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

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phr

Ex-Bluelighter
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May 25, 2004
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What: Suboxone = buprenorphine/naloxone. Bupe is a partial agonist(mu) and antagonist(kappa). Bupe has higher mu affinity that most opiates, including some antagonists(naloxone, naltrexone). Its higher affinity allows you to shoot suboxone tablets. It also may cause precipitated withdrawals if you are dependant on other opiates. Also, its higher affinity blocks the affects of other opiates when taken in conjunction with bupe.

Dose: Depends on tolerance. 1-2mgs is a typical recreational dose for someone with no tolerance. If you're using bupe to taper off of another opiate, you should dose once you're experiencing wd's(typically 36-48 hrs. for most opiates). Start with 2-4mgs and dose at 2mg increments every 30-45minutes until a dose holds you. Most people take their full dose once a day.

Withdrawal: Typical physical and psychological symptoms associated with opiate withdrawal. Insomnia, chills, diarrhea, depression, anxiety, lacrimation, sweating, increased heart rate, etc. They are not as strong as a full agonist's symptoms, but may last longer. Physical symptoms last 1-2 weeks on average and psychological symptoms may last months.

As most opiates, it's recommended to taper down to the lowest dose possible before stopping. <1mg is ideal. The best way to dose at that level is to crush up a tablet and divide the powder into lower doses.

Ceiling: 24-32mgs

Bioavailability:
jasoncrest said:
Buprenorphine bioavailabilities:

intravenous: 98%-100%

intranasal: 50%
"Studies of buprenorphine bioavailability have also examined the [...] intranasal (bioavailability, 48%)
"The bioavailability of buprenorphine, HCl (BPP) in sheep after nasal administration of two formulations has been studied. 0.9 mg BPP in 150 microl was administered nasally and compared to 0.6 mg i.v. The test solutions were formulated with 30% polyethylene glycol 300 (PEG 300) and 5% dextrose, respectively. The bioavailability for PEG 300 was 70% (S.D.+/-27%, n=6), whereas the bioavailability for 5% dextrose was 89% (S.D.+/-23%, n=6)."
"Mean intranasal bioavailability was 48.2 +/- 8.35% (mean +/- s.e.m.) of the intravenous value"


intramuscular: 68%
"The observed mean intramuscular bioavailability was 68%"
"Studies of buprenorphine bioavailability have also examined the intramuscular (bioavailability, 50%–100%)"


intrarectal: 54%
"bioavailability of the drug was found to be: [... ]intrarectal (54%)..."
"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] intrarectal, 54%..."

sublingual: ~30%
"Buprenorphine is well absorbed sublingually, with 60% to 70% of the bioavailability of intravenous doses"
"Study results indicate that bioavailability of sublingual buprenorphine is approximately 30%"
"Literature on bioavailability of sublingual buprenorphine presents variable numbers ranging from. 19–58% of the administered dose."

"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] sublingual, 13%"

oral: 10%
"the oral bioavailability for buprenorphine is state to be 10%"
"due to extensive first-pass metabolism, buprenorphine has very poor oral bioavailability (10% of the intravenous route) if swallowed"


intrahepatoportal: 49%

intraduodenal: 9.7%


Other Notes:


Images:
p05331b1.jpg

Subutex

p05331a6.jpg

Suboxone

I couldn't find photos of Tamgesic, and Buprenex just comes in vials

Locate a doctor that prescribes Suboxone.
 
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Please note any errors or post any information you'd like to see in the above post.

Hopefully this will decrease the amount of Bupe threads we're currently seeing here in OD.
 
Q: How long after my last bupe dose can I take an opiate and feel its effects?
A: It depends on what dose of bupe you were taking and how long. The short answer is 36-48 hours. Caution should be used when dosing, as you will still have a tolerance but it will not be as high as it was when you first got on bupe.

Q: Is bupe a good replacement for methadone?
A: Maybe. Some people with a high enough opiate tolerance may not be held by bupe at any level, even at the highest(ceiling) possible dose. You should research both before deciding what to go on, as they both have different positives and negatives in regards to their use.

Q: I'm thinking about switching from methadone to bupe. At what methadone dose should I be when I switch?
A: Most places recommend being at 30-40mgs of methadone when switching. That may be hard to achieve since that level is lower than the recommended therapeutic maintenance level. Also, you'd have to wait 36-48 hours before your last methadone dose to switch in order to avoid precipitated withdrawal

Q: Will I still have cravings on bupe?
A: Maybe. Some people report no cravings, while others report the same level as before.

Q: Is bupe good for depression/anxiety?
A: Yes, it may help with depression and anxiety. It is not currently prescribed for either and its effectiveness has not been studied for long term use for either. You may be able to get it prescribed off label for depression/anxiety, but its not likely to happen. Here is an article on PubMed about a study on bupe being used to treat depression.

Q: Is it safe to shoot Suboxone/Subutex?
A: No. It can cause many of the same complications as shooting other pills. Just because Suboxone/Subutex dissolves easily, unlike other pills, does not mean it's any safer to to shoot. The best advice is to use a micron filter. This* is a good indication of what can happen. (Although that could happen from injecting any other drug/pill.)

Q: Is bupe recreational?
A: Yes. Although it is rarely the preferred opiate for people who have experience with full mu agonists.

Q: Can you overdose on buprenorphine?
A: Yes you can. Buprenorphine causes respiratory depression which may lead to death. The person most likely to OD on bupe has a low(if any) tolerance to opiates and may have taken another depressant. A buprenorphine overdose may not be reversed by naloxone(or naltrexone for that matter) due to bupe's higher affinity. Diprenorphine may reverse the overdose, but it is not regularly stocked by emergency personnel or hospitals. If a proper antagonist isn't available, the person suffering an overdose may be maintained with assisted respiration.

Q: Can I still get high on other opiates if I'm on bupe?
A: This depends on what dose of bupe you're on. You will most likely be able to shoot through a low dose of bupe(1-2mgs). But, don't expect the full effects of the opiate you're shooting through with. Even at higher doses, if you take enough of the opiate you may feel it. This is not recommended, as you may overdose before reaching the desired recreational effects.

*Link to article provided by hfrs in a different thread
 
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I hope that it will be. Any corrections or things to add?
 
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^ dude, phenomenal thread. Probably the best ive seen the whole time ive been around bluelight. What, with the last couple days and the same suboxone questions being asked 20 times, its about fucking time a thread like this was made.

No excuses when it comes to searching from now on!

good job phrozen.
 
Thanks a lot phrozen, answered some of my questions I was gonna post.
 
I'd add that certain people have claimed they have failed certain urine tests due to suboxone. One of the many reasons I quit this horrid "opiate"
 
I haven't heard of that. It doesn't metabolize into morphine, codeine, or 6MAM. So I don't see how you'd fail a regular 5 panel test.

With that being said, it could be like oxycodone, where high enough daily doses may produce a positive on a 5 panel test.

Do you have anything to support your claim?
 
I've never heard of any regular tests or even non-standard tests that test for bupe. Unless you get one that tests specifically for it or a toxicology test that tests for all known drugs
 
Now, is there any differences in effect from suboxone and subutex? If bupe's affinity is that much stronger than naloxone can one confidently use suboxone disregarding any naloxone content?
 
Phrozen, I want to commend you on what is certainly one of the best threads here in very long time and what is certainly the most needed thread probably since I have been here. Great job.

Also, it does not score a 5 panel, EVER. They require specific tests, just like methadone.
 
rachamim/others:

as a student of chemistry I know bupe should not show up on a standard 5 panel test (morphine), but as has been mentioned above, neither should oxycodone and that does sometime...... does anyone know what specific part of the morphine molecule the test binds so? I imagine its somewhat like an antibody, binding to part of the molecule and causing the color change, sorry if that doesn't make sense, I could be totally wrong...

I don't think it would, but you never fucking know, high doses very well could pass through, the molecules are similar yet they have a few differences... on the nitrogen, 6 position, and the position adjacent to 6 - if this means anything to anyone - it is less structurally similar then oxycodone I guess. Sorry I just realized I'm rambing about nothing.

phrozen - awesome post, I wish I had the patience/motivation to do similar work, perhaps in the near future I will.

side note, I have friends who have dosed in the morning with suboxone (I've introduced them to low-dose suboxone therapy- ie 1-4 mgs, usually ~2 per day, no need to take a whole pill or 2 or 3 just to keep the sick away, even for people with 1 gram + heroin tolerances (tar) they can easily get by with low doses... anyway rambling again - I have friends who have doses in the morning, with about ~2 mgs, and been good to take full agonists that night (so 12 hours later) and get high (so they claim... I'm not the type to try to defy science) do you have any experience with this? ultra low doses and being able to nod within 12 hours? I guess its possible when you consider the dose in relation to the half life........................
that is all, I'll have more to say later
 
I think the opiate part of the NIDA 5 panel test detects morphine, codeine, and 6mam. That's just off the top of my head, I wouldn't bet anything on it. Maybe someone who knows for sure can post...


As for breaking through low doses of suboxone, yeah it's possible. I've shot right through 1-2mgs plenty of times. The rush and high wasn't all there though.
 
I don't have "scientific" references - You won't Pubmed.com a blown urine test. BUT, if you GOOGLE suboxone + drug tests you will hear SUBJECTIVE experiences of people who have blown their fuckin urine test - Including a kid who was FORCED to take a urine screen in front of a judge - he failed it, had to explain the suboxone.

I have read NUMEROUS examples that it CAN trigger the opiate line. I for one am on probation so I am not taking a fucking chance. Go ahead and blow your probation and years of education for suboxone, the worlds shittiest opiate.

Besides all this, I would like to add that for every suboxone "addict" who wants to quit, it is almost assumed they will begin a benzo habit. This, again, has not been studied by "scientists" but SUBJECTIVELY I believe it is a huge amount of people who have to substitute suboxone for another drug. Why is this? Maybe because they are on such a long acting "high" that when the long acting high is gone (what a shitty fucking high, bupe is the devil) they must switch it to something that also lasts along time.

If your taking drug tests for the courts go ahead and chance it and post your pass or fail rate.
 
i know someone who takes suboxones and shoots herion everyday, i told him hes defeating his purpose because the sub blocks the high.. but he knows what hes doing i guess he been shooting junk longer than i been alive.
 
i know someone who takes suboxones and shoots herion everyday, i told him hes defeating his purpose because the sub blocks the high.. but he knows what hes doing i guess he been shooting junk longer than i been alive.

He's not only wasting his time/money, but he's also wasting his suboxone and heroin. Whatever, it's his shit.

I don't have "scientific" references - You won't Pubmed.com a blown urine test. BUT, if you GOOGLE suboxone + drug tests you will hear SUBJECTIVE experiences of people who have blown their fuckin urine test - Including a kid who was FORCED to take a urine screen in front of a judge - he failed it, had to explain the suboxone.

I have read NUMEROUS examples that it CAN trigger the opiate line. I for one am on probation so I am not taking a fucking chance. Go ahead and blow your probation and years of education for suboxone, the worlds shittiest opiate.

Besides all this, I would like to add that for every suboxone "addict" who wants to quit, it is almost assumed they will begin a benzo habit. This, again, has not been studied by "scientists" but SUBJECTIVELY I believe it is a huge amount of people who have to substitute suboxone for another drug. Why is this? Maybe because they are on such a long acting "high" that when the long acting high is gone (what a shitty fucking high, bupe is the devil) they must switch it to something that also lasts along time.

If your taking drug tests for the courts go ahead and chance it and post your pass or fail rate.

I did a Google search and a Usenet search. The majority say you won't test positive, while one or two claim they did. Those positive results aren't something I'm willing to quote right now or make conclusions from, as there is a bunch of trash and misinformation on Usenet.

It looks like you're most likely to test negative, but if you're at all worried and your freedom is based on testing negative, you might want to think hard before using bupe. At least until this can be definitively answered.

Now, is there any differences in effect from suboxone and subutex? If bupe's affinity is that much stronger than naloxone can one confidently use suboxone disregarding any naloxone content?
The only difference between Suboxone and Subutex is that Subutex does not contain naloxone. Yes, you can use Suboxone without worrying about the naloxone it contains. Various credible people here even shoot high doses of Suboxone (~24mgs) and have not reported any ill effects from the naloxone it contains.
 
Severe opiate withdrawal in a heroin user precipitated by a massive buprenorphine dose


This case highlights a number of features of buprenorphine's unique pharmacology which are pertinent to healthcare providers. Firstly, it shows the relative safety of buprenorphine in very high doses. This patient took 88 mg of buprenorphine within one day — almost three times the maximum recommended daily dose (32 mg). This is consistent with another reported case of massive buprenorphine overdose, in which 112 mg was taken orally, also without significant respiratory depression.2 This safety is due to the ceiling effects of buprenorphine in high doses.

Secondly, rather than experiencing features of opiate overdose (eg, respiratory depression, sedation), our patient experienced precipitated opiate withdrawal. When buprenorphine is taken soon after opiates with less opiate-receptor affinity, such as heroin and methadone, it displaces them from the receptors. Since buprenorphine is only a partial agonist, this causes a drop in the level of overall opiate activity and is experienced as opiate withdrawal. While we are aware of only three other reported cases of buprenorphine-precipitated withdrawal after heroin use,3,4 it is common in methadone patients transferring to buprenorphine therapy, particularly with higher doses of methadone (> 40 mg), a short time between the last methadone dose and the first buprenorphine dose and when higher initial buprenorphine doses are used.5-8 Withdrawal symptoms typically commence within 1–3 hours of the first buprenorphine dose and can last for several days.


That's just part of the article published by the Medical Journal of Australia. It's a interesting read. :)
 
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