Opioids Short-term Bupe for morphine withdrawal

[neu_nobody]

Anybody did it? I am taking morphine 200mg/day orally for a few months and is planning to quit.
I have read about bupe detox (not maintenance).
Basically, you take small doses of bupe - like 1-2mg and less - for a very short period of time. For a period of acute morphine's WD symptoms duration (approx. 3-4 days, maybe a little more).
In theory (and from some anecdotal exp.) it will greatly ease the WDs. After a few days of bupe, you will still have WDs but much less intense. After that, you use kratom/pregabalin/benzos for another week or so and than stop with no/very minimal bearable wds.
My plan:
Day 1 of WDs - 2mg
Day 2 (the worst day for me) - 2mg
Than 1mg, 0.5mg, .25mg and stop. I will add Lyrica and maybe benzos from day 2. After 4-5 days - stop the bupe, continue Lyrica for a week or two, maybe benzos (if I will manage to get them), maybe some Kratom if needed.
Your opinion/experiences?

 

[neu_nobody]

Nobody?

 

[Curt Mandible]

When I did it, I started with a small dose of bupe—about 1.5mg to start with—on the first day, which helped get me through the worst part of the withdrawal. After that, I dropped the dose down gradually and by the end, I wasn’t feeling that awful acute withdrawal pain anymore.

I’ve used Lyrica to help afterwards, which helped a little with the lingering symptom so you can try it aswell

 

[neu_nobody]

When I did it, I started with a small dose of bupe—about 1.5mg to start with—on the first day, which helped get me through the worst part of the withdrawal. After that, I dropped the dose down gradually and by the end, I wasn’t feeling that awful acute withdrawal pain anymore.

I’ve used Lyrica to help afterwards, which helped a little with the lingering symptom so you can try it aswell

For how long did you use the Bupe?

 

[Keif' Richards]

Hey @neu_nobody I think I can give you some pointers here.

Buprenorphine (Subutex) is a partial Opioid antagonist. You have to wait until you are fully in withdrawal to take Buprenorphine, otherwise you could experience Precipitated Withdrawal. PW is a sudden, complete onset of withdrawal symptoms as the Buprenorphine kicks all of the Morphine out of your receptors. It is a very painful experience. If you plan properly you won't ever have to deal with it.

You're going to want to wait 24 hours after your last dose of Morphine, ideally. Once you get to this point and you're in withdrawal, you can test the waters by taking a very, very small amount of Buprenorphine. Most clinics/doctors are going to start you at ~8mg Buprenorphine, which is often way too much. Such a high dose given prematurely can cause a very potent reaction.

Whether you have tablets or sublingual film, you can break the medication down into extremely small amounts. The kind of dose you're looking for is 0.2-0.3mg Buprenorphine. This is going to be impossible to eyeball with accuracy. Keep this number in your head as a benchmark though. So, take your tiny sliver of film or minuscule crumb of tablet and put it under your tongue.

Wait ~15-20 minutes and be very mindful of how you're feeling. Are you feeling slightly more relaxed or are you feeling rising tension? If you feel the former, then you can try another small dose and repeat the process of waiting 15-20 minutes. If you feel you're in the clear/the medication is not making your withdrawal worse, you can try a bigger dose like 2mg Buprenorphine. If that bigger dose works out, then you should be in the clear to take however much you're gonna need. For 200mg Morphine per day orally, I wouldn't expect you would need anything beyond 12mg Buprenorphine per day at the most. Frankly, I think 8mg Buprenorphine should be plenty.

Take however much is required to make you feel stable and allow you to eat, drink and sleep. By day 3, you can start making reductions. I would make it a goal to get down to 2mg by day 5. Next, you can titrate down to zero in small increments until day ~14 when ideally you'd take your last dose of Buprenorphine.

Volumetric Dosing

Buprenorphine, I believe only goes down to 2mg doses. The most common dosing strength is 8mg generally. In order to get doses of 0.2mg or similar, you can follow the relatively easy process of dosing volumetrically.

Let's say you have an 8mg tablet or film. Take an oral syringe with milliliters on the barrel. These can be acquired for free at literally any pharmacy anywhere. Draw up 8ml of water. Crush tablet into powder or otherwise just place a film into a small vessel like a drinking glass. Add your 8ml of water and mix into a solution. Draw the solution back up and you now have a means of easily administering 1mg at a time. You do this by dropping the 1ml of liquid under your tongue and then leaving it just as you would normally to be absorbed sublingually.

Furthermore, you can can take 1ml of said solution which we know contains 1mg Buprenorphine. Squirt that back into the vessel, draw up 9ml of water and add it to the vessel. Mix it up and now you have a solution of Buprenorphine equaling 0.1mg/ml Buprenorphine.

This method will allow you to make very minuscule adjustments throughout your taper. Smaller adjustments typically are easier for a person to handle. If you have questions, just ask.