Bupe Suboxone/Buprenorphine FAQ & Megathread v2; 2010

[Captain.Heroin]

Well thx that partially answers some of my questions, can someone please give me a detailed answer to each question??

I already did in the FAQ.

Q: How come you can IV Suboxone? Isn't naloxone going to put you into withdrawal?
A: No, naloxone will not put you into withdrawal. If you are using heroin or a full agonist, and then use Suboxone, you will go into precipitated withdrawal if you don't wait for regular withdrawal first. If you are otherwise already on buprenorphine, IVing Suboxone will not put you into withdrawal. This is because buprenorphine has greater receptor affinity than naloxone does. There is no functional reason why naloxone is in Suboxone, and for all intensive purposes, Suboxone and Subutex are the same thing - both can be used with any route of administration.

 

[astroboy007]

Nice, thx Cap. And pegasus sorry i didn't mean to come across as rude or disrespectful, just wanted a thorough explanation of exactly when you should dose if you are going to use, eg- is the initial onset of withdrawal the exact time that you use heroin and is the initial onset of withdrawal the exact time that you dose again? To prevent these withdrawals?
And what is precipitated withdrawal, compared to normal withdrawal?

 

[Captain.Heroin]

Nice, thx Cap. And pegasus sorry i didn't mean to come across as rude or disrespectful, just wanted a thorough explanation of exactly when you should dose if you are going to use, eg- is the initial onset of withdrawal the exact time that you use heroin and is the initial onset of withdrawal the exact time that you dose again? To prevent these withdrawals?
And what is precipitated withdrawal, compared to normal withdrawal?

I'm not sure what precipitated withdrawal is like compared to normal withdrawal since I haven't experienced precipitated withdrawal, so I'll let someone else describe it.

As for your other questions I was confused, and not sure what you meant.

 

[jamesBrown]

Thank you all for your kind responses about my brother.
and yes, i was only talking about that one person really who i quoted when i mentioned the whole suck it up thing. i am sorry for the confusion.

and yes, we know that our only option now is to go to a far away place or hospital or doctor or something and get him treated without telling about his past drug use. but one of the biggest problems with that is that he cannot sit in a car for more than a minute or two before his pain increases tremendously, even beyond what it allready is, which i cant even imagine because he says his average pain is a 1000 on a scale of 1-10. so i dont even want to think about how the car would make him feel.
also, my family is not rich, and im not even going to mention how much money we have spent on medical expenses these past few weeks. lets just say that its mind boggling. we do have insurance but even with that, there are limits on his plan and it still is extremely expensive to go to all these hospitals and doctors and have all these tests done and then have them done again because they fucked them up. just the ambulance rides to the hospital are almost $800 each. and i know my family will spend every last penny they have to help him and they would tap out every resource they could find to help james but even then, it probably wont be enough. its rediculous how much medical procedures cost.
just a side note..my brother was sitting in a chair with a pillow folded up and behind his lower back outside of the house (thats where he goes when his pain gets really bad, the chair seems to help some), and he said about 45 minutes ago that he was feeling the worst pain he has felt yet. well, actually he screamed and cried it. and it was like 1 am here and he was sitting out there screaming at the top of his lungs and moaning and writhing in the chair and begging for death, no joke, and eventually the police showed up cuz a neighboor thought someone was being murdered. seriouslly. my brother couldnt even look at the officers he was in so much pain let alone talk to them so my dad had to explain the situation to them and they were insisting that he go to the hospital but thats the last thing my family and james wants, and also, he isnt allowed back to all methodist and baptist hospitals in the city because of them thikning hes a junky and because he left without consent. and thats pretty much every hospital in the city.
i think you people are right about taking him far away and keeping his history a secret but first of all, my parents are very straight edge and would not ever withold information from a doctor. allthough they are probably getting close to the breaking point because there son is almost dead. i almost think my mom is willing to but drugs off the street to help him...thats how serious it has gotten. thats pathetic, in america, a mother is forced to illegally buy narcotics for her dying son so she can save his life because no professionals will help.
also, dont you guys think it would look weird to a doctor in a near by city that we drove all the way out there just to go to that particular hospital or doctor? i mean, thats probably suspicious to a doctor. maybe not, i dont know. i never really used drugs so i am not sure about the answers to any of these things and appreciate all of your responses.
if in the end we do decide to take him somehwere far away, i would have to buy him a bunch of illegal painkillers or a shitload of kolonopin for the drive to make it barely possible for him to stand the pain. is there a drug he coudl take that would just knock him out for the whole ride so he wont have to deal with the pain?
oh no, thats probably not a good idea because when he sleeps in a position for longer than a few minutes it makes his body hurt like a motherfucker excuse my language so he has now decided that if he ever is going to get some sleep me or my mom have to wake him up every 10-30 minutes so he can change positions or move to a chair and sleep or move to the floor or someplace else we would have prepared for him.
im sry about the long post again its just my family has no one to go to now and your help is like gold to us.
please help us with some advice so we can decide what to do fast. he only has 1 80mg OC left that i got him and that really only takes away about 10-15% of his pain for like 4 hours. unless he injects it then it only works for like 2 hours. i am happy tho about one thing. he told me that the pills I got him were not even made anymore and are able to IV but i dont like that but if thats what keeps him alive than so be it.
anyway please help me please please please. after this last pill he will start losing weight again and continue getting weaker. i truly appreciate your advice and I see why james enjoys this website so much.
thank you and please hope pray wish that he gets better.

also i forgot we cant take him too far away because his is on probation so he cant leave the county or surrounding area or something like that.

 

[catcalls]

Sounds tough, eh?

On my own personal note: I'm upped to 4mg and feeling withdrawal every morning anyways but not as bad. I tend to sublingually take my Subutex. Is this normal? I hear of people plugging their pills, or IV? That sounds stupid to me because you want the pill to gradually release into the system over a period of 24 hours. And the only way is sublingually to do that, not mainlining the pills. Plugging might work, but I really don't want to push anything up 'that hole'/:

Okies, speak soon!

 

[Captain.Heroin]

Sounds tough, eh?

On my own personal note: I'm upped to 4mg and feeling withdrawal every morning anyways but not as bad. I tend to sublingually take my Subutex. Is this normal? I hear of people plugging their pills, or IV? That sounds stupid to me because you want the pill to gradually release into the system over a period of 24 hours. And the only way is sublingually to do that, not mainlining the pills. Plugging might work, but I really don't want to push anything up 'that hole'/:

Okies, speak soon!

Most people probably use Suboxone sublingually though (as directed). In order for IVing buprenorphine via Suboxone to be effective and somewhat safe, you really should micron filter. Short of this, I think it's smart to stick to sublingual use.

Some people enjoy snorting the tablets, or plugging them. I haven't tried either. I have tried snorting some of my IV solution, which was OK but I didn't much care for it.

You're probably best off with sublingual use. It has the longest duration.

 

[JamtasticX]

Jamesbrown's sister.

first, the situation with probation is usually the county, which will consist of several cities, although it allows the PO to still operate within that county, however, its usually leaving w/o notice. First, you can just tell his p/o. I doubt him, along with all the Dr's are that crazy, or two - why do you even care about the p/o?

If things are that bad, I doubt he'd get in trouble, or worse case get thrown and jail and probably recieve better medical treatment, seriously though..

dead, or alive and in jail (worst case)

Unfortunately your last post was full of excuses why action is not being taken, instead of taking that action.

Stop going to private hospitals, go to a state hospital, don't mention anything. If that's not done, he could die, seriously, think about it?

Sounds tough, eh?

On my own personal note: I'm upped to 4mg and feeling withdrawal every morning anyways but not as bad. I tend to sublingually take my Subutex. Is this normal? I hear of people plugging their pills, or IV? That sounds stupid to me because you want the pill to gradually release into the system over a period of 24 hours. And the only way is sublingually to do that, not mainlining the pills. Plugging might work, but I really don't want to push anything up 'that hole'/:

Okies, speak soon!

When you take it under the tongue it does not release gradually over 24 hours, sorry, but that is totally false. It in theroy releases all at once (maybe an hour due to dissolving time) but is taken sublingually to bypass first pass metabolism, the same for sniffing/pluggin/iv. Only difference is onset time and potency. Sniffing is ~2x stronger, although that means sniff 2 instead of 4, not 8

 

[catcalls]

I've tried sniffing Subutex. It burns the hell out of my nasal passages! And its not x2 stronger. I'd have to disagree with you there. In fact, I think most of the Subutex gets lost in the boogers in the nose.

So, in theory, I prefer to dissolve them under the tongue as prescribed. Also, why is it then that I 'peak' some 4-5 hours later after taking them sublingually? They kick in immediately, but the drug does not reach full potency until hours later. That is my experience with Subutex, which is a completely different drug to Suboxone.

 

[SkagKush]

^ as others have said, when you take bupe it absorbs in the amount of time that the tab is in your mouth........however, bupe takes two hours until it has reached peak plasma levels......

so thats two hours....when taken SL of course...

i still have to go read this mess on the last two pages.....i hope JB is ok....

 

[catcalls]

^ I agree with the above. It def. takes a few hours before I peak taken Sublingually. Lets just say that I agree to disagree with Mr X! Lets keep the peace, eh? Rather than cause a flame war.

 

[PurpleLibra]

I am so sorry to hear this. I am pretty sure that your family needs to contact an attorney because of what the hospital did. That would be my first step.

ABSOLUTELY! I work in the legal profession and I know a TON of lawyers that would LOVE to take a case like this on. This is God damn ridiculous! This makes my blood boil.

And telling anyone (regardless of the circumstances) to "suck it up" is, in my opinion, fucking mean. You ain't walked in their shoes so until you do, I would suggest taking a step back and shutting the fuck up before you know the whole story.

To James and his sister. I am sooooo sorry. What a fucking nightmare. My God in heaven... People drink and drive and kill people every day and they are given more sympathy than this. My heart breaks for you both.

Ugh, I had a long post, but I decided to not pots it.

I will say this, in regards to the jamesbrown posts, if this sttory is exacly as written, drive him to a far away/out of state hospital, and LIE. If you've truly done everything, then this would have been done.

Do not mention past Drs/hospiatals/drugs/records. If you have done everything else, this avenue should be seriously considered

EXACTLY! Just go to a new hospital, say he's in EXTREME pain, and hopefully they'll give him enough drugs to take the pain away.

If it were my brother, I would go score for him just in case the hospital didn't give him enough pain meds. My father was dying of lung cancer and was scared to death. He was addicted to Xanax and those fucking idiots in Hospice gave him like, .25 mgs a DAY! The man was used to taking a full 2mgs. I went out and scored for him after I yelled and screamed at his hospice nurse and doctors.... WTF? The man was dying! What are they afraid of? That he'll get addicted? Oh my GOD shit like this pisses me off to no end.

Anyway, I carry a card from my doctor that says I NEED a boatload of pain killers because of my high tolerance to them. My ma also has a pretty big stash of Roxi's in case anything ever happens where I need.... I can see me going into the hospital after a major accident or something and the stupid hospitals/doctors giving me a Vicodin. Hell, a Vicodin would be like taking a sugar pill to me. TWENTY Vicodins wouldn't even do me much good.... Know-it-all fucking doctors who think they're God....

There are TWO doctors in my NA meetings. LOL! THAT is the doctor I want when I go to a hospital.... The one who's a recovering opiate addict!

 

[SubDude]

Regarding JB... like everyone else here I hope the situation gets resolved and he's better soon. However, some of whats been posted just doesn't make sense to me. Especially the way the dr's and hospitals are treating him. I've been a junky all my life and though I've had a few drs seem suspicious over my pain complaints, I've never been treated like that. It's been my experience that nowdays they ask your pain level on a scale of 1-10 and anything 8+ and has surgery forthcoming... is given some kind of narcotic pain meds. When I was on methadone... I had a couple of occassions where they gave me higher than normal pain meds [3x 80mg oxycontin a day] because I was an addict and on methadone.

His sister didn't say where his previous "dozens" of bone fractures [from soccer] were located... but it would seem at least a few of those would have shown on the scan. Even though healed... prior bone fxs can cause residual pain from degenerative arthritis...etc. So, if for no other reason, [which he has plenty] perhaps complaints of pain near or close to some of those fractures [in addition his other pain] might do the trick for him?? BTW... thats one heck of a lot of fractures for one person to endure. I hope they have all healed. A bone broken in the same place multiple times is some serious shit for most people.

Anyway, maybe it's a geographic thing or else it's some kind of new stance hospitals and chains are now taking with regards to narcotic pain meds prescribed to documented addicts?? So far... they don't do that here and it kind scares me if thats a trend. To withold pain meds to someone who needs surgery and whose lost 25 lbs in a couple of weeks and looks like a holocaust survivor... sets a new low threshold in decent medical care. It would seem they would be concerned about a lawsuit at the very least.

 

[jamesBrown]

this is james' sister again. thank you all for caring.

to the man who said that we should stop making excuses and just go and do something allready, im not mad at you for seeming so insensitive, i kind of agree with you in some way, its that its not that easy now given james' condition.
just like i told you that james' couldnt do the tests that they had allready done earlier and they had messed up apparently, like cat scans, because he was in too much pain and couldnt even lie down or sit still, and so the doctors wrote in the charts and files that he refused treatment even though he wanted to do it badly, it was just physically impossible. just like that, we cant just throw him in a car and drive far away without him probably having a heart attack because of the pain. for some reason cars cause his pain to escalate alot, especially when he is getting in and out of them. we would have to buy some illegal narcotics like oxycotin in order to lower his pain enough so he could even get there. and if we go to another hospital, they will do a drug screen just like al the other hospitals have, and they will see he has used strong drugs that he isnt prescribed too. and im not sure if that in itself will cause the doctor to refuse treatment or if they will somehow work around it. its really a matter of getting lucky and getting a doctor who is understanding. but since out of all of the 12-16 or so doctors he has seen so far, none have been understanding, and most have been hostile, even when james had clean urine samples and hadnt used until two nights ago when i gave him the oxycotin, the odds of us getting a doctor willing to help seem very small. and that would make that trip a waste and more than likely it will aggrivate his pain and make him extremely stressed and unpleasant, because after all he has gone through, he has little patience, respect, or trust in any doctor or medical establishment. he gets enraged with what little energy he has left and that stresses his heart even more.

also, we would like to hire an attorney but first of all we cant afford one right now with all the medical bills that have piled up and not to mention all the new bills that we will get in the future. we also only have the energy to concentrate on his health right now. having to deal with a lawsuit at this time would just be too much. but i dont know if james has told you but we have legal connections in the form of very good attorneys through our family and in fact thats the only reason he is not in jail right now. he should be locked up but instead he is on 2 concurrent probations that will make the charges dissapear once he completes the probations correctly. so we can get an atorney but if we are going to have to drive all over the place to find him an understanding doctor, or have to decide whether or not to give him illegal pain meds in order for him to been even capable of being ina car, and deal with all the othe crap that is going on with him on a minute to minute basis, we just dont have the energy, or mental capacity right now to worry about a lawsuit. maybe after he gets better god willing.

i promised myself i wouldnt write a really long post like i have been doing because i noticed that my posts are much longer than most others. so im sorry. i will stop here.

james told me to tell all his friends here that he appreciates there concern and wants to come back as soon as possible. he said "i wish i could use bluelight on my goddamn phone!" last night during one of his screaming sessions.

thank you all.

and to the poster above me, subdude, im sry some of this doeesnt make sense to you. it doesnt make sense to us either. we are at a loss of word every time he is refused treatment or called a junky.
and his injuries were always soccer related. he broke both his ankles, sevral toes, sprained his ankles on several occasions which can be even more painfull than a fracture apparently, he also broke his left forearm, his left wrist twice, his right wrist 1 or 2 times, I cant remember, also he has broken every single one of his fingers atleast twice, if not more. and I know thats a hard one to believe but it is 100% true. he played goalie for a period of time and i guess he has weak bones, maybe because he never drank milk as a kid. also, he usually refused to stop playing even with a broken finger or toe or something. he would just tape it up and deal with it. he also has broken his clavicle if thats how its spelled, got kicked with metal cleats right in the shoulder area and snapped it. also, during his high school soccer career it is much more intense, im not sure if you know much about high school soccer but its basically like football without all the pads. they were allowed to tackle each other using there legs and lower torso as long as they touched the ball. believe it or not. he also had broken a shin or two, im not sure exactly which one or how many as i was away at college during his high school years. i know he has a couple more fractures but thats all i can remember. its odd cuz he never broke his spine or back but thats where his worst pain is. and sometimes his legs. but, he has had constant back and leg pain for the past 6 years or so from playing intense soccer for so long, its just a part of his life. if you play hard long enough you will end up with constant soreness, which is how he described it, but he never took even tylenol for it because he said he coud just deal with it and the pain wasnt bad or debilitating enough for him to go to a doctor. of course whenever he did go to a doctor he would tell them about it and im sure it had been checked out, but nothing was ever diagnosed as being a problem. he hast had a fracture in over 3 years now since he quit soccer to use drugs. in fact i think thats why he started taking pills, because of the constant back and leg pain. and it eventually led to heroin. he probably has told you guys this already.

also, i dont know about anyone who has 8+ pain automatically getting surgery but he told them the pain was like 1000 and if you read my previous posts, you would have known that they had made a diagnoses and planned for surgery the following morning but in the midde of the night the surgeon looked at the cat scan and disagreed and that diagnoses was thrown out. and then after that he was in too much pain to do any more tests without painkillers, which they refused him, so it ended up in him having to leave because it was impossible for him to do the tests and yet the doctors wouldnt budge about the pain meds.

 

[Suboxone]

this is james' sister and i would first like to thank everyone who seems to care about him and is wishing him luck, but i have to say that i am disgusted at what some of you are saying. he told me that he had explained in detail what he has gone through, and i would imagine that would have made it clear to some of you, like the man who posted this quote, that james has done everything possible to get better. and when i read about you telling him to suck it up, it just makes me want to say things to you that i wouldnt say to my worst enemy but he told me to act civil when i posted for him so i am going to respect that.but you saying that makes me sick to my stomach.

You are incredibly naive. I can't say anything but that.

He's an addict and he's in pain, I've been in the same boat (with 9/10 pain daily when untreated) for a very long time. He's gotta put on the big boy pants and do what he's gotta do. There are many treatments that work without narcotics, he really needs to just suck it up and deal with it. He became an addict by choice, he's got to deal with the consequences.



Aside from that, today is day two without bupe. Although the pain has increased quite a bit, I'm only feeling no negative effects.

 

[DrinksWithEvil]

hey guys, ive been a 4 year opiate head, shot up for the last three months . then i decided to get on suboxone. they started me at 16mg a day then to 20mg a day, i was like wtf. i kept myself at 16mg. then the last 4 days i just took 8 mg and was fine but still had some urges. and i ended up smoking some H 3 days ago. havent touched it since. but now im taking 12mg a day. i was wondering what your opinion on my situation would be . should i wean down some? or stay at this level. or just get the fuck off suboxone? it makes me pretty damn irritable hahah. but it keeps my cravings at bay.

 

[Jabberwocky]

just like i told you that james' couldnt do the tests that they had allready done earlier and they had messed up apparently, like cat scans, because he was in too much pain and couldnt even lie down or sit still, and so the doctors wrote in the charts and files that he refused treatment even though he wanted to do it badly, it was just physically impossible. just like that, we cant just throw him in a car and drive far away without him probably having a heart attack because of the pain.

Since the pain started abruptly and seemingly without origin, I imagine there is a very real explanation as to why jamesBrown is in pain. Unfortunately, he must have regular tests completed to give any hint as to what the underlying condition may be.

I would urge him: be as cooperative as possible. Lay down as best as he can. The fact that doctors wrote in: 'refused treatment' indicates to me he wasn't trying. Even if he couldn't lay still, but was giving it an honest effort, I doubt any doctor would refuse him then, and they'd come the rest of the distance to get the tests DONE.

 

[SubDude]

hey guys, ive been a 4 year opiate head, shot up for the last three months . then i decided to get on suboxone. they started me at 16mg a day then to 20mg a day, i was like wtf. i kept myself at 16mg. then the last 4 days i just took 8 mg and was fine but still had some urges. and i ended up smoking some H 3 days ago. havent touched it since. but now im taking 12mg a day. i was wondering what your opinion on my situation would be . should i wean down some? or stay at this level. or just get the fuck off suboxone? it makes me pretty damn irritable hahah. but it keeps my cravings at bay.

It depends on a lot of factors whether to stay on or get off. 4 yrs on opiates is a good indication you need some [relatively] long term help. Many of us here do better on less vs more. You need to figure out whats right for you mainly thru trial and error. JB calls it a "sweet spot" which is a good way to term it. Hopefully you have a good support system in place including an addiction specialist who really knows about subs. We have one at our clinic whose actually on BMT. Good luck!

 

[Ashley26]

Back to suboxone! For awhile anyways. Day 1 is always rough. I'm so sleepy

 

[sveets]

i'm prescribed 16mg a day, but i find that 10-12mg is more than enough to hold me over until i go to sleep. Why do you think doctors prescribe so much?

 

[JamtasticX]

i'm prescribed 16mg a day, but i find that 10-12mg is more than enough to hold me over until i go to sleep. Why do you think doctors prescribe so much?

many reasons, from wanting to make sure nor-bupe can't bind to just making a shit load of money, either way you could probably go much lower