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Opioids Fecal Impaction... Bupe?

The lower the dose, the worse it is, that's my experience at least and I've got a theory. Buprenorphine's effects are all about buprenorphine/norbuprenorphine levels ratios. Norbuprenorphine being a secondary amine is more hydrophilic than buprenorphine, so it will have a harder time going past the blood-brain barrier. It doesn't necessarily have a lower affinity to MOP receptors, actually some research found norbupe to have affinity almost as strong as bupe does, but norbupe concentration is always going to be higher peripherally than centrally. For the same reason it's got a lower therapeutic index than popular full agonists like morphine. Also, I've noticed that even when buprenorphine does produce some pronounced opioid effects for me, the high doesn't last so long as weaker opioid effects linger in the background and I'm free from withdrawal anyway, so I'm guessing it's norbupe that got to your brain wearing off.

For some time I had terrible problems with constipation when I was at 8mg a day, but usually there's a short period of time when it's actually much easier to pass stools. This is right after you take your dose, I guess this is because buprenorphine you've just taken is forcing out norbuprenorphine bound in your intestines. But after 15-30 minutes my muscles were contracted again. Recently I've been at 2-4mg a day and I was much more constipated at 2mg than at 4mg, so it must be all related to bupe/norbupe ratios in different parts of your body.

Buprenorphine is a weird opioid IMO and the lower the dose (with proper tolerance of course), the more effects come from norbuprenorphine and although you take a partial agonist, when you taper off, you actually feel almost like you're quitting a full agonist. I don't find it a bad thing that I can get slightly high from norbupe at lower doses of Suboxone, but honestly, purely for maintenance purposes a true partial agonist would be much better than buprenorphine when it comes to quitting. With the long half-life of buprenorphine it's hard to get high from it every day unless you're on a very low dose, 2mg or less, I guess.
 
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this happened to me when i had surgery and after abused the hell out of oxy (having no tolerance). It was one of the most painful things ever. embarassing as all hell to. Once I built up an oxy tolerance though using that same amount that caused the impaction never constipated me or caused any more problems.

4 mg is a very big dose of suboxone so it may be causing it. you would be surprised at how little you really need, dr. are oblivious to this or just over prescribing to benefit the pharma companies. .5 mg or so has been enough to keep me "well" even when i was doing milligrams of fentanyl perday
 
adder said:
The lower the dose, the worse it is, that's my experience at least and I've got a theory. Buprenorphine's effects are all about buprenorphine/norbuprenorphine levels ratios. Norbuprenorphine being a secondary amine is more hydrophilic than buprenorphine, so it will have a harder time going past the blood-brain barrier. It doesn't necessarily have a lower affinity to MOP receptors, actually some research found norbupe to have affinity almost as strong as bupe does, but norbupe concentration is always going to be higher peripherally than centrally. For the same reason it's got a lower therapeutic index than popular full agonists like morphine. Also, I've noticed that even when buprenorphine does produce some pronounced opioid effects for me, the high doesn't last so long as weaker opioid effects linger in the background and I'm free from withdrawal anyway, so I'm guessing it's norbupe that got to your brain wearing off.

For some time I had terrible problems with constipation when I was at 8mg a day, but usually there's a short period of time when it's actually much easier to pass stools. This is right after you take your dose, I guess this is because buprenorphine you've just taken is forcing out norbuprenorphine bound in your intestines. But after 15-30 minutes my muscles were contracted again. Recently I've been at 2-4mg a day and I was much more constipated at 2mg than at 4mg, so it must be all related to bupe/norbupe ratios in different parts of your body.

Buprenorphine is a weird opioid IMO and the lower the dose (with proper tolerance of course), the more effects come from norbuprenorphine and although you take a partial agonist, when you taper off, you actually feel almost like you're quitting a full agonist. I don't find it a bad thing that I can get slightly high from norbupe at lower doses of Suboxone, but honestly, purely for maintenance purposes a true partial agonist would be much better than buprenorphine when it comes to quitting. With the long half-life of buprenorphine it's hard to get high from it every day unless you're on a very low dose, 2mg or less, I guess.
Click to expand...

I had the exact opposite experience, constipation was far worse at 8mg sub then it was at 2-4mg.
 
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Im on 6mg a day and I have a bm almost daily ( sometimes I cant go..and if I get a sickness like flu or cold I slow down in my gut too).my bm has a pattern, I go in the morning. I have to wait to dosethough or I wont go. I eat alot and drink protein drinks too. Stress will slow my bowel down too. Usually stress is related to myobsession with takin a shit.
 
I've been on subutex since June last year, doses from 20mg to 2mg, and found it a lot less constipating than every other opiate I've tried (and I have tried literally ALL of them!) I guess everyone's body reacts differently to meds though.

When I do exoerience that problem, I find movicol sachets is the best treatment, and I have no side effects from it. I rarely have to use it though. The WORST thing you can take for opiate-related constipation is bulk forming laxitives such as fybogel (ispaghula husk) or methylcellulose. They will only make the problem worse.
 
I don't know about bupe, but I have been on methadone for 7 years and I have to say the most common sense ways to relieve constipation gets overlooked a lot. But your right by day 2 or 3 , or even if I had to push harder then I feel is ok. I eat a lot of oatmeal , fruits , veggies and water. Just those alone will help. I do agree if I eat a lot of meat it happens more often , or course you want to stay away from most dairys. I use to eat a lot of yogurt , which some yogurts are good for you but the ones I was eating had tons of sugar. Best advice go buy a nutribullet , throw in some fruit even a veggie (you won't taste) add protein (I use plant base proteins ,the one I get has the good probiotics too, don't want to use whey)coconut water or jus plain water. Drink at least one a day you won't have any issues. If one doesn't work drink two a day. If that doesn't work stop drinking caffeine ( I drink monsters but doesn't affect me if I drink my shakes). Anyways you have a lot of good points
 
you could try an enema? i was on morphine as an inpatient and didn't take a dump for like two months.
got so bad that i was throwing everything i drank back up as my body literally couldn't process any more stuff.

five phosphate enemas later and i was flying
literally.

explosive
 
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