Bupe: The Less Is More Myth Exposed

[formanchristopher]

The problem is people using what they have experienced to give medical advice that is contrary to prescribing guidelines/treatment protocol. If it were simply giving a report about your experience, then there wouldn't be a problem.

The problem that led to this threads creation was people who use lower doses of Buprenorphine daily blanketing Bupe threads in BL with statements like "Any dose over 8mg is too high, no one needs that much"- multiple members reinforcing this and related opinions in virtually every thread on the subject.

We should be telling eachother about experiences and give recommendations based on them when it comes to treatment. I don't think its right to disregard treatment guidelines and protocol and give medical advice based on this disregard.

For example, after being a part of this said discussion for months now, I finally went to my Suboxone doc and asked for a 4mg(1/2 tab) increase, to 12mgs a day. I did it to see just what would happen, even though I too very much agree that 8mgs daily is plenty...again, only my opinion. Turns out I was right, for myself anyway. All I can say is that I can tell zero difference between 8 or 12 mgs when taken sublingually in the a.m. However, one thing I'd like to note is this: If I take my 8mg tab in the a.m., and then at approx. 1pm I take the other 1/2 tab? I get an overwhelming feeling of energy and "go get 'em", which isn't a bad thing, but yet it's not exactly what an ex-heroin user would call euphoric, either. And I realize that chasing euphoria with Suboxone is pointless, it's the addict in me talking.
One last thing...I've noticed some recent chatter concerning affinities(sp?) and whatever when it comes to too much naloxone in your receptors, and therefore possibly causing a person to feel ill, or not too comfy. Something along those lines, for those of you who know what I mean. Back to the increased dosage, I do get some rather harsh headaches when I'm on the 12mgs. which is still just another reinforcement(to me) that says just how damn strong this drug really is, and that I have zero reason to be on anything over 8mgs. Probably could do with less than that, but not ready to try yet.
Have a great day...

 

[Captain.Heroin]

One last thing...I've noticed some recent chatter concerning affinities(sp?) and whatever when it comes to too much naloxone in your receptors, and therefore possibly causing a person to feel ill, or not too comfy. Something along those lines, for those of you who know what I mean. Back to the increased dosage, I do get some rather harsh headaches when I'm on the 12mgs. which is still just another reinforcement(to me) that says just how damn strong this drug really is, and that I have zero reason to be on anything over 8mgs. Probably could do with less than that, but not ready to try yet.
Have a great day...

I believe it's the buprenorphine which is causing the headache. I don't think the naloxone is the culprit here.

I would try to stay at 8mg a day, or to break your 8mg tab into 2mg pieces, and take them throughout the day. Whichever you want.

If people take too much buprenorphine it tends to antagonize itself at the mu opioid receptor, and this in itself can cause a headache (my own subjective experience and other's).

It's good to hear you are doing well on suboxone though. If you have any more questions about drug affinities you can ask away. The idea is that the affinity of buprenorphine to the mu-opioid receptor vs the affinity of naloxone to the mu-opioid receptor typically yields only buprenorphine effecting the mu-opioid receptor. Affinity describes how likeable a drug is for a certain receptor.

 

[Eight0Eight]

I believe it's the buprenorphine which is causing the headache. I don't think the naloxone is the culprit here.

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I don't know about that.

Headaches are listed as a very common side effect with suboxone, but not subutex.

 

[StaffWriter]

I've heard that headaches can be avoided by prescribing subutex instead of suboxone and there is some evidence that naloxone may be the culprit.

 

[Captain.Heroin]

Yes, some people may be sensitive to naloxone and this may be causing it for some people.

However, headache is also a symptom of opiate withdrawal, and most of Suboxone's "side effect profile" is simply opiate withdrawal, and can typically be associated with acute heroin withdrawal (or whatever drug of choice) and therefore is not really from the Suboxone but from cessating heroin/morphine/oxy/etc.

If you are experiencing chronic headaches and have already evaluated any other cause and ruled them out with a primary care physician, then I would talk to your suboxone doctor about the idea that the naloxone accompanied with individual naloxone sensitivity may be causing the headaches, and possibly switching over to subutex.

However, this is probably not all that common and I don't expect too many people to have to switch over.