Bupe Safety of Buprenorphine + Soma?

[SuperPsych]

I apologize, I think I made a slightly similar thread a while back. I've been trying to do research on this and can't seem to find a solid answer.

I'm currently prescribed 4mg of Buprenorphine daily. I take 2mg Sublingual in the morning and 2mg snorted in the evening. I am also prescribed 900mg of Gabapentin a day but lately I've only been taking 300mg in the AM.

I'm curious about the safety and danger of my 4mg daily Buprenorphine and 500mg of Carisoprodol taken at night. They seem like fairly low doses of each so my gut tells me that I'd be fine, but I'm overly cautious with downers.

My train of thought is this: The Holy Trinity is a popular combo that consists of Hydrocodone/Carisoprodol/ and a Benzo. It's a popular combo and being that its a popular combo for recreational drug abuse, I imagine that people push the doses higher than I am considering. There is also the fact that Hydrocodone is a full opioid receptor agonist, therefore there is no ceiling to it's respiratory depression. There IS a ceiling to the respiratory depression of suboxone and over all it doesn't seem to effect breathing all that much once you get accustomed to it.

I did read on reddit one guy who is prescribed 8mg Suboxone/ 500-1000mg Carisoprodol/ and a couple of doses of Clonazepam a day and seems to be doing okay

One concern I have is that one night I was taking some soma (this was before being on bupe) and I definitely felt my breathing become a bit shallow. This was at a cumulative dose of 2000mg or more.

I know that the safest thing to do is to not take Soma if I'm currently on Suboxone, but I have a decent amount of Soma and I just started a new job which is a bit stressful and sometimes physically demanding. I'd love for a way to unwind. I don't enjoy weed, am trying to stay away from stimulants and I don't have any dissociatives. Buperenorphine doesn't give me any sort of buzz and I dislike alcohol.

Has anybody ever mixed these 2? If so how did it go?

 

[Keif' Richards]

Hey @SuperPsych

It's a good question for sure. Good on you for being so careful.

Buprenorphine [Suboxone (w/ Naloxone); Subutex] can be a bit of a rabbit hole for folks learning about Opioids. Most Opioid agonists we are familiar with operate in a linear function. Buprenorphine produces all of the hallmarks of an Opioid agonist at lower dosages i.e. respiratory depression, pruritus, miosis and perhaps most importantly, respiratory depression. The drug's unique pharmacology comes into play as the dose is raised, basically making it "safer" than the aforementioned other Opioids. Buprenorphine as a single agent is unlikely to kill a person through respiratory depression. That is not to say it has never happened, though it is not the norm.

However, when we throw other central nervous system depressants into the mix, we increase the potential for danger. We have plenty of cases in which Buprenorphine in combination with things like Benzodiazepines, Alcohol have led to fatalities. We need to always exercise caution with these combinations, though the safety profile is always going to be better with Buprenorphine than with traditional Opiates like Morphine for instance.

Carisoprodol (Soma) is an especially dangerous sedative in combination with Opioids. Carisoprodol is largely a prodrug for Meprobamate (Miltown). Meprobamate is classified as a Non-Barbiturate Sedative among other things. A "Non-Barbiturate", as if any moniker could be any more misleading or confusing, is a drug that for all intents and purposes will behave like a Barbiturate despite being chemically distinct from the true Barbiturates like Secobarbital (Seconal), Pentobarbital (Nembutal) and so on.

Barbiturates are especially dangerous in combination with Opioids. Barbiturates were replaced by the Benzodiazepines more or less for the improved safety profile of the latter. Knowing what we know about how dangerous Benzodiazepines can be, the danger should be apparent to anyone reading this.

However, if a person is in control of their usage, they keep it to reasonable, rational dosages and they are unafraid of compulsive behavior, then there is no reason why you can't use a single dose of Carisoprodol in the evenings. Just don't do anything untoward in terms of dosage increase without special consideration. This is a dangerous combination, yes, but we also make fire every day in our backyards capable of theoretically burning down the entire planet. We just need to be cautious and respectful of these drugs.

I hope this answers your question buddy.