Bupe SUBOXONE questions after IVing SUBUTEX for 3 yrs

[Amr1991]

I have been on subutex/ bupenorphine(only, no naloxone) for 3 years as a maintenance med & have been clean off other opiates&drugs this entire 3 years w/out relapsing; however; i have been doing the subtex IV all 3 years. I do not get high from it I just get normal, I really only started IVing it at the time becuase I was addicted to needles & I felt I was going to relapse on heroin otherwise, & ultimately it worked as I've been clean & taking a consistent prescription of subutex for 3 years.

But I have now found out that I am going to have to transition to suboxone or some form of bupe W/naloxone, unless I can find an allergist to document that I am unable to take Naloxone( which I dont think I'll likely be able to do)

I have wanted for a while to stop IV'ing & eventually start getting on lower doses to eventually taper off, but I'm in no rush ro get off completely & would like to do so over time & have no withdrawal or negative functioning. So it puts me in a predicament to be forced of subutex abruptly when I've been stable on it& otherwise clean for years. I cani't just start taking it sublingual without it ending up dramatically reducing the amount I'm getting & thus making me sick/feel wd.

It was my understanding that regular suboxone/bupe with naloxone could not be injected, that only bupe/subutex could be, although I've seen some posts on here that are making me question that somewhat. So I guess one question I have is what is the general consensus on whether suboxone(particularly pill form not film) can be IV? Ideally I wouldnt be IVing it daily but it would make me feel alot better to know that I could do so when/if needed occasionally to make my doses mast & so on. But my original question that I was planning to ask was based on the assumption that you cannot IV suboxone at all, & I suppose either way I am interested in this since I'd eventually like to stop IVing anyways whether that's sooner or later.
So question is, I've been thinking about trying to start plugging since ive heard this is closest to that of IV, but I'm wondering how realistic it is that ill be able to not exprience a drastic difference/how much more in dosage would I need to have the same effect & be stable on my dose.
I'm basically just panicking& while I dont want to be IVing or even on subs forever I also have been stable & functioning & can't afford to just mess up my while structure at this point & being sick & not able to function the same, so I'm just hoping to get a sense of what my options are & how to deal with this.

 

[izo]

How much buprenorphine did you Iv per day?

 

[Azed]

Like you said pretty early on in your post, you aren't doing it to get high you are doing it to feel normal. IV'ing the Suboxone would significantly increase the speed and effect of the drug it would simultaneously be cancelled by the naltrexone and you would begin to feel withdrawals immediately. This is based off of the literature so maybe someone on this site has some more experience with it. Otherwise, I think it might be time to call it and give up IV drug use.

 

[Amr1991]

How much buprenorphine did you Iv per day?

Honestly this is part of the problem in that I really don't know the EXACT dose because basically I'm PRESCRIBED x2 8mg a day, and generally by the end of the month I really only have a few extra pills, BUT I loose alot of of stuff when making it & filtering it & so forth & so I just don't know exactly how much gets done vs lost through the process.

 

[MewTwoReceptor]

Dude, don't believe all the hype about how "the naloxone with throw you into precipitated withdrawals". That might be true if you've been slamming horse for a while or something, but if all you've been doing is bupe you'll be just fine. I IV'd suboxone for years and the only time it ever made me sick was once when I was stupid and shot some bupe like 12 hours after a 3 day long H bender. That was terrible.
Anyways yeah dude you're fine to IV sub. All the literature about the naloxone having any real effect is just pharma marketing bullshit.

 

[Eligiu]

Dude, don't believe all the hype about how "the naloxone with throw you into precipitated withdrawals". That might be true if you've been slamming horse for a while or something, but if all you've been doing is bupe you'll be just fine. I IV'd suboxone for years and the only time it ever made me sick was once when I was stupid and shot some bupe like 12 hours after a 3 day long H bender. That was terrible.
Anyways yeah dude you're fine to IV sub. All the literature about the naloxone having any real effect is just pharma marketing bullshit.

I agree but disagree with this for seperate and unconnected reasons.

Correct about the naloxone having no effect when IVd. They just say that as a deterrent to try and prevent people from doing it. I've done it, and I got zero precipitated withdrawal either. As stated it will only do it if you do it too close to when you use full opiate agonists.

Disagree with being fine to shoot subs. In the interest of harm reduction I feel obliged to point out there is a decent amount of literature available about why this is a terrible idea and can cause some really unpleasant scenarios due to the shit they put in the strips. The deterrent isn't to stop people shooting it to get high, it's to stop people shooting it and fucking their body up and their veins.

I would honestly start boofing it as a form of harm reduction and to get off the needle and reduce the fixation. Use a baby syringe instead of breaking the tip off an insulin one so that you aren't tempted to use it to IV

For when you do want to taper, here is my taper that I've used several times to get off bupe with zero withdrawal. And I mean zero. It does however depend a lot on how long you've been on bupe and how high a dose you were on. Also, I've never really had terrible withdrawal from any substances except after a 9 month long bender in 2017, and this includes psychiatric medication. I've literally stopped shit like lithium without negative side effects. So this works for me but I'd be selfish to keep a taper schedule which has had a 100% success rate to myself so here you go.

Week 1 2mg dose every day, skip last day
Week 2 1.6mg dose every day
Week 3 1.6mg dose every day, skip last day
Week 4 1.2mg dose every day
Week 5 1.2mg dose every day, skip last day
Week 6 0.8mg dose every day
Week 7 0.8mg dose every day, skip last day
Week 8 0.4mg dose every day, skip last day
Week 9 0.125mg dose alternative days
Week 10 finish

Skip the final day before you drop a dose. It tricks your body into accepting the lower dose as being tolerable because you're in a very mild state of withdrawal (basically sniffles) so it just drinks up the sub and goes 'cool' at least that's been my experience.

Time the taper so you can use take home doses (if you have supervised dosing like where I live) or if you get a bunch of take homes divide the final week down to a quarter of the 0.4mg dose and skip every second day. Basically this means there is an overall lower level of the substance in your body when you jump at the end because you've consumed half the amount as you would have if you took it every day.

This has worked for me 4 times but I'm now on the injection Buprenorphine. I just have an awful habit of ceasing treatment too early because I resent daily chemist pickups and then I go off and relapse after 3 months or so. Now I just go and get a shot once a month and I'm more stable. But I'll definitely use this taper again when I come off next time.

Good luck

 

[DeathIndustrial88]

What above poster said ^^^^^^^


You won't be worrying about naloxone when you have to have your arm chopped off from IVing a drug that doesn't even get you high in the first place.


The naloxone doesn't do jack shit. It's binding affinity is too low to compete with buprenorphine. And even if it does, it ususually results in a laxative effect (for me) for about 10 minutes before the buprenorphine finally takes over.

The only reason subs throw a person on a full agonist into withdrawal is because of the buprenorphine itself, not the naloxone.

Switch to plugging. Even snorting would be a better option than IVing the strips or pills for years.

 

[buprenorfiend]

For me, when I have run out of my buprenorphine prescription (which I usually IV even though I know I shouldn’t) that IVing suboxone films in small quantities does indeed come on slower than mono bupe. I have not iv’ed any more than maybe 1.5-2mg at a time of suboxone though. I’m usually a bit sniffly and anxious already when I get to that point, so I don’t really notice if the first half hour or so are worse as far as precipitated withdrawal, I just know that I don’t usually get the bupe warmth until 20-40 min in.

aside from slightly delayed onset, when I do use the combination product, I get a bit more pronounced effect than with the monoproduct.

I have at some point read a study that tested if very small amounts of naloxone (far less than the amount in suboxone) would give a potentiating effect on a buprenorphine dose, I believe they found that it does indeed increase analgesia in the study.
Here’s the link to the study:

Potentiation of buprenorphine antinociception with ultra-low dose naltrexone in healthy subjects - PubMed

Previous reports have demonstrated greater antinociception following administration of a buprenorphine/naloxone combination compared to buprenorphine alone among healthy volunteers. The aim of the current investigation was to determine whether buprenorphine antinociception could be enhanced with...

pubmed.ncbi.nlm.nih.gov

Edit: not analgesia, anticociceptive properties*

Anyways. In the name of harm reduction, I think that if you have been using your subutex for 3 years IV, and are faced with a forced change over to suboxone, that it’s probably time to give up the needle. Even using a wheel filter, the combo product contains a lot more gross shit that ends up in solution, that will have irreversible effect on your veins and body.

 

[Las Veghost grower]

I know a couple people who Iv sub strips and don’t get precipitated wd, your probably better off just taking it as directed anyway