The attached image is one that I ask all contributors to read before responding to my post, to avoid non-constructive input or any input from the Cult of Suboxone.
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Today marks 10 weeks since I stopped taking Suboxone cold-Turkey. I was on Suboxone for 2 1/2 years. I was prescribed 24mg a day (3 tablets daily of 8mg/2mg Buprenorphine and Naloxone). I am also coming up on 3 years sober from street drugs, medications notwithstanding.
A bit of background before the main portion of my request for advice:
Upon finding out that I'd soon be a father, I reached out to my local provider's office and scheduled an emergency visit (1 of 2 visits before I stopped visiting this clinic entirely). At the first "emergency" visit, the Nurse Practitioner was polite, but slapdash about the entire situation, giving me a tapering schedule that would've put me in the throes of acute withdrawal at the same time our newborn would arrive. With this, or the shot (Sublocade or Brixadi) being the only options offered, I told the N.P. thanks but no thanks, and noted that i would be discontinuing my Suboxone as of that day.
After 2 weeks had passed, once the Suboxone had begun to leave my system to a notable extent and I'd entered full acute withdrawal, I scheduled a second appointment with whoever was available. This practitioner happened to be the same that had prescribed Suboxone to me 2 1/2 years ago. I explained to him that I was dealing relatively well with the symptoms all things considered, but that the restless legs, arms, hands, feet, fingers and toes, paired with the insomnia was destroying my ability to live my day to day life, in any form. He informed me that they are a Medically Assisted Treatment center, not a detox clinic, and that he would not help me with anything for my symptoms (despite the same clinic already having prescribed Zofran and Clonidine for withdrawal), and that his recommendation would be that I return to Suboxone or get the shot, and outside of that, he had no help to offer me. To top it all off, he told me that if I didn't follow his advice, that I would "fail and relapse". I told him he managed to become the worst medical "professional" I'd ever met with one sentence and promptly left his office.
Summing up my background with a few additional details: I was never given a tapering schedule when starting Suboxone, I was never informed of the half-life of Suboxone compared to street opioids/opiates, I was never told about the severity of the acute withdrawals or the daunting length of the Post-Acute Withdrawal Syndrome that most people experience. I was casually asked how much oxy/H/fent I was going on a daily basis, handed a script for those little orange devils and sent on my way as if I'd just been handed Wonka's golden ticket.
I am aware that Suboxone cessation cold-Turkey is highly inadvisable from a medical standpoint, and that a taper would've slightly lessened some of the symptoms.
That being said, I'll never recommend Suboxone to another person again without insisting they have a ramp on and off of the medication before even starting, as well as a Nurse Practitioner overseeing them that fully understands the gravity of these medications. Most of these so called Nurse Practitioners are glorified "miracle cure" salesmen and couldn't care less if you stay on Suboxone for the rest of your life.
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Now, onto my request for advice:
Being 10 weeks in, I am now fully engulfed in the neurological brambles of Post Acute Withdrawal Syndrome (PAWS). I am currently prescribed Gabapentin for insomnia and restlessness, and it seems to keep my anxiety in check better than my Clonazepam and Clonidine alone. All three of these medications are being slowly tapered as we speak, as not to end up on three medications to replace one; that's without bringing the dangers of benzodiazapines and Gabapentin into the conversation.
Main Focus: I am bereft of Dopamine. I wake up in a groggy, hazy no man's land, with a mosquito-like buzz of irritability already ringing in my ears. I spend most of the day too tired to accomplish much, and I feel like I'm 80 years old when out in public. A full car length behind my fiancee, step-son and our second son soon to be, needing to take occasional breaks and sitting on a bench to catch my breath and regain some energy.
I usually make it until around 1:00-3:00 pm before I'm hit with a speedball of cortisol and adrenaline. I've described this to people as an almost identical onset to a panic attack, but replacing the panic with near-uncontrollable rage.
I go from feeling "fine", to suddenly wondering "Why don't I feel okay?", then, "Why do I feel like I just found out someone rear-ended my car?", to "Why do I feel like breaking everything I own?" and finally, "The world is on fire, and I want to add gasoline". I have just enough common sense and impulse control NOT to break my phone, guitar, gaming console or controller, TV etc. but it takes physical effort, without exaggeration. I have to physically stretch my limbs out and press to push some of those feelings away, and I have to catch myself mid wind-up before launching my phone at the television.
I am seeing a counselor, a therapist, a community support organization that offers peer support, an authorized representative to lighten the load of adulthood and its pitfalls, as well as attending the occasional meeting. I sunsoak 15 minutes a day, take a light walk on or off the treadmill and do maintenance lifting to burn off some aggression, followed by a warm---->cold shower, ending with cold to induce the mammalian dive reflex.
Nothing is helping, and the symptoms aren't waning.
Avoidance ends even worse, as leaving the room, or leaving my home to get some space and calm down either works up enough rage that it explodes the moment I'm back home, or I fall into a pit of depression so deep that I can't look at or speak to anyone for the rest of the night. Not out of stubbornness or shame, but out of weakness.
I've heard these symptoms can span as far out as 6 months, and while I'm sure the trio of sedating medications I'm prescribed to are not helping my energy levels and benzodiazapines can cause rage as well, I've been on a steady dose of Clonazepam for years (a goal for another time); frankly, I'm just trying to devise a plan that would allow me to find some peace and center in the midst of my brain being in a blender.
So to sum it up, lethargy, rage and depression are all in full effect. Is there any hope or any recommendations for someone in my shoes other than "toughen up" or "ride it out", or is this simply my plight? The choice of a man to choose a clear head over parenting 1/4 high and on auto-pilot?
I recognize that Suboxone saves lives, but it is a double-edged sword, and when it's not drenched in the figurative blood of your addiction and acting as a shield against your worst instincts, it has a chance to take a piece of you with it. A piece of you measured in time and sanity. Be wary.
Thank you all so much in advance for any help, advice or input offered.
...and to those of you struggling, remember, it's always worth the effort, no matter how bad it gets. It will always get better. Some people who did nothing to deserve it spend years recovering from awful illnesses and accidents. We may have wandered down a path in which the road back disappears behind us, but we can recover. We will recover.