Nearly Six Months, PAWS And Stopping Smoking!

I've not been too good at writing posts recently, my only excuse is that when I cleaned up, life kinda took over!

It's coming up on six months now since my last Iboga flood. 

Apart from a couple of minor slips, ie: one or two small shots, months ago, I haven't slipped back into a full time opiate habit, nor am I on any maintenance meds anymore! :)

As ever when coming off long term opiates, it takes quite some time for the body to heal and adjust. Often longer than you expect, actually when I got clean back in '06, I tapered myself off a 120mg a day methadone habit. 

It took about 18 months of dropping 1-2mg each 4-5 days. 

It was slow and arduous but it worked, I got three years opiate free after that too!

I'd never heard of Ibogaine at that stage, if I ever had to do a slow meth taper again I'd microdose with rootbark without a doubt. 

Funny too, I'd not heard of the dreaded PAWS back then either, I think if I had I'd have probably talked myself out of the detox, or at a minimum suffered a lot more. 

Looking back now, knowing more, I did struggle with it. From 120mg down to about 12mg was easy in comparison to that last 12mg!

I got so worked up convincing myself that the last drop, from 1mg to 0 I'd go into hellish cold turkey that I nearly talked myself out of it altogether! I started to do the addict thing of coming up with justifications why I should just stay on 12mg forever! Haha

As it happened, I actually swapped over onto subutex for the final bit. It wasn't easy, the transition is difficult and I got pretty sick. I was really pissed that I ended up needing a full 32mg to hold me, I thought I'd be ok at 16mg max! 

It took about a week of pretty shitty withdrawal symptoms to stabilise, I then stayed at the 32 for a couple of weeks then started tapering. 

It was much easier to taper with, I set myself a three month limit for taking subs, much longer and I've noticed people start to struggle getting off. 

I got right down to 0.02mg, shaving the pills with a razor. 

When I finally stopped altogether, I remember sitting at home that day waiting for the ct to hit me, I had subs on hand if it did... It never did!

Yeah, I was amazed.. But it just goes to show, if you have the discipline and willpower to taper it is possible..

Anyway. I'm getting off track..

I wanted to talk about PAWS, or Post Acute Withdrawal Symptoms/Syndrome, like I said, I'd never even heard of it, so I didn't really know what to expect in the way of symptoms when I finally stopped. 

Physically I had minor sweats and chills, goosebumps and sneezes that went on for maybe another week or two, my main problems were insomnia and depression. 

For about a year after I stopped I was battling severe depression, I researched medications and antidepressants that were good post opiate addiction and the SNRI Venlaflaxine/Effexor came up. I asked my doctor and was prescribed Effexor. I can't say I felt on top of the world but if lifted me out of the suicidal zone. 

It seems to take about a year to fully recover from long term opiate abuse, after that time I felt pretty much 'normal' and happy and had forgotten all about my past life really. 

Why am I talking about this? 

I guess because its kind of where I'm at again now, feeling sad and suffering a lot of anxiety. 

Iboga rootbark helps me loads, I take about a gram whenever I feel I need it, which is usually about every two weeks. It seems to stop any drug cravings I'm having dead in their tracks and lifts my mood. 

I actually even stopped smoking about six weeks ago too. Which is just crazy for me, I've always loved smoking and never had much intention to stop. 

I bought one of those E-cigs from the pharmacy and never looked back, haven't smoked since! :)

Can't recommend them enough

That's all for now anyhow 

Sid 

Getting Injectables Prescribed In The Uk

I'm currently in the process of helping a good friend who's having trouble with our local drug service. 

When I was using I know I could have done with someone on my side, advocating for me. So now I'm in a better position myself i thought I'd try and help.

So this is the situation, she is a long term user, around 20 years. IV heroin for most of it but speedballs, heroin and crack combined, for the last five years. Which I know from experience is a total bitch to kick. 

When I first started using, I used to hang with a guy that did both. He used to infuriate me because after hustling money, we'd go to score the heroin, I'd be chomping at the bit to use it! But this guy wouldn't do heroin without crack! Seriously, we'd have to wait around for hours sometimes for his crack dealer. He just point blank refused to do just the heroin and I just didn't get it! .... Fast forward 15 years and now I get it! I fell into the speedball trap too towards the end. It really is difficult to do just the heroin. It's just not the same. 

It's difficult to explain if you haven't experienced it, it's like toast without butter, or tea without sugar. Haha

It obviously also makes it that much harder to stop, you have a double whammy addiction!

I read somewhere about the physiological side of it. IV heroin or IV crack, alone, obviously induce a huge dopamine release, which gives the high. 

Put the two together however and the dopamine release is around 400% more!

It's an awful addiction to have, at least with just heroin, psychologically, you're on a pretty even keel. Yeah you have ups and downs, when you're sick and skint you feel crap but trust me, once you've been on speedballs you appreciate the difference. The crash after a day of using is just awful. It used to take me a week to recover from a speedball binge. Not even wanting to talk to anyone else, physically feeling awful but the psychological side of it is like nothing else. Well, maybe like an amphetamine come down,.. a bit..

When it's time to stop, you're not only battling cravings and physical symptoms of normal opiate withdrawal, you get the extra fun of cocaine cravings and withdrawal! Cocaine cravings are pretty intense on their own!

Like I said, double whammy! .... Why did you think it was a good idea to try a speedball again? ;)

So anyway, my mate is an old school addict. Been at it a long time, been in and out of rehabs and programmes. Spent the majority of her addiction on methadone, 180mg at the highest. In drug service terms anything over 60mg is classed as an 'optimised' dose. 60mg is believed to be the minimum to achieve a 'therapeutic effect', the 'optimised dose'. 

This has changed over the years, it wasn't too long ago that 60mg was considered a high dose!

Incredibly, in the United States, doses of up to 500mg daily aren't unheard of.

The most I have ever heard anyone being in here was 250mg. 

She tried subutex but didn't get on with it. Some people just don't get on with buprenorphine. It's a very different drug to methadone and heroin, pharmaceutically and subjectively. It's a semi-synthetic, partial opiate agonist/antagonist. 

It can feel quite 'chemically' to some people.  If you're used to full agonist opiates like heroin or methadone, the crossover to subs can be difficult. 

Right now she's frustrated with her treatment, she feels as though they have given up on her almost. A 'lost cause' .. It's very sad actually, this girl is an amazing person, really creative and kind. I've known her a long time, she's a little like me I guess, in that she's not really what you'd class as a 'junkie'. Having worked and supported herself, her kids and her habit most of her life. 

Like me, getting caught up in opiates using them almost like a sticking plaster, to deal with emotional pain. Opiates are great at numbing those painful memories some of us damaged people have. They were almost a natural progression for me, I'd spent most of my teens struggling with feelings and emotions that I just didn't have the tools to deal with. 

She's currently under the care of our local specialist addiction unit, at the hospital. This is where they send the people that don't respond well to traditional treatment, maintenance scripts which can be given by a key-worker at a community drugs service. 

They are, by definition, there to provide a specialist service, in my eyes you would think that that involves using a wider range of medications and psycho-social interventions like psychotherapy and family counselling. 

About a year ago, while I was still there actually, the budget was slashed.

Lots of NHS services were cut, obviously addiction services are an easy and obvious target and therefore one of the first to feel the pinch. 

The consultant that ran the unit for years was fantastic, I've written about her before I think. A really amazing, caring doctor. 

Part of the cuts included her having to incorporate the alcohol unit into the drugs unit. Splitting her time overseeing both units and pulling back on direct patient contact.  She wasn't prepared to make this compromise and ended up resigning, it was a travesty actually and makes me mad to this day. Things at the SAU really went downhill after she left. Every week I'd hear clients moaning in the waiting room, keyworkers would change from week to week, it became impossible to see a doctor and you could just tell that most of the staff couldn't really care anymore, they'd be out the door by 4.30 whereas in the past stayed til gone five.

Rather than clients seeing doctors, nowadays everyone sees a keyworker, no matter what their needs or level of priority. The keyworker is like the liaison between the client and 'the team'

The team consists of registrars, keyworkers, one psychologist (to cover every client), the consultants, the manager, nurse and various other workers. They meet weekly to discuss the clients. 

This may seem a sensible idea, and certainly streamlines things, but at what cost?

I know for me, when I was still there, I just felt a total lack of care or even interest. I had a different keyworker every appointment at one stage. They were obviously temporary agency staff, with no specialist training in the drugs field. One lady In particular was so obviously uninterested in me I played around a little and told her I was injecting benzos and that I was self harming again. To see her reaction. There was none.. She just wrote it down and moved on. I don't know what I was expecting really, maybe 'are you ok?' I guess..

Back to my mate.. She asked me to look up the government guidelines for injectable opiate prescribing. 

I have an interest in this too because I was looking into it for myself before I stopped using. 

It's a bit of a grey area, it's not a common practice, but technically it's possible to get an injectable script. The studies looking at injectable vs oral prescribing show positive outcomes, there is plenty of evidence from Europe, we all know about Zurich's incredible results with 'needle park'. They had a huge and very visible heroin problem some years ago, addicts would (infamously) stand out in the open, injecting eachother. 

They rather bravely, implemented an injectable opiates policy. Set up a clinic where addicts could go and get a legal, safe and regular supply of heroin. There were conditions attached of course, the addicts had to attend the clinic twice daily and inject in front of staff where they could be monitored to ensure they were injecting safely and to stop overdoses. Incredibly they cut their new addict numbers by around 80%. By taking the 'glamour' out of IV drugs, they essentially stopped people wanting to start using. They have similar places in Canada although these are just safe spaces to inject, with staff on hand dealing with OD's and to offer safer injecting advice. They don't prescribe here just supervise. Many many lives have been saved and local HIV and Hep C rates have dropped. 

Portugal have recently decriminalised the use of drugs, where before an addict would be punished through the courts and prison system, they started instead to offer them a place in rehab, or opiate replacement therapy. Again, they have proven the concept and cut drug related crime dramatically.

The glaringly obvious point here is that people will use drugs wether they are illegal or not, criminalising and punishing people for using DOESN'T WORK. Putting programmes and systems in place to help drug users is the only way to make a real difference. 

Although I don't personally need medical treatment anymore, it's not long ago that I did, and I feel strongly about the UK's and the rest of the western world's outdated and useless drug policies. The 'war on drugs' hasn't, and never will, work. 

I'm hopeful that things will change though, there is a small but rapidly emerging worldwide movement towards the decriminalisation of drugs. 

UK drug policy does allow for the off label prescription of injectable opiates for addiction. 

A home office licence is required to prescribe diamorphine though and there are only around 90 doctors that hold one. 

No licence is required to prescribe methadone amps though.

I feel my mate is a good candidate for injectable prescribing, after reading the NTA and NICE guidelines she fits the criteria. The only other things in the way are practical things like being able to demonstrate good injection technique and having good venous access. It's also necessary to monitor people closely who start this treatment. Especially during induction. It may not be logistically possible to prescribe at your local unit and this will have an impact on their decisions to provide injectables. 

Essentially though, the final decison rests with the prescribing doctor.  it literally is as simple as the personal prejudice, preference, experience and maybe even the whim, of the consultant. 

If you can demonstrate that you fulfil the criteria and you can show a good case for a realistic reduction in harm and improvement in illicit drug use, then there is really nothing stopping you pursuing it. 

Cost is another major factor, we all know oral methadone is cheap as chips. As low as 20p per dose. 

Currently there are around 5000 addicts receiving injectable methadone and around 450 diamorphine. Most of these people have been on it long term and were often inherited patients to the new doctor. Injectable scripts account for 80% of the total cost for methadone prescriptions.

Maybe some of you will think that I'm wrong. And that addicts shouldn't be given injectables. Maybe you're right. I just feel we should be given the option, if it works then all the better. 

As I keep saying, addiction is a complex, difficult issue, it is not a 'one size fits all' problem and treatment should be tailored to the client. Utilising all the treatment options, including medications. 

Trial results show a large amount of people either coming off opiates altogether or achieving a significant reduction of illicit drug use. That can't be a bad thing no?

If people aren't needing to commit crimes to get their drugs anymore doesn't society in general benefit?

Precipitated Withdrawal's ... A Painful Reality Check

I learnt a valuable lesson last night.. 12 hours isn't long enough to wait before taking suboxone!

I've been really struggling recently, every week I run short of my MST, the 600mg daily im prescribed just isn't enough. The problem is, because I stabilized for a good couple of months at 600mg, my doctor now doesn't think I need more.

Obviously my heroin use on top has blown my tolerance through the roof. 

I've had to come up with stories about loosing my medication, over-using it because I have a cold and am mistaking the symptoms for WD's etc, but last night was the final straw.

I was 24 hours short again, I wasn't too worried because I had 4mg in total of suboxone stashed, I thought this would be enough to get me through, maybe not comfortably, but enough nether the less.

I had my last shot at 4pm Tuesday afternoon, so by midnight I was starting to feel it.. the sickness was in the post as sickboy would say.

After some quick research I concluded that 12 hours was pretty much the minimum time needed before taking the subs.. this was suboxone too by the way, not subutex.

3am came, and I was really starting to feel it, 11 hours post last hit. So i nibbled a quarter of a 2mg suboxone and waited 45 minutes,.. nothing.. so I had a half, 1mg.. and waited again.. 

An hour later I felt a slight lessening of symptoms so I just shoved the rest of the other 2mg down me neck.

Well... the rest is a bit of a blur.. within half an hour I had grey, cold clammy, sweating skin. My bowels had turned to water and the snot was pouring out my nose. 

I started to panic, im asthmatic, and with the sudden lack of opiates suppressing my cough reflex I felt like someone was sat on my chest.

I was tearing the flat apart, quietly, trying not to wake up my boyfriend, anything!, I must have something stashed somewhere!

By 5am I was freaking out and felt like  I was three days into a methadone withdrawal.

I decided my only option was to call an ambulance and go to the ER. Through the snot and tears I was apologizing for wasting theyre time with my self inflicted, non emergency call out.

They were all lovely though and took me up to the hospital. 

It didn't occur to me until this morning that it wasn't just normal withdrawal I was experiencing, but the dreaded 'precipitated withdrawal' that happens when buprenorphine and naltrexlone is taken when you still have opiates in your system!

When the paramedics handed me over to the triage nurse in ER, she actually looked me up and down and said 'so, sorry, what's the actual medical issue?' .. I looked at the paramedic and said  ' yeah, that's exactly why I shouldn't have come'  haha.. 

The nurse just couldn't understand why I was there, no injury or obvious complaint.

She told me to go sit down and wait... The doctor will see me but there's a three hour wait..!

THREE HOURS! .. That's the one thing I dont have!... TIME!

By this point I thought I was going to pass out, I was dizzy and couldn't sit still, honestly the last time I was that sick was at rehab doing a cold turkey from 90mls of methadone!

At some point the doctor saw me, I told him all I needed was some methadone but they don't have methadone in ER, he was worried about giving me anything as he didn't want to OD me, if only he knew what my tolerance is like! I can easily get through 3grams of heroin a day plus 600-1000mg MST IV.. I finally managed to get 60mg codeine phosphate and 10mg diazepam out of him and sort of slipped into an uncomfortable sweaty sleep....

9am the 'substance misuse' nurse came to see me, told me they weren't going to admit me and all she could do was take me over to the 'specialist addiction unit' at 10am when they open. Then she just disappeared

I took myself over to the SAU at 10am but all the doctors and key-workers were in the morning meeting, and my psych wasn't even on site.. Now im just so tired, sick and pissed off I didn't know what to do. 

Im stuck 5 miles from home and a possible H link up, they they tell me I won't be dealt with till after 1.30, and even then theres no guarantee of getting any medicine.

I get a cab home, borrow some cash and go score.. like a zombie.. sick, no sleep, crawling down the road to my link, i make it, then I have to get to the park toilets.. Finally, I make it, I cook up, im telling myself 3 minutes, 2 minutes... I get it in.. I stare at the mirror at my pupils like saucers waiting for the gear to hit and them to pin... im waiting.. I just shot near enough half a gram of decent heroin.. nothing!.. Nothing happens!

It dawns on me as I tear up that the subs are blocking my opiate receptors.. I only had 4mg! Im still sick...!

medicine

I manage to blag some MST and shoot 200mg three times in a row.. NOTHING..

Its taken my all day, and a ton of gear to feel normal again, I literally cannot believe what's just happened to me!

So guys and girls, what's the moral to the story!? DON'T take subutex/suboxone 11 hours after shooting gear when you have the tolerance and habit of an elephant!

Government Cuts Hit Local Drug Services - Part Two

Govenment budget cuts hit local services...

More..

So.... A little update on the situation at the SAU (Specialist Addiction Unit)

Since my psychiatrist left the service due to funding cuts things have gone from bad to worse!

All the clients now have 'key-workers', no one actually gets to see a doctor any more.
My 'key-worker' has taken a disliking to me because I dare to challenge and question the way things are done... Like I said before, and as people have confirmed in the comments to the previous post, drug services are set up for your stereotypical 'junkie' .... Take your methadone, jump through all the hoops, tick the boxes and shut up...

Well, I'm sorry but that's just not me!...

I was so happy when I was first referred to the SAU, and met Dr Crawford,... For the first time in fifteen years of counsellors, key-workers and doctors I actually felt like this doctor gave a shit about me and my treatment.

We had a great relationship, we kept in touch by text which meant I could get in contact any time I needed, and we developed a good treatment plan.. together.. (which is really bloody important)

So often, addicts are relegated to a life on methadone or subutex and drug services seem to exist solely to keep people alive....

Dr Crawford actually listened to me, we trusted each other and she gave me chances I wouldn't have got with any other NHS psychiatrist (MST for a start, she also spent money getting me music equipment, got me into one of the best music tech colleges in London, sent me to one of the most expensive rehabs in the country and has worked with me very step of the way when it comes to medication)

I would see her every two weeks, we would chat for an hour or so, and decide where to go from there.
Most recently I came with the suggestion of trying MST and amazingly she agreed.

I had to sign a contract stating I wouldn't take any other recreational or prescription drugs (diazepam, cannabis, crack cocaine etc)

When she asked what I had been taking I was always honest and it's never been a problem, until now!

Now my key-worker keeps bringing up the contract, testing my urine for 'illicit' drugs which when positive for cannabis and benzodiazepines she reminds me that I am breaching my agreement and risking my treatment.

I saw her for all of 4 minutes last week, she literally gave me my script, asked how I was doing and fucked me out the door.

The reason I smoke the odd spliff and take a valium a couple of times a week, is because I'm not stable and can't sleep when I'm sick! 

Now I'm struggling on 200mg MST twice daily. I'm ill, it's barely keeping me well, let alone helping with cravings. I was really hoping it would.
I'm also still stuck on daily pick up at the chemist which is incredibly difficult when your trying to hold down a job!

I need an increase, I wake up every day ill, and run to the chemist.. take my morning dose and then have to try and leave it as late as possible before taking my evening dose so I'm not too ill when I wake up.

I don't see the point, when I'm barely well I want to use! I might as well not be on anything!
I need a dose increase, and I need weekly pick up at the chemist.

Now if Dr Crawford was still at the service she would sort it out on the spot.
Now I have to ask, and my key-worker 'takes it to the team' ... The weekly meeting of key-workers and doctors... I've been waiting a week already for a decision.

I want to get on with my life! I want to work, I can't when I'm ill!

I hope this post doesn't come across as sounding arrogant or self centred.. I understand there are budget cuts and things are changing.. but the treatment I'm getting at the moment is no treatment..! I might as well use and not bother going to the SAU at all...

Who is this meant to help?

I thought the idea was to work with people to get them clean.. Not trying to fuck people over at every opportunity...

I want to write to the new doctor over-seeing the SAU but am scared if I stick my neck out it will get chopped off!

We're not meant to complain and challenge the doctors, they know best, they've been to medical school and learnt about addiction.. they know best! Who am I to dare have some input to my treatment?!

I actually don't even want to go to the SAU any more, the idea was to get me stabilised on a suitable dose of MST and then refer me back to my GP. I wish they would just do it now actually... At least with my GP we have quite a good relationship.

Anyway, moan over...

How drugs services SHOULD be run...

So, here are my thoughts on how a drug service should be run....

        The service should be based around these core principles:

• Harm Minimisation
• Appropriate Opiate Substitution Prescribing & Maintenance
• Detoxification & Abstinence
• A Client Centred Approach
• Relapse Prevention

       Government Drugs strategys' should include:

• Early Drug & Alcohol Education In Schools 
• De-Criminalisation Of Cannabis
• Raising The Price Of Alcohol In Supermarkets
• Regulation Of Advertising Of Alco-pops
• Working Towards De-Glamorising 'Hard Drugs'
• Early Intervention Where Drug Use Is Suspected In Teens (Education In Schools)
• Reducing 'Binge Drinking'

  The most important of these is 'client centred' - By this I mean, working with the client to define and attain sensible and achievable goals.

For some reason this government has gone backwards! Drug services are being told to push clients towards detox and abstinence, long term maintenance is being phased out..

Forcing addicts to detox WILL NOT WORK! 

I believe the best approach to drug treatment would be...

It should be decided with the client what his/her expectations of treatment are and then:

• Re-assessing current dosing guidelines (30mls methadone is not enough to keep an average addict well), to stabilise the client (this means a dose that 'holds' the client as well as attenuates cravings, over 60mls in most cases)
•  Prescribing suitable opiates for the individual client based on history of use, age etc. whether this be methadone, subutex, MST or diamorphine, the full range of medication available should be employed as required.
•  Working with injectable opiates for injecting users.
•  Working with smokeable forms for smoking users.
• Not punishing the client for topping up with street drugs whilst titrating substitute.
• Establishing whether the client wants to detox or maintain.
• Allowing clients to maintain for as long as required.
• Providing intensive support for clients wishing to detox.
• Providing regular 'key-work' and counselling sessions.
• Providing access to a nurse.
• Providing proven 'alternative' aids to detox (auricular acupuncture, meditation, CBT, NLP, Hypnosis)
• Providing 'shooting rooms' for clients, providing on-site medical support for injectors including workshops on safer injecting techniques.
• Providing support for clients wishing to detox at home, home visits, detox plan, adequate medication (benzodiazepines, quinnine, immodium, vitamins, clonidine etc)
• Post detox medication. Provision of Naltrexlone implants and tablets
• Support groups for abstinent clients

Now, the way I see it, the above really isn't that far from reality, and isn't anything totally out there or unachievable.

Most of these have been used either in the past in the UK or are currently being used around the world in other countries.

Appropriate prescribing of diamorphine to heroin addicts is a controversial subject and one that inevitably raises concerns. In every trial that has ever been done, diamorphine vs methadone has better results in terms of attenuating illicit drug use, clients getting on with they're lives, finding jobs and contributing to society etc.
Yet the government for some reason will not roll it out nationwide.

(You can sign the petition to the government here by the way)

The same old arguments come up every time... 'why should we give them heroin', 'the diamorphine will be diverted to the street', it's too expensive'.

Let me tell you now, the lucky few on diamorphine prescriptions do not 'divert' they're scripts, why would they!? And why should we give nicotine patches to smokers?
Prescribing pharmaceutical heroin to addicts is the right thing to do, injecting street heroin carries so much risk, not least collapsing veins and DVT's, the spread of viruses like HIV/HCV through sharing of injecting equipment, risk of overdose with constantly changing batches of heroin of varying strength and purity etc..

MP's always say diamorphine maintenance would be prohibitively expensive and apparently there is a worldwide shortage.
It is only expensive because in the UK we use freeze dried preparations. A powder in an ampule to which sterile water is added.
The extra step of freeze-drying is unnecessary and as far as I know only done to prolong the shelf life.

The cost of producing diamorphine would come down as demand increased and would level out at around the same price as methadone.
(On a side note, I along with most addicts would happily pay the cost of the medication)

Post detox, providing naltrexlone implants on the NHS is a must. Currently there are only a handful of private clinics in the UK that carry out the procedure and it's very expensive.

The crux of the issue is about working with the client and not re-hashing old treatment models that don't work.
Listening to the hopes and wishes of the client and providing the support for them to achieve them.

It doesn't seem like too much to ask, and as I say it's not exactly groundbreaking stuff I'm talking about.
It could all be done with a few minor changes to protocol with the existing network of local drug services and agencies.

Stand up for your rights, stop laying back and letting Cameron and Klegg fuck you up the ass just because you found opiates relieved whatever issues or pain you can't cope with in your lives.
Seek help. challenge existing ways of working, post comments in your DDU's' suggestions box.
Start a local users forum, sign the petition, write to your MP...

Just because your an addict does not make you a bad person, you are human and deserve equal treatment to anyone else...

Peace out...

Using Ibogaine With Different Opiates

 

Using Ibogaine for detox from differing opiates

• I'm writing this piece in response to questions around the suitability of Ibogaine detox from short acting opiates like heroin vs long acting like methadone and subutex.

• I would like to make it clear that in no way am I a professional in the field, I'm writing only from my personal experience and what seems to be the general consensus from various forums and mailing lists composed of Ibogaine users and treatment providers.

My blog was recently used in a thread on the suboxone forum as evidence that Ibogaine doesn't work for long acting opiates like Suboxone or Methadone.

The person quoting me (without my permission) and also by the way had no personal experience of Ibogaine was arguing that Ibogaine has no effect on PAWS and cravings and that it only postpones the inevitable withdrawals.

It is generally accepted that Ibogaine is much more effective for treating SAO's like heroin, it's also true that most treatment centres (any that genuinely care anyway) advise people switch to a SAO for at least a month before treatment.

This doesn't mean Ibogaine does not work for LAO's like subs/methadone, because with a suitable dosage regime and some willpower from the client it can!

Dosing for detox from heroin vs methadone/subs are very different, LAO's hang around for a long time, especially if they have been used for many years.

As with any opiate detox there is no quick fix, this does not mean Ibogaine doesn't work! and it annoys me when people say otherwise.

To complicate matters, there has been many 'clinic's' popping up in Canada and Mexico offering 'instant, painless detox'. Inevitably people are going to be let down, high expectations play a big part in peoples negative views to Ibogaine. 

A lot of these 'clinic's' are run by unscrupulous providers that are looking to make a quick buck.

I've heard many horror stories about people being left under dosed, in pain and thrown out if they kick up a fuss. These providers are exploiting desperate addict's, looking for a way out.

Another problem with Ibogaine is as it is still experimental and schedule I in the U.S there isn't much research going on, and a lack of scientific evidence about it's efficacy.

No one is even sure still exactly how it works. We know it affects pretty much every system in the human body, it seems to fill opiate receptors although it is not an opiate, and it seems to empty the receptors of any existing opiates thereby having the perceived effect of 're-setting' tolerance.

I can vouch for the tolerance re-set personally, and I can also say 100% that it stops acute withdrawals by around 95% for around three days (after a full flood dose)

This, by the way is true for any opiate, methadone or heroin (I've used it for both)

The issue of PAWS is a big one, and will exist whether Ibogaine has been used or not, and this I think is the crux of this argument.

People say Ibogaine doesn't work because some people struggle with PAWS and cravings post detox.

Well of course some people will! Ibogaine or not!

There are a small majority of people that have successfully detoxed with a single flood dose and did not suffer PAWS, cravings and are still clean today.

But for most people, especially people with years of use behind them and those using LAO's boosters will be needed, and sometimes even a second flood dose.

For methadone/Subutex, after the initial 100mg 'test' dose, a flood of around 19mg/kg is given, boosters of around 400mg(TA) or 200mg(HCL) are then given as required for as long as the next two weeks!

Please do not write off Ibogaine as a treatment option simply because some people struggle afterwards... I have tried pretty much every method of detox over the years and Ibogaine is the easiest I have ever done.

Next to a traditional quick methadone reduction and cold turkey, Ibogaine is a walk in the park.

And don't take my experiences as evidence it will not work for you! 

Every one reacts differently to Ibogaine, and everybody's body is different, the speed the Ibogaine is converted, the amount's of body fat that hold LAO's longer, age (research has shown those over 30 have a higher chance of attaining abstinence) and willpower have so much to do with your chance of a successful detox that it's not sensible as simple as taking one persons word for the outcome of your treatment.

Do your homework, read the existing research papers, get medically checked before contemplating treatment and make an informed decision.

This Blog...

Needs a new name I think!

Initially I wanted to write about using Ibogaine to stop my cycle of addiction to heroin, but I now seem to be documenting my battle with my addiction and my various attempts at getting clean, and maintaining abstinence...

As such, I want to write a bit about a previous attempt at detox, I got clean around 2006 using methadone. And as this seems to be the only option available to most people I want to say it can be done! 

At the end of the day it comes down to willpower and determination, and unfortunately these are two things that can-not be forced.

So, here is the story of how I got clean (and stayed clean for two years) using methadone and subutex.

By the age of twenty six, I had been using heroin for nearly ten years. I was at this point, homeless and begging on the streets for cash every day to support my habit. 

I befriended an American girl and we used to work together as two people is better than one when it comes to begging.

I guess we hung around together for about a year.. We would wake up, have our morning hit and go begging, get £40 together, which would take a few hours, then go and score, have a hit and go back out do the same again for the evening money. Out of this we would make sure we either saved enough gear for our morning hit (the most important one of the day) or have enough cash left over to score in the morning..

This went on, day in, day out for what seemed like forever, it's soul destroying, everything would revolve around using heroin, and getting the cash to buy it.

It got to the stage where I was so sick of it I decided to go to my GP and get a methadone script and clean up.

I guess the old cliche of having to hit rock bottom is true, as it took me getting to the stage of having nothing to actually want to clean up.

I offered to share my script with her if she wanted to clean up too but she wasn't ready, we ended up having a screaming row and we parted ways.

I literally stopped using that day, and I didn't touch heroin again for three and a half years.

I went through a period of being ill while we found a dose of methadone I was stable on, 120mls I believe.

Within a month I started to reduce my dose, and believe me I felt every drop, Id drop 1ml and wouldn't sleep well for a few days, once I felt OK again I'd drop another 1ml, hence why it took eighteen months to get off the stuff.

I also had to split dose as it never held me for the full 24 hours. This was fine when I was on high doses, eg on 60mls I'd have 30mls when I woke up, and 30mls around 6pm.

When I got down to 10mls I hit 'the brick wall' people talk of, when it's difficult to get any lower, plus having to split dose, 5ml and 5ml twice a day it was getting harder and harder to measure it.

I talked to my GP and we decided to swap me onto Subutex for the last bit of the taper. 

The swap was difficult, because of methadone long half life you have to wait a minimum of 24 hours after the last dose of methadone before starting Subutex or you can go into precipitated acute withdrawals due to Subutex being a partial opiate antagonist.

Subutex (Temgesic/Buprenorphine) Is a strange semi-synthetic opiate agonist/partial antagonist.

It fills the opiate receptors and also blocks them (at sufficient doses) so any other opiates can-not get in.

I stabilised on Subutex after about a week, I ended up on a dose a lot higher than I thought I would need (16mg) and soon after started to taper.

It's a lot easier to taper on subs, once I was down to 2mg you can cut the tablet with a razor, I think I got down to a quarter of a 2mg tab...

When it came to stopping altogether, I was so anxious about going into withdrawals, but I didn't!

I was FINE!

I didn't suffer PAWS, the only problem I had was with depression, I'm prone to depression anyway, that's why I started taking heroin in the first place!

I researched anti-depressants that help after long term opiate use and I started taking Venlaflaxine (Effexor)

It definitely helped, it stopped me feeling suicidal at least!

So... here I am again, well, I'm not on methadone this time, after the hellish 18 months it took to get off it last time I will never touch it again hence the MST.

But I wanted to give people on long term methadone maintenance that there is hope, it is possible IF you have the will power and determination to do it!