or answer for everyone.
I'm sorry for only scanning throught the fastest and best I could through your thread and the question I was looking for is not in here as far as I can see. What are your thoughts and experiences with Mitragyna speciosa AKA Kratom?	I've never used it in the capacity of alleviating withdrawal, nor do I know too much about it. Sorry.
Is it integrated into your program at all?	Only if patients wish to participate. We don't force them to do it.
By that logic, you could say that smoking cigarettes is a gateway drug too.	I guess what I'm trying to say is that I don't look at anything as a gateway drug. People can avoid substances including marijuana and cigarettes and move straight to heroin/opiates etc. I don't think it's fair to label one substance as a "gateway" to another if that makes any sense.
I agree with you! I was just making a point that following TheWingnutSquid's logic would mean that other things not considered drugs in our society are then also so called "gate-way" drugs.	Oh, by no means was I trying to be a smart-ass. Just clarifying the point.
Not exactly related to rehab, but what are your opinions about programs that provide clean needles to heroin addicts in hope of decreasing chance of disease.	I think they are fighting a good fight. Enough harm is done to people who use illicit substances intravenously so if these people do not wish to stop using then at least they can use as safely as possible and help stop the spread of things like HIV/HEP C etc.
Biologist with a huge history of family addiction, here. If you ever consider interventionist training at any point, please look invitational/systemic, its showing a LOT of promise (I can provide studies).	I'd love to read them. Not because I doubt it, but just for my understanding of it.

Last updated: 2013-05-30 20:03 UTC
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[Table] IAmA Substance Abuse Nurse AMA.

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Date: 2012-10-16
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Questions	Answers
Does anyone actually come in and get treated for marijuana addiction/treatment? Does the conversation go like the one in Half Baked when he gets up in front of the NA meeting?	I've seen one guy who came for that. My personal opinion is that if you can't stop doing that then maybe there is something there going on. As someone who's smoke weed in the past I think its more of that addictive thinking or an underlying thing, like using it to cope with other things. The other clients don't really take that person seriously when they're trying to kick heroine or something like that, but if someone feels they need help that's what we're here for.
You can absolutely be addicted to marijuana - it's a major component in cyclic vomiting syndrome. We nearly had to put a patient in a Nursing Home to carry out treatment.	I've heard you can be addicted, I was just speaking from a personal opinion.
What's your favorite type of pornography?	I should have said ask me almost anything.
Do you yourself abuse any substances? If so, which ones? Does seeing what these substances do to others have an effect on your opinion of them?	No, we get drug tested here randomly. I would be a big hypocrite if I was using drugs and asking others to change their lives not to use them. I have used drugs in the past when I was younger, before getting into nursing school. I used to smoke weed, was really fond of MDMA, tried a few other things here and there, Benzos as well. As for the second part of the question, do you mean does it effect me opinion of the drugs or the person?
Your opinion on drug use.	It made me see what I already knew, that people have choices, but it did show me how maybe some doctors need to be help reasonable for getting some of these people hooked and help them out or be mindful of that when giving a script to someone. I realized now too how its all walks of life. I already saw a lot of this in my own family and friends though.
I imagine you regularly see some interesting characters. Who is by far the strangest person you have seen, and what did they do?	Due to . I have seen some clients do some strange things. I have had a person once who I'm pretty sure had some how sneaked some drugs in and was still getting high as we were detoxing him. He spit on and punched one of our staff and started cursing all of the nurses out. He would walk away from getting medication and refuse them then lie and say we were refusing to give him his medications. I've had people who shoot up in the parking lot before coming in for treatment and people who have their drug dealers calling our facility to settle debts.
How often after insurance runs out are people magically deemed "cured"? (Im assuming this is an in-patient facility)	So much, we fight for them to get coverage to stay because they really need it but insurance companies think they know best when they haven't even met the person. I know our insurance person here has to get creative to try to get insurance to improve them to stay as they have been through treatment too they know how life or death a stay can be. We don't consider them "cured" but the insurance company will. It's so aggravating.
Have you had any patients addicted to Tramadol? My husband has been taking them for 6 years. Are the withdrawls of that medication serious or dangerous? Should I be afraid to have my children around him while going through withdrawls? Like, will it affect his mental state?	No, I can not say I've ever seen someone come off of Tramadol or be addicted to it. Most doctor's like to use it as an alternative to narcotics as it is non-narcotic. I have read stories of people claiming to be addicted to it online, but I have no personal stories on it. For general for opiates though you see all the opposites than what the drug does for you. You will have diarrhea, stomach and body aches, anxiety, dilated pupils, sweating and cold chills, etc.
Which is more abused - prescription opiates, or heroin? Does it vary by age?	I would say more opiates, roxy etc. We do see a good bit for heroin though, some just abuse heroine while other use it when they can't get their roxy/oxy. Umm really not. I see all ages of all kinds, but for heroine I haven't seen any of the older guys on it. The oldest I've personally seen on Heroine where I am is abound 30. Most of the guys over that are abusing alcohol, pain pills or benzos.
The old heroine addicts are all dead.	Excellent point.
Do you drink? How much, percentage-wise, would you guess of the staff are teetotalers?	Not really. I don't suffer with addiction. I may have a glass of wine on an anniversary or something, but I wouldn't even say I drink monthly. I could honestly live without it and wouldn't care. A lot of our staff is in recovery so they don't do anything. I can't speak to others here though.
What was the worst case of substance abuse you've ever seen?	We get a lot of polysubstance abuse, but just one drug I'd say one guy who was drinking a gallon of vodka daily.
I once transported a patient who had been a long time alcoholic but had recently (3 months prior) accelerated his consumption to about 750ml + of vodka/day. Guy was in his early 30s and his liver was functioning at 5% of what it should have.	That's so unfortunate. Are you a EMT? People don't realize how bad it can affect you. We automatically draw labs on admit to check for these types of things.
Wait, that's bad?	Lol...guess its who you ask.
Woah, I think I'm drinking a lot when I'll drink a litre and a half in two or three weeks.	That's still a lot.
Yes, I work as an EMT. The guy had been hospitalized for 30 days. He was jaundiced and was getting all fluids through an IV and all food through a g-tube. The transport happened almost 2 years ago so I assume he's probably dead by now :/	Sad.
I drank 2/3 of a litre last night. Am I in trouble?	It's all in your own eyes. Your life.
This made me feel bad. Ill drink that in 3 days.	Yeah.
It is, it is, but that's rather rare. I'm not usually so bad.	Do you binge?
Aw, I'm kidding. I really do appreciate what you do for a living though, I've been and known a lot of junkies. So thank you.	It's all good I kinda thought you might be kidding, but you never know.
Once in a while I'll drink a little more than normal and actually get drunk. The recent increase in consumption is likely related to my girlfriends medical issues (possibly cancer). Just coping as best I can.	Man, I'm sorry to hear that.
Thank you, though I think this tough time is coming to an end. We are told it is /likely/ not cancer. It's something, at least.	I hope its the "not" cancer part. Good luck and best wishes.
Whats the worst kick? For them (freaking out, hallucinations, whatever)? For you to have to deal with (vomit and poop)?	I have had client's have hallucinations but that wasn't really related to their detox it was side effects from psychotropic medications as we are co-occurring, which means we have people with psych issues too. Mostly the extreme anxiety for opiate and benzo users gets them along with body aches. For people really abusing alcohol we see seizures sometimes if they were not honest with the real amount they were using, so in turn we were unable to get them the proper detox medication orders. For me, I don't have to deal with poop or vomit. Our clients are able to walk around and care for themselves in that aspect. For me dealing with people who feel entitled due to their status or who their daddy is or how much money they make. Sometimes the wounds from using IV that become infected can be kinda interesting, but it doesn't really bother me. I like seeing that type of stuff.
Ive heard kicking xanax and other anti-anxiety drugs can be really grim. Have you had much experience with heavy abusers of them?	Yes I can think of some in particular. They really have to have been using a good amount though to really see a tough one. They experience obviously a lot of anxiety, possible tremors etc. It can be tough because they will have anxiety from the detox but more than likely have some underlying anxiety issue that they got started on the anxiety stuff for in the first place. I can't stress enough though how much it depends on that person, their size, their tolerance, use, length of use etc.
Is the facility you work at for men or women? How many clients are there? Are the clients there by choice or DOC/court ordered?	It is for men only. I find that when they are mixed you have to be accountable for relationships and people trying to sneak off etc. We maintain a small client base and sometimes there are waiting lists. Most are by choice some are court ordered, but anyone is free to go if they wish, we can't physically keep anyone.
What is the general industry opinion of Ibogaine treatment for heroin?	No one around here would probably know what that is. I first read about it through some David Pinchbeck books or Breaking open the head, I don't remember. I've heard of people going out of the country for it, however no one uses it professionally here, at least where I live. Subutex or Suboxone is our standard here. However we do not use it for maintenance treatment we only use it to taper someone off of it or opiates while on detox. Some MDs have no problem giving someone a script for it. I am highly against that since the person will then be addicted to Suboxone. We do have people who come in addicted to that.
Should drugs be legal? Put differently, is incarceration an effective deterrent?	Well if you look at places where soft drugs are legal like Amsterdam they have lower rates of drug addiction than we do. So much money is spent on small offenses dealing with drugs. Its tricky to answer because sometimes people need consequences and other times its a waste of tax payer money. I think money would be better sent with sending some of these guys with drug issues to treatment instead, however there are big time guys who don't even abuse the drugs who are authorizing killings in cartels that need to be brought to justice. It comes down to our choices to use something or not.
My dad is an alcoholic. I lived with him during his lowest points - depression, lethargy, anger, sadness, verbal abuse towards our dogs, etc. He's sober now, thanks to a substance abuse nurse who actually came to live with us for a short time. Rather than go to a facility, the guy comes to stay with you, helps nurse you back to health, and helps you get into programs (like AA) that will keep you sober. I was just wondering what you thought about home-nursing for substance abuse, and if it's something you could fathom doing? Also, how do alcoholics compare to other addicts? Are they more or less difficult to treat?	I'm glad to hear that your dad is sober now. I haven't heard of anything like that before but I would love to do something like that. The only issues would be someone trying to get violent or pass certain lines. You said the person was a male, for myself as a woman it might be a little different. Alcoholics are just like any other addict the only thing is I feel a little worse for them. I don't go out to dinner with my family and have a wide variety of heroine on the menu to choose from. Alcohol is everywhere so it can make it harder to refuse. Some, not all, alcoholics tend to deny that they are doing anything wrong..its just alcohol..etc.
What kind of music do you like?	A variety, some examples are: The Black Keys, Rise Against, Krayshawn, Of Monsters and Men, some Iranian music etc.
Whats a typical treatment day like? Is there a particular psychologist's standard you follow?	For the clients if they are on detox they get a little more time to take it easy and rest and their bodies are going though a lot. For the regular clients, not on detox, they wake up early morning to go to AA meetings, do groups (individual and as a group) during the day, we have yoga and gym time off site and on weekends they do activities like go to the movies etc. We have different levels of care so I'm just speaking to this level. They have tv time too and can go outside and smoke, three meals a day plus snacks. We are no sugar or caffeine here. :(
Why can they smoke but no sugar or caffeine?	Right? I don't make the rules because I love sugar and caffeine. Smoking is super hard to quit, some would say harder than "drugs". They want them to focus on one big thing at a time I guess. Like I said I didn't make the rules.
That seems like a good way. Ive heard people crave sweets like mad when they are coming off lots of things, from H to booze.	Indeed I know my mom coming off opiates would only eat candy bars and diet coke. Its not about the cravings though its about replacing addiction to drugs to addiction to sugars and caffeine also its a stimulant.
Falling in love with tea saved me from alcohol addiction (Well, Islam too, but nobody likes it when I mention Allah on reddit :P ). I seriously think if America was a nation of tea drinkers we would have much less alcohol. It's just so much more wonderful than anything else.	I don't mind if you mention Islam, its your right. My dad's side is from Iran and my grandfather preached in a mosque daily there. You're right it is. There are so many flavors and the warmth is soothing. I'm from the south so I like ice tea too.
Would you say your mom's addiction issues led you down the substance abuse path in nursing?	I'd say it helped me know where I already wanted to go. I already was interested in this before that.
That's pretty cool; despite all the conflicts between Iran and the west (which we started for the most part), Iran's an interesting place with a deep culture and history, shi'a or not.	I can tell you its very difficult there right now, I just was there in June and part of July this year. The sanctions are really hurting the economy and making it tough on everyday people.
Yeah, sanctions just hurt everyday people and don't help at all. "Smart sanctions" don't work either. It's a damn sorry state of affairs.	Indeed. I miss it there though.
Do you know of Alan Carr - the "Easy Way" guy? What is the general opinion of his philosophy among substance abuse treaters?	I'm not gonna lie and say I am. I briefly read on it and I believe a lot of issues must be tackled in treating addiction. I can't talk about other places but where I am we focus on all issues that deal with addiction, why someone came to use, what causes them to not stop despite knowing consequences, they also work with the family too because sometimes they really don't help the situation or are hurting themselves.
How long does it takes for someone to fully recover from heroin? I don't just mean getting past withdrawal, but to where their personality and mental state returns to 'normal'?	I can't answer that really, you can't put a time limit on when they will feel back to "normal". Maybe they don't even get back to that, maybe they have to find a new "normal">
I used to do Medicaid interviewing for patients trying to get into the Detox for my hospital. I also handled any insurance coming through and being that I usually worked on the weekends, anything other than Medicare and Medicaid was sent away. So, I'd like to apologize to any nurse who had to deal with an irate patient I sent up after I made them jump through loops to meet insurance requirements. That being said, I've met a lot of interesting patient. Some of which, I continued to see and made friends with while they were at the facility. Some of the ones I helped out said they'd watch out for me on the street and would "have my back." Some touched me in their drive to make themselves better. In contrast, some have taught what and what not to say to a person going through a big personal problem. So, my question is this: Has dealing with these patients changed you for the good? Or, have they made you callous towards people with addiction issues?	Thanks first off for what you do, trying to get people help. To answer your question I think they've taught me that you never know what someone's going through just by looking at them or just by their attitude. Some of these guys have been through so much that I could never even fathom. It doesn't make me callous to them, but it does make me wiser to their behavior and to not get played or manipulated into things. These guys show me that they may be hardened but after a while there's something special inside that wants real happiness.
Might be a weird question, but ever had clients addicted to medicines? also: funnies / happiest thing you have seen?	We have plenty of people addicted to prescription pain medications or anxiety medications. Happiest thing. That's a good question. I think the happiest thing I've seen is a guy who came in heavily addicted to heroine who had a really bad detox. I came in one day after being off for a while and I hardly recognized him. He was bright and smiling for once. He told me " I finally have something to smile about". Anytime I'd mention his wife had called he smiled ear to ear. It made me smile as well.
I've always been concerned about substance's feelings. What sort of abuse do they have to put up with? What do people say to them? Is there any topics I should avoid bringing up when talking to substances?	It depends on the person and what's they're sensitive to or open to talking about.
As a person with hands on experience, do you believe drug possession and use should be treated as a crime and lead to incarceration, or do you believe it should be treated as a health concern and require rehab?	I think it depends on the amount and situation, the person's past crimes etc. I think you have to have consequences or you won't have good boundaries. We have so many people who come in so entitled that no one ever tells them no or shows them they are accountable for their actions. On the flip I think some people need real help and maybe instead of using money on jail they could send them to rehab, I could see how this could be abused though. I did clinical during school at a mental health facility where I met a man who was perfectly sane who was there because he abused the system and had really good lawyers. So you can see how someone might use that to get out of charges.
Thanks for your response! I can definitely see people abusing the system, but I can also see treatment as a very good resource for a lot of people in need. How do you think changing the laws from incarceration to rehab would affect your job as a nurse at a substance abuse facility?	I think there would be a lot more volume and maybe more people who don't want to be here. My facility lets people leave freely if they want, so we couldn't keep anyone here like a jail facility. I would see maybe less room for people not mandated by jail trying to come in or longer wait times.
Does lexapro cause extreme withdrawal symptoms??	Any medication, especially mood altering can cause some withdrawal, its important to have your MD help you decrease your dose if you want to get off of it. Taper down.
As a recovering addict, I have to first say thank you. Your field doesn't get enough appreciation for the impact you have on peoples' lives. 1) What are some ways that today's youth could be better educated? (I always jokingly suggest Requiem for a Dream) 2) On average what proportion of patients are there as a way to circumvent jail? 3) What is your opinion of IOP or OP rehab?	Thanks, I really do appreciate that. 1.) I think that by showing them the real truth behind what can happen and not just saying "Don't do it" but rather letting them see real people who have jacked up teeth from smoking so much rock. Also maybe being there for them, family etc, and showing them other ways to get pleasure and fulfillment out of life. 2.) I'd say only a few every now and again who maybe were suggested to come from their lawyer so it looks good on their case, but the counselors write to their probation officers or judge and let them know if they were really taking it seriously or not, usually those type of people get bit in the behind on this. 3.) Outpatient is good for those who need that level of care, been sober for a while but need support. If they really haven't gotten a good grasp on things or need detox or more care then residential is better. We screen people here to find out what level of care is best for them.
What is the most UNCOMMON substance that you have seen someone seek treatment for? has anyone ever been in for like, caffeine addiction?	Here I would say, fake weed or synthetic thc. We don't treat caffeine addiction.
Great subject for AMA, I have 4 friends who became addicts so the issue means a lot to me. I have 2 questions for you. 1Do you think that all addicts, if they had the strength of will, could be sober on their own? (This is excluding those who could die from withdrawals without medication)	I think someone could, but part of it is sometimes excepting you need help. For a lot of people they have to be strong, take care of others etc and have a hard time accepting they need help or have a problem. I find that people do better when they have others to help them by telling their stories, talking to them about skills to help them along their path etc.
Do you ever see addicts on drugs in rehab? If so how do they and you react?	Yes, I have seen it before sadly. Our guys are searched upon arrival but there are rare instance were drugs were missed and sneaked in. They deny it of course even when we catch them with drug screens. We let their counselors talk to them about these things, but if my guys start acting like they're on something and I have reason to think they are doing something shady I look further at how they look and are acting, ask a tech to search their room and or their person.
I heard that cocaine addicts tend to be the most charismatic. Is this true?	That's funny. I haven't seen many honestly. I've seen them in my personal life and they are. I'd say meth.
Sorry if this was asked before, but what areas of nursing did you work in before, and what about substance abuse nursing do you like better than the other areas you have experience in?	I used to work in Neurology before this. I like the fact that I'm seeing people make an effort to change their lives, I like that we can be here for them during that process where others may have abandoned them. I like getting to know my patients and see them daily and learn from them as well. Before nursing though I did hospitality stuff, cake decorating, and some retail while in school.
I used to live with my father, but now live with my mother because of his addictions. He is addicted to xanax and suboxone, primarily. He recently had a knee surgery, and is now on oxycontin. He is absolutely in denial about his problem. I miss the old him. How should I go about getting him help?	You can talk to an interventionist because sometimes they can help you and your family show him he needs help. You can be supportive and get help for you through alanon. It's hard I know. I had to move out at one point while in school because I couldn't take my mom using. I wish I had done more for me during her addiction.
Is it true that some drugs cause such severe withdrawal that it should only be attempted with the help of a medical professional?	Not that I'm aware of, but once you start some drugs its hard to stop and then its hard to quit.
	Yes, I'm sorry I miss read earlier. If some people are on things like, lets say, alcohol at such high amounts for long periods then detoxing alone can be life threatening. Seizures can occur etc.
Roughly what percentage of patients actually stopped substance abuse after going through rehab?	I wish I had a percentage for you, but I don't. Even if we tried to get statistics people will lie and say they're sober when they aren't.
You don't really know what the hell you're talking about do you?	I think I miss read the original text for some reason I though the person was saying the drug itself should only be attempted once in the presence of a medical professional. I was checking this on my work computer and I guess I glanced at it too fast.
Thanks for taking your time to talk to me :)	No problem.
Pretty tough number to nail down. You would have to track people for a long time too.	Indeed. There are people sober for 30 years who relapse.
Have you ever had someone addicted to Codeine or Cough Syrup? Bit of a stupid question but i was just curious Thanks :)	Hey, It's not a stupid question at all. I have not, but I have seen people abuse it. There are plenty of people who abuse it, I just haven't seen one where I work. I've seen people dip cigarettes in it or blunts.
I would love to do that and am starting nursing school soon. Have you personally seen any patients die from withdrawal? (ie alcohol)	Aww awesome. Once you're in nursing school and you start doing clinicals you will find what you like and what you don't like. No, I have not seen this, but people have come close before getting help.
Have you ever done drugs?	Yes. I have. Thankfully I was able to put them down without having a real issue.
Have you seen anyone having serious brain damage from long-term use of substance? I'm asking this because I suspect a friend being in this sort of trouble and it's making me extremely sad as I pretty much feel like he will never be the same again. He's horribly paranoid, angry and delusional even though he's not in active addiction anymore. All he does is smoke weed. Also, he has extreme memory loss issues, which I suspect it's because of long term use of benzos. As a background, he's been abusing pain medication (oxy) and whatever he would get his hands on for over 15 years. He's always been weird, but lately it has become impossible to have a normal conversation with him... could it be permanent damage to the brain because of all the shit he's been taking over the years?	I haven't seen anything serious, but it can happen. Each time you do drugs, depending on the drug, the effects get worse. For instance you can become paranoid or develop psych issues. There are such conditions called drug induced psychosis. He should be evaluated by a MD though to be sure and be honest about his drug use.
did that have any part in your career choice?	Of course. In addition to that my mom was an addict and some of my ex boyfriends growing up. I've seen a lot of devastation and death with this.Substances in general amaze me at what they do to us, how they make us feel and how they can have a hold over us.
Do you ever get parents bringing in their kids who are clearly not addicts but were maybe caught with say coke or MDMA? Do you try to tell the parents that the kids do not need rehab?	Of course we get that, but as a nurse that's not my place to say, that's more for the counselors and the people doing admissions. At time of assessment they talk to them and the family about what's the best level of care for them.
A bunch of my good friends became coke heads. how do i get them to stop?	They have to want to stop. Talk to them about it. Really nothing is going to matter unless they want it.
Do you see many "functional" substance abusers? Professionals who are very adept at keeping their secret?	Yes. I've heard of doctors who put in ports on their bodies to be able to shoot up without anyone seeing track marks. Very successful people, by most standards that is, who pull it off but are falling apart in their home lives.
Whats the prefered drug/method to sedate someone who is losing their shit?	From detoxing?
Yeah i really don't think they want to.	You can't really stop someone if they don't want to. Even if they were court ordered if they don't want it then it wont' happen.
Yep - Im guessing benzos for alcohol and methadone for opioids but wondered what others.	Actually for opiates its Subutex or Suboxone now. Methadone is used in outpatient clinics in some cities, but Mds are moving more towards Subutex or Suboxone. For Benzos and ETOH it is Valium usually. Other detox medications for signs and symptoms are catapres and vistaril .
So you work in a methadone clinic?	No. I work in an inpatient rehab that offers residential 30 days and long term care.
Ive heard the side effects of Subutex are wild (heard about a guy who had all the hair falling out of his legs).	From what?
From taking the Subutex. That being said, its supposed to be magic for getting rid of "dope sick"	I've never seen or heard of that happen to anyone, doesn't mean it didn't though. It is not magic, but it does help. the key is to taper off of it and not to stay on it so you're not replacing one drug with another. It really can make a difference in making detox more comfortable.
What are some household remedies to treat someone going through withdrawals? Or would you just recommend letting them go through them on their own?	If its for opiates then I would use as needed stuff, ibuprofen and tylenol for pain, immodium and tums for stomach issues etc.
What is the age of the youngest patient(s) you've had? I'm curious because I'm still in high school but almost all of my old friends are either in, or have been to rehab. Luckily for me, I straitened out and got new friends after I saw too many people turn into zombies from popping pills.	We don't allow younger than that, but there are places specifically for adolescents.
Working in addiction care in Rotterdam (the Netherlands) here. Where is it that you work?	Southern United States. Nice. How is it there ?
Different substances for example. We don't really see any crystal meth or prescribe medication dependance for example. Except for the ol' benzo addiction of course. Most of the time it's crack cocaine and alcohol. Heroïne too but shooting up isn't too 'popular'.	Interesting. Meth is a big issue and something I've been doing a lot of reading on lately. Prescription drug abuse is huge here.
There are also many government funded projects and in some cases they pay (part of) the treatment. I imagine our work is very different in many ways, but quite similar in some. Human nature and all that. ;)	I wish we had more funding government wise that is.

Last updated: 2012-10-21 03:33 UTC
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what percentage of recovering addicts relapse video

When asking what percentage of addicts stay clean, it is also important to know about some of the long-term statistics that are out there on the subject. When it comes to long-term results: • In people who have achieved at least a year of sobriety, less than 50 percent will relapse. Also according to the same study, if you get the five-year sobriety mark, your chances of relapsing are less than 15%. The general theory is that the longer you abstain from alcohol, the better your chances of success and the chances of relapsing after a long period of abstinence are very low. According to a study published in 2000, relapse rates for addiction in the first year after stopping are between 40 and 60 percent; similar to other chronic diseases such as asthma, hypertension, and type 2 diabetes mellitus. Still, about 25 percent of them will relapse even after 15 years of clean time. Recovery Relapse Rates. The numbers vary when it comes to what percentage of addicts recover, with studies usually reporting anywhere from 30 to 50 percent. According to the study, between 40 and 60 percent on newly recovering addicts will have a relapse in the first 12 months of their recovery. Why Are the Odds of Staying Sober After Rehab So Low? The relapse rate for substance use disorders is estimated to be between 40% and 60%. This rate is similar to rates of relapse for other chronic diseases such as hypertension or asthma. 19 Addiction is considered a highly treatable disease, and recovery is attainable. Relapse is not a failure but instead a common — and very frustrating — part of recovery from addiction. The truth is that many recovering addicts have one or more relapses: Up to 60% of patients who receive substance abuse treatment will relapse within one year, according to the Journal of the American Medical Association — and the relapse rate is even higher for some drugs, like heroin. Drug Addiction Recovery Statistics in Relapse Rates. Believe it or not, many people fail to remain sober after rehab. In most cases, they haven’t reached out for the proper support before falling for triggers. In fact, 85 percent of individuals relapse within a year of treatment, according to the National Institute on Drug Abuse. Recent drug relapse statistics show that more than 85% of individuals relapse and return to drug use within the year following treatment. Researchers estimate that more than 2/3 of individuals in recovery relapse within weeks to months of beginning addiction treatment 6. Why are these drug relapse statistics so discouraging? Gloomy Addiction Relapse Statistics Drug and alcohol rehab statistics show that the percentage of people who will relapse after a period recovery ranges from 50% to 90%. This is a frightening statistic and it is often used as justification for those who wish to carry on with their addiction. What these figures hide is that...

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Having a Relapse? (Relapse Prevention, Recovery and How to ...

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Alcohol Relapse Rates and Statistics

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Addiction is just... absolute insanity.