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Bupe Suboxone/Buprenorphine FAQ and Megathread v.1; 2007 - 2010

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Suboxone re-induction help

First off, thanks to everyone who took the time to read and reply to my post. After going through 3 days of precipitated withdrawal twice in two weeks I find myself terrified of even trying to normally go back to the suboxone. Any tips on how force the issue? I can't bring myself to trash the outfits.

And regarding the 80mg of bupernorphine, I had read that in order to treat precipitated withdrawal, one should take 4-8 mgs/hour until symptoms subside.
 
Yeah, just wait until you are *properly* sick before you take the sub.

I then take 2mg doses every couple hours or so until I feel OK.

Your mileage may vary!

* I also wait around 10 hours since I took my first sub - then get a bag of H.

I find by this time the sub has done what its going to do, I feel "OK" - like 70% of normal. I find that if I do gear the first day then it doesn't get me high at all - but it makes me feel normal.

The next day, I just take some sub in the morning, and a smaller dose in the evening and I'm fine. By the second day I'm normally sleeping and eating as normal.
 
^^^ I think dude's got it right.... Although I would say take more like 1mg (or slightly less) every couple of hours... From what I recall, inpatient bupe detox gives .2 or .3 (point 2 or 3!) every two hours... That's a pretty conservative amount, but it's also the liquid suspension stuff so I'd say .8 or 1mg of the pills...

Many a junkie has self-induced misery by taking a whole 8mg pill on a medium or higher sized habit and hated it for a day or more! That post by the dude who kept taking 16 or 24mgs thinking it would kill the WDs on a 100+mg methadone maint. brought on the shivers just thinking about it!

I've done some careless shit myself. I'll never forget how HARSH it was taking a whole naltrexone pill thinking I could do the Ultra Rapid Detox thing by myself @ home with no general anesthesia, no benzos, no nothing! Anyone else here tried that? Describe it if so!

Also, has anyone ever hyperventilated as a withdrawal symptom?
 
The first time I ever took Subutex I had bought it off the street, and didn' know a whole lot about it.

I waited until I just started to feel slightly anxious - you know, the first "pangs" of withdrawal (about 5 hours).

I took 24mg. I was actually half-way through a lecture at college when I took them!

Holy fuck. It was a nightmare. I couldn't just say "I'm ill - I need to go home" as I looked and was acting fine just 10 mins ago. I also didn't want anyone to see I was in SERIOUS precipated wd, so I had to try and act normal. I even had to give a joint presentation!

Never, ever again.

That taught me to treat Subutex with respect - and to make sure I have at least 2 days off any responsibilites when switching over.
 
^^^ That's my problem, after the last 2 weeks of having to take time off from work and life in general twice for 3 days each, I can't bring myself to do it again. I need to time it so that I can go be in sufficient withdrawal (COWS of 6+) around midnight so that I can spend the night doing sub induction and hopefully come out of it by the morning and being normal enough to make it into work. Any ideas?
 
I hope someone can answer this question, it's always been bothering me: Can suboxone be used as an emergency way to bring someone out of OD? In other words, if someone kept a couple 8mg tabs of suboxone around and accidentally took too much heroin or oxycodone or fentanyl, could they pop a suboxone tab or 2 under their tongue and be OK?

Is the naloxone in sub pills to be used in this manner? I would think the naloxone in the tabs plus the competitive agonist manner of buprenorphine would mean that suboxone tabs can be used in this manner, much like naloxone is used in hospitals in emergency settings when an Opiate OD patient comes in. Anyone know if this is the case?
 
That's a good question..... it would seem that maybe since subs block the receptors for opiates, it could maybe prevent an OD, but I don't really think it could be used to revive someone from an overdose.
My guess is that in the ER they use those shock things to make the person regain consciousness, and try to somehow reduce the amount of drug in their system.
 
marti1317 said:
That's a good question..... it would seem that maybe since subs block the receptors for opiates, it could maybe prevent an OD, but I don't really think it could be used to revive someone from an overdose.
My guess is that in the ER they use those shock things to make the person regain consciousness, and try to somehow reduce the amount of drug in their system.
Click to expand...

No they do use IV naloxone is ER to bring someone out of severe OD. It is standard procedure and all ERs must have naloxone on hand for just that purpse, and in case somone accidentally recieves too much fentanyl or sufentanyl or alfentanyl as an anesthetic during surgery. So naloxone is the standard of care for reversing the effects of an OD. But I've never heard anything about recreational opiate users using suboxone to avert disaster when feeling an OD coming on or during an OD.

Precipitated WDs are basically the same thing, so it seems like it should.
 
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marti1317 said:
That's a good question..... it would seem that maybe since subs block the receptors for opiates, it could maybe prevent an OD, but I don't really think it could be used to revive someone from an overdose.
My guess is that in the ER they use those shock things to make the person regain consciousness, and try to somehow reduce the amount of drug in their system.
Click to expand...

No, they use IV naloxone for heroin overdoses.

You don't sound too well versed in the medical field, I wouldn't guess if I didn't know. Just some advise for how to post next time.

powerranger said:
I hope someone can answer this question, it's always been bothering me: Can suboxone be used as an emergency way to bring someone out of OD? In other words, if someone kept a couple 8mg tabs of suboxone around and accidentally took too much heroin or oxycodone or fentanyl, could they pop a suboxone tab or 2 under their tongue and be OK?

Is the naloxone in sub pills to be used in this manner? I would think the naloxone in the tabs plus the competitive agonist manner of buprenorphine would mean that suboxone tabs can be used in this manner, much like naloxone is used in hospitals in emergency settings when an Opiate OD patient comes in. Anyone know if this is the case?
Click to expand...

It shouldn't be used for that matter. You should use a vial of naloxone. A suboxone tablet takes too long to onset and you're going to have the person die with that nasty orange taste in their mouths...what a horrible death that would be.

When someone is ODing on heroin or morphine or any other opiate, you call 911. That, or you administer IV naloxone if you have a vial and some syringes and know what you're doing.

Don't use suboxone in the case of an overdose situation. That's a horrible idea.

powerranger said:
But I've never heard anything about recreational opiate users using suboxone to avert disaster when feeling an OD coming on or during an OD.

Precipitated WDs are basically the same thing, so it seems like it should.
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You'd be putting yourself through hell.

The thing is, if you're having an overdose with an opiate like heroin and you're also on other sedatives like a benzodiazepine, adding buprenorphine into the mix could be very dangerous.

In an OD situation, you call 911. That's how that goes.
 
marti1317 said:
i'm sorry. you are smarter than me. congratulations=D
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Also, "those shock things" are otherwise known as defibrillators. I believe that's what you were attempting to refer to.

http://en.wikipedia.org/wiki/Defibrillation said:
Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.

Defibrillators can be external, transvenous, or implanted, depending on the type of device used or needed. Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no training at all.
Click to expand...
 
I knew what they're called, I've watched almost every episode of House. I just couldn't think of it at that moment. And I knew anyone with half a brain would know what I was talking about, so I wasn't gonna waste my time googleing it or something. Sorry i didn't use the correct terminology....:(
 
dopiate said:
Way to demonstrate your intellectual insecurities to the board you pompous deuchebag. I hear Jeopardy is aching for individuals with the ability to use wikipedia.
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People shouldn't guess about things they know nothing about, clearly displayed by poor wording choices, grammar and spelling mistakes.

Correcting people's inaccuracies is part of being on an online forum.

If you don't like being corrected because you were wrong, don't guess about things you don't know. It's as simple as that.

Marti1317 - I'm sure you knew the word too, but watching House episodes isn't the same as being trained in the area of pharmacology.
 
Captain.Heroin said:
No, they use IV naloxone for heroin overdoses.

You don't sound too well versed in the medical field, I wouldn't guess if I didn't know. Just some advise for how to post next time.



It shouldn't be used for that matter. You should use a vial of naloxone. A suboxone tablet takes too long to onset and you're going to have the person die with that nasty orange taste in their mouths...what a horrible death that would be.

When someone is ODing on heroin or morphine or any other opiate, you call 911. That, or you administer IV naloxone if you have a vial and some syringes and know what you're doing.

Don't use suboxone in the case of an overdose situation. That's a horrible idea.



You'd be putting yourself through hell.

The thing is, if you're having an overdose with an opiate like heroin and you're also on other sedatives like a benzodiazepine, adding buprenorphine into the mix could be very dangerous.

In an OD situation, you call 911. That's how that goes.
Click to expand...

I know they SHOULDN'T be used for this purpose. I'm well aware of the biochemistry and pharmacology of naloxone and naltrexone. What I was asking was if they COULD be used this way. I know it isn't the ideal solution to an opiate OD, but I'm sure there have been people who have had suboxone on hand and have taken too much of heroin or oxycodone or some other opiate. Maybe they feel dysphoric, are vomiting, and can't see straight. I was wondering in that situation, if they either couldn't call an ambulance/hospital or just didn't want to go the hospital, could they take 1 or 2 tabs of sub to avert the

Also, you don't have to be so aggressive to people that make a mistake. The guy below me clearly said he didn't know but was curious, and then he made a guess on what he thought a possibility was. There's nothing wrong with this, its called contributing. There's just no reason to act like that. And when you act like that, people look down on you, not him. Belittling someone does not embarass them, it makes people think less of you. So it has the opposite effect of what you were trying to accomplish. Just ease up a bit on people, and people will return the favor.
 
i've UA'd a few posts on this last page. cut the shit out, captain.heroin is simply stating facts, we're not here to spread mis-information. i can see how captains words could be mis-construed as harsh, but this is the internet, words get conveyed in many different ways.

now back on topic
 
powerranger said:
I know they SHOULDN'T be used for this purpose. I'm well aware of the biochemistry and pharmacology of naloxone and naltrexone. What I was asking was if they COULD be used this way. I know it isn't the ideal solution to an opiate OD, but I'm sure there have been people who have had suboxone on hand and have taken too much of heroin or oxycodone or some other opiate. Maybe they feel dysphoric, are vomiting, and can't see straight. I was wondering in that situation, if they either couldn't call an ambulance/hospital or just didn't want to go the hospital, could they take 1 or 2 tabs of sub to avert the

Also, you don't have to be so aggressive to people that make a mistake. The guy below me clearly said he didn't know but was curious, and then he made a guess on what he thought a possibility was. There's nothing wrong with this, its called contributing. There's just no reason to act like that. And when you act like that, people look down on you, not him. Belittling someone does not embarass them, it makes people think less of you. So it has the opposite effect of what you were trying to accomplish. Just ease up a bit on people, and people will return the favor.
Click to expand...

I've noticed that when people ask a question like yours, and someone answers with the false and/or dangerous conclusion that people who ask questions like this "want to hear", they take it as validation that yes, it is ok.
Then it becomes difficult to convince this person that it is not ok according to the best information at our disposal.

While the atmosphere and environment is important (as this is a social place by default) to foster exchange of ideas and information, I think it's more important that the information is correct and safety is everyones primary focus.

Above all else, Bluelight is a Harm Reduction forum. It is important that we do not allow or support false or dangerous advice or information. People often do take what they are told or asked or read on here to heart and act on that information. Therefore it is very important that we all do our very best to make sure our answers are in fact true or at least based on good faith.

I think it is more important that good, solid information is expressed than whether or not this place is comfortable and fun for everyone. Safety and Harm Reduction are very serious.

Refer to the Overdose FAQ:

http://www.bluelight.ru/vb/showthread.php?t=369616

What if I have Narcan, Suboxone, Naltrexone, etc?

Unless you are qualified and experienced, you should not rely on these. This is someone's life we are talking about, and if you fail you will be responsible for their death. Are you willing to bet you know exactly what you are doing and can handle the pressure? Are you willing to bet their life and the possibility of knowing you killed someone?


Do not use Suboxone, or administer Suboxone in any way! While there is Naloxone in it, the main ingredient in Narcan, the binding affinity of buprenorphine, the main opioid in it, is extremely high, so high that it rivals the Naloxone. By administering Suboxone to an overdose victim you may very possibly be effectively increasing the amount of opiates in their system. In plain English, don't use Suboxone, it won't work, and will make the EMT's job harder.

Do not attempt to shoot them up with Narcan unless you have proper medical experience doing so and are personally qualified, and do not try to shoot them with naltrexone. While these methods may work, are you really going to bet the person's life that you can do this correctly, the first time you ever try to, under such pressure you are not familiar with? No, it would be stupid. Call 911.
Click to expand...
 
Mods, i'm sorry for arguing with Captain Heroin. Maybe I am being too sensitive, but I thought I made it clear that my post was merely a guess and that I didn't really know the correct answer, but i was also curious:



marti1317 said:
That's a good question..... it would seem that maybe since subs block the receptors for opiates, it could maybe prevent an OD, but I don't really think it could be used to revive someone from an overdose.
My guess is that in the ER they use those shock things to make the person regain consciousness, and try to somehow reduce the amount of drug in their system.
Click to expand...

The way Captain Heroin responded included the correct answer, but also an attack at me. I just wanted to stand up for myself.
 
Tchort said:
I've noticed that when people ask a question like yours, and someone answers with the false and/or dangerous conclusion that people who ask questions like this "want to hear", they take it as validation that yes, it is ok.
Then it becomes difficult to convince this person that it is not ok according to the best information at our disposal.

While the atmosphere and environment is important (as this is a social place by default) to foster exchange of ideas and information, I think it's more important that the information is correct and safety is everyones primary focus.

Above all else, Bluelight is a Harm Reduction forum. It is important that we do not allow or support false or dangerous advice or information. People often do take what they are told or asked or read on here to heart and act on that information. Therefore it is very important that we all do our very best to make sure our answers are in fact true or at least based on good faith.

I think it is more important that good, solid information is expressed than whether or not this place is comfortable and fun for everyone. Safety and Harm Reduction are very serious.

Refer to the Overdose FAQ:

http://www.bluelight.ru/vb/showthread.php?t=369616
Click to expand...

Ah, thanks for the link and quote. That is helpful and that explains it pretty well. Just FYI, I was never going to attempt this and I never had any intention to. It is just something that I've always wondered about.

But I do still have a lingering question: What about precipitated WDs? Aren't those based on the fact that adminstering suboxone or buprenorphine to someone high on heroin causes the bupe to kick off the heroin from the mu receptors and replace it with bupe? And because the dose of bupe given USUALLY is less potent than the dose of heroin sitting on the receptors, the person goes into precipitated WDs. Using that logic, if someone is ODing on heroin, wouldn't adminstering a moderate does of buperenorphine with or without naloxone cause the heroin to be kicked off the receptors to be replaced by the bupe, and thus causing the person to go into precipitated WDs just like a normal person is just high instead of ODing?

Sorry for all these questions, but I've always wondered this and its kind of fascinating to me since I am curious about pharmacology. Thanks for any info.
 
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