4 ms·

> Suboxone is a compound of two drugs that decreases one’s cravings for opioids while blocking their effects. It is safer and less cumbersome than methadone, wh

> Suboxone is a compound of two drugs that decreases one’s cravings for opioids while blocking their effects. It is safer and less cumbersome than methadone, which requires daily or weekly visits to a clinic, and more effective than any abstinence-based treatment, which requires people to withstand cravings and suppress physical discomfort. This highlights one of the issues I have with articles like this about Ozempic at this current moment - this glosses over something major with these two particular drugs. With methadone, yes, it will keep you off of heroin, but you'll also likely never, ever get off of methadone because the withdrawal is 1) just as horrible and severe as heroin and 2) can last months. To the point where you'd almost be better off just kicking the heroin the "old fashioned" way. suboxone is similar - the drug isn't without side effects either. Of course, that isn't to say these things aren't useful - to have a methadone/suboxone dependency is way preferable to heroin addiction. My only real point is that we should wait to see what long term side effects these drugs have before calling them miracles and glossing over their down sides, because I think the end effect of that is counterproductive to medicine. I'm always immediately skeptical as to what drugs pharmaceutical companies are pushing out, due to the history I've witnessed so far in my lifetime. That all said Ozempic probably would've saved a relative of mine's life. In the end, they'd likely not care about the side effects all that much.

quickthrowman 2y ago
Suboxone is far easier to discontinue than methadone, I took it for 18 months and then discontinued use about 10 years ago. Methadone withdrawals can last for a month (I’d never make it that long) but suboxone physical withdrawals were gone in a few days. Suboxone also has a dosage ceiling (32mg) where methadone does not.
BearOso 2y ago
> I'm always immediately skeptical as to what drugs pharmacies are pushing out Major nitpick here. Pharmacies aren't pushing anything. Pharmaceutical companies are pushing these drugs. Worse yet, independent pharmacies have only been losing money selling GLP-1 agonists. Insurance companies have begun to collude using pricing networks. They claim that the market value that pharmacies get the drugs for is too high, even though they are still patented and brand-name, so the insurance and pharmaceutical companies together are the ones that set the price. Then they refuse to reconcile the cost minus the deductible. Last I knew, it was about -42$ on a month prescription.
- JohnMakin 2y ago
  Of course this is what I meant, and I'll update the original post. Thanks
- halJordan 2y ago
  Pharmacies are absolutely pushing stuff, the DOJ has repeatedly investigated and fined pharmacies for things they did during the opioid epidemic. The entire industry is so incestuous that it's almost not even worth distinguishing as if the singleton Mom and Pop drug stores still exist, even if they do in some form these days.
  - BearOso 2y ago
    Walmart, Walgreens, and CVS? You mean those small pharmacies--two of which also contain insurance companies, and the other one still has its own clinics? Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked. But you're right about health care in the US. We need a single-payer system to get prices lower, but that means fairness and cutting out unnecessary costs. The whole health insurance industry would cease to exist, and all the people abusing it don't want that to happen.
    - SAI_Peregrinus 2y ago
      "Ask your doctor about <insert drug here>" is "pushing" the drug. "Pushing" is advertising, "selling" happens later.
    - TeMPOraL 2y ago
      > Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked. I think they can - specifically, the pharmacies that mix drugs locally can mix and sell a drug that's declared in shortage. IIRC Ozempic was in that situation recently.
      - 2y ago
SoftTalker 2y ago
They are a 2nd-best alternative to just doing the work to change your behavior. If you are overweight, eat less/eat better and exercise. If you are addicted to alcohol or drugs, quit. Those are the ideals. If you can do those things it's better than depending on chemicals that for-profit pharmaceutical companies would love to see you buying for the rest of your life. But if you can't do those things, it's probably better than continuing the status quo. Better to pay Reckitt Benckiser than support some criminal fentanyl dealers. I feel that many people have never really tried, or tried but did not appreciate that it would be really hard, and gave up.
- borski 2y ago
  > I feel that many people have never really tried, or tried but did not appreciate that it would be really hard, and gave up. With all due respect, this is nonsense. This is a very common trope, but I can guarantee you the vast vast vast majority of people who are obese have tried “eating less and moving more,” and that is not new advice to them. Nobody who has been obese for a long time walks into a doctor’s office going “okay I finally think I want that injection that will help me lose weight” as if they just suddenly noticed they’re obese. There are lots of reasons they might not have been able to deal with it before, and “laziness” is not usually in the top 5. Genetics, means, access to knowledge, living in a food desert, depression, etc. are all far more likely causes. Being obese sucks. People who are obese are far more aware of that than anyone choosing to judge them from afar.
  - AntiEgo 2y ago
    On the topic of the obesity epidemic, it's worth noting that lab rats with controlled diets are also getting fatter over time. The leading theories are microbiome shifts or environmental contamination (microplastics?,) but afaik no conclusive cause has been found. When people fail at health, (as when they fail at finance or addiction), a lot of propaganda tells us to blame individuals, with no sympathy or awareness of our failing systems. SMH at the cruelty.... https://www.scientificamerican.com/article/how-lab-rats-are-changing-our-view-of-obesity/ https://www.scientificamerican.com/article/how-lab-rats-are-...
Jerrrrrrry 2y ago
>of course, that isn't to say these things aren't useful - to have a methadone/suboxone dependency is way preferable to heroin addiction. Heroin will cause you to be sick. Suboxone will make you go into a blind rage so manic you will never find yourself without it. For those who actually "need" Suboxone, it is a magnitude easier to taper off of than the reasons for needing it - unfortunately a medical system with perverted incentives shrowd how (read: trivially, comfortably) easy it is to start and taper off of Suboxone, even from literally incredulous depths of synthetic opiate addiction - sometimes without even as much as a single iota of withdrawal. It is literally easier to start and taper with Suboxone without Big Pharma - with no paper work inhibiting your and jeopardizing your future in perpetuity, as a nice perk. Recreational suboxone use makes fentanyl look like a child's game. Methadone, however well-intentioned, or altruistic in its creators' motives, is a resignment to the inevitable life-long dependency. Chemical handcuffs.
- JohnMakin 2y ago
  > Methadone, however well-intentioned, or altruistic in its creators' motives, is a resignment to the inevitable life-long dependency. Chemical handcuffs. It’s of course less common these days but back from what I remember 20 or so years ago they did not inform patients very well to this reality. My experience was not for addiction, but was prescribed 10mg methadone daily for severe chronic pain, took it for a few years - that’s a relatively small dose and I cannot tell in plain English words how awful it was getting off of it. Tapering does not really work, the smallest reduction in dose will send you into just as severe withdrawal symptoms as if you cold turkey’d. I ended up buffering the withdrawal with tramadol, which was the only other thing I could take, but the entire process lasted about 6 months til I felt entirely normal again and the first month was 24/7 full blown acute withdrawals. I’ve since quit smoking cigarettes and laughed at how easy it was in comparison.
RedditKon 2y ago
We actually have a lot of data on Ozempic and GLP-1s generally, going back to the first GLP-1 FDA approval in 2005: • Exenatide - FDA approved in 2005 • Liraglutide / Saxenda - FDA approved in 2010 • Dulaglutide / Trulicity - FDA approved in 2014 • Semaglutide / Ozempic/Wegovy - FDA approved in 2017 • Tirzepatide / Mounjaro - FDA approved in 2022 Ozempic / Semaglutide was FDA approved in 2017, but clinical trials started in 2008. That was 16 years ago. Obviously it's always possible there are even longer term side effects we're unaware of, but generally if this class of drug caused large scale problems for kidneys, liver, etc, we'd likely know by now.
consteval 2y ago
> To the point where you'd almost be better off just kicking the heroin the "old fashioned" way You said this and never expanded on it

quickthrowman 2y ago

Suboxone is far easier to discontinue than methadone, I took it for 18 months and then discontinued use about 10 years ago. Methadone withdrawals can last for a month (I’d never make it that long) but suboxone physical withdrawals were gone in a few days. Suboxone also has a dosage ceiling (32mg) where methadone does not.

BearOso 2y ago

> I'm always immediately skeptical as to what drugs pharmacies are pushing out Major nitpick here. Pharmacies aren't pushing anything. Pharmaceutical companies are pushing these drugs. Worse yet, independent pharmacies have only been losing money selling GLP-1 agonists. Insurance companies have begun to collude using pricing networks. They claim that the market value that pharmacies get the drugs for is too high, even though they are still patented and brand-name, so the insurance and pharmaceutical companies together are the ones that set the price. Then they refuse to reconcile the cost minus the deductible. Last I knew, it was about -42$ on a month prescription.

JohnMakin 2y ago
Of course this is what I meant, and I'll update the original post. Thanks
halJordan 2y ago
Pharmacies are absolutely pushing stuff, the DOJ has repeatedly investigated and fined pharmacies for things they did during the opioid epidemic. The entire industry is so incestuous that it's almost not even worth distinguishing as if the singleton Mom and Pop drug stores still exist, even if they do in some form these days.
- BearOso 2y ago
  Walmart, Walgreens, and CVS? You mean those small pharmacies--two of which also contain insurance companies, and the other one still has its own clinics? Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked. But you're right about health care in the US. We need a single-payer system to get prices lower, but that means fairness and cutting out unnecessary costs. The whole health insurance industry would cease to exist, and all the people abusing it don't want that to happen.
  - SAI_Peregrinus 2y ago
    "Ask your doctor about <insert drug here>" is "pushing" the drug. "Pushing" is advertising, "selling" happens later.
  - TeMPOraL 2y ago
    > Pharmacies can only give out what people are prescribed, the only things they can push are OTC products. They can't get and sell scheduled drugs without being explicitly tracked. I think they can - specifically, the pharmacies that mix drugs locally can mix and sell a drug that's declared in shortage. IIRC Ozempic was in that situation recently.
    - 2y ago

SoftTalker 2y ago

They are a 2nd-best alternative to just doing the work to change your behavior. If you are overweight, eat less/eat better and exercise. If you are addicted to alcohol or drugs, quit. Those are the ideals. If you can do those things it's better than depending on chemicals that for-profit pharmaceutical companies would love to see you buying for the rest of your life. But if you can't do those things, it's probably better than continuing the status quo. Better to pay Reckitt Benckiser than support some criminal fentanyl dealers. I feel that many people have never really tried, or tried but did not appreciate that it would be really hard, and gave up.

borski 2y ago
> I feel that many people have never really tried, or tried but did not appreciate that it would be really hard, and gave up. With all due respect, this is nonsense. This is a very common trope, but I can guarantee you the vast vast vast majority of people who are obese have tried “eating less and moving more,” and that is not new advice to them. Nobody who has been obese for a long time walks into a doctor’s office going “okay I finally think I want that injection that will help me lose weight” as if they just suddenly noticed they’re obese. There are lots of reasons they might not have been able to deal with it before, and “laziness” is not usually in the top 5. Genetics, means, access to knowledge, living in a food desert, depression, etc. are all far more likely causes. Being obese sucks. People who are obese are far more aware of that than anyone choosing to judge them from afar.
- AntiEgo 2y ago
  On the topic of the obesity epidemic, it's worth noting that lab rats with controlled diets are also getting fatter over time. The leading theories are microbiome shifts or environmental contamination (microplastics?,) but afaik no conclusive cause has been found. When people fail at health, (as when they fail at finance or addiction), a lot of propaganda tells us to blame individuals, with no sympathy or awareness of our failing systems. SMH at the cruelty.... https://www.scientificamerican.com/article/how-lab-rats-are-changing-our-view-of-obesity/ https://www.scientificamerican.com/article/how-lab-rats-are-...

Jerrrrrrry 2y ago

>of course, that isn't to say these things aren't useful - to have a methadone/suboxone dependency is way preferable to heroin addiction. Heroin will cause you to be sick. Suboxone will make you go into a blind rage so manic you will never find yourself without it. For those who actually "need" Suboxone, it is a magnitude easier to taper off of than the reasons for needing it - unfortunately a medical system with perverted incentives shrowd how (read: trivially, comfortably) easy it is to start and taper off of Suboxone, even from literally incredulous depths of synthetic opiate addiction - sometimes without even as much as a single iota of withdrawal. It is literally easier to start and taper with Suboxone without Big Pharma - with no paper work inhibiting your and jeopardizing your future in perpetuity, as a nice perk. Recreational suboxone use makes fentanyl look like a child's game. Methadone, however well-intentioned, or altruistic in its creators' motives, is a resignment to the inevitable life-long dependency. Chemical handcuffs.

JohnMakin 2y ago
> Methadone, however well-intentioned, or altruistic in its creators' motives, is a resignment to the inevitable life-long dependency. Chemical handcuffs. It’s of course less common these days but back from what I remember 20 or so years ago they did not inform patients very well to this reality. My experience was not for addiction, but was prescribed 10mg methadone daily for severe chronic pain, took it for a few years - that’s a relatively small dose and I cannot tell in plain English words how awful it was getting off of it. Tapering does not really work, the smallest reduction in dose will send you into just as severe withdrawal symptoms as if you cold turkey’d. I ended up buffering the withdrawal with tramadol, which was the only other thing I could take, but the entire process lasted about 6 months til I felt entirely normal again and the first month was 24/7 full blown acute withdrawals. I’ve since quit smoking cigarettes and laughed at how easy it was in comparison.

RedditKon 2y ago

We actually have a lot of data on Ozempic and GLP-1s generally, going back to the first GLP-1 FDA approval in 2005: • Exenatide - FDA approved in 2005 • Liraglutide / Saxenda - FDA approved in 2010 • Dulaglutide / Trulicity - FDA approved in 2014 • Semaglutide / Ozempic/Wegovy - FDA approved in 2017 • Tirzepatide / Mounjaro - FDA approved in 2022 Ozempic / Semaglutide was FDA approved in 2017, but clinical trials started in 2008. That was 16 years ago. Obviously it's always possible there are even longer term side effects we're unaware of, but generally if this class of drug caused large scale problems for kidneys, liver, etc, we'd likely know by now.

consteval 2y ago

> To the point where you'd almost be better off just kicking the heroin the "old fashioned" way You said this and never expanded on it