BUPRENORPHINE/BENZODIAZEPINE INTERACTIONS (OR LACK THEREOF)

[SpiralusSancti]

You know, the discoverers specifically stated that it was of utility in 'opioid detoxicifaction' i.e. the acute period i.e. a couple of weeks. But I guess a medicine one takes for 2 weeks isn't nearly as profitable as something you take for years.

And than people wonder why I hate bupe so much. Seeing fucking destroying some places and many lives, yeah I know that might sound funny to someone where fent is a thing or even like where you are, where hard-core drugs are a lot more mainstream than at my place, especially before the war, during and after the war is when heroin epidemic started.

What else really bothers me that IT REALLY IS EFFECTIVE FOR INTENDED USE! But no, give a shitload to everyone and let them figure out it destroys veins and causes amputations and what not if used I.V. even in “I.V. resistant version with naloxone”. Well, fuck them for misusing water soluble pills, right? Who would ever though any junkie would ever thought of that and even if would, it wouldn’t work, yeah right.

Source of my hate for bupe goes much deeper. In my country it was praised by leading doctors as a revolutionary drug, basically 100% non-abusable will-save-your-life get-as-much-you-want alternative to methadone. And not only that, while at the same time cutting of people from methadone and morphine by force. Not only that but we had a fucking celebrity junkie praising it in public media as something that saved his life. Guess what, not long ago he got back to better stuff.

 

[Keif' Richards]

There are a lot of sidebars going on in this thread. That's all good, I just want the OP to get his questions answered instead of going to far into other areas of discussion. For what it's worth, I believe Buprenorphine was entirely over-prescribed. Not only was it prescribed to too many patients, it was prescribed at inappropriate dosages that in general, were too high and more specifically, were not tailored in any meaningful way to the specific needs of the patient. Everyone gets 24mg/day is not optimal for the majoirity of patients. Patients requiring 24mg Buprenorphine, in reality are better suited to Methadone maintenance, as Methadone possesses a more linear pharmacokinetic profile.

I just want to say, I've heard so many people, friends, family, fellow BL'ers, strangers, bums tell me about how their drug of choice completes them. It fills in the gaps, lifts them up, gives them what they need to live, makes them the person they always believed they could be, unlocks the secrets of life... I've heard it described in all ways.

I love Gollum from Lord of the Rings. I know it's corny, but the One Ring is such an apt description of the process of addiction. We find this wonderful thing. It solves all problems. At first we describe it as making us more confident, better at work, everything in between. However, at the end of the line, we're all just sitting indian style with our kit in our laps mumbling "precious". There's no need to describe all of the great things the drug does as the drug is the beginning, the end and everything in between.

It's the foolish person in the story who picks up the ring and decides to wear it, as he or she will be the only one in the world to ever really "use it properly". They will use it for good, use it the way it's power was supposed to be used, even when every person and thing around them knows full-well that the thing only corrupts.

Sure, you can use the ring every once in a while, turn yourself invisible, avoid the ring wraiths... you'll take it off before anything bad happens, so why even worry about the consequences. You'll be different.

This is why we need gatekeepers for these substances. I believe in having access to drugs, but I also feel this access has to be managed in some way. If you need to take Benzodiazepines, pick them up every other day from the pharmacy or a week at a time at the very most. Then when you start fucking up, the authoritites will become aware earlier rather than later. I believe all of these drugs have value, even as purely recreational substances, there is value. However, we are talking about the point when that value ends and it does end.

 

[AlsoTapered]

When their is a profit made by all parties except the patient, Grisham's law will inevitably kick in.

I find it particularly sad when I knew one of the discovers of alprazolam and at least met one of the discoverers of buprenorphine, both now sadly dead (93 and 80 - not bad). The former wanted to develop alprazolam and was partway there (adinazolam), the latter was actually looking for an alternative to codeine for use in compound (i.e. [P]) analgesics. THAT was what buprenorphine was hoped to be. Sadly oral bioavailability is low and differs between individuals.

I'm pretty sure both of them would be devastated to learn of how their work has been misused. In fact - interesting that they were only misused AFTER the discoverers died. Possibly telling.

BTW yes, diazepam is the safest and most appropriate benzodiazepine. It WAS used to treat depression in the 1960s... then they realized that someone who had been taking them for potentially years was HOOKED. Just look at Vivian Stanshall. He 'lost' a decade because he was on so much diazepam for so long.

 

[Señor Moreno]

I can see ciclotizolam and the other high-affinity low-efficacy benzodiazipines being used to ween people off other benzos.

Sorry @AlsoTapered, can you tell me more about those low eff benzos? I am not versed on this matter, so promissing and interesting. Would you include in that group things like clobazam? The weakest benzos known to me are ketazolam and oxacepam, diaz "relatives' I think. Do you think that those meds can be labelled as low efficacy benzos?
I would be grateful if you were kind enough to list some of those compounds that you have in mind, as that ciclotizolam that I admit knowing nothing about,

 

[Señor Moreno]

, I believe Buprenorphine was entirely over-prescribed. Not only was it prescribed to too many patients, it was prescribed at inappropriate dosages that in general, were too high and more specifically, were not tailored in any meaningful way to the specific needs of the patient. Everyone gets 24mg/day is not optimal for the majoirity of patients. Patients requiring 24mg Buprenorphine, in reality are better suited to Methadone

So true, can't agree more. When I first had bupe, decades ago, there only were 0.2 mg pills and 0.3 mg ampoules. No typo, 0.2 and 0 3 mg. They were brands like Buprex or Prefin in Spain, Temgesic in the UK.... of course such low dosages were intended for pain management, no addictive disorders.
It's clear that those meds were underdosed, but then all of a sudden it all was 8 mg pills, somerimes 4× a day, totally overkilled.
On the other hand, I totally dan relate with people like the OP who has endured a methadone wd, choosing to try bupe.
Btw, it were them Frenchs who pushed those massive dosages and not happy enough with it, they then pushed naltraxone to the recipe . Great.
I don't know to what degree have Subutex and Suboxone helped addicts, but I am fairly sure that those patents have made rich (richest) french pharma

 

[AlsoTapered]

Sorry @AlsoTapered, can you tell me more about those low eff benzos? I am not versed on this matter, so promissing and interesting. Would you include in that group things like clobazam? The weakest benzos known to me are ketazolam and oxacepam, diaz "relatives' I think. Do you think that those meds can be labelled as low efficacy benzos?
I would be grateful if you were kind enough to list some of those compounds that you have in mind, as that ciclotizolam that I admit knowing nothing about,

In effect, they are like buprenorphine. They will blockade the benzodiazepine site while only being relatively weak in their own action. There are a few of them, I just named the one I remembered first.

Their are also partial agonists but they don't have such strong affinity. Their structures are rather odd so I freely state I haven't learnt of their pharmocore. Too few to run a training-set.

 

[Señor Moreno]

Thanks mate, apreciated. Wasn't even aware that partial benzo ( gaba?) agonist were even a thing. As I said I have no experience beyond regular pharma benzos, in fact never used rc ones, not even etizolam. Thanks again

 

[SpiralusSancti]

So true, can't agree more. When I first had bupe, decades ago, there only were 0.2 mg pills and 0.3 mg ampoules. No typo, 0.2 and 0 3 mg. They were brands like Buprex or Prefin in Spain, Temgesic in the UK.... of course such low dosages were intended for pain management, no addictive disorders.
It's clear that those meds were underdosed, but then all of a sudden it all was 8 mg pills, somerimes 4× a day, totally overkilled.
On the other hand, I totally dan relate with people like the OP who has endured a methadone wd, choosing to try bupe.
Btw, it were them Frenchs who pushed those massive dosages and not happy enough with it, they then pushed naltraxone to the recipe . Great.
I don't know to what degree have Subutex and Suboxone helped addicts, but I am fairly sure that those patents have made rich (richest) french pharma

Actually 0.2 or 0.3mg can provide quite nice pain-relief. I don’t think that above 0.5mg without tolerance is needed or useful if used for pain. In fact someone without any opiod tolerance, not looking to get high would almost certainly found 0.5mg too much.

 

[Señor Moreno]

Sure it does. Some old relatives, now gone, of mine used those 0,2 sublingual pills and found good relief on it. They had not cáncer or other superpainful conditions, but painful enough.

 

[TimTim1993]

I took 10 Klonopins and a Suboxone once and I woke up in the Emergency room, they said I was unresponsive and having difficulty breathing. But this was at recreational doses, if you are taking them as prescribed you are fine. You can still become dependent though

 

[cant_overdose]

I think Keif's LOTR analogy is good one. If somewhat cynical. It's true, addicts do say all these things. In my cocaine phase, long ago, I remember how my first good shot taught me that I'd never been happy. And I became miserable without it. Of course, the only alleviation for this was more cocaine. I'm grateful that somehow I was eventually able to connect the misery with the drug and got to where I wouldn't do a bump if you paid me to. That was decades ago
I'm not sure I agree that we need "gatekeepers." This whole idea of regulating drugs and punishing end users seems to me to me to be the product of of only the merest chance of modern political climate. If you think about it, Madame Curie would be considered an outlaw in this ridiculous era. By what right does a governing entity dictate what a person ingests, as long as it hurts no one else. In legal terms this kind of crime in referred to as mala prohibitum as in "wrong because statutes say so," as opposed to mala in se, or "wrong in and of itself" - like murder or rape.
Also, in response to other posters, the bupe does exactly what I need it to do. It doesn't give me any form of high or opiate feeling - even if I take a ridiculous amount. But it does block all other opiates, meaning I can go into a friend or family members household, see a bottle of morphine, and feel no temptation whatsoever because I know it simply doesn't work on me. It's almost like a vaccine in that regard. I need to stay on it; things get ugly very quickly when opiates are a possibility for me. The bupe does away with all that.
As far as bupe being effective for pain relief...well, if you say so. I also find it incredulous that it has lead to overdoses, as I said earlier.

Sure it does. Some old relatives, now gone, of mine used those 0,2 sublingual pills and found good relief on it. They had not cáncer or other superpainful conditions, but painful enough.

To me, it would be a special kind of hell to be in genuine pain and be given suboxone. If that were the case, I'd have to go back to heroin or similar.

 

[AlsoTapered]

Schizoaffective disorder, if my understanding is correct, is described as lying somewhere between schizophrenia and depression or bipolar disorder.

Now it has long been known that opioids are somewhat effective in treating schizophrenia and indeed was sometimes prescribed before the neuroleptics were discovered. So were you using opioids as a form of self-medication?

Buprenorphine has been shown effective in treating schizophrenia:

Antipsychotic effect of buprenorphine in schizophrenia - PubMed

The antipsychotic potency of the partial opiate agonist buprenorphine was evaluated in 10 neuroleptic-free schizophrenic patients suffering from frequent hallucinations, delusions, and severe formal thought disorders. Buprenorphine had a pronounced antipsychotic effect, which lasted about 4...

pubmed.ncbi.nlm.nih.gov

Now aplrazolam is used to treat anxiety and as I previously stated, long-term conditions such as GAD and unipolar depression and although it has been shown to promote mania in certain cases, it has been trialled in the treatment of certain forms of bipolar disorder:

Alprazolam for depression - PMC

The 'off‐label' effect of alprazolam on depression has not been systematically evaluated. To determine the antidepressant effect, including tolerability and acceptability, of alprazolam as monotherapy for major depression, when compared to placebo ...

www.ncbi.nlm.nih.gov

Alprazolam in bipolar-I depressions - PubMed

In an open-label study of alprazolam in five bipolar-I depressed patients, three patients remitted completely, one failed to respond, and one responded transiently, based on the Hamilton Rating Scale and Beck Depression Inventory scores. Further studies of alprazolam as an antidepressant are...

pubmed.ncbi.nlm.nih.gov

If that's the case, I can see the reasoning behind the doctor's choice. The neuroleptics can cause terrible side-effects and so this sounds much more like an attempt not to make any depressive symptoms worse.

I could not find any more robust data but I think it perfectly reasonable to ask the doctor about this. Treatment generally works better if doctor and patient are on the same page. But generally, doctors don't like explaining too much. I don't quite know why.

But as a bipolar disorder sufferer, I would tell the doctor if you are or were using stimulants as self-medication for depression. I suspect your doctor might have guessed because generally speaking, if you are caught using street drugs, obviously they will be concerned that you might misuse your prescribed medication.

If the alprazolam is prescribed to treat depression, an effective dose is surely required. Other benzodiazepines have been used to treat depression but only the US still uses one; specifically alprazolam.

If the higher dose of alprazolam means you don't need the modafinil then it may be a useful tool in discussion. After all, it's one less drug and so one less possible interaction. Frankly, any more than two different medications and NOBODY understands the interactions. It might alter the metabolism of the other medications increasing or decreasing plasma concentrations and clearance times.

But I just take the oxycontin I am prescribed as directed by my doctor to manage chronic pain and clobazam as prescribed to treat myoclonus. I totally avoid all other drugs and alcohol as well. I was given a neuroleptic but I was simply asleep for most of the time and groggy when awake. So I stopped after a week. I manage the bipolar myself which means having a routine, avoiding stressors (where possible) and trying to remain positive. I know, it's easier said than done BUT I received proper counselling which had enormous value.

You mentioned auditory hallucinations. Is that your own description or one applied to your condition? Because it's a very vague term and I am lead to believe that with schizophrenia, voices that are experienced which is disturbing enough but sometimes voices that are malign which I imagine must be dreadful.

I hope this of some help.

 

[Keif' Richards]

@cant_overdose I understand the whole "gate keepers" theory I have in my head probably isn't that popular. I just think there is value in having the drugs distributed in an effective way. Heroin prescription programs and increasingly, Methadone programs allow the user to essentially dictate their own dosage. I just think there is value for certain people in having a soft-barrier between them and the drugs to help maintain long-term stability. I'm not sure what the best solution is.

 

[AlsoTapered]

The wish to alter one's consciousness seems built in to our species. Throughout history almost every culture discovered naturally occurring psychotropic materials. We have evidence of trade in psychoactives in Australia from many thousands of years ago. But it seems like such materials were used mostly in a cultural context.

When it was crude opium instead of heroin, coca leaf instead of cocaine and beer/ale/wine instead of vodka and so forth, the scope for harm was less. The Romans certainly had access to opium but I don't think their is any evidence of much non-medical usage.

Now science has unleashed much more powerful psychoactive medicines which are more accessible and so a much larger part of the population know of their effects and so self-medication is referred to as 'drug abuse'.

Criminalization increased interest because people quite reasonably asked why is something that was legal yesterday illegal today?
As for 'gate keepers', I don't have an answer. The Dutch really look at the harm and deal with that but it's Portugal's decriminalization of possession of drugs that is most interesting. 99% of people who choose to use drugs do not develop a problem but do we institute an outright ban OR do we have pharmacies sell drugs legally and the extra tax collected ring-fenced to be spent on helping the minority that do get into problems. I mean, it's radical but if the USA declares a 'fentanyl crisis' then what will they call the next, more potent wave that is already upon us. The nitazines can be up to x3000 morphine in potency and let me tell you, x40000 and possibly x100000 compounds are known and as yet remain uncontrolled.

 

[Señor Moreno]

Heroin prescription programs and increasingly, Methadone programs allow the user to essentially dictate their own dosage.

That's a big truth, only me being a cunt pushed things to 200mg, after less than a decade of opi addiction. Only mysef is to praise for keeping it under 40mg once the lesson had been learnt my lesson.
Sorry what are "gate keepers"?

 

[Señor Moreno]

it's Portugal's decriminalization of possession of drugs that is most interesting.

Portugal law 30/2000 its a good law, as you say it decriminalized the possesion of drugs, bit before decrminalizing it you need to have labelled it as a crime. Possesion of drugs never was a crime in Spain, and before 1/1992 law you didn't get even fined or privated of your drugs. Police has given back my gear many a time. They searched you and if they didn't find notorious amounts or múltiple bags and money they just gave it back to you, because no tribunal would accept a case over non criminal activity.
I have been in open air shooting galleries with the police telling us literally " no worry, do your thing, we will wait for you to end" then, they reserched us, often finding on you another baggie ot two, some hash, rohypnol, whatever, only to gave us back the drugs. In fact, if you were not a dealer, the only fear of their researchs was that you got your stuff exposed, and then when cops left the place, there you were surrounding by 7, 12 ,20 junkies that had been just thaught what did you had in your pockets. Nasty situation.
In Portugal back them if they were to caught you with a single not prescribed benzo you were in problem, but if they found heroin/ needles on you, you were fucked, specially if busted by the GNR (Portugal form of spanish Guardia Civil or italian Carabinieri).
Today the two countries have similar politics, possesion of drugs is an administrative fault, they both fine you. Only difference is in Portugal they can made you undergo some program., But they reached this point from different starting points: Portugal law stop seeing addicts as criminals, so 30/2000 law was seen as very progressist; Spain just made 1/92 law, among other things, to stop allowing people to have drugs just like having tobacoo, so it was seen as repressive.

Btw, I live on the border, speak the two languages and have lived and worked in Portugal, have had many portu addicts friends an two girl friends. Hell even my wife was portu ( non addict) and just before separation we were doing my paperwork to get the double nationality just like she has. So being a frontierman and a junkie allows me to know how things are and specially were
Every step Portugal took to the current situation was taken following Spanish experiences. That's the bare truth, not some kind of " drug treatment chauvinism, I am not a french ffs!
I fucking love Portugal and portus, I prefer them rather than Spaniards as individuals, but I prefer Spain as a society in this kind of regards.
Sorry about the lenght of the post @Also Tappered. I find it hard to concentrate info in English, I feel I am not making sense when I try.

 

[Keif' Richards]

Portugal law 30/2000 its a good law, as you say it decriminalized the possesion of drugs, bit before decrminalizing it you need to have labelled it as a crime. Possesion of drugs never was a crime in Spain, and before 1/1992 law you didn't get even fined or privated of your drugs. Police has given back my gear many a time. They searched you and if they didn't find notorious amounts or múltiple bags and money they just gave it back to you, because no tribunal would accept a case over non criminal activity.
I have been in open air shooting galleries with the police telling us literally " no worry, do your thing, we will wait for you to end" then, they reserched us, often finding on you another baggie ot two, some hash, rohypnol, whatever, only to gave us back the drugs. In fact, if you were not a dealer, the only fear of their researchs was that you got your stuff exposed, and then when cops left the place, there you were surrounding by 7, 12 ,20 junkies that had been just thaught what did you had in your pockets. Nasty situation.
In Portugal back them if they were to caught you with a single not prescribed benzo you were in problem, but if they found heroin/ needles on you, you were fucked, specially if busted by the GNR (Portugal form of spanish Guardia Civil or italian Carabinieri).
Today the two countries have similar politics, possesion of drugs is an administrative fault, they both fine you. Only difference is in Portugal they can made you undergo some program., But they reached this point from different starting points: Portugal law stop seeing addicts as criminals, so 30/2000 law was seen as very progressist; Spain just made 1/92 law, among other things, to stop allowing people to have drugs just like having tobacoo, so it was seen as repressive.

Btw, I live on the border, speak the two languages and have lived and worked in Portugal, have had many portu addicts friends an two girl friends. Hell even my wife was portu ( non addict) and just before separation we were doing my paperwork to get the double nationality just like she has. So being a frontierman and a junkie allows me to know how things are and specially were
Every step Portugal took to the current situation was taken following Spanish experiences. That's the bare truth, not some kind of " drug treatment chauvinism, I am not a french ffs!
I fucking love Portugal and portus, I prefer them rather than Spaniards as individuals, but I prefer Spain as a society in this kind of regards.
Sorry about the lenght of the post @Also Tappered. I find it hard to concentrate info in English, I feel I am not making sense when I try.

Everything I'm writing comes from a position of acceptance. I mean accepting that I ultimately can't control the end-result whenever I consume certain (most) drugs. Whatever I do, whatever happens, I ultimately will not be in control of my life or the situation.

Along with just the "doing hard work" bit when trying to get clean, there are some things that really helped me. I didn't put myself in situations in which I was likely to be exposed to drugs. I deleted phone numbers etc. None of these things are fool-proof. There was an instance 2 years into my clean-journey when the only thing that stopped me was that I no longer had this person's number. Of course I could get the number, I could go downtown and score, all that stuff. The thing is, every layer of security between myself and drugs is helpful.

When I say "gate keepers" I just mean I don't believe in automatic, unlimited, as much as you can carry drug prescribing. I believe in giving them what they want/need. I think it adds an extra layer of security to the stability of users. They know they can only go once/twice per day and that's it. They know any dope they could score would not compare in quality. With all of these considerations, the addict hopefully forgets the craving and continues treatment.

I've been in situations in my life where I had unlimited quantities of Morphine/Heroin. I always assumed that would be the best thing ever. When I was using 5g a day I just fel completely numb, emotionally, physically all of it. It wasn't fun or enjoyable. The only way I got my perceived benefits back from Morphine was by lowering the dose to no more than 2g Heroin at most. This is still a lot, I know.

If we're talking about peoples' long-term success, I think it would be good, at least in the beginning of treatment, to monitor and dispense the drugs carefully. Too little will lead to relapse, too much leads to the symptoms described above. There seems to be a goldilocks zone and it seems to be under 2g per day. After that, I just get more side-effects than anything.

I just think it would be really great to have someone work closely with the patient and balance the cravings and urge to use with their actual goals in life. In short, I just think there needs to be documentation. I believe Buprenorphine exploded due to people adjusting their own dosages to unnecessarily high levels. I don't want to see a similar situation occur with newly-legalized drugs.

 

[Señor Moreno]

Everything I'm writing comes from a position of acceptance. I mean accepting that I ultimately can't control the end-result whenever I consume certain (most) drugs. Whatever I do, whatever happens, I ultimately will not be in control of my life or the situation.

Along with just the "doing hard work" bit when trying to get clean, there are some things that really helped me. I didn't put myself in situations in which I was likely to be exposed to drugs. I deleted phone numbers etc. None of these things are fool-proof. There was an instance 2 years into my clean-journey when the only thing that stopped me was that I no longer had this person's number. Of course I could get the number, I could go downtown and score, all that stuff. The thing is, every layer of security between myself and drugs is helpful.

When I say "gate keepers" I just mean I don't believe in automatic, unlimited, as much as you can carry drug prescribing. I believe in giving them what they want/need. I think it adds an extra layer of security to the stability of users. They know they can only go once/twice per day and that's it. They know any dope they could score would not compare in quality. With all of these considerations, the addict hopefully forgets the craving and continues treatment.

I've been in situations in my life where I had unlimited quantities of Morphine/Heroin. I always assumed that would be the best thing ever. When I was using 5g a day I just fel completely numb, emotionally, physically all of it. It wasn't fun or enjoyable. The only way I got my perceived benefits back from Morphine was by lowering the dose to no more than 2g Heroin at most. This is still a lot, I know.

If we're talking about peoples' long-term success, I think it would be good, at least in the beginning of treatment, to monitor and dispense the drugs carefully. Too little will lead to relapse, too much leads to the symptoms described above. There seems to be a goldilocks zone and it seems to be under 2g per day. After that, I just get more side-effects than anything.

I just think it would be really great to have someone work closely with the patient and balance the cravings and urge to use with their actual goals in life. In short, I just think there needs to be documentation. I believe Buprenorphine exploded due to people adjusting their own dosages to unnecessarily high levels. I don't want to see a similar situation occur with newly-legalized drugs.

Oh, so that means gate keeper? Fine thanks. I agree 100% that you will limit yourself, andy it happens naturally,, or happened to me at least. As you said you don't want to be forever numbed to retardation, you dont want to have a serious accident or disease that caughting you on 120 methadone, jeopardizing your pain relief chances and hoping for the doctors to give you half a gram of morphine 3× day....

 

[AlsoTapered]

Most people reach a level they are happy with but a minority will always just keep increasing the dose. Most drugs become toxic which limits them eventually - but at a level which is harmful. But opioids... I've heard of people reaching 1.5 or 2 grams of fentanyl a day.

I truly think someone's long term plan is to add a little carfentanil to the fentanyl (as happens now in some places) so that they can get people hooked in a manner that for all intents and purposes is a one way street.

Their ARE drugs one could use to substitute even carfentanil (at least at lower ranges) but they were discovered in the 1960s so are off-patent thus nobody will produce them (they are quite costly/complex to make). R-4066 is the best known, a methadone derivative. The chiral acetyl methadol is some x212 morphine and duration is 2-3 days. But it's not cardiotoxic AFAIK. BUT I imagine that would be a nightmare to reduce BUT possible.

Of course, maybe they aren't so Machiavellian- carfentanil is preferred for it's longer duration and of course, much more profitable.

But it's a bleak future either way. I truly think that the US and Canada are approaching this as the Japanese do. If you are an addict, you are worthless and society SHOULD shun you (in Japan this is the case). But sooner or later a rich and famous person will get hooked and their will be an outcry. The R-4066 derivatives are legal so someone with $$$ could have it made.

 

[Pickledlemons]

I take xanax and bupe every day. 16mg of bupe, which I still do enjoy the effect of, even 7 years later. So I totally don't agree with the almost consensus that it has no recreational value. Though I suppose its different for everyone.

Also xanax around 6mg or so, I'm working on getting that down. Used to be 8mg. I'll admit taking both of these two, plus all my vaping can leave me somewhat short of breath at times but I haven't died yet.

I've pretty much resigned myself to taking bupe for the rest of my life but I'm still pretty scared of lifelong benzo addiction... and do want to get off..... and you should too. It doesn't lead to anything good. Especially xanax of all benzos. Maybe your doc would be more relaxed with something like diazepam.

But geeze if you are that dead set on getting more xanax just buy some online. I bought a bag of 1000 bars like 3 years ago and still have plenty left. Probably didn't cost me much more than a few of your doctor appointments.