Bupe Suboxone/Buprenorphine FAQ and Megathread v.1; 2007 - 2010

[mr Bungle]

Hey man, if you're using Heroin and wait for 24 hours or even more (until you'e are so sick that you can only twist in pain on the floor constantly crying/screaming) and then take the Bupe, you won't feel ANY withdrawal symptom, actually you will get some heavenly relief from Buprenoprhine.....

So, just wait until you're in HARDCORE Heroin withdrawal before taking bupe, and then you won't go through withdrawal.

thanks man!

thank for your time and help


the reason I avoid waiting for hardcore withdrawls is that when i came straight of 50mls of methadone, and lasted just three days and couldnt stand the hell anymore! so i drank 50mls to make myself feel better, waited 3 hrs, I felt a alot better but still fell terible! felt like i had been kick by a large horse! (so I just scored some gear and then was fine)

I dont know, if everythings so cut and dry, so black and white?!

sorry for ranting guys, im just so down and depressed at the min! I ran away from heroin, back to my shity small home town. I found I carnt run away from the stuff, i can sniff it out anywhere. So now instead of being in a big city with my friends and a nasty habit, im in a small town, with no-body and a nasty heroin habit!

sorry for sounding wimpy but this horrible lonleyness, (a dull ack in the bottom of my stomack) is making me ill. herion aleaveiates it, but takes me back to the start, as its the course!

sorry for ranting on this site but i dont have anything else, exept dark thoughts about self hard and ending it all...
...I never thort id be a stupid fucking, lame sadcase that carnt deal wityh life, like a moaning baby....FUCKING WORM
sorry if someone read my laughable post
The more i realise that i am nothin that my life is just a shity boaring life, that no-one love a junky, that i wont be able to aford to see beautiful things and dont deserve it. then a part of me keeps dying, which hurts at first, but then i feel good, well Numb. I just need to get it in to my head that im nothing, self absorbed people who believe they should have something in life get depressed, I just need to realsie that most of my life will be without pleasure, that there wont be any big 'things' i wont be rich and famous and have models falling allover me... i just need to grow up stop being a dick

I resent the family who love me as its the only thing that stops me,,, which would hurt them and they dont desere it (i should smile that people love me)
so sorry if im sounding so meladramtic guys

 

[phr]

When talking about methadone doses, refer to how much you're taking in milligrams. It's quite pointless to quote it in ml, as solutions may vary in concentration.

If you're switching from methadone to buprenorphine, most clinics and doctors make the switch when you're at around 40mgs of methadone. Even then, they make you wait until you're withdrawing in order to avoid precipitated withdrawal.

 

[zzITCHY420zz]

if you're on a low dose (1mg~) , taper from it as well. the suffering you endure while tapering is more than worth it. while i was at the end of my bupe use, i was using so little that most of whatever i "got off" on the sub, was placebo. i felt better than i did while being on the sub when i got off, for i knew that i at least got rid of the physical dependance, and that i also did a good taper.

with suboxone, learn to listen to your body, not your doc, or anyone else. you'll know when u are ready to get off, but maybe not. perhasp peer pressure did me in on quitting, but however i did it, i feel a little lucky. only downside is that im using relatively low dosages of valium/alprazolam for anxiety, and ambien to sleep if needed..anyways, good luck guys. i also hope that i don't need any goddamn AD's to get by, because i will do what i got to, to get through my days (and i hope to be able to get by without any other shit).\

edit- if anyone is looking for any kind of blog on getting off narcotics, or involving buprenoprhine "treatment"/detox (although i can't say im living sober), i've posted quite a bit on this forum..same handle (zzitchy420zz) http://p098.ezboard.com/Subbupe-help/fthedetoxforumfrm9

 

[SolidForm]

My doc prescribes so much that I have a solid stash if I ever come off and have any trouble. I'll never go down the road to other opiates again so I'm just keeping a safety blanket.

 

[johanneschimpo]

Anyone here used a CYP3A4 inhibitor (like tagamet/cimetidine) with buprenorphine before?

I was reading the prescribing information that comes with suboxone and it had a little bit of info on CYP inhibitors and suboxone. Thought I might like to give it a try, but thought I'd see if anyone else has done it first. The only thing I'm not sure about is the strength of its main metabolite, norbuprenorphine's strength compared to the parent drug. A little bit of research says it has a different binding profile than bupe does. That could either be good or bad, does anyone know what the differences are?

If anyone has done this, please tell me how it went.

 

[phr]

Good question.

I don't have any hands on experience with potentiating buprenorphine, so I can't tell you how well it works.

Here's what I found with a quick search:

Buprenorphine undergoes both N-dealkylation to norbuprenorphine and glucuronidation. The N-dealkylation pathway is mediated by cytochrome P-450 3A4 isozyme. Norbuprenorphine, an active metabolite, can further undergo glucuronidation.

Buprenorphine hydrochloride is administered by intramuscular injection, intravenous infusion, via a transdermal patch, or as a sublingual tablet. It is not administered orally, due to very high first-pass metabolism. Buprenorphine is metabolised by the liver, via the CYP3A4 isozyme of the cytochrome P450 enzyme system, into norbuprenorphine (by N-dealkylation) and other metabolites. The metabolites are further conjugated with glucuronic acid and eliminated mainly through excretion into the bile. The elimination half-life of buprenorphine is 20–73 hours (mean 37). Due to the mainly hepatic elimination there is no risk of accumulation in patients with renal impairment and in the elderly.

The main active metabolite, norbuprenorphine, is a δ-opioid receptor and ORL1 receptor agonist, μ- and κ-opioid receptor partial agonist, but buprenorphine antagonizes its effects.[4]

And this is the abstract(about norbuprenorphine) from an article on PubMed:

Buprenorphine (BUP) is an oripavine analgesic that is beneficial in the maintenance treatment of opiate-dependent individuals. Although BUP has been studied extensively, relatively little is known about norbuprenorphine (norBUP), a major dealkylated metabolite of BUP. We now describe the binding of norBUP to opioid and nociceptin/orphanin FQ (ORL1) receptors, and its effects on [(35)S]guanosine-5'-O-(gamma-thio)triphosphate ([(35)S]GTP gamma S) binding mediated by opioid or ORL1 receptors and in the mouse acetic acid writhing test. Chinese hamster ovary cells stably transfected with each receptor were used for receptor binding and [(35)S]GTP gamma S binding. NorBUP exhibited high affinities for mu-, delta-, and kappa-opioid receptors with K(i) values in the nanomolar or subnanomolar range, comparable to those of BUP. NorBUP and BUP had low affinities for the ORL1 receptor with K(i) values in the micromolar range. In the [(35)S]GTP gamma S binding assay, norBUP displayed characteristics distinct from BUP. At the delta-receptor, norBUP was a potent full agonist, yet BUP had no agonist activity and antagonized actions of norBUP and DPDPE. At mu- and kappa-receptors, both norBUP and BUP were potent partial agonists, with norBUP having moderate efficacy and BUP having low efficacy. At the ORL1 receptor, norBUP was a full agonist with low potency, while BUP was a potent partial agonist. In the writhing test, BUP and norBUP both suppressed writhing in an efficacious and dose-dependent manner, giving A(50) values of 0.067 and 0.21 mg/kg, s.c., respectively. These results highlight the similarities and differences between BUP and norBUP, each of which may influence the unique pharmacological profile of BUP.

So, it looks like you're right. It can theoretically be potentiated through 3A4 inhibition.

If anyone has any first hand experience with bupe potentiation, please share.

 

[theanine]

Come on...we all know that Adolf was a chemist in his spare time. He made this crazy bone penetrating substance that we now call methadone. He first came up with the name Hitlerjuice, but it was shot down. After killing the man who shot it down...he later settled on dolophine. Most obviously after himself. After we discovered this creation of his we adopted it as methadone and made up some latin words to coincide with it's original name of (a)dolophine. Then the government swept all this info under the carpet so we wouldn't know that we are really drinking hitlerjuice. At least that's what the junky at my dealer's place told me when I said I was going to get on methadone to quit heroin.

Hitlerjuice Hcl I haven't laughed like this in ages! People actually believe this?

 

[nabollocks]

I just have a question for the long term users out there:

What is the constipation like with Bup? How does the constipation compare to other opiates?

I am thinking about going onto a 5mg patch which lasts for 7 days. Low dose I know, but it is for pain management not w/d.

 

[biggerstronger]

Hitlerjuice Hcl I haven't laughed like this in ages! People actually believe this?

Yes, The old WW2 veteran junky told me. He told me he walked right up on Adolf and saw him making it out of various toxic and radioactive chemicals. So it must be true. He sold me a bundle of black tar instead of me getting hooked on that bone degenerating substance. God bless that heroin addict. He saved my soul from Hitler and his poisonous elixir.

(note: this is a joke for those who don't know. lol. )

 

[rashandreflex]

i've been on buprenorphine (subutex then suboxone) for a month and a half, and so far i've been pretty disappointed. for me, it's sedating, constipating (beyond what's typical from opiates), and dysphoric in doses above 4 mg. to boot, it doesn't do shit for cravings.

secondarily, i expected to catch a mild buzz, but no luck there unless i take a couple of tramadols with it, which gives me a very mild opiate high and a ton of sedation. it's very confusing to me as i have seen non-regular opiate users get really fucking high from snorting, like, .2 mg or less. i didn't take anything other than tramadol, codeine, and poppy seed/pod tea for the six months leading up to when i got on bupe, so i don't think i don't feel shit from bupe because i'm used to really strong opiates (although i have had strong opiates in the past.)

i know the point of bupe isn't to get high anyway. however, from my own life experience i have come to believe that a malfunctioning endorphin system plays a primary role in depression/anxiety/amotivation in some people. i've seen a couple doctors who support this hypothesis, and that's why i went on the bupe in the first place - one doctor thought that it would be the ideal anti-depressant for me, given my response to opiates in the past....so i did expect a lot, but i guess i should have known: there's no such thing as a magic bullet.

anyway, i'm just rambling. i'm thinking of switching to methadone and then use the suboxone if i decide to come off methadone. as of now, i'm thinking pretty seriously of just being an opiate lifer. i wish methadone wasn't only available through clinics, though.

 

[phr]

From what I've read, suboxone works best for depression at low doses.

Have you noticed a difference between Subutex and Suboxone? Some people react negatively to the naloxone. (and I know that very little becomes absorbed when you're taking Suboxone, and that its affinity is less than bupes) Just throwing that out there. It'd be worth a shot, imo.

As for the methadone, you could get it by prescription, but not for OST. For OST, it has to be dispensed at a clinic. Since your doctor was willing to prescribe Suboxone for depression, s/he might prescribe methadone. Don't expect a high dose though. Oh, and "blocking" happens at around 70mg+.

I'm not sure why you want to switch to methadone, but the "high," if you want to call it that, doesn't last past 2 weeks or so. After that, it'll be similar to Suboxone. But, most methadone users report less cravings than Suboxone users.

Oh, and getting off of methadone is harder than getting off of Suboxone. If you want to switch from methadone to Suboxone, it's recommended that you be at 40mg. You'd still have to deal with wd's for a few days to avoid precipitated withdrawal.

 

[biggerstronger]

methadone to suboxone is a tricky thing. Even when switching from 30mg to 24mg of suboxone it was somewhat difficult for the first few days. Even though I took less bupe then prescribed I had to basically go through about 2 days of somewhat precipitated w/d's. That was after waiting 36 hours after my last methadone dose to taking my first bupe dose. I never got high off of the bupe like you could with methadone (or what ever you want to call the methadone feeling). Bupe is sedating at higher doses. The constipation is pretty bad. Methadone is hell to get off of but it covers the cravings much better than bupe. Bupe w/d's aren't too bad in comparison to most other opiates.

 

[biggerstronger]

oh btw there wasn't much difference with subutex or suboxone. They are basically the same to me. However with the subutex I would tend to shoot it or snort it which is pointless but I would still do it. My abusive nature at work.

Oh and about the Cyp3A4 inhibition...I used to take my bupe (and xanax that I'm prescribed) with cimetidine and didn't notice too much of a difference. Maybe it worked better maybe not. I couldn't tell you.

 

[rashandreflex]

i don't think i felt a difference between subutex and suboxone. initially, the subutex made me really sedated and gave me bloodshot eyes, but presumably that was just adjusting to the bupe. the transition was fairly seamless.

i know the studies on bupe and depression used low doses, so right now i am in the process of tapering the bupe down. i'll report back as to how the lower dose treats me (aiming for, like, 1-2 mg.)

i don't know any methadone users personally (although i have used it recreationally in the past and loved it), but anecdotally on the internet, people seem to say that they can feel a weak opiate buzz for the first couple hours with methadone. plus, it's a full agonist whereas bupe is not. logically, tolerance should kick in over the longterm and that buzz should diminish as you point out. i don't know....maybe some methadoe users can comment.

yeah, i've heard the methadone WD horror stories. in the hypothetical situation that i was on methadone and wanted to switch to bupe, i'd probably transition from methadone to some short-acting agonist for a couple weeks and then to bupe.

i'm really not at the point where using illicit opiates every day negatively impacts me. i'm only getting help for it because my family pressured me a lot, and my lack of desire to quit is obvious in my attitude. what i really want is just to somehow obtain a lifetime supply of a potent agonist. i suppose dealing with the family is for a different thread.

 

[LinZ-E]

So has anyone gone from suboxone -> methadone?

I may not make the switch from a low-dose partial agonist to a full...but I ran low on sub before I expected and my drawn out taper has turned into a rapid one.... about 1mg/day right now but it is hell.... Got the depression, anxiety, pain in the joints... trying to tough it out.

 

[xxanxxtwo]

^^I have. I went from 32mg of bupe(in the form of suboxone), per day to 160mg of illict methadone(4 40mg wafers), per day. Went fine until my methadone source dissapeared. After that happened I went back to heroin/oxycodone/morphine/whatever I could get my hands on. I am currently waiting to get into a methadone clinic.

 

[sixpartseven]

Good question.

I don't have any hands on experience with potentiating buprenorphine, so I can't tell you how well it works.

Here's what I found with a quick search:

And this is the abstract(about norbuprenorphine) from an article on PubMed:


So, it looks like you're right. It can theoretically be potentiated through 3A4 inhibition.

If anyone has any first hand experience with bupe potentiation, please share.

Im looking for the thread Im about to refer to right now, but Im having trouble finding it, so for now, these claims are unsubstantiated.

The only good thing that can come out of Bupe potentiation is longer duration of effects. The problem with having more norBupe is the higher risk of overdose due to respritory depression at normal (12 - 24mg) doses, and more unpleasant side effects would be present due to its antagonistic action.

Remember, I cant back these claims up yet, if I can at all (still cant find the thread), so take this for what its worth.

 

[johanneschimpo]

I would like to note I took a 5-panel diptest today, and have been taking suboxone for that past two weeks, although at low doses, ~2-3 mgs a day. It did not show a positive for opiates. But the person who tested me says it can show up when used at higher doses. Just thought I would let people know about that. First hand experience, not some random rumor.

 

[phr]

Im looking for the thread Im about to refer to right now, but Im having trouble finding it, so for now, these claims are unsubstantiated.

The only good thing that can come out of Bupe potentiation is longer duration of effects. The problem with having more norBupe is the higher risk of overdose due to respritory depression at normal (12 - 24mg) doses, and more unpleasant side effects would be present due to its antagonistic action.

Remember, I cant back these claims up yet, if I can at all (still cant find the thread), so take this for what its worth.

Alpha and I discussed norbupe in another thread. I don't remember the title(something about buprenorphine or norbuprenorphine), but the OP was rashandreflex.

I would like to note I took a 5-panel diptest today, and have been taking suboxone for that past two weeks, although at low doses, ~2-3 mgs a day. It did not show a positive for opiates. But the person who tested me says it can show up when used at higher doses. Just thought I would let people know about that. First hand experience, not some random rumor.

Cool, as expected. I'd still a little skeptical about higher doses dropping positive, but I wouldn't risk it either.

 

[mr Bungle]

Someone who uses Suboxone for maintenance can answer this one.

When you dose (even if you don't feel very bad to begin with), do you feel uncomfortable/anxious/chills, etc. for about 30 mins, and then begin the positive effects from bupe(relief from opiate withdrawal, appetite increase, mood lift, etc.)?

Is this common to all users, or something that only I experience? It almost seems as if the drug needs to "level-off." Any clinical explanation for this?

I get this alot too!
im not going through withdrawls at the time but its not far off. I take my dose - also the same if i smoke a few lines also- and i get the mini withdrawls - like the start of withdrawls, before the drug takes over.
I dont know what this is, does anyone???
I know its wrong but in my head i explain it like, the last of the opaites are clinging to my recepters or what have you, and there isnt much left in my system. So i take my dose or smoke my few lines and it pushes the opiates that are left in my system away so there is nothing - or not much, i feel the chills and what have you, then the new opiates get in there and i feel ok. But there is a transition period where i go woooh! getting the chills abit here!
I now this isnt what probley happens, but i dont know what it is, so thats how i explain it to myself.
Can anyone do better,????
does anyone else experience this???