Bupe Safety of Buprenorphine + Soma?

[SuperPsych]

I apologize, I think I made a slightly similar thread a while back. I've been trying to do research on this and can't seem to find a solid answer.

I'm currently prescribed 4mg of Buprenorphine daily. I take 2mg Sublingual in the morning and 2mg snorted in the evening. I am also prescribed 900mg of Gabapentin a day but lately I've only been taking 300mg in the AM.

I'm curious about the safety and danger of my 4mg daily Buprenorphine and 500mg of Carisoprodol taken at night. They seem like fairly low doses of each so my gut tells me that I'd be fine, but I'm overly cautious with downers.

My train of thought is this: The Holy Trinity is a popular combo that consists of Hydrocodone/Carisoprodol/ and a Benzo. It's a popular combo and being that its a popular combo for recreational drug abuse, I imagine that people push the doses higher than I am considering. There is also the fact that Hydrocodone is a full opioid receptor agonist, therefore there is no ceiling to it's respiratory depression. There IS a ceiling to the respiratory depression of suboxone and over all it doesn't seem to effect breathing all that much once you get accustomed to it.

I did read on reddit one guy who is prescribed 8mg Suboxone/ 500-1000mg Carisoprodol/ and a couple of doses of Clonazepam a day and seems to be doing okay

One concern I have is that one night I was taking some soma (this was before being on bupe) and I definitely felt my breathing become a bit shallow. This was at a cumulative dose of 2000mg or more.

I know that the safest thing to do is to not take Soma if I'm currently on Suboxone, but I have a decent amount of Soma and I just started a new job which is a bit stressful and sometimes physically demanding. I'd love for a way to unwind. I don't enjoy weed, am trying to stay away from stimulants and I don't have any dissociatives. Buperenorphine doesn't give me any sort of buzz and I dislike alcohol.

Has anybody ever mixed these 2? If so how did it go?

 

[Keif' Richards]

Hey @SuperPsych

It's a good question for sure. Good on you for being so careful.

Buprenorphine [Suboxone (w/ Naloxone); Subutex] can be a bit of a rabbit hole for folks learning about Opioids. Most Opioid agonists we are familiar with operate in a linear function. Buprenorphine produces all of the hallmarks of an Opioid agonist at lower dosages i.e. respiratory depression, pruritus, miosis and perhaps most importantly, respiratory depression. The drug's unique pharmacology comes into play as the dose is raised, basically making it "safer" than the aforementioned other Opioids. Buprenorphine as a single agent is unlikely to kill a person through respiratory depression. That is not to say it has never happened, though it is not the norm.

However, when we throw other central nervous system depressants into the mix, we increase the potential for danger. We have plenty of cases in which Buprenorphine in combination with things like Benzodiazepines, Alcohol have led to fatalities. We need to always exercise caution with these combinations, though the safety profile is always going to be better with Buprenorphine than with traditional Opiates like Morphine for instance.

Carisoprodol (Soma) is an especially dangerous sedative in combination with Opioids. Carisoprodol is largely a prodrug for Meprobamate (Miltown). Meprobamate is classified as a Non-Barbiturate Sedative among other things. A "Non-Barbiturate", as if any moniker could be any more misleading or confusing, is a drug that for all intents and purposes will behave like a Barbiturate despite being chemically distinct from the true Barbiturates like Secobarbital (Seconal), Pentobarbital (Nembutal) and so on.

Barbiturates are especially dangerous in combination with Opioids. Barbiturates were replaced by the Benzodiazepines more or less for the improved safety profile of the latter. Knowing what we know about how dangerous Benzodiazepines can be, the danger should be apparent to anyone reading this.

However, if a person is in control of their usage, they keep it to reasonable, rational dosages and they are unafraid of compulsive behavior, then there is no reason why you can't use a single dose of Carisoprodol in the evenings. Just don't do anything untoward in terms of dosage increase without special consideration. This is a dangerous combination, yes, but we also make fire every day in our backyards capable of theoretically burning down the entire planet. We just need to be cautious and respectful of these drugs.

I hope this answers your question buddy.

 

[SuperPsych]

Hey @SuperPsych

It's a good question for sure. Good on you for being so careful.

Buprenorphine [Suboxone (w/ Naloxone); Subutex] can be a bit of a rabbit hole for folks learning about Opioids. Most Opioid agonists we are familiar with operate in a linear function. Buprenorphine produces all of the hallmarks of an Opioid agonist at lower dosages i.e. respiratory depression, pruritus, miosis and perhaps most importantly, respiratory depression. The drug's unique pharmacology comes into play as the dose is raised, basically making it "safer" than the aforementioned other Opioids. Buprenorphine as a single agent is unlikely to kill a person through respiratory depression. That is not to say it has never happened, though it is not the norm.

However, when we throw other central nervous system depressants into the mix, we increase the potential for danger. We have plenty of cases in which Buprenorphine in combination with things like Benzodiazepines, Alcohol have led to fatalities. We need to always exercise caution with these combinations, though the safety profile is always going to be better with Buprenorphine than with traditional Opiates like Morphine for instance.

Carisoprodol (Soma) is an especially dangerous sedative in combination with Opioids. Carisoprodol is largely a prodrug for Meprobamate (Miltown). Meprobamate is classified as a Non-Barbiturate Sedative among other things. A "Non-Barbiturate", as if any moniker could be any more misleading or confusing, is a drug that for all intents and purposes will behave like a Barbiturate despite being chemically distinct from the true Barbiturates like Secobarbital (Seconal), Pentobarbital (Nembutal) and so on.

Barbiturates are especially dangerous in combination with Opioids. Barbiturates were replaced by the Benzodiazepines more or less for the improved safety profile of the latter. Knowing what we know about how dangerous Benzodiazepines can be, the danger should be apparent to anyone reading this.

However, if a person is in control of their usage, they keep it to reasonable, rational dosages and they are unafraid of compulsive behavior, then there is no reason why you can't use a single dose of Carisoprodol in the evenings. Just don't do anything untoward in terms of dosage increase without special consideration. This is a dangerous combination, yes, but we also make fire every day in our backyards capable of theoretically burning down the entire planet. We just need to be cautious and respectful of these drugs.

I hope this answers your question buddy.

I greatly appreciate the thorough response. Your answers are always well thought out and insightful.

I am pretty set on trying it at some point. I do have problems with compulsive behavior but I do have a time lock safe. I have only broken into the safe for dissociatives and twice for stimulants. I have broken into more than I'd care to admit. However, I do take out my dose of suboxone for the following day at bedtime and then lock it up until the following night. I've never broken into it for that, but that's a different story considering that Buprenorphine has little to no recreational value once one becomes tolerant to it. I was mainly concerned about this combination when getting back onto the bupe after a heavy kratom addiction.

I did use Soma somewhat compulsively when I first got it. I do love the stuff. I only kept it to night times and never exceeded 2000mg over the course of a night. I actually only made it to 2000mg once but I found it too intense and dialed it back to 500-1500mg over the course of a night.

I do remember a couple of years back I was on suboxone, though I don't remember the dose at the time and I took .5mg-1mg of Bromazolam and noticed no added respiratory depression. As you said though, Carisoprodol is a bit more dangerous, although bromazolam is one of the heavier physically sedating benzos that I have tried.

I started a new job where I'm on my feet all day and it's fairly physical. Today my back was killing me and I was very tempted to take a soma. I decided against it and staggered gabapentin until I reached 1200mg. Unfortunately now I'm out of my prescription but I should be able to have it filled in a couple of days. In the meantime I'll do low doses of Phenibut.

Today I took 900mg of Phenibut, 1200mg of gabapentin and 4mg of Suboxone with no added side effects. Gabapentin and Phenibut are nothing compared to Soma in terms of CNS depression.

I may try 10-20mg of Zolpidem at some point before I try the soma, just to ease my anxiety. Regardless, I know as soon as the soma kicks in I'll freak out that I killed myself, until the anxiolytic effects hit me.

I am certain that I'd be safe with 500mg of Carisoprodol at night after taking my Suboxone in the day. I just have a bad tendency of getting anxiety attacks over health related things. I swear I'm a borderline hypochondriac. It's always best to play it safe with substances though.

When I do try it I'll be sure to take one 500mg Soma and lock up the rest for a few days. I'll probably even take the soma in halves or quarters until I feel certain that it's safe. I'll likely wait to try it until my roommate is back from his trip or my friend comes to crash for a night, just for that added layer of safety.

I really appreciate you and all that you do around here. Much love

 

[SuperPsych]

I'm just updating this thread to maybe help others in the future who have the same question that may stumble upon this thread in search for answers.

I finally decided to try the Soma last night and I'm still kickin'.

I am prescribed 4mg of Buprenorphine daily. I have been on it now for a month and a half or so, so I am tolerant to it. Other than that I've been physically addicted to opioids constantly since 2020, bouncing between Kratom and Buprenorphine. I am also prescribed 300mg of Gabapentin 3 times a day.

Last night I took the plunge and tried taking Carisoprodol despite my anxieties. I took 250mg and waited for it to kick in. Once it kicked in and no side effects were felt I took another 250mg. I continued this until I had reached a total of 1000mg. I stopped there so as to not push my luck.

Throughout the experience I noticed no respiratory depression or any other worrisome side effects. The only part I didn't care for was that I fell asleep fairly quickly after they kicked in so I wasn't able to stay up and enjoy it. I slept well though.

I am tempted to do them again tonight but I am going to try and save it for work nights as my work causes me tension and pain in my neck and back. Muscle Relaxers are more enjoyable when you have muscles that need relaxing anyways

 

[Chemicallydependent]

I'm just updating this thread to maybe help others in the future who have the same question that may stumble upon this thread in search for answers.

I finally decided to try the Soma last night and I'm still kickin'.

I am prescribed 4mg of Buprenorphine daily. I have been on it now for a month and a half or so, so I am tolerant to it. Other than that I've been physically addicted to opioids constantly since 2020, bouncing between Kratom and Buprenorphine. I am also prescribed 300mg of Gabapentin 3 times a day.

Last night I took the plunge and tried taking Carisoprodol despite my anxieties. I took 250mg and waited for it to kick in. Once it kicked in and no side effects were felt I took another 250mg. I continued this until I had reached a total of 1000mg. I stopped there so as to not push my luck.

Throughout the experience I noticed no respiratory depression or any other worrisome side effects. The only part I didn't care for was that I fell asleep fairly quickly after they kicked in so I wasn't able to stay up and enjoy it. I slept well though.

I am tempted to do them again tonight but I am going to try and save it for work nights as my work causes me tension and pain in my neck and back. Muscle Relaxers are more enjoyable when you have muscles that need relaxing anyways

I came across your post and wanted to share my experience with Soma. I broke my neck 12/2007 and have been stuck living life through pharmacology for what seems like an eternity. I have titrated to high levels of opiods daily (2-36mg xtampza 2/day (the long acting anti-abusive replacement of Purdue Pharma's 80mg Oxycontin -green OP's) 30mg oxycodone for breakthrough pain 4/day and take 3mg alprazolam at bedtime for sleep (sometimes if I am jittery from the opiods I'll take 1mg xanax during the day and then 2mg before bed. Years ago, after my last surgery, I was able to get by on a lower opioid dose of 80mg oxycontin 3/day and 20mg oxycodone 3/day and 2mg xanax but I was also prescribed 350mg soma for the spasms. At first I didn't notice much interaction, but after a while, the combination toxicity built up and I started having episodes of syncopy (blood pressure drops fast when standing causing fainting). It took some detective work between myself and my DO doc to figure out it was due to the soma. I dont think taking xanax with it helped me either. I stopped the soma and have been taking flexeril for spasms as needed instead without any issues with all my other med combinations. I applaud you for the time lock safe! what a great idea!! i did titrate up on all my meds over time and had to have shear will power to get down from 8mg xanax a day to just 3mg-it's true that benzodiazepines have horrible withdrawals.

 

[SuperPsych]

I came across your post and wanted to share my experience with Soma. I broke my neck 12/2007 and have been stuck living life through pharmacology for what seems like an eternity. I have titrated to high levels of opiods daily (2-36mg xtampza 2/day (the long acting anti-abusive replacement of Purdue Pharma's 80mg Oxycontin -green OP's) 30mg oxycodone for breakthrough pain 4/day and take 3mg alprazolam at bedtime for sleep (sometimes if I am jittery from the opiods I'll take 1mg xanax during the day and then 2mg before bed. Years ago, after my last surgery, I was able to get by on a lower opioid dose of 80mg oxycontin 3/day and 20mg oxycodone 3/day and 2mg xanax but I was also prescribed 350mg soma for the spasms. At first I didn't notice much interaction, but after a while, the combination toxicity built up and I started having episodes of syncopy (blood pressure drops fast when standing causing fainting). It took some detective work between myself and my DO doc to figure out it was due to the soma. I dont think taking xanax with it helped me either. I stopped the soma and have been taking flexeril for spasms as needed instead without any issues with all my other med combinations. I applaud you for the time lock safe! what a great idea!! i did titrate up on all my meds over time and had to have shear will power to get down from 8mg xanax a day to just 3mg-it's true that benzodiazepines have horrible withdrawals.

Benzodiazepine withdrawal is indeed horrible. Good on you for getting down to 3mg of xanax a day, that's much more manageable than 8mg a day.

I can imagine that adding the soma could lead to all sorts of bad interactions after a while. Carisoprodols metabolite does have a half-life that definitely would build up with daily use and in combo with other mediocation that lower blood pressure I can see how it'd lead to syncope. Good thinbg y'all were able to get to the bottom of it before things got any worse

 

[Chemicallydependent]

Benzodiazepine withdrawal is indeed horrible. Good on you for getting down to 3mg of xanax a day, that's much more manageable than 8mg a day.

I can imagine that adding the soma could lead to all sorts of bad interactions after a while. Carisoprodols metabolite does have a half-life that definitely would build up with daily use and in combo with other mediocation that lower blood pressure I can see how it'd lead to syncope. Good thinbg y'all were able to get to the bottom of it before things got any worse

the soma definitely had a nice mellowing affect to tight or spasming muscles, and was one of the meds i got good results with for its intended purpose. it just doesn't play nicely with other meds. feel better soon

 

[BadBoy377]

Soma is both highly addictive and quite a serious and a dirty drug.

There's nothing quite like the right combo. But if you overdo it you get a weird zombie shuffle thing. I should really get someone to video ime and it might put me off it.

I'd advise extreme caution when combining with opiates and benzos. Doses of less than a gram should be reasonably safe. However from my experience the pills going about the UK seem to be inconsistently dosed.

This is a hard drug and can easily fuck you up. Extreme caution. Safe travels,

BB

 

[Chemicallydependent]

When you say pills going around the UK are inconsistent are you referring to what is provided at a pharmacy or what's bought from the street?

 

[BadBoy377]

I'm referring to pills sold in blister packs by 'pharmacies' online.