Opioids Extreme reaction to Espranor.

[Zopiclone bandit]

Began on Tuesday with my first dose of Espranor, I was meant to be going upto 16mg by a few mg's per day & I google searched this last night & it said 16mg is the MAX dose & I am 100% glad I never got there.

Anyway Tuesday evening I waited till I began to feel cold, sneeze, feel my body hurt etc (the basic start of a Heroin withdrawl) & I took 4mg which kicked in really quick after putting it on the top of my tongue, it helped & I slept for a good 8-10 hours that night.

Woke up the next day (Wednesday 26th November AKA yesterday) & still felt ok, I decided to wait till I began to feel sick to take more & the chemist didn't close till 6pm so I sat back & waited. Around 12.30pm - 1.15pm I began to feel VERY COLD & began to get very pissed off, that typical Heroin withdrawl sulky face, shitty mood where you wanna burn the world down etc & I still didn't go to the chemist but was shocked how bad I felt so fast. Give it another 45 mins I am in pieces, I have used heroin for 24 years & am UK based so we still have Heroin, our supply isn't Fent or any of the stuff in the USA & the way this rattle was coming on I have NEVER FELT BEFORE.

I had none of the gut issues you get in withdrawl BUT the dry heaving, gagging, dry throat issue, spraying stomach acid out of my nose was insane & heroin addicts will know how sharp your smell becomes in withdrawl well this damn poison made it 1000 times more worse than the most savage heroin withdrawl I ever known.

I will NEVER as long as I live touch Espranor, imho this stuff is NOT fit for Humans to take, how the hell it got a licence as a medicine & is sold by doctors as being "better" than methadone & a "painless withdrawl" is for the birds, it is lies!!!!!!

Anyone else had really bad effects off this damn stuff?

Also the Doctor wanted me to work upto 16mg, I am 100% sure a sudden withdrawl from 16mg of this stuff could make someone NOT be able to stand it & end their life!!!!!

 

[Keif' Richards]

Damn @Zopiclone bandit so if the Buprenorphine isn't going to work for you, what is your alternative? Don't get back on gear if you've already been through the pain of Buprenorphine induction.

 

[4DQSAR]

I can only point out that pill-cutters exist and if one large dose results in severe side-effects, splitting that dose into two or four small doses may reduce those side-effects.

After all, when prescribed for pain, buprenorphine is usually taken three or four times per day.

As for dose, the minimum that works. It is insane that regardless of the client, the protocol is to go up to 16mg/day and reduce (at some unspecified future date).

 

[Keif' Richards]

Yes and @4DQSAR I'm in the camp of believers that if 4mg Buprenorphine isn't ultimately enough, other options should be considered instead of raising the dose. That's just how our society has prescribed it. It is most "effective" for our purposes when taken in doses lower than 2mg Buprenorphine.

 

[4DQSAR]

I admit it's a guess but I always assumed the single large dose was chosen to allow for supervised consumption.

 

[Zopiclone bandit]

Damn @Zopiclone bandit so if the Buprenorphine isn't going to work for you, what is your alternative?

The doctor won't put me back onto Methadone, she has this bizarre concept I am "a high risk user" to quote her 100% as I use alone, these doctors know nothing about what it's really like, they are only book smart, they have ZERO real life, lived experience & view ALL addicts with long running Heroin issues the same. I have NEVER in all my years of using woken up in the A&E ward of a hospital, I have blacked out a very few times which I can count on one hand & since September 2001 the longest period I have been sober was 7 days & that was because I went on a 9 day, none stop a-PVP smoking session (a-PVP AKA Flakka) https://en.wikipedia.org/wiki/Α-Pyrrolidinopentiophenone

So in all I have a good record using Heroin, I have smoked it, I.V. it only a few times, I would say at total of around 20ish in all that time, boofed it etc. I have a HUGE ability to process opiates, when I had an abscess right on my bum (the actual hole bit where the poo comes out) I had it cut away, the pain was horrific, I was taking 240mg of pure Codeine washed down with 40-60mg of Oral Morphine for breakfast, I do mean Breakfast too I took all the Codeine in one gulp washed down with the oral morphine in the first 3-5 minutes of waking up & I didn't go on the nod one bit, I am quite sure that would put most people on the nod. Right after the operation when I came round I rolled over & felt the pain in my bum, I screamed & the nurse gave me 250mcg (microgram) of Pure NHS fentanyl as I am UK based the Fent wasn't some crap off the street, it was proper clean Medical grade quality & 50mg Oral morphine chaser, the Fent was given I.V. via the needle / medical cannula so it went right into the blood via my hand vein & I STILL DIDN'T go on the nod or "gouge" as we call it over here, that shows how much opiates I can take, a risk of over dose huh? more chance of Hell freezing over imho.

Don't get back on gear if you've already been through the pain of Buprenorphine induction.

It is more easy said than done, I cannot express to you the way Heroin has got me, I love most drugs but Heroin is like a Relgion to me, some people go to Church on a Sunday, I smoke good Afghan #4 with Coffee.

The next rip / detox I do is planned out, when I am paid next I have access to Indian Pre-Gab, I can get the red 300mg per pill Pre-gabs at a very good price which I won't say as I know it breaks The BLUA but it's less than 7p per 300mg. I have used the 300mg Pre-gabs before when being sick, I know "YMMV" but to me they cured me 99% of the way, I could function like a normal person or like I am right now, I smoked 0.3gram of Afghan #4 at 9:45am this morning, I had only been awake since 9:15am.

 

[Keif' Richards]

It is doable @Zopiclone bandit you know what you´re doing. Bide your time until you´ŕe stable enough to do this with confidence.

 

[4DQSAR]

Yes and @4DQSAR I'm in the camp of believers that if 4mg Buprenorphine isn't ultimately enough,

I susect not if someone has been consuming a lot of opioids. Maybe things have changed but last time I talked to someone, the local HR agency was running people up from 4mg to 16mg in a week. Each day 2mg more.

But it seemed to be the prevailing opinion that if someone struggled with the side-effects, the staff would quietly suggest using a pill-cutter. If a given dose was enough and a client didn't want more - pill cutter. I have no way of knowing if this is the official line, if it's just the staff of the HR agency local to me or if there is a more widespread concern that the one-size-fits-all model is not in the best interests of their clients.

 

[Señor Moreno]

It doesn't surprise me a bit, Zopi, bupe is straight poison for some people like me, and you seem to be in the same case. Appart of that, you are not the kind of an addict that bupe can help, you are way too deep into opi addiction for bupe to work; despite making me feel horrible, it worked for me to stop h wds for a while, some years, but eventually it simply wasn't enough, not a matter of mg, it simply wasn't (and I i.v.ed the stuff, let alone sublingually...).
The pregabalin way should work, find a dose that let you function and taper from there, but don't develope a dependence on pregabs, it's wds can be really nasty.
But, even if your detox is successful, then there come paws and depression and, even after that, there comes life in general with all it's bullshit. So, being honest -like you deserve-, you eventually will score again at some point, no matter when or why.
You are very clearly a maintenance patient. I have read that some places in the UK use morphine sulphate. Could you somehow join one of those programs (begging for it or seeking legal help, even. I know a pain patient, ex user, who had to sue our NHS and half the system in the way, but finally he got what he needed). That would be great, as methadone is nearly imposible to quit if you had to suddenly do -I fear an eventual mdne shortage more that death itself, and I totally mean it-

Anyway, wish you all the best and keep us informed

 

[tryptakid]

I susect not if someone has been consuming a lot of opioids. Maybe things have changed but last time I talked to someone, the local HR agency was running people up from 4mg to 16mg in a week. Each day 2mg more.

But it seemed to be the prevailing opinion that if someone struggled with the side-effects, the staff would quietly suggest using a pill-cutter. If a given dose was enough and a client didn't want more - pill cutter. I have no way of knowing if this is the official line, if it's just the staff of the HR agency local to me or if there is a more widespread concern that the one-size-fits-all model is not in the best interests of their clients.

16mg is where the receptors are nearly fully saturated but this is well within the 'partial agonist/blockade' range of effects. 4mg is viewed as about the top end of the 'agonist' effects. Use for pain starts at around 200mcg QID or more. The lowest prescribed dose for opioid dependence is 2mg and typically up from there. Rx likes 16-24 because you get full blockade saturation without additional increases in agonist effects, while also taking longer to taper down off of. 16mg is more likely to prevent an overdose than 4mg if someone uses while taking the medication. That's the primary motivation for working people up to between 8-16mg+.

I can only point out that pill-cutters exist and if one large dose results in severe side-effects, splitting that dose into two or four small doses may reduce those side-effects.

After all, when prescribed for pain, buprenorphine is usually taken three or four times per day.

As for dose, the minimum that works. It is insane that regardless of the client, the protocol is to go up to 16mg/day and reduce (at some unspecified future date).

While buprenorphine seems to have a maintenance effect over 24 hours, it's effective analgesia is only in the range of 4-6 hours, hence the QID dosing. It's also much more analgesic in the 2-4mg range (or lower when considering formulations such as temgesic) so dosing 2-4mg q4-6hr is a robust pain management approach with far less 'blockade' activity.

 

[4DQSAR]

@tryptakid - Well, I can only report on that which I'm told.

Others have suggested that people are baing 'parked' on high doses of buprenorphine for months and years. I did point out that when originally conceived, the team at Edinburgh let by Bentley only ever tested the idea of buprenorphine being prescribed for 7-14 days to reduced the AWS.

I've read that in some places it's common for people to reciever up to 24 or even 32mg/day. But I would say the KEY difference is a medication being used at the lowest dose possible for the shortest time possible isn't the most PROFITABLE model.

 

[tryptakid]

@tryptakid - Well, I can only report on that which I'm told.

Others have suggested that people are baing 'parked' on high doses of buprenorphine for months and years. I did point out that when originally conceived, the team at Edinburgh let by Bentley only ever tested the idea of buprenorphine being prescribed for 7-14 days to reduced the AWS.

I've read that in some places it's common for people to reciever up to 24 or even 32mg/day. But I would say the KEY difference is a medication being used at the lowest dose possible for the shortest time possible isn't the most PROFITABLE model.

No disagreement here.

Lot of money to be made in chemical dependence....

"We're great at getting people onto buprenorphine, and terrible at getting people off of it". I have known so many patients over the years whose maintenance on buprenorphine was 3/4/5 fold + the length of their illicit use. One of the folks on our clinic had used oxy for 2 years and had been on subs for 10+.

 

[Kurt Cobain]

Yes and @4DQSAR I'm in the camp of believers that if 4mg Buprenorphine isn't ultimately enough, other options should be considered instead of raising the dose. That's just how our society has prescribed it. It is most "effective" for our purposes when taken in doses lower than 2mg Buprenorphine.

Yup gotta get that norbupe action in

 

[4DQSAR]

Yup gotta get that norbupe action in

Sorry - do you refer to norbuprenorphine?

I've noted recent papers that suggest that norbuprenorphine reduces respiration far more than buprenorphine and that it has around 20% the analgesic activity of buprenorphine. What I couldn't find was any paper in which people were given norbuprenorphine to conifrm either activity.

The affinity of norbuprenorphine IS known but isn't so important if the compounds cannot cross the BBB an/or if the LogP means it doesn't accumulate in the brain and/or it's actively removed from the brain. We know other opioids also produce periperhal analgesia and so it would be valuable to know if this is the case with norbuprenorphine i.e. is it centrlly and/or periperally active?

Mostly I note that norbuprenorphine levels are use to confirm chronic consumption of buprenorphine... which seems mad to me. People being penalized for NOT taking a medicarion. If I don't take a pain pill, my consultent tells me I'm 'managing my medication well', not that I'm at fault for consuming a medication I don't need.

 

[Kurt Cobain]

Sorry - do you refer to norbuprenorphine?

I've noted recent papers that suggest that norbuprenorphine reduces respiration far more than buprenorphine and that it has around 20% the analgesic activity of buprenorphine. What I couldn't find was any paper in which people were given norbuprenorphine to conifrm either activity.

The affinity of norbuprenorphine IS known but isn't so important if the compounds cannot cross the BBB an/or if the LogP means it doesn't accumulate in the brain and/or it's actively removed from the brain. We know other opioids also produce periperhal analgesia and so it would be valuable to know if this is the case with norbuprenorphine i.e. is it centrlly and/or periperally active?

Mostly I note that norbuprenorphine levels are use to confirm chronic consumption of buprenorphine... which seems mad to me. People being penalized for NOT taking a medicarion. If I don't take a pain pill, my consultent tells me I'm 'managing my medication well', not that I'm at fault for consuming a medication I don't need.

As far as my limited understanding goes low doses of bupe metabolize into norbupe which is a full agonist and gives yoh more of a classic opiate feel and that I can attest to, 2mgs or less always gave me such a better effect when my tolerance was low compared to any higher dosage. I could tell there was full agonist action going on without a shadow of a doubt. The reason it doesn't accumulate in the body is simply a dosage issue and frequency of dosage. That's my best educated guess though

 

[Kurt Cobain]

Sorry - do you refer to norbuprenorphine?

I've noted recent papers that suggest that norbuprenorphine reduces respiration far more than buprenorphine and that it has around 20% the analgesic activity of buprenorphine. What I couldn't find was any paper in which people were given norbuprenorphine to conifrm either activity.

The affinity of norbuprenorphine IS known but isn't so important if the compounds cannot cross the BBB an/or if the LogP means it doesn't accumulate in the brain and/or it's actively removed from the brain. We know other opioids also produce periperhal analgesia and so it would be valuable to know if this is the case with norbuprenorphine i.e. is it centrlly and/or periperally active?

Mostly I note that norbuprenorphine levels are use to confirm chronic consumption of buprenorphine... which seems mad to me. People being penalized for NOT taking a medicarion. If I don't take a pain pill, my consultent tells me I'm 'managing my medication well', not that I'm at fault for consuming a medication I don't need.

The reason doctors get mad about you not taking your bupe is the same reason they put people on such a wicked high dose regardless of the patient. It's partially due to bupe only blocking in higher dosages although I can say for me personally 4mg for only 3 days gives me sufficient blockage that greatly reduces subsequent effects with doses of H but everyone is different, the other reason it they have a full bar excuse to keep people dependant, there is zero backlash for doctors prescribing insane amounts of this drug, I've personally known doctors putting people on 48+mg a day which isint doing anything more than say 24mg would do if only to make you more dependant but what do I know take what I say with a grain of salt, I'm withdrawing rn and Ira hard to even think atm

 

[4DQSAR]

As far as my limited understanding goes low doses of bupe metabolize into norbupe which is a full agonist and gives yoh more of a classic opiate feel and that I can attest to, 2mgs or less always gave me such a better effect when my tolerance was low compared to any higher dosage. I could tell there was full agonist action going on without a shadow of a doubt. The reason it doesn't accumulate in the body is simply a dosage issue and frequency of dosage. That's my best educated guess though

https://sci-hub.se/10.1124/jpet.112.193433

To be clear - this is an animal model and is over a decade old. But notice the effux. I was quite impressed that loperamide of all things was used as a model of active transport OUT of the brain.

https://www.agilent.com/cs/library/applications/5990-9930EN.pdf

Depending on where you read, the LogP value differ, but norbuprenorphine is always lower which one would expect with an extra HBD. Now obviously it would be ideal to know which species exist at physiological pH but this, I feel, has some limited utility.

BTW I decided I wanted to know how many fatalities due to buprenorphine intoxication had occured in the last decade but everywhere I looked, it kept on referring back to a 2009-2013 study. I could not work out why every paper referred to such old data. Then I checked - nobody is recording the data! I have posted this elswhere a few weeks ago, but I do find it odd that if a medication known to cause fatalities was being prescribed more frequently and at higher doses, nobody is publishing what I think is an important metric. In the UK we DO have such data but then we only go to 16mg/day (as far as I know).

 

[Kurt Cobain]

https://sci-hub.se/10.1124/jpet.112.193433

To be clear - this is an animal model and is over a decade old. But notice the effux. I was quite impressed that loperamide of all things was used as a model of active transport OUT of the brain.

https://www.agilent.com/cs/library/applications/5990-9930EN.pdf

Depending on where you read, the LogP value differ, but norbuprenorphine is always lower which one would expect with an extra HBD. Now obviously it would be ideal to know which species exist at physiological pH but this, I feel, has some limited utility.

BTW I decided I wanted to know how many fatalities due to buprenorphine intoxication had occured in the last decade but everywhere I looked, it kept on referring back to a 2009-2013 study. I could not work out why every paper referred to such old data. Then I checked - nobody is recording the data! I have posted this elswhere a few weeks ago, but I do find it odd that if a medication known to cause fatalities was being prescribed more frequently and at higher doses, nobody is publishing what I think is an important metric. In the UK we DO have such data but then we only go to 16mg/day (as far as I know).

As far as the data not being researched I'd again chalk it up to monetary gain, they found a opioid drug that's relatively accepted all around that they can push as a "safe" option for all kinds of shit. They're putting alcoholics, benzo heads, fuck even a ton of the meth heads around have all been prescribed sub for their addiction even though they have zero history of opioid use disorder. It's a huge cash cow especially when you think about how long they keep people on that shit instead of the 1-2 weeks that they should actually be staying on it for, wouldn't want to besmirch the good name of suboxone. They knew about the rapid tooth decay since day 1 and people are only finding out about it now decades later. It could also just be that subs do have a pretty good safety track in terms of OD the most that typically happens with a sub OD is you just get sick for 24 hours, never heard of anybody actually dying from it alone

 

[Zopiclone bandit]

It doesn't surprise me a bit, Zopi, bupe is straight poison for some people like me, and you seem to be in the same case. Appart of that, you are not the kind of an addict that bupe can help, you are way too deep into opi addiction for bupe to work; despite making me feel horrible, it worked for me to stop h wds for a while, some years, but eventually it simply wasn't enough, not a matter of mg, it simply wasn't (and I i.v.ed the stuff, let alone sublingually...)

Thank God I am not the only one that it is poison for.
These NHS Doctors know nothing Amigo they think we are all tonto & estúpido, well they are nothing put malditas putas to the Big Pharma people who sell this stuff to them.

But, even if your detox is successful, then there come paws and depression and, even after that, there comes life in general with all it's bullshit. So, being honest -like you deserve-, you eventually will score again at some point, no matter when or why.
You are very clearly a maintenance patient.

I have had PAWS before, everything seems flat, you cannot get any joy from anything, life takes on a total Nihilist viewpoint & even suicide is too much, I am well versed in it sadly.
Yes all the junkies I hang out with have said I am "A lifer" & high chance I'll be a junkie for life but I accept it, heroin isn't even a "drug" anymore to me, it's a part of daily life such as eating food & drinking water is to everyone else, I need Heroin to just get out of bed. The odd thing is even on a high dose of heroin that would kill most people or even an "average" junkie I can go to work & function like a normal person, it's not till I have my unemployment payment from the state I go on a real binge for 3-5 days, I will nod/ gouge when I smoked several grams of Smack but upto that point I need it to function & people can't tell I am "high" as a general rule, I don't "nod out" in public etc like the unprofesional junkies do & those who CANNOT handle their heroin, I despise these types they have NO class about them.
Who the fuck gets loaded on Fent or some Nitazine & goes on the nod in public FFS? It's equal to being caught having sex in public in a toilet or behind a bush imho.

I had a look online a few days ago, back in 2012 the Police where I live pushed for legal Diamorphine scripts as where I live in very bad for heroin addiction, it didn't happen but I am going to press this issue now, what have I got to loose?

 

[Zopiclone bandit]

I've personally known doctors putting people on 48+mg a day

they should be taken out & shot.

if you lost your script for any reason & had to do a sudden detox off that level with withdrawl would be brutal, YET AGAIN it shows to me doctors only know "book wisdom" which isn't equal to "lived experience"
I can read any text or book about how to drive a WRC car, it's a very different thing when I get into one on a gravel road, have 400 BHP at the pedal & I feed the clutch out for the first time.

Book wisdom is worth fuck all, it's equal to pissing into the Ocean.