Well I thought I'd share my experienece to help anyone going through this. So I recently was on a two month run. Basically everytime I tried to quit heroin I'd wait up to 60 hours before taking a suboxone. No matter how long I waited I would go into precipitated withdrawl which would lead me right back into doing heroin. I accidentally found a way to avoid p.w. what I did was take the sub, go into p.w., use heroin, then immediately after using I would take a sub. I've done this 5 times and everytime I wouldn't go back into p.w. Now I hate to suggest using but for some reason this works. If you have any input as to why this works I'd love to know.
Found a way to avoid precipitated withdrawal from suboxone
- Thread starter Sofedup
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Was it subutex? Or actual suboxone? So subutex would make more sense due to there being no nalaxone in it, however bupenorphine in general is a pig.... it binds to approx 80 % of the brains opioid receptors therefore kicking off the h or whatever else is used so there is minimal receptors left for h to actually bind to. Maybe I haven't read enough about h to understand it, but the half life of h is so much less than that of subs that could also be a factor.? I don't know. Thank you for sharing. It is what it is and I don't like p.w. So I appreciate your info!!!!
It sounds like you essentially throw yourself into precipitated withdrawals only to add dope to undo it then you can take the bupe when the dope wears off while the suboxone is in your system preventing you from going any further than opiate stability on bupe vs any less so if you take more It will essentially add if anything.
If this 80% thing mentioned above is true than it makes even more sense tag if not. The heroin is probably adding effect with the last 20% to get that extra kick to kill the withdrawals without affecting your body adjusting to the bupe with the rest of the 80% unless you overpower it with too high of a dose of heroin while fentanyl would be the worst choice. In fact I would suggest to use something weaker like Morphine that can not out compete although can bind to extra space.
It's an interesting method to purposely cause PWD to then reverse the precipitated withdrawal with a new full agonist dope that can bind to open receptors and not knock bupe off with something like fentanyl as that will probably he more difficult to manage as it wil knock the bupe off, but possibly it could also work as after fentanyl knocks it off when it's short half life runs out bupe will gently replace the receptors that the fent fall off of.
This is all speculative though. As the op should've made more clear in the title as something like, "my way of beating precipitated withthdrawals that I hope help others if it can." Not something that sounds a gaerunteed method that avoids pwd, but something that will throw you into them with a way to get it aver gentally
If this 80% thing mentioned above is true than it makes even more sense tag if not. The heroin is probably adding effect with the last 20% to get that extra kick to kill the withdrawals without affecting your body adjusting to the bupe with the rest of the 80% unless you overpower it with too high of a dose of heroin while fentanyl would be the worst choice. In fact I would suggest to use something weaker like Morphine that can not out compete although can bind to extra space.
It's an interesting method to purposely cause PWD to then reverse the precipitated withdrawal with a new full agonist dope that can bind to open receptors and not knock bupe off with something like fentanyl as that will probably he more difficult to manage as it wil knock the bupe off, but possibly it could also work as after fentanyl knocks it off when it's short half life runs out bupe will gently replace the receptors that the fent fall off of.
This is all speculative though. As the op should've made more clear in the title as something like, "my way of beating precipitated withthdrawals that I hope help others if it can." Not something that sounds a gaerunteed method that avoids pwd, but something that will throw you into them with a way to get it aver gentally
svacheme3
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tacodude your post makes me curious, is there a DB of specific binding affinities that's fairly complete? I was curious but most articles only list a few at a time, and in different ways with wildly different values even just in humans. Would take a while to reconcile myself so curious if theres a good one already, since I certainly don't recall which of the many values listed in KiDB i'm looking for. The NPD forum thread on this is similary confused about just what Ki is being cited.
(side note, can a moderator inform me on the policy regarding citing with a scihub link?)
More on the point of the thread, I would guess you don't go back into precipitated w/d because the additional bupe just isn't enough to overcome the effect to begin with, given how much heroin you have to use to stop it in the first place. And I definitely sympathize, I avoid bupe entirely now after still getting PW 36 hours after last dose (oxycodone at the time).
(side note, can a moderator inform me on the policy regarding citing with a scihub link?)
More on the point of the thread, I would guess you don't go back into precipitated w/d because the additional bupe just isn't enough to overcome the effect to begin with, given how much heroin you have to use to stop it in the first place. And I definitely sympathize, I avoid bupe entirely now after still getting PW 36 hours after last dose (oxycodone at the time).
I just put myself in PW accidentally this morning then did 12 bags to try to make it stop! Im not violently sick anymore but still sweaty and feel like shit. So I should take more subutex now?? Wont that put me back in withdrawals? I took 4mg subutex about 6 hours ago...help!
Rachella666
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12 bags? Wow, how can people afford it????
Jekyl Anhydride
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Everyone has always told me that that when they are on subs and try to use heroin or other opiates it simply does not work because of the naloxone but does not cause and P/W and that you only experience precips when you go from heroin or other opiates to suboxone too quickly. This is also what my doctor told me when she prescribed my suboxone. Why else would people wait days before switching to subs? This is all corroborated by the fact that when someone is overdosing and gets shot with naloxone they experience p/w because they are taking naloxone with opiates in their system. Which means that OP is very wrong and this method will send you into precips. Can somebody help verify that it is a good idea to take subs to minimize or defeat P/W? Because if this is incorrect and could make it worse I don't want people to read this thread and go through hell. Also I was under the impression that P/W happen when you take suboxone before the other opiates are out of your system.
Lorne???
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^Pretty much, except it isn't nalaxone that is responsible; when taken sublingually BA% is pretty much zero
However buprenorphine itself has such a high binding affinity it knocks other opioids off the receptors. Yet, it is a partial agonist, so in particular if you have a heavy habit or are on something like methadone, the bupe will basically displace it much like nalaxone would, and although bupe is a potent opioid(at low to moderate doses) it is a partial agonist, meaning it has less intrinsic active, and so it will not replace the full effects of the opioids it knocks off, and it does so rapidly enough that it can cause precipated withdrawal, which can in some cases be quite intense, again methadone patients in particular should avoid buprenorphine until they have adjusted to a lower dose of methadone and even then, wait at least a couple of days for methadone to leave there systems and full wd to start
However buprenorphine itself has such a high binding affinity it knocks other opioids off the receptors. Yet, it is a partial agonist, so in particular if you have a heavy habit or are on something like methadone, the bupe will basically displace it much like nalaxone would, and although bupe is a potent opioid(at low to moderate doses) it is a partial agonist, meaning it has less intrinsic active, and so it will not replace the full effects of the opioids it knocks off, and it does so rapidly enough that it can cause precipated withdrawal, which can in some cases be quite intense, again methadone patients in particular should avoid buprenorphine until they have adjusted to a lower dose of methadone and even then, wait at least a couple of days for methadone to leave there systems and full wd to start
Cotcha Yankinov
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Sci-hub is cool.
I'm not entirely sure why taking suboxone 60 hours into a cold turkey is sending you into withdrawals, bupe shouldn't have this effect and theoretically the naloxone is added just as a deterrent for IV use (the naloxone isn't absorbed orally very well).
There have been some changes noted in the way that opioid receptors behave after using opioids chronically that may help explain what the OP has rather anecdotally reported, but I'm not sure exactly how.
Normally most opioid receptors couple to a signaling cascade element called a G protein, with activation of the opioid receptors resulting in different effects depending on what type of G protein the opioid receptor is coupled to.
Most of the opioid receptors in question (Mu Opioid Receptors) are bound to the G protein "Gi/o", which causes inhibition of cell firing and the desirable effects. But with chronic use of opioids, the MORs can switch coupling to excitatory "Gs" G protein coupling, stimulation of these Gs coupled MORs essentially produces withdrawal symptoms.
The reason why ultra low dose naltrexone/naloxone can help with opioid tolerance/withdrawal at very low doses is that naltrexone/naloxone can help reverse this aberrant coupling by binding to a high affinity site on the cytoskeleton that is involved in this G protein coupling switch, hence doses like 0.125mg naltrexone appear to help with opioid withdrawal and tolerance without blocking enough MORs to offset the beneficial effects on G protein coupling. If the naltrexone dosage gets too high, it becomes unhelpful.
Agonists display differential affinity for a G protein coupled receptor depending upon what G protein its coupled to, and its thought that opioid agonists tend to have higher affinity for Gs coupled MORs than Gi/o coupled MORs, thus leading to some facets of tolerance (the opioids tend to stimulate the Gs coupled MORs). The old theory of why ultra low dose naltrexone helped with opioid tolerance/withdrawal was actually that it preferentially bound to and blocked the Gs coupled MORs.
One explanation is that bupe is particularly good at stimulating the Gs coupled MORs that can still be present in acute WDs, but that stimulation of Gs coupled MORs will wear off and downregulation/desensitization of those Gs coupled MORs by bupe could mean that its only a matter of time until bupe no longer causes precipitated withdrawals.
The heroin used to negate precipitated withdrawals could simply be buying time while the Gs coupled MORs are endocytosed/downregulated.
So to recap the theory
1. Bupe stimulates lingering Gs coupled MORs, worsening withdrawals
2. Heroin use compensates and relieves
3. Gs coupled MORs are downregulated by bupe stimulation while heroin is buying time
4. Bupe eventually doesn't produce precipitated withdrawals after the heroin is gone because the Gs coupled MORs finally downregulated or reversed their coupling (maybe its possible the oral naloxone could be playing a role in this too?
sorry for the novel,
CY
For the record years later, I've found OPs theory to be true. It's basically the bernese method slightly modified.