methadone, buprenorphine and other opioid pharmacotherapies

[junkie skumbag]

EDIT - As the name suggests (and so I stop derailing the smackie thread), this thread is for the discussion of opioid pharmacotherapies like methadone, buprenorphine and naltrexone.

Latest bupe posts from the smackie thread have been moved here - Foots

this isn't advice - just personal experience - but before i knew anything about bupe i took it in the afternoon many times following a dose of pst or codeine. never experienced precipitated withdrawal (thankfully). this may not be the case for everyone, and i don't properly understand how opiate receptors work, but i never had an issue having buprenorphine right after pst.
many variables in this however - in the name of harm reduction i would definitely not recommend risking it.

it must vary from person to person.how often were you taking bupe?when i was using it twice a week (2-4mg doses anymore than 4mg would have me puking) i had a point and a bit of some kootah smack and about 40mg of oxy the day after taking bupe and i was throwin into full on withdrawls busting out in sweats then freezing cold running to the toilet each 20 mins.not much fun -_- anyone taking bupe should wait atleast 3 days after dosing to take a opiate just to be on the safe side imo

hope ya go well at uni footsy

 

[Ashley]

I'm the same as you spacejunk, with regards to precipitated withdrawal. I have never experienced it, from IV bupe (Subutex/Suboxone tablets and film) and seem to be able to take it quite soon after dosing a full agonist without going into precipitated withdrawal. We're just weird.

A.

 

[tentram]

i had a point and a bit of some kootah smack and about 40mg of oxy the day after taking bupe and i was throwin into full on withdrawls busting out in sweats then freezing cold running to the toilet each 20 mins.not much fun -_-
hope ya go well at uni footsy

doesn't make sense, it's the other way around. you would have had to have been high on the oxy and smack and then dosed the bupe to have been thrown into precipated withdrawals. dosing afterwards as you did would have led to diminished effects of the heroin and oxycodone.

anyone taking bupe should wait atleast 3 days after dosing to take a opiate just to be on the safe side imo

as i said, that's to get the full effects of whatever opiate/oid you're dosing because bupe, despite being a partial agonist/antagonist and some preparations containing nalaxone, has a much higher binding affinity for mu than most full agonists (including nalaxone) and will be hogging and blocking the receptors until you've given it time to clear.

very simply put, when you're still on a full agonist and you dose bupe it strips your receptors clean of the opiate/oid, leaving you in withdrawal until it's had time to bind back to your receptors and take effect. this isn't inclusive to IV use either as the nalaxone is rendered inert - i can attest to it along with every other anecdotal report. it's a bullshit, trivial marketing tactic and scheme by reckit benckiser

 

[spacejunk]

^ agreed. ash, i'd rather be weird than be in precipitated withdrawal

 

[footscrazy]

very simply put, when you're still on a full agonist and you dose bupe it strips your receptors clean of the opiate/oid, leaving you in withdrawal until it's had time to bind back to your receptors and take effect.

I thought the reason was because bupe was a partial agonist rather than a full one, rather than it having anything to do with the time it takes to bind back to your receptors? My understanding was that because bupe has a higher affinity it pushes all the other opioid off, but doesn't then provide the same level of agonism, hence the wd's if you have a habit. It's highly likely you know more about this than me though. I'm curious about it.

My pharmacist fucked up today, when she gave me my dose for today I thought she'd given me too much - 10mg instead of 6mg. I was right too, because she gave me the incorrect dosage of takeaways too - it looks like she's made the mistake of thinking the 8mg tablets are 4mg ones, so I've got too much. I'm glad I checked in time to spit out most of the 10mg I had in my mouth, and only take 4mg. Not too happy about it really, I'm surprised she'd be so careless.

Thanks for the well wishes too junkie

 

[spacejunk]

jesus - that's a pretty bad oversight. i'm glad you noticed and were able to spit it out. a pharmacist should surely know better than that??
at least you'll have some emergency supplies if you have too much....it's better than not having enough, right?

 

[footscrazy]

You would think they'd know better... 8(

Having extras to tuck away is a good thing but I'm wondering what'll happen if she realises her mistake and asks for them back - I'm not sure if there'd be consequences for not having them anymore. I sat in my car for ages wondering wtf to do, whether to go back in and tell her or what, but ended up not doing it thinking at least at this point I can say I haven't even looked at the takeaways yet and haven't noticed the mistake.

 

[poledriver]

a pharmacist should surely know better than that??

Right, but they are only human of course there will be mistakes sometimes. Sometimes fatally, i'm sure it's happened many times over in the industry. They should have more double checking and shit if they don't already. They have to be on the ball with that kind of stuff or it can kill people.

A friend was telling me recently how a local pharmacy has stuffed up the blister pack a few times over the yrs for their loved one (elderly dementia sufferer) the last one she told me was the pharmacy gave her mum another persons blister pack and her mum was taking the meds out of it as she should, and when she checked on it and made sure she was taking them all etc, to her horror they were for a totally different person, totally wrong meds! Lucky she's only taken one of the wrong meds, i was like WTF! that's so dangerous.

 

[spacejunk]

that's scary. you're right though - human error can occur anywhere. i guess i like to imagine that it doesn't happen so much in industries where people's health is directly at stake.

 

[psytaco]

I have a friend who has tried bupropion recreationally. What are peOplrs thoughts on its use in this way? Worth it?

 

[Mel22]

^ I wouldn't even consider it. Activation syndrome, seizure risk...etc. Absolutely not worth it IMO. There are much safer drugs around that are also a lot more fun.

I have no experience with Bupropion personally, but have read some interesting trip reports on Erowid that you should check out. Some people do enjoy the experience, but a lot of people are very glad once it's over.

I'd advise your friend of the risks, and make sure they're aware of the potential dangers.

 

[footscrazy]

I have a friend who has tried bupropion recreationally. What are peOplrs thoughts on its use in this way? Worth it?

Bupropion/wellbutrin the anti depressant? Or do you mean buprenorphine? Perhaps you're in the wrong thread?

 

[tentram]

I thought the reason was because bupe was a partial agonist rather than a full one, rather than it having anything to do with the time it takes to bind back to your receptors? My understanding was that because bupe has a higher affinity it pushes all the other opioid off, but doesn't then provide the same level of agonism, hence the wd's if you have a habit. It's highly likely you know more about this than me though. I'm curious about it.

no, i think you're right there. it seems i've had some deluded thoughts while off thinking about the nalaxone in the scheme of things.

the point is don't go dosing bupe while you're dependent and under the influence of another opioid. if you're lucky you won't be feeling like shit for too long but being thrown into the pits of withdrawals so quickly is a painful experience.

 

[psytaco]

Bupropion/wellbutrin the anti depressant? Or do you mean buprenorphine? Perhaps you're in the wrong thread?

nah I meant bupe, as in what your all talking about. it was just i was using an iphone and it did an autocorrect

 

[spacejunk]

^ it's ok, if you're not a habitual opiate user IMO. most users seem to find it quite 'recreational' for the first part of their maintenance program.

 

[footscrazy]

Yeah it's definitely commonly reported to be recreational for people with low to no opie tolly.

My pharmacist fucked up today, when she gave me my dose for today I thought she'd given me too much - 10mg instead of 6mg. I was right too, because she gave me the incorrect dosage of takeaways too - it looks like she's made the mistake of thinking the 8mg tablets are 4mg ones, so I've got too much. I'm glad I checked in time to spit out most of the 10mg I had in my mouth, and only take 4mg. Not too happy about it really, I'm surprised she'd be so careless.

The pharmacist did this again today, had a little internal battle over whether to tell her or not, my inner junkie coming out and all...but I thought nah fuck it, I'm doing this legit and I want to come across that way, so I did tell her. Funny though, she just said 'oh..I know, that's what I was saying' when she'd just told me the 8mg she'd got for me was 4mg, and fucked it up last time too. I wonder how many other people she's been over-dosing in the meantime though

 

[Ashley]

I'll take the other 4mg!

A.

 

[footscrazy]

^ You're doing so well cutting down, I wouldn't dream of interrupting your progress

Has anyone on else on bupe experienced nausea from it? I'm getting it so badly, I've been taking travacalm everyday to try and combat it, but it's still making me so useless. I've had to run out of two uni lectures now for fear of vomiting, and I'm just so over feeling this way all the time. I've always been super susceptible to opioid nausea, and it's the reason I disliked opies completely until I discovered anti histamines. The travacalm makes me drowsy though which is also problematic.

I can't wait to be off this. I've halved my dose to 4mg in the 2 weeks I've been on it and hopefully can keep dropping quickly. The pharmacist is pretty cool but still tries to convince me to keep taking a higher dose. Doesn't really make sense to me, unless she just wants the income of me paying for bupe for longer...

 

[tentram]

your dose might still be too high, footsy?

i've always found promethazine king of curing opioid related nausea for what it's worth.

 

[footscrazy]

Yeah, I'ver wondered that, but I thought since I've been taking it for 2 weeks my tolly would've caught up...I've tried taking 2mg but that's too low. I will try dropping again to 3mg soon.

I'll give prometh a go, I've never found it the most effective when using opies recreationally, travacalm has always been my best bet in that regard, but things might have changed, so it's def worth a shot, thanks