About Me

J Junig MD PhD is a Board Certified Psychiatrist practicing in Fond du Lac Wisconsin.  He first worked in neurochemical research, completing his PhD in Neuroscience at the Center for Brain Research in Rochester, NY in 1986.  He then attended medical school at the University of Rochester in NY, graduating with honors.  He completed a residency in anesthesiology and critical care at the Hospital of the University of Pennsylvania, and then worked in operating rooms and pain clinics for the next ten years.  In 2001 he left the field of anesthesiology after developing an addiction to opiates.  He eventually returned to study of the brain and mind, completing a residency in psychiatry at the Medical College of Wisconsin in 2006.

Besides his solo psychiatry practice he teaches at the Medical College of Wisconsin, where he is Asst Clinical Professor of Psychiatry, and serves as supervisor for several psychotherapy clinics in NE Wisconsin.  He co-hosts a weekly radio show about psychiatry and addiction, and podcasts can be found on i-tunes by searching under ‘junig.’  In the past he was Medical Director for Nova, a residential and outpatient AODA treatment facility in Oshkosh WI, and a psychiatrist for the Wisconsin Dept. of Corrections, working at a maximum-security prison for women and a medium-security prison for men.

Further details regarding his background, education, and publications can be found at the home page of his psychiatry practice, Fond du Lac Psychiatry.

Educational information about opiate dependence, addiction treatment options, and buprenorphine can be found at addictionremission.com.

He is currently accepting new patients.

Fond du Lac Psychiatry

Suboxone Talk Zone

Suboxone Forum

Addiction Remission

Terminally Unique Publishing


35 thoughts on “About Me”

  1. Hi Doc,
    I have been on suboxone for 6 month, following a 10 year addiction to oxycontin, fentanyl, and vicodin. I was on very high doses. I started suboxone at 8mg 2x day, and have titrated down to 2 mg a day, where I have been about 2 months. My Doctor wants me to stay at this dose for a while to minimize the chance of relapse. I’ve heard some horror stories about getting off that last 2 mg. of Suboxone. I really want to be fully “clean” of drugs.
    What do I have to look forward to in getting off the Suboxone?

  2. Sorry– I missed this post! On the main page I address Suboxone w/d in a number of posts. The short answer is that w/d from buprenorphine, a partial agonist, is not near as bad as coming off a full agonist like oxycodone or methadone. I have seen the horror stories, but I have witnessed the surprise of many people that is wasn’t as bad as they expected. I’m not sure why some people spread those stories… but they just aren’t true.

    On the other hand, the relapse rate for people going off Suboxone who haven’t done anything in the way of a solid recovery program is very high. If a person isn’t going to meetings, doing readings, working steps, etc, they won’t stay clean. Sounds like an exaggeration… but it isn’t. Once an opiate addict it’s long term Suboxone or long term meetings– or jails, institutions, or death as the big book of AA says it.


  3. I wouldn’t say it’s all that bad dropping from 2mg to 0, but it’s best to taper relatively slowly. I’m on suboxone for the third time and I’m hoping this time is the last. Good luck to you, and what the admin says is right, suboxone w/d is nowhere NEAR as bad as a full agonist. I could still go to work, school, and live my life while coming off of sub, not so on oxy.

  4. Thanks Kevin. Your experience is the usual for what I hear from people going off Suboxone.


  5. maybe I’m to old to understand this but way back when I was on every drug I could get my hands on including oxy’s, spent 5 months inpatient no detox drugs just intense therapy and another year seeing my psychiatrist and psycholigist. yes it was painful and yes there are days when I would love to take something to relax but I don’t I just don’t I know what it will or could lead to and it’s just not worth it. I just don’t get why people need suboxone for years and years? I have read and read your web page and countless others, talked to doctors and it all sounds the same to me. In fact suboxone almost could be looked at by spelling as oxy substitue. Substitue oxy what ever this is all a joke to all the doctors perscribing this medication to make a big buck off of addicts and I will not buy your tapes to pad your wallet. But thanks for the advise. All I wanted to know was if there were any people here who had completly gotten off of the subs and the pain killers? Obviously the answer is no. Good luck to all of you who are trying but therapy is your best bet face to face not over the phone there is no way of reading the face of an addict on the phone……

  6. one thing i have to say to what kathy wrote, is not everyone can go to rehab, i have been on sub for 21 months and it was the best thing i have ever done i have 3 kids and married me and my husband both were addicts so we both got on sub we would have lost are kids and neither had time are money to go to rehab. I am now down to 1 mg a day and feel great so far, I am a little scared to come all the way off for fear of withdrawal but still going to do it i told myself when i stared this that when i was ready i would go all the way, My husband is staying on it he had more of a problem with drug’s then me and you know what it doesn’t bother me one bit because i know he’s better off then before. i will never take drugs again i love my kids and my self to much.

  7. Hi, I just found this website. I’ve been taking Suboxone for about 2.5 years, and have been clean from heroin & other opiates during that time, until recently when I had a relapse.

    I was excited to find this site, called “suboxonetalkzone”… I thought it had a cute name, but I come to it & the first thing I see is an arm tied up in a rubber strap & a big old syringe!! I’m really shocked and upset about this imagery, not to mention I am now feeling very very triggered, because I was feeling vulnerable already.

    I’d be surprised if I’m the first person to say this… But I feel very unsafe with that picture up there, reminding me of what I used to do. I wish you’d change it please.

  8. Hi, I also Just found your website.I have been on suboxone for about a yr. and
    a half.I actually went through an out patient program first and the doctor there cut me down to the 2 mg to soon and I went back to using more than before.I have done alot better with the suboxone this time cause,I have attended meetings this time an not just rely on the meds.I am scared about coming off suboxone,but I think Ill be okay as long as i have support from my husband and attend meetings and stay out of stressfull situtations.The more support you have the easier it will be to stay clean. Thank you for your web-site

  9. I just have a few things to say about some of the comments made on the postings. I have been on Suboxone for 2 weeks. I know that doesn’t seem like long to some of you, but I have had NO problems with withdrawals, depression, anger, EVERYTHING that comes along with the whole process. I taking 10 lortabs for 4 years, the last two years being the worst. I was taking 10/10mg a day at the least. I have been happier in knowing that I am not taking/buying pills off the street, and waiting until someone calls me to say they have some pills to get rid of…..I now am taking Suboxone, as prescribed, and feel ALOT more sufficient in everything I do. My fiance and I had alot of trouble in the past, which I now see that most of it was drug related. He and I have both commited to the Suboxone program for ourselves, his beautiful little girl, and our future lives. I guess if some people out there do not agree with the program….GOOD LUCK. I have found much happiness in it so far…

  10. Hi Stephanie,

    Just like any time there is something popular, there is an ‘anti-Suboxone’ lobby out there that occasionally says something ridiculous. When that happens I want to correct the information, which makes me appear to be totally gung-ho Suboxone. In reality my opinions are a bit more tempered.

    I do believe that the use of buprenorphine for treatment of opiate dependence is the most important development in addiction treatment in decades. I have no doubt that it has saved the lives of countless addicts, and improved the lives of many more. At the same time I recognize that the use of Suboxone for treatment of addiction is not perfect– but what medication is ever perfect treatment for anything?

    As I have shared before, I am medical director of a large sobriety-based treatment center where Suboxone is not looked on as favorably. One reason is because in any step-based treatment program the patients must get to a certain level of desperation before they will ‘get it’, and patients who have been on Suboxone rarely become that desperate– instead they check out, saying ‘screw this, I’ll go on Suboxone!’

    I often think of a patient of mine earlier this year who really minimized his use—I thought he had been using for only a few months, when in reality he was using for about year. I offered Suboxone and he resisted, and thinking he had been using for only a short time I didn’t push the issue. I hoped to get him into step-base treatment, but then he got a great job—great for a 25-y-o— managing the grounds of a golf course. He said that ‘he would never use because now he had too much to lose.’ I explained that it doesn’t work that way—that addicts use exactly when they have ‘too much to lose’. But it is hard to convince a person that thing are going bad when for the time being everything looks to be going in the right direction.

    He took the job and didn’t go into treatment; his roommate found his body a month later when the job called to ask why he didn’t come in that morning. He was dead, in his bed, with opiates in his system. I now treat both his parents for depression—his dad usually sits in the same chair where his son used to sit. If I had got him onto Suboxone he would certainly be alive right now.
    He was a good kid. My thoughts of him and the half-dozen other people I once knew who are now dead fuel my anger at the idiots who continue to stigmatize the treatment of opiate dependence, and who hold it to a different standard than we do for all other health conditions.

    Thanks for sharing, Stephanie, and good luck to you.


  11. Thank you for the reply, but I do not understand your statements in the third paragraph about patients saying “screw it” in the end. Do you think this is the right treatment that I should be going through???


  12. I see where that statement gives a certain impression– one that I am not trying to give about Suboxone treatment.

    In traditional treatment the goal is to engage the serious, desperate part of the addict in the recovery process. There is not an attempt to ‘soften’ the initial recovery experience because we don’t want the addict to get back into ‘cocky’ mode– because an addict in that state of mind cannot learn anything, instead thinking that he/she has all the answers already.

    So ideally, the addict will be scared, desperate, and lonely enough to drop the old way of seeing and doing things, and instead have the attitude, ‘just tell me what I need to do, and I will do it’. All addicts develop a ‘front’ or ‘false self’ that is all BS, and that front will keep them sick if they can’t drop it and find their own sincere desire to change. They will only drop it if they have no other options. Suboxone, in some cases, becomes an option that prevents the addict from finding sincerity.

    I talk about this in the recordings that I sell, particularly the first one about treatment options. Sober recovery is a wonderful thing, but it does not come easily; it requires a mind that is open to change, and a sincere desire to do whatever it takes to get there– starting with leaving everything else to enter residential treatment, and then accepting the treatment plan– regardless of the sacrifices that may be required. One sacrifice in my case was leaving my career as an anesthesiologist– it iseemed like a big thing at the time, but now it is a no-brainer.

  13. I believe sub treatment is a wonderful thing. There is one major problem with most of the people on sub. Most addicts now days are so scared of the sickness they automatically get on maintenance drugs and never get the full withdrawal experience. When people detox their brain has to reboot and the brain chemicals slowly come back and this causes a lot of mental anguish , depression and pain.I hear all the time about how people tapering slowly off of sub and when they get to a low dose they feel bipolar type symptoms and slightly depressed and some people get mad at the drug manufacturers and claim these problems to be bad side effects. The truth of the matter is those same things would happen no matter what opiate you detox from and people don’t understand that. My whole point is if you are tapering and you feel slight mental anguish just remember it would have been a lot worse if you came directly off the opiates you were on , and your brain chemicals came rushing back suddenly. Tapering your brain does the same thing only over a longer period of time.If you are tapering I just want to say hang in there and if you feel abnormal or slightly depressed it is normal and it could be a lot worse. I have talked to lots of people who have tapered and none have complained of physical pain only mental. .Just remember the physical pain of it is the reason we as addicts chose the sub in the first place. My depression and bipolar type symptoms I had for nearly a month after quitting heroin cold turkey were way worse than anything I’ve heard of from people tapering from sub. On another web site I read where several people were saying they should sue the manufacturer of sub because of the mental anguish they had detoxing and I totally believe they have no clue how well they had it because cold turkey is horrible physically and mentally sub tapering is the better option by far so stay strong and remember it could be way worse. Good luck!


  15. How’s it going people thanks for the education dr. >ive been on suboxone for 3 months now and am down to 2 mils a day, I have found that getting physical exercise is such a key to my over sense of well being. I believe that it is one of the major parts in the tapering process because of the addition of natural dopamine release and just the overall feeling of wellbeing of doing something positive and constructive. I do have a question in regards to how I should taper down from 2mils should i keep doing it by halves every week or should i try and take it at 2mils every other day but i know if i get to low then it brings up cravings. Any advice would be great. Me personally I try eating a lot of fruits especially bananas along with good exercise in the sun is really helped me a lot. which when I was on opiates I would have to get loaded in the morning so I didn’t get wds which limited all my activities and made me lazy leading to an overall degraded self esteem and image when I feel so much better being able to feel good about constructive behavior and radiate positive energy to people. But ids rather stay at 2 mils a day for the rest of my life and be happy, and positive, then go off when im ready. Rather than be in a constant struggle with trying to be happy, feel well and also the cravings. Finally What’s the long term consequences of maintenance suboxone use ive heard rumors it might effect memory or something like that(at lets say 2mg) ??

  16. Pingback: Generic Suboxone Hits the Market « DadOnFire
  17. Hey there guys, I have been on Suboxone for 3 years now, and let me tell you I have nothing but wonderful things to say and now DO with my life.
    I am however struggling with my new Doctor. I have Kaiser out here in San Diego, Ca..and he is a Pain Management Specialist. Due to the fact that YES, I was definitely dependent borderline addicted to Oxycontin for 6 years prior, I still have had major back surgeries and chronic pain to deal with. That being said, he is just fighting me tooth and nail every month on my Suboxone scripts. I just get met with so much hesitation. He would rather me be on Oxy than Suboxone, he does not like the limitations that the FDA requires, and therefore treats me..(A stable patient, with 2 years of Suboxone use, AND prior Medical records IN HAND) as if I came in from the back ally w/ a needle stuck in my arm, and then asked if I was ever sexually abused and said “well people like you usually have been” OUCH…and YES for the record being raped by your Father does not make life easy, but being violated yet again has not been very easy to trust this person I “Need to Trust” I left his office last May in such hysterics..(I broke down as soon as I walked out the door) that I just do not know how to handle this situation. I am in fear every month that he will just “Decide” to stop prescribing to me..although I don’t even pick it up from the pharmacy UNTIL the actual 30th day..never had a “issue” with a “lost/stolen/etc” script….Has anyone else had this issue..I have spoken to Him, about the disrespect he has shown me, and have gotten NO WHERE! Please advise….

    and sub-Doc…THANKS…I love this site, and think you are an amazing supporter and Trooper. If only we can get the word out to most addicts that you don’t have to keep using due to fear of WD…you can get off the roller coaster much easier…and start living…I think you are doing a Great Job of getting it started!!!

    Thanks guys,
    SoCal mom!

  18. I am involved in 12 step NA meetings, and at one time had 8 yrs. clean from all drugs. Then I had surgery and relapsed with pain meds, and I never used opiates in my using days…go figure, addiction is cunning, baffling and powerful. I used opiates other than heroin for about 3 yrs. and then found Suboxone and got involved in my recovery program again. I have been on 8 mg. of Suboxone for 3 months and I am having hand surgery so I was looking for answers about taking my medication or discontinuing it temporarily. My prescribing doctor told me it is also used for pain relief and to just continue taking it, but I did not feel that his answer was detailed or informative so I researched it. This is what I found, and I hope it helps others. Let me know your opinion of this.

    Recommendations for Patients Receiving Maintenance Buprenorphine Therapy

    Clinical experience treating acute pain in patients receiving maintenance therapy with buprenorphine is limited. Pain treatment with opioids is complicated by the high affinity of buprenorphine for the  receptor. This
    high affinity risks displacement of, or competition with full opioid agonist analgesics when buprenorphine is administered concurrently or sequentially. There are several possible approaches for treating acute pain that requires opioid analgesia in the patient receiving buprenorphine
    therapy (Table 2). With such limited clinical experience, the following treatment approaches are based on available literature, pharmacologic principles, and published recommendations. The most effective approach will be elucidated with increased clinical experience. In all cases, because of highly variable rates of buprenorphine dissociation
    from the  receptor, naloxone should be available and level of consciousness and respiration should be frequently monitored.

    Treatment options are as follows.
    1. Continue buprenorphine maintenance therapy and titrate a short-acting opioid analgesic to effect (90, 98). Because higher doses of full opioid agonist analgesics may be required to compete with buprenorphine at the  receptor, caution should be taken if the patient’s buprenorphine
    therapy is abruptly discontinued. Increased sensitivity to the full agonist with respect to sedation and respiratory depression could occur.
    2. Divide the daily dose of buprenorphine and administer it every 6 to 8 hours to take advantage of its analgesic properties. For example, for buprenorphine at 32 mg daily, the split dose would be 8 mg every 6 hours. The available literature suggests that acute pain can be effectively managed with as little as 0.4 mg of buprenorphine given sublingually
    every 8 hours in patients who are opioid naive (47, 99, 100). However, these low doses may not provide effective analgesia in patients with opioid tolerance who are receiving OAT. Therefore, in addition to divided dosing of buprenorphine, effective analgesia may require the use of
    additional opioid agonist analgesics (for example, morphine).
    3. Discontinue buprenorphine therapy and treat the patient with full scheduled opioid agonist analgesics by titrating to effect to avoid withdrawal and then to achieve analgesia (for example, sustained-release and immediaterelease morphine) (90, 98, 101). With resolution of the
    acute pain, discontinue the full opioid agonist analgesic and resume maintenance therapy with buprenorphine, using an induction protocol (98, 102).
    4. If the patient is hospitalized with acute pain, his or her baseline opioid requirement can be managed and opioid withdrawal can be prevented by converting buprenorphine to methadone at 30 to 40 mg/d. At this dose, methadone will prevent acute withdrawal in most patients (97) and, unlike buprenorphine, binds less tightly to the  receptor. Thus, responses to additional opioid agonist analgesics will be as expected (that is, increasing dose will provide increasing analgesia). If opioid withdrawal persists, subsequent daily methadone doses can be increased in 5- to
    10-mg increments (103). This method allows titration of the opioid analgesic for pain control in the absence of opioid withdrawal. When the acute pain resolves, discontinue the therapy with the full opioid agonist analgesic and methadone and resume maintenance therapy with buprenorphine, using an induction protocol (98, 102). If the patient is discharged while full opioid agonist analgesics are still required, then discontinue methadone therapy and treat the patient as stated in the third buprenorphine approach. If buprenorphine therapy needs to be restarted (buprenorphine induction) after acute pain management (that is, the third and fourth approaches), it is important to keep in mind that buprenorphine can precipitate opioid with-drawal. Thus, a patient receiving a full opioid agonist regularly should be in mild opioid withdrawal before restarting
    buprenorphine therapy (98, 102).Acute PainManagement for Patients Receiving OAT Perspective http://www.annals.org 17 January 2006 Annals of Internal Medicine Volume 144 • Number 2 131

  19. I am gratified to see that the suggestions for treating pain are the same as what I came to recommend through working with my patients. I discuss the issue in significant detail in my e-book, along with other suggestions for handling the unique challenges that arise for the patient taking buprenorphine (shameless plug!)

    See http://bupeguide.com for details.


  20. Used OC 40mg-80mg every day for two years….now im on day 2 of suboxone treatment.
    This is my first time ever trying to stop using Oxycontin, and my first time using suboxone.
    I hope it works well, and Im glad i found this website for support. Thanks for creating it Doc.

    If anyone has encouraging words or tips please email me at [email protected]


  21. A doctor will hate me for what i have done, I made my own prescriptions on the computer, printed them out and waited until after 5pm then went to get them filled, my Dr, is cutting my 4 mg dose in half and Im not doing well, just was barely making it on the 4 mgs daily, I never tell when I go to the other doctor what I am on because they treat you like crap, but its better than if you tell them you are on methadone, becuase then you dont have a holy chance in hell, you could be cut in half and the doctors would say oh, so sorry but we cant give you anything for pain you are a DRUG ADDICT… there is a serious stigmatism associated with this, like we get hurt just to get some drugs, Im wondering does Torodol have the same effect on a person using suboxone and one using methadone? No one will believe this but sometimes when they suspect you are an evil DRUG ADDICT, they will purposely give you Torodol and sit back and laugh at your suffering. then blame it on you… if they didnt treat us like shit maybe we could be honest and tell, I never will which is why Im asking this question, I dont ever want to go through that again. I did well tapering from 24 mgs down to 8, but then my dr has to step in and lie to me, I wont be opposed if you are under 8 mgs daily, then cuts it to 4, now to 2, for my own good he says, wont listen to shit he thinks he knows it all and he dont. what am I going to do when he just says Im done? Its not his choice, I keep telling him I dont feel well, then he smiles his phony ass smile, your doing good, no Im not, Im finding another doctor as soon as possible, any referrals are welcome.

  22. I can’t, of course, support what you are doing. But I do understand your anger. I don’t think that many doctors actually ‘laugh’ at the misery of addicts; I think that some docs are simply arrogant, or ignorant, and they see ‘classes’ out there, with addicts somewhere near the bottom.

    You know the truth of what is happening out there, and others do not– don’t let the end result be your incarceration. They do lock people up for forging prescriptions, even just for personal use. So find yourself a doc who ‘gets it’ as soon as possible.

  23. Need help. 911. My wife is currently taking this Subox to get off of the opiates she has been taking for 5 years since her spine surgery. She started taking Subox about 2 months ago and she is just about done with taking opiates. However, I have noticed a dramatic change in her patience – she has none. She has terrible mood swings. She has twitches when she sleeps, hot flashes, and seems downright angry. I mean really angry. This is not the woman I maried 16 years ago. She is totally different. Is this normal? She is spending money like crazy. She is having some weight gain. She seems like her self-esteem is totally blown. She says things to me that make no sense. I am at a loss. She does no physical activity at all, preferring to stay in her PJ’s and sleep most of the day. Please help me if you can. I have no idea how long I should expect this to last. I want my wife back. :-(

  24. The symptoms that you describe are not typical of someone taking buprenorphine; the symptoms are consistent with some other psychiatric condition, perhaps depression or bipolar disorder. Please consider taking her to see a board-certified psychiatrist ASAP.

  25. I was addicted to oxycodone. Well i found out I was pregnant so I went to a doctor an got put on subutex. Well the doctor told me their would be no withdrawal for my baby. But I had him on February 23, 2012. An on February 24, 2012 he was taken o the NICU, At Johnson medical Center in Johnson City, Tennessee. They was giving him sugar water for a couple days then they said his scores were not going down, so they put him on morphine. They started him out on .3 an now he is down to .15, but he has been at that dose since March 3, 2012. His scores before they started the morphine were as high as 15 then once they started it they went down to a 3 or a 4. but they are now up to a 9 or a 10 at the .15 dose. I just want him home. I was just wondering if they are helping him or if i should get a second opinion. Because its really stressing me out an i cant stay with him all the time because i have 2 other children.

  26. Need Advice!
    I became addicted to opioids after a car accident about 8 years ago. After years of only taking a prescribed, I had a few life altering events that led to an addiction of Oxys for about 6 months. I knew I needed help and began treatment from a Suboxone doctor 5 months ago. Initially he had prescribed 4mg 3x a day. This was kept me so fatigued all I could do is sleep for days. I finally found 2mg a day works fine. However, I want to stop taking it all together. I have been prescribed so many medications from anti-depressants to stimulants that I was a walking zombie. I have been undergoing treatment 2x a week by a functional neurology chiropractor that has worked miracles for me. He has helped guide me off of the only medications I continued once I began the Suboxone. (Zoloft 50mg, Wellbuturin 150mg, & Mobic) Through diet and exercise I no longer have the pain I had even when I was on high doses of Oxycodone. Now my Suboxone doctor wants me to continue the 2mg. I understand the fear or relapse but I am going to therapy & doing everything I should be. I want to stop the Suboxone and focus on the chiropractor’s plans. I respond well to the adjustments but by the time I return the following week, my left pupil does not respond to light and I still appear to be “dopey”. He says my body is not sustaining the adjustments. I really want to focus on the diet and exercise but the Suboxone makes me so tired. Who’s treatment do I follow? I only see the Suboxone doctor once every 3 months the chiropractor is a trusted family friend. The only reason I continue to take it is because I am afraid of the pain returning. One day I forgot to take the Suboxone for 48 hours and got the euphoric feeling I use to have from pain meds. It scared me because it felt too familiar. I had just returned from exercising and didn’t know if it was the film or the exercise. My Suboxone doctor informed me skipping days could do this. I just want my life back and I feel my brain is too foggy from the Suboxone. I can’t focus clearly on it. I use to develop financial systems and now I can barely remember yesterday. Please help or tell me where to turn.

  27. I’m on here to see if anyone has advice for me. My husband was taking Vic’s for about 3 years and in Sept. of 09 had switch to suboxone. He began taking 8mg a day then jumped to 2- 2 1/2. In Nov. of 2011 he stopped cold turkey for about 2 months. Then he got back on the pain killers for a month then went back to his doctor to get suboxone. He got back on and within 3 months went from 2 1/2 to 5-6 films at 8 mg. we have 4 kids, our own business, and no insurance. I’m tried of being lied too and being 2nd in his life. He is spending at least $2000 that can be saved or spent on us. He can’t start his day without it. I feel Like I don’t know who my husband is. Help Me please

  28. I read an article on this site about suboxeon will not cause you to wake up during surgery. Well it happened to my wife and if suboxone was not the cause we need to know WTF did happen. My wife has an ileostomy and in 2010 developed an infection around her stoma that would not heal. Additionally, she has had rheumatoid arthritis since she was 13 and was on Vicodin for over 15 years. Thinking medication could be causing the infection she stopped each of her meds but has withdrawal symptoms stopping the Vicodin so she was put on suboxone which helped. After about 8 month the infection did not get better and the doctor decided surgery was needed. The surgery was same day and was to last about an hour and half, total. The nurse who started her IV wrote down her medications which were simple; suboxeon, lomotil, & cymbalta. The anesthesiologist came in, introduced himself, told us he has the same disease my wife has (ulcerlative colitis; the reason for her ileostomy) and how he almost died 3 time but the surgeon doing my wife’s surgery saved his life. Then he said he’ll see my wife in the OR. My wife went into surgery and remembers going “asleep” and when she woke up she thought it was over but couldn’t move so she just waited and listened. She her the surgeon say first incision and then felt the scalpel cutting her. From there it was a nightmare. My wife has had almost 10 major surgeries and nothing like this has ever happened. She was paralyzed, on a ventilator and eyes taped shut. She could hear and feel everything but no one knew she was aware. At one point she said the voices and pain started to fade and she thought she was dying and was happy about it. She has a time span where everything was gone and she thought she was dead; she said she was yelling (in her head) for her dad who had passed away suddenly 3 months prior. She waited and he never came; she started to think she was in hell or purgatory then the voices and the pain came back. Only later did we find out she disassociated during the event. She said she finally gave up trying to move and waited. She counted her stitches when they were doing them. When the surgery was finally over she woke up fighting so bad she had to be held down because her breathing tube was still in. When she told them what happened no one believed her until she repeated what was said and things done during the procedure. She said the anesthesiologist asked her if she was on Adavan or Xanax and she said she hasn’t taken anything like that. During this her eyes were still taped shut and she only her a woman’s voice say “oh my God” then she was knocked out with something. When the anesthesiologist came out to tell me what happened not only did he tell me she heard the surgery (didn’t tell me she felt it); he also asked me what medications she was on. I told him we gave that information to the nurse to which he said a nurse will bring me to my wife shortly and promptly walked away. My wife has not been the same since; she suffers from sever PTSD. My wife has been through hell and back with her illness but her spirit was never broken until this event. She was happy, fearless, funny and ambitious prior to the surgery; now she isolates herself, is afraid of the dark and sleeping because her nightmares are so bad and is afraid to go out in public. Doctor kept telling us it was anesthesia awareness but we finally went to lawyer who found out the anesthesiology did not do his paperwork which included my wife’s medical history but a box was checked off stating she did receive enough anesthesia. If this was not a conflict between the anesthesia and the suboxeon then can anyone provide me with some insight as to what happened to my wife? I appreciate any help!

  29. Please read that post carefully, as it explains the issue in detail. First I’ll say that recall during anesthesia is a common reason for filing, and winning, malpractice suits. Consider getting a good attorney.

    Most cases of recall occur in specific situations– during c-sections before the baby comes out, when a limited amount of anesthetic is given, or during cardiac or other critical cases where the anesthetic could lower the blood pressure in a patient who is already close to the edge of survival.

    But even in those cases, there are a couple drugs that provide reliable amnesia. If they were not given, your wife has a good case.

    Suboxone only blocks opioids. Opioids do not block ‘recall’, and so they are not an important factor when people remember surgery. Opioids are given to supplement the anesthetic, to reduce swings in blood pressure, and to reduce the stress response; NOT to provide amnesia. Amnesia is provided, usually, by either a gas agent (nitrous oxide plus isoflurane, sevoflurane, or desflurane) OR an IV drug, trickled in over time, like propofol.

    If your doctor blamed Suboxone, shame on your doctor.

  30. well first off let me say that suboxone has saved my life…growing up in the dc/meropolitan area, it seemed that everytype of drug was right out my front door, and when most kids are at the age when theyre just smoking weed and drinkng, my group of friends were starting to use heroin and other hard drugs like crack and pcp. I have been an addict for 10 yrs now, im a 27 yr old male and have tried everything..but the PAWS (post acute withdrawl symptoms) were way too much for me to handle..id still be hurting fo months after, and forget about sleeping. so id always relapse. never geting more than a couple months clean. well suboxone, when taken correctly can be a wonderfull way for longterm addicts to slowly reintergrate themselves into society. I had never had insurance and suboxone programs are expensive, espescialy when the doc wont prescribe the much cheaper subutext, so i always had to find a way to make due these past couple yrs ive been serious bout getting clean which can be just as stressful as being a dope addict. I have lost almost every single one of my friends to heroin and thought for sure id be next, the most devestating year was 2010…i lost all 3 of my best friends, my fiance left me, i lost my house, car, job and pret much my sanity, the biggest trauma came when my best friend of 20 yrs, the guy who took me into his home time after time, heing me in everyway he could…died. And the thing is, he was on subutext at the time, but he was not taking it as directed. He was not ready to totaly give up opiates so he would sell more than half of his script everytime he got it and only take a small fraction of what his daily dose was. the reason he did this was so he could take the profits from the subutext he sold and use it for a couple extreme binges a month. at the time i was horribly addicted and he would always take care of me by giving me about 4 mgs a day, which isnt alot but it got me through, i knew this was the wrong way to go about geting it but an addict will do anything to feel better and my friend Gary would do anything to help me. well, i wasnt happy about his frequent binges as i was seriously trying to get clean, but he was keeping me well, so my addict mind was basically like “i cant control him, he’ll get serious when hes ready”….well he never got a chance to get serious…he ran out of his subutext too early one month, sold too many, and we both got dreadfully sick…i was trying to hold on but Gary was not having it, he was detrmined to find something to make him well…well after hours of him begging and pleading, he knew that i had city connections for heroin, he wore me down…he even hit me with “i keep you well all month and you cant go get me a few bags?” i wanted nothing to do with the ghetto anymore, but i was living in his house in crofton MD , a nice neighborhood close to annapolis, getting free opiate maintenance, free room and board…so i was in no place to deny him.
    so we went, i saw my dealer who told me he had the best shipment ever, we got a few bags and went home, needless to say Gary died off one 20 bag of heroin…one bag! it was unheard of with our tolerances and im still not sure exactly what happened, he shot the bag, obviously got a huge rush then looked at me just as i was about to shoot my bag and said “dont do that stuff” he then started choking, gasping for air…trying to use his nebulizer( he was a chronic asthmatic)…then just as i called 911 he collapsed in my arms…i tried rescue breathing but it was like tryin to blow up a punching bag, no air went in…the emt’s got there, said he was i cardiac arrest, took him away and that was the last time i saw him, he was in a coma for five days, his parents blamed me so i couldnt go see him, i even got kicked out the viewing and banned from the funeral…and i was the most important person in hs life.
    well the next yrs for me were a ptsd induced haze of rehabs, psych wards and psychiatrists trying everything to keep me clean. finaly after moving to seattle for a few months and having on last run with heroin, i moved back home, found state prescription insurance and decided iwas done with opiates. i have been in a suboxone program for 10 months now, along with meetings and counseling and i am ten months clean. i started at 24mgs a day and now take 4mg a day.
    the point of this story is to show that it is too hard for most long term users to do it alone, but the most important thing is you have to want to get clean and you have to integrate seious counseling and meetings into your treatment plan. Gary’s doctor sent him 60 subutext a month, and three months at a time! along with 90 klonopin a month…and all over the telephone. so that means gary only had to make a 30 min phone call once every three months to get these serious meds. I do NOT agree with that, he was very manipulative and had convinced the doctor that he was doing great. how could the doc know otherwise when he never saw him, and couldnt track his recovery. Buprenorphine can be a life saver, but it must be used as directed in addition to closely monitored therapy, i wouldnt be clean without it..

  31. Thank you for sharing your story– and I’m very sorry for your loss. It is always a tough balance, trying to decide how often to see patients; I would prefer to see people weekly, but patients will complain that they are trying to ‘go forward’ in life, to own a car, to HAVE the things that other people can have… You are left with one extreme— the doc who never sees the patients and just provides the meds, or the other extreme— a very controlling doc who sees people every week— for years! I try to avoid the extremes, and reward patients who do well by allowing them more time between visits, but that places extra responsibility on those people to be honest with me.

    I have heard stories of similar overdoses. I assume that death was caused by chest wall rigidity, not by the more-typical respiratory depression. When someone dies from overdose they typically appear very sleepy or unarousable, and stop breathing. Sometimes they can be kept alive by yelling at them to ‘BREATHE’ every 20 seconds or so. But very potent opioids, injected in high doses, can cause the muscles of the chest wall to become rigid– so rigid that the person feels as if they are in a ‘bear hug’ that keeps them from breathing. I’ve seen that occur during surgeries, in cardiac anesthetics, when large doses of fentanyl were given at the start of the case. The rigidity was treated by small doses of a paralyzing drug… but I would be surprised that paramedics would ever give a paralytic agent, as that removes a person’s ability to breathe on their own, even if they are given narcan and become fully awake.

  32. I have been on subutex since August of 2010 and it has saved my life. My question is has there been any side effects from patients that shot there medicine up? This does happen and someone I really care about has been doing this for over a year now and claims she can’t stop and rationalizes this by saying “least it’s not heroin” I just wish I had some kind of evidence to show how it’ll destroy her veins or even worse heart attack, sad to say. Suboxone and subutex is the best treatment for opiate addiction with the help from therapists also or na and aa. Appreciate any suggestions since I’m about out….

  33. I’ve known a number of addicts who become ‘addicted to the needle’– they get reinforcement and comfort from the ritual of injecting. There are plenty of dangers– but addicts are good at rationalizing away pretty much any danger out there. But a few risks: infection is the probably the greatest, as there is no way to fully sterilize the slurry of buprenorphine without destroying the molecule. A bacteria or fungal spore could seed any part of her body, including heart valves, spine, lungs… and the infection would destroy the area that it seeds. Bacterial endocarditis is a relatively common outcome of IV drug use, and heart valves can be destroyed enough to require replacement— which is a big deal. Abscesses can form in bone tissue or in the brain. causing pain, disability, or death…., Even if the mix is sterile, the particulate material will go to the right side of the heart, through the right ventricle, and out the pulmonary artery to the lungs– where it will cause scar tissue to form, reducing lung function over time. If she is in the 5% of the population who has an opening between the two sides of the heart, the tiniest air bubble or particle could go into the brain circulation— causing brain infection or stroke.

    If she accidentally hits an artery, she can cause an aneurysm that ruptures her brachial artery (which can be fatal). The veins will be destroyed over time, making it difficult to get healthcare when she is sick with something and older….

  34. Thank you very much for taking the time to answer my question. I want to applaud you for your work and the empathy you have towards a normally social throwaway class of people. Once the world understands how effective buprenorphine is in treating opiate addiction the quicker lives will be saved. Instead of selling my medicine I do even better I help them find their own doctor since mine has such a long waiting list, there are places to look and with persistence I’ve found five people there own way to feeling free from opiates even though buprenorphine is a type of one. Drastic takes drastic measures when it’s life threatening! One thing for sure bottom line addicts got to WANT to be clean before recovery can begin…..

  35. I am perscribed soboxone and i drive over an hour a couple times a month to see my doctor. Can i ask why doctors would rather persrcibe me to xanax then just let me smoke marijauna. I ask not to be on any benzos for my anxiety because i know i wont take them correctly and medicines like zoloft juat make me worse. Please give me some suggestions on what to do. Can my doctor kick me out of the suboxone program for smoking marijauna.

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Questions and Answers about Opioid Dependence and Buprenorphine