kinkyjohn
Bluelighter
- Joined
- Jan 23, 2015
- Messages
- 175
Introduction:
So, thought I would finally post this buprenorphine induction technique on the off chance anybody else is brave enough to give it a try. Sorry it's a little terse, but it's tested only on me and should be considered at best a hypothesis rather than a "will work for you too" methodology you can follow blindly. Those who wish to comment might just want to scan the intro and methodology section but anybody who is brave enought to try - do at least attempt to read carefuly / ask questions. I'm about to have to do this ... so if anybody speaks up as interested to try in the next few days .. I'll be happy to have a withdraw-along with you on bluelight with free sympathy if you wind up in preciptated WD.
The method involves taking small doses of bupe that are insufficient to trigger precipitated withdrawal and repeating at regular intervals until sufficient bupe has been taken to cover withdrawal. It involves no further doses of full agonists, no waiting since a final dose of full agonist, and (if done right) no withdrawal symptoms during the induction of bupe. On the down side the process is tested only on me and with a small selection of opiates, requires proper gem scales, a lot of patience with small doses, some basic maths, off label use of bupe insulfated, and most importantly of all ... a what the fuck I'll walk it off attitude to precipitated withdrawal as that is what will happen if it goes wrong.
The only significant risk to life and limb from trying this is if you attempt to resume full agonists after starting bupe .. since this method involves low doses of bupe it will at least at the start be much easier to still get well from full agonists and the overdose risk will be much lower but it's still there so please beware (please ... no needles if you must!). I always take all my full agonists before switching (junky see junky do ..) and have triggered preciptiated WD on all magnitudes of WD. Ironically, precipitated WD is much worse for mild withdrawal as for hardcore WD it really can't get much worse but isn't long enough to dehydrate severely / suffocate by wretching / lose your mind like it is with a proper crazy 5 day WD (fent FTW!).
Methodology.
1.) Take a final dose of full agonists.
2.) If totally baked .. wait till reasonably conscious.
3.) Weigh out 0.15mg of buprenorphine. Don't forget to adjust the bupe content to the weight of your pill and carefuly read the note on dosing below. To adjust to the weight of the pill .. record the weight of your full pill and derive weight of pill matter needed to get that 0.15 mg dose of bupe (e.g. my pill weighs 700mg and has 8mg of bupe which means 1mg of bupe is available from (700/8)=87.5mg and 0.15mg of bupe from (15/100)*87.5=13.125mg pill matter. If you're not confident on you calculation do post your pill weight / bupe content and ask for help. Also add a small adjustment for sex / weight if you are exceptionally large male / small female (for ref. I am a 70kg male).
4.) Crush it up very finely and rail it (insulfate)
5.) Note the dose and time taken (you can skip this when you know exactly how much bupe you need to get well, but you may skip doses, lose some bupe, etc. so it pays to keep a note.
6.) Set a timer for 45 mins.
7.) After timer return to step 3 unless total dose is above target.
Dosage:
The max individual dosage that you can take without causing precipitated withdrawal is a complete unknown and likely dependent on opiate and personal physiology. For me (70kg male) it is 0.25mg of bupe so I do 0.2mg and that seems safe for all opiates I've tried. It flips from being ok to being in precipitated WD in very small dose ranges and with very little warning .. so be cautious.
The 45 minute dose frequency is based on time taken to peak blood plasma when insfulating .. which is 30 minutes and is reasonably stable by person / situation. It's probably pyhsically localised concentration of bupe shortly after you consume it that is most likely to displace existing full agonist so I recommend giving it some chance to dissipate especially given the rapid onset nature of insulfation so add on 15 mins for good luck.
If you don't know how much to use in total then start with 4-6mg and then when you start to feel a little sick after that .. take another small dose till you get to the 24-48 hour mark (i.e. when your full agonist will have mostly cleared and just the bupe is keeping you well). Obviously it helps to know where "just enough," bupe is so in future you can stop with the crappy micro doses and just sublingual whatever else you want.
Done this about 10 times off H / fent-a-log WDs and all quantities (max per-dose and total amount of bupe needed) are stable as hell in me regardless of habit and opiate and I've done this with everything from mild H withdrawal up to proper bat shit crazy constant wretching K hole of pain fent withdrawal. It's generally worth it as it avoids severe withdrawal which is the main driver of cravings .. that's obviously true for the recently withdrawn opiate user .. but I've als o found it to be true weeks after withdrawal when I'm even off the bupe as well.
If it goes wrong:
If it goes wrong you will be in precipitated withdrawal. If it hits then the official recommendation is to do 4mg bupe every 30 mins till it goes though you can start with 8mg if you've not got far into your dose. There isn't much overdose risk with bupe except in combination with full agonist / other sedatives so if you avoid other downers and of course full agonists .. you can ramp your dose up even quicker.
Precipitated WD is over in an hour or two provided you take more bupe. If you're not used to severe WD you may find it a little fruity and should have somewhere you can writhe in agony that's near a bathroom and without other people providing stimulus (a sitter is great! but you likely won't be able to function .. and shouldn't try). Really .. it's just the shock of the transition from well to hell in about 5 minutes that makes it feel SO bad. Do NOT worry even if you have potentially fatal grade withdrawal (provided you have more bupe) ... it will be too short lived to be fatal and it will become tolerable quickly.
Precautions:
- With this approach less, less often is always ok, the converse is never true:
- If a line looks a bit fat .. cut a 1/4 of it off.
- If you forgot a timer .. wait another 30 mins unless you're really sure.
- If you want to skip a dose cos your doing something else .. that's not a problem at all.
- Be very careful of slack things like weighing out 4 doses in one go and cutting it in quarters (the only way I've ever messed this up non-intentionally).
- Also be careful with weighing each pill .. I've seen some per-pill variation and this can be big between batches / europe vs UK supplies. We're hardly talking large doses here .. be careful.
- NEVER EVER dose when you are out and about and always wait 5-10 minutes after a dose before going out. It shouldn't need to be said, but I'll say it for a third time - if you need to go out / drive then always delay your dose.
- Avoid loperamide until you're finished or have triggered proper withdrawal as it does seem to interact poorly. Expect your bowels to be loose .. as you will likely be silly constipated and they're returning to normal (unless you've got a totally rock n roll codeine habit or summing!).
- Insulflation is absolutely essential to take accurate dose sizes though good luck if you want to try sublingual as there is a possibility it will be far superior as it achieves less localised concentration so you can take bigger doses. It probably won't work though as the dose you actually get with sublingual is likely all over the place and is probably not easily repeatable. I guess an IV drip would be ideal .. but needles really aren't as you don't want sudden condensed doses.
- DO DO DO check your particular opiate is suitable for buprenorphine induction. It's easy to switch to something else first if needed (and you can get it).
- It is supposedly the case that around 1/3rd of people get less effect from buprenorphine, and it's likely that lucky 3rd will need a lot more than 6mg total and it's quite possible they can't take correspondibly more than 0.15mg of bupe per dose. On balance such people may decide the length of time taken to induce makes this not worth it .. and if your such a lucky person do let us know how it goes.
How you will feel:
You'll probably need to spend time in the bathroom and might have some temperature sensitivity / cough a bit but it's just your autonomous nervous system waking up after it's long opiate induced slumber as bupe has a much milder effect on it. You ain't gonna feel great as you're not high anymore and being sober is shit to start with plus you're coming down and bupe doesn't cover severe withdrawal anyway (but does make it doable). Smoke weed, have a (FEW!) beers, cuddle something / somebody (real men WD with a teddy bear!) .. and do whatever helps you chill out and have a normal at home day. Don't arrange to do anything stressful, time consumimg or far from the bathroom .. unless it's reasonably short. Do not dose when doing it.
If you feel proper WDs (can be a bit hard to be sure for a good few minutes after a dose) and you don't have a crazy habit bupe won't cover and/or aren't using crazy short half life fent that's wearing off then it's likely you're going too fast and too much. Get ready for the BURN!
If you want to take more than 0.15mg then you really should deliberately set out to take larger lines every 45 mins till you trigger precipitated WD and let us all know where that is. This is mainly because it is safer and easier to cope with precipitated withdrawal when you know it's coming. Furthermore, if you build a reasonable dose of bupe before doing this escalating dose the precipitated WDs will be shorter .. although not generally much milder. I've deliberately precipiated WD with both mild year long heroin habits and batshit crazy fentanyl habits and have never attempted to go back to full agonists. That's mainly because I wouldn't be taking bupe if I had full agonists that were strong enough and because I am used to the WD's you get from a 6 month 8x fent OD offset with meth habit. Please be careful .. that shit fucking hurts!
Final note:
Please remember it is ONLY me that has tried this so do not be surprised if it just doesn't work properly .. or even at all for you or for the opiate you are using (no sympathy for those who haven't checked their opiate is suitable for bupe substitution first!). I also always recommend taking the minimal dose of bupe you need to feel well as afer the initial few days of WD you will feel so much more human. I also rapidly reduce my bupe use to 0 before I habituate to it .. for an easily manageable withdrawal to opiate and bupe naive (if using fent) or no withdrawal at all (if using H).
Happy to answer questions and help out any psychonaughts out there willing to upstage my precipiated WDs for science! Got the life so might not reply quickly, but promise to check back every week or so. I appreciate few wil l likely try this.
Learn to love those precipitated WDs! Feel the pain .. feel the burn .. empty your stomach both ends ... then trip OUT! they are also fantastic for getting days off work while looking like very severe food poisoning (but oh god .. the journey home from work ... bring a friend with a car!).
References:
Original idea from:
Sublingual Buprenorphine/Naloxone Precipitated Withdrawal in Subjects Maintained on 100 mg of Daily Methadone. See [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094723/]
45 minute spacing from:
The pharmacodynamic and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/naloxone tablets in opioid abusers. See [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776483/]
Bernese method (very similar - but much more involved .. and less suited to implementation at home): Just do a search on bl .. quite a few threads on here.
So, thought I would finally post this buprenorphine induction technique on the off chance anybody else is brave enough to give it a try. Sorry it's a little terse, but it's tested only on me and should be considered at best a hypothesis rather than a "will work for you too" methodology you can follow blindly. Those who wish to comment might just want to scan the intro and methodology section but anybody who is brave enought to try - do at least attempt to read carefuly / ask questions. I'm about to have to do this ... so if anybody speaks up as interested to try in the next few days .. I'll be happy to have a withdraw-along with you on bluelight with free sympathy if you wind up in preciptated WD.
The method involves taking small doses of bupe that are insufficient to trigger precipitated withdrawal and repeating at regular intervals until sufficient bupe has been taken to cover withdrawal. It involves no further doses of full agonists, no waiting since a final dose of full agonist, and (if done right) no withdrawal symptoms during the induction of bupe. On the down side the process is tested only on me and with a small selection of opiates, requires proper gem scales, a lot of patience with small doses, some basic maths, off label use of bupe insulfated, and most importantly of all ... a what the fuck I'll walk it off attitude to precipitated withdrawal as that is what will happen if it goes wrong.
The only significant risk to life and limb from trying this is if you attempt to resume full agonists after starting bupe .. since this method involves low doses of bupe it will at least at the start be much easier to still get well from full agonists and the overdose risk will be much lower but it's still there so please beware (please ... no needles if you must!). I always take all my full agonists before switching (junky see junky do ..) and have triggered preciptiated WD on all magnitudes of WD. Ironically, precipitated WD is much worse for mild withdrawal as for hardcore WD it really can't get much worse but isn't long enough to dehydrate severely / suffocate by wretching / lose your mind like it is with a proper crazy 5 day WD (fent FTW!).
Methodology.
1.) Take a final dose of full agonists.
2.) If totally baked .. wait till reasonably conscious.
3.) Weigh out 0.15mg of buprenorphine. Don't forget to adjust the bupe content to the weight of your pill and carefuly read the note on dosing below. To adjust to the weight of the pill .. record the weight of your full pill and derive weight of pill matter needed to get that 0.15 mg dose of bupe (e.g. my pill weighs 700mg and has 8mg of bupe which means 1mg of bupe is available from (700/8)=87.5mg and 0.15mg of bupe from (15/100)*87.5=13.125mg pill matter. If you're not confident on you calculation do post your pill weight / bupe content and ask for help. Also add a small adjustment for sex / weight if you are exceptionally large male / small female (for ref. I am a 70kg male).
4.) Crush it up very finely and rail it (insulfate)
5.) Note the dose and time taken (you can skip this when you know exactly how much bupe you need to get well, but you may skip doses, lose some bupe, etc. so it pays to keep a note.
6.) Set a timer for 45 mins.
7.) After timer return to step 3 unless total dose is above target.
Dosage:
The max individual dosage that you can take without causing precipitated withdrawal is a complete unknown and likely dependent on opiate and personal physiology. For me (70kg male) it is 0.25mg of bupe so I do 0.2mg and that seems safe for all opiates I've tried. It flips from being ok to being in precipitated WD in very small dose ranges and with very little warning .. so be cautious.
The 45 minute dose frequency is based on time taken to peak blood plasma when insfulating .. which is 30 minutes and is reasonably stable by person / situation. It's probably pyhsically localised concentration of bupe shortly after you consume it that is most likely to displace existing full agonist so I recommend giving it some chance to dissipate especially given the rapid onset nature of insulfation so add on 15 mins for good luck.
If you don't know how much to use in total then start with 4-6mg and then when you start to feel a little sick after that .. take another small dose till you get to the 24-48 hour mark (i.e. when your full agonist will have mostly cleared and just the bupe is keeping you well). Obviously it helps to know where "just enough," bupe is so in future you can stop with the crappy micro doses and just sublingual whatever else you want.
Done this about 10 times off H / fent-a-log WDs and all quantities (max per-dose and total amount of bupe needed) are stable as hell in me regardless of habit and opiate and I've done this with everything from mild H withdrawal up to proper bat shit crazy constant wretching K hole of pain fent withdrawal. It's generally worth it as it avoids severe withdrawal which is the main driver of cravings .. that's obviously true for the recently withdrawn opiate user .. but I've als o found it to be true weeks after withdrawal when I'm even off the bupe as well.
If it goes wrong:
If it goes wrong you will be in precipitated withdrawal. If it hits then the official recommendation is to do 4mg bupe every 30 mins till it goes though you can start with 8mg if you've not got far into your dose. There isn't much overdose risk with bupe except in combination with full agonist / other sedatives so if you avoid other downers and of course full agonists .. you can ramp your dose up even quicker.
Precipitated WD is over in an hour or two provided you take more bupe. If you're not used to severe WD you may find it a little fruity and should have somewhere you can writhe in agony that's near a bathroom and without other people providing stimulus (a sitter is great! but you likely won't be able to function .. and shouldn't try). Really .. it's just the shock of the transition from well to hell in about 5 minutes that makes it feel SO bad. Do NOT worry even if you have potentially fatal grade withdrawal (provided you have more bupe) ... it will be too short lived to be fatal and it will become tolerable quickly.
Precautions:
- With this approach less, less often is always ok, the converse is never true:
- If a line looks a bit fat .. cut a 1/4 of it off.
- If you forgot a timer .. wait another 30 mins unless you're really sure.
- If you want to skip a dose cos your doing something else .. that's not a problem at all.
- Be very careful of slack things like weighing out 4 doses in one go and cutting it in quarters (the only way I've ever messed this up non-intentionally).
- Also be careful with weighing each pill .. I've seen some per-pill variation and this can be big between batches / europe vs UK supplies. We're hardly talking large doses here .. be careful.
- NEVER EVER dose when you are out and about and always wait 5-10 minutes after a dose before going out. It shouldn't need to be said, but I'll say it for a third time - if you need to go out / drive then always delay your dose.
- Avoid loperamide until you're finished or have triggered proper withdrawal as it does seem to interact poorly. Expect your bowels to be loose .. as you will likely be silly constipated and they're returning to normal (unless you've got a totally rock n roll codeine habit or summing!).
- Insulflation is absolutely essential to take accurate dose sizes though good luck if you want to try sublingual as there is a possibility it will be far superior as it achieves less localised concentration so you can take bigger doses. It probably won't work though as the dose you actually get with sublingual is likely all over the place and is probably not easily repeatable. I guess an IV drip would be ideal .. but needles really aren't as you don't want sudden condensed doses.
- DO DO DO check your particular opiate is suitable for buprenorphine induction. It's easy to switch to something else first if needed (and you can get it).
- It is supposedly the case that around 1/3rd of people get less effect from buprenorphine, and it's likely that lucky 3rd will need a lot more than 6mg total and it's quite possible they can't take correspondibly more than 0.15mg of bupe per dose. On balance such people may decide the length of time taken to induce makes this not worth it .. and if your such a lucky person do let us know how it goes.
How you will feel:
You'll probably need to spend time in the bathroom and might have some temperature sensitivity / cough a bit but it's just your autonomous nervous system waking up after it's long opiate induced slumber as bupe has a much milder effect on it. You ain't gonna feel great as you're not high anymore and being sober is shit to start with plus you're coming down and bupe doesn't cover severe withdrawal anyway (but does make it doable). Smoke weed, have a (FEW!) beers, cuddle something / somebody (real men WD with a teddy bear!) .. and do whatever helps you chill out and have a normal at home day. Don't arrange to do anything stressful, time consumimg or far from the bathroom .. unless it's reasonably short. Do not dose when doing it.
If you feel proper WDs (can be a bit hard to be sure for a good few minutes after a dose) and you don't have a crazy habit bupe won't cover and/or aren't using crazy short half life fent that's wearing off then it's likely you're going too fast and too much. Get ready for the BURN!
If you want to take more than 0.15mg then you really should deliberately set out to take larger lines every 45 mins till you trigger precipitated WD and let us all know where that is. This is mainly because it is safer and easier to cope with precipitated withdrawal when you know it's coming. Furthermore, if you build a reasonable dose of bupe before doing this escalating dose the precipitated WDs will be shorter .. although not generally much milder. I've deliberately precipiated WD with both mild year long heroin habits and batshit crazy fentanyl habits and have never attempted to go back to full agonists. That's mainly because I wouldn't be taking bupe if I had full agonists that were strong enough and because I am used to the WD's you get from a 6 month 8x fent OD offset with meth habit. Please be careful .. that shit fucking hurts!
Final note:
Please remember it is ONLY me that has tried this so do not be surprised if it just doesn't work properly .. or even at all for you or for the opiate you are using (no sympathy for those who haven't checked their opiate is suitable for bupe substitution first!). I also always recommend taking the minimal dose of bupe you need to feel well as afer the initial few days of WD you will feel so much more human. I also rapidly reduce my bupe use to 0 before I habituate to it .. for an easily manageable withdrawal to opiate and bupe naive (if using fent) or no withdrawal at all (if using H).
Happy to answer questions and help out any psychonaughts out there willing to upstage my precipiated WDs for science! Got the life so might not reply quickly, but promise to check back every week or so. I appreciate few wil l likely try this.
Learn to love those precipitated WDs! Feel the pain .. feel the burn .. empty your stomach both ends ... then trip OUT! they are also fantastic for getting days off work while looking like very severe food poisoning (but oh god .. the journey home from work ... bring a friend with a car!).
References:
Original idea from:
Sublingual Buprenorphine/Naloxone Precipitated Withdrawal in Subjects Maintained on 100 mg of Daily Methadone. See [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094723/]
45 minute spacing from:
The pharmacodynamic and pharmacokinetic profile of intranasal crushed buprenorphine and buprenorphine/naloxone tablets in opioid abusers. See [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776483/]
Bernese method (very similar - but much more involved .. and less suited to implementation at home): Just do a search on bl .. quite a few threads on here.
