Needle fixation and addiction!

[Dant1]

I was a heroin addict for a number of years, and recently managed to get on a program and to kick it. i finally cracked doing gear in november/december after being on the program for a few months. i was prescribed 16ml subutex and 20ml Valium. i didnt want meth because i wanted a blocker in me so i if i did gear on top it would have no effect, unfortunatley i still done gear every week or so having to use alot to break through the subbys or just not take them. but when i kicked the gear for the last time i took subbys for a the first few days under the tounge and then a mate of mine showed me that you could hit them up. and being of the gear for only a few days, shooting up subs was kind of taking the edge of. but its now august and ive been hitting subs up foor 9 months. and its mad because i got a really bad case of cellulitis from it on my left arm. i was given 2000mg of penicillin aand 2000mg of flucoxicilline to get rid of it, which is a very high dose and you would think that would scare me into quitting but that was back in march. Anyway i cut down from injecting 16ml a day to 14ml a day, but i inject an 8ml in 3 hits and the 2mls in 2 - hits. so sum days i can hti up 12 to 14 times a day and its getting a bit of a joke now. ive been trying to cut down on how many times i hit up and im doing ok but not brilliant. so if anybody reads tthis and feel they can chat to me or feel in a similar situation or have feelings about the subject please send me a message.

Trying to quit
Dant1

[znagemq]

Hi Dante
I am not sure what to say here.........what I immediately thought is go back to using the gear, it will cause FAR less damage to your veins. It sounds like you are not ready to give up the lifestyle of using - 12 - 14 times a day does not shout to me that you really want to stop. Before you use - what are your thoughts, desires, fantasies that drive you to hit up again? You really need to look at what is causing you to use, why you are using Subbi's instead of gear and be realistic. Often people become fixated with the needle but would you still use 12 - 14 times per day if you were injecting water? Part of what you describe is about habit but my feeling is that if you were shooting up water the habit would soon go away because you need to get the positive/desired effect from a hit for continuation of the behaviour. It is like conditioning - if a behaviour is accompanied by a positive response, the behaviour is reinforced. If no response or a negative one then the behaviour ultimately will become extinct. This may sound strange?! I used gear and eventually I had a Naltrexone implant but for a couple of months after I was still smoking, even though all my opiate receptors were bloked with Naltrexone. I was continuing to use through habit and ritual, craving the high. After a while though I did not use any more because I was not getting the desired effect.

[bp]

Hi

It does seem as if this is about a needle fixation rather than getting an actual buzz from the subutex because, reading your post, it seems as if you don't get a buzz.  Using drugs involves a ritual, for you it's about crushing up the pills, adding the water etc, looking for a vein and once you find one, putting the needle in, drawing back, the blood rushes in and off you go; what's the best part of this ritual for you? For me, it used to be seeing the blood rushing into the syringe; anything afterwards tended to be a bit of an anti climax. Twelve to fourteen times a day is definitely a bit of a joke but I have a feeling you're not laughing

.

but its now august and ive been hitting subs up foor 9 months. and its mad because i got a really bad case of cellulitis from it on my left arm. i was given 2000mg of penicillin aand 2000mg of flucoxicilline to get rid of it, which is a very high dose and you would think that would scare me into quitting but that was back in march.

The problem is we don't scare easily, when I think back on some of the abscesses I've had it almost makes my hair curl, but it didn't stop me fixing, like you, I took the antibiotics, the abscess healed and off I went again. I never fixed tablets though, I think I was too lazy to go through all that hassle. Do you have good veins, you mentioned you had cellulitis, what about abscesses? Are you prescribed subutex or do you buy them, are you in contact with any drug service, or have you got a counsellor with whom you can discuss this problem? Obviously you know that you need to stop this practice but until you do, I've included some info that may help to prevent you getting cellulitis again but you really need some support. BTW, how old are you.

INJECTING SUBUTEX (BUPRENORPHINE)

There is no safe way to inject Subutex (also known as buprenorphine or 'bupe'), as it has been designed to be taken orally. This guide is intended to reduce the risks for people who insist on injecting Subutex.
Why injecting Subutex is dangerous

If you intend to inject your Subutex tablets you need to be aware of the potentially serious risks involved. You also need to be aware that this medication is only designed to be dissolved under your tongue - if you do intend to inject a Subutex tablet you have to have the skills to transform a solid substance into an injectable solution. This is more difficult than most people think and takes time and the correct use of specific equipment.

When you inject buprenorphine or 'bupe', it doesn’t last as long in your body as when you dissolve it under your tongue as prescribed, you may start “hanging out” and go into withdrawal quite a while before you can get your next dose. If you get caught diverting your dose there may be a lot of penalties coming your way from the clinic; as in no more take away doses, an enforced change of pharmacy, dose changes etc.

Injecting can lead to vein problems, hepatitis C and HIV/AIDS. Safer shooting techniques can reduce these risks. If you still choose to inject, here is a guide to reduce some of the risks involved.
Equipment needed to inject bupe

Use new, clean equipment with each shot. Never share your equipment.
Sterile water
Mixing bowl or teaspoon
Syringes
Two 3ml syringes
'Drawing up' needle
Ideally a 19 guage needle, able to draw up your mix into the barrel
Cotton wool or cotton filters
A wheel filter
Click here to find out more about wheel filters and how to use them. You can also use a butterfly if you have multiple barrels.
Swabs
Use these to clean your equipment and injection sites. Wipe them in one direction, once only. Wait for the area to dry - it is the drying action that kills germs.
Soap
Clean your preparation areas, and hands before and after using to reduce the risks of blood borne diseases like hepatitis C and HIV/AIDS.
Tourniquet
Make sure you clean this with soap before and after use and never share. Click here to read up more on tourniquet use.
Safe disposal bottle
This should come with your gear from the NSP. It is illegal not to use one with used injecting equipment!
Step one

Before you begin it is extremely important that you know where the Subutex came from. Only use tablets that you have removed from the packet. If the Subutex has been “diverted” from anyone’s mouth; including your own, do not inject it. Even small traces of saliva can permanently harm your health and destroy veins.

Wash or swab your hands and preparation area. Swab out the spoon or bowl you are going to crush the Subutex tablets into. Crush the tablets as fine as you can, then begin to gradually mix sterile water into the crushed tablets. Mix the water and the crushed tablets thoroughly.

Diluting your mix is VERY important; dilution means adding sterilised water when you are crushing up your tablet. When you dilute your drugs by adding water, it does not mean you will dilute the effects of the drug. It simply makes it easier to filter any undesirable substances out of your mix, which will also help to keep your veins healthier.

The more sterile water you add, the better the filtering. The sterile water you use for dilution must be room temperature only, never use warm or hot water. Subutex tablets are not a chalk-based tablet like the majority of pills you may have tried to inject. Subutex utilises maize starch to form a tablet. Therefore it may be necessary to utilise different techniques to break Subutex down into an injectable solution.
Step two

Do not heat the mix! Subutex has a maize starch base, rather than being a chalk-based tablet which is more common. If you heat the mix you will make something akin to gravy!

Draw up the mix through cotton filters into a syringe with a 19 gauge tip. Repeat this process as many times as it takes until you have a milky looking fluid. Set the mix aside on a sterile surface.
Step three

Prepare (aka ‘prime’) the wheel filter for use: (slowly inject 1ml of sterile water from a 3 ml syringe through the wheel filter prior to injecting the drug mix through it). Then, attach the ’primed’ wheel filter to the 3 ml syringe containing the mix, followed by a new 19 g needle tip. Push the mix through the wheel filter into another syringe or into a swabbed clean bowl.
Step four

Wash your hands, swab your injection site, attach a 26g needle tip and inject the mix slowly into the vein.
Step five

Wash your hands immediately after injecting. Place all the used equipment into a sharps container and dispose of responsibly.

Important: If there is any pain, inflammation or redness around your injection site seek medical assistance.

When you take the needle out of your arm, put pressure on the injection site for a couple of minutes to stop the bleeding. Using a swab will only make it bleed and bruise.

Wash your hands and place all used equipment in to the safe disposal bottle and seal. Dispose of the bottle responsibly.

[will-c]

What ever you think about methadone, at this point, it sounds like your best option, other than going back on the gear. Your use of Subutex is completely contridictory to your starting statement in your post, concerning wanting to have a blocker in you to conteract gear.

I have been were your at, only I was banging up bundles of Temgesic, ending up with completely messed up veins, which has made it near impossible for me to go forward for Hep C treatment due to the amount of blood test they need to take. As they have to pin me at least 3 to 5 times for blood causing me all sorts of anxieties.

Like other say it sounds like you got more of a buzz fixation rather than a needle obsession. I would bet my bottom dollar that if you went on a optimum methadone script you would stop the injecting.

You sound like you can make sensible decision, I think its time for one of those balanced views to come forward  and get your self to either your GP or drug service to discuss your options.   

[Tony.B.]

Dante
I would not think you would be better off back on gear for one second.
I understand and agree about positive reinforcement and it's place in addictive behaviour but i think the whole point of dependency or addiction is that you WILL continue to behave in the same way even with life changing events happening around you.
The thing with Buprenorphine is that when used out of guidleines it can act very differently.
So if one were to snort it one would be better off snorting a little often, i would have thought injecting would be similiar if not the same. Meaning more damage.
Will C is of course right 'your use of Subutex (Buprenorphine) is contradictory to your starting staement in your post'. There is evidence that the blocker doesn't work in this situation, though i'm sure you knew that. You sound confused mate, not surpisingly.
You do need to try and engage in drug treatment again, in a more positive way.
I couldn't tell you if you are into the needle, the drug or both but you will soon get pretty poorly if you carry on injecting these tablets. 'Nine months'............ is long enough, at least it's not too long. You can still turn this around. I, for one, am rooting for you.
Methadone would certainly be a good option for you and it helps but it is only as good as your will and desire to stop living a life you don't like. If you really don't want to stop then you will just continue to think Methadone is crap.
Hope you can get this sorted. PM (personal message) me if you want to chat about it a little more.
My best
TonyB
 

[simon]

What ever you think about methadone, at this point, it sounds like your best option, other than going back on the gear. Your use of Subutex is completely contridictory to your starting statement in your post, concerning wanting to have a blocker in you to conteract gear.

I have been were your at, only I was banging up bundles of Temgesic, ending up with completely messed up veins, which has made it near impossible for me to go forward for Hep C treatment due to the amount of blood test they need to take. As they have to pin me at least 3 to 5 times for blood causing me all sorts of anxieties.

Like other say it sounds like you got more of a buzz fixation rather than a needle obsession. I would bet my bottom dollar that if you went on a optimum methadone script you would stop the injecting.

You sound like you can make sensible decision, I think its time for one of those balanced views to come forward  and get your self to either your GP or drug service to discuss your options.   

Will, I'm with you it would be much safer for this poster to be on Methadone and to be honest - don't let them reail-road you into going onto Suboxone. The people who I see who think they have a 'Needle fixation' tend not to be on enough of a substitute drug.

[Dant1]

Hello again, thanks for responding to me. I might not of explained myself last time. I will never use methadone!, it may work for some people but from my experience the people I know only use meth so they can use on top, so its not to much of a change from gear. The other side of the coin is most of them hate subbys because they say it makes them to straight and they cant handle that, which I understand but my thought is you need a kick up the arse to get you on the right road again. I will conquer this problem without changing my treatment. I don’t buy subby’s I am prescribed them through CAN, who have been very helpful to me in getting of heroin in the sense that they were there when I needed them. But ultimately I kicked it myself with  my mum at my side. But I always said that I had to do it my way, otherwise I wouldn’t feel I truly conquered it.  From the last time I posted, I am doing a lot bettter. I have cut down injecting from 12-14 times to only 7 so effectively halving my injecting. Im still on 14mg but that’s fine for now. Last time I posted I was looking for answers, anybody who had experience in what I was going through in regards to fixation. Because before I started searching I thought what I was doing was very rare, but what I have found is that its not that rare and have read many accounts of other peoples experiences. In regards to the comment about “getting back on gear” Ive never heard more of a backwards step. I am proud to say that I have no desire for heroin anymore and that is only getting stronger.
I have been thinking about what it is I like about injecting and its definitely the whole process of dissolving subbys, the sting of the needle then the pull back of blood and finally seeing the sub going in. I am glad to say that it is getting boring now at certain parts of the day. I am definitely on my way to quitting and returning to oral taking. By the way Im 25. I thank you  all for your comments they have really helped me come to terms with what im doing. Please feel free to comment back, would still like your feed back.

[Flip]

Hi Simon
I'm sure you are right about the people you see and in one sense you are right about them not having enough substitute drug. But I think it goes a little further than that. I've known people to sit jacking and re-jacking the same hit for up to 15 minutes, well beyond the time even the most paranoid addict would be satisfied that they had got all of the drug out of the syringe (these people were not on methadone). Also I've seen people hit up water or even whisky simply to have something to shoot (again not on methadone) even when not in withdrawal of any kind..

 I tried an unbelievable number of different therapies and techniques when I was trying to give up opiates and yet I kept retuning to it despite my best efforts. A long spell  on methadone followed by withdrawal,  resulted in me finally attaining "straightness" for the last 15 or so years.

I've done an awful lot of introspection since that time about what finally allowed me to get free and while I recognise that the long break and the stability methadone added to my life are major factors  as well as a maturing outlook on life ,I truly believe that it was the ability to put down needles that was the biggest breakthrough for me.(obviously methadone was a major factor in the long break from IV use)

I also do some work in the voluntary side of harm reduction and so still have a fair degree of contact with using addicts. I hear quite a wide variety of ways people are attempting to stop using including some purely on methadone right down to the other end of the spectrum where people are gradually trying to taper their IV use.

I don't like to make absolutist statements or condemn or support any one method but honestly I've never seen *anyone* who has gone straight from IV use to what could reasonably be called a "permanent cure" ( if there is such a thing for people with presumably damaged endorphin systems).

 In a personal sense  I can now watch people hit up, mix hits for them or  even do the injection itself without the slightest personal craving but I am very aware that to have one hit would very likely send me back down the old road. Its not the drug itself ( in my case and at this stage of my life) that would restart the addiction process. I am reasonably confident I could have a few snorts or smokes or even drop a few pills without feeling any real need for another one tomorrow, but IV is a different matter. Its not that I love the needle as such I was never much of a needle freak myself  ( i.e. I never did any of the practices I described above) in fact at the time I was entirely convinced that all I wanted to do was get the dope into myself as quickly as possible and get the needle out of my arm quickly to more enjoy the sensations of the initial rush.

I realise I've talked much here about my personal experience and there's no way I would want to generalise that to everyone or even to a single individual. But I must admit that when I hear someone say" I'm on methadone now but still have a few hits" I get a sinking feeling about their chances even compared to someone who says "I'm on methadone now , I used to IV but now I just have the odd smoke/snort".

I believe there is far more to needle use than appears on the surface. To go into all those factors would take too long and is outside the scope of the current discussion anyway. So while I agree with what you said in the terms in which you described it I think it is a slight simplification to put the whole thing down to simple lack of substitute drugs. I'm not sure whether you have ever been an addict yourself or have had wide contact with addicts outside the clinical setting and I'm certainly not going down the line "you've never been an addict so you dont understand". I ask simply because if what I suggested was the case I can see how you could come to the conclusion you have reached.

I hope you realise I am simply offering a different viewpoint here and it is in no way intended to be personal or combative.

All the best
Flip

[delgj74]

im the same way love the whole process of the needle and the drawback . ive been hitting oxy 80 but it just aint the same as h i miss that feeling , its never around . which is probably a good thing for me. anyway thats normal for the fixation

[MattYorks :) :-)]

The risk of injecting subbies.

(tryed to upload the pictures of this poor lads hand - thanks to Hazelle246 I found the site. Just look at the link as I dont know how to take the pics off the site.

http://www.annals.edu.sg/pdf/34VolNo9200510/V34N9p575.pdf#search=%22injecting%20subutex%22

Just don't do it, and tell others to not even try it as they WILL end up like that.. Painfull!

[Anon33]

Hmm....shooting bup.....opened a can of worms....the fact is with injecting anything...it is only a matter of time before your veins will collapse, you already have infection and if you are really unlucky you may be heading for pseudo aneurysm.....scare tactics do not work, but the day when you really do not have ANY visible veins left, you will get so frustrated- you may javelin that needle into the carpet.
It is the great debate is there a needle fixation or compulsion...of course there is and for most it is the most difficult part to put down. I can only talk from what I have experienced, seen over the years.....I know you are very resistant of Methadone, but have you ever tried it, at a correct dose? If your dsp know you are injecting your Subbies, I would be quite sure they would stop your script sharply which for you may help as you wouldn't have that amount to shoot or be disastrous as you would be buying them illegally and they would have probably been in someone's mouth, prior to your needle
You seem very sure that injecting subutex is morally better than Heroin .....I don't think that is correct (in my opinion), regardless of what it is you are using, if it is problematic it needs addressing and you are normalizing your injecting practice and may be in denial.....If my veins were still there I certainly know that I wouldn't waste them on subbies oh no
It is your body and your choice, but maybe you should re evaluate where you think are on the spectrum.....from a harm reduction point of view....use clean works etc.
One day you will not have a choice, so whilst you have one use it wisely Good luck, much love xx   

[MattYorks :) :-)]

I don't know if you talking to me Hays but if you are you have got it all wrong. I don't inject subbies, have never injected them and don't stand by the fact that injecting them is a good idea to do at all..

You seem very sure that injecting subutex is morally better than Heroin .....

 How you think this I don't know!

And... You go on to say. Which just isnt true about me what-so-ever, You must be getting your wires crossed with the author of this thread. I was just pointing out the fact that injecting them is a bad thing to do and wanted to get the word out there so more people know about the risk's! Sorry if I miss-led you in anyway.

I know you are very resistant of Methadone, but have you ever tried it, at a correct dose? If your dsp know you are injecting your Subbies, I would be quite sure they would stop your script sharply which for you may help as you wouldn't have that amount to shoot or be disastrous as you would be buying them illegally and they would have probably been in someone's mouth, prior to your needle.

 

[derek d j]

You're talking about our best hope of ever seeing a return to Rolleston there, Anon33. Some confusion with the OP, perhaps.

Good luck with your doctor, Matty. Perseverance furthers, as they say. It only took me nine years and several ruins before sense was seen.

[Anon33]

I should really press quote button .....SORRY Matty was not to you....was to original author who is injecting Subutex that I was directing to.....was never great at forum etiquette- to avoid confusion I will name (and use the quote button)...sincere apologies x

[froude]

Injecting that many times a day ,even with your cut down on injecting ,next thing you if your not careful is that not  only will you have an infection but you could also get a virus, the Hep C virus ,be very careful,and take on board what people have said about using your hit kit,good luck in the future and all the best Froude