Bupe Horrible precipitated withdrawals from IV bupe... thought this couldn't happen?

[Crankinit]

Background: I'm on 24mg of suboxone film a day, and have been for the last two months, during which I've stuck to the program and avoided all other opiates.

Now earlier this afternoon I was bored and had some fits around, so I did some reading to confim what I remember reading ages back, and every single source I came across suggested that the bupe had a higher affinity for the receptors than the naloxone, and as such you could IV bupe without going into withdrawal.

So I went through the process of prepping up my dose, I only used 16mg, dissolved, filtered, etc. Hit a vein and shot.

Within 15 sconds I had a horrible tingling feeling run down my body. Within 30 seconds I was drowned in sweat. Within a minute I had to rush to the bathroom and was struck by horrible nausea and diarrhea at the same time, having to throw up into a bowl while sitting on the toilet. I continued sweating profusely and just generally feeling horrible (my eyes dilated to the point that I looked like I'd been smoking ice) and my heart rate shot up dramatically. most of the symptoms abated within30 - 45 minutes, although the nausea persisted for another hour or so until I IM'd an anti-emetic. Eventually once the nausea was suffiently under control I necked some benzos and passed out for a few hours, then woke up fine.

So uh, wtf Bluelight? Over and over I've read that IV suboxone is perfectly safe if it's the only opioid you take, that the bupe has such a high affinity for the receptors that the naloxone makes no difference, etc etc. Why did I get so horribly sick? Is the internet full of shit?

 

[Znegative]

No you injected an absurdly high amount of suboxone, if you took the time to read more carefully, you'd here that everyone that's shooting bupe never does shots above two mg. injecting sixteen mg is fucking nuts dude! The BA for sublingual absorption is only 30%. Injecting four mg is about equal in strength to taking sublingual suboxone,16 mg. you definitely can inject suboxone, but if you want to do so,taper down to like four mg, and nevr iv more than.5mg, this way you'll get the most out of it

 

[burn out]

Yeah, you took an insane dosage. A lot of people IV doses around 0.1 or 0.2 mg.

 

[SUB SHOOTER 2010]

dude why the hell did you shoot so damn much? You can def shoot suboxone Ive done it hundreds of times. The most Ive ever shot was half a pill 4mg. And that was back in the day before I realized that less is really more with bupe.

The only time I ever felt like that from suboxone was when I was withdrawing from opiates and I shoot suboxone it will make me feel like that for 10-15 min or so. But if I take a small piece and wait a couple hours till it gets on my receptors then I can IV it without having any bad effects.

Subutex I can IV if I'm in a withdraw and it wont cause any problems. BOTH will put you in a prec withdraw if you are opiate dependent and you take either while your not withdrawing enough and you still have too much of other opiates still on your receptors. Especially if you IV.

 

[dittybopmonster]

way way wayyyyyy too much suboxone shot. Shooting over 2 mg is going to go downhill. 16 mg IV makes me quiver at the thought. sorry bud

 

[Znegative]

Plus, if you think about the ratio of bupe to naloxone in suboxone, its 4 to 1, so shooting 16 mg of suboxone does contain 4 mg of naloxone, and while bupe does have a higher affinity, I imagine that that amount of naloxone is probably enough to put up a fight

 

[dittybopmonster]

its not. Naloxone still does nothing. Regardless of the amount. 16 mg of bupe not only completely blocks naloxone, but it antagonizes itself at that high amount.

 

[Znegative]

Yeah I imagine that's true but I still wouldn't want to inject 4 mg of naloxone regardless

 

[XTCAKE]

I normally take 1 to 4 MG under my tongue daily. The (only) two times I used my Suboxone via IV, I used approximately 1.5-2MG. I was nodding off that dose, I swear on it!
It was not a very euphoric heroin-like nod, however. It was extremely sedative. And dull!

You must not have done enough thorough research on your IV Suboxone dosage.
If you looked at several sources, all would highly advise NO WHERE near your ~16MG for IV.

No harsh feelings, we all make mistakes. At least now you'll know not to do this again.

 

[Crankinit]

Are you guys implying that the symptoms I experienced were from OD, and not withdrawal? That makes no sense. Dilated pupils, increased heart rate, diarrhea, heavy sweating, are symptoms of withdrawal, not overdose (and I've experienced both, so I'd know).

Furthermore, my regular daily dose is 24mg, with the cap generally accepted to be 32mg sublingually, even accounting for the increased BA from IV use the maximum dose I could have received would have been equivalent to 32mg sublingually (the cap), which I've taken before with no problems.

Once the naloxone wore off within an hour or two, I was fine again, whereas if my problem was OD I would have continued to be sick for a day, if not longer.

 

[Tommyboy]

Nobody said that you were overdosing. They said that the extremely high IV dose may have resulted in
-The naloxone becoming active in higher doses
or
-The buprenorphine antagonizing itself

Now I don't know which, if any, of those are true, but that is what people were saying.

If you want to take "the cap" into account, then your shot would have put you over it due to its long half-life. What I mean is, you still had bupe in your system, so the shot would have added to that dose, and the only way that it would have been the top dose is if you did it over 74+ hours after your last dose.

 

[Missykins]

Are you guys implying that the symptoms I experienced were from OD, and not withdrawal? That makes no sense. Dilated pupils, increased heart rate, diarrhea, heavy sweating, are symptoms of withdrawal, not overdose (and I've experienced both, so I'd know).

Furthermore, my regular daily dose is 24mg, with the cap generally accepted to be 32mg sublingually, even accounting for the increased BA from IV use the maximum dose I could have received would have been equivalent to 32mg sublingually (the cap), which I've taken before with no problems.

Once the naloxone wore off within an hour or two, I was fine again, whereas if my problem was OD I would have continued to be sick for a day, if not longer.

Despite junkie lore, naloxone DOES in fact have an effect when used in combination with buprenorphine, and you are living proof. Your symptoms are attributable to precipitated withdrawal facilitated by naloxone antagonist effect at the receptor.

 

[Tommyboy]

Despite junkie lore, naloxone DOES in fact have an effect when used in combination with buprenorphine, and you are living proof. Your symptoms are attributable to precipitated withdrawal facilitated by naloxone antagonist effect at the receptor.

Not at reasonable doses though, and I am living proof of that, as are many other BLers.

 

[dittybopmonster]

I kind of always seen an IV habit as being a bit more than 3 times the potency of a sub-L habit. In other words, if an individual uses 2 mg IV per day, I basically equate that with a 6-8 mg habit a day. I derive this theory simply from the BA bupe chart. For me personally, I need 4 mg sniffed at a time, 3 mg plugged, and 8 mg sub-L to give myself a proper personal dose. I have found this generally works for others as well. Given this theory, and I know it is my own so it VERY well may not apply to you, then a 16 mg injection should equate about 48-50 mg of sub sublingually. Thats a SICK amount of bupe to administer at once brothaman.

Also, given the argument and the whole naloxone issue being brought to light...have u ever injected subutex? If the naloxone activation argument stands, then you theoretically should have not had this reaction if injecting 16 mg of subutex, correct? I personally think a 16mg of injected subutex = a very VERY shitty time.

 

[Znegative]

I kind of wanted to bring this up too, regarding subutex. I've known quite a few people who've shot upwards of twelve mg subutex no problem. Perhaps this individual has a real sensitivity to naloxone? I don't know I personally can confess to having injected eight mg of suboxone at a time and probably sixteen mg in a day a while back, and I never had this reaction. Perhaps the op is a R&B plant trying to fool us all into believing suboxone cannot be injected again. Or maybe it was just a dirty shot, I've had similar nasty reactions to shooting drugs with used works.

 

[Swimmingdancer]

I thought that one of the main reasons that they put naloxone in Suboxone is to prevent people from injecting it?? I was always told that if you injected more than a couple mg you would be put into precipitated withdrawals.

 

[Swimmingdancer]

its not. Naloxone still does nothing. Regardless of the amount. 16 mg of bupe not only completely blocks naloxone, but it antagonizes itself at that high amount.

Why are you so sure about this? What are your sources? That is certainly not what I've read. *confused*

 

[Tommyboy]

I thought that one of the main reasons that they put naloxone in Suboxone is to prevent people from injecting it?? I was always told that if you injected more than a couple mg you would be put into precipitated withdrawals.

I have personally injected suboxone at a dose between 1-2 mg. It is a common misconception that the naloxone will cause precipitated withdrawals. You will however experience precipitated withdrawals (no matter the route of administration) if you take buprenorphine products like suboxone or subutex, while other opiates are still in your system. Here is some info with sources about this.

"Suboxone contains buprenorphine as well as the opioid antagonist naloxone to deter the abuse of tablets by intravenous injection. Even though controlled trials in human subjects suggest that buprenorphine and naloxone at a 4:1 ratio will produce unpleasant withdrawal symptoms if taken intravenously by patients who are addicted to opioids, these studies administered buprenorphine/naloxone to patients already addicted to less powerful opiates such as morphine.[3][4][5][6][7] These studies show the strength of buprenorphine/naloxone in displacing opiates, but do not show the effectiveness of naloxone displacing buprenorphine and causing withdrawal symptoms. The Suboxone formulation still has potential to produce an opioid agonist "high" if injected by non-dependent persons which may provide some explanation to street reports indicating that the naloxone is an insufficient deterrent to injection of suboxone.[8][9] The addition of naloxone and the reasons for it are conflicting. Published data clearly shows the Ki or binding affinity of buprenorphine is 0.2157 nM, while that for naloxone is 1.1518 nM.[10] Furthermore, the IC50 or the half maximal inhibitory concentration for buprenorphine to displace naloxone is 0.52 nM, while the IC50s of other opiates in displacing buprenorphine, is 100-1000 times greater.[11] These studies help explain the ineffectiveness of naloxone in preventing suboxone abuse, as well as the potential dangers of overdosing on buprenorphine, as naloxone is not strong enough to reverse its effects" (source).

"It is a common misconception that the Naloxone in Suboxone initiates precipitated withdrawal. This is false. The Naloxone can only initiate precipitated withdrawal if injected into a person tolerant to opioids other than buprenorphine. Taken sublingually the Naloxone has virtually no effect" (source).

I hope that helps clear a few things up for you.

 

[muvolution]

I have personally injected 1-2mg before and it made me sick as hell every single time. Lots of people will tell you it can be done, but for me, it can't.

 

[Tommyboy]

I know some people that took suboxone sublingually and got very sick from it, and they had not taken any other opiates for a while before it. They did take 8mgs, so it could very well have been that they got sick from that high of a dose.

Muvolution, I would be interested to see if you would get sick from IVing that amount of subutex, but you are probably better off not trying it to find out.