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  • BDD Moderators: Keif’ Richards | negrogesic

Confusion- 1st time Precipitated WD

N

NY2soFlo

Greenlighter
Joined
May 3, 2020
Messages
8
Hey All-
Quick rundown I’ve been addicted to opiates (oxy->H) for about 10 years and have been through the using to sub and back routine a millions times, I’n completely comfortable with sub induction and can usually take subs as early as 18 hours.
I had some clean time and recently relapsed and have been using everyday for about 2-3 months. Nothing crazy but enough each day to be decently sick of cold turkey.
SO
This morning I waited till about 25 hours before taking 2mg sub. I wasn’t “sick sick” , but past the limbo stage and starting to get hot/cold flashes, restlessness and general anxiety and that feeling of tension in your chest. I suppose I could have waited longer but had plans today and had always been able to take subs at this point with no problem. About 15-20 mins after taking the sub I started sweating like crazy, got an intense whirl of anxiety and all WD symptoms kicked in. Not complete hell, but absolutely worse then I had felt, so I assume with no doubt this was a “lighter” case of precips. I assume it wasn’t compete hell since I did wait 25 hours, and it was only 2mg sub (any sooner or any more sub and I’m sure it would have been worse). Long story short I got some dope and fixed it. My plan is to go another day or so and try this again but wait much longer before inducting subs.
Has anyone experienced this before? In terms of getting precips way later then normal and getting them once WD symptoms had started? Obviously whatever I was using was cut with some type of long acting optiate in it, I won’t know. It scared the hell out of me and I absolutely don’t want this again. I also only have 10mg more sub, so it’s going to have to be a quick taper (similar to what you’d get in a detox facility). I also have some clonidine, tizanidine, hydroxyzine, and gabapentin to aid with the beginning and very end of the taper- the times I won’t be feeling great.
Anyone have any insight or advice here other then just waiting longer? I’m going to wait at least 36 hours next time and just use those other meds to get me there. Ask making sure I’m 100% sick.
should I try less sub? 1mg? I assume less would lead to lower precip if that’s still the case.... wait an hour, make sure I’m ok/feeling better then take another 2mg or so? FYI my planned taper is 3/2/2/1/1/1 or 3/3/2/1/1. Any help is greatly appreciated!!!!
 
2mg might have been not enough to hold you. Nonetheless, Just take the clonodine and knock yourself out for 48 hours. Then take 2 mg every hour till you feel well.

wait, just read the last sentence. Are you trying to taper in 5 days or weeks?
 
5 day taper. Yea, a quick one but ime it works better fast for me. I agree that 2mg definitely isn’t enough alone- I was planning on taking more. The main issue here is the immediate and definite worsening of WD right after taking the sub. My regular WD of course would have continued to get worse, but it went from like 2/10 to 7/10 within 30 mins. To me, this 100% is in response to taking the sub. If 2mg wasn’t enough wouldn’t I just have not felt anything at all?
 
I don't agree that dose was the problem, without question you faced a moderate case of precipitated. As soon as i start pouring sweat I know I fucked up and took a sub too early.

There is no real explanation or advice to give here. Your brain and body maybe changing from it's ability to bounce back, as mine has. I can't just abuse heroin and go lalala and take a sub whenever I want and then chip the addiction entirely.

Maybe both of us are deeper than we'd like to be.

Good luck
 
Hey OP! This is definitely strange in that it's different than what you usually experience. The hard part is that there is no hard and fast method for calculating the time and dose of a Buprenorphine induction from an Opioid-dependent state.

I tend to agree that there is probably some quality to the dope that you're using that is effecting your tolerance in an unexpected way. What that is is the big mystery.

I agree that waiting until you are in full withdrawal is going to be the plan here. Luckily you have some useful medication on-hand to make the abstinence period a little bit more tolerable.

I'm guessing you understand the basics about what you have, but if you have any questions, dont hesitate to hit us up!
 
For sure the 2mg put you into pencil wd. What I meant is it may have been enough to do that but not enough to hold you like, say, 8 mg would have. You were perhaps in the no mans land. of course 8 mg may have really brought on the hell so I don’t blame you for backing out.
 
Karamazov said:
For sure the 2mg put you into pencil wd. What I meant is it may have been enough to do that but not enough to hold you like, say, 8 mg would have. You were perhaps in the no mans land. of course 8 mg may have really brought on the hell so I don’t blame you for backing out.
Click to expand...

Hi Karamazov! I agree with a lot of what you are saying. It is possible that the dose wasn't high enough, however, I feel the defining issue here is the timeline.

I believe we all are pretty mindful of how our withdrawal symptoms tend to progress and OP is reporting a noticeable acceleration of his syndrome following the dose of Buprenorphine.

The timeline is the factor that makes me think this is PW and not an issue of too little Bupe.
 
Guys thank you all for the responses. I suppose there is really nothing else to do other then wait as long as I can do take the sub. This whole time I was thinking “this is the perfect time to do this (during quarantine) and not having to do it on a weekend or something”. I guess I just have to man up and deal with it. I’ll report back with how it goes in a day or two when I try this again.
has anyone used cbd as an Aid in withdrawal? I’ve obv smoked plenty of weed before.... I can’t really do that this time so I have some cbd to mostly help with sleep and anxiety. Nothing amazing but it seems to help a little.
 
I guess my other main question I had too, was what exactly should you do once you’re in precips? I couldn’t just deal at the time so I used to get out which worked. But say it happens next time, and it sucks but it’s not absolute hell bc I still waited pretty long. Obviously I’ll take some of my comfort meds, but what’s the next move? Wait it out until it lessens and then take more sub? Take more sub immediately? (Risking worsening everything) this next time I do this I’m sticking in for the ride
 
I'm very sorry man, but I feel the best answer I can give you is to resolve yourself to a compromise. You dont have to get sick with PW again, but to do that, you will have to commit to a little more pain than you did previously.

I know its hard to wait. I don't judge your situation at all dude.
 
For future reference, what’s the best move when you enter PW? Take more sub? Or wait it out and take more later on? assuming you don’t want to go back to using to get out of it
 
When I went to the ER with severe p/w the only thing that seemed to help was more Subutex. Over about 3-4 hours they gave me 16mgs. They gave me other things too but nothing seemed to stop the misery til I had enough bupe in my system.
 
The only known way to quickly escape precipitated withdrawal is to use more full agonist opiates, like heroin or oxycodone to try and break some of the Bupe off and restore the brain back to what it is used to. This is not only a waste of money, but also effort and time seeing as you're trying to use suboxone not heroin.
 
Just an update, I’m currently 54 hours in. I took 5mg suboxone throughout the day, starting at 40 hours this time. No pw thank god. The mix of clonidine, tizanidine, and gabapentin got me through to that point and actually feeling ok. Right now I’d say i moderately feel the presence of the subs. If I had more I’d take another 2mg, but I’d rather save what I have to do the best taper possible. I plan to take another 2mg tomorrow morning, which would be around 64 hours in. So far so good this time.
 
I just want to say keep fighting the good fight. It’s rough somewhere and somehow no matter how much thought and planning you put into it when you kick, imo. Good luck to you though. 🍀
 
Thank you. About a week post sub taper being finished. Things went lrettt smooth, and never really got much of that residual “sub detox” several days after. Just having problems sleeping, for a week I’m taking a half a stick and hysroxyzins before bed, then now tapering to just hydroxyzine as needed. So far so good just need some meetings to open back up!
 
Are you sure there's no fentanyl in your dope? Because you would have to wait 48-72 hours if that was the case
 
ComfortablyNumb95 said:
Are you sure there's no fentanyl in your dope? Because you would have to wait 48-72 hours if that was the case
Click to expand...

This. Although fent has a short duration of action, there's some sort of pharmacological fuckery that goes on with it, maybe it hangs around in the blood plasma for considerably longer or remains bound/modulates your receptors in such a way that a partial agonist kicks residual fent out or something. I'm not sure of the mechanism behind it but from personal experience with using heroin and being to use bupe 18 hours later with zero precipitated WD and waiting over 2 full days after last using fent and getting horrific precip WD, you need to wait a very long time to use bupe and the more and more you try to switch back and forth, the longer you have to wait and the worse the precipitated WD will be. At a certain point it is probably easier not to even bother unless you're 7 days clean THEN induct, though only if you want to do so to prevent further use or manage cravings.

I went through a period of shooting butyrfentanyl instead of heroin so I wouldn't fail a drugstest whilst I was on buperenorphine. I only used fent on and off for 6 weeks, but as I used it more, it was harder and harder to re-induct to bupe and each time I would get precipitated WD and it got more and more nasty, even though I waited longer and longer. The last time it happened I waited over 50 hours and it was the worst precipitated WD it had ever been. It was so bad I stopped the bupe, got on methadone and will never willingly ingest bupe ever again. The experience is so deeply burned into my skull, I doubt I'd even be able to get the bupe under my tongue without vomiting

There isn't much you can do with precip WD. I have found that a full agonist can help a lot, it won't get you high, but will dull some of the symptoms, though I only ever got to try using fent to fix it, not heroin. Some say more bupe can help but I haven't tried that personally.

FWIW if you wish to still use, methadone is a better option, though that carries risks and drawbacks, namely much higher risk of overdose, jacking your tolerance up and dulling the rush. I was able to stop using (eventually) with methadone, I wasn't with bupe and part of the reason I used fent instead of gear for a while, aside from the drug testing thing, was that it could punch though the bupe blockade.

EDIT: just read that your taper is going well NY2soFlo, you can ignore my methadone advice. If bupe works for you, you are much better sticking with it rather than methadone, as it has less side effects, is easier to get off and is safer if you do slip up and use
 
TargetX said:
This. Although fent has a short duration of action, there's some sort of pharmacological fuckery that goes on with it, maybe it hangs around in the blood plasma for considerably longer or remains bound/modulates your receptors in such a way that a partial agonist kicks residual fent out or something. I'm not sure of the mechanism behind it but from personal experience with using heroin and being to use bupe 18 hours later with zero precipitated WD and waiting over 2 full days after last using fent and getting horrific precip WD, you need to wait a very long time to use bupe and the more and more you try to switch back and forth, the longer you have to wait and the worse the precipitated WD will be. At a certain point it is probably easier not to even bother unless you're 7 days clean THEN induct, though only if you want to do so to prevent further use or manage cravings.

I went through a period of shooting butyrfentanyl instead of heroin so I wouldn't fail a drugstest whilst I was on buperenorphine. I only used fent on and off for 6 weeks, but as I used it more, it was harder and harder to re-induct to bupe and each time I would get precipitated WD and it got more and more nasty, even though I waited longer and longer. The last time it happened I waited over 50 hours and it was the worst precipitated WD it had ever been. It was so bad I stopped the bupe, got on methadone and will never willingly ingest bupe ever again. The experience is so deeply burned into my skull, I doubt I'd even be able to get the bupe under my tongue without vomiting

There isn't much you can do with precip WD. I have found that a full agonist can help a lot, it won't get you high, but will dull some of the symptoms, though I only ever got to try using fent to fix it, not heroin. Some say more bupe can help but I haven't tried that personally.

FWIW if you wish to still use, methadone is a better option, though that carries risks and drawbacks, namely much higher risk of overdose, jacking your tolerance up and dulling the rush. I was able to stop using (eventually) with methadone, I wasn't with bupe and part of the reason I used fent instead of gear for a while, aside from the drug testing thing, was that it could punch though the bupe blockade.

EDIT: just read that your taper is going well NY2soFlo, you can ignore my methadone advice. If bupe works for you, you are much better sticking with it rather than methadone, as it has less side effects, is easier to get off and is safer if you do slip up and use
Click to expand...
I think it's because fent and its analogues are extremely lipophilic so they stay in the brain for much longer (the brain is mostly fat)
Don't quote me on that though
 
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