The Basics
Introduction and Basic Description
Suboxone is a pharmaceutical drug that is a combination of buprenorphine and naloxone, and is used primarily to treat opiate addiction.
Buprenorphine is a thebaine derived opioid agonist and antagonist, while naloxone is an opioid antagonist. Due to its higher affinity to the opiate receptors, buprenorphine essentially "out competes" the naloxone, rendering the naloxone inactive.
Timeline of Experience
Buprenorphine has a very long half-life (~37 hours) making the effects often noticeable into the following day.
Onset 0-30 minutes, peak T+2, plateau T+3, Afterglow T+16, end of experience T+24.
This timeline will vary depending on ROA.
Effects
Since buprenorphine is a thebaine derivative, most people find it to be one of the more stimulating of the opiates, next to oxycodone (also thebaine derived). At first onset, the user will usually feel a warmth come over their body, and may have flushed skin. Pupils will become constricted (as they usually do with opioid use) as euphoria is felt by the user.
Those that find Suboxone to be stimulating will often enjoy talking a lot more than usual, while feeling very empathetic. They may feel energetic which may lead to them cleaning or doing other chores that one would normally not enjoy.
Those that find Suboxone to be depressing or "noddy" will feel euphoric and content with where they are.
The euphoric effects of this drug will usually diminish as tolerance increases, and those that use this drug daily for opiate maintenance usually report feeling very little euphoria after stabilizing on a dose.
Taking breaks from this drug may result in a brief return of the euphoric effects, but the user will often have to experience withdrawal during this break.
Dosages
Suboxone prescription:
Suboxone is currently available in two doses.
8mg buprenorphine/2mg naloxone
2mg buprenorphine/0.5mg naloxone
The buprenorphine in Suboxone is a very potent drug. Taken sublingually (under the tongue), effects from dosages as small as 1mg are felt. Other routes of administration (ROA) with higher bioavailabilities allow for an even lower dose to have an affect on the user.
The ceiling dose of Suboxone is said to be ~32mgs, which is the highest dose prescribed.
Method of administration
Describe method. This should generally be a link to an individual page describing that method (e.g. IV, orally). Add in this section anything that is relevant to that method FOR THIS DRUG.
Due to the change from pill form to strip form, preparing Suboxone for any ROA other than sublingual use will vary.
Sublingual
Nasal
Intravenous
Intramuscular
Rectal
Problems
Contraindications and Overdose
Respiratory depression is not as big of an issue with Suboxone, as it is with other opioid drugs.
As with any CNS depressant, it is dangerous to combine Suboxone with other CNS depressants (alcohol, benzodiazepines, barbiturates, etc).
Something that is somewhat unique to Suboxone is its ability to cause precipitated withdrawal in those that use Suboxone while other opioid drugs are still on their opioid receptors. The other thing that is somewhat unique to Suboxone is its "blockade effect," which prevents other opioid drugs from becoming active since they cannot bind to the receptors.
For these reasons, one should be extremely cautious when using other opioid drugs before or after taking Suboxone, and should wait the appropriate amount of time between dosing Suboxone and other opioid drugs.
How Long To Wait.....?
1. How long after taking my Suboxone do I have to wait before getting high off of a different opioid?
2. How long after taking a different opioid do I have to wait before taking Suboxone without risking precipitated withdrawals?
These two questions are some of the most asked questions on Bluelight.
There are several variable that come into play when trying to answer this question, and in the end, everybody is different so it's hard to know.
As for question 1, one of the main variables is if the person has been taking Suboxone regularly, or if they just took it once. The other variables, of course, are dosage and ROA. Daily users of Suboxone will generally have to wait longer to be able to feel other opioid drugs than someone that has only taken Suboxone once. The general rule of thumb is to wait 36 hours before taking another opioid, however there are people at the far end of each spectrum. Some people are able to get high the same day (~12 hrs later) and some have to wait ~72 hours before feeling the full effects of another opioid. ROAs such as intravenous may allow for a waiting period on the short side of the spectrum since the drug is eliminated faster that way.
As for question 2, this two has several variables. The half-life of the other opioid drug previously taken is one of the main variables, and the longer the half-life, the longer you should wait. In clinic settings, people who are switching from Methadone to Suboxone have to wait 3 days after their last dose of Methadone, to be dosed with the Suboxone. One general rule is to wait until you are in moderate withdrawal before taking Suboxone, but for drugs such as Methadone that have long half-lives, this may not apply.
Negative Short-Term Side Effects
Headache, drowsiness, trouble sleeping, trouble urinating, itchiness, and dry mouth.
Negative Long-Term Side Effects
Constipation, weight gain, and fatigue.
Addiction and Withdrawal Issues
Although Suboxone is used to treat opiate addiction, it is also a drug with the potential for abuse. Physical dependence is an issue with just about every Suboxone patient since they use it daily. When one decides to end their Suboxone treatment, they should work out a tapering schedule with their doctor. The withdrawal from Suboxone is often reported to be longer and more drawn out than most other opioid drugs, but less intense if the patient tapers properly.
Harm Reduction
Use micron filters if you choose IV as you ROA.
Do not combine this drug with other CNS depressants, other than those that your Suboxone doctor permits.
Do not drive or operate heavy machinery until you know how this drug will affect you.
Legal Issues
Schedule III (V some states)[1] (USA)
Schedule 8 (Aust)
Class C(UK)
Cat. A Singapore
Schedule III Germany
[
http://en.wikipedia.org/wiki/Buprenorphine]