CLYDE'S STORY: RIDING THE DETOX ROLLERCOASTER
After two years of street-accessed pain relief, Clyde ended up on 4mg of Suboxone daily for 7 years. After 6 months of tapering down and detoxing, he is now off the MATOD program completely!
This is my story about coming off buprenorphine. I’m here to say it can be done, but the road is rocky.
The only person I knew who'd come off maintenance bupe before was my partner James, who jumped off 4mg cold. He spent five days in a detox – the maximum time they allowed – and then came home, where he proceeded to rock back and forth on the couch for 10 days before starting using again. James ended up back on methadone. I thought he was being a drama queen and that he just couldn’t take it, because someone had told me Suboxone was meant to be an easy detox.
I figured it would be easy if I did it the ‘right’ way – the way it was recommended. Slowly. I thought I was different, that I really wanted to do it and that James failed because he lacked proper motivation. Poor James. Now I know what he must have been going through and I wonder how he lasted as long as he did. Truth is, there is no one size fits all, and there is no such thing as an “easy” detox from a Suboxone maintenance program.
The experience was a nightmare for myself and people close to me. The withdrawals were horrible – when things got bad, I would lash out, or find myself in the depths of near-suicidal chemical depression. I was coming down in increments of 0.4mg every two or three weeks, and no decrease was the same as the one before. I had no way of knowing how long or intense the fallout would be each time.
Every time I dropped, the dosing staff shook their heads and asked if I’d really thought about what I’m doing. It's never about how well I'm going or how far I've come, but suspicion and doubt about my motivation. I feel like the staff always assumed there must be something else behind any positive step you take. For example, you're doing it because you're in trouble with the law; because you want to use other drugs; or because you're trying to impress someone. Never because you want to make a positive life change and feel this may be the way to go. Truth be told, the staff were one of the biggest reasons I had for wanting out – I was sick of being judged, underestimated, and treated like a child.
Since I started my Suboxone detox, I’ve talked to three others who tried to come off as well. Two of them ended up back on high doses of methadone, and the other back on Suboxone. Three of us agree that it feels like our ability to cry or have a belly laugh is gone, and none of us were offered support of any kind by the clinics who prescribed and dosed us.
Coming off Suboxone maintenance was unpredictable and bloody hard. I would cry a lot, fly into intense rages, and felt like I'd kill for a decent sleep. Experiencing these horrible withdrawals while being told it’s all in your head is soul destroying. The relief and validation of talking to peers who had been through the same journey was pure magic – we could literally finish each other’s sentences.
James warned me not to use while detoxing, that it would only prolong the inevitable. He said that when he used, he would feel ok for two or three days, but then the withdrawals would come on again, painful and slow. So instead I kept one of my 4mg takeaways for when it got too bad. Only once did I cut a slither off it and have some, when James reminded me it was there and almost begged me to. Although it wasn’t a permanent fix, it felt completely worth it at the time.
Going from 0.8mg to 0.4mg was really painful, so for my last step down to nothing, I ended up switching to 1mg of methadone a day – 0.2mL of syrup. It was enough to ride out my withdrawals comfortably and coming off 1mg of methadone was a walk in the park. I was on that for about a month and then slid off. It was all over. I did something that, a year ago, seemed impossible.
If I could turn back time to when I started Suboxone, I would walk into that first consultation and make a clear plan with my doctor, with detox and exiting the program as the end goal. I wish that I made it clear to my prescriber that substance use isn’t the only issue I have, because I would have benefited from regular counselling, complimentary therapy, and ongoing support. Don’t expect them to make a plan for you, because in my experience they won’t unless you ask. Be prepared and go in with a clear visual of a start, a middle, and end.
At a time when the experts are trialing long-lasting injections of buprenorphine, while telling anybody who asks about withdrawal or long-term effects that “according to the data, it doesn't sound like a problem”, I believe we need to be very cautious. If you’re thinking of starting on bupe maintenance, it’s important to realise you are likely committing to many years or decades. Not weeks. Not months. Maintenance is a long-term treatment.
Suboxone detox is a roller coaster ride with definite ups and downs. For those detoxing or thinking about it, all I can say is this: it will be tough, but it is doable. There are good days and bad days, but eventually, it will all be okay. You just have to look after yourself – make sure you eat well, keep your fluids up, and are able to have some personal space when needed. And remember – the bad days are not forever, they’re just part of the process.