I don't understand the bupe injection really (well I can understand it in some of the extreme cases mentioned above)....
But If it's meant to stop cravings, how do they expect a steady stream of a partial agonist that causes zero effects to do anything for cravings?
For me, being able to feel a slight change in my mood/perceptions when I dose, is what has kept me in treatment, rather than feeling nothing at all.
It bothers me a bit that they will try to force everyone onto the injection one day in order to keep people from feeling bupe at all. This would push a lot of people out of treatment, including me. Buprenorphine wouldn't even do anything for me at that point honestly. It basically is just antagonist therapy with the injection or super high doses, rather than agonist/partial agonist therapy.
As for OP's question...
I highly doubt anyone is getting high on full agonists with 16+mg of bupe in their system. It's actually almost impossible, since at that point your receptors are so saturated. Unless they're using fentanyl.
It's most likely the partial agonist of the bupe eliciting these things.
Once your tolerance to full agonist drops, it is very likely to start getting slight effects from buprenorphine that will look almost identical to some one who's using regular painkillers or heroin.
Though I'm sure your partner is most likely not feeling the same intense amount of euphoria or a 'high'' from it. Buprenorphine will make you tired/noddy at times though and even causes constipation, small pupils, etc.. it is still a semi-synthetic opiate after all. It will go away after awhile.
In my personal experience, it stops cravings for me because I get cravings to use when I can use. Because the medication nullifies the effects of opiates, I have no craving to use because it's pointless. There's no reason to attempt it, so I don't get the urge to, if that makes sense.
My history kind of demonstrates the different ways in which cravings occur. You, clearly, are using maintenance therapy as a (probably) cheaper, more reliable, less illegal method of still obtaining a bit of a buzz. And hey, if that is what you need to stay off dope or prescription pills, then have at it. The strips had the opposite effect for me - I got no buzz from it (unless I abused it, which is why I did) and I could skip my takeaway doses (which I did) to get high off heroin. So I had cravings specifically *because* the Suboxone did nothing for me, and because I could miss a dose whenever and use the real thing.
For me it's the possibility of using that gives me cravings and that's true for opiates for me all the time. Less true for other drugs. As soon as I cannot physically use opiates, my cravings vanish. This is why naltrexone also didn't work for me. I did enough research to find out if I waited 5 days after my last dose, the drug would be out of my system and I could abuse heroin again.
So I understand why this medication wouldn't work for you - you're using the bupe in a completely different way. It's not the wrong way (although I'm sure some professionals would argue that it is but who really cares what they think so long as it's working for you, and it seems to be) so I mean keep doing what you're doing.
I think the reason they want to transition everyone onto it is diversion. That's the thing they care most about with controlled substances. I'm on dexamphetamine and I've been given a restricted access authority (I'm in Australia so we actually allow people with substance use histories to access controlled stimulants if they medically need them and I have both narcolepsy and ADHD so I do) and my prescription conditions are
1) twice weekly pill pickup from one chemist only, always the same one and have to apply for permission to shift dispensing if I move location
2) twice monthly urine drug screening
3) random checks for IV drug use due to my history as an IV user (they had my heroin use on record as I'm registered as drug dependent on government records)
Now, one could argue that they care about me taking illicit drugs. They don't really - they're not going to revoke my access to a much needed medication for drug use and currently I am using illicit drugs. But they also know that I can use between the drug tests as they're not actually random, one is at the place I get my Buvidal injection, so I know the exact date and time, and the other is at my GP, where I personally book the appointment. Avoiding getting caught for IV drug use is also not a hassle. I limit my intake, and don't use in the week leading up to the appointment or I use a different ROA. If I got caught they would be asking my prescribing doctor to engage me with treatment or see what he can do to help me managing and what isn't working.
The ONLY thing they care about is the diversion. That is the issue and that is what will lose me the medication. That is the reason for the restricted supply - I can't divert it if I'm only getting 12 or 16 pills at a time and I need most of them to get through my day. I often have around 40 left over due to my dosing regiment, but that'll change as my tolerance increases. Currently it's low as I only just started the medication. It's also the reason for the drug testing really - if my piss test shows up negative for stimulants they know I'm not actually taking it. It's not actually really to check if I'm on other drugs, that's just a handy second function.
So with the opiate replacement therapy, diversion IS a huge problem. It is in Australia (hence why you have to pick it up from the chemist every day and have supervised dosage and earn your takeaway doses - some people are barred from ever having takeaways if they have any red flags for diversion and can only get them on days the chemist is closed) and I know it is in the US because you guys get given a month's supply at a time, which has led to an explosion of Buprenorphine being available on the streets.
The clear solution to this is either making it like it is here with supervised dosing, which doesn't fit well with the concept of American freedom and I think people would very much protest about. Or its to phase in injections. I understand their logic. I don't really think they care that some people catch a buzz, so long as they're not doing more dope. They are far, far more concerned about diversion of controlled medication than something as innocent as that.
It just very much sucks for people such as yourself.
