Bupe Using Suboxone like Narcan?

[Tommyboy]

I have heard people claiming to use suboxone similiar to narcan, in order to prevent overdosing? Has anybody heard of this or done this? My friend always kept a suboxone on him incase of overdose, since it is supposed to induce precip withdrawal. I have read about many bluelighters saying that they wish that they could get narcan (either on the "street" or at a needle exchange, and was wondering if suboxone could be used in the same way. This would allow many people that cannot get narcan to use suboxone the same way. And if this does work, how does it have to be administered (sublingual, IV, IM etc)? Also was wondering if this would apply to the thread about reducing withdrawal time by inducing withdrawal by using narcan.

 

[Falcon0r]

I don't know about preventing/saving an overdose, but it would throw them into some big withdrawals once they take it.

 

[30roxi30]

ive heard it works.. you would have to inject it for it to work ... i shot a sub a few months ago for the first and last time!!! OMFG i went into the worst precipitated withdrawals cause i didnt wait long enough.. i would think it would work because i instantly got goosebumps cold sweats puking and shiting within 30 seconds ... it was the worst feeling in the world! i thought i was going to die

 

[Tommyboy]

I have seen alot of people saying that they wish they could get narcan so they wouldn't have to goto the hospital everytime they o.d, and it seems that many people can get suboxone easier than getting the narcan so I am curious to see other peoples responses to this. Also, what is the likelyhood of a person being able to administer suboxone or ever narcan for that matter if they are by themselves when o.d'ing. I am sure that a second person would have to be present, unless sublingual (under the tongue) adminstation would be sufficient. Also, subutex doesnt contain contain naloxone correct?

 

[DopeTriker]

I've never heard of Subutex? I'm familiar with Suboxone(bad scene there, I'm sticking to the opiates- I.E., methadone), & I know what Nalaxone is(sp?). I can't imagine the drug companies would let something like that onto the market, unless it's used like narcan?

 

[Captain.Heroin]

In the event of an overdose, administer Naloxone or call 911. This does not mean administer Suboxone/Subutex.

Would you mind if someone gambled with your life in the event of you overdosing on an opiate agonist, and gave you another opiate instead of an opiate antagonist? I know I would.

 

[Rogue Robot]

Homeless -> OD

 

[Oxymorphone]

The idea behind this is that buprenorphine has a higher bonding affinity for the opiate receptors than almost any other opiate ( apparently even naloxone). So it would theorhetically "kick" whatever opiates were occupying the receptors in a similair manner to narcan.

I have asked the same question with this logic in mind and never got a straight answer, just theories that it would make the OD worse and isn't worth trying.

I am interested to see if anyone has a real answer to this.

 

[Tommyboy]

In the event of an overdose, administer Naloxone or call 911. This does not mean administer Suboxone/Subutex.

Would you mind if someone gambled with your life in the event of you overdosing on an opiate agonist, and gave you another opiate instead of an opiate antagonist? I know I would.

Well what about if you live far from a hospital, and the ambulance will take a long time before getting to you? Wouldn't you want to know if the suboxone would work in that case if that is the only type of treatment you could get for the next half hr?

 

[BilNerd]

In theory it would work if you had a prepared shot and someone to give it to you. The problem is how much needs to be administered is anybodies guess. I have heard anecdotal reports of people successfully doing this.

 

[Foul Play]

In the event of an overdose, administer Naloxone or call 911. This does not mean administer Suboxone/Subutex.

Would you mind if someone gambled with your life in the event of you overdosing on an opiate agonist, and gave you another opiate instead of an opiate antagonist? I know I would.

This.


It can't be said better.

 

[ranunky]

The only thing I'd be worried about is if it doesn't wake them up that suboxone has higher affinity that Narcan, so if you ODed them on subs then narcan wont work.

 

[KnowBudz]

Expecting drug users to be able to use a drug like Narcan on their own seems pretty pointless. Administering suboxone for an opiate OD would be a terrible move, even though it contains a bit of nalaxone, the buprenorphine would simply compound the effects of the on board opiate and likely kill the person.

 

[charmcity.exile]

In Baltimore there are all kinds of drug studies since Johns Hopkins is there and they are at the forefront of addiction research. I was talking to a girl several years ago who was in one of the inpatient studies (they pay good). She told me about a pill they gave her one day that didn't do all that much to her. The next day, they injected the same pill and she went into immediate withdrawels. Years later, I figured that those were test trials for Suboxone.

One time I had just gotten back from Miami, and I realized I had a letter in the mail. A friend from NJ had sent me something. Even though I was already high, I shot it. I had to go to work in a few hours and knew I was wasted. I took a quarter of a Sub8 and it straightened me out enough. So in that manner, I guess it worked. I have heard horror stories about people shooting Subs. The old Subutex or straight Bupenorphine are a different story. In fact, years ago in Baltimore, there were tons of clinics (many of them free) where you would go in the morning and they would give you a shot of Bupe in the arm. I have shot straight Bupe before, and no WDs. I guess thats why they added the Naloxone. To prevent recreational use.

 

[StaffWriter]

^^It's the buprenorphine (agonist-antagonist) that causes the withdrawals, not the naloxone. This has been discussed to death.

 

[PetSMiLE]

Expecting drug users to be able to use a drug like Narcan on their own seems pretty pointless. Administering suboxone for an opiate OD would be a terrible move, even though it contains a bit of nalaxone, the buprenorphine would simply compound the effects of the on board opiate and likely kill the person.

Bupe does not compound the effects of a full agonist... if it did why is precipitated WD's such a well established result of taking suboxone too early?? I have always thought that in theory this would work if someone had no other choice, but I could be wrong.

It just seems to make sense though, if adding suboxone to a full-agonist cocktail throws someone into instant WD's (with bupe knocking the others off the receptors) why would this known process be a predictable result every time *except* in the case of an overdose??

I probably would not risk it but I have always wondered this myself.

 

[Captain.Heroin]

Well what about if you live far from a hospital, and the ambulance will take a long time before getting to you? Wouldn't you want to know if the suboxone would work in that case if that is the only type of treatment you could get for the next half hr?

In that case, I would find a vial of naloxone and keep a pack of needles on hand. I don't think I would take Suboxone in the case of an opiate overdose. It could be what pushes someone into having a fatality during an opiate overdose. It might be what saves them too...but I'd rather not make that gamble and find out.

It's OK to be asking this question - it's good to know if what you're planning on doing would be beneficial or not, and it's also a good thing to have a plan B if plan A goes wrong. So I'm not saying it's a 100% bad idea, it's just a better idea to have a vial of naloxone and a pack of needles on hand.

I don't know if Suboxone would even really take effect within 30 minutes...so what I'm going to say (since it's somewhat the only responsible thing to say) is I would still wait the 30 minutes for an ambulance, and save the Suboxone for once I get out of the ER feeling like shit from naloxone. Just my 2 cents.

I hope someone else can chime in with their 2 cents as well.

I have never had a severe OD before, so I can't really give you subjective experience, sorry.

The only thing I'd be worried about is if it doesn't wake them up that suboxone has higher affinity that Narcan, so if you ODed them on subs then narcan wont work.

This is an excellent point. OD on heroin, naloxone can work. OD on buprenorphine, nothing's going to work. Then again it's questionable whether or not buprenorphine can cause an OD by itself. It can with other sedatives, and how do you know what someone's on when they're ODing? Hence why naloxone is the only smart choice when in an opiate OD.

In theory it would work if you had a prepared shot and someone to give it to you. The problem is how much needs to be administered is anybodies guess. I have heard anecdotal reports of people successfully doing this.

You're right, if you were/had to take the Suboxone action, then the only route which would be effective (in time) would be IV. You can't IM a pill (no time to micron filter obviously!).

 

[Captain.Heroin]

In Baltimore there are all kinds of drug studies since Johns Hopkins is there and they are at the forefront of addiction research. I was talking to a girl several years ago who was in one of the inpatient studies (they pay good). She told me about a pill they gave her one day that didn't do all that much to her. The next day, they injected the same pill and she went into immediate withdrawels. Years later, I figured that those were test trials for Suboxone.

One time I had just gotten back from Miami, and I realized I had a letter in the mail. A friend from NJ had sent me something. Even though I was already high, I shot it. I had to go to work in a few hours and knew I was wasted. I took a quarter of a Sub8 and it straightened me out enough. So in that manner, I guess it worked. I have heard horror stories about people shooting Subs. The old Subutex or straight Bupenorphine are a different story. In fact, years ago in Baltimore, there were tons of clinics (many of them free) where you would go in the morning and they would give you a shot of Bupe in the arm. I have shot straight Bupe before, and no WDs. I guess thats why they added the Naloxone. To prevent recreational use.

You can IV Suboxone and not get precipitated WD's, just don't use buprenorphine (any form of it) until you're in WD. How long it'll take will vary on what opiates you're on.

Buprenorphine out-competes naloxone for the mu-opioid receptor.

What kind of an ass-backwards clinic would give someone ONE shot of buprenorphine in the morning? That sets people up to turn to heroin at night.

I have never heard what you're talking about, care to shed some light on what you're talking about, or are you just trolling OD for the hell of it?

Bupe does not compound the effects of a full agonist... if it did why is precipitated WD's such a well established result of taking suboxone too early?? I have always thought that in theory this would work if someone had no other choice, but I could be wrong.

It just seems to make sense though, if adding suboxone to a full-agonist cocktail throws someone into instant WD's (with bupe knocking the others off the receptors) why would this known process be a predictable result every time *except* in the case of an overdose??

I probably would not risk it but I have always wondered this myself.

Buprenorphine would compound the effect of an opiate overdose, especially in the case where someone is on other CNS depressants, and not just an opiate.

It would probably just kick off the full agonist, but not all opiates are "kicked off" by buprenorphine (think tramadol). Obviously we haven't been talking about tramadol in the thread...but this is just an example.

 

[charmcity.exile]

"^^It's the buprenorphine (agonist-antagonist) that causes the withdrawals, not the naloxone. This has been discussed to death. "
From my experiences, I don't believe that to be the truth.

"What kind of an ass-backwards clinic would give someone ONE shot of buprenorphine in the morning? That sets people up to turn to heroin at night. "
In Baltimore about ten years ago, this was a standard practice. Ideally, they wanted to give you one at night as well, but if work prevented you from coming back, they would just double dose you. Other outpatient places that give you the pills only dose you once.

"I have never heard what you're talking about, care to shed some light on what you're talking about, or are you just trolling OD for the hell of it?"
I am new here and do not want to get in any pissing matches. I don't know you, nor you me, but dubbing yourself Capt. Heroin does not automatically make you the foremost authority on dope. I know alot of shit, but the most important thing I know is that I don't know everything.

Here's the deal- I've certainly been around the block a few times. Back in 2000, I was living in Baltimore, which as most people know has a serious heroin problem. They also have one of the best research hospitals in the US - Johns Hopkins. As a result, they are often the first to get advances in opiate treatment.
I am originally a NYC kid and did my share of dope up there. Untill living in Balt, the only thing I had ever heard of for opiate withdrawel was methadone. Then about ten years ago, while living in Balt, people told me about a new treatment for getting off dope. There were and still are clinics where they dispense all kinds of symptom relieving pills in a giant blister pack the size of a piece of legal paper - everything from Celebrex to things for sleep, GI disorder, cramping etc. On the top are 3 Subutex (oblong, white with a cross on them). They tell you to not take anything 24 hours prior to coming in. They do not let you go home with the Subutex, and you take it in front of the nurse. They pop out all the Subutex and lock them up, but you can leave with the other stuff. At Hopkins Bayview (inpatient), they give you Suboxone which is the first place I ever saw that.
In the old days, they would give you an intramuscular (sp?) shot.
I have never had the Subutex or straight Bupe put me in WDs. I have been to each of the above mentioned types of detox once each. Once, after leaving the clinic with the blister pack, I stopped and copped on my way home (stupid, I know). It was called "Red Line". Later that afternoon, I ran into a friend of mine and she told me that she copped Red Line and it was fire. I told her that I got it and it sucked. That is when I realized the bupenorphine had blocked the dope. I have experienced that once or twice after that. It is my belief, through my personal experiences, that the bupenorphine blocks opiates from getting in, the naloxone will pull them out of you. I shot a piece of a Suboxone one time and it wasn't pleasant. I am glad I never tried a whole one. I have friends who have and instantly regretted it.
Another thing I have noticed is that Suboxone seems to have more of an adverse effect on people on methadone. In detoxes and on the street, the only people I have met who have had real bad adverse reactions to Suboxone were on methadone.

BTW- as far as the daily dose of bupe turning people to heroin at night, I would guess that if the person went to the clinic with serious intentions of quitting, they would most likely not go cop at night. The dosage they give you is plenty to keep the WDs away.

As far as trolling OD for the hell of it is concerned - I basically troll the ENTIRE internet for the hell of it. I'm not a professional web surfer, although it would be nice if somebody paid me for it... lol

Peace.

 

[Captain.Heroin]

From my experiences, I don't believe that to be the truth.

How? Do you have naloxone by itself?

Would it offend you if I guess you don't have naloxone, and came to this experience with just Suboxone? Because it's likely you came to that conclusion by just using Suboxone, not naloxone.

I am new here and do not want to get in any pissing matches. I don't know you, nor you me, but dubbing yourself Capt. Heroin does not automatically make you the foremost authority on dope. I know alot of shit, but the most important thing I know is that I don't know everything.

We're not talking about dope. We're talking about pharmacology, and the fact that buprenorphine out-competes naloxone for the mu-opioid receptor. There's nothing you've said to that so far that would make me, or anyone else think otherwise.

It is my belief, through my personal experiences, that the bupenorphine blocks opiates from getting in, the naloxone will pull them out of you. I shot a piece of a Suboxone one time and it wasn't pleasant. I am glad I never tried a whole one. I have friends who have and instantly regretted it.

What you're talking about is taking Suboxone after heroin. That's of course, obviously going to be unpleasant. Buprenorphine, at a high enough dose, will prevent other opiates from reaching the mu-agonist receptors. The naloxone has nothing to do with it. There isn't enough naloxone in Suboxone to do what you're talking about.

If you shot Suboxone and it wasn't pleasant, it's because heroin was in your system! That's called precipitated withdrawal. It's due to buprenorphine, not naloxone.

Another thing I have noticed is that Suboxone seems to have more of an adverse effect on people on methadone. In detoxes and on the street, the only people I have met who have had real bad adverse reactions to Suboxone were on methadone.

That's because buprenorphine will ALSO kick off methadone off the receptors. You typically need to go back on a short acting opiate (like heroin, morphine, etc) after last having methadone, before getting on buprenorphine. Or, you need to wait long enough for the methadone to leave your system - which takes longer than regular opiates.

It's not due to Suboxone that people have an "adverse reaction". It's because people are on heroin, or methadone, and then they take a drug which they should by now know well will just kick off the other opiates, putting them into instant precipitated withdrawal.

The naloxone has nothing to do with it - it's all buprenorphine.

BTW- as far as the daily dose of bupe turning people to heroin at night, I would guess that if the person went to the clinic with serious intentions of quitting, they would most likely not go cop at night. The dosage they give you is plenty to keep the WDs away.

One shot of buprenorphine isn't enough to keep WD's away for a whole day, unless you're extremely lucky (or unlucky depending on how you view it) and are an extremely slow metabolizer.