The weather’s nice, my girlfriend is amazing, I officially work for myself, and I’m pretty broke. I can honestly say that I’m not depressed. Dare I say I am happy? I truly am. For once, I am actually embracing my happiness instead of waiting for something to come along and ruin it. Being happy used to make me paranoid as hell. It felt as though it wasn’t supposed to happen to me. I had been miserable for so long, that I forgot what it felt like to be happy! It was weird to me, and I used to be quite comfortable in my unhappiness. Lots of people dig their graves, and sit in them without ever dying. It’s time to climb on out!
I haven’t been to my addiction therapist in two weeks now. My birthday was on the same day as my appointment, and I wanted to go out with some friends, so I it switched to Wednesday, the day after. Needless to say, I did not have the energy to get up and goto the appointment. It was at 1 PM, the time I usually get up around. Working for yourself has its perks, like getting up when you want. Anyway, he called, and I failed to return the call until yesterday, two weeks later. My therapist probably thinks that I’ve had a relapse. Quite the contrary! I’m still very much C&S! I’m still waiting on a phone call back from him to set up my next appointment. The thing is, I don’t feel like it is helping all that much. I suppose just going for the sake of going imprints something positive in my mind. It reminds me of what I have invested in sobriety.
I also haven’t had a cigarette in about a month. I’m using the Step 3 nicotine patch, which has 7 mg of nicotine in it. It’s a 24-hour patch; however, I take it off before I goto bed. If the patch is as reliable as the pharmaceutical companies claim it is, I only get about 4.67 mg of nicotine a day, the equivalent of smoking five light cigarettes a day. That’s hardly any nicotine at all. The problem with weaning off of cigarettes using cigarettes (i.e. reducing the number of cigarettes you smoke every week) is that anytime a cigarette is smoked the level of nicotine in the body is spiked, resulting in the “nicotine rush.” When using the patch, there is never a spike in nicotine. The nicotine levels in the body remain fairly stable throughout the 16-hour period I wear it, which is just enough to take the edge off. Smoking cigarettes to quit smoking cigarettes makes absolutely no sense at all. The brain is still used to getting a rush of nicotine, whereas my brain is now used to a much lower, and stable level of nicotine. It seems as though withdrawal would be just as difficult even if the number of cigarettes smoked were reduced to five before making the jump.
The first week I got on the patch, I was a monster. My girlfriend hated me. I hated me. The world was not a fun place for me during that week. When I moved down to the Step 3 patch, I noticed I was a little more irritable and restless. The worst part about the jump from the 14 mg patch to the 7 mg patch is insomnia. The resultant insomnia isn’t horrible, but I do wake up a few times throughout the night. If I kept the patch on for 24 hours, I’m sure my insomnia would be lessened, but I really just want to deal with this, and make my withdrawal as mild as possible when I make the final jump.
The nicotine patch reminds me of Suboxone. The gross practices of doctors really makes me wonder what the motives are for pharmaceutical companies. Doctors don’t really undergo extensive training so they can prescribe Suboxone. The education required on addiction and Suboxone is fairly minimal. As a result, there are doctors giving out 16 mg of buprenorphine to patients with a 100 mg / day Vicodin addiction. In my opinion, this should be sufficient for a doctor to have his/her license taken away. It’s dangerous, and wrong. It’s malpractice.
Suboxone is a wonderful treatment for opioid dependency, when used correctly. It should be used to soften the fall, and help extinguish old habits. Perhaps for some, a six month stay on Suboxone is necessary. For the overwhelming majority, a 21-day detox plan should be enough, coupled with some sort of outpatient program. I think that is problem number two. A lot of patients only goto a Suboxone doctor, and have no additional support. Only going to a doctor for Suboxone is completely counterproductive to recovery. It should be mandatory that the patient attend groups and/or see an addiction specialist.
Merely taking a drug is not enough. The behaviors of an addict need to be changed. Like a criminal, cigarette smoker, a compulsive eater, an opioid addict needs to be rehabilitated. After months or years of opioid abuse, habits are entrenched within the addict. Habits are not going to change just by switching to a different opioid. A recovering addict needs coping strategies and plans to get through difficult situations, and to stay sober. Someone who hasn’t been using for that long, or only uses a small amount might benefit more from a short detox, ranging from one week to three weeks. On the other hand, someone who has been using opioids for 20 years might need to stay on it for a year or so. Some doctors believe some patients will have to stay on either buprenorphine or methadone indefinately. Without the proper foundation/backbone/support for recovery, he/she will end up at square one, or dead.