Fentanyl -->Naloxone Precipitated Buprenorphine induction (Advice/Harm Reduction)

[Sxuldxath]

Basically what the title of the post says, im trying to do a naloxone precipitated bup induction. i tried to do one last weekend. it didnt go very well. i use 1.5 to 2 grams a day of non tranq fent powder for starters. i followed this "guide" https://www.boulder.care/quickstart . i figured that i would give it a try because i am very desperate to get clean because i dont have alot of time to do so with my job. i work at amazon and have a somewhat mostly functioning life with financials in a good place, a car, and a home. i also have a relationship that is falling apart because of this stuff and figured that this could give me my life back. this is essentially a place that does this via telehealth. the guide essentially tells you to take comfort meds an hour before initiating the percipitated state, and then taking the nasal naloxone and 24mg of bup at the exact same time. folllowing this guide, i put myself into precips using the nalaxone and proceeded to take 24mg of suboxone, tablet form. the method calls for strips but i only had tablets because that is what i get from my provider. i am working on getting this changed. i got about 10 minutes into the process with the 3 8mg tablets in my mouth in a large pool of saliva before my throat invoulantarily swallowed and i proceeded to violently throw up for about 5 minutes through the worst of the percipitated withdrawls. i was also hallucinating and dissasociating. im trying to figure out what exactly went wrong here. i think that if i were to have used strips, that i wouldnt have had such a large pool of saliva, if any in my mouth to swallow. therefore avoiding throwing up. i feel like i wasnt able to absorb any of the bup. if anybody has any advice for me it would be greatly appreciated. i have done a huge deep dive into the science of how this works, and i know that it does work. boulder care has successfully inducted over 60 people using this method and they are still on their telehealth suboxone program. this method is from start to stop over and done with in an hour or so. its horrific but i want my life back. im getting the strips with my next refill. any advice from people that have done this etc or just advice in general is appreciated. thanks!!

 

[PenguinWithNapalm]

So you are just throwing yourself into precipitated withdrawal on purpose and a doctor is guiding you through this?

 

[TheFunkeeJunkee]

If you cannot tolerate the 24 to 48 hour period before initiating buprenorphine then maybe this method will work for you. However I have never heard of it being done without direct medical supervision. Precipitated withdrawals can have serious health risks, especially if your dependent on fentanyl analogues.

You can continue torturing yourself if you want, but this is the exact reason why Naloxone-precipitated buprenorphine induction has slowly fallen out of favour in recent years. Personally I'd drag myself through 10km of broken glass and lemon juice then intentionally induce precipitated withdrawals.

The Burnese method is now the preferred mode of induction if a patient cannot tolerate the washout period. It's far less traumatic, carries less health risks and importantly can be done at home.

 

[TheFunkeeJunkee]

So you are just throwing yourself into precipitated withdrawal on purpose and a doctor is guiding you through this?

I suspect OP may be in some sort of sadomasochistic relationship with his doctor.

 

[notsmokeymcpot42088]

Yea uhh dont do that guy?? would be my advice

Have you ever been through precipitated withdrawal -- I suspect you dont know what you are signing up for. If it is only fent you are on 24 hours off should be plenty of time to take bupe with no precip w/d??

 

[PenguinWithNapalm]

I suspect OP may be in some sort of sadomasochistic relationship with his doctor.

Um.. yeah.. this is barbaric as far as I’m concerned

 

[notsmokeymcpot42088]

Personally I'd drag myself through 10km of broken glass and lemon juice then intentionally induce precipitated withdrawals.

That is not sarcastic or that hyperbolic. Ppl kill themselves during precipitated.

The basic idea is to condense 3 or 4 days of withdrawls into a super small period of time where you experience all 3 or 4 days worth AT ONCE.

Conventionally you get on a drug with a LONG HALFLIFE and you are in w/d's for a LONG TIME but they are bearable. Please do some research!

Suboxone is that drug with a long halflife --that is where you are going to end up -- WHY ON EARTH GO THROUGH PRECIP TO GET THERE??? Answer this question

 

[PenguinWithNapalm]

Personally I'd drag myself through 10km of broken glass and lemon juice then intentionally induce precipitated withdrawals.

That is not sarcastic or that hyperbolic. Ppl kill themselves during precipitated.

The basic idea is to condense 3 or 4 days of withdrawls into a super small period of time where you experience all 3 or 4 days worth AT ONCE.

Conventionally you get on a drug with a LONG HALFLIFE and you are in w/d's for a LONG TIME but they are bearable. Please do some research!

Suboxone is that drug with a long halflife --that is where you are going to end up -- WHY ON EARTH GO THROUGH PRECIP TO GET THERE??? Answer this question

What kind of fuckwit doctor is doing this and where tf did they receive “training” to do this?

 

[notsmokeymcpot42088]

I am guessing sadist wasn't far off --- some prick with a MD who has it out for drug users and is gunna make anyone ignorant enough to partake suffer. (Maybe a family member OD'd, who knows the "Justification" but alot of docs like that are out there)

What kind of fuckwit doctor is doing this and where tf did they receive “training” to do this?

Right after I had surgery and a fent shot they INSISTED I take my prescribed dosage of bupe like 3 hours later -- I swallowed it like a pill and they seemed to have no idea that was wrong lol

 

[PenguinWithNapalm]

I am guessing sadist wasn't far off --- some prick with a MD who has it out for drug users and is gunna make anyone ignorant enough to partake suffer. (Maybe a family member OD'd, who knows the "Justification" but alot of docs like that are out there)


Right after I had surgery and a fent shot they INSISTED I take my prescribed dosage of bupe like 3 hours later -- I swallowed it like a pill and they seemed to have no idea that was wrong lol

They insisted? What would have happened if you don’t them to fuck all the way off? You would have to physically hold me down and force it into my mouth

 

[opiandy]

Yea uhh dont do that guy?? would be my advice

Have you ever been through precipitated withdrawal -- I suspect you dont know what you are signing up for. If it is only fent you are on 24 hours off should be plenty of time to take bupe with no precip w/d??

Wait, what? Only 24 hours? I've been told on here, repeatedly I might add, that you need to be at least 36 hours minimum and severely in withdrawals before taking bupe.

I laid up feeling mildly shitty for like 30 hours, with bupe on hand, waiting to be deep in wd's because my guy was out of h/fent, thinking I had to be really bad off before taking it. My guy called at like hour 30 and I haven't ran out since. That was 5 months ago.

Fuck, I can do 30 hours again, if you're saying 24's all it takes.

24 hours from the last use? Does bupe expire? I've had it, unopened, for 5 months.

 

[opiandy]

Personally I'd drag myself through 10km of broken glass and lemon juice then intentionally induce precipitated withdrawals.

That is not sarcastic or that hyperbolic. Ppl kill themselves during precipitated.

The basic idea is to condense 3 or 4 days of withdrawls into a super small period of time where you experience all 3 or 4 days worth AT ONCE.

Conventionally you get on a drug with a LONG HALFLIFE and you are in w/d's for a LONG TIME but they are bearable. Please do some research!

Suboxone is that drug with a long halflife --that is where you are going to end up -- WHY ON EARTH GO THROUGH PRECIP TO GET THERE??? Answer this question

So this the suboxone experience? Go through mild wd's over a long time? I thought it was experience severe wd's for a short time, take the bupe, starting with a small dose, then build up until you are not experiencing any wd's. That's how the doc and nurse at the clinic explained it to me.

If what you're saying is correct, I'd rather go back to methadone starting at the 30mg dose still using h/fent until building back up to a maintenance dose, then stopping the h/fent. I did that before and didn't experience any wd's at all. I hated the process, but it worked.

 

[opiandy]

If you cannot tolerate the 24 to 48 hour period before initiating buprenorphine then maybe this method will work for you. However I have never heard of it being done without direct medical supervision. Precipitated withdrawals can have serious health risks, especially if your dependent on fentanyl analogues.

You can continue torturing yourself if you want, but this is the exact reason why Naloxone-precipitated buprenorphine induction has slowly fallen out of favour in recent years. Personally I'd drag myself through 10km of broken glass and lemon juice then intentionally induce precipitated withdrawals.

The Burnese method is now the preferred mode of induction if a patient cannot tolerate the washout period. It's far less traumatic, carries less health risks and importantly can be done at home.

What is this Burnese method you speak of and is it successful.

 

[Xyborg]

What is this Burnese method you speak of and is it successful.

I have personal experience with the Burnese method and can attest to its viability. The Burnese method entails using ever increasing dosage of bupe alongside the patients normal full agonist intake. You start with tiny doses of bupe like .5mg and under for the first couple days. While also maintaining your normal habit. Then slowly increase the amount of bupe per day while also decreasing your full agonist intake. There are no set dosages as each patient is different and will respond differently to the bupe. The trick is to finding the balance that makes you feel well enough to function like a normal human being. You can google it for some more in depth info, there are some doseage charts that have been published from differnt studies. But again, everyone is different and responses can vary wildly.

Like I said I have personally used this method to transition off fent to bupe. In honesty, I've used it 3 or 4 times when I had slipped off my bupe routine. The burnese method is becoming mroe popular due to the fentalogues that have flooded the market so your doctor might even have experience with it. A doctors supervision is recommended as it can be hard to limit your use of your street opiate forthe first week or so. However, I managed it on mine own so your mileage will vary.

 

[PenguinWithNapalm]

Wait, what? Only 24 hours? I've been told on here, repeatedly I might add, that you need to be at least 36 hours minimum and severely in withdrawals before taking bupe.

I laid up feeling mildly shitty for like 30 hours, with bupe on hand, waiting to be deep in wd's because my guy was out of h/fent, thinking I had to be really bad off before taking it. My guy called at like hour 30 and I haven't ran out since. That was 5 months ago.

Fuck, I can do 30 hours again, if you're saying 24's all it takes.

24 hours from the last use? Does bupe expire? I've had it, unopened, for 5 months.

I’ve always only waited 24 hours for fent. One time I took it at hour 18 and was fine but I think I might have a fast metabolism. Also I wasn’t super dependent on it. I was using heroin then got some fent when I ran out then toon subs. It might just be a guardian angel because I was on vacation at the time

 

[PenguinWithNapalm]

Wait, what? Only 24 hours? I've been told on here, repeatedly I might add, that you need to be at least 36 hours minimum and severely in withdrawals before taking bupe.

I laid up feeling mildly shitty for like 30 hours, with bupe on hand, waiting to be deep in wd's because my guy was out of h/fent, thinking I had to be really bad off before taking it. My guy called at like hour 30 and I haven't ran out since. That was 5 months ago.

Fuck, I can do 30 hours again, if you're saying 24's all it takes.

24 hours from the last use? Does bupe expire? I've had it, unopened, for 5 months.

I don’t think it realistically expires if it is kept in reasonable conditions

 

[notsmokeymcpot42088]

So this the suboxone experience? Go through mild wd's over a long time? I thought it was experience severe wd's for a short time, take the bupe, starting with a small dose, then build up until you are not experiencing any wd's. That's how the doc and nurse at the clinic explained it to me.

If what you're saying is correct, I'd rather go back to methadone starting at the 30mg dose still using h/fent until building back up to a maintenance dose, then stopping the h/fent. I did that before and didn't experience any wd's at all. I hated the process, but it worked.

Okay so either way you are gunna end up on suboxone -- when you stop that you will have mild w/ds over a bit of time

There is NO REASON for you to experience withdrawal before than!

Just wait until you are 24 hours after your last fent dose to start suboxone and you eliminate the hellish precipitated!

Google the burnese method

 

[TheFunkeeJunkee]

What is this Burnese method you speak of and is it successful.

Another commenter answered your question very well.

I’d just like to suggest considering buprenorphine depot injections as an option.

Once you’ve stabilised on Suboxone, you can transition to a long‑acting depot formulation such as Buvidal. The benefits include monthly or quarterly dosing so there’s no need for regular pharmacy visits to pick up strips, a built in commitment to absitence since it's much harder to ‘take a break’ compared to daily Suboxone and most importantly: depots have a built in taper if you decide to stop. Because the pharmacokinetics of depot buprenorphine allow blood levels to gradually decline over months. For most people this means they don't experience much discomfort or withdrawals

This is what I did, and it worked very well. I even forget that technically I was detoxing from buprenorphine. It really was that painless.

 

[opiandy]

I have personal experience with the Burnese method and can attest to its viability. The Burnese method entails using ever increasing dosage of bupe alongside the patients normal full agonist intake. You start with tiny doses of bupe like .5mg and under for the first couple days. While also maintaining your normal habit. Then slowly increase the amount of bupe per day while also decreasing your full agonist intake. There are no set dosages as each patient is different and will respond differently to the bupe. The trick is to finding the balance that makes you feel well enough to function like a normal human being. You can google it for some more in depth info, there are some doseage charts that have been published from differnt studies. But again, everyone is different and responses can vary wildly.

Like I said I have personally used this method to transition off fent to bupe. In honesty, I've used it 3 or 4 times when I had slipped off my bupe routine. The burnese method is becoming mroe popular due to the fentalogues that have flooded the market so your doctor might even have experience with it. A doctors supervision is recommended as it can be hard to limit your use of your street opiate forthe first week or so. However, I managed it on mine own so your mileage will vary.

Appreciate the reply. I Googled it, but it's good to hear personal experiences. I may give this a shot, but I am curious of one thing, does the suboxone completely take care of wd's?

I own a business and have a separate full time job. I can't operate at the level I need to even with mild wd's, at least not at the moment. Maybe when business slows down, but not now.

 

[opiandy]

Okay so either way you are gunna end up on suboxone -- when you stop that you will have mild w/ds over a bit of time

There is NO REASON for you to experience withdrawal before than!

Just wait until you are 24 hours after your last fent dose to start suboxone and you eliminate the hellish precipitated!

Google the burnese method

Appreciate it. I Googled it. I may give it a shot.