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Heroin Subutex won't give you precipitated WD will it?

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mike.vick

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Aug 24, 2011
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Hey, I am gonna be finishing the last bit of my heroin, worked up to 40-50mg+ per day snorting.
I have 6 subutex pills and I know you can snort these too.
Does it work right away since it doesn't have naloxone? Will it give you precipitated withdrawals or if you take it when your still high on heroin will it just give you a less potent high? How long since last heroin use 6 hours?
 
Subutex will cause pwd!! it's the buprenorphine that causes it, not the naloxone. wait 20-24 hrs



- Hopeless
 
Subutex can, in fact, cause precipitated withdrawal. It does this by expelling and replacing opioid molecules attached to receptors in the brain. When bupe replaces the stronger opioids, it has a much weaker effect. The effect of millions of receptors being replaced with the weaker bupe comes with a net decrease of overall effects, which in turn may not be enough needed to stave off withdrawal.

You should be in mild or moderate withdrawal from the H before taking the bupe. Are you trying to completely stop your heroin use or are you just trying to get by for a couple of days until you can acquire more?
 
7nos- Why wait that long, why not do it when in the morning when I wake up after 6-7 hours. I am in WD at that time and I've seen studies that said people currently using opiates don't WD from bupe alone.

cannablissss- I don't know just use the bupe for a while cause it makes me feel better after a couple days, way more energized and healthy feeling. Only done it a few times and only suboxone. this time I have subutex so Im gonna snort
 
Well, don't take it while you're high on the heroin, it isn't gonna do much. If 6-7 hours will put you in mild withdrawal, wait until the morning to take your first dose.

What dose of Subutex do you have?
 
7nos- Why wait that long
Click to expand...

I said that to be on the safe side. Now everyone is different, I've heard both ends of the spectrum, someone took it after only a few hours, and avoided pwd, then others have waited 48 hours and still had pwd.

I say if you're in wd, you're in the clear. However anything under 12 hours is risky.



- Hopeless Soul
 
cannablissss said:
Well, don't take it while you're high on the heroin, it isn't gonna do much. If 6-7 hours will put you in mild withdrawal, wait until the morning to take your first dose.

What dose of Subutex do you have?
Click to expand...

Thanks guys, 8mg
 
mike.vick said:
I've seen studies that said people currently using opiates don't WD from bupe alone.
Click to expand...

Please post a link to ANY study that says that buprenorphine alone does not cause precipitated withdrawals. That is simply not true. It's the buprenorphine that causes it, not the naloxone. The naloxone in Suboxone doesn't even really do anything. You have to be at a certain level of withdrawal before taking Subutex. Exactly how long that takes to reach varies from person to person and situation to situation. There are withdrawal scales likes COWS that people use to help estimate when it's safe to start the Subs.
 
Swimmingdancer said:
Please post a link to ANY study that says that buprenorphine alone does not cause precipitated withdrawals. That is simply not true. It's the buprenorphine that causes it, not the naloxone. The naloxone in Suboxone doesn't even really do anything. You have to be at a certain level of withdrawal before taking Subutex. Exactly how long that takes to reach varies from person to person and situation to situation. There are withdrawal scales likes COWS that people use to help estimate when it's safe to start the Subs.
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http://www.ncbi.nlm.nih.gov/pubmed/9952063
Sublingual buprenorphine is a promising new treatment for opiate dependence, but its opioid agonist effects pose a risk for parenteral abuse. A formulation combining buprenorphine with the opiate antagonist naloxone could discourage such abuse. The effects of three intravenous (IV) buprenorphine and naloxone combinations on agonist effects and withdrawal signs and symptoms were examined in 12 opiate-dependent subjects. Following stabilization on a daily dose of 60 mg morphine intramuscularly, subjects were challenged with IV doses of buprenorphine alone (2 mg) or in combination with naloxone in ratios of 2:1, 4:1, and 8:1 (1, 0.5, or 0.25 mg naloxone), morphine alone (15 mg) or placebo. Buprenorphine alone did not precipitate withdrawal and had agonist effects similar to morphine. A naloxone dose-dependent increase in opiate withdrawal signs and symptoms and a decrease in opioid agonist effects occurred after all drug combinations. Buprenorphine with naloxone in ratios of 2:1 and 4:1 produced moderate to high increases in global opiate withdrawal, bad drug effect, and sickness. These dose ratios also decreased the pleasurable effects and estimated street value of buprenorphine, thereby suggesting a low abuse liability. The dose ratio of 8:1 produced only mild withdrawal symptoms. Dose combinations at 2:1 and 4:1 ratios may be useful in treating opiate dependence.
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mike.vick said:
http://www.ncbi.nlm.nih.gov/pubmed/9952063
Click to expand...

Thanks! That certainly is misleading. No wonder you thought bupe alone can't cause PWD. Must be some factors at play in that small study, perhaps the dosages and ROAs. It's not like every single opioid-dependent person who takes buprenorphine (whether combined with naloxone or not) gets severe PWD, but dozens of people here on Bluelight have had PWD from Subutex (check out this thread as just one example). It definitely happens. The National Alliance of Advocates for Buprenorphine Treatment agrees, as does plenty of literature. One thing you can do to minimize your chances of experiencing precipitated withdrawal is to start with a low dose of the Subutex, like try 1 or 2 mg initially. Buprenorphine is a really weird drug, sometimes less is more.

If an individual who is physically dependent on opioids receives an acute dose of a partial agonist, the partial agonist can displace the full agonist from the receptors yet not activate the receptors as much as the full agonist had. The net effect would be a decrease in agonist effect and a precipitated withdrawal syndrome. Precipitated withdrawal with a partial agonist is more likely to occur in an individual who has a high level of physical dependence (e.g., high use of opioids each day), who takes the partial agonist soon after a dose of full agonist, and/or who takes a high dose of the partial agonist.

Buprenorphine is a partial agonist that exerts significant actions at the mu opioid receptor. As reviewed in the previous section, however, its maximal opioid effects are less than that of full agonists.

Administration of buprenorphine can precipitate an opioid withdrawal syndrome. Although there is much variability in response to buprenorphine, precipitated withdrawal symptoms tend to be milder than those produced by antagonist‐precipitated withdrawal, and intervention is rarely required. In controlled studies in which buprenorphine was given to individuals who were physically dependent on opioids, the precipitated withdrawal syndrome was both mild in intensity and easily tolerated (Strain et al. 1995). However, at least one open‐label small‐sample trial of low‐dose buprenorphine caused a patient to experience pronounced, precipitated, and poorly tolerated withdrawal of severe intensity (Banys et al. 1994). The probability of precipitating a withdrawal syndrome is minimized by reducing the dose of mu agonist before buprenorphine treatment is initiated, by allowing a longer elapsed interval between last agonist dose and first buprenorphine dose, and by starting treatment with a lower buprenorphine dose.
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From: http://www.ncbi.nlm.nih.gov/books/NBK64236/#A72334
 
If you've been doing H exclusively for a while (there is no bupe in your system), then taking bupe will DEFINITELY plunge you into pwd and it will be Hell and you will learn a lesson you will not soon forget.

The correct way to do it is wait until you are in AGONIZING withdrawal. Some people use hours. I don't. I say, wait until w/d begins, then wait, then wait more, then wait more, then when your legs have kicked enough to get a bike to travel a mile, then dose your sub. The relief that will wash over you 30 minutes later will be worth the agony in waiting, believe me. You can use gabapentin and benzos during this time to help weather the storm. I'm sure you know your benzo dose tolerance so I won't make a suggestion there, but I can say that you can eat grams of gabapentin with no ill effects (as far as I know).

There is another way. If you want a shortcut/not wait as long, you can chop your subutex REAL small, and take ~.25mg first. Wait an hour. That dose will partially knock off the H bound to your receptors. Do it again for good measure after that hour has passed (~0.25mg). An hour later, take 0.5mg. An hour after that, take 1mg. After 4 hours, if no pwd has presented, you can then take a large dose safely. The first infusion of small doses served to "gently" cleanse your receptors of the H. This method is far from fool-proof but I've used it before and it worked. But I'd recommend option 1, it really is the right way to do it. YOU CAN'T CHEAT NATURE.

The reason this is so is because bupe has a binding affiity to your receptors hundreds to thousands of times stronger than other opioids, and a least several times stronger than naloxone, which is why naloxone does nothing. That means that even if other opioids are locked in, intersynaptial bupe will outcompete them and knock them off, but often won't actually bind. This is what I imagine someone high on H being administered narcan would feel like. The naloxone has nothing to do with it. It is inert due to its lower affinity and was placed in Suboxone formulations as a way to extend the patent and market the new product as being "unabusable", which it is not.

PS - If you don't take our advice and wait only 6 hours and plunge into pwd, keep infusing more and more bupe. You'll end up using more than you need, but it will pull you out eventually. I've hit 16mg when inducting too early and plunging into pwd, starting with a 4mg dose too soon (~12 hours after last use, having used daily for nearly 2 years). The rule will still be to go slow. Don't take 4-8mg doses at once. Even if you induct using option 1, you should induct at about 2mg/hour or so. Who knows, you may be held at 4mg.
 
Last edited:
Phil.McKeer said:
If you've been doing H exclusively for a while (there is no bupe in your system), then taking bupe will DEFINITELY plunge you into pwd and it will be Hell and you will learn a lesson you will not soon forget.

The correct way to do it is wait until you are in AGONIZING withdrawal. Some people use hours. I don't. I say, wait until w/d begins, then wait, then wait more, then wait more, then when your legs have kicked enough to get a bike to travel a mile, then dose your sub.

There is another way. If you want a shortcut/not wait as long, you can chop your subutex REAL small, and take ~.25mg first. Wait an hour. That dose will partially knock off the H bound to your receptors. Do it again for good measure after that hour has passed (~0.25mg). An hour later, take 0.5mg. An hour after that, take 1mg. After 4 hours, if no pwd has presented, you can then take a large dose safely. The first infusion of small doses served to "gently" cleanse your receptors of the H.

The reason this is so is because bupe has a binding affiity to your receptors hundreds to thousands of times stronger than other opioids. That means that even if other opioids are locked in, intersynaptial bupe will outcompete them and knock them off, but often won't bind. This is what I imagine someone high on H being administered narcan feels like. The naloxone has nothing to do with it. It is inert and was placed in Suboxone formulations as a way to extend the patent and market the new product as being "unabusable", which it is not.
Click to expand...

^All of this.
 
The problem with buprenorphine is, it's affinity for the mu-opioid receptor is pretty high, so it'll knock of most opioids, but it's intrinsic activity is pretty low, meaning that bupe won't activate the receptors as much as full agonists.
 
kleinerkiffer said:
The problem with buprenorphine is, it's affinity for the mu-opioid receptor is pretty high, so it'll knock of most opioids, but it's intrinsic activity is pretty low, meaning that bupe won't activate the receptors as much as full agonists.
Click to expand...

Well I snorted the bupe this morning, 8 hours from last dose, all 8mg over about 45minutes, and I feel fine NO wd and feel as happy as I do when I do H- pretty content. Took .5 klonopin too

Thanks guys!
 
Ok we all know Subutext can give you precipitated withdrawal. Buprenorphine in any formulation can cause precipitated withdrawal if taken too soon. No need for another thread on this topic.
 
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