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The Big Buvidal Thread - Buprenorphine Extended Release Injection

T

THECATINTHEHAT

Bluelighter
Joined
Oct 17, 2005
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I'm just about to start on this medication after spending the last nine months relapsing and trying and failing to get clean. I've noticed that there's very little information out there about this medication, certainly there's very anecdotal evidence or information on Bluelight so I'm going to chronicle my experience with it and try and lay out some of the important information people might want to know if they are considering this medication.

Buvidal is a sustained release sub-cutaneous injection of buprenorphine aimed primarily at opioid maintenance patients. It is available in either weekly or monthly preparations, with the weekly coming in 8mg, 16mg, 24mg and 32mg strengths and the monthly coming in 32mg, 64mg, 96mg and 128mg strengths. This denotes the TOTAL amount of buprenorphine in the injection, NOT the daily dose. It may appear as if these doses are low as it's not uncommon for someone to be on 24mg of sublingual tablets, but this disparity is because the bioavailability of injected buprenorphine is going to be 100% whereas sublingual comes in around 30%. So for instance if we look at the person on 24mg a day we can reasonably assume that they are actually consuming 30% of that 24mg, which is 7.2mg. If they were to move on to the 32mg weekly injection they would be getting 6.3mg a day. There's much discussion about the ceiling dosage (the point at which taking more drug has no more incremental effect) of sublingual buprenorphine, some people being dosed as high as 32mg a day but generally it's thought there is little further effect after 24mg.

So looking at those numbers it seems like if you are on a very high dose of sublingual buprenorphine then it's questionable whether the highest dosing of Buvidal will cover your habit entirely. That's pure conjecture though, it may be research showed a 32mg weekly injection was reaching that ceiling dose. We'll have to wait for people's experiences to see how that goes, certainly doing the basic maths it seems to be delivering the same ballpark of substance at max dosage as sublingual does at max dosage.

So a little about me and my personal situation......I've been struggling with opioid addiction for about 13 years, I had five years clean but relapsed about a year ago and have been dependant again for about six months. I've used a wide variety of opiates in this last run including dihydrocodeine, tramadol, morphine (oral and IV), buprenorphine (oral, sublingual and iv), methadone and heroin (iv). My habit has yo-yoed from being pretty tiny, getting by on 1mg of sublingual buprenorphine, up to where it was recently using about half a gram of iv heroin a day. I've been switched on to sublingual buprenorphine the last couple of days before having the Buvidal injection, and the switch was fucking rough for some reason. I've jumped between bupe and full agonists quite a lot without much problem, but even though I left about 14 hours from last using this time, the 10mg suboxone i was scripted on day 1 just put me in to precipitated withdrawal. I tried to mute it by IVing a bag of heroin which helped a tiny bit but of course was mainly blocked by the bupe. This was a pretty dumb thing to do and on day two I had 16mg suboxone and it was bearable (I was scripted for 12mg, I added half of the 8mg I was given to take on the morning before the injection). Today is day three and I've had 12mg suboxone, I don't feel too bad but definitely not 'OK', I'm probably going to eat the other half of the 8mg I was given for tomorrow morning before the injection and just ride it out tomorrow morning until I get the jab.

So tomorrow will be day four back on buprenorphine and I believe I'm going to be given the 16mg weekly injection as a kick off before moving to the monthly at a later date. I wasn't even aware of this treatment before visiting this clinic though so I didn't press them on details at the time. I think they jab me with the weekly and see how I go for a few hours and then jab again if it's not enough, but I'm not really sure. I'll document exactly how the process goes here and how I find it personally, if other people have had experience with this medication please post it up in this thread and hopefully we can get a resource going that will help people know what to expect with this medication, and whether it's right for them.

So I'm just going to take my last 4mg of suboxone now and when I go in to get the jab tomorrow I'll explain that the 12mg I was scripted for yesterday and today definitely wasn't enough. I've never experienced this problem moving to bupe before even when leaving way less time before the switch so it's a little unusual for me, the only thing I can think is that the dose just wasn't high enough.

So here it is, the big Buvidal thread, get posting kiddies!
 
OK so they put me on the maximum 128mg monthly preparation straight away, I had the jab about two and a half hours ago. I was starting to withdraw when I went in to the clinic and that is basically all gone now but I do feel the tiniest bit shivery still. Maybe that's just because I'm in England and it's fucking freezing.

At this stage I don't feel 100% but pretty close to it, I can get on with my life like this. I'm sure over the next day or two that will fade and I will settle in to feeling just normal, I hope so anyway.

One thing I've noticed is that there's another montly bupe injection on the market under the brand sublocade, but their monthly dosing options run from 100-300mg. Anyone got any idea why such a vast disparity in dosing options between the different brands?
 
god it is annoying when they change your treatment without consulting you. i'm afraid i've never had the shots so can't offer any experience but i hope it works well for you. i do have a

why are you moving from daily script to monthly? are you hoping to end the cycle of relapsing/going back on maintenence?
 
They didn't change it up he didn't make it exactly clear what dosage his plan was, I just over heard him mumbling something about 16mg to his assistant and I guessed. I was only on daily suboxone as a bridge between heroin and the buvidal injection, I imagine if you give someone with a large opiate habit a buvidal injection and it isn't enough to cover their habit then they're going to be in real shit because it's going to be weeks at least before the bupe levels are getting low enough to enable recovery via a different opioid. I was being forced to pick up bupe daily when I was on an NHS prescription last year because they are complete morons, I can't be fucked to go in to the details but that is literally the answer.

Buprenorphine doesn't really hold me for 24 hours, I wake up ill everyday and then have to lie in bed with a mouthful off subutex for an hour to feel normal, even on 24mg sublingual I had this problem. I was also being forced to pick up daily which is just totally unworkable for me, and that combined with feeling ill every morning is enough for the idea of being able to get a jab once a month and then just be able to get on with my life is very appealing.

I'm not really in the position to detox right now (I've tried and failed due to time bounding a couple of times recently) so being as stable as possible on an opiate is my best option and this seemed like the most stability I could get (I've been on bupe and meth scripts in the past so I know the score). That in combination with the fact that you can totally forget about the cycle of taking meds (which keeps you in a mindset of always thinking about when your next chemical gratification is coming) and just live like a 'normal' person without having to worry about the fact you're going to be ill if you lose your meds or whatever was appealing. I can live like normal and then line the detox up for a time when I know I wont have to rush and can do it in the right way.

Still feeling a wee bit shivery but I do have the remnants of a benzo habit hanging around and I haven't had anything yet today so I'm probably going to have 10mg diazepam and I expect that to make me 100% fine. I'll do a couple of days on 5mg then try to pack the benzos in (I've been taking 10mg kind of every other day for the last couple of weeks, but 20mg the last two days because the move to suboxone was rough).

So yeah I'm not quite as comfortable as I would like right now but there may be other factors involved there and it's very minor. It's worth noting that I'm on the max 128mg dosage and I had what I felt was a fairly small habit (no more than 0.5g uk street gear IV a day, and the quality of the smack is shit I doubt more than 30%) so if you have a larger habit this medication probably isnt going to be strong enough to cover your habit.
 
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10mg of diazepam seems to have done the trick so I think it's safe to say the Buvidal is basically covering my opiate habit, but only just. I was expecting that if they went for the 128mg dosage I might be feeling a little bit fucked up for a few days based on the limited experiences that people have recorded on the net, but that's definitely not happening I'm just about OK. If I had been using any heavier I don't think this would be covering me and I'd now be worrying about being ill until I could force enough agonist in to get a look at the receptors.
 
About 48 hours in now and I feel fine. No diazepam yesterday because i had a few on monday night. None yet today and seem ok. If the Buvodal holds me here for a month then I'll be happy. I do t feel under the influence but I'm not withdrawing.
 
Nice one man, always been curious about the depot injections of bupe or naltrexone. Moreso for convenience sake rather than oral subutex formulations not holding me long enough.

Are you noticing that not having to take something daily is changing how you prioritise your thoughts? Or still too early?
 
No my thoughts are changing already for sure. I HATED being stuck in the cycle of giving over so much of my headspace and time to getting and using opiates, it held no excitement or thrill or anything like that anymore it was just a chore.

Now instead of waking up, using to get rid of withdrawal, assessing whether I have enough gear for the day or whether I need to score (if not on a script), or going to collect my meds, and then planning my day around that.......I get up and think about what I'm going to have for breakfast or what I'm going to do at work that day or any other normal shit that having to use everyday stops you from being able to focus on.

As I mentioned I still have a small diazepam habit I think so I'm still in the headspace of meds a bit, but I've got 30mg diazepam left total and after that I should be able to kick it in to touch. It's also a bit different for me because I'm scripted dexamphetamine for ADD which I haven't been taking for the last six weeks or so whilst I was trying to get off opiates, I had 10mg for the first time in weeks today and it helped a lot but it did make me feel a bit weird....so I'm kind of in that headspace (but I'm lucky in that I've not felt compulsed to use misuse the dexamp and don't think of it as 'drugs')

It's really nice being able to go wherever I want or do whatever I want without first having to plan drugs, so yes my headspace has moved already. I had five years clean at one point though so it's a lot easier for me to move to a 'drug-free' headspace (I know I'm still an addict, but psychologically I don't feel the tie to substances I did before having that experience of being clean) and feel comfortable with it than it was when all I knew was using.

So far so good, it's basically been what I was hoping for up to this point.
 
A week in and it's definitely been good for me so far, any anxiety or chills are definitely related to minor benzo withdrawal, I have no cravings for opiates, I don't feel dozy or spaced out.

Now remains to be seen whether it lasts the 28 days....
 
great to hear!!

i hope it lasts for you- if you feel it wearing off contact your drugs services ASAP otherwise you could end up in a very vulnerable position.
 
They contact me 7-10 days out from the injection date to check that ifs still holding me. Fuck knows what they do if you say it isnt, probably top you up with sublingual suboxone until its jab time I guess.
 
Wow so that first four weeks went by fast, I had my second jab two days ago. It basically covered me pretty evenly and nicely for the month, it was noticeably a bit stronger at the start of the month than at the end, and the last couple of days I had some very mild withdrawal but it didnt stop me from getting on with daily life.

Overall the effects have been very stabilising so far, got to say I'm pretty happy. The only downside is the price from what I can see so far. Oh, and the jab I had yesterday hurt REALLY badly. The first one was a bit sore but this was like the worst missed shot you can imagine, it was brutal. Took me a good minute or two to actually recover and be able to get up.
 
glad it is going well for you!!!

though i wonder why there was such a difference in pain levels? guess slightly different areas vary greatly in sensitivity. lets hope in future its more like round 1 than round 2.

what is your long term goal with this? once you've been stable for long enough and you come to think about coming off it, how would you taper using a month long injection? i guess it doesn't matter for now. most important is that you can get your life together and have space to work on the issues underlying your addiction.
 
Yeah i dont know how the taper process works, i didnt even realise you could get monthly bupe jabs so when i found out about it i went for it straight away because it provides so mich stability. WAY better for me the daily oral/sublingual, if this was my only issue i would basically be leading a perfectly normal life, not even thinking about meds each day.

Long term goal is deffo to taper and come off, the list of medicines im on at the moment is fucking huge. I have a benzo habit to take care of first though.

Tbh im really unstable mentally at the moment and a doctor said for the first time ever they didnt want me to reduce my benzo level at the moment.
 
ah well yes, there is no point in making things worse for yourself. sorry to hear that.

been pretty unstable myself recently, really disturbed sleep is not helping.
 
I'm about 15 weeks in to buvidal maintenance and its been pretty life changing for me even in comparison to daily buprenorphine. Not having to go through the ordeal of waking up in minor withdrawal every morning and then having to take meds to wait to feel normal is amazing.

Even though I'm on loads of other meds including benzos, having the opiate groundhog day routine removed makes life feel fairly normal and means I can operate like a normal human being to some extent. If this was the only med I was on I imagine I would have pretty much totally forgotten about the fact I'm dependant on drugs.

One thing to say is that although the first jab didnt sting too bad, the second one was fucking agonising (and I do mean agonising) and the third one one hurt a lot. The doctor says this is related to the fact I have low body fat and I am pretty thin but I am not super skinny. It's a fairly minor thing that wears off in 30 seconds or so.
 
What part of your body do they give the shot out of curiousity?

Glad to hear it's working out for you man.
 
They put the first two just above the groin on each side then they moved on to the pinch of skin between the hip bone and the ribcage. I guess this will depend on your doc though.

Tbh it's working out amazing in terms of the meds, I wouldnt swap this for a diamorphine script.
 
I've been on Buvidal for just over a year now - they rotate sites from upper arms, left and right sides of belly button - they used to do thighs but have since stopped! Some sting real bad, but the brief pain is so worth it!!
 
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