Hello, I have a quick question. It's been day 1 since i been given suboxone. I know for sure that mixing it with heroin is a NO NO. But how about fentanyl? I've heard mixed comments. People say that it'll be fine, others say it wont do a thing, others say you can't take it together otherwise you'll get serious side effects. So which one is it?
Buprenorphine blocks the effects of substances that stimulate or otherwise "agonize" the Opioid receptors found in our brains and gastrointestinal complexes, among other locations in the body, typically to a lesser degree than the aforementioned. In addition to being a partial agonist in its own right, Buprenorphine will both bind to empty Opioid receptors in vivo and will actively antagonize typical Opioid agonist substances i.e. Morphine.
This is a simplification, but both for yourself and for others just getting their feet wet in terms of binding affinities, enzyme activity, unique physiology (including statistical outliers possessing statistically rare conditions that make them even further unique than your average human), the big takeaway is that an Opioid is an Opioid in terms of danger. They can all kill you and just like how 1 pint of beer is a tasty refreshment and a pint of Gin is a guaranteed fight with your girlfriend's mother, their potency varies considerably by weight.
Again, this main takeaway is that Fentanyl is Morphine/Heroin that is more potent by weight. A few milligrams of Heroin will be well tolerated by most any naive individual whereas the same weight of Fentanyl could quite easily cause Death by Respiratory Depression.
In general, if you end up suffering painful trauma, sudden need of surgical intervention etc. that require Opioids for proper anesthesia/analgesia will generally have them administering a drug like Remifentanil (Ultiva), a short-acting, ultra-high potency Fentanyl analog.
Administering Opioids to the Buprenorphine-maintained/dependent patient typically leads to greatly-diminished or subjectively absent effects. If you reverse this equation, you will typically be thrown into immediate and full-blown withdrawal from Opioids i.e. that slow progression to day 3 of acute Opioid withdrawal that we all know can be experienced with the Disney Fast Pass lightning speed. A Japanese bullet train to a nightmare Hell that you previously though couldn't have possibly existed.
Once upon a time I was sentenced by a judge to 21 days of rehab in the lovely city of Brockton, MA. There was this 19 year-old kid who fancied himself something of an amateur Pharmacy tech. He was really confident in his ability to differentiate between differentiate between Mirtazapine (Remeron) and Naltrexone (ReVia) especially. So confident that, despite being maintained on ~100mg Methadone per day, he decided to roll the bones.
"I have trouble sleeping in hospitals and institutions man"
"Granted, Mirtazapine is great for sleep, but that is not like any Mirtazapine I've ever seen"
The kid was screaming at such a volume and pitch that his voice was gone within less than a couple of minutes. Guy started hyperventilating, purged so hard that he started turning blue from lack of oxygen, proceeded to tear his clothes off and run up and down the hallway, completely naked in front of what is essentially G-Pop of your average county jail. His coup de grace was banging his head against plexiglass until being sedated. Crazy shit.
