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maois (in ayawaska/ayahuasca) and suboxone- safe?

daysonatrain

daysonatrain

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Feb 6, 2009
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Hey bluelighters,

Got a quick question that i couldn't find the answer to, maybe someone out there can help out. are maois safe to do in combination with prescribed suboxone for addiction maintenance. A friend and I had planned on taking an ayahuasca trip, however he is currently taking 8mgs of suboxone daily. I havnt found anyone saying that opiates react badly with maois (or any info saying its fine really:\). And though sub isnt an opiate it kinda works on the same receptors (i think...).

Im very, very, wary of trying this out with him, since i cant imagine anything worse than seeing my friend getting seratonin syndrome while high on dmt (though we would have a trip sitter) not to mention the possibility of a close friend dying.

I guess another option would be for him to stop taking it, but the half life is like 72 hours i think, so he'd have to be off for like a week, which would then lead to withdrawals, not a good state to trip in.

Chance are i will not do this unless i get a definative answer (with a source) that there is no contraindication between the two.

Thanks for any info anybody out there has.

Peace,
-DoaT
 
thanks immunity, i have checked over those links already.

does anyone have any first hand experience combining an opiate (or suboxone) with an maoi?
 
From a very in-depth (or maybe not) scout about the interwebz, it would seem to be safe to use an MAOI with Suboxone

According to the one ADD thread I found it's safe - Opiates (Buprenorphine) and MAOIs

Wiki says: "Purely opiate-acting analgesics, such as morphine, and buprenorphine may be used safely with MAOIs, but may require a dosage adjustment." on its MAOI page in the "Dangers" bit.

A study published here in the Oxford Journal agrees, at least as far as the specific MAOI used in the study goes - "In the model used buprenorphine, in contrast to pethidine, showed no interaction with the MAO inhibitor phenelzine."

The only mention of any potential adverse reaction I could find was that an MAOI may slightly increase the potency of Suboxone. As long as your friend is well used to taking it then I would doubt that a slight increase in potency would cause any problems. I am, of course, not a doctor so make of that what you will...

From a personal perspective, I was on Subutex (same thing but without the vile Naltrexone) for many years and used any number of drugs - including many psyches and stims - with no noticable interaction. Unfortunately, that long list of drugs I used whilst on Sub didn't include ayawaska.
 
This is a good question. What about maois and kratom? Should one not have any kratom in their system at all if caapi or harmala is going to be used to potentiate something else? Just wondering. I've always wondered about the strict diet with some of these shorter acting reversables but would never even take the chance.
 
Very little information on combining Kratom with an MAOI as there's so little research on Kratom itself so far, but what little there is all seems to agree that it's a potentially dangerous combo and best avoided.
 
^ Agreed. My thoughts exactly. Thanks Shambles. Being a large group I was thinking someone may have combined the two but I believe kratom should fall under a dietary restriction along with cheese, wine, pickles, etc...
 
shambles, much thanks for all that info. never really expected a response so in depth. you are my new best friend :):):)
 
Anytime, Mr Onatrain - hope it was of some use to you :)

Well, anytime I'm a lil overstimmed anyway - does have a few uses beyond preposterous prolixity :D
 
good news for me your overstimmed i guess. does change things quite a bit, we will probably take that trip now, though i will probably ask he either take a few days off or take a few days with significantly less suboxone. thanks again!

if anyone else out there has ever tried this combo, i'd love to hear about it.
 
Righty. Despite containing rather less information than the other one, this post actually did involve a fair bit of research. Massive overstimulation has faded to moderate OCD so worked out well. It's a good question too - the kinda information that I could've done with in my pre-BL days. Some of the combos I took back then with zero knowledge of the potential risks involved make me shudder :|

One slight concern I'd have with abstainance from, or cutting down too heavily on, the Subs beforehand is that your friend would be in withdrawal to a greater or lesser extent. That would be about the worst possible state of mind to go into a trip I can think of. Add on the vicious withdrawals and it sounds like the trip from hell to me.

From all that I've read online - rather a lot now - the possible increase in potency from the MAOI would not be a huge one if it happens at all, but there seems to have been no actual specific studies done on it. There also seems to be no great concern about the Sub/MAOI combo which maybe suggests that it's not a big concern. Maybe. Bupe is a long-acting one so maybe skip the dose on the day prior to the trip would be my (completely inexpert) approach if it were me. It's not me though so a call that only your friend can really make, I'd say.

Every mention of Suboxone and MAOIs I found either said no interaction or possible increased potency based only on interactions with morphine not Suboxone - different drugs. The only one that said not to combine was with the BuTrans transdermal buprenorphine patch - again not really the same thing. There were no mentions of any contraindications on any of the MAOI no-no lists.

The one single, solitary reference to the safety of ayawaska and Suboxone was a tiny one on Drug Forum. Not much there, but said to be safe and the fella said he would do the combo that weekend. I'm not a member there so couldn't search for it but maybe worth a look as it seems to be the only one.

And that really is it as far as I can tell. Over to others :)

Only other thing that occurred to me was if it would be possible for your friend to try a small sample of the MAOI with his Sub prior to the main event to see if it has any effect before diving in.
 
very good advice, thanks again shambles. i agree on withdrawal aspect, and certainly would not want him to be in a withdrawal mindstate prior to ayahuasca ingestion, however i also want to reduce (as much as possible) his chances of having a negative reaction between the two. however, from the info you have given me it seems relatively safe.

i have a ton of syrian rue and will give him a sample to try out before we embark on the actual trip.

thanks again.
-DoaT
 
bump, from an old convo with shampbles. nobody really seemed to have any first hand knowledge of this combo so ill tell you what happened to my friend. he was on 12 mgs a day (not a tiny amount) and he tried the combo of 3grams syrian rue, as a safety test run for taking ayahuasca. he had a very bad reaction, got quite sick and said it potentiated the sub quite a bit. something to watch out for, for sure. be careful, hope this helps someone out there.
 
Most probably the bad reaction came from something else than the suboxone. I've been on suboxone for years (22mg per day) and I've never had any adverse reaction from any MAOI.
 
Yes I've combined methadone & morphine with harmala on several occassions with no ill effects
 
Taking an MAOI for ayawaska whilst on Subs as in the original question would be PD material though, no? I'll change the title to make it clearer :)
 
Buprenorphine is not metabolized by MAO enzymes, so a MAOI should not affect the efficacy of suboxone whatsoever.
 
hm, strange to hear all these responses now. he claimed that it made the suboxone several times stronger. and aside from weed he is not on any other drugs or things that would react with maoi's. strange. i too was suprised that he told me this, since from the little info i had subs would not react with maios...
 
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