Buprenorphine Maintenance + Precipitated W/D after Admin!!!

[LightBlueEyes]

Hello Everyone,

I am on buprenorphine maintenance and I am currently at a dose of .5-1 mg a day. I never used to experience precipitated w/d after each dose of bupe at higher doses, but recenly at lower doses I experience between 30 mins-One hour of minor w/d symptoms after dosing bupe. sixpartseven has also experienced this precipitated w/d. Anyone else?

No, I am not taking a full agonist and going back on bupe too soon. I think I know what I am talking about when I introduce: a wonderful hypothesis

I believe that when dosing buprenorphine sequentially there is a build up of norbuprenorphine (the main active metabolite.) Now, at very high doses (8 mg +) bupe may antagonize most of norbupe's effects just like it blocks full agonists. At lower doses such as mine, norbupe may have an effect on opiate receptors. When re-dosing bupe, the norbupe is knocked off the receptor sites and we experienced precipitated w/d.

Norbupe activity at low doses may also account for why bupe is more enjoyable at lower doses of less than 4 mg.

Cool idea huh?

norbupe info web site:
-http://www.ncbi.nlm.nih.gov/pubmed/11303059-

LBE

 

[sonic]

Personally I've never experienced any negative symptoms from the naloxone in suboxone, but I've also only taken larger doses.. I do 8mg in the morning, and 2-6mg in the evening.

Your theory MIGHT be true, but the counter argument is that the ratio of buprenorphine to naloxone is still 4:1, so when dosing, you're still taking 4x as much bupe as you are naloxone. There still should be some build-up of norbuprenorphine. If there wasn't, you'd be in withdrawal before you even re-dosed. The link you provided stated that norbup was shown to have a "high" binding affinity for mu receptors "comparable" to that of bupe. Also, it wouldn't matter since you're never dosing on naloxone itself, whenever you dose, you're always taking 4x as much bupe as you are naloxone, so the ratio is the same regardless of the dose.

Also, .125-.25mg of naloxone shouldn't be enough to do much. Maybe your are hyper-sensitive to naloxone. This is the most likely answer. Then again that doesn't explain why you didn't experience negative effects from higher doses of suboxone. I do know of other people on this board who have taken really low doses of suboxone and they haven't experienced negative effects from the naloxone.

It'll be interesting to see what other people have to say. Since you're on such a low dose, maybe you could ask your doctor for subutex.

 

[LightBlueEyes]

sonic,

I believe that the substance causing the precipitated w/d is in fact the bupe and NOT the naloxone. Bupe has higher affinity for opiate receptors than both naloxone and norbuprenorphine. The bupe/norbupe difference is the one in question. I believe that after dosing, the body metabolizes some bupe into the also active norbupe which can be active at low bupe doses b/c of the open receptors (higher bupe doses block receptor sites totally, blocking norbupe activity altogether.)

Now, when re-dosing bupe the norbupe is knocked off and one experiences minor w/d until bupe and norbupe attach to receptors once again.

any questions... just ask

Should I post this thread in advanced drug discussion?

LBE

 

[sixpartseven]

I do know of other people on this board who have taken really low doses of suboxone and they haven't experienced negative effects from the naloxone.

I have, but like LBE said, its not from the naloxone.

Usually it only happens with my morning dose. I wake up, feeling slightly sick, not too bad, but definitely need some suboxone. I snort my 2mg, and about 3 minutes later my withdrawals are 10 times worse. It last about 20 minutes, then I start feeling the normal effects of the suboxone.

I cant explain it. I know, I know, its a well known fact that I still do heroin sometimes, but this happens when I havent done heroin for weeks. It happens everyday - every morning, to be specific.

I really have no idea what causes it. I dont doubt LBE's theory, I just dont know.

 

[LightBlueEyes]

6/7,

Thought I would let you know (and anyone else) I experimented today with a gradual dosage of intranasal bupe in the morning (snort 1 mg over 30 mins, snorting 1/3 mg every 10 mins) and I found a reduction in withdrawal symptoms.

Thanks for clearing that up,

LBE

 

[sonic]

If this is true, I wonder what makes norbuprenorphine so special? Is it a stronger mu agonist than unmetabolized buprenorphine? I just don't understand why buprenorphine doesn't immediately stay bound to your receptors? Apparently not all that much is known about norbupe according to LBE's link. It might play more of a role in bupe related maintenance than most people know.

It does often take me 2 hours to peak after taking suboxone sublingually, or about 1-1.5hours if I snort it although I usually start to feel relief within 20 minutes of dosing. Maybe bupe does need to begin to be metabolized before it works best.

 

[dadiddy23]

hey, this is kinda off the subject, but i've heard of a lot of detox facilities using subutex. im on suboxone and my doctor stated that federally it is illegal for a male to take subutex. from what he says, only women who are pregnant are allowed to take subutex -- obviously this is a lie because men on this site take subutex -- so why would he lie about something as worthless as that? i know nobody knows the real reason, but this guy has a p.h.d. a d.o. he's an m.d. how can he be so stupid on this subject. maybe misinformed?

 

[LightBlueEyes]

Yea, you said it...really off topic. Not much I can say to that actually...

sonic, norbupe has weaker affinity than bupe for most receptors, but has more agonist properties. I would like to see more research done on norbupe because I think it may also be very good for maintenance.

Thanks again,

LBE

 

[biggerstronger]

I can also attest to this phenomenon. I feel like I get precipitated w/d for about 20-30 mins then it goes away. It doesn't happen all the time, but perhaps about 1/2 of the time. I also take low doses.

 

[LightBlueEyes]

Thank you biggerstronger, I was wondering if this is just my own, or mine and 6/7's phenomenon lol

Peace+Love

LBE

 

[LightBlueEyes]

*sobs uncontrollably*

bump...I never thought I'd see the day...

 

[LightBlueEyes]

bumptastic