A few basic buprenophine questions

[bluesteyes]

Next week I am going to be seeing a doctor who is an addiction expert and who is licensed to prescribe buprenorphine pills. I'm a chronic pain patient who takes roughly 90mg of OxyContin per day and who has failed miserably the past few months at tapering off this med that I want off of. I get the sense that he may want to substitute the Oxy with buprenorphine pills, and then taper from there. Or he may just recommend a quick detox program. Who knows. But I had a few questions. Please forgive my naivete:

1) Is it the case that in order to even get prescribed buprenorphine pills, you must show up in the doc's office in full withdrawals? Or is it just a situation where you need to wait until you go into full withdrawals before you take your first buprenorphine pill? I don't know how much of a factor precipitated withdrawals can be with a patient who is taking under 100mg of Oxy per day as opposed to someone who is a full blown heroin addict with massive tolerance.

2) Once I taper down to the lower levels of buprenorphine, are these pills truly even harder to get off of than most opioids? Because, let me tell you, when I got down to 10mg of Oxy, 3x per day, I failed miserably. The chronic pain and the lack of energy boost that I normally get from Oxy (the pills don't make me sedated for some weird reason) just weren't there at all.

3) Can buprenorphine pills actually make you depressed? I know one of the ideas behind this concoction is to reduce the euphoria effect of the medication so that recreational users are less likely to abuse it. While I have never, ever used opioids for the sole purposes of getting high, to say that the feeling of well being that accompanies a painkiller isn't a nice thing for me (especially when you suffer from chronic pain and depression) would be a lie. The last thing I need is a pill that makes me more depressed.

 

[keeping]

1) no, you don't need to be in wd's
2) the wd lasts longer bit isn't as bad, but i would personally rather the shorter wd cause ive got shit to do
3) i'm not sure about that one - in fact, one poster on here was actually prescribed bupe for major depressive disorder

 

[Kittycat5]

I think bupe withdrawal can be harder than that of full agonist because of its actions as an antideppresant. Bupe is a kappa opioid receptor antagonist and this action has been shown to boost mood and alleviate depression. But when coming off bupe, you also have to battle the reverse of those in addition to normal opioid wd symptoms. Fucking sucks.

 

[opiatekrzy]

Every doctor I different. Some believe that bupe is only meant for short term and to gradually be weaned off. while some doctors will literally favor maintenance and keep you on it for "life". My old doctor didn't care if you seen him addicted and in withdrawal, or seeing him in fear of relapsing and putting you on it to be safe anand not relapse. When I went to prisson, he let me see him the day I got released, when I was clean and started me off from there. It depends what doctor you are seeing, a maintenance doctor or a typical recovery advocated physician prescribing it for detox purposes, short term or immediate. It's a tough road and a very gray area lol.

 

[Ilove2nod]

1.- I would wait at least 12 hours, for me with oxy and most other opioids that are rather "short acting" I can usually get away with taking up to like 200mg of oxy one day, when I used to take vacations from my bupe, and do another opioid, it was usually anywhere from 5-7 30mg oxy IRs if I were to do oxy on my vacation(mostly did H, or mixed oxy and dilaudid together IV when taking these vacations, but sometimes just oxy), the thing is you are on OxyContin, the ER form, which does last a bit longer than the IRs obviously, and I would say I have a fast metabolism too, so idk how long you yourself would have to wait before dosing your first bupe pill/strip... all I know is I would do some maybe 1-2 hours before going to sleep when I took these vacations, then the next day after about 10-14 hours from my last oxy dose, do some bupe... and I have never REALLY gone into precipitated withdrawls before, luckily, I have heard they suck BAD though, so really you don't have any amount of time, you MUST wait to get bupe prescribed to you, in most clinics, the doc just asks when you last took it, then tells you when your safe to take it... the whole "you must wait 24-48 hours and be dying of withdrawl to take bupe, after a full agonist!" isn't true for everyone, just some people... most of my friends could get away with taking subs, like 12 hours on avg. after taking any shorter acting full agonist, such as oxy.. so that is just an idea for you..

2.- The longer you take bupe, the harder it is to get off of... just like oxy, except the withdrawls IME are way worse... I have been taking bupe, off and on, mostly on for almost 5 years now, and I feel as if I cant make myself even want, to try, to get off of it.. I am totally dependent/addicted to bupe, and feel if I were to try getting off of it, in the area I live.. I would no doubt fall victim to heroin/pharm opioid addiction once again.. so for that one, it all depends on how you want to go about it.. being a chronic pain patient, I think something like bupe, probably wont do a whole lot for your pain to be honest... my back is killing me and has been for the past week from a little tumble I took on the job, that really put a hurting on me.. and I haven't felt pain this bad in years, and for the first time, I can really tell you, even at relatively low doses of bupe done IV with the ~100% BA, in 2mg shots, don't do shit for pain... not for me at least, I have taken micro doses for other times in the past I have been in pain, like 200mcg-500mcg, and still, nada for pain... It works for some people, but I guess you wont know until trying it... if you are in legit pain, methadone may be a better solution if at all possible.. They are both opioids,(bupe is partial agonist, 'done is full agonist)that have a very long half life, methadone lasting a little longer.. I believe.. only tried it like 2 times before though, in very low doses.

3.- Never have I heard of anyone becoming depressed, at least as long as they are on buprenorphine, not coming off of it.. coming off of it, again I will say, is shitty.. worse to me than oxy withdrawl, and can last for weeks... but to me, I feel it has anti-depressant qualities to it, as Kittycat5 mentioned above.. It is very mood uplifting for the most part, and the majority of people who take it, and like it.. some people hate bupe.. it really takes a bit of getting used to, so don't expect to not still want to take an oxy for the first week at least, for me it took a good 2-3 weeks before I really actually was used to the bupe, and had no more bad cravings, and no desire to go get opiates... so just know.. that it wont be an instant, cure all pill, the first few days at the very least.. most likely you wont at all feel like you enjoy it, until after that first week of being on it is passed.. it is a very odd reacting drug, giving almost everyone, a different opinion on it, and how they describe how it feels for them.. I really, truly can say, although I am addicted to it, and I IV it no less(I know, bad, NEVER TRY THIS BTW!) I feel as happy as I have felt in a long time, and stableized, with absolutely no desire to use dope or oxy anymore.. which, I guess, I am still better off doing, abusing my sub, rather than abusing oxy and heroin, risking my life of an overdose, mainly from heroin, not knowing whats really in it! I would much rather be a bupe addict, legally.. than having to put my ass on the line both for the fact I don't want to get arrested going to the "hood" to pick up.. nor do I want to overdose.. or wait in parking lots for hours blowing up my connects phone.. overall, no matter the ROA bupe is most always going to be the safer choice...

Sorry, if this is a bit long.. I tend to over type sometimes on my posts, but I just like to write, ever since being put on Adderall lol... used to not be able to remember a single thing I just read/wrote, before it, living with bad ADHD for most of my life... hope this helps!

 

[bluesteyes]

The thing that I will not do is Butrans patches. They itched like hell, and caused a massive rash on my chest. Way too expensive as well, even with a discount card. I got caught in a situation a couple of weeks ago where I had a 20mcg Butrans patch on that wasn't providing enough relief, and I had to burn through by Percocet bottle too quickly. My primary care doctor was out of his office for a week, so I was truly screwed. I had to remove the 20mcg patch, and apply two 20mcg patches side by side to ward off withdrawal symptoms. I just had to put up with the risk of developing elevated heart rate issues. It worked out okay, but I couldn't wait to get those patches off. I got a new script for OxyContin on Monday, and I took my first 30mg tablet just a few hours after tearing off my patches. Something about that caused a massive rise in my tolerance level. The past 3 mornings I have woken up in a soaking wet bed, shaking and in full withdrawals. I have had to use 90mg of Oxy to kill off these withdrawal symptoms. They have been truly nasty. Something in my body is really off. I am then able to use 30mg 8 hrs later and 30mg 8hrs after that, and I am fine until the next morning. I don't think I have ever used more than 50mg of Percocets in my life, and that wasn't to kill off withdrawals, but to kill off massive pain.

If I elect to use buprenorphine pills, I am going to try to taper quickly and get off of them as soon as I can. I have a relative who was an IV heroin user for a period. She's been on methadone for 15 years. Just can't get off of it. She has a degenerative nerve ailment in my her leg, so the methadone does have a legit purpose, but it is just so hard to get off the maintenance drugs.