I was never on buprenorphine long term but people use tramadol while on it sometimes it works they say...and maybe other atypical opioids can work too but they probably provide u with their other then opioid effects while u are on buprenorphine. SRA + SNRI etc tramadol effect is actually very noticable and can be simmilar to low dose of amphetamine. But no it is not safe.
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Opioids I want to use opioids but I'm on suboxone
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4DQSAR
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Mostly buprenorphine is simply a competitive partial agonist. I assume if one has a sufficient quantity of an opioid with a similiar or higher affinity, they would compete (although the mean receptor-occupancy time might mean that buprenorphine stops the flash of an IV opioid.
But if someone has made it to buprenorphine, isn't the goal to eventially stop needing to consume opioids?
I can only say that I've talked to both police officers and probation officers who noted that people who went through full 'cold turkey' appeared less likely to return to opioids. I suppose the point being the sheer horror of the experience 'rewires' the consciousness to produce aversion to all opioids.
I did a lot of pure hydromorphone for example...had fentanyl and basically everything except levomorphan, methadone and very rare ones...And buprenorphine was so potent i couldnt pee..Smoking ton of pure hydromorphone made me so high it was in heaven but i still could at least pee...But buprenorphine must have extremely high affinity...U would probably have to consume a lot of some fentanyl derivatives to overpower buprenorphine....or fentanyl + some atypical...
And yes I agree that using buprenorphine as a substitution for other opioids should be enough to be satisfied and if u are not, maybe your tolerance is super high and using different drug on top of it - maybe just simple cannabis would be more effective than using other opioids on top of buprenorphine...Sure 1000mg of tramadol will make u feel something atypical but u will also suffer brain damage from seizure....
Try to look for uppers, psychedelics or cannabis...Downers are risky and opioids won't make u any higher cause u already are high on buprenorphine u just can't notice it now
Yeah, not gonna happen babe. You will never feel the effects of the good stuff while subs in your system. I’ve been there too. That’s why suboxone never worked for me. The cravings were so intense and relapsing meant just wasting money and not getting high.
I switched to methadone and honestly it saved my life. It has enough of a buzz that you don’t have cravings. Never got that with suboxone. I never thought I’d live to see the day without a craving. But I got on methadone for a couple years, tapered off, and now I have around 5 years completely free of opiates. Not one relapse, not one craving since. I say you give methadone a try. It could have the same outcome for you.
Message me if you ever have any questions
puke
Bluelighter
U know when I was on methadone I heard quite a few times people tell me u can't get high on dope while on methadone, like it counteracts it or something. Welp I'm telling u I could and that's why I would still occassionally do it an not have to worry about wds. People must say that to just kinda boogeyman u out of doing it telling u it won't work. Oh use to be on 100 mg and have been off 16 years now off methadone, can't believe it's been that long already.
U mean, taking an alpha blocker solve the "not being able to pee" problem ? I didn't have this problem now for many years if i take anything but if i knew this in the past, it would helped me a lot.
4DQSAR
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In response to your points - Yes and yes, it happens. It can be limited to certain opioids. I had two extremely painful experiences with tramdol.
You might think after being hospitalised a first time my clinician may have finally conceded that plain codeine or even dihydrocodeine would be better options. But no.
It was only because the same doctor in the hospital asked me why I was back with a week and being informed my GP refused to substitute that words were evidently exchanged and a formal letter sent.
As if I would be taking either of those very weak opioid for a buzz? Insane. Anyway my GP left the profession and became an aromatherapist of all things. I strongly suspect he KNEW he was getting so many formal complaints, it was better to change profession that be struck off.
I am mostly prescribed dihydrocodeine but they do rotations with morphine and once in a while with tramadol - i should not take it cause my epi risk is higher so they changed my main prescription to dihydrocodeine and for me it workes better than morphine. It's actually my second fabourite after hydromorphone. Tramadol works too but every day it has different potency so my liver enzymes probably work differently every day.
4DQSAR
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Wow - rotating opioids has pretty much been discredited, unless it's specific to your case.
I have to remind people that as synthesized, tramadol is in fact FOUR stereoisomers, the cis-pair being used medically. The bizarre thing is that the (1R, 2R) aka (+)-cis enantiomer, the semi-rigid homologue of codeine is responsible for almost 100% of the analgesia in man.
I have posted how cheap tramadol is and how simple it is to resolve those two cis isomers and then how simple to O-demethylate - (+)-cis ODMT having been shown to be around 2.5x more potent as an analgesic in man (orally). I would guess via paretheral administration and based on animal models it's a lot like morphine i.e. five times as active.
So why then is the cis-pair still the only form used medically? Because it was only ever sold as 'less abusable than codeine' without anyone adding 'oh yeah, also vastly more toxic in overdose'.
We had a mini-epidemic of mostly young people dying because they were messing with codeine phosphate tablets where a strip of 10 x 30mg provided them with a decent 'buzz' and street-wisdom suggested that 10 x 50mg tramadol should have more or less the same effect. So sad to say a lot of kids ended up dead - seizures being common.
Your tramadol safety concerns and also the enantiomeric part of your post is very true.
This seizures are preventable ( if u are lucky and some antiepileptic med will do absolutely nothig except only one effect - eliminating seizures completely. Which I am lucky in this situation ).
Many ultra rapid metabolisers are able to achieve long and semi amphetamine-like hybridhigh with tramadol, feeling ENERGY, EMPATHY, very intense opioid effects later when u have been through 3 hpurs of the high it can provide. I loved it but it is unfortunately more toxic then for example codeine phosphate. Yes it's true and it is also really cheap to produce compared to other mild ( if recommended doses are taken ) opioids.
Rotrating is not done usually.
My doctors from private algesiology clinic and me realised after a while that for me it does help preventing tolerance from getting higher but like i mentioned, morphine which they chose do less for me compared to dihydrocodeine and tramadol is used only after 2 rotations of previous were done because while it works for me it is dangerous because of seizures. I had many seizures, some of them while falling down the stairs. I had to learn how to write again after one
Classic codeine works for me too but for some another individual reason i coudn't stop tolerance to build RAPIDLY and they also say it is not very effective after certain dose because enzymatic metabolism to more potent metabolites is often reduced by the codeine - simply they know that codeine can prevent itselt from turning into morphine ( and others ). Tramadol do not have this disadvantage but it has even worse one - seizures.
So...after not even oxycodone was doing much for me and not wanting to go into hydromorphone again we made decision than dihydrocodeine is my individual preffered option.
And we tried many, i am on prescriptions for many years now...
Drugs including opioids can be very individualy different in effects.
Somebody would take oxy immediately rather than other choices but i found the best effects, most positive effects and least negative with dihydrocodeine which is quite poorly described in literature. U need to dig deepet to find the right descriptions ( i mean research proved descriptions like potency to receptors, half-life, bioavailability and metabolism into many metabolites....
Just try to find the righ one for YOU and avoid very appealing ones not because they can't be used safely but to use them when something serious happens and suddenly your casual painkillers will not help.
Just my advice.
Have a nice and healthy day everybody.
4DQSAR
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Ah - so that is why certain African-American musicians died from tramadol overdoses (African-Americans often having the genetics for ultr-rapid metabolizing of codeine, DHC, tramadol and I would GUESS hydrocodone and oxycodone. They got some sort of stimulant 'buzz'.
But at $280/Kg for tramadol and both O,O-DBTA and 48% HBr being similarly 'cheap as chips', I'm constantly amazed someone isn't cranking out (+)-cis ODMT as it's morphine-range in potency and I'm informed qualitatively similar as well.
One supposes it's because that would require SCALE and modern grey-market vendors make a few grams of some REALLY obscure but highly potent opioid, adding a Wikipedia page to increase verrsimilitude and by the time end-users know WHY it's really obscure, the vendor is making their next mystery powder. Some have the gall to use sock-puppet accounts to write rave reviewes here on BL. But someone who turned up a week ago and had a post count in single figures are rightly ignored. Still, it bugs me BL is abused to shill poison.
DeathIndustrial88
Bluelighter
Not necessarily. I got on buprenorphine because I lost my tramadol & heroin connections after 13 years. So the only fast & easy way to get a legal opioid for me was to get on buprenorphine. But my goal was never to actually quit using opioids or anything. And my clinic even knew that about me when I started & they were fine with that (as in, me wanting to be on bupe for pain & legal reasons, rather than using it to come off opioids forever).
Buprenorphine does have a high binding affinity. It's 45x more potent than morphine. I too use to get urinary retention on buprenorphine. I got it on all opioids generally but it always went away on full agonists. But on bupe, that side effect lingered for 10 years.
As far needing fent or whatever to break through bupe, it depends on what your dose of buprenorphine is. And your own bodily chemistry.
I personally can feel 30mg of hydrocodone or some heroin if I'm on a dose of buprenorphine lower than 4mg. But it varies. As for why some people aren't necessarily happy or satisfied with buprenorphine is because of it's partial agonism.
I got tired of buprenorphine, not because my tolerance was high or anything, but because the partial agonism provided subpar pain relief.
It made me more tired & sedated than full agonists too. All I wanted to do on buprenorphine was lay down & nap. It felt more like a sleeping pill than an opioid after awhile. And I could see how that could bother a lot of people who need analgesia or some sort of mental effects to lift their mood or get rid of cravings. I started feeling extremely dead inside on buprenorphine too.
When I was using tramadol, heroin or hydrocodone, my personality more or less stayed the same. Enhanced it even, like I would get really creative, appreciate art & people more, etc... But on buprenorphine, over the 9-10 years I was on bupe, it was like it slowly took away everything I enjoyed. Music started sucking, making music started sucking. I had no energy to focus or deal with anything anymore. I was constantly tired & anhedonic. So this is another good reason some one may want to get off buprenorphine & switch back to a full agonist. I truly felt like a shell of a person after so many years on bupe. I just couldn't take it anymore.
I was recently able to switch back to tramadol after buprenorphine. But I'm finding the switch to be a little difficult. I don't seem to be getting the same opioid effects from tramadol that I use to get for over a decade in my 20's. I think being on buprenorphine all these years, despite being a partial agonist, has raised my tolerance or something. It's strange because I can take full agonists (including trams) & I'll somewhat feel them, but at the same time I'll still get withdrawal symptoms from the buprenorphine (constant yawning, watery eyes, no energy). Makes me wonder if because buprenorphine is so potent, that once your body is use to having a higher % of receptors occupied (even by a partial agonist), going back to full agonists can be a rough transition, because while the full agonist will activate the receptor all the way, all those other receptors that are usually covered in bupe are still crying out to be agonized. And with a full agonist, you only ever have a small percentage of your opioid receptors covered at one time. But with bupe, if you take enough & for long enough, all of your opioid receptors become saturated. So it makes me wonder if it's still possible to have weird quasi-WD from buprenorphine even if you switch to a full agonist.
4DQSAR
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Wow - may I ask, do you pay for the clinic and the buprenorphine either dirctly or via insurance?
I've honestly never heard or a clinic saying such a thing unless they profit from so doing.
If nothing else, I've know people on buprenorphine substitution who were in a serious car-wreck and left in agony because buprenorphine has quite a limited analgesic effect, the ceiling seeming to be around that of 10mg morphine [Q4H] which isn't much. Especially if someone has tolerance due to the buprenorphine. The people I knew were given ketamine as an in-patient as the paramedics weren't confident that mixing the two was a good idea.
Maybe paramedics are better trained now, this was a long time ago.
I can see that like methadone, parking people on buprenorphine in theory is supposed to ensure that if they consume another opioid in a 'moment of weakness', it stops that opioid producing the desired effects. But all clinicians look for the best outcome (statistically) and I don't know of any who really want patients on a medication just because interactions are problematic. Buprenorphine being incompatible with other opioids (obviously), other CNS depressents, antidepressants, antipsychotics and as always, odd ones like certain antifungals, antibiotics and antiseizure medications - that last lot all because CYP3A4 is the main enzyme for buprenorphine metabolism and all those things listed monkey around with that enzyme.
I suppose this would all be considered and with fentanyl about and so deadly, parking a patient who openly says they would use opioids buprenorphine means parking is that best outcome.
Keif' Richards
Bluelight Crew
Hey @WellTram you may have covered this already in-thread, if so forgive me. Tramadol and Codeine are nearly identical in terms of pharmacokinetics. They are both pro-drugs that require 2D6 for conversion to O-Desmethyltramadol or Morphine respectively. It's stated interestingly that the bioavailability with Tramadol increases from ~70% - 90% with repeated dosing? Also, Tramadol is unique in this situation in that both 3A4 and 2B6 play a role in metabolizing O-DSMT to inactives. I suppose some of this could account for the unpredictability.
@4DQSAR if you are ever curious about how Methadone functions in the United States, I am un-proud to say that I am an authority on the subject. I've been in and out of the program for ~12 years, in different states.
In Vermont, clinic is public. You have to pay in theory if you lack insurance, though in practice, nobody has ever been cut off. In Nevada, my clinic is private/for-profit as are the majority in this country as far as I know. Here, if you don't have insurance you absolutely do need to pay. It is currently $16/day and they are increasing it to $18.50 January 1st.
For those who can't pay, you get a few warnings, then a final warning in writing, then an "Administrative Detoxification"; 25% reduction of your dose each day for 4 days before you fuck off. You would think this practice totally insane.
I would call the private clinics callous and almost predatory in how they operate. The tacit understanding is that you NEED them. They are your only way of getting it. This creates a sort-of monopoly for these clinics. Furthermore, in this business, your "clientele" rely on your product to eat, drink, wake, sleep, think, live. It's perhaps too much power to give individuals with a thirst for money that transcends their humanity.
Clinic doctors man. I could go on for days. I am not sure how some of these people got through medical school. I assume they blackmailed/killed/imprisoned/tortured the right people. It's one thing for a general practitioner to not be an expert on Methadone. It is an entirely different thing when the entirety of your practice of medicine concerns the prescription and management of a single drug. I love talking about drugs, so I always pick the brains of the clinic doctors out of curiosity and boredom. My current doctor at this clinic:
- Did not know what I meant when I referred to "Racemic Methadone". I literally had to re-explain the concept to her.
- I had to explain to her that a urinalysis for Methadone searches for its metabolite, not actual Methadone (She was warning against trying to introduce Methadone into a sample or some stupid shit)
- Did not have an understanding of the Opioid receptor system whatsoever. What is a Mu, Kappa, Delta, Sigma and what might they do?
- Did not know what NMDA stood for in reference to Methadone's pharmacology
This is the norm with these doctors; completely and totally out to lunch. Sober up in the morning, splash some water on your face, dress the top half of your body and run through a few intakes. Sign the scripts, do a bong rip and go back to bed. Hippocrates would be proud.
The one that always pisses me off. I tell them we found the solution to the Opioid epidemic decades ago. The solution was demonstrated to be administration of Heroin in a controlled, regulated manner; simple. Switzerland did it. The British had a solid system of Heroin prescribing until the 1960's when we forced them to get in line with our philosophy. Then illicit Heroin exploded.
I just get the "yeeeeaaaaa, I'm sure that worked out great". They would never even consider such a thing in a million fucking years. They are cogs in a machine designed by the DEAl, more idiots with little practical understanding of the issue.
4DQSAR
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I really appreciate your taking the time to lay it all out for me.
As you know, due to my work, I have cause to know how much bulk APIs cost. Raecemic methadone costs no more than $600/Kg.
HAT still exists in the UK. But it's now considered a second-line treatment and if I'm honest, it's only offered when it's pretty clear a client is about to drop off their perch.
The thing that REALLY bugs me is that The Netherlands probably had an even better treatment system than the Swiss. Bezitramide rather than methadone and their second-line treatment was Palfium tablets. The only opioid that provides an IV-like rush when consumed orally. I THINK Belgium and Luxembourg also used that system and it worked really well and in all cases was free.
People bang on that giving addicts opioids free just means people descide to become addicts...
I don't think a single client has EVER spent however much it costs to swindle the system into giving them relatively small but regular doses of an opioid.
I always thought you were a HR worker because all the good ones were or still are dependent users but crucially, functional. Every one of the HR workers I've thought great at their job certainly are or were. Obviously I won't be naming names. But some people who have done amazing stuff e.g. one founding the first methadone clinic in Kabul.
DeathIndustrial88
Bluelighter
Well technically it wasn't them that said anything, I just went in there & told them my stances on opioids. They were an "addiction/rehabilitation center".
I was already using buprenorphine that I was getting off the street at the time anyway & peed dirty for it, so it just made more sense to go get on it legally. Plus I told them I had been dependent on opioids for 10+ years prior (which I was) and with fentanyl cropping up at the time, I didn't want to get caught up in having to find opioids on the street, which could have been tainted with fent.
It's all dependent on the doctor & the clinic. Some clinics operate differently & force you to go to NA classes & all that. But I never had to do that, it was just recommended. Some doctors are assholes & very judgemental. Some are very open minded & some actually agreed with me that opioids aren't that bad. But every doctor & every clinic is different. I stuck with mine for a very long time because they were pretty open minded & didn't hassle me. They knew I wasn't your average, moronic drug user & that I had an interest in medicine & knew what I was doing. I also got mental health care & pain care there, even though I'm not sure they were in the field of doing that. But I got plenty of different meds while I was there other than just the buprenorphine. No other opioids or anything, but stuff like flexeril, baclofen, gabapentin, etc..etc.. I don't wanna get too personal about everything out in the open here, but yeah. Short of prescribing me a full agonist, they took pretty good care of me.
Methadone clinics on the other hand are vastly different than Sub clinics & they're a lot more strict, with having to come in to dose to earn take homes and all that. I've never been to a methadone clinic because of those restrictions. I can't handle going out somewhere every day just to take my meds. I need my meds before I can even function for the day, so it just seems arbitrary to me.
I walked out of my first Sub appt with a script for twenty-eight 12mg Suboxone strips & twenty 8mg generic Subutex (mono-buprenorphine) to take while I waited for insurance to cover the Suboxone. And this was waay back when they were capped at only being allowed to see like 200 patients or something like that. I don't think there's a cap now, but there was when I started.Last edited:
4DQSAR
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The mad thing is that in the UK, Aspire still starts clients out on daily pickup of buprenorphine i.e. it's just as much of a barrier to treatment as prescribing methadone.
But outside of prisons, I don't know if buprenorphine has ANY steet value. I've certainly never heard of it being sold on.
Methadone is cheap but dubious for all manner of reasons but times change so possibly since a linctus in a bottle is SO easily turned into 'aquadone', a pill still in it's patient pack is trusted.
But I suppose if someone has zero experience of opioids... maybe some do use buprenorphine?
Andrew Caesar Augustus
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Buy Some Kratom.
For starters work on getting your daily dose down. Bupe will saturate like 90% of your receptors at like 4-6mg. Any dose above that is purely diminishing returns (as far as binding to the opiate receptors in your body) as well as drastically increasing the shitty side effects.
With that out of the way, everyone is different. Some people can break through fairly high doses of bupe (8-12mg+). Others, like me have a hard time breaking through doses as low as 2 or 4mg. When I was on bupe I had to abstain from taking my script for at least 2 days with 3 days being ideal. Mind you, I was even using dirty 30s (fentanyl pressed oxycodone) and still had problems getting around bupes blocking effects. Good news, is that bupe withdrawal takes 2-3 days before it really starts; so you shouldn't be too uncomfortable while waiting for most of the bupe to clear your receptors.
Also just to clarify, I was never on the needle; most substances go up my nose (some I eat but that is substance dependant). So maybe, if I was banging said fetty I would have had an easier time. However, I cannot in good faith recommend someone go shoot up fentanyl to breakthrough Suboxone.Last edited: