Addiction Recovery with Medications-First Person Experiences

Tone Prada, in his early 40s, was recently released from prison after a 25-year sentence. While there, he’d developed an opioid habit. He was shocked when the prison started offering Suboxone, but he decided to take the leap, and he’s glad he did. “My life is just so much better,” he told me.He started on Suboxone, and eventually transitioned to the Sublocade injection, which allowed him to avoid stigmatizing dosing rituals. Listen to his experience or read the transcript of our conversation below. If you’d like to hear more from Tone about his experience in prison and release, check out his Substack.EmmaYou started on Suboxone while already incarcerated, right? So can you tell me a little bit about your opioid use before that moment before you started Suboxone? To the extent that you’re comfortable.ToneSo just a quick backstory that leads into that. In January of 2001, I was arrested and charged with a homicide offense, and a couple years later, I was sentenced to 25 years to life. So as an 18 year old getting that amount of time, that’s life, right? It’s death by incarceration. I had to mentally cope with that and deal with that in prison. In prison culture—I think people have never been in prison don’t understand the extent of how much drugs and money, the drug trade is involved in prison—there’s a lot of drugs and a lot of money made, and some people stay away from it. Some people indulge in it. It’s dangerous, but it’s a culture, though. So when I first was incarcerated, I didn’t do nothing. I just was focused on doing my time and surviving. Sometime later, years later, you meet people, you grow, you network. This is my life. And I had somebody who was an early mentor. I was smoking a lot of weed. That was my normal habit. There came a time where I just, I had this super like anxiety attack or panic attack when I tried to smoke weed and I couldn’t do it no more. I wouldn’t get high. I would just get super paranoid. So I was sober for about 2005 to 2006 and somebody who was really influential in my life, like a mentor... I found out that he was using heroin. He was snorting heroin in prison, and I didn’t know how prevalent that was. It opened my eyes to that in there. And, you know, he kind of introduced me to that world. And once I had seen it, I couldn’t unsee it. The high looked really appealing, and it looked like it would treat what was going on with me as far as my anxiety and depression, right? So I took to it immediately. Went through my ups and downs with it, and tried to leave it alone. And I did. I was pretty successful leaving alone. It’s expensive, it was dangerous in prison, and I had a pretty good head of my shoulders to leave it alone. But once you get a taste of that, there’s nothing like it. It never leaves you. So years later, I was introduced to this orange pill that people were crushing up and snorting. I didn’t know anything about it. This is 2008-2009 ish. And, yeah, they’re telling me it’s this stuff called Suboxone. I was snorting the pill. They called “Stop sign.” I didn’t like it. It was too strong. It was making me throw up. It just wasn’t worth the high at the time. Years later, the strip came out—the film, and that took over the prison. It got to a point where people didn’t want the heroin. They wanted the Suboxone, because the Suboxone was guaranteed it would work. There was no such thing as “bad Suboxone.” There is such thing as bad dope. It would do the trick every time, and it was just prevalent. And it got to the point where it was very cheap, and you get a bunch of it, and people are severely addicted to snorting it. And for guys like me, so it’s considered contraband in prison. If the officers or administration finds that you have it, they’re treating it just like if you have weed or dope. You’re going to the box. But it worked its way into the prison system, and slowly, slowly took over. So by the time 2015, 2016, 2017 comes around, it’s everywhere. And, you know, people who like are addicted to opiates...we all gravitated towards the Suboxone. I ended up going to the box over my addiction. And the moment I get into the box, this is March of 2022 and we have tablets in the prison system.EmmaWhen you say you have tablets in the prison system, you mean that those are, you know, official Suboxone tablets. They’re coming from the doctor in the prison? I mean iPad-type things. So we have law library, we have podcasts, we have everything. So we get this alert [on the tablets] that Suboxone is being introduced into the prison system now. And now I’m in the box reading this— imagine my frame of mind at this time— I’m in the box because of addiction-related issues. And then I get this alert on my tablet, like, “hold on, so if you have this addiction or this disease, you can apply to get on this?” And I couldn’t believe what I was reading. I’m like, “No, there’s no way they’re doing this. Kathy Hochul, the governor and commissioners, they’re allowing this. There’s no way.” And when I get out the box, I go to another facility, and sure enough, they’re, they’re doing these medication runs where guys are going to get their Suboxone. And I was scared to sign up because, you know, I’ve been trying to break free from this addiction, right? I’m trying to break free. That’s already what you were using. You weren’t using heroin and switching to Suboxone. You were already on Suboxone. Right. And again, there was nobody selling heroin in prison no more. It just didn’t exist. Everybody was on Suboxone who had the opiate use disorder. I want to say this too, because this is important. So there’s another drug that is the number one drug in prison is K2. Guys smoke K2 and guys who are signing up on the MAT program getting the Suboxone, what most of them were doing was they were taking the Suboxone...Sometimes they take it... but most time they’re trying to sell it, so they could get k2 by deuce. So this is what I mean by the gift and a curse. It depends where you’re at in your addiction or trying to be sober. So if you don’t care about being sober, you’re going to the medication line, getting your Suboxone, trying to cheek it so you could take it back and sell it—and you might keep a little bit for yourself—but you’re trying to sell it so you could trade it and get some K2. For somebody like me, Suboxone was a godsend, because I’m really taking it and going about my life. What made you decide to take it? You described being so shocked and you were already taking it. I was taking it like illegally. I was buying it off the street. And I didn’t want to sign up and get it. Because I said to myself, “if I sign up for this, I’m really all-in getting this every day, and I just might as well accept that I have this and take this, because it’s like, the more you take it, the more you’re addicted?” I didn’t want to have withdrawal, so I battled with it on and off, on and off. And you know, if you’re buying it off the street in prison, it takes money. You’ve got to spend commissary money and that can lead to trouble. It can lead to drug debts. So I’m like, “I have to make a decision.” So I ended up signing up for it, and I got on it. Actually, I think the first of April in 2023 is when I officially got on a program. That day changed my my life, my time in prison, because I’m no longer worried about getting money to pay for it in debts and own money for this. My mental health is 100% better. I always told people that Suboxone is like a mental health drug, if that makes sense. EmmaIt is for a lot of people, for sure.ToneIt took care of just everything I was dealing with, no anxiety, no depression. I could just go do my time in prison. I was working in the print shop in the prison, then I would go work out at night and just I would my well being was just so good when I got on that program. Every day at four or five o’clock in the afternoon, I go up there, get my Suboxone, and I’m just... I’m good. My life is just so much better. Maybe a year and a half after that I got on the program, I got transferred to another facility, a lower security facility, and in this facility, the the staff, they made it like a spectacle of it. So in the first facility I was at where you could get Suboxone, it’s just, you get in line, they give it to you. They couldn’t care less if you cheek it, if you take it, whatever. They didn’t care. They just gave it to you. The facility I went to after, it was awful, you know, it makes you think of the old Seinfeld episode with the soup Nazi. That’s what it was like. They really ridiculed us. It was awful. You know, they made us really feel like straight up addicts in there. And everybody complained about it, and I said to myself, like, “I got too much time in. I’m of different mind frame of I’m mature. I carry myself like a man. I’m not gonna let these people treat me like this because I’m on this medication.” So they started giving people this option of getting the shot. Now most people don’t want the shot, the Sublocade, because you can’t cheek it, you can’t hide it, you can’t bring it back. People want the oral Suboxone so they can hide it on their tongue, to take it like I said, sell it, whatever, trade it me. I’m not into it. I’m taking it just to really take it. So I’m like, “you know what? Sign me up for the shots. I’m not going through this every day. The way they’re treating us going to get it...They’re really treating us, really bad.” And so, I started getting the injections. And to me, that was even better, because now it’s like, it’s private. Because there’s a stigma in prison around it.EmmaI mean, that’s something even I hear people who are not in prison say. One of the reasons that they choose the shot is that there’s less stigma going to the pharmacy. They don’t have to deal with the pharmacist as much, because some pharmacies are better than others, just as you described in the prison. That is one of the reasons people choose it.ToneAt first, I’m thinking, “damn, I made a messed up decision, because I’m not feeling this the way I felt when I was taking orally.” But once you get that second shot, because of that residual, once you get the next month, that second shot, now you’re good. Like, I’m alright. I feel good. I feel normal. And so I did that all the way up till Christmas of December 2025. Last month was when I got my last shot. I went from 300mg to 100mg but I even went through some stuff with that. I got off of it for a few months and went back on. And, you know, she had me at 300 milligrams for too long, and I started to have bad liver levels. I said, “listen, you got to take me down. You’ve been having me at 300 every month for so long.” She was like, “yeah, your liver levels are too high. We’ll bring you down.” And I went down to the lowest dose. I was like, 100 milligrams a month. And I took my last shot, like I said, Christmas Day. Last shot. Okay. How have you felt since then? Now? I don’t think I’ll feel it, because it’s I have so much in my system that I probably won’t feel it for a while. But mentally, I am good because I’m okay again. My addiction didn’t begin before prison. I never shot heroin. Yes, I was snorting, years and years and years ago. But, I don’t, think I’ll deal with withdrawal too bad. I’m ready to move on with my life. So something that I think is interesting about your story in particular, is that you went from using suboxone one way to using it another way. A lot of the time, when I talk to people, we talk about that the transition from whatever they were using before to using Suboxone. It can be a rough process for some people. Was there a challenge for you and getting started? Did you feel any sort of withdrawal symptoms? Did it take a while to find a stable dose? Well, I went from snorting it every day for years taking it orally. And to me, there wasn’t too much of a bad effect. I had that genuine desire. I wanted to better my situation. But, yeah, I was in that place where I wanted some change in my life, so I wanted that transition. I went from snorting every day for years to just taking it orally and completely stopping the snorting. I didn’t really deal with any withdrawal or too much of any type of pain or discomfort like that. How did the people around you—whether it was your mentor in prison, if you’re in contact with your mother or your family—how did they respond to you starting to take suboxone officially, under the doctor’s supervision? So for a while, I kept that from my family. It was just getting to a point where I was soliciting too much money from home, and I felt bad about it, and I was felt guilty about it, so I’d like reveal it to my mom on an email, like, “listen, I’ve been doing this, this, and that you’ve got to stop sending me money. I’m trying to stop cold turkey. It’s not working.” The only thing that did work is when they started that MAT program. Okay, boom, I’m good. I think my mother definitely feels it’s what’s best for me. I don’t think she likes the fact that I just stopped taking it so abruptly. I think she’s still kind of watching me, monitoring me to see how I’m reacting. But, I kind of showed her like, no matter what, I’ve got so much in my system, I’m good for the next few months. I was on a Sublocade for about a year and a half now. How has your experience with treatment changed since you’ve been released?ToneI’ve been home for two weeks today, exactly. I think there’s so much to occupy my mind that I’m not thinking about it right now. Who knows what’s going to happen in future, but right now, I’m just so occupied with this new world we’re living in that it’s not hitting me. I was smoking a lot of cigarettes when I was in prison, and I smoked my last cigarette on New Year’s Eve. So the not smoking and not getting my shot in January, I drink a lot of coffee right now, and I think when I have a moment to just chill and reflect, it’s going to be on my mind. I’m going to be thinking about it, but I think the goal is just to keep moving forward. The day I left prison, I was supposed to get the shot, because it’s like, mandatory that you get your shot right before you go home. And I refused it. And they had a fit in there. They had a fit, and they didn’t understand that. See, I already have this problem right now—I nod off a lot because of the Sublocade. I nod off all the time, and I hate that, I hate that I can’t control how I feel. And it’s humiliating. It’s embarrassing. So when I was going home that day and they were going to give me a shot, I didn’t want that in my system, because I wanted to be really aware. I wanted to be...what’s the word? Sentient. I wanted to feel this experience. I didn’t want that numbing and I wanted to move on. So I refused the shot. And like I said, they really questioned me, “why? Why do you want to refuse?” I’m about to go home. I want to be aware. I want to live in this moment. I don’t want that stuff coursing through my body right now. And I don’t want to be dependent on it in the outside world.EmmaYou’ve only been home for two weeks, I’m sure there’s a lot to do. Are you set up with a doctor, whether it’s a Suboxone doctor or just primary care? There’s a place called Odyssey down here. I’m down here in Atlanta area, and I’m going to meet with them in the next few weeks. There’s some logistics with respect to getting my ID changed from New York State to Georgia before I can sign up and do all that. But yeah, I have an outpatient group that I’m going to sign up with and meet with. I spoke with them today, actually, so I’m in the process of signing up for that right now. Good, good. And I mean, that’s one of the biggest risks, losing continuity of care, particularly when leaving prison, which is probably why they were so worried about you not getting the shot. So that’s a good step. What advice would you give someone if they were currently incarcerated, and this option, was offered to them?ToneIf you have an addiction? Take Suboxone, take Sublocade, because it will save you a lot of grief with respect to being in the kind of underworld, underground culture of prison and drugs. Get it legit. Get it from staff. Don’t try to sneak in and keep some for later and trade it. Do this. Take it the way it’s supposed to be taken, and move on with your life. I’m saying it’s a godsend. We didn’t have that for so long. I’m really glad the governor or the legislators, whoever in New York State, agreed to do the MAT program did that because for so long, so many people, it caused so much pain, damage and just misery, drugs in prison. So by them providing it, and if you really were trying to get on that track to being sober or to maintain it, it is a beautiful thing.EmmaAre there any side effects you would tell them to watch out for or just be aware of that you felt?ToneSo there’s a discipline that comes with it, right? Like I said, that numbing effect, it just comes with it, that nodding off from time to time. If you smoke, it makes you chain smoke like crazy, because cigarettes taste like steaks. Be mindful of your overall health, right? Drink plenty of water, exercise.Emmaokay, yeah. And is there anything you would want their families to know?ToneIt’s a good thing if used well and used properly. Again, in I can’t speak to the outside world, but inside, there’s a lot of stigma around it. There’s that kind of shame around it. So when they make the announcement, “MAT run,” there’s a lot of ridicule. You’re perceived as a junkie and this and that. It’s unfortunate, but that’s the reality of how it’s perceived. But you have to do what’s best for you, because what’s the alternative? The alternative is a lifetime of addiction and misery and incarceration and potentially death and just all these negative things, right? If used properly, it’s a life vest. It’s flotation device in a sea of despair, right? It can get you safely to shore. That’s the end goal. Keep the end goal in mind. The end goal is a better quality of life, and it definitely gets you to that point.EmmaGreat. Well, those are all the questions I had. Is there anything else you want to talk about that we haven’t mentioned?ToneThis last point, which I think is really, really important. It’s called the MAT program, Medication Assisted Treatment. So when it was first rolled out, it was supposed to be part medication, part counseling. There was 0, counseling, zero. No, I was in it for 1, 2, 3, facilities. There is no counseling that comes with it. So you’re just going to get this medication, and depending on what facility you’re in, some staff will give it to you and could care less what you do with it after. Others are super strict and watch you put it in your mouth and don’t touch your face, don’t touch your hands. But there’s no counseling with it. So what’s the end goal? What’s the plan? What’s the treatment plan? So if you’re in there for 2, 3, 4 years, taking this and now you just got Suboxone or Sublocade in your system, and there’s just no like, “Yo, how you doing?” Once a twice a month, you meet with the provider, the nurse provider, and she would ask the same two or three questions. But I’m talking about on a weekly basis there’s just zero counseling, and that part of it is not good. I had a good head on my shoulders. I had support. I had a goal to work towards my liberation. I was doing all the right things. I was able to use it and use it in a positive way. But counseling is supposed to come with it. It’s like 50% of it, and there’s none. There’s not even staff, a person to do it who does counseling for MAT in any facility. There’s nobody.Thanks for reading The Road Back: Insights on Medications for Opioid Recovery! Subscribe for free to receive new posts and support my work. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com

Chris (name changed for privacy) first sought treatment for his drug use around age 21 from a local methadone clinic, over ten years ago. This is a long interview, in which Chris describes his experience with methadone, the first medication to help stabilize his life, Kratom, which helped stave off withdrawal but gradually became a problem for him, Suboxone, which helped him through incarceration, and Sublocade, which he’s using to taper off of medication for opioid use disorder today. His story highlights so many themes common in the lives of people with substance use disorders: transportation problems, untreated conditions, grief and loss, and trouble with the law. I hope you appreciate his candor and his insights in this interview. You may see yourself in his story, or it’ll help you understand your loved ones or your patients. It’s definitely worth the read or the 54-minute listen.If you want to share your story, please reach out. Emma: You said methadone is the first thing you tried. So what led you to try that?Chris: So it was just a cycle. At some point my using was just way too chaotic. My life went downhill significantly. It was kind of controllable for a while, but when it got bad, it got bad quickly. A lot of legal issues. I was just trying to get my life together and I got tired of being sick. Methadone, I knew about. I knew about Suboxone, but something about methadone appealed to me in that it would kind of give me the pleasurable effects of opioids at first. I could choose my dose, and it was just like the easiest thing to do. The clinic I went to—they didn’t penalize you for using. It was definitely a gradual thing because their view on it is you can use until you feel comfortable to stop. But really, the idea was just stability. It was convenient, but it kind of wasn’t. The clinics are pretty far apart.Getting Started on Methadone for Opioid Use DisorderEmma: How far were you from the clinic where you were getting the methadone?Chris: So the clinic was 12 miles away, which it’s not extremely long compared to some people, but I don’t drive because my license is suspended, and my mom, at the time, wasn’t driving... It was an Uber or a Lyft. Every day for three years, I paid $20 to $25 every day. My logic was, I was spending anywhere from $120 to $300 every day on heroin. So it was cost efficient. My mom helped me a lot. I found an Uber driver that I was cool with, and I just paid them a flat rate every day to take me there and back.Emma: That’s nice. You said you knew a little bit about it before starting. How did you learn about it before you got started?Chris: I’ve always been into pharmaceuticals and that kind of stuff, and I always knew that methadone was an option, but I didn’t know anything about how it worked. I just was tired of using one day, and I just called the clinics around me, and I researched it as best as I could. I just jumped into it.Emma: And what was the initiation process? Like,Chris: The initiation at my clinic—and this is pretty standard from what I know in my area, at least—the initiation process, I went in, I did an intake, and that was with a counselor, and they did your evaluation. They did a COWS (Clinical Opioid Withdrawal Scale) score to address your withdrawal, if you were going through withdrawal. They also address your use and they do a drug test. And within 24 hours after that, they started me on—I think it was 30 milligrams—what they started me on.Emma: So they’re starting to do a little more now. But that was a very standard starting dose in the recent past.Chris: This was before fentanyl was popular. I first went to a clinic in 2014. So you could go up 10 milligrams a week. Okay, a lot of that was just consistency. You have got to go every day and I slowly got up to a dose that worked for me. It was nice, because that dose was holding off the worst part, but I was still kind of feeling uncomfortable, and I think I was still using for about five months.Emma: Were you using almost every day? Or was it more like the methadone kept you stable in between uses?Chris: I was using when I was able to. If I could do something, and I could earn some money. And because of the stability, I was able to get back to work consistently. I think I was more using from habit than physical need.Finding Stability on Methadone with Family Support and CounselingEmma: You mentioned your mom. You said she didn’t drive, but she was supportive. Did you tell any other family or friends, and how did they react if you talked to them about this?Chris: I hid my use from a lot of people for a while. The only person that knew was my mom—my mom and my sister. I always believed in being honest with them. And my mom was in the position of “I don’t know what to do, because if I kick you out, you’re going to go use on the street, and you’re probably going to die, and nobody’s going to help you. So we just got to figure this out.” and then she’s like, “I know you’re not going to get clean until you want to get clean.” It was a lot of harm reduction. She was just trying to make it as safe as possible for me to do what I was going to do, without enabling me completely. But they were supportive. Actually, when I went to the intake, I was very nervous, and I actually brought my mom with me. This was 2014 so I would have been 21. My mom was there the whole time. She went through all that. My mom is the one that did the paperwork for the Medicaid and all that, because I wasn’t educated on that yet. And my mom, I think she saw this as an out for all the stress that it was causing her. And I didn’t put this together until I got clean. But just because I wasn’t being a terrible son doesn’t mean that it wasn’t extremely stressful for her. So I think she saw it as a compromise. And, like I said, my mom was the one pretty much paying for the Ubers the whole time.Emma: Okay. And you mentioned getting up to the dose slowly and still using a little bit. At what point did you feel like you really got to a stable dose? And how could you tell?Chris: It didn’t happen immediately. Things started slowing down a little bit. I wasn’t using at all, and it was probably because I wasn’t getting high and I wasn’t sick. Around 140 milligrams was where I didn’t have to use and I was just, I was giving clean urines. It just slowly faded out from my life, which was a surprise to me. I think the stability helped. I think the idea of “I’ve got to get up every morning, even on the weekend.” So the clinic that I was at, there wasn’t any take homes, not even for holidays. The only time you got to take home was if it was a snowstorm. Gotta do those counseling sessions. I had to do them once a week at first, and when I wasn’t testing positive for opiates, I was bumped down to once every two weeks. So I think all those things combined helped.Emma: Did you find the counseling helpful?Chris: I think it helped me just externalize my thoughts and the reason why I was using. And it was just handy. It just got me acclimated to talking, and acknowledging the addiction. Because the only people I’d talked to about it were people on Reddit, or Blue Light back then.Cravings and Side Effects of MethadoneEmma: Okay, when you started to feel stable, did you have cravings anymore? Or were they pretty much gone?Chris: The cravings were gone. The only thing that was kind of weird, and this is kind of common with some people is because you’re not getting high off the opiates anymore, you might try to experiment with things that you usually don’t do, or that you don’t have a problem with, like cocaine. Because I think a lot of it was like the needle and the rush. And I think before I got stable I had given some positives for cocaine, but I quickly just discovered it just wasn’t a good thing for me. It didn’t really resonate with me like the opiates did. The cravings went away. And I think I just enjoyed the stability.Emma: Did you ever experience any side effects from methadone?Chris: Oh, yeah for sure. So the stomach issues—the GI issues, the heartburn, the acid reflux. The testosterone—it just completely wrecks your testosterone. And that’s the same thing with Suboxone. I got my testosterone tested when I was 23 and, like, average levels are, like, 353, 375 [Editor’s note, recent research suggests even 375 is a little low for this age. The cutoff for “low testosterone” would likely be around 400.] I was at 70. And that was, like, a direct thing from methadone, and that’s not uncommon. Also, the sex drive, which had been gone the whole time that I was on heroin. So that didn’t really matter.Emma: Eventually it might if you’re trying to change your life.Chris: That’s a thing too, as well. With companionship around that time, it was rough, because I was kind of embarrassed to be going to the clinic. It wasn’t a thing I was forward about with people.Missed Methadone Doses[Note: Read about new research into clinic protocols for missed methadone doses here.]Emma: Were there ever times that you missed doses of methadone?Chris: Not often, very rarely. I think I might have missed two doses in total. Out of those three years.Emma: I see a lot of people asking, “what do I do if I miss a dose?”Chris: The one time that I missed a dose, I went to the hospital. I had tried this before. The first time I missed one I didn’t have too much luck with it. Then the other hospital I found, they were reasonable. They would give me my dose, but if it became a repeat thing, they would turn you down. Because that happens a lot, especially in the city where people don’t have transportation and the buses don’t go out there. People miss their doses a lot. It’s easier to go to the hospital than it is to go to the clinic, so they know the people that are trying to take advantage of it, and they know the people that are just having trouble and they haven’t had their dose. If I had to go two days without it or a day without it, I could. And I wouldn’t feel terrible, but the next morning, I would definitely be feeling it, and I would have to get it.Emma: That’s super helpful to know. It’s got a long half-life. So I think in a lot of cases, you’re probably afraid of missing it before you’re actually feeling the symptoms of missing it.Chris: Absolutely, absolutely 100%, especially with methadone. So the thing with methadone is that your plasma levels are peaking at times, because you’re taking your dose, and then they peak, and then it’s a gradual come down, so you get acquired to the peaking and the lowering. And you know your body, so your body gets accustomed to that. The best way I can describe it is when an opiate addict feels sick, and they go to cop (get drugs). The drugs are in their hands, and they feel better. They didn’t even use it yet, but the idea that you have it, it’s in your hands, and you’re going home to get well, it’s like, a huge load off your shoulders. I mean, at least it was for me.A 90-Day Methadone Taper and Transition to KratomEmma: And at what point did you decide to switch to Suboxone, or whichever drug came next?Chris: I was on methadone. At the clinic I was at, you could not be on prescription benzos. You absolutely could not. That’s not the policy for every clinic, but a lot of clinics, they don’t care if you have a prescription. They don’t care if it’s legal, you can’t have it. And I’ve been on Klonopin since I was 14. I had dropped it when I went to the clinic, and then I went back to my primary care doctor at some point when I was stable, and I got back on it. And I knew it was just a matter of time before the clinic popped me, because they do these random prescription checks, and if you have another controlled substance or anything like that, it’s gonna pop up on the database in Pennsylvania. So I knew that was gonna happen. I was depressed the whole time on methadone. And I think it’s just opiates, in general, they’re just bad for my mental health, like I get in these moods. Anxiety and night terrors have always been a problem for me. So I got back on the Klonopin, and the clinic found out, so they told me I could get off it, or I could do the 90-day taper. And at this point, I was clean off opiates and everything besides weed and benzos for about a year. And I was confident. “Okay, I think I can do this. Like I’m just gonna come off. I’m tired of going here. I’m tired of spending the money, or my mom spending the money. Okay, I’ll do the 90 day taper.” We started the 90 day taper. It was okay until I got down to like, 45. I don’t know exactly how they did it, or the rate at which they tapered my dose, because I did blind dosing, where they don’t actually tell you. And I had a plan. My plan was, if I had to, I would switch to kratom, because I’ve done that before. And towards the end of the taper, I was taking Tagemet, which is a heartburn med, and it actually inhibits the enzymes that process methadone. It’ll increase your plasma levels. So I did that. I was just trying to keep it in me as long as possible. And then, eventually, I was done with the taper, and I wasn’t feeling awful, but I wasn’t feeling good, by any means. It was hard for me to get out of bed. It was hard for me to do a lot of things. I just remember that I had to move because I got a job offer. And I just had a bunch of kratom. I went up north and I got a new job, and I just quit. And I was too busy doing things. I had this new job I wanted to be good at. I just powered through it. It wasn’t ideal. And I had a crazy kratom habit. That was almost worse, to be honest.Emma: Were you ever using 7-OH or just kratom? There’s so much debate, such a hot topic right now.Chris: This was 2019 and 7-OH wasn’t a thing in the synthetic form. But I was extracting it, and I was trying to make it as strong as possible, because of my tolerance. The only good thing about it was it was cheap. The only time it got out of hand was with the extracts, which can get expensive, like 20 bucks a piece. And I managed a smoke shop, and I got it for 10 bucks a piece. And I was still using at the peak, four to five of those a day. And it wasn’t long before I got dependent. It was just a lot easier to maintain. And I did that for two years.Emma: Were you able to maintain the lifestyle you had that was more stable throughout that?Chris: Everything about that was stable. The only thing that’s worth mentioning is when I got this new job, I was there for a year, and I lost my insurance. My Klonopin cut off. I remember that. And I had switched to Xanax. I was at work, I couldn’t find any and I had a seizure. That typically doesn’t happen for me with benzos. It’s not uncommon, but when I’ve used Klonopin or Ativan, I’ve never had that issue. But, Xanax was completely different. I had a seizure. I cracked my skull on the ground, and I was in the ICU for 14 days. One thing that was eye-opening about that was my tolerance to opiates, because I woke up and I was in terrible pain from the ocular pressure. It was probably the worst pain that I’ve experienced. And I remember I was up and I told the doctor. I was like, “Hey, you gotta, you gotta give me more opiates, because I was a methadone patient for three years.” I told him to check the prescription history, because it’s all there. And then he comes back and he was extremely nice. They had a doctor there that would just administer more and more and more, and they would check your vitals and watch your breathing. And I finally got to the point where I got pain relief. And that was eye-opening, because if I wasn’t able to tell them, or if I didn’t have the proof, I don’t think they would have done it. And it was like, an insane amount of, like, hydromorphone and, like, morphine on top of a benzo, because the dose got so high that they couldn’t go higher, and they used a benzo. I’m like, 125 pounds. I’m not a big person. So that was surprising to them, but they were extremely understanding. And I told them “as long as you don’t send them home with me, I’ll be fine. I have to have the pain stop. I just don’t want a bottle to take home, because I’ll take them all. I already know.” And the doctors blamed it on the kratom, and I knew that wasn’t the case.Emma: They blamed the seizure on the kratom or the tolerance?Chris: The seizure. Because they tested me for Xanax there and I didn’t have any, and I’m like, “Well, that’s the problem. I don’t have it in me. That’s why I had the seizure.” And so I explained to them, but they weren’t well-educated on kratom. So I did that for a while, and I got out of the hospital. I continued to use kratom. I just noticed I was getting a little more reckless with the things I was doing. And this is kind of crazy, but I ended up getting with this girl who sold pills. It’s actually extremely crazy, because the house got raided that I was in with her. This was 2021, and then I got in trouble for conspiracy, possession with intent, because I was ordering stuff for her and middle manning it, and they found some text messages, and I went to jail, and I had to kick it. I just had to kick kratom because jails don’t test for it, so they’re not going to treat you for it. You’re just going to detox. And the county that I was in, they didn’t even treat opiate detox until pretty recently, but they weren’t doing Suboxone yet. I got an unsecured bond, and then I went back home. I just got away from the people, and I just decided I gotta change this because I’m gonna go back to court because I’m on bail. And I don’t know how this is going to work out, and I don’t want to go to jail and kick a kratom habit again. So that’s when I went to a Suboxone doctor. I posted bail, and then I found a doctor when I went back home.Choosing Suboxone for FlexibilityEmma: Any reason you chose Suboxone that time instead of methadone?Chris: It was more manageable. The prescription, I could take it home with me. I didn’t have to pay for rides. I didn’t have to find a clinic. For three years I didn’t go on a vacation or anything like that because of the guest dosing. (Getting your methadone at a clinic that is not your usual home clinic when traveling). It’s a headache and you’ve got to pay out of pocket. The Medicaid in Pennsylvania is not going to pay for a dose that’s in Florida. I mean, it’s just not going to happen. So that was appealing to me. I had tried Suboxone before, in the past, but I never tried to take it for maintenance. It just didn’t appeal to me. Methadone was a lot more appealing.Emma: Okay, so this time the freedom of Suboxone sounded good. So what was the process like of getting started on Suboxone?Chris: When I came home I checked myself into rehab. I knew it would make the people around me happy. So I did it. Probably not the right reasons. And there was a doctor there that could give you the script. They would evaluate and you would have your script in a couple of days. And it was convenient. They took Medicaid and then the day before my prescription was supposed to be filled, I tested positive for Suboxone. I’m in the rehab, which is kind of crazy that they would drug test me the day before, but because it wasn’t mine and I wasn’t supposed to be taking it yet, they decided to discharge me. I got into an argument with the nursing staff. The nursing staff was confused and then I asked them, “so can I have my Suboxone? Because I’m leaving, I’m taking my clothes. I’m leaving because you guys are going to kick me out. But I want my Suboxone. Those are my meds.” So they told me to come back. I explained to them. “If you don’t give me my Suboxone now, I’m gonna go use. I’m probably gonna die. I’m gonna go use.” And I tried to kind of guilt trip them into giving it to me, because I knew you can do that.Emma: And also, liability, right? They don’t want that on their hands.Chris: And it’s a possibility that could happen. That’s not uncommon. So I leave, and then I get a call back from the nurse an hour later, and she’s like, “okay, I have your strips, you can come get them.” And I went, I got them, and I just started. It was nice. It took me a while to get acclimated to it. I didn’t really like taking it, for some reason, I think it was the orange taste. It just made me gag a lot.Emma: Did you start gradually on a lower dose and go up? Or could you just start right away?Chris: So they started me at 3 eights a day. It was 24 milligrams, which was the max. The thing about it was that I got into it for the mood lift that I would get off of it, and it was kind of nice. It was like a subtle opiate buzz. But I wasn’t impaired, and for a while I would notice that I’m supposed to take it like, three times a day, but I was only taking it like once a day. Sometimes once every two days, because I didn’t have anybody around me telling me to take it. They would just assume that I was gonna take it. And I didn’t enjoy taking it to begin with. I kind of saw that as a blessing, because I didn’t want to be on it long, so I stayed at that dose, from 2021 until I went back to court in January of ‘24Emma: Wow, that’s a long time to wait for a court date.Grief, Trauma, and Relapse Risk: Coping With the Loss of a ParentChris: Yeah, a long time for a court date. It was continued a couple of times, and the charges were dropped, and they they only kept one of the charges. But when I was going through this, my mom was diagnosed with cancer. Actually, it was when I was in rehab, and we found out it was pretty late stage. It was stage four, so there wasn’t too much that they could do beside chemo and radiation. And then in November of ‘23 my mom got covid and she ended up in the ICU. It went downhill quick. And then this person that’s pretty much been in my life the entire time, through all this, was dying in front of me. Ultimately, she was in the hospital for 10 days, and the doctor said there isn’t really too much we can do. “Her lungs are failing. All we can do is keep her comfortable.” She was intubated by day four. So they were like “even if she does recover from this, there’s going to be problems.” And we knew this. We had a family meeting, and my grandparents are extremely religious. We decided “well, we’re gonna pull her off life support. And if she pulls through, she pulls through. But if not, it doesn’t make sense to hang on to it and have her suffer and all that.” So this was pretty traumatizing for me to say the least. This was the closest person in my life. Through ups and downs, my mom was always there. Every time I got in trouble, my mom was always there. Every time I was in a bind, my mom was always there. My mom’s boyfriend was an ex heroin user. He was a heroin user back in the 90s, like he was clean the whole time. And I actually have a picture of this when I was in the hospital—so we got to say the goodbyes to my mom, and I’m paying attention to what’s going on around me—and on the desk is a bottle of a Dilaudid. It was like a half vial. And I remember I’m in the room, and I saw it, and I was like, “What are the odds of that? That they leave hydromorphone just out?” At some point, it clicked in my head that I’m gonna take it. I’m gonna take it, I’m gonna go home and get high. I decided when she went to the hospital that if anything happened to her, I was going use. I’ve always used to self-medicate. It’s a good emotional number. You don’t care. And once I saw that bottle, it was a confirmation of that. So I stole the vial, and then we said our goodbyes. We unplugged her, and I wasn’t around for the unplugging part. And the tube pulling out. I didn’t want to be there for that. I thought I did, but I was just a wreck, so I went home. There was a lot of guilt around it, because I know that I had covid as well, and we don’t know if I gave it to her or if she gave it to me. There were just a lot of things that I still have some feelings about. But I went home that night. I’m a wreck. My stepdad is a wreck, and we both ended up relapsing, and it just went downhill. It just went downhill extremely quick. I think we were both using for a total of four months before everything just fell apart. He lost the house, and I had to move. I had to go back to court. My mom died in November, and then by early January, I was couch surfing and I was just trying to get by, and I knew that I had to go back to court. I knew I was probably going to prison, so I kind of just kept using. I tried to stay clean—or I tried to keep my script, because that was the plan. If I go to jail, like, I want to have the scripts, because then I’ll get Suboxone. The Klonopin was a no-go when it comes to prison. They won’t prescribe it. But the Suboxone was one that you could get. I was using, and I was casually using the Suboxone, but it got to the point where I couldn’t take the Suboxone because of the precipitated withdrawal. If I would use it, then I would have to continue to use it. If I go back and forth, I’m going to go into precip. But I kept the script, because I kept going to the appointments, which was surprising, to say the least.Taking Suboxone While IncarceratedEmma: You surprised yourself by continuing to go, or are you surprised to maintain a prescription?Chris: No, so it was surprising that I kept the prescription because of the appointment requirements and all that. I wasn’t really trying. Eventually, though, I was pulling out of a gas station, and I get pulled over, and I’m with my buddy, and I have drugs on me. This was 10 days after I didn’t go to court when I was supposed to, because it was an hour away. So I just couldn’t go. And I just didn’t go because I didn’t really care, to be honest. And we get pulled over. So they ask for my ID. I tell them I don’t have it, and then they search me, and then they find it, and they run my name and I have a bench warrant. So I have to go to another county that’s two hours away. They didn’t charge me for the drugs I had. I came in, they do the intake. I explained to them that I’m on Suboxone and all this. So that was all good, but I was in the holding cell for like 20 hours and I didn’t get my meds. I was starting to get sick. I was also on xylazine a lot of times—it was a problem in my area, but I wasn’t too educated about it. I figured I had been taking it because when I was on it, even if I had Suboxone it wouldn’t help the withdrawal. It was a terrible time. For like, three days, I tried to take the Suboxone. The first day I went in the precipitated withdrawal, and then the second day, I was just throwing up the whole time for three days. And I don’t remember much about it. I just know it was a terrible time. They gave me a Valium taper at the county jail, which is lucky, because the majority of them don’t typically care. The only thing they’ll do is they’ll give you Keppra, so you don’t have a seizure. But I got a Valium taper, which is supposed to be 10 days, but I knew the county that I was wanted in was going to come get me within two days. So I just tried to hoard the medication as much as I could, and split it up. So the other county came and got me, and I go through kind of the same process all over again. This is when I found out that all the jails in Pennsylvania now—if you’re on Suboxone and you come in, that’s what you get—which was nice, because I think the first time that I got arrested, we didn’t have Suboxone in jail. The only people that got MOUD were pregnant females who would get methadone, and that’s only if they paid for it. It wasn’t an automatic thing. So that was nice to have, because I wasn’t expecting that. And the only difference was they transition you to once a day dosing instead of twice a day. So I did that at the county jail. I was in the county jail from that January, and then I think I got to court in May.Emma: Is this 2024 we’re in? Did you stay at eight, or did you go up to 12?Chris: Yeah, yeah. This is 2024. I got to court in May, and I was sentenced. And at that point I just copped out. I took an open plea, I got a sentence, and the judge is like, “All right, we’re gonna give you a one to two.” And this whole time that I’m in I don’t have money, because, my mom died, and that was a person that helped me out when I was in jail. Well, I was, like, cheeking my Suboxone to make money. They’re expensive in jail. This is a crazy setup of scenarios. So I got caught, and I go to “the hole” for a month. I think they reduced my dose in half, and I get out the hole, and within a week or two, I’m doing it again because I need to make money. I know I’m going upstate, I know I don’t have people on the outside. I’m just trying to get as much money as possible, because at this point, I was making maybe 400 a week on Cash App from the Suboxone, and I get caught again. It’s probably about a month later I get caught. They say “we’re going to have you taper now, we’re going to kick you off.” And I’m stressing out about it, because I know it’s a 10-day taper. And when you get sentenced, you don’t know when the transport is going to come get you. They don’t tell you that. It’s a security thing. But I’m in “the hole.” I was on day five of the taper, and I asked them, “hey, so what’s my dose for tomorrow?” And they’re like, “we don’t have a dose for tomorrow.” And I’m like, “what?” They’re like, “no, we don’t have one.” I know it’s a Wednesday, so I’m like, “wait, they do transports on Wednesday, so they’re probably coming to get me at 2am.” And that’s what happened. They came and got me. And when I get there, they asked me about my prescriptions, and I say I’m on Suboxone. And they’re like, “okay, what’s your dose?” I didn’t know what to tell them, because I’m not going to tell them that I was tapering. That’s for damn sure. Emma: Yeah, that seems like an oversight on their part. Chris: A huge one! So I just told them I was on 12 at the time, and so it takes them 24 hours to do the verification. So they call the other jail, they find out your prescription history and all that. Well, when they did the prescription check, the only thing they did was they checked the dose, which at the time was eight, because I was like halfway through, like the 10 day taper. And they kept me on the MAT program, which was nice. So they moved me down to eight. And what it is in the prison system, is the dose you come in on. I was like, super grateful. The dose cut wasn’t huge for me, because I was only taking like half of it, because I was selling half of it.Emma: You had already cut your own dose, essentially.Chris: So I was extremely grateful, because I was watching people go through it, because I’m in quarantine. So there’s people there from all over the state. So there were three people who came from a county that only does methadone. So they had to get inducted.Emma: And where you were, they didn’t do methadone? They only did Suboxone?Chris: Exactly. It’s only Suboxone, and people were getting their first dose five days after their last methadone dose, and it was terrible. They were going through it. People throwing up. They were vomiting. I was just extremely grateful that I wasn’t going through that. So that, on top of the change of environment, the better food, I got to see some people I know from my city. Everything about where I was was great. It’s kind of sad to say, but I was extremely happy. I was like, the food is a lot better. There’s actual programs.Transitioning from Suboxone to the Sublocade ShotEmma: Did you use programs? What did you do?Chris: So I’m a graphic designer. I got a job in the print shop, and I was a teacher, and I was teaching people Photoshop, because they had just got the computers and Photoshop and nobody knew how to use it. I came in and I was like, “okay, I think I could teach people this, and I can make it into a curriculum.” And that’s what we did. We just made an entire curriculum, and I got paid for that. I also had to do drug treatment there, which they call a TC, which is a therapeutic community. And it’s like a rehab, but it’s on a jail pod. It’s kind of a joke. It’s not really that serious, but the state tries to send as many people through it as they can, because they get funding for it. It’s just a way for them to say, “hey, we have a program. It’s for drug addicts. They’re going. Attendance is high.” But it’s not really intensive. You go to meetings. You have some groups, and that’s really it. But you had to do it in order to get parole. I had to complete my programs. So I was on Suboxone still, but then I transitioned to Sublocade. The prison had just gotten it. It’s expensive because it’s not generic, but the idea to me was that I could increase my dose, because the 300 shot is technically—so if you divide it by 30—it’s like the 10 milligrams a day. So in my head, I was like, “that might work better for me.” The other incentive was so I didn’t have to go every day to the chow hall and I didn’t have to get patted down, and my mouth inspected with a Q tip. It was just a headache because it was cold outside. So we had to walk across the prison compound, and we would go to a cafeteria, and we would stand in line, and there was, like 300 of us. They could only seat 20 at a time, and you’re there for five minutes at least, so you’re in the cold for like a half an hour. And I was just tired of that. I was burnt out by it. I was just like, “I just want to go on the shot. I hate this. I don’t want to go in the cold. I don’t want to leave the pod.” Emma: So what was that transition like? So it sounds like you needed a higher dose, whether it was from the shot or or the oral form.Chris: It was easy, actually. So the process was, you jump to 300 and you get two shots, and then you go down to 100 and then you could be on that for as long as you want. So I did the 300. I got the first one, and it hurt a lot. It wasn’t unbearable, but it was noticeable. And they don’t numb you. So a lot of doctors will numb you, which is nice. My last shot, which was in September—that doctor introduced me to lidocaine and bupivacaine and that was a miracle. But we didn’t have that in prison. So you got the shot usually from, an inexperienced nurse that barely knew what they were doing. And if you go slow with it, it hurts, because it burns, and it’s kind of viscous. And the 300 shot is like one and a half, mLs, which is a lot of fluid and it solidifies. But I got used to it after the first two shots. It wasn’t that bad. I actually got a buzz off of it, which surprised me, because I was up for like two days. I could not sleep. And that’s a pretty common side effect with me when it comes to opiates, I can’t sleep. But it wasn’t bad. I felt more stable. 100%. I was way more stable. Emma: Okay, and you said that you took your last dose in September. So did you taper off of it?Chris: So I jumped off the 100. I just jumped off.Emma: Well, some people are doing that now, because it naturally tapers essentially.Chris: So I wasn’t expecting anything, because I heard some tales from people saying, “hey, I got off it.” One out of every 10 people would probably say, “hey, I felt it.” And when I got out in September, I was a little more educated about it, so I read a lot about it. I saw the clinical trials and all that. But the one thing about the prison was that they tested your plasma levels every month. So I got to see the plasma levels, and I was like, “wow. Those are pretty consistent.” I have the same amount in my blood 35 days after my last injection. And the lump is there. It’s noticeable, so I know it’s there. I know it’s still releasing today. I took a drug test three days ago and I was still positive.Emma: Okay, so you’re two and a half months out?Chris: And that’s not abnormal. I know people that have been off like 18 months and they’re still coming up hot, yeah. And the literature says it can take up to 32 months. That might have helped me.Emma: When you decided to come off of it, was it a decision because you didn’t want to be on it anymore? Or was it just because you had left prison?Chris: I didn’t feel like I needed it. I don’t know. Whatever changed in my life—there was something that changed. It was probably the combination of my mom dying, the prison sentence, and everything. That the idea of using just doesn’t appeal to me any more. And that’s partly because I wasn’t getting high any more, because the tolerance was so crazy. Everything now is fentanyl, which, if you’re a classic opiate user, fentanyl sucks. It’s garbage. You don’t have that warm blanket feeling. You don’t have that blissful euphoria. If you do too much, you die, and if you don’t do enough, you’re getting sick every four hours. It’s garbage. It’s not like heroin or like oxycodone. People use it because they have to.Rebuilding a Life in RecoveryEmma: If you faced a trauma like you did with your mom passing again today, do you think you would be equipped to handle it without using?Chris: Yeah, yeah. After my mom died and I got high for those five months, at one point, I got sober enough where I came to and thought, “at some point, I have to deal with this, and if I don’t deal with it now, it’s going to be worse.” And I knew I was going to prison. I saw it as the perfect opportunity to get everything right in my life, slowly and gradually, and that’s what happened. A big part about it was treating my mental health, which I wasn’t able to do too much in prison, because everything there is a formula. So they go by very specific guidelines, and they use extremely specific medications. They don’t go outside the box, at all. So I left September 10, and that’s when I got my last shot. I arrived at a halfway house that day, and I’m an hour and a half away from home, like maybe two hours. In the first month, I treated my mental health. I got a job as a supervisor at a retail store/gas station, which pays decently. I have a stable income. I’m going to look at apartments in the next two weeks, and I have a savings account. I have a psychiatrist now that I can visit, which is a big thing. The psychiatrist component was a huge thing, because every time I used it was for self-medication. It was to get away from whatever I was experiencing.Emma: That’s why I was asking, because you’ve made very clear with your mom’s passing that it was a very obvious trigger.Chris: Oh yeah, for sure. And it’s always been a tool that I use. Opiates were always a tool to use when things got too tough, and I wanted to just forget about it. I didn’t treat my mental health. That was partly my fault, because I only treated the anxiety and the night terrors, the PTSD.Emma: Well, those seem like pretty urgent symptoms. I think anyone would start with them.Chris: And I think I got dependent on the benzos because they work well. A part of me felt like I couldn’t function without them. And it took going to jail and being in prison for me to realize I’m not a complete mental wreck without them. But I do have issues and I talked to the psychiatrist. We were talking about the symptoms I had: the anxiety, the procrastination, I’m bad with appointments, and she goes “you have ADHD, and you’re not treating it.” And I was like, “yeah, I don’t think so. I’m not hyper.” And then she goes, “well, that’s not a prerequisite. You don’t have to be hyper.” But then we went through my childhood, I was a pretty decent kid, up to high school. Then I started being impulsive and doing things recklessly, especially, with my mouth. I would say off-the-wall stuff. I was just the typical Class Clown kid. For whatever reason, the anxiety to me felt like a bigger component, but I still had these problems where I’d think “I’m gonna get to this tomorrow,” but I would never do it. I’d just procrastinate. So I got out and I got on some meds, and the psychiatrist was extremely understanding. I had told her I had tried Straterra (a non-stimulant ADHD medication). I had overdosed back in, like, 2021 and I got 302’d (put on involuntary psychiatric hold for 72 hours), because they thought I did it on purpose. And I saw the psychiatrist there, and he talked about it. He gave me Straterra because he also saw the ADHD, but it didn’t work, so I just kind of forgot about it. And then I talked to the psychiatrist— it was like five weeks ago now that she started me on Concerta—I was surprised that she gave it to me, because it’s a stimulant, and I know how they like to label people when it comes to addicts. But I was honest with her. I told her that I’ve tried meth. It just doesn’t appeal to me. It just wasn’t my thing. I have tried Adderall and stuff like that, in high doses, and it keeps me up, but I feel level on it. But I never pursued a prescription for it. I think it’s because I thought of them as a stimulant that’s not going to help me. But I got on Concerta, and it’s night and day. I feel like life now is on normal mode. And the entire time, I’ve been playing on expert mode, and I couldn’t do it. I just couldn’t do it.Emma: I talked to a lot of people about ADHD, in general, outside of substance use, and that’s what they often tell me. The first time they took it, they told me, “I cried tears of joy, because I just realized how different it was.”Chris: I noticed that I’m not a lazy person. And I knew that, but if things don’t interest me, or if I can’t focus on them, I’m not going to do them. And that was my problem. I would get sidetracked a lot. I can tell you this, if a random person contacted me and said, “hey, I need to be on zoom at 6:30 tomorrow.” There’s no way. I would have been late.Emma: I was thinking you said you’re bad at appointments. But you were on time today. You sent a confirmation email and everything.Chris: I’m doing supervisor work now. So it’s a lot of managing people and paperwork and problems, and I feel like it’s just, night and day. I’m on point, but I’m not stimulated. I don’t feel like I consumed anything. It’s extremely odd that a stimulant would help your anxiety, but that’s exactly what it did. I mean, it’s working pretty well, so I can’t complain.Emma: Those are about all the questions I had. Is there anything else you want to add that we haven’t touched on, that you think is important?Chris: What I said before is, there is a MOUD for everybody, no matter the stage that you’re in. If you want to get high still, but you just want a blanket to fall back on so you don’t get dopesick, I understand it. Just go do methadone. But eventually you’re gonna get into the routine of trying to be productive. I mean, it’s gonna rub off. It could take a while. And I understand if you’re a MAT person, and you also have chronic pain, I would also probably go to methadone if I had that problem, because it’s a full agonist. But, Suboxone, if you want to try to get your life together and want to work, and you want to have a schedule, and you want to be active in your kids’ lives and stuff like that. I think Suboxone works extremely well for that. And then Sublocade is for people on the tail end of that. I have seen people try to jump to Sublocade because they’re concerned, thinking “I don’t want to be on this long.” And I think that’s a huge mistake. Because, every study has shown that the longer you’re on it, the better chance you have. I can’t recommend MOUD or Sublocade enough to people. It’s been a game changer, and I think people should evaluate where they’re at. Especially towards the tail end, especially in the halfway house, the Suboxone or the shot, it was like an insurance policy in case I decided to use. There’s a good chance I wouldn’t die. So people just have to do what’s best. And I think they should talk pretty candidly when it comes to their doctor, and they should not be concerned about how long that they’re going to be on it. I think that’s a mistake that a lot of people make, because it’s stressful. It’s only probably going to hinder you. And it’s probably going to take you a couple more attempts. I mean, it’s probably going to be a cycle thing, like it was for me.Thanks for reading The Road Back: Insights on Medications for Opioid Recovery! Subscribe for free to receive new posts and support my work. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com

Kratom is sold as a dietary supplement at stores throughout the U.S. It’s naturally-derived and contains trace amounts of 7-OH, a chemical that works on opioid receptors in your brain. It also contains mitragynine, which becomes 7-OH in your body. (I’m work on an upcoming post that’ll describe the difference between Kratom, 7-OH, and other Kratom derivatives, which are sold in synthetic and concentrated forms.)Though there’s fierce debate on social media about whether using Suboxone to help kick a Kratom or 7-OH habit is the right choice, doctors have started prescribing the drug to treat patients who are struggling with problematic use of these and related supplements. In this brief conversation, I speak with a TikTok a follower about his experience choosing to use Suboxone to get off of Kratom. For him, the transition was smooth and taking Suboxone helped stabilize his lifestyle. It’s been a few years, and after some health problems, he’s been doing a gradual, self-guided taper. Listen above or read the transcript of our conversation below.Guest: I was starting to go to college. I had been a Kratom addict for a decade. I’ve been taking Kratom since Kratom came out on the market, like in 2009 ish. So even longer than a decade. And let’s see, so, I was starting school. I was in a relationship. I was living in a state where Kratom was illegal. I was living in Indiana, and I was trying to survive, trying to work my way through school, not having a lot of money, and it just occurred to me that Suboxone would be covered by my insurance, and it would be an affordable and legal option. And Kratom is something that I never really felt like I had a real serious problem with. I would go on and off of it. But I found when I was on Suboxone, though, that there were benefits. I felt like I had a much more sober lifestyle, and I came to really prefer that to being on Kratom. I can’t stress enough how being on Suboxone and taking it like you’re prescribed—I was taking up to two eight milligram films a day— was not altering me in any way; I was sober.Emma: And when you talk about using the Kratom, did you feel sober when you were using it as well? Or were you using that for intoxication?Guest: I was using it to get high.Emma: When you started using Suboxone, were you intending to get sober? Or you said it was just another option?Guest: I was going to school. I’ve always had sort of a mixed attitude about, quote, unquote, “sobriety.” You know, I’m 38. I consider myself to function well. I still use cannabis, eating edibles. I still take psychedelics every now and then. And that was always stuff that I intended to continue doing. But opioids are a thing—Kratom was a thing—that I’ve always intended to get off of.Emma: When you started Suboxone, what was that experience like?Guest: It was a transition. They put me on one and a half and that was too much at fist. And frankly, instead of telling them that that was too much, I just took what was enough and saved the rest. Because there were, in fact, rainy days. There were plenty of times when things didn’t sync up and I couldn’t get my appointments, and I ended up using all of that over the years. I was at the clinic for three years.Emma: Parents. Did you ever talk to them about being on Suboxone? What kind of reaction did they have?Guest: Yeah, they supported it. They know about it. I’ve had it a lot, lot worse.Emma: And when you first started taking it, did you have any trouble with the transition? Did it take you a while to feel stable, or was it kind of right away—within a day or two—that you felt stable?Guest: The only struggle that I had was with constipation. That continued to be an off and on struggle. Taking magnesium, and I kept MiraLAX on hand in case there was any problem. I’m really grateful that that has not been an issue since I’ve really reduced my dose. I’m on less than a milligram currently.Emma: At what point did you decide you wanted to start trying to taper off?Guest: When my lung collapsed. [Editor’s note, lung collapse was about 1 year ago and was not related to Suboxone or Kratom use.] I was in the hospital, and I didn’t have my Suboxone with me. I was also on extremely strong opioids. I was on morphine and fentanyl, and those weren’t really doing anything for me, because I had that tolerance from the Suboxone, so they were giving me Ativan and that did help. It was during that [that I decided it was time to taper.] And subsequently after that, I found out while weaning down from Suboxone, that my liver enzymes were high. I had to look at getting off a little faster, because that was really one of the only things that we could arrive at—me and my doctor—as to what was causing it. Emma: How did this conversation go with your doctor? So your doctor is helping you with this paper?Guest: No, he knows about it, but he doesn’t practice this kind of medicine, really. So I really feel like he doesn’t have much of a clue about substance use and about mental health stuff. I’m really looking for another doctor, but this is a primary care doctor that I’ve had since last year when my lung collapsed.Emma: So he supports you in saying, “Okay, getting off of this is an option to help with the liver enzymes,” but he’s not directing you and telling you how to taper, is that correct? Guest: Yes. Emma: Okay, so how have you adjusted your doses yourself?Guest: Well, it takes me about a week to reduce by about 1/8 of a film at most. It’s been very slow. That was over a year ago. I’m still trying to get off, and frankly, I have interspersed some days I’ll just not have it, and I will take a little bit of Kratom. And I find that that’s not really satisfactory. The half life is too short in the shadow of the Suboxone, it just doesn’t keep up.Emma: Okay, have you felt any withdrawal symptoms?Guest: Oh, yeah, every day.Emma: For the whole last year you’ve been feeling them?Guest: Yeah, it’s subtle, mostly, thank God. It’s not like quitting-quitting. But every day I have a bit of a tummy ache, and I get sweats.Emma: I don’t know if you have seen discussions on Tiktok: some people are very worried about Kratom, and some people are very against using Suboxone for Kratom. But you say for you, it was very helpful, right?Guest: I think whatever gets someone through and gives someone a quality of life is what they should do. In my opinion, if somebody takes heroin responsibly—I think that that’s possible—people should do that if that’s what they need to do. So I certainly think that using Kratom is appropriate when it helps. Suboxone for Kratom, it helped me to establish a sober sort of lifestyle.Emma: Is there anything that you want other people to know about medications for opioid use disorders?Guest: People should do what they need to do to get through the day, whether that is reducing or trying to find a safe way to do their drug of choice, or getting on to Suboxone. It’s a good thing to do, and any degree of harm reduction is a good thing. I think that’s about it. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com

Katie had been prescribed pain medication to manage Lyme disease, but she was cut off from her medication, leading her to seek illicit substances. With the support of her family, she went to rehab and started Suboxone. This is her story.If you’d like to share your own story, please send me a message! This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com

In June 2025, I interviewed Pixie, who told me that methadone helped them recover from heroin addiction. Shortly after starting methadone, Pixie became pregnant. Several years later, Pixie did a gradual methadone taper and managed to avoid any methadone withdrawal symptoms. Here is their story.If you want to share your MAT story, let me know. I’d love to hear it. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com

Listen to Jen describe her struggle with prescription pain killers and how she ultimately improved her life with the help of Suboxone, a medication for opioid use disorders. And check out her TikTok here. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dailymat.substack.com