Bupe Help! Redosing Suboxone AFTER breaking through PWs

[mtm268]

So I was attempting to induct on suboxone from H/fent cut dope, developed quite a large habit actually. Well the doc told me to wait 15 hours and dose the following day (I used that day at about 8pm). I waited 17 hours, was feeling mild withdrawals, and dosed (8mg) while at work at about 1pm. BIG MISTAKE.
Needless to say I was hit with Moderate Precipitated Withdrawals and felt absolutely terrible. Ended up having to leave work and buying dope to break through the PWS (actually felt a good bit better after just one bag) and stopped using at roughly 730pm today. Would like to note after the dulled rush, there was a very brief 2-3min VERY mild PWS feeling.... then the typical normal response of using.
Now idk if the bupe is kicked off, inert, still in my system or what. BUT what I am wondering is WHEN it would be safe to redose the suboxone again??? Should I try waiting 24 hours this time (which a big portion of would be at work)? I would imagine the previous sub is still in my system, but idk? When can I safely redose and not go into PWs after the break through???? Will it be necessary to be kind of sick at work? Please help, as I am seriously trying to get off this crap and move on with my life!!!
Any personal experience, and educated advice is needed and welcomed. Thank you for your time.

 

[crzydiamond]

The sub is in your system now.

You should be ok to induct. Still, start at 1 mg sub and make sure you don't have any issues. ( I mostly say this because while sub displaces heroin, the fentanyl wouldn't be displaced by the sub. So depending how much of your "dope" is actually fentanyl would affect the transition)

 

[tacodude]

I'll add who knows if it's regular fent or an analog with a longer half life that lingers. Just a thought

 

[crzydiamond]

That is also true.

Which is why-- whenever attempting to induct and you're not sure if you're going to be clear from precipitated withdrawal, *always* start by dosing 1 mg of sub first. Wait and see if this throws you into wd or if you feel fine. ( trust me you will know within a few minutes if your blood runs cold and you get instant shakiness...)

If your body doesn't react after 15-30 minutes ( to be completely safe/ really you'll know sooner) then titrate up 1-2 mg every 15-30 minutes until you're at normal /desired dose.

OP-- don't *ever* do what you did and just take an 8 mg dose at once. Precipitated wd intensity is affected by dose...you'd much rather have precipitated wd from 1 mg instead of 8 mg...( less severe and shorter duration)

 

[Niknik420]

I have a question- yesterday i went to a sub doctor to get off H. It had been 22 hours since my last shot, so i thought i'd be good. It turns out, not so much! I took 1/2 sub at 5pm and was in full precip
withdrawals by 6pm, so i thought if i took the other 1/2 it would help, IT DID NOT! Was puking all night, took another 1/2 about 5am, nothing- and another half around noon.Last night was the worse night ever, and it continued all day. I know suboxone has a blocker but i needed to do something so i went and saw my guy and felt better immediately- i didnt get high, just felt normal. Now, my question is- since the subs has a blocker in it, do i still have to wait to go into full withdrawals again before taking another 1/2 sub? I really only did the dope to get out of those withdrawals, i really do want to continue on the subs to get clean, but the withdrawal symptoms were too much to handle. Any suggestions?

 

[jamesBrown]

To the OP.....

The answer to your problem/question is EXTREMELY simple and has been discussed and answered over and over again....
If you are switching to suboxone from a full agonist like heroin or fentanyl, you need to wait until you are in the ABSOLUTE WORST WITHDRAWALS THAT YOU CAN HANDLE before dosing the suboxone. And even then when you take the sub, ONLY TAKE ABOUT 0.5 - 2mgs at first. Wait about 15 minutes, and take 1 mg more if you still feel like complete shit. You shouldn't have to take more than 4mgs(if that)...in 1mg increments....in order to take away the physical WD symptoms.

I have a question- yesterday i went to a sub doctor to get off H. It had been 22 hours since my last shot, so i thought i'd be good. It turns out, not so much! I took 1/2 sub at 5pm and was in full precip
withdrawals by 6pm, so i thought if i took the other 1/2 it would help, IT DID NOT! Was puking all night, took another 1/2 about 5am, nothing- and another half around noon.Last night was the worse night ever, and it continued all day. I know suboxone has a blocker but i needed to do something so i went and saw my guy and felt better immediately- i didnt get high, just felt normal. Now, my question is- since the subs has a blocker in it, do i still have to wait to go into full withdrawals again before taking another 1/2 sub? I really only did the dope to get out of those withdrawals, i really do want to continue on the subs to get clean, but the withdrawal symptoms were too much to handle. Any suggestions?

Suboxone IS a blocker(opioid antagonist). And by that I mean the buprenorphine. The buprenorphine IS what binds to your opioid receptors and blocks other opioids from binding because of it's STRONG binding affinity. The nalaxone DOES NOT act as a "blocker". It has a lower binding affinity than bupe so it basically has no reason for being in a suboxone pill/strip.

 

[crzydiamond]

^ that applies and is completely true and good advice when originally inducting...

But this poster now has sub in her system. Therefore, it should take over the receptors as the full agonist (heroin) clears. She should be able to dose suboxone as soon as the h wears off. Again, this is ONLY because she has recently taken it. This does NOT apply to someone initially inducting.

wait until you start withdrawing. Wait as long as you can, because then the sub will make you feel better. (Though because it is in your system even if you dose sooner you won't go into pw again). Then start with no more than 1mg...just as I said to OP above.

You should always start low with sub, as the precipitated wd is worse with higher doses. This means don't take a half sub at once!! That is a 4 mg dose--not low...

I wish you well

 

[jamesBrown]

^Most of the time this is true I agree. BUT...I have personally witnessed people in the exact situation the OP is in....and when they took more sub because they thought it would be OK since it was already in their system(along with the heroin they took to help with the PW's)...they ended up having PW's AGAIN.

This definitely didn't happen every time....but it was VERY clear to me that it was a definite possibility in that kind of circumstance, so I would be very careful when telling the OP that it's perfectly fine to take more sub since it's already in their system. Yes, chances are there will be no more PW's, but that's not a risk I think anyone would want to take.

And yea, the lower the suboxone dose the better....in all circumstances.

 

[Niknik420]

Thank you guys so much- the sub doctor didnt tell me much and the rx bottle had instructions for the film not the pill. I took half an 8mg at 5 pm, and started feeling shitty and took the other half at 8. By then i was in full PW, and reading the forums, most say it lasts an hour so i was expecting to feel better. By 10 i was puking that bile and thought maybe i had thrown up the previous doses and that's why it wasnt working. Overall over night i took 2 1/2 8mgs hoping to get it to work, it just made it worse, thus the H today. TBH, i didnt think it would help at all b/c i had so much sub in my system but i felt better immediately, not high just normal- my last dose of sub was noon and it was a quarter pill. So should i wait until withdrawals again? Like really bad ones? I had gone 22 hours before taking the sub that put me into PW's. This has never happened before, id taken it maybe 8 hours after and felt great. Ive obviously learned that less is best and will start with a quarter and hope it doesn't put me in PW's again, but like i said- i have over 24 mgs of sub tablets and another 1/2 strip thinking it just wasnt absorbing in my system in the last 24 hours- so i think that counts for something as far as the blockers, right?

 

[crzydiamond]

No. Do not start with a quarter. Listen to what I and jamesbrown is telling you. You want to start LOW. yes I understand with most pills a quarter is low but with buorenorphine it just isn't.

Again--start with no more than 1 mg. That's about1/8 pill, or half of a quarter.

And though what I'm saying above about that you should be fine because it's in your system is true, jamesbrown is also correct when he says that sometime people still go into precipitated wd on the second induction. (I highly suspect that is due to fentanyl cut dope, as the fentanyl has a higher affinity for binding). So that is why i completely agree to start low as possible.

Take the 1 mg. Wait about 15-30 min. You'll know if you're going to be ok....if you're fine at that point go up 1 mg every half hour or hour until you feel comfortable

And yes. You should wait until withdrawal. Theoretically you would be ok to take it sooner, but if you have fentanyl cut dope that may not be true, so to be safe and avoid the same thing happening wait until you don't feel well

The above poster explained to you (quite well) why blockers (naloxone) have absolutely nothing to do with precipitated withdrawal. It's the sub itself that blocks due to higher binding affinity. I don't mean this offensively--but you're asking questions that are answered and then you're asking them again...so maybe read over the answers better before posting? I don't mind helping, but it's
frustrating to answer or see someone answer your question and then the next post asks the same thing...

 

[SS373dOH]

I'll add who knows if it's regular fent or an analog with a longer half life that lingers. Just a thought

This exactly what I was thinking! Why would your doctor give you a time to take it, opposed to inducting based on symptoms!?

It baffles me on how many people think dope is cut with legit fentanyl, when 99℅ of the time it's a cheaper fent' analog.. The point is, these analogs have highly contrasting characteristics. Some of their potency's are 20% of fent and some are 10x as strong.. one of their half life's could be 5 mins, and the next one's could be 12 hours.. So unless you know exactly which analog it is, telling you to wait "X" amount of time before induction is absurd.

 

[tacodude]

There's something called the COWS sheet or something meant to rate your wd severity. If it was under five points then it was not time to take the sub. Something like that

 

[kleinerkiffer]

There's something called the COWS sheet or something meant to rate your wd severity. If it was under five points then it was not time to take the sub. Something like that

Clinical Opiate Withdrawal Scale (COWS)

 

[mtm268]

Ok what about after induction? Say I'm on 16mg daily for a few days and break through .... can I follow my normal dose regimen and redose suboxone the following am or no?

 

[mtm268]

And thank you all for the thoughtful and educated responses

 

[crzydiamond]

Ok what about after induction? Say I'm on 16mg daily for a few days and break through .... can I follow my normal dose regimen and redose suboxone the following am or no?

Yes you can resume your normally dose schedule at that point...plenty of buprenorphine will be still in your system. Once you are stabilized on bupe, often you can skip a day and do other opiates, then resume bupe the following day.

However, I'd really wait to play around like that until you're stable and able to maintain on a lower amount of bupe. 16 mg is a large amount, it's going to be tough to break through unless you skip a day or two of bupe (or unless its fentanyl or fentanyl-cut dope). People may need doses of 16 mg in the beginning when transitioning but for maintaining you won't need to stay up there

Plus, you really need to give your body a chance to adjust to the bupe. "A few days" on it then trying to break through already isn't going to help you stabilize, and may in act make it more difficult to stabilize.

If I were you, I would just take the bupe for a few weeks. Then if you want a "vacation" day, have at it. You went on the buprenorphine for a reason, so you really want to give it a chance to successfully stabilize. Obviously, once you're not dopesick and haven't been off dope for long your mind starts trying to convince you to use. And no one is saying you can't...but I would wait a couple weeks.

I imagine your question means you did manage to successfully induct?