Bupe From Belbuca to Suboxone

[MrBaconHawk]

I was recently taking 450 micrograms of belbuca twice per day. Insurance told us they would no longer cover belbuca and so my pain clinic decided to switch me back to oxycodone 15mg 3 times a day. It was tough getting through the month because oxycodone does not help my back pain nearly as well as belbuca does, so today I asked them to give me a generic form of Suboxone so that insurance would pay for it. I told them the closest dosage I knew of was 0.7 MG. The doctor told me they would need to research it as they had never prescribed Suboxone previously, they called me back later in the day and told me they had prescribed 8 mg Suboxone 3 times a day. Obviously this is a pretty large jump from my previous prescription. What would happen if I took it as prescribed? Should I cut it up instead? Is there abuse potential? I'm glad they don't fight me on moving medications as requested but I also don't want to ruin my tolerances or get nasty side effects

 

[G_Chem]

If I was you, cut them down to 1mg pieces and maybe even cut those in half using .5mg in morning and .5mg at night. DO NOT take all of it, he clearly doesn’t know how to prescribe bupe. You’ll have a nice stockpile before long

-GC

 

[MrBaconHawk]

If I was you, cut them down to 1mg pieces and maybe even cut those in half using .5mg in morning and .5mg at night. DO NOT take all of it, he clearly doesn’t know how to prescribe bupe. You’ll have a nice stockpile before long

-GC

So I just picked it up, it's a round orange tablet with 415 on the front. I shouldn't cut up the tabs, should I?

A few times, I'd take 3 or sometimes 4 of my 450mcg Belbuca when in more pain. I wanted to take that amount every day a few times throughout the day, so perhaps this is for the better so I can finally enjoy more of my day...

I have a Full Retrolisthesis L5-S1 (the entire vertebrae is shifted by about 25% out of alignment), a Herniation on the same L5-S1 which is compressing not only the nerve root but the spinal cord, and L4-L5 is bulging with some nerve compression, not to mention I have shortened Pedicles which is narrowing the space for both sides of nerve roots even more... I am in a lot of pain every day, my average WITH meds is around a 4 or 5 and I've got a pretty high pain tolerance. So, honestly, as weird as this situation was, it seems like I was finally thrown a lifeline by the Universe... I had a Suicide Attempt 3 weeks ago (tried to take about 30 times my highest dose of Oxycodone, went to sleep thinking I wouldn't have to wake up, woke up in the middle of the next day and couldn't move for nearly an hour, ended up getting taken to a Psych hospital for 2 days but I denied I ever did anything so they released me after 48 hours cause they had nothing to go off of) and although it still often feels like I don't ever get a break, this is at least a little something. I'm just hoping they'll operate soon but they keep hesitating cause I'm young. Anyway....

Yeah, about cutting up pills... Doesn't that release all the naloxone at once if you do, causing unpleasant symptoms?

 

[ChinaGroove]

Orally the Naloxone will have no effect. Even taken IV the Bupe will overpower the Naloxone for the receptor.
Be aware of the misconception that the Naloxone causes precipitated withdrawl. While Naloxone can cause pwd in larger doses, when someone experiences pwd after taking Suboxone, it is because of the Buperenorphine. Being a partial Opioid agonist, Subs will cause pwd when knocking other Opioids off the receptor. You will probably be fine, but for your doctor to just switch you from Oxycodone to Buperenorphine without going over this is at best irresponsible and at worst dangerous.

 

[MrBaconHawk]

Orally the Naloxone will have no effect. Even taken IV the Bupe will overpower the Naloxone for the receptor.
Be aware of the misconception that the Naloxone causes precipitated withdrawl. While Naloxone can cause pwd in larger doses, when someone experiences pwd after taking Suboxone, it is because of the Buperenorphine. Being a partial Opioid agonist, Subs will cause pwd when knocking other Opioids off the receptor. You will probably be fine, but for your doctor to just switch you from Oxycodone to Buperenorphine without going over this is at best irresponsible and at worst dangerous.

Thanks a lot for the information.

As an update, I had taken a singular full pill, sublingually, about 3 hours ago. About 20 minutes ago I was beginning to feel decently dizzy/nauseated from the effects, then 10 minutes later I had a very weird feeling like I wasn't breathing enough but after taking a Pulse Oximeter test I was at 98% oxygen... Realized I was feeling that feeling right before you puke so I walked to the bathroom and threw up a couple times. I felt better after, still a bit nauseated.

I will be cutting the pills in 4ths from here on out, and will only take 1/2 if I need extra pain relief at any point in the day. That should allow me to have quite a lot of extra so I'll just leave it as is.

 

[ChinaGroove]

That's another thing I should have mentioned. If you aren't used to Buperenorphine, it can make you feel almost too "good" if you know what I mean. Lots of Vomiting and you won't desire to touch an Opioid for at least the next 48 hours.
Good luck all the same.

 

[Xorkoth]

Wow that's insane, you were on 900 micrograms a day of bupe (with belbuca), and now they're giving you 24 milligrams a day? That is absurd, very irresponsible of them, actually. On the plus side, you'll accumulate a whole lot of extra meds in case they ever suddenly cut you off.