Buprenorphine/subs with full agonist for breakthrough pain. Does this work ?

[Deru]

Yes bupe has an established pharmacodynamic profile. However making a credible and accurate determination with regard to its therapeutic benefit for said individual using it in conjunction with a full agonist for pain management is not plausible. Gets into mostly uncharted territory.

Fair point.

I used buprenorphine and oxycodone daily for a decade, so most of my advice is based on anecdotal evidence with a little bit of scientific evidence mixed in

 

[copium7777]

Both of you present interesting points. It seems there's not enough literature to say what the tipping point is wherein bupe would block. a full agonist , but that point exists. So experimentation would be the only way to find out

 

[morphonorconic]

^Thats what I was about to say. Trial and error. The science that exists on this subject warrants further research. It’s just that further research is needed for nearly any clinical application you can think of.

 

[copium7777]

My thought was at the right dose bupe could provide a steady amount of long lasting mild pain relief without respiratory depression and wi thg out building much tolerance and then full agonists could be used for more intense acute pain flare.


Another question. How crazy or impossible would it be , if one isn't taking pain meds daily but is taking often enough to build. tolerance, to use narcan to totally reset tolerance. I usually just go with ldn which is effective when u take it multiple days in a row for awhile , but if u just wanted to reset tolerance in w matter of hours. Especially for someone with only w mild moderate tolerance, would narcan work ?

 

[copium7777]

The pharmacological profile of buprenorphine is pretty well studied and well known.

Only long term usage of dosages over 8mg/day would you really start seeing the effects of another opioid muted for that long.

I agree based on experience. Took 2 mg of bupe. 4 hours later took twenty mg oxy. Def felt the oxy. wasn't fully blocked by bupe. Actually good combo if u want a subtle long lasting opioid for pain baseline and then a shorter more intense one for flares or just to give more euphoria. My concern is now that I took the oxy will taking bupe AFTER that cause precipitated withdrawals even tho I already have some bupe in system. In about twenty minutes we shall see !

 

[Faxefyren]

I agree based on experience. Took 2 mg of bupe. 4 hours later took twenty mg oxy. Def felt the oxy. wasn't fully blocked by bupe. Actually good combo if u want a subtle long lasting opioid for pain baseline and then a shorter more intense one for flares or just to give more euphoria. My concern is now that I took the oxy will taking bupe AFTER that cause precipitated withdrawals even tho I already have some bupe in system. In about twenty minutes we shall see !

You probably found your answer already, but if you're in bupe daily or used to taking it regularly, as long as you don't wait more than 48 hours before your next dose, you should be good

 

[smokeymcpot42088]

The smaller the bupe dosage the less receptors will be locked; hence better but probably never 100% of what you would have got across the BBB. I am unsure of that but it feels correct since ANY bupe WILL lock to your opi receptor and your full agonist won't reach them. (correct me if I science'd wrong, this is more at the hypothesis stage)

General rule of thumb for me, week of going down to 2mg, 24 hours later I suspect I am getting 65-90 percent effect; depending on a lot. 65-90 is just how I feel and comes from no source.

oh yea and always take the bupe first no matter what if you are mixing; I am sure that as been explained

 

[polarthedog]

i mix bupe with other opiates in order to increase the effect sometimes, i take 170 mg of methadone a day, and i have found that i can take up to 2mg a day with it without pwds or any reduced effects