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Opioids Subs->heroin->subs, stuck in w/d

U

undercoverrn

Greenlighter
Joined
May 3, 2016
Messages
3
Hi, I've been on suboxone for 3 years, 8mg. Have a few times slipped off to delve into old habits, IV heroin, oxy, dilaudid, whatever. I can usually time the getting back on subs part pretty well to avoid precipitated w/d, but this time I messed up. I was off (subs) for 2 weeks, had come into a large amount of H and did that with much dedication. It was all gone, so I did my last wash of the cottons and went to bed. The next morning with the chills already starting I took 8mg of subs which threw me into w/d. Ok, I can deal with this, had some benzos, did more subs a few hours later, and some more later 24mg total...W/d never eased. That was yesterday. This am I had read about taking more opioids( fentanyl, dilaudid) to ease this, but that didn't help. More benzos and some more subs and today I feel better GI wise but still have anxiety, slight pupil dilation, hypersensitive skin, aches etc.
My question is, WTF? WHy isn't the bupe doing its thing? 1) im stuck in precipitated w/d 2) My tolerance was bumped up from the round the clock H binge...

If nothing else, it helps to write it out since I am hiding all of this from my wife, subs doc , etc.
 
Holy fuck. That's weird. You'd think the 8mg would knock off the H and plunge you into pwd but then the other 16mg would plug up those receptors especially after this long...

In the future, try to prolong your time between last dose and sub induction. Gabapentin and clonidine (+ you have xanax) will help you add time between the two. When you induct, go 1mg at a time if possible, every 20-40 mins. That will make pwd impossible.

As for your current situation, I'm completely lost as to how you could have taken 24mg of buprenorphine over 24 hours and still be in withdrawal.

My best advice is keep adding bupe (in smaller amounts - go like 2mg/hour or so) until you feel right.

Also, I've heard from some people that jumped back and forth many times that "subs stopped working" but I never really bought into that and figured they had done it wrong.

24mg's of bupe would make a rhino nod.
 
You should wait at least 24 hours to induct bup'. After you induct, if not feeling better, do not take full opioid agonists, rather continue to dose sub until you feel relief. From what I read, it sounds like you went into pwd twice.. At this point you might just want to start from scratch. Reiduct the sub, when its been 24 hours since you last took the other opiates. Sometimes more is less with bup', so try dosing around 1-2mg, also this will lessen the chance of pwd. Also what is your roa for the bup'?



- Hopeless Soul
 
I forgot to mention, sometimes the strips get "dried" out, when exposed to air. Did you take the sub right out of the package when you took it? Or was it lying around for a while?


- Hopeless soul
 
Ok, this is day 3, I haven't taken any narcs since yesterday am. My strips have been from sealed packages, is roa route of admin.? I put it under my tongue. Iv'e been able to eat little bits but I'm stuck in this awake , achy, hyper-sensitive state. Like functioning but just feeling shitty and weak. I've had 6mg this morning and now I'm just waiting for relief. Waiting for that , haaaaaaah long exhale when I feel just normal again.
It's been too long and my wife knows whats up, which is a relief on one level because I don't have to lie to her anymore, but now I wait to see if she will take action as far as 'we' are concerned.
...It seemed like a pretty good idea at the time but now everything is all fucked up.
 
7nos-SS373dOH said:
You should wait at least 24 hours to induct bup'. After you induct, if not feeling better, do not take full opioid agonists, rather continue to dose sub until you feel relief. From what I read, it sounds like you went into pwd twice.. At this point you might just want to start from scratch. Reiduct the sub, when its been 24 hours since you last took the other opiates. Sometimes more is less with bup', so try dosing around 1-2mg, also this will lessen the chance of pwd. Also what is your roa for the bup'?



- Hopeless Soul
Click to expand...

This is what I was going to suggest too, if higher dosages aren't working. I mean, my general stance on buprenorphine is that when you induct yourself, more usually is more until your body starts to stack the subs up, but I've also heard that buprenorphine can start to antagonize itself at higher dosages (which is a little confusing to me, but anyways..). Either way, since you're still experiencing some nasty symptoms, it couldn't hurt to try lower dosages, and in the end it would be better to stabilize at a low dosage of suboxone rather then a high one.

Your experience reminds me a lot of a predicament I got myself into a long time ago after I had been shooting oxymorphone for two weeks straight, during one of my 'vacations' from subs. When I went back on suboxone it also immediately threw me back into withdrawal, and as I remember it took quite some time to re-adjust to the Buprenorphine. I think what happened was that I had raised my tolerance to a point that even at Bupe's ceiling dose (as far as being a mu-agonist) wouldn't keep me completely out of withdrawals, so I had to basically wait until my tolerance dropped to a point where I was once again adjusted to the 16-24mg I had been taking (to no avail) to try and get myself out of that mess. It really sucked too, because prior to my lapse I had dropped my tolerance to opiates down significantly, I was only IV'ing 150mcg of suboxone maybe 3 times a day, and boy did oxymorphone ruin all of that. It sounds like maybe a similar thing has happened to you. If that's the case, you should start to feel better over the next few days, if you can get some gabapentin and clonodine that would help a hell of a lot too.
 
Oh my god, pwd are awful, I am so sorry.
I apologize, I don't have advice on this but I just want to throw out my experience on pwd in case maybe it does help? or if anyone has anything to say about it because it was new and unexpected for me. I have an addiction to needles so anytime I was using sub strips, I shot them. (I am aware of the dangers, i just can't take them any other way). I haven't been on subs for a few months now, I have been actively using heroin. However, one morning I woke up and I didn't have my wake up shot, I did it the night before because I figured I could just get more in the morning. My dealer was not around, I had one sub strip for "emergency situations" because I was not really aware of pwd and how they happened. I did look up online though when to take sub after coming off of H before I took it because I obviously do know that you cannot take suboxone and heroin at the same time. I was caught off guard about how long the time period was! I couldn't wait 2-3 days!!!!!

I waited 18 hours.
My inexperienced ass thought I was withdrawing so bad because I had never ACTUALLY withdrew from heroin at this point in my addiction. Oh god, was I naive. I mixed up my shot and hit my vein. Within seconds my entire body became hot, I was sweating profusely. Then I became cold. I was overcome with the worst cold sweats I imagine anyone could experience. Inside my chest felt like I had drank a bottle of hot sauce, my internal temperature felt so so sooo hot but every time I exhaled, it felt as if I was inside of an icebox. It was so strange and painful and scary. BUT IT ONLY LASTED 20 MINUTES... then it was as if I wasn't a heroin addict anymore... I had no withdrawals whatsoever. Later on that day, I finally scored my dope but it was a total waste. I wasn't able to experience a heroin high until about 24 hours after this incident.
 
I'm basically in the same boat, my general rule of thumb is to wait as long as I possibly can before I take subs after opiate use.
And any precipitated withdrawal isn't going to get better with more subs! Typically that only makes it worse!
 
I finally just went to my MD (last resort) because I was so baffled by all of this. She was pretty cool about it, suspected that maybe something more long acting was mixed into that H that I had been shooting. She pretty much thinks that I have just too much going on up on those receptors. She's calling it anxiety. Gave me an Rx for some clonopin for the next few days, which let me sleep last night (toss and turn a bit). I think I'm going straight an narrow, subs maintenance , treatment, and all that. Getting too old and have too much to lose for this shit.
Thanks for the input. I really felt alone sweating/ chills/ running in place/ yawning/ sniffles/ and almost barfing the last couple days :)
 
Good for you man, wise decision,. only thing that I would suggest, is a quick sub taper, opposed to being on maintenance. 'Cause you'll have to face sub wd's at the end of that line too.



- Hopeless 7nos
 
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