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

[ingannilo]

I feel like I am in a world of shit...

I have been on Buprenorphine (Subutex) for about 7-8 years now, and I feel like I am a slave to my own body. My gf at the time thought it would be fun to snort our medicine, and being the lovesick idiot that I was, I started to abuse my medicine. Here I am 7 years later, and I still snort my pills. (I feel like Chris Rock from New-Jack City, crying but still smoking that hit off his crackpipe)

I wake up, snort 1/2 mg, and continue to snort 1/2mg about 6 times throughout the day. I take my meds based on "how I feel," not on a standard consistent daily regimen as prescribed. As a result, a few hours after I snort each dose, my thoughts start to race, my emotions tend to flair up, and my anxiety increases. Essentially I need my "fix."

I am a doctor, and I just started a new job where I treat patients from 8AM-5PM. It is very demanding, and I need to be focused, and for the most part this is not a problem, except for when I need to sneak away form the other residents during lunch and snort my bup, and perhaps once later on in the afternoon.

I can not live like this anymore, yet it is so engrained in the way that I live. It's the "pre-WD paranoia" that keeps me from making any sort of meaningful progress.

Essentially I need to:
1) go from snorting --> sublingual
2) Stabilize myself at a consistent daily dose
3) take all my medicine at once when I wake up in the AM
4) When I feel comfortable, begin to slowly taper down
5) schedule a vacation, or whatever, so I can go to 0mg

It seems so easy, yet I always get tripped up at step 1. Sublingual seems to be stronger, and if I take the same dose, I end up raising my tolerance. I tried to do this over my summer vacation, and the net result was a 2mg increase (I went from about 4mg-6mg).

I CAN NOT live like this anymore! I just can't! The constant mood swings, emotional outbursts, going from nodding --> crying. I am a doctor for god sakes, I need to be more solid. Not to mention I am single, and need to focus on my dating/personal life, and the more I take the lower my libido gets.

I feel like I can't talk to my psychiatrist about this, because I don't want him to know that I am abusing my medication. I can't talk to my family, I have no wife or gf. NA doesn't work for me...I am truly alone in my struggle.

I feel like I am in a world of shit. I want out of this nightmare!

It's not that hard to kick bup from any dose < 2mg IME.

I also feel sick in the mornings when I first get down to low doses (<2mg), but I just suck it up. It's not so bad, and you stabilize here in a week or two tops.

It's very important to keep your dosing consistent. Beyond words important. That's the whole point of maintainnance.

You know all this stuff if you're a physician. You can do it, just be strong.

My favorite way to combat the feeling of "constant minor withdrawal" in a taper is by scheduling vigorous exercise for the times of day when it's worst. In the morning and evening I go for bike rides/do yoga/stretch out/go on a run. It makes me feel a million times better, especially if you take a bath afterwards to clean up.

I always get tripped up at step 1. Sublingual seems to be stronger, and if I take the same dose, I end up raising my tolerance. I tried to do this over my summer vacation, and the net result was a 2mg increase (I went from about 4mg-6mg).

That's a pretty lame excuse, and it doesn't make sense. If it's stronger under the tongue for you, why would you raise your dose? When you say net result, do you mean "When I gave up taking the medicine responsibly" resulted in a 2mg increase? If you get more effect from putting in under your tongue, then adjust your dose accordingly!

Really now. Tough up, get out, and stop making excuses. If you intend to get off of the drug you can do it. Sounds like you're still stuck in the "deciding to stop" phase (8 years on bup!)

There's nothing wrong with staying on the meds, especially if you're living a responsible and satisfying life. However, if you do honestly want to get off, just do it. You're making it seem way harder than it is.

You stop putting it up your nose but not putting it up your nose anymore.

 

[JohnnyGoodBoy]

But just this morning I woke up feeling like half dopesick, like so groggy and tired that I don't want to function until I do my bupe. And it's been like this for a few weeks, unless I dose late at night, I wake up feeling like I'm in mild withdrawal. Last time I felt this way I tapered down and got off bupe because at the time I was completely sober and was sick of the ups and downs.

This is EXACTLY how I feel all day! Up/down/up/down. It isn't until the end of the day when I have all of my daily bup in my system until I finally feel "normal." And logic would say, then do MORE in the morning. But if I do that, I end up using more throughout the day.

Ideally I wish I could simply wake up, take my full daily dose sublingual, and go about my day. Hell, I'll settle for 2X/day sublingual. Anything but the way I'm doing it now. I'm around doctors all day, and they are very perceptive, and sooner or later they'll notice something bizarre about my behavior and call me out, I guarantee it!

Why don't you just taper off the bupe as slow as possible to not get w/d symptoms (even if it takes 6 months to taper) but take less and less, and take it sublingually, it lasts longer... or ask to change to methadone, and taper off methadone... i've gone from 90mg to 40mg... from 90 to 50 was easy, now its starting to get hard,,,

but be strong, if you trully want to quit you will find the will power!!!

Good luck

Every time I implement a taper schedule I break it within the first few days. I possess a really sensitive milligram scale, so theoretically I can create a taper schedule that would take me down so gently, I wouldn't feel anything. But If i don't stick to it, it's pointless.

I disagree about methadone. I think being on bup is a MUCH better situation for a long list of reasons. It isn't even something I would consider.

Im fairly sure that intranasal and sublinguil BA is roughly the same.

That's what they say, but not in my experiences. I find that intranasal hits me faster, but doesn't last as long. And sublingual is stronger, and sustains me more throughout the day. The net result is that I require a smaller dose sublingually, yet I don't get the "snorting" buzz (be it physical or psychological).

I think half my problem is that I'm snorting medicine 7-8 times a day, which makes my nose run, and my eyes water, and makes me FEEL like a drug addict.

his shit is strong. Its a godsend but eventually becomes a curse!

Exactly! But all things being equal, it saved my life, and the positives outweigh the negatives. God only knows where I'd be right now if it wasn't for buprenorphine. I guarantee I would NOT be a practicing doctor.

I have a VERY light day tomorrow (no patients). I'm going to experiment by picking a dose slightly below what I've been snorting (lets say, 5mg instead of 6mg). I'm going to break that 5mg into 2 or 3 doses, and choose EXACT times to take them tomorrow (lets say 7AM, 12PM, and 6PM). I might "frontload" the day, taking more at 7AM and progressively less at 6PM.

Who knows, this might work, and might be a disaster, but it is worth a try. I need to take control and start making SOME sort of progress here! I can not continue living my life this way.

 

[JohnnyGoodBoy]

That's a pretty lame excuse, and it doesn't make sense. If it's stronger under the tongue for you, why would you raise your dose? When you say net result, do you mean "When I gave up taking the medicine responsibly" resulted in a 2mg increase? If you get more effect from putting in under your tongue, then adjust your dose accordingly!

Really now. Tough up, get out, and stop making excuses. If you intend to get off of the drug you can do it. Sounds like you're still stuck in the "deciding to stop" phase (8 years on bup!)

There's nothing wrong with staying on the meds, especially if you're living a responsible and satisfying life. However, if you do honestly want to get off, just do it. You're making it seem way harder than it is.

You stop putting it up your nose but not putting it up your nose anymore.

ok...um...just stop, got it. You should write a book on beating addiction entitiled "Addiction: Just stop." It'll be one page long, you'll save a shitload of money on paper and ink!

anyways...what I was trying to say is that before I was snorting 4mg/day. Then I switched to sublingual 4mg/day for a few days. Unfortunately, I relapsed to snorting and felt like 4mg snorted was no longer keeping me stable, so I started to do more before I realized I was up to 6mg (which is where I am now).

I'm posting this because I am well aware that I have a problem, I'm not all happy about it. Who knows, maybe I CAN muster up the strength to "just stop" snorting my bup, and TRUST ME, I hope I have that strength inside of me. I've kicked this stuff before in the past (I've been on it for 8 years, but in that time I did manage to taper/get clean for about 4 months).

PS - I'm not a physician. I am a doctor, and I do have a DEA liscence, but I want to keep myself as anonymous as possible, so lets just keep it at that.

 

[Eight0Eight]

Aren't you tempted to get hold of a shit load of REALLY GOOD painkillers - and enjoy?. It must be reletively easy being a GP.


I can't even imagine being in such a position - it would be savage. Utter pure chaos. The only thing worse would be a chemist.

The fact that you have managed to hold onto a good job (with such obvious "attractions") whilst being a junky - should give you at least a bit of motivation through your taper.

Try dosing twice a day, like you talked about. It certainly works fine for me. I'm on 1.6mg/day. I do 1.2mg in the morning, and 0.4 at night. I wake up a little sick in the mornings but once I've dosed I'm fine.

 

[Captain.Heroin]

Essentially I need to:
1) go from snorting --> sublingual
2) Stabilize myself at a consistent daily dose
3) take all my medicine at once when I wake up in the AM
4) When I feel comfortable, begin to slowly taper down
5) schedule a vacation, or whatever, so I can go to 0mg

It seems so easy, yet I always get tripped up at step 1. Sublingual seems to be stronger, and if I take the same dose, I end up raising my tolerance. I tried to do this over my summer vacation, and the net result was a 2mg increase (I went from about 4mg-6mg).

1) This should be the easy part if you value your nasal membrane.
2) & 3) You don't need to dose 1 time a day, you can take buprenorphine sublingually two to three times a day. I find it more efficient than just once a day.

If you're getting tripped up at step one, you need to talk to a therapist about why insuffulating drugs is specifically addictive for you, and how you can work past that.

emotional outbursts, going from nodding --> crying.

It sounds like you have something on your mind that you should talk to a therapist about...that's not really normal. Most people don't cry when they're on buprenorphine, to the contrary, most people find it to be a really effective antidepressant.

I think you have some issues you need to work on. Especially if you didn't get this "nodding->crying" effect from the sublingual route. If you did, then it stands to reason that you aren't reacting well to the medication and you should switch to another ORT program. Some people get god-awful side effects, even from such a low dose as 0.5mg, such as irritability, extreme itchiness (which transcends beyond any itch inspired by heroin), etc etc.

I am a doctor for god sakes, I need to be more solid. Not to mention I am single, and need to focus on my dating/personal life, and the more I take the lower my libido gets.

It sounds like you have interpersonal issues which are causing the depression. IMO most people would be pretty happy to get to snort buprenorphine up to 6x a day.

I feel like I can't talk to my psychiatrist about this, because I don't want him to know that I am abusing my medication. I can't talk to my family, I have no wife or gf. NA doesn't work for me...I am truly alone in my struggle.

So, you don't have any friends? It sounds like you need to make some friends. Even if you don't want to talk to a psychiatrist about this, which is understandable, you must have someone to talk to.

Did you get through college not having a single buddy to talk to?

I don't really consider snorting subutex as "abusing medicine" it's just using it. You can't abuse a drug, it's not like you can mentally or physically abuse any drug. It's a drug, not a living thing.

If you aren't so hard on yourself and you look past using your subutex, you might not feel so bad about it and may be able to feel better about not snorting it any more. Your post says to me that you get down pretty hard on yourself...you don't need to do that man. Getting down on yourself is what gets most people craving opiates in the first place. If you had a more positive outlook, then maybe you wouldn't feel like you "needed" to do what you are.

Also, you're going to have to go through withdrawals anyways. Buprenorphine only helps minimize the symptoms. Snorting your medication is going to ensure you have a worse WD, because you're dosing more times than necessary. If you don't like feeling like you're coming down all the time, I wouldn't snort subutex any more.

When you get down to low doses, I find it doesn't hold you properly for the whole day (regardless of ROA).

Even when I was sublingually using buprenorphine, 4mg at a time wouldn't last me all day. I still dosed 2 or 3 times during the day.

I've been sniffing my bupe for a while because the bioavailabilty is better.

By only 20%. That's not that much better. Also, if you want a higher BA, try 6/7's sublingual + alcohol method.

But just this morning I woke up feeling like half dopesick, like so groggy and tired that I don't want to function until I do my bupe. And it's been like this for a few weeks, unless I dose late at night, I wake up feeling like I'm in mild withdrawal. Last time I felt this way I tapered down and got off bupe because at the time I was completely sober and was sick of the ups and downs.
I think I'm going to try tapering and maybe going sublingual (but idk, it doesn't ruin my taste for 2+ hours if I sniff it...suboxone tastes awful). But once I taper down low enough I'm going to take kratom 15x extract for a few days and then hopefully quit.

You should try tapering indeed. If you're taking too much buprenorphine, it can lead to WD-like symptoms, and feeling like you can't do anything without it.

I would stop snorting it, because it's not helping you out. I also wouldn't bother with kratom, if you get down to 0.5mg/day or lower, jumping off should be easier. If you find it isn't, you can always go to dosing every other day.

Im fairly sure that intranasal and sublinguil BA is roughly the same.

Sublingual is around 30% (give or take) while snorting it is around 50%.

You can boost the BA higher than just 50% by using 6/7's method, which is why I never understood why people would even bother snorting buprenorphine.

Its a godsend but eventually becomes a curse!

Would you rather try to quit using heroin? Is that less of a curse for you?

I might "frontload" the day, taking more at 7AM and progressively less at 6PM.

Buprenorphine is much more effective at a similar dose, so that you keep the level of drug in your system at a steady rate. This will help ensure you feel the least WD symptoms.

 

[ingannilo]

I'm not trying to be cold, but there's nothing else you can do. "Addiction: Just Take The Time To Get Your Priorities Straight, Muster Up Some Will Power, and Slowly Stop" would work but it's a bit wordy. I was(and am) offering genuine from the heart advice, not trying to condescend.

Exercise, a nice long taper schedule, and will power are all you need once you make the decision to come off. That's good news, because we've all got those on tap if we take the time to bring 'em to the surface.

The issue seems to be a willingness to face reality, and that's reflected in you expressing surprise at me suggesting you just stop snorting your bup. What you want to hear is some magical answer that will absolve you of respnsibility for how choose you take your drugs. With this formulation that doesn't exist.

There's a few threads on bup patches. Maybe consider those.

No hard feelings, mate. I'm just being honest.

 

[liquidfyre]

Suboxone sublingual question

When i take my suboxone i noticei get alot of spit and am worried that i am actually just swallowing it instead of letting it go through the bloodstream under my tounge..

does anyone have any tips on how to reduce this?

 

[Captain.Heroin]

Exercise, a nice long taper schedule, and will power are all you need once you make the decision to come off. That's good news, because we've all got those on tap if we take the time to bring 'em to the surface.

I agree here.

Committing the time to exercise is what's going to help you feel better the most. I regularly work out (muscular and cardio) and it helps a lot with endorphins, and the effectiveness of buprenorphine.

The issue seems to be a willingness to face reality, and that's reflected in you expressing surprise at me suggesting you just stop snorting your bup.

I agree, +1.

What you want to hear is some magical answer that will absolve you of respnsibility for how choose you take your drugs. With this formulation that doesn't exist.

Thank you, +1.

No hard feelings, mate. I'm just being honest.

I agree immensely. There's no Get Out of Jail Free card; it's something one must do for themselves.

 

[Captain.Heroin]

You should have posted this in the Buprenorphine Mega Thread.

Prepare for the merge!

If you want Suboxone to dissolve efficiently underneath your tongue, try applying some high proof alcohol with the pill underneath your tongue; it will help dissolve the pill very quickly and effectively, and you can spit out the saliva after a few minutes.

 

[liquidfyre]

i just put some alcohol under my tounge as well? I hate the megathread becasue its too mega now..

 

[Captain.Heroin]

i just put some alcohol under my tounge as well? I hate the megathread becasue its too mega now..

http://www.bluelight.ru/vb/showthread.php?t=404947 <- 6/7's sublingual buprenorphine with alcohol thread. Read up, it's interesting.

What the hell do you mean by "too mega"? We recently created the 3rd one: http://www.bluelight.ru/vb/showthread.php?t=440368&page=17

A mod is going to lock or merge your thread anyways, did you think posting your own thread would be more efficient than posting in the mega thread? I typically answer most of the questions in the buprenorphine mega thread anyways.

 

[morphonorconic]

ok...um...just stop, got it. You should write a book on beating addiction entitiled "Addiction: Just stop." It'll be one page long, you'll save a shitload of money on paper and ink!

Good shit! This gave me a good chuckle.


Anyway, anything I would say has pretty much already been said, and you know what must be done. I understand you have spent years in this pattern of behavior, but there are no written rules for beating an addiction, so don't be so hard on yourself when you have those occasional lapses in willpower.

Just take it moment by moment, and think of what's at stake. Best wishes,

 

[ingannilo]

let me preface this by saying i know theres so many threads about this, and ive searched, but i dont want to get lost in the mix (not to mention how huge the megathread is), and am looking for some quick, specific advice to my situation, so thanks in advance... (maybe this should be moved to the megathread, idk)

so after a 5-6 month dope sniffing habit, i got on a methadone program. was on that for a couple months (55-60mgs, then down to around 45 before quitting), and stopped going last weekend after sleeping in on a saturday and missing my weekend dosage. so i got some dope, and holy jesus my tolerance was much larger than when i got into the program. it took me 5 bags just to feel half normal! i was already on a done taper, and it wouldve been another month and a half till i was off, but well i fucked up, and it is what it is, and i want to quit the cycle now more than ever. so i've had a hellish week tapering down on heroin from 5 bags to where im at now with 1-1.5 bags a day the past two days.

so, im about ready to drop the dope habit now that i got to a low dosage, and considering im going on vacation in a few weeks and want to be opiate free. so i have four, 8mg buprenorphine (orange) tablets, and im looking to taper from my now one bag a day habit with them pills. the girl i got them from said at that tolerance, i should take one, wait 2-3 days and if i feel i need more take another 4mgs (half a tab) and that should do it. is it really that easy? i can handle a bit of discomfort as shown by this past week of tapering heroin. should i use the full four tabs to taper or just follow the advice i already got and see how i feel? how long after using should i pop the first tab? any kind of schedule? can i be opiate free in 5-7 days? oh i've also got valium and loperamide to help. thanks a million you guys. any help would be hugely appreciated!

edit: oh yeah, am i going to feel any lingering affects from the methadone after the two weeks (this past one and the coming bupe taper one) of being off of it? maybe not bc of my low dosage and short stint on it?

Wait until you're proper sick to dose the buprenorphine.

You do not need 8mg of bup if you're sniffing 1.5 bags per day. You don't need 4mg either. Start with 2mg (quarter of a pill) and wait a day (you won't feel great, but taking more will not help!). The next day break off another 2mg but crush it into powder and divide into two almost equal piles. Take the larger pile that morning (under the tongue) and then if you're too ill to sleep in the evening take the other pile.

Once you get to the point where you don't need the second dose (if you ever did) start dividing into perfectly even piles and taking one of those (1mg) per day.

Then stop whenever you feel ready, or repeat the process and lower your dose more (divide 1mg piles into two blahblahblah)


you can PM me if you'd like with any questions. keep us updated.

 

[JohnnyGoodBoy]

The issue seems to be a willingness to face reality, and that's reflected in you expressing surprise at me suggesting you just stop snorting your bup. What you want to hear is some magical answer that will absolve you of respnsibility for how choose you take your drugs.

I've been through too much in life, and in too smart to believe in some sort of "magic answer." Yet, as we speak I am taking your advice and hopping on the treadmill to get some sort of exercise regime going.

I'm looking for advice, seeking out those with similar life experience, maybe seeking sympathy, who knows?

I know there is no magic pill. I also know I am more or less alone in my journey, so I post online because it acts as some sort of support.

@Captain: I have one friend I can talk to, but she is very consumed with her own life, and I only confide in her on rare occasions.

My family is in the dark. My fiancé left me 2 years ago. And lately my social life has flatlined. As a result, I tend to befriend lame ass lossers, and wind up thinking "WTF am I doing wasting my time with this person."

When my confidence is up, I get chicks, I go out, I enjoy my own company, and generally LOVE life.
When it is down, I become my own worst enemy and even get incredibly needy.

I am a very introspective person, and I know I have some issues, and it's all one big spiderweb.

The good news is that when shit gets bad, I always make it out of the darkness. I'm a fighter.

 

[ingannilo]

When i take my suboxone i noticei get alot of spit and am worried that i am actually just swallowing it instead of letting it go through the bloodstream under my tounge..

does anyone have any tips on how to reduce this?

This is something that just takes practice to get right. Do not swallow your saliva while you can taste any buprenorphine in it. You correctly presumed that doing this wastes a lot of the drug.

I find that there is a muscle under/part of the tongue which need to be trained to relax in order to slow saliva production. Push up with your tongue on the roof of your mouth(right now, without drugs in there). See what I mean? When you take the buprenorphine relax your tongue/that muscle and breathe steadily through your nose. Relax your jaw but keep your lips together.

After about 30 minutes you can swallow or spit out the saliva.

 

[ingannilo]

I've been through too much in life, and in too smart to believe in some sort of "magic answer." Yet, as we speak I am taking your advice and hopping on the treadmill to get some sort of exercise regime going.

I'm looking for advice, seeking out those with similar life experience, maybe seeking sympathy, who knows?

I know there is no magic pill. I also know I am more or less alone in my journey, so I post online because it acts as some sort of support.

@Captain: I have one friend I can talk to, but she is very consumed with her own life, and I only confide in her on rare occasions.

My family is in the dark. My fiancé left me 2 years ago. And lately my social life has flatlined. As a result, I tend to befriend lame ass lossers, and wale up thinking "WTF am I doing wasting my time with this person."

When my confidence is up, I get chicks, and LOVE life.
When it is down, I become my own worst enemy and even get incredibly needy.

I am a very introspective person, and I know I have some issues, and it's all one big spiderweb.

The good news is that when shit gets bad, I always make it out of the darkness. I'm a fighter.

I'm familiar with the feelings you mention. Shit can be real tough sometimes and it's hard to stay positive. Running will help, I promise that. If you need someone to talk to you can PM me or whathaveyou. I know it's not quite the same as a good friend you've known all your life, but you know.

I'm at about the same place you are/were (2mg, but under the tongue). The withdrawal does go away and you do start to feel more stable after a while. The last few steps are always the hardest. Part of me advocates hopping off around this dose just because the withdrawal from 2mg is comparable to the withdrawal I've experienced during the process of tapering down lower, but you get that sensation of "finally doing it", "getting it done". EDIT: the one time I did jump from 2mg I had a really good network of supportive friends and family at the time, though. That helped a great deal.

 

[Betterdaze]

I just took my first 4 mgs(prob. need to take more) but it tastes like shit. It says it's lemon lime flavored, ya right. Plus my mouth was very dry.

 

[ingannilo]

I just took my first 4 mgs(prob. need to take more) but it tastes like shit. It says it's lemon lime flavored, ya right. Plus my mouth was very dry.

that didn't contribute to the thread at all &belongs in your journal.

ps- if you tasted it you wasted it.

 

[Betterdaze]

Starting Sub today

The answers I'm looking for are probably in the thread but I'm short of time right now to look. My doctor gave me a script for 8 mg. tabs, and I can take up to 16mgs. a day. Yesterday I took my last 5mgs. of methadone. I had been taking methadone and dilauded daily more then 6 years, and have tapered down to 5mgs of methadone. I think I dropped to fast the last month I have suffered W/D daily.

I started today with 4mgs. of Sub 2 hours ago, and have a slight buzz. Still feel somewhat crappy though. Should I stay where I I'm on 4mgs, or take more? Also how long is it effective? Methadone for me was about 7-8 hrs . Do most people just take it the one time per day?

What's NA like really? I went to AA many, many years ago and didn't like it.8)

Thanks for any input.

 

[Tchort]

If you are an opiate addict and want to quit, withdrawal is almost an inevitability. Maintenance programs often just delay the inevitable, assuming you actually want to quit. Quitting is hard, period. There is no way to avoid withdrawal in its entirety, and there is a high probability of relapsing without the psychological problems that are often at the root of addiction.

If you are resigned to being an addict (which I am, so no judgment here) then maintenance programs are A-ok.

Being against maintenance programs is fine if thats your opinion.

It is inaccurate to compare opiate replacement therapy with addiction. The differences between the two are legion; MMT/BMT patients resemble opioid dependant pain patients more than addicts.

Telling people Methadone or Buprenorphine maintenance is no better or different than their current addiction is simply not true. So is the advice is other threads that 'there is no need or benefit' for certain opioid addicts to pursue MMT/BMT (the benefits of opiate replacement therapy are the same for the most hardened street Heroin addict, poppy pod addicts, Codeine addicts, etc).