white knuckling

The 24 hour struggle

One of the most difficult parts of starting Suboxone treatment is waiting to take the first dose. Unfortunately, if you want the treatment to work properly, you have to wait until you are in withdrawal. Therefore, you have to prepare to wait for up to 24 hours. In some cases, you may have to wait longer. Fortunately, when you do take that first dose, the withdrawal sickness will subside and you will feel better. During the waiting period, you must resist the urge to get high again. In recovery circles, they call this struggle to resist drug cravings, “white knuckling” as described in this article.

Why do I have to wait so long to start Suboxone?

While Suboxone’s main ingredient, buprenorphine, is an opioid, it is also a blocker. Because of this, it will interact poorly with any remaining opioids in your system. This means that if you take Suboxone too soon, you will feel more sick rather than better. So waiting it out from your last opioid use until you are fully ready for your first Suboxone is important.

So, is white knuckling a good thing?

It is a very good thing for you to do whatever it takes to hold out and not take more opiates or opioids. In fact, it can be a matter of life or death. Hence, you should have a loved one stay with you, give up the phone and car keys, do some deep breathing exercises, read recovery literature. In short, do what it takes to stay focused so you can get through to the time when you can finally take your first Suboxone.

What if I just can’t make it?

While I believe that anyone can do what they have to do to get through the 24 or so hours needed, some people say they just can’t do it. They say the dealer is too easy to call. Or, the friend with the pills lives right next door. In fact, I can give every bit of advice I can think of and they counter me with reasons why it just won’t work. So, I then discuss the alternatives and consequences of not being able to do the brief period of white knuckling.

The methadone clinic might work better.

While methadone has many drawbacks, experts still call it the gold standard of opioid addiction treatment. In fact, it has a higher success rate than Suboxone. Additionally, you will not have to wait to get started. You can go to the clinic right away after you get high. Unfortunately, once you are on methadone, you will have to go to the clinic every morning. The flexibility and freedom of Suboxone is lost if you choose to go with methadone. Still, if you must go that direction to save your life, then, by all means, go to the methadone clinic. Otherwise, if you can hang in there for those usually 18-24 hours to start Suboxone, you may be able to progress to monthly visits. This will give you far more freedom to live your life between doctor visits.

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