Hi there so I am on 12 mg of suboxone daily. My birthday is coming up and I want to have some drinks and a couple bumps. The question is should I not take suboxone for a couple days before I use or what could happen if I use the same day I take the suboxone. Sorry if I sound like an idiot or if this is in the wrong field i just started using suboxone.
Please avoid highly ambiguous terms like "have a couple bumps" unless you're actually specifying *what* you're going to be bumping up your nose.
The above poster thinks you're probably referring to heroin, whereas I usually hear "doing bumps" in the context of using cocaine. Buprenorphine does not directly interfere with the interaction of *all* drugs, just opioids (which cocaine obviously ins't). So for this post, I am going to assume you mean "bumps of heroin".
Anyway: Buprenorphine (the active compound in suboxone and subutex) has extremely high affinity for opioid receptors, but only acts as a "partial agonist". A "full agonist" like morphine can fully activate a receptor, but it will drift away from the receptor as quickly as it came. Buprenorphine, on the other hand, isn't good at activating receptors, but once it has bound to a receptor, it doesn't like to let go, and will keep trying to activate it.
So at low doses, buprenorphine can make up for its partial agonism by simply binding to way more of your receptors.
However, as you increase the dose, you'll eventually encounter diminishing returns - the bupe can no longer compensate for its partial agonism, because there are no more free opioid receptors for it to bind to and awkwardly finger. This is sometimes called the "ceiling". If I am correct about you being a (normal-weight) woman, 12 mg should already be a ceiling dosage for you.
So you've got two effects:
- the buprenorphine produces enough of an opioid "high" to stop your opioid cravings. Your body is technically still dependent on external means of keeping its opioid receptors activated. The idea is that mentally, however, you are free from the rapidly alternating ups and downs of heroin addiction, and you can work on improving your life without being distracted by constant opioid cravings. If you stop taking suboxone for a couple of days, you will simply go into opioid withdrawal. A rather unpleasant process, or so I've heard.
- since all the opioid receptors are already being occupied by the buprenorphine, it will simply block off full agonist opioids like heroin or oxycodone, making it pointless to use them.
Re: Using on the day you're taking suboxone, that's actually two questions:
- using *after* taking the suboxone: the buprenorphine will simply prevent the other opioid from working
- using *before* taking the suboxone: the buprenorphine will quickly displace the other opioid from the receptors due to its superior binding affinity. Due to its inferior efficacy at activating the receptor, however, your overall level of opioid receptor activation will drop rapidly, a phenomenon called "precipitated withdrawal"; this is considered a very unpleasant experience.
