Suboxone: A Positive Alternative to Heroin Addiction

Addiction is a mental illness that has been misconstrued and stereotyped, especially since the early 1900s when it was criminalized. Addicts are often represented as bad people rather than sick people. In 1914, the Harrison Narcotics Act was passed into law, immediately criminalizing people suffering from substance use disorder.

Ironically, the Bayer company, famous for aspirin, named the drug heroin, which they derived from morphine and aggressively marketed as a painkiller and cure for morphine addiction.

It worked. Unfortunately, it had an addictive capability beyond morphine. Before heroin became illegal, the majority of users were hard-working, honest citizens and housewives. The Harrison Narcotics Act changed all that. Prohibition didn’t work either; it just blew up in our faces faster. Now it’s time to take another look at our drug laws.

A person with substance use disorder is mentally ill and should be treated with a medical model, not punished for having a disease. Unfortunately, when it comes to the illness of addiction, we’re still in the dark ages.

As I write this, the drug Suboxone is dissolving beneath my tongue. I’ve been diagnosed with major depression, severe panic disorder and post-traumatic stress syndrome complicated by addiction. I’ve been in treatment for mental illness since I was seven years old. My introductory drugs were caffeine and nicotine. When I was nine years old, a group of friends and I, sitting in a patch of wild strawberries, broke out a pack of non-filter cigarettes. I remember getting dizzy and nauseous yet deriving a sense of pleasure from the powerful drug. I smoked regularly from 1956 until April 25, 1999, when I had my last cigarette.

I used the patch to detox. The only drug I’ve found harder to kick than cigarettes is heroin. Since March 1994, I’ve had long periods of abstinence from heroin, but I’ve fallen victim, time and time again, to the sudden overpowering impulse to use it. There are a few people who’ve maintained longer periods of abstinence through support groups, but I’m not one of them. For me, the groups help; I just need extra help.

My first experience with opiates was with a codeine-based cough syrup. I thought I’d found nirvana. When I was a teenager, this type of cough syrup required a signature at the drugstore to obtain it. Now a prescription is necessary. My habit accelerated rapidly to the point that I began drinking two to four bottles of cough syrup a day and boosting the effect with what were called “goofballs” back then. They were barbiturates, such as Seconal, or hypnotics, such as Doriden. A friend introduced me to heroin and that was that.

I became a maintenance user, meaning I worked regular jobs and treated myself with heroin as a form of self-medication. I worked in psych hospitals, group homes, factories, gas stations and many other jobs to get along. I also had to do things that were against the law (besides using the drugs) to get by because the illegality of heroin caused the price to be excessively high.

Now I treat this illness in three ways. I receive medical, mental and spiritual support for my addiction. For the physical aspect of the treatment, I use Suboxone, which is a new treatment developed for opiate users. You could say it’s Prozac or Closaril for the heroin addict. A person like myself could take Suboxone daily and live a normal life. Suboxone has two components. The first component is buprenorphine, which fills the receptor cells that crave heroin. The second component is Narcane, which is a heroin blocker that doesn’t work on buprenorphine.

You could look at it like this. A person contains an empty space, which, if filled with heroin, causes a state of euphoria. This space is the receptor that acts on the opiate. Buprenorphine fills the space without causing the euphoric effect, yet it eliminates the long-term craving for the opiates. The space is full, ergo nothing else can be put in it. The second drug, Narcane, is an opiate blocker.

Many addicts who stay abstinent for long periods of time suddenly use. Why is that? The addict is hit with an “impulse craving,” which, if given enough time, will disappear. The Narcane, the opiate blocking component, lasts long enough to fill the time of the craving, because the addict knows that even if he/she uses, nothing will happen because of the blocker.

Heroin activates the opiate receptors in the body. In medical terms, heroin is called an agonist. Medically, Narcan is called an antagonist because of how it reacts with the opiate receptors. Buprenorphine is an opoid partial agonist. This means it has a ceiling, and the euphoric reaction heroin causes is extremely limited with “Bup,” as they call it on the streets. When taken daily, it eliminates craving and fills the opioid receptor without causing a euphoric reaction.

Suboxone can be obtained from physicians who’ve been specially trained to dispense this drug. There’s a list of them on the Internet if you run a search engine on Suboxone. This list is not always up-to-date, and I talked with at least six of the physicians on the list before I found one that satisfied me. There were a few doctors who were only in it for the money and treated me like a “junkie.” I took my time and found a physician who was compassionate and cared about his work. I recommend you do the same.

The Suboxone takes care of the physical component. Support groups take care of the mental component. There are many different types of support groups that treat the psychological aspect of the illness. The type of support group used should be determined by the person with the substance use disorder through experimentation. For me, a certain type of support group works best, and I attend it five to six days a week. At the support group, I don’t speak about medication. I’ve known people to be criticized for taking medication by others at a support group and who then stop taking their medication and commit suicide. Even in support groups, narrow-mindedness and prejudice can continue to exist. Thank God not everyone feels that way.

The third aspect of the illness is the spiritual component. This I treat with a specific type of prayer and meditation. There are many different forms of prayer and meditation, depending on one’s beliefs.

One could use a mantra or a repetition of a word or a group of words that may or may not mean something specific. I know of other types of meditation. I use a particular type of meditation. It involves the Rosary. Previously, I used a meditation with a mantra. The purpose of a meditation, as I see it, is to shut down the “small mind,” the one we use when we do our everyday thinking.

Meditation awakens my spirit to a greater degree, as it shuts down the “small mind.” I’m a beginner at this. One can read about meditation and never “understand” it. Only the practice of meditation can give any insight into what it is.

I hope this essay has given you some information that rectifies any misunderstandings you might have about addiction, that you can come to accept addiction as a mental illness and that you can understand the medical, mental and spiritual paths that lead to wellness.

Marc D. Goldfinger is a member of the board of directors of the Homeless Empowerment Project, which publishes Spare Change news. Formerly homeless, he serves as the paper's poetry editor.

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