Expert: Caroline West - 12/13/2010

Question
Caroline, my husband and I have been married 23 years (just so you know).  Four years ago I discovered the reason he quit living outside our garage and paying any attention to me and our family.  Heroin.  After making the discovery, he took himself in for medical detox.  He followed with intensive outpatient, and celebrated 3 years clean.  Then several months ago, those same behaviors started resurfacing.  He was quick to be mean and angry, dozing off all the time..sure enough, he relapsed.  Again he went to medical detox, but this time claims he has all the tools and is assisted with suboxone...now for a month. Isn't that an opiate substitute?  He seems better, but not completely, and I still see evidence of nodding.  What can you tell me about this and what to expect?  I am scared ):
Thank you for reading,
Susan

Answer
Hello Susan.

The thing with getting clean and becoming abstinent from Heroin is that however long it's been there will always be the risk of a lapse or a total relapse. Some say it's complacency others that it's a lapse in vigilance,but either way a user will always for the rest of their lives have to be on point to past and even new triggers. It's not really that different to Smoking. A successful quitter can still pick up a cigarette 10 years down the line for whatever reason,and the same goes for Heroin and other drugs.

The positive is that the more times quitting has been successful,the easier it becomes to get back on track. Like in your husbands case,he picked it up again after 3 years clean,took it for a few months and got himself into Detox again,that is I imagine faster than the first time. But still those few months are damaging and it could take several months for him to fully recover from mainly the psychological aspects of having relapsed. He's on Suboxone which your right is a substitute. To put your mind at ease,Suboxone has an ingredient in it which blocks any highs if Heroin was used again plus it can send the body into withdrawals if Heroin is used. So as for substitutes,Suboxone is far the best one to be taking.

The reason he is nodding is probably due to the sedating qualities of Suboxone. It is still in the Opiate family so some drowsiness is to be expected. Once he is stabilized on a maintenance dosage,he can then start reducing and the nodding will gradually wear off. There is no need to rush it as for the risk of a possible relapse,but let him get stable and the Heroin 'habit' out of his system and then let him decide with his Care Provider the best course for reducing the Suboxone.

He has got clean before and I have no doubt that he can get clean again. The habits he has got into will eventually wear off and in time he will be totally clean again. I really don't think you need to be scared,as I mentioned he cannot use Heroin while on Suboxone so his chance of recovery is going to be much higher and successful. I know that it's difficult but hold on and in time you will get your husband back,it will just take a bit of time,that's the best I can say to you.

If you feel you wish to vent or talk more about this then feel free to write in again. Hold onto the fact that your husband has done this before,he is in treatment and in my mind I feel very positive about his chances of getting clean again. Take care,Caroline.