My youngest son is a wrestler – athletically and intellectually. Wrestling didn’t come easy to him, but he simply loved the sport and being part of the school team. At first I would watch his matches with my hands covering my eyes just peeking through my fingers and praying he wouldn’t get hurt. It was a foreign sport to me, but I made it to as many wrestling matches as possible and began tagging Facebook photos with the hashtag #ProudMatMom. He became a better wrestler and I became a more comfortable spectator and supporter of his choice to wrestle.
When he started wrestling in sixth grade in 2011-2012, his older brother (affectionately known in many of my blog posts as #SoberSon), was struggling with addiction and losing the battle. Little did I know that in July 2014 #SoberSon would eventually find his sobriety on a “mat” of his own: Medication Assisted Treatment (MAT)*.
Today, #ProudMATMom has double meaning and I am an avid proponent of MAT as a viable, preferred – and even necessary – treatment for opioid-use disorder.
Finding a Solution
Not unlike his younger brother, #SoberSon got pinned and lost quite a few matches before experiencing a “win” and committing himself to ongoing training. After trying several different treatment approaches, and experiencing relapse, #SoberSon through his own anecdotal research came to the conclusion that he wanted to try Suboxone, a form of Medication-Assisted Treatment. He had some other criteria, too: not 12 step and not in-patient.
That trifecta proved a difficult find. Ironically, the option that we found was one I’d never encountered in the years leading up to this and it was within a few miles of our home. Imagine that! Sometimes the solutions are so close, but we don’t even realize it.
Suboxone (Buprenorphine combined with Naloxone)
Gloria Englund, MA, a recovery coach and author of Living in the Wake of Addiction – Lessons for Courageous Caregiving, defines Suboxone as follows:
Suboxone is a partial agonist because it doesn’t bind to the opioid sites as does a full agonist so it produces much fewer endorphins. Because of its “partial” nature, it is much easier to withdraw from than a full agonist like methadone. Suboxone is the commercial name for buprenorphine (partial agonist) combined with naloxone, an opioid antagonist which is very effective at blocking euphoria when combined with the buprenorphine. Used alone, naloxone (Narcan®) is very effective in reversing opioid overdose if administered in a timely manner. Suboxone is also available as a film which is dissolved under the tongue thereby lessening the potential for abuse even more. In May 2016 the FDA approved a buprenorphine body implant that will dispense medication for up to 6 months but has not stated when in will be available for use.”
Note to readers: I’m excited to share an upcoming blog by Gloria on MAT and also an interview with her about her book, which is a must-read for parents.
Be Open-minded to Treatment Options
For my son, Suboxone has provided the stability he needed to focus on his recovery. He tried Naltrexone (also available as Vivitrol) during an in-patient treatment program but didn’t find relief; he was still craving opiates, which meant his head was anywhere but the treatment group. All he could think about was getting out so he could get his fix. He was just passing time, counting days, and was convinced he could moderate his use upon discharge.
Of course, he couldn’t and he returned to use within a few months of completing in-patient treatment. He was overwhelmed with freedom, a poor-fit after-care plan and insufficient means through employment, housing, and support. He wasn’t interested in coming home and we weren’t sure we were ready either. It was an awkward, difficult time of transition that went the wrong direction quickly.
From Relapse to Recovery
That relapse and its devastating demise unified our family and son’s friends. Together, we conveyed our concern for his well-being and voiced our very real fear that he was going to die soon.
He said, “Thanks but no thanks” to returning to treatment.
He wasn’t ready to stop using, but with hindsight, he was shifting from needing to stop to wanting to stop, and he learned that Suboxone might just be the best way for him to treat his opioid-use disorder.
Suboxone accomplishes three things for my son: 1) It takes away withdrawal symptoms; 2) It eliminates cravings; and 3) It makes it impossible to get high (for at least 48 hours) if he were to use an opiate. This combination provides incredible stability as he actively works an integrated treatment plan.
Right away, he enrolled in a high-intensity out-patient (HIOP) treatment program offered by the MAT clinic. In addition, he met one-on-one with a counselor. He has progressed from dosing daily at the clinic to picking up a week’s supply at a time. He passes all of the random, monthly UAs and sees his counselor regularly. More importantly, his self-confidence and self-esteem is returning: He got a job within a few months of starting Suboxone and has held it ever since, and he enrolled in college courses and has gotten straight A’s.
Stigma from Unexpected Sources
Unfortunately, like many aspects of addiction, Suboxone users, proponents and supporters encounter stigma. Interestingly, the stigma – from my perspective – comes from the broader recovery community and not from the general public.
These folks (certainly not everyone) seem to feel that recovery must not include medication assistance – they say it’s trading one drug for another, that it’s just another form of addiction.
This simply isn’t true as my son and many others will attest.
More encouraging, however, is the open-mindedness that friends, family and the general public seems to take regarding Suboxone, and perhaps more so with the news that Prince was about to start using Suboxone. They are amazed to learn that such an option exists. They see it as comparable to taking an anti-depressant or anti-anxiety medication to treat those brain disorders. They see it as taking insulin for diabetes, as taking cholesterol-lowering medication … they see medication as a form of treatment for a chronic disease. In this case, the chronic disease is a brain disorder known clinically as substance-use disorder or opiate-use disorder, or more familiarly as addiction (which takes us down a whole other rabbit hole of lexicon vs stigma).
Like any medication – prescribed, over the counter, or illegal street drug – Suboxone can be abused, it can be used to get high, and it can be sold on the street. UNLESS, it’s being used with integrity as prescribed and under the care and guidance of a physician who specializes in opiate addiction. AND, when it’s used in conjunction with other treatment protocols – group, individualized therapy, mental health, support, etc.
We’re fairly new to Suboxone – just two years in July 2016 – but the benefits are amazing. I understand that some physicians and people believe in life-long maintenance; others believe it’s possible to taper off Suboxone, slowly and with full support.
My son’s clinic believes in an individualized approach to MAT offering a general guideline that it takes 18 to 24 months for a person to stabilize (their life) using Suboxone in conjunction with ongoing counseling services. My son would like to taper off, very slowly, at some point. Our family will support him in that decision and remain open minded to the possibilities that it brings.
But, as he says, “Why mess with what’s working?” I wholeheartedly agree.
With MAT, Suboxone in particular, our family is no longer wrestling with opioid addiction and that makes me a very, very #ProudMATMom.
*Medication-Assisted Treatment (MAT): This is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating substance-use disorders, a combination of medication and behavioral therapies is most successful
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