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View Full Version : taking a benzo while on suboxone?



mytownsux
20-01-2006, 09:25
say someone is on 24 mg suboxone daily and gets some cool benzos like valium 10mg, what is a safe dose to take while on sub? heard that taking a safe dose of benzo while on an opiate enhances both. So anyone ever take a benzo while on suboxone? what are the effects? good or bad?

jasoncrest
20-01-2006, 20:11
say someone is on 24 mg suboxone daily and gets some cool benzos like valium 10mg, what is a safe dose to take while on sub? heard that taking a safe dose of benzo while on an opiate enhances both. So anyone ever take a benzo while on suboxone? what are the effects? good or bad?

It's dangerous to mix Opiates+Benzos, because of respiratory depression,
BUT Buprenorphine (Subuxone) is really safe concerning respiratory depression, just don't take to much benzos (40mg Valium MAX), and you'll be safe...

blahblahblahblah
26-01-2006, 05:22
I take it everyday, prescription guidelines advice against dual scripts of benzos/bupe for good reason. All most all of the buprenorphine OD's involve benzo's, while its very hard to OD on bupe itself, its still pretty hard to OD on bupe and benzo's but be advised it can be problematic. The one opiate you dont want to OD on is bupe because of its high affinity for the receptors. Once it gets into those receptor sites its a bitch getting out, think of the bupe molecule as a barbed fishhook covered molecule. Those barbs did in and its very hard to remove them, even in some OD's Narcan/naloxone can not effectively dislodge bupe from the sites. So if you do OD from bupe you better pray that multiple, large infusions of naloxone will do some good. As many reports state that bupe OD are almost irreversible.

just some info for ya.

jasoncrest
26-01-2006, 19:57
I take it everyday, prescription guidelines advice against dual scripts of benzos/bupe for good reason. All most all of the buprenorphine OD's involve benzo's, while its very hard to OD on bupe itself, its still pretty hard to OD on bupe and benzo's but be advised it can be problematic. The one opiate you dont want to OD on is bupe because of its high affinity for the receptors. Once it gets into those receptor sites its a bitch getting out, think of the bupe molecule as a barbed fishhook covered molecule. Those barbs did in and its very hard to remove them, even in some OD's Narcan/naloxone can not effectively dislodge bupe from the sites. So if you do OD from bupe you better pray that multiple, large infusions of naloxone will do some good. As many reports state that bupe OD are almost irreversible.

A Bupe OD will most likely happen when taken with benzos, as you said.
Maybe the better idea then is to take Flumazenil ( a benzo antagonist) rather than an Opiate antagonist? I don't know, I'm not sure...

BilZ0r
26-01-2006, 22:46
Of the 43 bup overdoses recorded in the UK from 1980 to 2002; 23 involved benzodiazepines/sedatives (53%). So it's probably a risk factor (I mean, I don't think 53% of the people on bup use benzos (or maybe they do?))[1 (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15957155&query_hl=3&itool=pubmed_docsum)].


Narcan/naloxone can not effectively dislodge bupe from the sites I don't get these statements. I've heard it repeated a lot, but there's no such property for a ligand, you know, a "how hard is it to displace" property. Ligands have on rates, and of rates, and that is all. Now while it's theoretically possible for a drug to have a rediculously low Koff, which would make it hard to displace, it's just fucking unlikely, I mean; it would have to have a Koff 3,4,5 orders of magnitude lower than normal ones... but seeing as bup can act very quickly in brain slices, I don't see that as being possible

mytownsux
05-02-2006, 01:15
Well I tried taking a valium 10 an hour after my 8mg suboxone dose and I was dissapointed that I didn't get more buzzed, all I did was get tired. Last night I took 3 valiums at once before bed and boy did I sleep good, didn't wake up till 12 noon. Way back when I was 18 years old and recovering from alcohol use, I got a hold of a ton of my dad's 2mg ativans. I started taking them and they sure were a lifesaver, they did like a detox and took away all the cravings for booze and the strange thing is, I started getting buzzed from them. One day I took 4 of them and was starting to giggle like crazy and feel awesome. I wonder why that happened and now when I take valium I dont get that same effect anymore? anyone got any ideas what I should do? if I take like 5 of them valiums will I get buzzin?

blahblahblahblah
09-02-2006, 01:11
I dont get it either Bilzor, but same as you I have seen it reported in quite a few reparable places. I dont get into chemisty or biochemistry nearly as much as you do and have a hard time figuring what you meant by ligands, rates, and Koff orders, can you dumb that down for me if you get a chance?

Personally I have never been involved directly or indirectly in a buprenorphine overdose so I have no real personal experience with Naloxone reversing buprenorphine. I wonder what the amounts of deaths were in the study you mentioned and if the death was caused because Naloxone was not able to antagonize the bupe from ones receptors or were a benzo-antagonist given as a last resort chance to save the life. I just dont know where to find info concerning the procedures a doctor would use in a bupe OD and the steps he would take after a failure of a treatment occurred.

I have been involved with heroin + benzo OD'd where even after 3 injections of Naloxone the patient would not become conscious, they hooked up a IV saline bag drip and asked me to hold it while they worked on him, fuct-up scene [I assume thats what it was, I was very scared atm as this was all playing out on a friends kitchen floor]. Next they used a defibrillator to try to shock the heart to beat, no luck one more injection of Naloxone and another shock brought my friends to, immediately puking up black sludge and almost going into a seizure. Nothing was mentioned about using a benzo antagonist I wonder if they would of even tried that [one would hope as a last ditch attempt].

Do you know where I could find medical procedures concerning a check list type of things one would do to try and reverse an OD and if one of those tasks failed to work what other options are available?

jasoncrest
09-02-2006, 03:22
I've heard it repeated a lot, but there's no such property for a ligand, you know, a "how hard is it to displace" property. Ligands have on rates, and of rates, and that is all. Now while it's theoretically possible for a drug to have a rediculously low Koff, which would make it hard to displace, it's just fucking unlikely, I mean; it would have to have a Koff 3,4,5 orders of magnitude lower than normal ones... but seeing as bup can act very quickly in brain slices, I don't see that as being possible

Morphine or Hydrocodone can not displace Buprenorphine, then maybe Naloxone or Naltrexone cannot either?

BilZ0r
09-02-2006, 09:35
Well they can, I mean; they patently can. That's how the figure out the affinity that buprenorphine has for the opioid receptors (Well actually they probably use DAMGO, but tis' the same thing).

blahblahblahblah
10-02-2006, 05:38
I dont think naloxone absolutely can not reverse buprenorphine OD's but I do think it does play a role in some people. Considering buprenorphine varies wildly in its effects per individual I can easily see that in some people it would be hard reverse an OD.

atforum-safety (http://www.atforum.com/SiteRoot/pages/current_pastissues/safety_methadone.shtml)
A potential difficulty with buprenorphine is that, due to its strong mu-opioid receptor affinity, there appears to be no specific, completely reliable antagonist for its respiratory depressant effects when they do occur. There have been reports that even very high doses of the potent opioid antagonist naloxone may produce only partial reversal.[29,30]


If bupe can displace morphine, when your receptors are flooded with morphine and buprenorphine is introduced to the body, it will displace the morphine molecule and replace it with buprenorphine, hence the 'instant w/d's' brought on when bupe is taken to quickly and ones system is flooded with another opiate.

What makes Naloxone unable to displace buprenorphine? Just because of its high affinity? Once again if you can describe what you meant concerning ligands, rates, and Koff orders it would be appreciated.