Suboxone and fentanyl precipitated wds

[kames91]

This is my first post so bear with me please. I am at 72 hours opiate free. I took 8mg suboxone at 48 hrs clean and still got precipitated wds. Does anyone have any advice when I'll be safe to dose suboxone?

 

[OpiateKiller]

This is my first post so bear with me please. I am at 72 hours opiate free. I took 8mg suboxone at 48 hrs clean and still got precipitated wds. Does anyone have any advice when I'll be safe to dose suboxone?

If you took 8 mg of Suboxone and are 24 hours later chances are you’ve experienced all the precipitated withdrawal you will as long as you didn’t redose fentanyl.

Fentanyl has a very short half life but for whatever reason builds up in the system almost as methadone it appears.

The head of nursing at a detox I was at said she’s seen PWD with fentanyl and tries to get people to wait till 72-96 hours since last dose.

Also start small it will show you if you take it too soon. Next time start with 1-2 mg of Suboxone and dose yourself again after an hour if you don’t feel PWD onset.

 

[Coffeeshroom]

Im a weird person when it comes to this. I have never used fentanyl (to my knowledge) but i can get away only waiting 16-24hrs after my last H use and then swap to bupe and have no PWD but that doesn't mean my wd are away completely. I normal start with 1mg Subs and take more if needed. I just want to get past the cold sweats part as that is what breaks me the most from opiate WD's. I can handle the unpleasant projectiles from top to bottom but the coldsweats i can't bare, especially here where its Hot constantly.

 

[OpiateKiller]

Im a weird person when it comes to this. I have never used fentanyl (to my knowledge) but i can get away only waiting 16-24hrs after my last H use and then swap to bupe and have no PWD but that doesn't mean my wd are away completely. I normal start with 1mg Subs and take more if needed. I just want to get past the cold sweats part as that is what breaks me the most from opiate WD's. I can handle the unpleasant projectiles from top to bottom but the coldsweats i can't bare, especially here where its Hot constantly.

Can relate but it’s freezing here haha. I’d be freezing in full winter gear but covered in sweats with it 10 degrees out. Thankfully that WD symptom is gone for me now

 

[kames91]

If you took 8 mg of Suboxone and are 24 hours later chances are you’ve experienced all the precipitated withdrawal you will as long as you didn’t redose fentanyl.

Fentanyl has a very short half life but for whatever reason builds up in the system almost as methadone it appears.

The head of nursing at a detox I was at said she’s seen PWD with fentanyl and tries to get people to wait till 72-96 hours since last dose.

Also start small it will show you if you take it too soon. Next time start with 1-2 mg of Suboxone and dose yourself again after an hour if you don’t feel PWD onset.

Thank you for the information. I've detoxed heroin many times but never fentanyl. When I dosed suboxone I started at 2mg and after an hour upped it to 8. I thought 48 hours would be enough but I had no idea fentanyl hung around like methadone. Is it lipophilic?

 

[OpiateKiller]

Thank you for the information. I've detoxed heroin many times but never fentanyl. When I dosed suboxone I started at 2mg and after an hour upped it to 8. I thought 48 hours would be enough but I had no idea fentanyl hung around like methadone. Is it lipophilic?

Honestly I have no idea why fentanyl would act like this. It’s half life is much shorter than heroin, I guess maybe because of its potency it really sticks to receptors thus causing the potential for terrible precipitated WD.

It’s unfortunate because most people are sick within 24 hours after there last fentanyl dose, I remember shooting up even 4 hours later cause it was seemingly wearing off.

I found at the beginning going back and forth between fent and subs wasn’t a problem. As I continued this cycle it became incredibly painful to continue.

You’re better off sticking to one or the other.

 

[TheInvisibleStoner]

I think you should be OK to take another piece. Small piece. Around 1mg or less and see how you feel.

Oddly with subs I found lower doses to work better. When I was trying to switch from methadone to subs they really didn't work for a few days.

 

[kames91]

Took 8mg worth and hit no precipitated wds. For anyone who reads this later on I had to wait about 86 hours

 

[OpiateKiller]

Took 8mg worth and hit no precipitated wds. For anyone who reads this later on I had to wait about 86 hours

I’m happy to hear that. Just know if you precipitate withdrawals at 24 hours chances are it’s a one and done and you can take more subs once it’s over without reoccurrence. Don’t quote me but that’s my experience it’s a one and done thing - for each fentanyl binge at least

 

[kames91]

Thank you for the help. Much appreciated. It's funny because even my buprenorphine doctor said 30hrs and id be fine to dose. I waited the 48 because of how indescribably terrible precipitated withdrawals can be and because of a friend's warnings. At least now I have a better estimate of how long to wait

It's crazy how fucked up fentanyl is.i used to dose 12 hours after black tar and was 100% fine

 

[OpiateKiller]

Thank you for the help. Much appreciated. It's funny because even my buprenorphine doctor said 30hrs and id be fine to dose. I waited the 48 because of how indescribably terrible precipitated withdrawals can be and because of a friend's warnings. At least now I have a better estimate of how long to wait

It's crazy how fucked up fentanyl is.i used to dose 12 hours after black tar and was 100% fine

Yeah it doesn’t make much sense and I’ve been in some horrible PWD that’s for sure.

It’s funny some detox faculties actually offer to medically induce a coma, and then they hit you with high doses of naloxone / suboxone / narcan depending on the place. The idea is to cause an instant and rapid detox and they believe the overall withdrawal process will be faster and shorter overall.

I’m not sure I believe it would make a difference in the length of withdrawal but maybe haha. I guess it doesn’t matter if you’re asleep. Still pretty crazy concept and I’m sure greatly expensive.

But no problem yeah sadly some doctors really don’t know drugs like we do.

 

[neversickanymore]

If you took 8 mg of Suboxone and are 24 hours later chances are you’ve experienced all the precipitated withdrawal you will as long as you didn’t redose fentanyl.

this

 

[kames91]

Yeah it doesn’t make much sense and I’ve been in some horrible PWD that’s for sure.

It’s funny some detox faculties actually offer to medically induce a coma, and then they hit you with high doses of naloxone / suboxone / narcan depending on the place. The idea is to cause an instant and rapid detox and they believe the overall withdrawal process will be faster and shorter overall.

I’m not sure I believe it would make a difference in the length of withdrawal but maybe haha. I guess it doesn’t matter if you’re asleep. Still pretty crazy concept and I’m sure greatly expensive.

But no problem yeah sadly some doctors really don’t know drugs like we do.

Ive always been curious as to that procedure. I can see why it would be an appealing option. Even with the variety of "comfort meds" practically nothing you can take besides another opiate will completely help with wd and sometimes that's not even enough. So taking away the hellish first 3 to 4 days would help tremendously as anyone whose detoxes opiates will understand.

 

[midgy]

Yeah it doesn’t make much sense and I’ve been in some horrible PWD that’s for sure.

It’s funny some detox faculties actually offer to medically induce a coma, and then they hit you with high doses of naloxone / suboxone / narcan depending on the place. The idea is to cause an instant and rapid detox and they believe the overall withdrawal process will be faster and shorter overall.

I’m not sure I believe it would make a difference in the length of withdrawal but maybe haha. I guess it doesn’t matter if you’re asleep. Still pretty crazy concept and I’m sure greatly expensive.

But no problem yeah sadly some doctors really don’t know drugs like we do.

Those procedures run around 20k-30k give or take

 

[TheGame985]

You must not have a doctor and maybe that's why you can't get the exact information. I would think that after 72 hours you wouldn't have a problem, especially with a short acting opiate like fentanyl, but I could be wrong. What I have always done is wait until the opiate is as much out of my system by flushing, and then waiting for the withdrawal process to kick into high gear and based on feel and the time that's elapsed then I'll attempt to take the suboxone.

Opiate withdrawal is a nghtmare though.

 

[midgy]

You must not have a doctor and maybe that's why you can't get the exact information. I would think that after 72 hours you wouldn't have a problem, especially with a short acting opiate like fentanyl, but I could be wrong. What I have always done is wait until the opiate is as much out of my system by flushing, and then waiting for the withdrawal process to kick into high gear and based on feel and the time that's elapsed then I'll attempt to take the suboxone.

Opiate withdrawal is a nghtmare though.

The reason why this method is being done is because although Fent is short acting, it sits in peripheral tissue regardless of dose, and it takes much longer for it to dissipate vs. other short acting opiates. Thats why people get precip withdraw despite being in full withdrawls from fent usage. Its really crazy but this method has adopted in Europe and other places medically and it seems very promising in the literature I've read and from user experience. Logically, it makes sense too as suboxone is an opiate, so naturally withdrawls from opiates should be mitigated or much less severe by nature.

 

[OpialiciouslyMe]

Thank you for the information. I've detoxed heroin many times but never fentanyl. When I dosed suboxone I started at 2mg and after an hour upped it to 8. I thought 48 hours would be enough but I had no idea fentanyl hung around like methadone. Is it lipophilic?

Fentanyl is very lipophilic. That's why it's so potent as being very lipophilic it crosses the blood brain barrier very quickly and more efficiently than heroin.

 

[Elchicodeoro]

The reason why this method is being done is because although Fent is short acting, it sits in peripheral tissue regardless of dose, and it takes much longer for it to dissipate vs. other short acting opiates. Thats why people get precip withdraw despite being in full withdrawls from fent usage. Its really crazy but this method has adopted in Europe and other places medically and it seems very promising in the literature I've read and from user experience. Logically, it makes sense too as suboxone is an opiate, so naturally withdrawls from opiates should be mitigated or much less severe by nature.

I’m attempting to kick pressed M30s been using them for almost 2 years pretty steady. Huge tolerance. I have all the necessary things to help ease my withdrawal, but how long should I wait before I take suboxone? I really really really want to avoid precipitated withdrawal. I have gaba, soma, and hydroxizine as well. Any feedback would be welcomed.

 

[kames91]

I’m attempting to kick pressed M30s been using them for almost 2 years pretty steady. Huge tolerance. I have all the necessary things to help ease my withdrawal, but how long should I wait before I take suboxone? I really really really want to avoid precipitated withdrawal. I have gaba, soma, and hydroxizine as well. Any feedback would be welcomed.

I would wait atleast 72 hours. Fentanyl is very lipophilic so 72 hours to 96 is the best, it is very different from other opiods. Make sure you dose the gabapentin 300mg every 30 minutes and not all at once as it works much better that way. I would also recomend getting some loperamide as well.

 

[Elchicodeoro]

I would wait atleast 72 hours. Fentanyl is very lipophilic so 72 hours to 96 is the best, it is very different from other opiods. Make sure you dose the gabapentin 300mg every 30 minutes and not all at once as it works much better that way. I would also recomend getting some loperamide as well.

Thank you so much! I genuinely appreciate any and all info I get. What dosage should I use of loperamide and what frequency???