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Extended research on the startling effects of ULD Naltrexone

starfarer

Bluelighter
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NOTE: If you do use Naltrexone in small doses you need to decrease your opioid use. This is very important because it both potentiates and reduces tolerance. Staying on the same dose is counterproductive at any rate. For ULD Naltrexone to work you need to reduce your dose so that your tolerance can come down.


Obviation of opioid withdrawal syndrome by concomitant administration of naltrexone in microgram doses: two psychonautic bioassays.
Ott J.

Entheobotanica, Solothurn, Switzerland.
Abstract
Two psychonautic bioassays (self-experiments) in stepwise and abrupt cessation of long-term daily oral ingestion habits of 800 mg of codeine phosphate are presented. Concomitant administration of minute doses (about 0.5 mcg) of the opioid antagonist naltrexone with each dose of codeine was found in both cases to obviate the expected opioid withdrawal syndrome, resulting in asymptomatic and uneventful transitions from physical opioid dependency states to exogenous opioid-free metabolism. These experiments are analyzed in the context of a conjectured, rapid, iterative reduction and complete elimination of opioid tolerance, once acquired. It was found that coadministration of naltrexone with codeine phosphate obviated the development of both tolerance and physical dependency over several months of four daily oral doses of 200 mg, allowing abrupt ("cold turkey"), asymptomatic and uneventful withdrawal. This points the way to the biochemical substrate of opioid tolerance itself, and shows that this can easily and inexpensively be blocked, even over months of iterative oral administration of substantial doses of opioid analgesics. Finally, it suggests the opioid withdrawal syndrome is directly related to the physiology of opioid tolerance, and can be prevented by blocking tolerance itself. Even when tolerance has been acquired, this can be reduced stepwise over a matter of days, with no symptoms of opioid withdrawal syndrome.



The above article certainly piqued my interest. Over the last few months I have been using 12-15 micrograms of Naltrexone daily in order to reverse my tolerance. I have found that my tolerance has been attenuated by around 50-75% but not by 100% as this article so sincerely claims to be the case. The idea that NLTX could accomplish that is contrary to the chemical changes that are induced by excessive opiate use that is to say there are a multiplicity of different pathways and mechanisms.
The idea of stabilising one's tolerance as well as potentiating opiates is however a fascinating prospect - this article adds something new to what is quickly becoming something of a sensation - do you think it shows promise?
 
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additional information and call for more research

I also found that article a few months ago, and of course it sounds rather unbelievable. But: it works works works! at least kind of.
I've been on suboxone almost two years now, and started tapering, from 20mg/d to hopefully 0 soon, so I have a strong personal motivation concerning that area of research.
While Otts (?) experiment might not not convince due to the sample size of 1, there is actually research being done in this field, with one combination drug, oxytrex (oxycodone and naltrexone), undergoing clinical tests. A good overview is
Lindsay H. Burns,
"Ultra-low-dose opioid antagonists
enhance opioid analgesia while
reducing tolerance, dependence
and addictive properties",
Recent Developments in Pain Research, 2005

and (to a lesser degree), Norman Brown and Jaak Panksepp,
"Low-dose naltrexone for disease prevention and quality of life" in Medical Hypothesis 72 (2009).

Burns gives a very good overview on the mechanics of tolerance (mu receptor switches G-coupling and changes from inhibitory to excitatory signaling; antagonists can somehow prevent this)

I tried to attach both papers, which was prevented by the file size limit. I got them from either blacklight or the other internet, so see there

Anyway: As I see it, there are two big open questions:

1. The effects of an antagonist like naltrexone on on tolerance and subjective effects are extremely dose dependent. The paper by burns reports good effects on both with a dose of 2 micrograms of naltrexone per day, and a marked decrease of effectiveness at 4 mcg/d. These numbers are for oxycodone at doses between 10 and 80mg oxycodone per day. Ott also used 2mcg while taking 50-800mg codeine per day, if I remember correctly. What is the optimal dose when consuming which opioid?

2. The effects of concomitant administration of antagonists are diverse: attenuation of tolerance development, greater analgesia, better subjective effects, and even "less drug liking" at some doses (as measured by conditioned place preference). Which dose/response curve peaks where and what are the maximal effects to be expected, especially with regard to tolerance.


What I am looking for specifically is the correct naltrexone dose for tapering suboxone. I tried 2mcg/d first, with inconclusive results. One day I tried 10mcg when I was already feeling slight withdrawal and waiting for my next morning dose, and bingo: 15 Minutes later my eyelids started resembling those of bassets, I checked my status by standing up, and realized I was very, very intoxicated and very, very high.

Scratch one for science. (http://xkcd.com/54/)

I've been experimenting with doses between 5 and 20 mcg/d now. 20 seems to high, 5 to 10 seems to work, but it's hard for me to determine the optimum for, say, a 100 kg male consuming 10mg buprenorphine a day. I could repeat the extreme effects I described above only once, by going into slight withdrawal, not using ntx for a day and then taking 10mcg ntx. It's still not clear to me what a good daily dose would be.

Help and hints by fellow researchers would be appreciated.
 
more

OK, I thought I post more info on that topic, just for reference, because I have been searching for that stuff a long time myself.

1 mcg IV together with street heroin:
http://www.bluelight.ru/vb/showpost.php?p=5906320&postcount=46 says:

"Anyway, the past 7 days I have been doing ULD naltrexone with each shot of heroin. I have also gotten 3 of my friends (also daily users) to do the same. I'm still experimenting with dosing but so far I (as well as my 3 friends) have had INCREDIBLY SUCCESSFUL results with using ~1-2mcg with each shot of heroin. Here are effects I have noticed (each of my friends claim to get these same effects):

TOLERANCE
I had gotten up to at least $20 #4 per shot to even feel slight effects from heroin. I was up to about 3-4 shots per day. AS SOON as I starting adding 1mcg naltrexone to my shots I have been catching extreme nods (like never ever before) from $8 of #4 per shot.

Not only has my previous tolerance been obliterated, it does not increase either; if I shoot $8 worth at 10am then another $8 2 hours later the rush is ALL THERE. No decrease in effects with subsequent dosing; each shot is like the first shot of my life no matter how much I've done that day.

CRAVING
Previously shooting junk would almost immediately induce cravings to do more and more and more junk. With naltrexone I experience NO craving to do more heroin at all.

WITHDRAWL
I have yet to experience WD since I've started doing naltrexone with my dope. Yes I have taken enough time off and have felt no signs of WD as well as no cravings when abstinent.

Again this is with doses of 1-2mcg per shot of dope, WITHOUT skipping the naltrexone at all with any of my heroin shots. Even after a week I am still nodding HARD (yes right now in fact) from ~$10 of NE #4.

Feel free tp ask me any q's at all i gott go though i cant keep my eyes open but holy shit i have NEVER nodded this hard from$8 of jj"

"Also the high is a bit different. The rush is full and immediate but the high continues to grow until about 20-30mins when it seems to peak and this is where the serious nodding starts to take place. I will never use chronic opioids without ULD naltrexone again."

BTW, nobody in that threat believed this an thought it was placebo. Luddites.

----------------------------------------------------------------------------------
Link collection and abstracts: Ultra-Low Dose Naltrexone - eight reference with abstracts, 1992 - 2001.

http://www.doctordeluca.com/Library/References/UltraLowDoseNal.htm

--------------------------------------------------------------------------------

OxytrexTM: a New Opioid Analgesic With Minimal Physical Dependence ...:

http://www.lifetreeresearch.com/med...oid Analgesic Minimal Physical Dependence.pdf

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Paradoxical Effects of the Opioid Antagonist Naltrexone on Morphine Analgesia, Tolerance, and Reward in Rats

http://jpet.aspetjournals.org/content/300/2/588.full

-------------------------------------------------------------------------------

Good article about ULD NTX and the mechanisms of tolerance:

Ultra-low-dose naloxone suppresses opioid tolerance, dependence and associated changes in mu opioid receptor-G protein coupling and G [beta][gamma] signaling

http://www.paintrials.com/publications/lb2005.pdf

-----------------------------------------------------------------------------

http://scholar.google.com/scholar?h..._links&resnum=9&ct=sl-citedby&ved=0CEsQzgIwCA

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I guess I stop here. Again, recommended dosage: Rodents 10ng/kg and day (morphine), human 1 mcg bid (morpine and oxy), ??? mcg buprenorphine? Because 2 mcg/d seems to low for me.


I hope nobody minds my link spamming, it's just I think somebody might need and use this information. The topics is well documented, shown to be true in vitro and in vivo, but only few people know about it or want to try it, since it sounds like being a homoeopatic placebo so much.

May all beings become happy.
 
I seem to have an unhealthy obsession with that question. If anyone wants to try it: after a survey of the existing literature, my recommendation is:

Take 1 microgram (0.001 milligram) naltrexone twice a day orally. Do that for a few days and observe any changes in your tolerance (if you already have one), in the development of tolerance, and in the subjective effects of the opioid of your choice. Preferrably, report here.

don't take more, just because you hope to amplify the effects. It does not work like that. Don't use naloxone, the dose would be different. don't be afraid of the naltrexone, 1 microgram can't hurt you.

To measure 1 microgram, crush and dilute the naltrexone you have, 1 mg in 1 liter of water. Store in fridge. (Use wodka if you have it instead of water, if you cannot keep the solution really cold, this will prevent bacteria from growing, multiplying and harassing you). Now 1 milliliter (1ccm) contains 1 microgram of naltrexone. Take 1 ccm in the morning, 1 in the evening.

See, if you can slowly lower your daily opiate intake. Good luck.


This article also gives 2mcg/d as correct dose for coadministration with methadone:
http://www.jpsmjournal.com/article/PIIS0885392403001398/fulltext
 
Thanks Villiers for your thorough and I must say revealing comments. Reading your posts has really been quite a revelation in the sense that hearing of others who have achieved similar results is always a confirmative experience :) I must however say that dosages do vary widely and the type of opiate in play may influence the NLTX dose. Mike Strates using Hydromorphone for example seemed to find his optiumum dose at 15mcg while Jonathan Ott using Codeine found 1mcg to be effective, whilst you are using 1-2mcg with H. It is a very inexact science as Ott and Strates found out, as there seems to be a wild fluctuation in response which requires adjustments to the dose within the 1mcg to 15mcg (i'd say 12mcg peronally) range.
Please visit my blog which documents my own and others' personal experiments with NLTX you certainly have a lot to contribute. Here's a preview:

The above list tells us one more thing. My results will have been totally thrown by my consumption of black pepper. Moreover I have calculated that with the half life of Beta 6 Naltrexol being 13 hours, using once daily will cause a stacking of doses which will eventually lead to a receptor blockade. It would be more sensible to use every other day
 
I am currently physically dependent on ~1200mg Codeine per day, divided into 3 doses. And although I am not alcoholic, I tend to turn to alcohol for relief of opioid w/d. I have some Naltrexone coming my way. Expect a report from me in a week or so - assuming that it does arrive. It will be a challenge though as the pills I'm receiving are 4.5mg a piece. I'm going to have to dissolve it in solution I guess.
 
I'm glad someone found the information interesting. It seemed important enough for me to delurk and create an account just for posting it. The earliest reports of the effects of ultra low dose antagonists seem to have been published in the 80s, two researchers patented it in the 90s, and it took till now that it became more widely known. It's sad, this could spare many people a lot of pain, and I guess we both know how much pain.

Btw., I am using suboxone, not H. I also think the dose depends on the opiate used, and until now I couldn't find any reports on the correct dose for that, except that it works at all.
http://www.ingentaconnect.com/content/adis/inp/2008/00000001/00001629/art00038 says:
'Buprenorphine analgesia "may be significantly enhanced" with the addition of ultra-low doses of naloxone'
but I can't access the article and there is no abstract.
http://drgimbarzevsky.com/Naltrexone/Low_Dose_Naltrexone_Observations1.html
Somewhere else I have seen remark that 80-400 mcg /day naloxone (not NTX!) amplified buprenorphine effects, but no exact dose recommendations.

So, we know it works, but we don't know the right dose, depending on amount and type of the opioid consumed. Maybe the time between antagonist and opioid application makes a difference, but for NTX bid we should expect a steady state anyway - but not a permanently increasing one. I'm an amateur in neuropharmacology, but from intuition I would expect there to be a limit below which accumulation does not occur. If e.g. 4 mcg every second day don't accumulate, why should 2 mcg every day? But these are speculations of a layman, so someone please correct me if I'm wrong.

Your blog looks very interesting, thank you. I hadn't found it yet while searching for relevant information, which shows that answers might be out there...Non-constructive proofs of existence are so annoying, especially when it is about drugs, but I digress.....

I think I'll post some more thoughts later.
 
What I meant about the receptor blockade only really applies to higher doses, so when dosing at 15mcg a day the metabolite B Naltrexol will still be present on the second day -this however will be the maximum level of accumulation and the previous dose will of course have deteriorated sufficiently to render any neurological effects neglibile.
Im currently using about 2mcg a day and have noticed mixed results. It seems that missing doses and being irregular with adminsitration times allows tolerance to creep back up - thus it woulod seem that whatever effects derived from NLTX may well be dependent on its presence in the brain.
Of course my other speculation would be that NLTX only acts on a small section of the specturm of mechanisms and pathways by and through which tolerance occurs - this is why Im trying things like proglumide.
And J im looking forward to hearing from you, what doses were you hoping to use during your experiment?
 
If the pills really are 4.5mg, it sounds like I'm going to have a lifetime supply!

I was hoping to start with 1mic and work up within the ranges you guys recommend to see how the effects change. Do keep in mind that since I take my codeine rectally, I will also be taking the naltrexone that way. I will also be taking it with every extra drink I have.

But now I really wonder how I'm going to measure that out.
 
Ive published an exhaustive guide on ym blog which answers pretty muich most of the questions pertianing to the actual dosing of NLTX . I usually take it 30 mins before intitial dose, but a more ffective approach may be to benefit from the pchanges induced by the NLTX rather than the NLTX itself by dosing after one's opiate dose rather than before, as there may be some antagonistic effects. As ive said before there is no hard and fast- it all comes down to trial and error. Bonne chance!
 
One mechanism of tolerance which I have no scientific name for, perhaps becuase it has not been explored in a scientific setting as of yet, is the idea that ones liver begins to produce excess quanitties of enzymes which break down opiates into their active metabolites resulting in rapid metabolism and thus shortened duration. Alternatively the induction of cyp34 for instance in the case of codeine would result in conversion to largely inactive metabolites which would equal attenuation of analgesic effect. Does anyone know of this theory?
 
I never heard of a change in tolerance due to an adapted metabolisms - maybe such an effect exists, but it would probably be insignificant compared to regular tolerance. I know of only two basic mechanisms of opioid tolerance mechanisms: one is endocytosis (intenalization of receptors), the other is the switch in G-protein signaling.(for overview see http://www.medscape.com/viewarticle/562216_print
Mechanisms of Opioid-Induced Tolerance and Hyperalgesia, Pain Manag Nurs. 2007;8(3):113-121)
(but see also http://www.opioids.com/tolerance/molecular.html)
I think all known methods to attenuate tolerance development somehow influence these two basic processes. Receptor internalization should be the easier on to reverse.
Starfarer, I think you have seen most of these links before, but for other readers I'd still like to provide them:
In
http://drgimbarzevsky.com/Naltrexone/Low_Dose_Naltrexone_Observations1.html
a doctor describes his experiments with ULD NTX for his pain patients. He seems to start with 1-3mcg per day and have them double the dose until they see improved analgesia. "Doses that patients have been using range from 10 micrograms 2-4 times daily to 100-200 micrograms 2-4 times daily."
Another observation he makes is that tolerance toward the antagonist seems to develop.He writes "10 micrograms might work very well initially, but then the dose needs to be increased to 100 micrograms, and then 1 mg. I've had some patients go from 30 micrograms daily to 1-2 mg/day. How much of the naltrexone is getting into the bloodstream is problematic since naltrexone has very extensive, but very individually variable hepatic metabolism."

I am still experimenting wildly, because
a) I'm tapering
b) I started taken 300mg modafinil per day, and it seems to induce Cyp3A4 enough to lower my buprenorphine level (I had to stop tapering at 5mg for a while, will go down to 4 next week)
c) I played so much with my NTX solution that I forgot how diluted it is exactly. I'll crush another Revia tab tonight. We will find out if we live in a hostile universe when they make antagonists illegal and we actually have to buy them by the microgram.

I will also try higher doses (see Mike Strates, http://web.archive.org/web/20041207190941/http://dilaudid.net/uldntx-trial.shtml), especially since the antagonistic effects of NTX on buprenorphine should be negligible anyway. As Strates says: "This loading dose may catapult me into a severe withdrawal syndrome, but science must come first. Any alteration to physical comfort would surely only be temporary."
...but from reading your blog, I think you might disagree.
 
I gave this a shot back when i was on methadone, but i neither did it accurately or properly so I suppose my findings (nothing) are irrelevant.

I am skeptical that it would translate into something you could subjectively notice, aside from some very subtle effects....
 
I would assume this would work for opioid withdrawals as well? like say if one was attempting to get off suboxone. just take a bit of naltrexone with the sub? or would you in general just suggest going through the w/d plain and simple, because apparently the w/d lasts a while.
 
IME, i am 2 to 3 months off of opiates totally.... did a suboxone taper... i am in PAWS right now, so taking low doses of naltrex doesn't seem to have helped that much. however, maybe i'd feel shittier if i hadn't had any naltrex, no way to tell

the only naltrex i was taking was the naltrex they put in subs to "prevent abuse"

it should be noted i think my metabolism is "off" (too high) due to taking lots of tagamet for potentiation during certain stretches of opiate use. or maybe it's just PAWs increasing my body's edginess
 
I'm not sure if this is one of the articles mentioned, but there was a great article I read by a dr self administering uld natrexone and something else. He went pretty in depth, trying sc,im,iv routes, different dosages, all over a several month period.

I got some naltrexone from a friend one time, took a tiny bit and got so sick I wanted to die.
 
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