Opiate Dependence- A Nursing Professional's Personal Account -Part II

The following Interview was recorded and originally aired on AM Radio in the summer of '07, and the audio file can be heard by scrolling to the bottom....

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Please go to TurnToHelp.com. This is an interactive site that is tailored and personalized to help people in all phases of recovery, and also family and friends of those dependent on prescription drugs like OxyContin, Vicodin, Percocet, or street drugs, like heroin.

The website facilitates a fast and easy path from considering whether to seek help, to seeking treatment for dependence on these drugs.

Visitors are welcome to explore useful information on the site, including streaming videos of patient testimonials, a comprehensive resource center, an identifier tool that helps you to discern whether or not you have a dependence problem, and physician locator tools.

Turntohelp.com also offers a free patient resource kit that provides information about opioid dependence, treatment with Suboxone, and questions that you should discuss with your doctor. Lastly, patients and caregivers are encouraged to sign up for the 'Here to Help' program offered on the website, which sends subscribers confidential emails with personalized support at all stages of treatment and recovery.

This is Dr. Michael Schiesser and I have with me today, Jennifer. Tell me about your current approach to maintaining sobriety? What are you doing in order to make sure that you don't slip back into where you were before?

Jennifer: As I said before, my biggest thing was withdrawal. I just felt like I couldn't live without the pills, but I also couldn't function with them. I was lucky that my mother-in-law emailed me an article from the New York Times about this new prescription medicine called, Buprenorphine, the brand name is called Suboxone. Alcoholics take Antabuse; people that are addicted to pain pills take the Suboxone.

It basically fills up the receptors in your brain with a low level of opiates so that you don't have cravings, but it also blocks any effects from other drugs. So if I were to relapse or use again, I wouldn't feel anything.

Schiesser: And do you think the Suboxone, on its own, is sufficient? Are you doing other things in order to keep your eye on the ball?

Jennifer: When I first heard about the Suboxone, I really thought it was a magic pill that would solve all of my problems, but it's definitely not that simple. I think it's about 60% of my recovery and the rest are meetings. It's a really active process. I really have to work at it, in addition to taking the medicine.

Schiesser: And right from the first day that you started Suboxone, was your ability to stay away from prescription pain killers been 100%? Or did you have some struggle in between?

Jennifer: There was definitely some struggle in terms of behavior modification, especially working in the medical field. I was around it, I saw it, and I had to handle it. So it was definitely lots of cognitive behavioral exercises, and having a clear mind.

Suboxone has allowed me to have that clear mind and walk through the steps: "If I do this what will it mean? If I steal what will happen?" It helps me to walk through the steps and make a better decision. It's much easier with the Suboxone.

Schiesser: Were there ever any work consequences for you relating to this? Or did you find your way into recovery independent of any problems that surfaced outwardly?

Jennifer: In the scheme of things, I thank God everyday. I really don't know how I stayed out of jail. I really don't. I was fired from two jobs.

Jennifer: Exactly, I was caught, eventually. I knew I was going to be caught. I was brought into a conference room, and I knew that was it, the gig was up. Luckily, these people loved and cared about me and sent me right to rehab, and that was my first stint.

Then I went back to that job, but in hindsight, that wasn't the right thing to do, being so fresh out of recovery. If you don't change anything, you're not going to be successful. Change your friends, if that was your reason for doing drugs. To stay clean, I needed to do a little work in changing my access to the drugs.

Jennifer: I am. It's so different being on Suboxone versus not being on the Suboxone. It's completely different being around the drugs. I'm not triggered like I was before to the sight of the pill, or having them in my hand. It's completely different.

Schiesser: How do you and your physician view the possibility of tapering off Suboxone at some point in the future, and relying on your self control to maintain sobriety from prescription painkillers?

Jennifer: It makes me a little nervous. Right when I started, I asked him, "When am I going to have to stop this?" because there's always an end in sight. But my physician is great, we deal with this as it comes, if you're ready, we'll do it, and I don't feel ready now. But at some point I would like to be completely drug-free. There's also a big stigma whether or not I'm really clean or not now, because I am taking the Suboxone, so I struggle with that as well.

Schiesser: I've heard that some AA groups have somewhat of a downward look at using Suboxone, or using any prescription drug, as a crutch, and it sounds like you've encountered that to some extent.

Jennifer: Definitely. The first time I was really surprised, it's usually such a supportive environment. Most of the time it is, but I think it's people that aren't educated about what Suboxone is and what it does were caught up [inaudible]. I think some people were jealous too, and then I feel it's like a role to educate: here's what this is about, maybe it can help you. But it is challenging, it's easy to say "I'm not going to meetings," but the key is to keep trying meetings, until you find the one that works for you.

Schiesser: Yeah, and in my own practice, I often emphasize that the goal here is that you are able to live a life consistent with your values, to be able to focus on your relationships and your professional life, and all the other things that are important to you, and that Suboxone is a tool. Even if you feel you may be strong enough most of the time to maintain your focus on your life goals without that tool, it's really there for the times that you may be having trouble and you want to stay out of trouble.

It's almost like saying "I don't expect to get into a car accident on my way home today," but I don't call my auto insurance company and cancel my insurance because I'm feeling confident. I keep it there because sometimes things happen.

Jennifer: Exactly. There's always going to be that bad day where you're not feeling so strong and I think if it covers a period of maintenance, you just have to keep it up no matter what.

Schiesser: Are there downsides to the Suboxone, as far as how it makes you feel? Things that would make a person say, "Hey, gee, I don't want to be on this because it clouds my thinking," or "it makes me feel lethargic," "it bothers my sleep," or anything like that?

Jennifer: Not that I have experienced, the only downside I think is that you can't swallow the pill and be done with it, it has to dissolve under your tongue. So you have a period where you can't talk. If you do that in public, people may think, "Hey, what's going on?"

I think there are lots of questions out there: "is this going to make my patient feel high? What's going to happen?" But I didn't have that. For the first two weeks that I was on Suboxone, it was definitely an adjustment period. My system was picking out the old opiates and the new Buprenorphine. But now I don't get that high feeling. I don't feel anything different than what I normally feel. It doesn't bother my sleep. I feel as close to normal as possible before my addiction to prescription pain medications.

Schiesser: I'm talking to Jennifer today from Colorado, she's a nursing professional, and is formerly dependent on prescription painkillers, and is describing to us today her struggle through that and ultimate recovery. I really appreciate you talking to us today, Jennifer. Do you have any other closing thoughts?

Jennifer: I don't think so; I would just like to thank you for all you do, getting information out there to people, and I really would like to let people know that they can get help and they can have a different life than they have now.

Schiesser: Today's program is sponsored by an unrestricted educational grant from Reckitt Benckiser Pharmaceuticals Inc. Visit turntohelp.com where you can get fast and easy access to physicians who treat opioid dependence.