These guys are all forces in the recovery community but together WOW, you can expect lots of inspiration, differences of opinions and thanks to Bobble every topic will be explained so that everyone will understand completely.
December 1st RECOVERYRADIO.FM went live out of Palm Beach, Florida. Three huge names in recovery are hosting the show, RJ Vied, James Sweasy and Bobble. These guys are all forces in the recovery community but together WOW, you can expect lots of inspiration, differences of opinions and thanks to Bobble every topic will be explained so that everyone will understand completely.
The show runs for three hours every Tuesday and Thursday from 9 pm to 11 pm on
96.1FM for Pompano to West Palm / 97.5FM for West Palm to Jupiter/ 1340AM for all of West Palm County. You can also watch the show live on RECOVERYRADIO.FM OR on Facebook at www.facebook.com/recoveryradio.fm
If you aren’t familiar with these guys, let me tell you a little about them from my perspective.
RJ Vied is a Recovery Advocate who is a talented writer, speaker and all around genuine guy. I guess you could say he is the eye candy of the show…at least that’s what all the ladies are saying but don’t take my word for it, check him out yourself. You can follow RJ Vied on Facebook at www.facebook.com/rjvied. Don’t think that means he is just pretty to look at, this guy has a genuine passion for reaching the addict still suffering and supporting those in recovery. RJ Vied is a triple threat, intelligent, talented and honorable. The eye candy part is just a bonus.
James Sweasy is one of those magnetic guys that when they talk you just know you need to listen. Sweasy is from my hometown Louisville, KY and his no-nonsense approach to recovery has made him one of the most followed Public Persona’s in Recovery, and he is just getting started. Sweasy’s fans are die hard and with Sweasy’s creative video angles and call it like it is approach this guy going to be HUGE…ok he already is huge so how about Enormous. Relatable is Sweasy’s middle name. If you aren’t a Sweasy Fan, you need to hope on over to www.facebook.com/jamessweasy and learn you a thing or two. That’s what us Kentuckiana’s like to say.
Last but not least is Bobble. Bobble is a musician that is rocking the recovery world with his relatable rhythms and hip hop recovery music. I don’t know a bunch about Bobbleother than thank goodness for him being on this show. Sure enough, when I am scratching my head about some odd term, idea or recovery approach Bobble is quick to say, HUH? Please explain that so we all can understand it. You can follow Bobble at www.facebook.com/bobblemuzikRAW
After my rehab stay I moved back home. My mom was very skeptical of me living in the house because my teenage years were a disaster. I assured her that no matter what, I will not use, steal or lie to her. She slowly began to trust me again, which I never thought possible.
Today’s guest blogger, Benny Emerling, got sober at 19. It’s valuable for parents and professionals to have this perspective in mind when working with young people. MWM
As a young kid, I always felt like everyone around me was given a golden textbook on life. Mine must have gotten lost in the mail. I was different, but not an outcast, in fact. quite the opposite. I had many friends, a loving family and a decently smart head on my shoulders. However, my idea of fun was different from most of my peers. Misbehaving, stealing and bullying were some of my favorite activities. I was always a happy jokester and had a smile on my face the majority of the time.
Having three older sisters and a younger brother, it was easy to slip through the cracks and get away with murder. In middle school, my behavior got worse and worse. I grew up in a primarily Jewish area, so when I was in seventh grade every weekend we had a bar or bat mitzvah party to go to. Virtually, every weekend there was a different elaborate party to go to. After a couple, I noticed the adults at the parties drinking. Curiosity grew inside me, it looked awesome. It was not long before I tried drinking.
I was 13, one of my friends at the time made me a delicious alcoholic beverage. By delicious, I mean repulsive, it was a combination of anything he could grab off the adult tables. This included wine, beer, a shot and a mixed drink. It was the most disgusting beverage I had ever had but at the same time the best. I felt the buzz of alcohol for the first time in my life and I was instantly ready for more.
Drinking at these parties became the norm for me and a couple of friends. Weirdly enough, none of us ever got caught. Then the summer hit, growing up every year I went to sleep away camp in Northern Michigan. And this year at summer camp was monumental, one of my cabin mates brought weed to camp with him and I smoke it for the first time. Drinking was a blast, but weed was a different type of fun. I finally found the missing piece to my life, and it was drugs. After my first experience getting high, I never wanted to be sober.
I became a huge pothead by ninth grade. I had drug hookups because my sister was older, and I was friends with kids who sold pot, among other drugs. Smoking weed became an everyday habit before school, at lunch, sometimes between classes, and always after school. Weed took over my life. I quit all after school activities I once did because it got in the way of me smoking weed.
Smoking weed is an expensive habit, so how could I afford it? I stole, manipulated, worked little jobs and sold drugs.
My first job was at an elite men’s fashion store that sold thousand dollar suits and top of the line shoes. I couldn’t stop smoke weed and I dabbled a little with taking prescription pills. I didn’t want to get fired, especially because of speculation about me being high at work was on the rise. I came up with what I thought was a brilliant lie: I told my boss who knew my stepmom that I was allergic to wool and that was why my eyes were constantly bloodshot.
I didn’t last long at this job, to say the least. I picked up a caddying job that summer, but no money compared to selling pills. So after a couple of months I made my money exclusively selling prescription pills and little amounts of weed. My supplier? My family. Members of family were prescribed prescription pills for medical reasons. I looked at these pills as dollar signs. My family gained suspicion. They knew I didn’t have a job, but they also knew I had a lot of money. Oh yeah, and all of the pills in the house were missing.
It didn’t take long for my parents to catch me red-handed. I was forced to take my first drug test, which I failed miserably.
It was then my parents started looking up local rehabilitation centers. When I was 16, I was put into my first outpatient treatment center. I was told I had to stay sober and there would be drug tests once a week. I tried to stay clean for about a month and decided it wasn’t for me.
My high school career could be summed up pretty easily, I got high and partied, then ended up in outpatient treatment. Maintained decent grades and did what I wanted, when I wanted—I thought it was the greatest time of my life. However, I knew the best years were still to come…college.
I chose to go to the biggest party college I got accepted to. The first couple of weeks were exactly how I wanted them to be. Huge parties every day, drugs whenever I wanted, and unlimited freedom to do whatever I wanted, without any consequences.Or so I thought…
The fun lasted about two months then I hit what most people would consider a bottom. I didn’t sleep, eat, go to class, and barely left my dorm room for five consecutive days. I ended up going insane from all of the Adderall I took, and it wasn’t long before I overdosed and ended up in the psych-ward.
By this time I hadn’t talked to my families in over a month, and everyone assumed I was either dead or in jail. My close friends stopped calling me because I betrayed all of them in one way or another and I was basically alone, miserable and physically and mentally broken.
I remember the exact moment when I realized I needed help and that I needed to get sober.
I was sitting in the psych-ward, I hadn’t slept for two days straight, and then I looked in the mirror. I was 40 pounds underweight, my eyes were sunk into my face and my body was bruised up from trying escape the hospital. At that very moment, I made the decision to get sober.
What’s It Like Now?
This was over six years ago. I was 19 when I admitted myself into treatment. I thought my rehab stay was only going to be three months, but I ended up needing a nine month stay. Rehab was great because I learned how to be a human again. I learned how to maintain relationships, grocery shop and take care of myself. I was taken to AA meetings and I actually learned from them and received hope from them.
I finally started feeling good for the first time in over six years.
After my rehab stay I moved back home. My mom was very skeptical of me living in the house because my teenage years were a disaster. I assured her that no matter what, I will not use, steal or lie to her. She slowly began to trust me again, which I never thought possible. I started paying back the people I owed money to, and I kept up with AA meetings. It didn’t take long before I found a friend group, all young, sober adults.
I realized the more meetings I went to, the more I hung out with my sober friends and the more time I spent helping others, the less I obsessed about myself or getting high. It was an incredible realization, for over five years, every waking moment I thought about my next fix and how I was going to achieve it. But after I came to terms with the fact that I will never be able to use like a normal person, my life was shot into what I call the fourth-dimension.
I got sober when I was 19, I am currently 25 years-old and couldn’t be in a better place.
The disease of addiction took me to the darkest world imaginable, but at the same time blessed me with an amazing one at the same time. Suffering from addiction has made me a better person. I wake up every day knowing that as long as I stay sober, I can accomplish anything.
Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.
We’re all talking about how nonaddicts stigmatize those of us with the disease of addiction, but more concerning to me is the way we, who suffer from the same disease, stigmatize and judge each other for traveling a different road to recovery. How did we get so righteous and indignant?
Why are we not overjoyed when a desperate sick and suffering human being stops using dirty needles, stealing from their kid’s piggy banks, or any other insane act in order to get money to get high just one more time. How can we possibly say we’re in recovery working the program, but in the same breath tell another addict they’re not really clean because they’re on Suboxone, Methadone or whatever maintenance drug they need to not do the low down, grimy shit they were doing the day before to try and recapture that 1st high.
Where is the empathy and compassion people need at this fragile time in their life? People in N.A., which I love because that’s where I learned there was a way out of that madness, say I’m not in recovery and can’t take on a commitment if I’m on MAT’s, or chair a meeting. Bill W. said some place in a letter before he died I think, and this is not a quote, but his hopes were for A.A. to evolve alongside modern medicine and science. I’m clean and in recovery and I take Suboxone and I’m fuckin proud of it.
I used to be one of those rigid nazi’s for many years who thought abstinence is the ONLY way, but God decided to show me where I was mistaken. There are people that have double digit years of abstinence and that’s all it is. They wouldn’t know a step if they tripped over it. They’re miserable and hateful, but like to tell me I’m not in recovery or can’t be part of their elite club because I take a prescribed medicine from my Dr. So be it. Say what you will. I know what I am!
I have a sponsor in A.A. an oldtimer, historian who has taken me through the 12 steps and no one nowhere is going to tell me I’m not really clean! So if you’re not robbing your mother and collapsing every vein in your body for one more shot of pure, uncut misery, Congratulations! Welcome to recovery! Don’t let anyone tell you you’re not really clean or you have to do it their way. You just keep rockin it any way you can, and I pray you find your path to never ending recovery. For now, just don’t use for 1 day, and try to be a little better person than you were yesterday. I promise you will find your way to a life second to none.
Hello, you don’t know me but I am an addict. I am one of the “junkies” you love to bash whenever someone mentions addiction on Social Media or hear it in conversation. I know it’s hard to forgive the things we sometimes do because of our addiction but I have a question for you.
WHAT IS THE WORST THING YOU HAVE EVER DONE?
Obviously, I won’t get an answer to this question but think about it. The thing that you hate that you did. You know, that one thing that not too many people even know about. Well, what if everyone knew about it. What if for the rest of your life you were labeled by that one act that you would erase in a second if you had the chance?
That is what being an addict is like, kind of. Now I don’t feel like being an addict is the worst thing a person can be or do. You, however, feel like it’s a terrible thing. Don’t get me wrong, if I could erase it from my life I would. In an instant, it would be gone, but I don’t have that option. I can’t even do what you do and pretend that this thing I did, didn’t happen. In order for me to ensure it never happens again I have to work hard on making sure it doesn’t. If I don’t my disease will tell me I can have a drink or do a line and not fall back into full-blown addiction, but I will.
DO YOU WORK HARD TO MAKE SURE YOUR WORST THING NEVER HAPPENS AGAIN?
Let me guess, you are thinking, addiction is not a disease…it’s a choice, right?
Yes, all addiction starts with a choice.
The same damn choice you made when you were young and hanging out with friends.
You drank the same beer I drank.
The same pot I smoked.
You even tried the same line of white stuff someone put in front of you at a party.
You were able to walk away and not take it to the extreme.
Since I have the disease, I will spend the rest of my life either struggling to stay high or fighting to stay clean.
As children, we don’t decide we would rather be an addict instead of a cop.
You don’t see children pretending that their dolls and stuffed animals are dope sick.
When is the last time you talked to a little girl that told you she couldn’t wait to grow up so she could turn tricks to feed the insatiable hunger of her drug addiction?
My best friend didn’t tell me about exciting plans to become homeless.
My Dad, not one time, told my Mother to think twice before marrying him because he had high hopes of becoming an angry drunk.
My sister in law didn’t blow out her candles as a child wishing for an S.U.D. ( Substance Use Disorder ) because she couldn’t wait for the day her children were taken into foster care.
Nobody WANTS to have Substance Use Disorder.
Some of us just do.
So always remember –
YOU MADE THOSE
SAME CHOICES TOO
YOU JUST GOT LUCKY
IT WAS ME
AND NOT YOU.
If you still have doubts you can take those up with the Center for Disease Control ( CDC ) or the United States Surgeon General. Since they have classified addiction as a disease, but then again I am sure you know more about it than they do, right
So to you, I pray that you don’t have to reevaluate these opinions because you find out your child or parent is an addict. If you do, just know that we will accept you into our community. We will help your loved one. Do you know why we would do that? Because we are good people that just want the chance to live like everyone else.
So please, before you post another post bashing people who are suffering think about it. Not only are you hurting the people who, have the disease, you could be hurting everyone that loves them. You have people on your friend’s lists or that overhear you at work who have children who are suffering right this moment from addiction. What did they do to deserve the awful things you put out into the universe, that does nothing but perpetuate hate and judgment?
You have a right to your opinion, but no matter what, hurting people is wrong.
This is the best information I can find about tapering off of Suboxone. Please if you have tapered from Suboxone and had success send us a message so we can share your story. When I came off of Suboxone I didn’t taper. I went to a three-day medical detox where they gave me a cocktail of nonnarcotic meds to help with the withdrawal from the Suboxone and 20 years of Xanax ( benzo ) use. The withdrawal was very tough and lasted for months. I was successful though and you can be too.
Summary: The purpose of a taper (instead of just stopping) is to gradually reduce tolerance, thus distributing withdrawal symptoms over a longer period of time minimizing the discomfort experienced on any single day.
Ending the taper at the manufacturer’s lowest available dose (2mgs for Suboxone Film® and generics or 1.4mgs for Zubsolv®) can still result in significant withdrawal.1,6 Here we lay out the rationale for tapering to much lower doses. As the data will show 2mgs/day is closer to the midpoint of a typical taper than it is to the end.
General rule: Pace the taper with the body’s ability to adapt to each decrease. Dose decreases of 25% separated by at least 10 days has been reported to be tolerable by many.1
The whole point of buprenorphine treatment is to suppress cravings and withdrawal so that you can make big changes in behavior, routine, living situation and thinking. It’s these changes which, in effect, rewire the brain and reverse some of the craving-causing brain adaptations. If this is not done first the taper will likely be shortly followed by relapse.
Have you made significant changes in behavior and had a period of time to gain experience with those behaviors? Have you been able to deal with stress, anxiety, and depression without craving drugs? This takes time and doesn’t happen on its own, it is a deliberate effort. If you have been in stable treatment less than six months, tapering is NOT advised.
Buprenorphine is NOT a detox medication, it is a treatment medication. If you are not clear on this distinction go to the treatment page and understand it before tapering. But assuming you are ready to taper there are some things to consider.
Tapering to very low doses minimizes withdrawal
Before we continue, it should be noted that the following is a detailed explanation for those interested in the nuances of tapering and not necessary to conduct a taper. It does however, help make sense of why certain protocols are likely to be more effective than others.
Cut pieces of film
Fig. 1. Suboxone Film can be cut into small pieces. Accuracy is not that important when cutting the dose. Blood levels will average out over a few days. Also, it is not a certainty that the medication is evenly distributed throughout the film or tablet, so super-precision in cutting isn’t warranted.
To understand the tapering process there are a few concepts you should understand:
The Ceiling Effect of Buprenorphine:
In short, at a certain dose of buprenorphine, nearly all available opioid receptors become occupied with buprenorphine.3 Each helps induce a small opioid effect.4 The cumulative effect created from all receptors is the maximum effect or the ceiling effect.4 The minimum dose to reach this point is the ceiling dose. Taking more than the ceiling dose involves so few additional opioid receptors that patients are unable to detect any additional opioid effect.4 Whether the patient’s dose is at, near or above the ceiling dose, they experience virtually the same opioid effect. For this reason, tapering can be more aggressive (per mg.) at higher doses than at lower doses when more receptors are affected by dose decreases.2
Fig. 2. PET scan showing available opiate receptors at various doses.
Fig 2 is a PET scan showing the amount of available opioid receptors at various doses.3 From this evidence it is clear that, for this particular patient, at some dose above 2 mgs. and below 16 mgs. the ceiling dose is reached, as the amount of available receptors have diminished to insignificant levels.3 If we extrapolate this admittedly very limited dataset and apply a curve shape common in biology, we can estimate approximate receptor involvement at various doses. Fig 2a illustrates this concept. It should be noted that there is great variability in reality and liberties have been taken with this particular graph, but it is meant to illustrate the point that the amount of receptors involved is not a linear relationship with dose. Therefore cutting the dose in half from 32mgs to 16mgs doesn’t mean that half as many receptors are affected, in fact due to the ceiling effect there would be no discernible difference.
involved receptor graph
Fig 2a. Approximate amount of buprenorphine-occupied mu receptors/dose
If a taper should follow a steady and gradual decrease of involved opioid receptors, then 2mgs would be about the midpoint of the taper. In one of the few taper studies, both long and short tapers ending at 2mgs resulted in very low success rates.6 The researchers concluded: “For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper”. They apparently gave no consideration to the possibility that maybe 2mgs is too high of dose to stop at. We will show it is and suggest their conclusion is wrong in that extending the taper well below 2mgs for a much longer period of time is beneficial.
Buprenorphine doesn’t completely metabolize between doses. It typically takes between 24-42 hours to metabolize half of it, but could range as much as 20-70 hours.9,10,11 We use 37 hours as an average in our calculations, but be aware of the range if your results don’t meet expectations. Therefore, after the first 37 hours, only about ½ of the buprenorphine has been metabolized, while half remains to continue to elicit an effect. After another 37 hours half of that remains and so on. At typical maintenance doses, previous doses can contribute to the overall blood levels for 5-12 days (depending on actual metabolic elimination rate). At very low doses, by day three the amount of buprenorphine still un-metabolized is so small its effects are negligible.
Although this graph starts at 16mgs., the curve would be the same for any dose.
Buprenorphine Blood Level Buildup, Stabilization
As patients take subsequent doses of buprenorphine before the prior dose has completely metabolized, a buildup occurs in blood levels. (Fig 3) The buildup continues for approximately 5-12 days at which time the dose taken 5-12 days prior has nearly fully metabolized. This is the stabilization period. When dose is decreased the effects of this build up should be considered before the effects of the new lower dose can be evaluated.
11 day half-life graph
Fig. 3. Blood levels build up until stabilization
Putting It All Together
We now know that doses at or above the ceiling dose can be decreased more aggressively than lower doses. We know that 2mgs/day is not the end of the taper but closer to the midpoint. We know that due to the half-life, buprenorphine builds up in the blood and may still produce effects 5-12 days later, particularly at higher doses. Armed with these considerations we can construct a taper plan which will minimize discomfort.
Buprenorphine Taper Plan
By coupling what we learned above with anecdotal taper testament found online, we can estimate that dose decreases of 25% with 10 days between drops should be tolerable.1 Furthermore, if our initial dose is at, near, or above our estimated ceiling dose we can taper more aggressive initially, maybe as much as 50% drops. As we approach 2mgs and below, we should expect more noticeable differences between each dose decrease and may need to slow down the pace. Once at a very low dose (less than 0.5mgs) we can speed up the pace once again as the buprenorphine is metabolized down to insignificant levels in just a few days.
Emergency Buprenorphine Taper
If you find yourself in a situation where you must taper off immediately for some reason and don’t have the time or enough buprenorphine for a planned taper, you can try an emergency taper. With the emergency taper you stop all buprenorphine until the onset of withdrawal. At that time you take small doses (<= 1mg) every hour until withdrawal is tolerable. Then, take buprenorphine only when symptoms become intolerable and only enough to stop the withdrawal. Although this method minimizes withdrawal intensity for a given amount of available buprenorphine, there could still be considerable withdrawal depending on tolerance and the amount of buprenorphine available.
Which brand of buprenorphine to use
As of early 2016 there are 3 name brand and at least 5 generic buprenorphine products to choose from. For ongoing treatment something can be said for the newer brands; with their better bioavailability side effects may be fewer and some dose and copay card combinations make it the least expensive option (including generics). (see cost page) But when tapering, particularly at doses below 2mgs, Suboxone Film (as pictured above) offers the advantage of being larger thus easier to cut into the fractional doses necessary for the taper. Pieces of film left over between doses should be stored in a childproof pharmacy bottle with a silica gel pack to absorb humidity and prevent the opened film from becoming sticky. (see storage section)
When to take your taper dose
Taking your buprenorphine first thing in the morning is best. There is good reason for this. By taking your dose in the morning, buprenorphine blood levels are lowest while you are asleep. Therefore, when the buprenorphine is providing the lowest level of craving and withdrawal suppression you are asleep and aren’t dealing with it. Another reason is, you want to avoid anticipation of taking the dose, because this is the type of brain activity you want to eliminate. Anticipating the dose then receiving the reward of the dose, may be reinforcing the behavioral patterns you have worked so hard to eliminate. By taking it early in the morning, there is no need to think about it for the rest of the day. Exception: If insomnia becomes acute, you may benefit from taking your daily dose at night.
Take your full day’s dose all at once
Don’t split up the day’s taper dose. As mentioned above, taking it early prevents you from thinking about and anticipating your dose. Also, once you finally stop, it is an easier transition from taking something once a day to zero times a day, than it is from taking something 2-4 times a day, to zero times a day. Also, avoid complicated rituals like dissolving the medication in water and metering out portions for the taper. Simply cutting the film or tablet is all you need to do. Exception: Again, if insomnia becomes acute, splitting the dose up by taking some in the morning and some at night might help.
Remember, the taper schedule is not etched in stone. Individuals will respond differently to the same taper schedule. It is meant as a rough guide which must be tailored to match an individual’s body and circumstance. The main concept is to pace taper rate with the individual’s ability to adjust to each decrease. However, it can be helpful to have a guide to loosely follow and to estimate about how long it will take and how much buprenorphine will be required.
Buprenorphine and Pain
Buprenorphine is a painkiller. A return of minor aches and pains is to be expected when you stop taking a painkiller. This is not withdrawal, it’s the pain the painkiller was killing but isn’t killing anymore. Aleve® or some other OTC painkiller might help but only when and if you need it. Hyland’s® Restful legs tablets have also been reported to be effective especially, at night. For sleep, patients have suggested Valerian root and Melatonin. Maintaining good overall nutrition and keeping well hydrated is also important. But maybe the most important thing is to keep busy, preferably away from home. Sitting home waiting for symptoms to appear is a sure way to fail.
Pain is progress
The discomfort you feel while tapering can be thought of as an indication of your tolerance diminishing. The necessary discomfort stimulates the body to produce endorphins. If you can possibly motivate yourself to exercise, even brisk walking, the pain will be less noticeable and you benefit form the exercise. It might also help you sleep better.
Depression and Tapering
Along with being a painkiller, buprenorphine has been recognized as an anti-depressant.7,8 Just as when you stop taking a painkiller, pain comes back, when you stop an anti-depressant, depression may come back too. The severity of the depression could determine the success or failure of the taper. Be prepared to deal with the reemergence of depression, particularly if you suffered from it before starting buprenorphine treatment. This might entail working with a psychiatrist and having antidepressant medication on the ready, before concluding the taper.
Pausing the Taper
If you hit a dose level which produces unacceptable levels of withdrawal discomfort, it is acceptable to go back up in dose, one step, for a few more days. Alternatively, you can hold at that dose for a longer period of time than indicated on the taper schedule. Since everyone’s body and brain is unique, the generic taper schedule may need to be tweaked slightly. Once your body adjusts to the dose level the taper can be resumed.
It’s okay to take a break from the taper if you need to, as long as it is minimal and infrequent. An example would be if you have been at 0.5mgs/ day for a week and still feel withdrawal discomfort, taking up to 1-2mgs one day will remove all withdrawal symptoms for that day and possibly the next, giving you time to refocus, get things done, and prepare for the final leg of the taper. One day at a higher dose will not increase your tolerance, thus reversing your progress, as long as you limit such higher doses to once or twice during the taper. If you can, try and not take any the following day. This may not be that difficult since about half will still be present the next day. Then resume the taper schedule.
Optional Ending Kicker Dose
Once you fill out the form above and create the taper schedule, you’ll notice that on the last day of the taper is a higher dose than recent previous doses. The idea is to take advantage of the half-life property and extend the taper a few days more. The higher dose raises blood levels, without raising tolerance, and as this final dose metabolizes blood levels slowly decrease until reaching zero, thus extending the taper. That’s the theory, but we know of no studies that have looked at this, only doctors who employ this in their taper plans.1 It’s up to you whether or not to include it. Good luck.
Anecdotal evidence compiled from several social media sites over a period of several years
National Alliance of Advocates for Buprenorphine Treatment- http://www.NAABT.org
PET scans- mu receptors- Effects of Buprenorphine Maintenance Dose on mu-Opioid Receptor Availability, Plasma Concentrations, and Antagonist Blockade in Heroin-Dependent Volunteers – 2003 – http://www.nature.com
TIP-40, buprenorphine treatment clinical guidance – government document 2004
Results produced by the NAABT.org taper engine (beta)
Buprenorphine tapering schedule and illicit opioid use- Clinicaltrials.gov, Identifier: NCT00078117 -Ling – study
Buprenorphine treatment of refractory depression, Bodkin [study]
The Buprenorphine Effect on Depression, Richard Gracer, MD [article PDF]
Zubsolv full prescribing information submitted to the FDA – Zubsolv PI
Bunavail full prescribing information submitted to the FDA – Bunavail PI
Suboxone Film full prescribing information submitted to the FDA – Suboxone Film PI
Brand names for buprenorphine/naloxone (bup/nx) combination products in the US: Suboxone Film, Zubsolv, Bunavail, and generic equivalents of the discontinued Suboxone Sublingual Tablets.
Buprenorphine products in the US WITHOUT the added naloxone safeguard:
Subutex Tablets (discontinued in 2009) but the generic equivalents remain available.
Buprenex® is an injectable, FDA approved for pain NOT addiction – illegal to prescribe for opioid addiction.
Butrans® Patch, also FDA approved for pain and NOT addiction – illegal to prescribe for opioid addiction.
Pharmacy-compounded bup or bup/nx preparations – NOT FDA approved for addiction – illegal to prescribe for opioid addiction.
Probuphine® is an insertable buprenorphine rod which goes under the skin and releases bup over the course of 6 months. It was FDA approved in May of 2016, and is for the treatment of addiction.
Belbuca™ is a buprenorphine film which goes on the inside of the cheak. It was FDA approved in October of 2015, and is for the treatment of pain – NOT FDA approved for addiction – illegal to prescribe for opioid addiction.
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Nothing on this site should be confused for medical advice. The information provided here should only serve to inspire you to find out more from credible sources. We hope to help you understand the disease better so that you know what questions to ask your doctor. Never take any online medical advice over that of a healthcare professional, assume it’s all made up. Despite the links to peer reviewed studies all interpretations of said studies may be opinion, unreliable or erroneous. If some patients found something beneficial to them it’s not an indication that it will be beneficial to you, on the contrary, it may be dangerous. You, not us, are responsible for what you do with the information you get from this site or any site.
Would you like to start a Facebook page for your business or cause? Let me take you step by step through the things I found helpful and those that were a waste of time. If you follow my hints you will have a successful page before you know it.
Let’s get started.
The more you put into your page the more you and others will get out of it.
Choosing a name, obviously, if you are starting a page for your business you need to use that name. If you are starting a page for a cause or just for laughs it helps people find you if your name says what your page is about.
For instance, if I am trying to promote ribbons I would use ribbon in my name with something catchy before or after it. My page is a cause page for awareness of the heroin epidemic. That is why I used Heroin News. We share up to date news articles and even write our own articles on our blog http://www.caringbysharing.net and then I share to my facebook page. It works great.
Be sure to create the address for your page with the same name. That way people can find you easily. You can create the link in the about section of your page. See example below:
Invite all your personal friends to like your new page and encourage them to share your posts. Every time your posts are shared there is a like button attached that people will click and that means more followers.
Join groups of like-minded people if you are a cause. For a business that has a physical address, you want to join groups in the area of your business address.
We post with the hope that it will be shared and seen. People sharing your posts is important. It’s the best way to get your posts in front of as many people as possible. That is why it is extremely important to always check notifications.
You need to be sure to say thank you. It will be tedious work but it will build loyalty to your brand or page. A quick comment under the post on their page simply saying, Thank you for sharing our post. You will be surprised how much it will help your page grow.
Another plus to commenting on shared posts is that every person who sees that post will see your page name and might follow your link to check out your page. I have gotten loads of new followers this way.
Read the comments on your page and respond. People like to feel important and if they are engaging in your page by sharing, commenting and/or liking your posts, they deserve your attention. This will also breed loyalty plus they ARE important.
If someone is being rude you can hide the comment after clicking the down arrow in the top right corner of the post itself. Facebook will then ask you if you wish to ban this person from your page. This is of course up to you and their offense. See example, of rude comment and the tiny arrow in the top right corner of the comment.
Find other pages that have lots of followers and as your page comment, like and share things that work with your specific page. Always comment Shared to __________. You share ethically by hitting the share button on their post. By doing these things the page itself may notice you and check out your page. With any luck, they follow your page and share a post or two. Not to mention anyone that sees the post that you engaged with will see the name of your page and may begin following you as well.
WHETHER YOU LIKE MEMES/POSTERS OR NOT FACEBOOK USERS LOVE THEM. Make your own posters/memes for your page and you will be twenty times more likely to be shared by your followers as well as other pages.
Websites/Apps to create posters/memes http://www.befunky.com http://www.picmokey.com
These can all be used free or paid. It’s all Heroin News and Holy Addiction uses. It’s also fun to experiment.
Facebook has an awesome feature that allows you to schedule your posts so they are spread out. The more you post the larger your chances of being shared, however people will get frustrated if you post twenty things in a roll because it clogs up their timeline. People will unlike your page if this happens.
You can also sit down and in one sitting schedule the posts for a few days or week ahead. You still need to check your page regularly to respond to messages, reply to comments and say thank you when you get a share. The schedule button is inside of the post button. On the right, you will see an arrow click that and you will see the schedule option.
Never make anyone an Admin on your page. Many pages have been stolen because of making this mistake. You can still get help with your page by adding them as an editor. This way they can do everything the owner of the page can but cannot make major changes to the page, like change the name or block you from your own page. Your page will show the name of the person who posted on every post. Those following the page cannot see this, it’s only visible to you or your editors. Keep this in mind so that if needed you can ask them to add their name to any messages they answer or comments on posts. That way your customers or followers will know who they spoke with. An editor has access to your messages on the page as well. There are other roles you can choose. Check them out and decide for yourself.
Celebrate with your followers when your page reaches milestones. When you reach 100 likes on your page post a poster that says Thank you for helping us reach 100 likes, we couldn’t have done it without you. Then make another every hundred after. Once you make it to one thousand start celebrating for every thousand.
When I first started my page I made a bunch of rookie mistakes. This is a list of the most important ones.
1. Memes that other people create are that person’s intellectual property. People spend time, money and thought into making these Meme’s or posters as I like to call them. Don’t make the mistake of downloading other people’s work and posting it to your page. This is why this is important. After you begin making your own memes/posters you will see how much work and love go into them. Those memes/posters are someone’s intellectual property.
a. If it is wrong, don’t do it.
b. If you do it and someone reports you for stealing their intellectual property Facebook can and will shut down your page.
c. The other pages and groups that are putting out memes that fit your page are the people you want to network with, you don’t want to piss them off.
2. Boosting posts is a complete rip-off. Don’t do it!! I wasted way too much money with little to no evidence that it got me any more followers.
3. If you join groups and begin sharing to the groups be cautious because Facebook Jail is very real and they get upset if you post too fast or too much to groups. There are two pages I know of that were made unable to share to groups for 30 days or more.
I hope this article helps. It would have been awesome for me to have had this information when I started. Helping others is a new addiction of mine so I hope this serves you well.
If you have questions about any of this or something else please comment below this article on the website and I will answer your questions. That way others will be able to use that information as well.
All these tips can be used for Twitter too, at least the basic idea. I am just now getting involved in Twitter. I will keep you posted on my progress.
” I had no idea my child was doing heroin, now he’s dead.” said a mother to me last night on the telephone. More and more I am hearing mothers and fathers say that they didn’t have a clue their child was doing heroin until its too late. These families are finding out their children have passed away and oh, it was an apparent heroin overdose. Often the families don’t even believe it’s true until the toxicology reports come back. They had no idea.
What are the signs that your child could have an opioid addiction or that they are experimenting with drugs of any kind?
Physical and health signs of drug abuse
Eyes that are bloodshot or pupils that are smaller or larger than normal.
Frequent nosebleeds could be related to snorted drugs (meth or cocaine).
Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
Seizures without a history of epilepsy.
Deterioration in personal grooming or physical appearance.
Impaired coordination, injuries/accidents/bruises that they won’t or can’t tell you about- they don’t know how they got hurt.
Unusual smells on breath, body, or clothing.
Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.
Behavioral signs of alcohol or drug abuse
Skipping class, declining grades, getting in trouble at school.
Drop in attendance and performance at work–loss of interest in extracurricular activities, hobbies, sports or exercise–decreased motivation.
Complaints from co-workers, supervisors, teachers or classmates.
Missing money, valuables, prescription or prescription drugs, borrowing and stealing money.
Acting isolated, silent, withdrawn, engaging in secretive or suspicious behaviors.
Clashes with family values and beliefs.
Preoccupation with alcohol and drug-related lifestyle in music, clothing, and posters.
Demanding more privacy, locking doors and avoiding eye contact.
Sudden change in relationships, friends, favorite hangouts, and hobbies.
Frequently getting into trouble (arguments, fights, accidents, illegal activities).
Using incense, perfume, air freshener to hide the smell of smoke or drugs.
Using eyedrops to mask bloodshot eyes and dilated pupils.
Psychological warning signs of alcohol or drug abuse
Unexplained, confusing change in personality and/or attitude.
Sudden mood changes, irritability, angry outbursts or laughing at nothing.
Periods of unusual hyperactivity or agitation.
Lack of motivation; inability to focus, appears lethargic or “spaced out.”
Appears fearful, withdrawn, anxious, or paranoid, with no apparent reason.
Now obviously many of these things could mean something other than drug use. The purpose of this list is to just give you something to think about and to watch for. Always remember that you can buy a drug test at most drug stores and even buy a test for just marijuana at stores like the Dollar Tree for just a dollar. These tests are great for teens who hopefully would start small with drugs like Pot.
If you suspect heroin use pay close attention to your spoons, because they use them to cook the heroin before injecting. Spoons missing won’t matter if they are not using by injection yet but it wouldn’t hurt to count the spoons in your silverware drawer.
Please pay close attention to your children and loved ones. You don’t want to find out your loved one had a drug problem the same day that you find that they have overdosed and it’s too late to help.