Opioids Using heroin to bridge from fentanyl to buprenorphine induction

[aspiringchemist]

Ok so I’ve been addicted to 1.5g of smoked fentanyl daily for the past year. I have tried cold turkey many times and simply cannot endure it due to the emergence of psychotic symptoms in conjunction with severe physiological symptoms. I have twice experienced severe precipitated withdrawal due to initiating buprenorphine at 20 hours post last fentanyl use, and have had minor success using ir morphine in doses of 15mg x4 daily for 1-3 days to replace fentanyl while allowing a washout to occur, followed by successful induction of suboxone at 12 hours post last morphine dose; however, I ended up relapsing on fentanyl a day later, not because suboxone didn’t work but because I wanted to get high. It surprised me how well the suboxone made me feel after a 72 hour fentanyl washout period using ir morphine to mitigate withdrawal and dosing suboxone 12 hours after morphine as is indicated in some new medical protocols.

My question is, can heroin be used in the same manner I successfully used ir morphine to bridge/washout fentanyl for 1-3 days and then induce suboxone 12 hours after last heroin dose? Given the close relation between ir morphine and heroin it would make sense that this was a potential avenue to suboxone induction without experiencing 72 hours of acute fentanyl withdrawal.

I know heroin is often contaminated with fentanyl but let’s say this heroin is not contaminated and let’s also say I have the will power to stick to the plan, ceasing heroin use (just like one would use oxycodone to bridge) after 24-72 hours, then waiting approximately 12 hours to induce small doses of suboxone. Is this a rational and potentially effective method of safely inducing suboxone when all else has failed and methadone isn’t an option?

For some bizarre reason 7OH and pseudoindoxyl actually induce a precipitated withdrawal state not dissimilar from suboxone induced PW and have done so consistently for at least 15 attempts so that’s out the window as a bridge for me. I’ve not tried plain leaf as a bridge and wonder if it may work but I’m more bringing this up to illustrate that kratom and it’s alkaloids, for whatever reason, induce withdrawal for me when used within close proximity (days) of fentanyl.

I’m currently nearing the end of day 1 using black tar heroin in place of 2g fentanyl. I’ve used approximately 1/4g and it’s approaching evening time. I’ve experienced no withdrawal from fentanyl other than cravings and that typical “things are out of control or feel unmanageable“ feeling associated with all opioid withdrawal. Theoretically I should be able to induce suboxone 12-24 hours after last heroin dose, correct? I’d like to stress that I tried so many times in various ways to quit fentanyl and induce Suboxone and each has failed miserably. The only attempt that was nearly successful as the use of instant release morphine for 72 hours prior to inducing Suboxone 12 hours post last morphine dose; and again I relapsed a day later out of boredom, even though I had successfully induced Suboxone 12 hours after the last morphine dose without experiencing precipitated withdrawal. There’s not much current medical literature on the subject, but there is some out there, of course, not in regards to heroin specifically but to short acting opioids as a bridge. My question is specifically in regards to the use of heroin as the short acting opioid as a bridge and the time needed between last dose of heroin and Suboxone induction. Sorry for the long fucking post I appreciate anybody’s Response and input.

https://www.sciencedirect.com/science/article/pii/S2352853226000271#b0095

 

[Xyborg]

In theory; absolutely it can be done. Although, it will require some intense willpower. Do you have someone you can trust to hold your stash and give out your doses? if so, then it becomes much easier.

With that being said, I would recommend trying the Bernese method of sub induction. You can Google it for official schedules. But typically they have you start on an extremely low dose of Suboxone, like .5mg. So day 1 would be .5mg of Suboxone along with your typical dose of fent. As the days go on you slowly increase the amount of Suboxone while simultaneously reducing the amount of fentanyl. Some people will follow a 1 week schedule meaning by day 5 or 6 (cannot recall the exact schedule) you are completely off of fentanyl. Some people will follow a 2 week schedule. The only difference is how quickly you are increasing the amount of Suboxone and decreasing the amount of fentanyl each day/ every other day. You can modify the schedules as you see fit. Just listen to your body; it will tell you if you are increasing/decreasing too quickly.

I have personally used this method when I was on Suboxone and had a few week slipup. It works great. I have also done the opposite; I used legit roxi's and morphine to get off Suboxone with nearly no acute withdrawal.

 

[aspiringchemist]

In theory; absolutely it can be done. Although, it will require some intense willpower. Do you have someone you can trust to hold your stash and give out your doses? if so, then it becomes much easier.

With that being said, I would recommend trying the Bernese method of sub induction. You can Google it for official schedules. But typically they have you start on an extremely low dose of Suboxone, like .5mg. So day 1 would be .5mg of Suboxone along with your typical dose of fent. As the days go on you slowly increase the amount of Suboxone while simultaneously reducing the amount of fentanyl. Some people will follow a 1 week schedule meaning by day 5 or 6 (cannot recall the exact schedule) you are completely off of fentanyl. Some people will follow a 2 week schedule. The only difference is how quickly you are increasing the amount of Suboxone and decreasing the amount of fentanyl each day/ every other day. You can modify the schedules as you see fit. Just listen to your body; it will tell you if you are increasing/decreasing too quickly.

I have personally used this method when I was on Suboxone and had a few week slipup. It works great. I have also done the opposite; I used legit roxi's and morphine to get off Suboxone with nearly no acute withdrawal.

Thanks for the reply. I’m currently at 36 hours without any fentanyl and sort of had a psychological breakthrough today with regards to what it’s done to me and how abhorrently different it is from traditional opioid withdrawal. I’ve been using black tar hero intravenously for this 36 hour period and I have to say I’m surprised at how not high it’s getting me. This could be because it’s bad dope or because my receptors are so down regulated from heavy fentanyl use (2g/day). I can only say with certainty that there is no fentanyl in the heroin, though I haven’t tested it. I went into withdrawal this afternoon before I was able to score and it reminded me so much of withdrawal from the last time I was strung out on heroin some 20 years ago that it was a breakthrough.

I don’t have anybody in my life that can dull it out to me and I’m certainly risking becoming dependent on it now; I did delete every single number related to fentanyl in my phone today, something I have not been able to do. I realized just how much it has changed me and destroyed my life and I don’t want it anymore even if the shitty tar isn’t getting me that high.

I’ve had a positive experience using morphine to bridge and was able to take my last dose before going to bed and wake up some eight hours later and take Suboxone without going into precipitated withdrawal; this was after 72 hours off of fentanyl using morphine. So I assume the same is true with BTH, that I could use my last dose at night and wake up in the morning and induce Suboxone however, I would be lying if I said a part of me didn’t want to stop using it. Part of me thinks it doesn’t really matter given that it’s the third of the price and last twice as long.

But thanks for responding. If I’m being honest, I went through, this is inappropriate to the thread, a divorce in which I lost the love of my life four years ago, and I realized today that I haven’t been able to process it and that fentanyl addiction has only been a means to hide the pain. I lost that person forever. They won’t speak to me. I don’t know where they are and it kills me inside and I need to find a way to find a light in this life again otherwise I’m gonna kill myself eventually one way or another and there’s no reason to think that that would happen right now so no need to do anything about that or worry I’m just kind of using the thread as a place to vent and maybe reach out for help to have someone listen because I’m so utterly alone. Immediately following my divorce, I caught a felony charge and was fired from my career as a social worker. I spent the last four years in isolation working as a bartender, poor and unable to work in my career field. Fucked me up and I, as inappropriate as it may be, still so strongly agree of the loss of my love. I’m sorry to puke all that and you don’t have to respond to any of it, but I do think that this method can work to get away from the fentanyl. It’s at least worked for 36 hours now and it’s the longest they’ve gone in months. And while I was in withdrawal this afternoon, I realized that I probably could’ve began to induce Suboxone during that time. Fentanyl withdrawal is a hellscape, unlike any other. At this point, I just want to get it out of my system so that I can safely. I guess get back on Suboxone even though I hate it. I’ve been trying cold turkey a lot lately, and it was like a hallucinatory nightmare of the utmost intense, anxiety and increased heart rate and blood pressure and internal restlessness and literal feeling like I was gonna have a heart attack. I literally feared I was going to die at 24 hours cold turkey because of how my body was responding. So this is a win in my book as long as I don’t go back and I realize today that I deserve to not go back. So thanks for listening being there and your input.

It’s been so long since I’ve had BTH perhaps you can or someone can provide some input, should it be felt strongly intravenously at 36 hours into fentanyl withdrawal, coming off a year long two gram a day habit? I can’t decide if this is just really shitty dope or if my receptors are so down regulated that it’s just incapable of producing a strong high.

Oh, and thank you for reminding me of the Bernese induction method. Perhaps I should start that. I am familiar and tried a few times with fentanyl, but it put me into precipitated withdrawal every time I got up to 4 mg and honestly fentanyl is so expensive that I couldn’t bring myself to waste the money.

 

[CfZrx]

Wow, so fent WD is hellish eh? I've oft wondered why fent addicts dont just switch to methadone and smoking weed. Am I being naive? Could it be that 160mg or whatever is the biggest dose of methadone still wont get a fent addict well?

Wishing you the best in this battle for your life.

cFzRX

 

[Xyborg]

Wow, so fent WD is hellish eh? I've oft wondered why fent addicts dont just switch to methadone and smoking weed. Am I being naive? Could it be that 160mg or whatever is the biggest dose of methadone still wont get a fent addict well?

Wishing you the best in this battle for your life.

cFzRX

Fent WD is so hellish because it is one of the few opioids that is stored in the fat cells. That's why induction onto Suboxone is very difficult.

As far a methadone, yes absolutely high dose methadone will take care of it. However, methadone is such a pain in the ass to get. Whereas Suboxone, one can get a script through telemed. However, Suboxone and methadone are very different in terms of action. Methadone is a full agonist. While Suboxone is only a partial agonist. Methadone will fully "flip the switch on" for your receptors; Suboxone acts as a dimmer switch. Suboxone requires basically all of the fent to be out of your system before you can start taking them. Whereas methadone you could jump straight onto it.

 

[Ballu]

Amazing that you're able to find H, I'm assuming you're not in the US? Everything is fetty out here as far as I know.

My suggestion if you're trying to get off fetty, and already have access to the subs, is to use the Bernice method. It will help you transition from fetty to subs, without experiencing PW when done correctly. I've personally used it myself, and didn't experience any withdrawal symptoms neither time. Spent about a little over a week transitioning and tapering down the fentanyl, while also introducing suboxone in my system in microdoses. As I mentioned, when done correctly.. you will get on suboxone, without experiencing any WD symptoms.

 

[tidalferry]

Ok so I’ve been addicted to 1.5g of smoked fentanyl daily for the past year. I have tried cold turkey many times and simply cannot endure it due to the emergence of psychotic symptoms in conjunction with severe physiological symptoms. I have twice experienced severe precipitated withdrawal due to initiating buprenorphine at 20 hours post last fentanyl use, and have had minor success using ir morphine in doses of 15mg x4 daily for 1-3 days to replace fentanyl while allowing a washout to occur, followed by successful induction of suboxone at 12 hours post last morphine dose; however, I ended up relapsing on fentanyl a day later, not because suboxone didn’t work but because I wanted to get high. It surprised me how well the suboxone made me feel after a 72 hour fentanyl washout period using ir morphine to mitigate withdrawal and dosing suboxone 12 hours after morphine as is indicated in some new medical protocols.

My question is, can heroin be used in the same manner I successfully used ir morphine to bridge/washout fentanyl for 1-3 days and then induce suboxone 12 hours after last heroin dose? Given the close relation between ir morphine and heroin it would make sense that this was a potential avenue to suboxone induction without experiencing 72 hours of acute fentanyl withdrawal.

I know heroin is often contaminated with fentanyl but let’s say this heroin is not contaminated and let’s also say I have the will power to stick to the plan, ceasing heroin use (just like one would use oxycodone to bridge) after 24-72 hours, then waiting approximately 12 hours to induce small doses of suboxone. Is this a rational and potentially effective method of safely inducing suboxone when all else has failed and methadone isn’t an option?

For some bizarre reason 7OH and pseudoindoxyl actually induce a precipitated withdrawal state not dissimilar from suboxone induced PW and have done so consistently for at least 15 attempts so that’s out the window as a bridge for me. I’ve not tried plain leaf as a bridge and wonder if it may work but I’m more bringing this up to illustrate that kratom and it’s alkaloids, for whatever reason, induce withdrawal for me when used within close proximity (days) of fentanyl.

I’m currently nearing the end of day 1 using black tar heroin in place of 2g fentanyl. I’ve used approximately 1/4g and it’s approaching evening time. I’ve experienced no withdrawal from fentanyl other than cravings and that typical “things are out of control or feel unmanageable“ feeling associated with all opioid withdrawal. Theoretically I should be able to induce suboxone 12-24 hours after last heroin dose, correct? I’d like to stress that I tried so many times in various ways to quit fentanyl and induce Suboxone and each has failed miserably. The only attempt that was nearly successful as the use of instant release morphine for 72 hours prior to inducing Suboxone 12 hours post last morphine dose; and again I relapsed a day later out of boredom, even though I had successfully induced Suboxone 12 hours after the last morphine dose without experiencing precipitated withdrawal. There’s not much current medical literature on the subject, but there is some out there, of course, not in regards to heroin specifically but to short acting opioids as a bridge. My question is specifically in regards to the use of heroin as the short acting opioid as a bridge and the time needed between last dose of heroin and Suboxone induction. Sorry for the long fucking post I appreciate anybody’s Response and input.

Given how unpredictable fentanyl exposure can be, I’d be very cautious about trying to use heroin or another opioid as a bridge to buprenorphine on your own. The risk of precipitated withdrawal and overdose makes the timing and product purity difficult to predict. This seems like a situation where an addiction-medicine clinician could help tailor the induction approach and monitor symptoms safely. Having naloxone available and avoiding using alone would also be important while working through this.

 

[notsmokeymcpot42088]

^Dont sneak hyperlinks into quotes -- I think that was the issue.

 

[aspiringchemist]

Wow, so fent WD is hellish eh? I've oft wondered why fent addicts dont just switch to methadone and smoking weed. Am I being naive? Could it be that 160mg or whatever is the biggest dose of methadone still wont get a fent addict well?

Wishing you the best in this battle for your life.

cFzRX

At least Ime it feels much different than traditional opioid withdrawal. This is in regards to street fentanyl; idk if pharmaceutical is different. It comes on so quickly, like once the symptoms begin they just escalate at a rapid rate. All of them are to the extreme. It alters my perception and causes hallucinations, both visual and auditory. I’ve gone about 36 hours cold turkey and I physically couldn’t handle it anymore. Thrashing in bed, sweating, hallucinating, hyperventilating, heart pounding, with no signs of it letting up. Uncontrollably shaking. They’re all symptoms of traditional withdrawal but there’s something about the experience that, for me at least m, is qualitatively different than traditional opioid withdrawal, where you know it’s gonna be uncomfortable but manageable. Fent doesn’t feel manageable, it’s scary imo.

Using a different opioid to get through the acute fentanyl withdrawal seems to help; then you’re more or less detoxing from whatever opioid you’re using and it feels more controllable and predictable. I’ve brushed off of it at least 5 times now using either morphine or heroin but failed to stay off.

160mg methadone would cover it, and does for me. I just would like to avoid being a clinic patient for various reasons. I often buy methadone to stay well because it’s so much cheaper.

 

[aspiringchemist]

Amazing that you're able to find H, I'm assuming you're not in the US? Everything is fetty out here as far as I know.

My suggestion if you're trying to get off fetty, and already have access to the subs, is to use the Bernice method. It will help you transition from fetty to subs, without experiencing PW when done correctly. I've personally used it myself, and didn't experience any withdrawal symptoms neither time. Spent about a little over a week transitioning and tapering down the fentanyl, while also introducing suboxone in my system in microdoses. As I mentioned, when done correctly.. you will get on suboxone, without experiencing any WD symptoms.

You truly switched without going through withdrawal?

I’m in the PNW US. It’s been nearly impossible to find. I haven’t verified its fent free through analysis but judging by potency I can’t imagine it has any in it.