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  • BDD Moderators: Keif’ Richards

Fentanyl -->Naloxone Precipitated Buprenorphine induction (Advice/Harm Reduction)

Another commenter answered your question very well.

I’d just like to suggest considering buprenorphine depot injections as an option.

Once you’ve stabilised on Suboxone, you can transition to a long‑acting depot formulation such as Buvidal. The benefits include monthly or quarterly dosing so there’s no need for regular pharmacy visits to pick up strips, a built in commitment to absitence since it's much harder to ‘take a break’ compared to daily Suboxone and most importantly: depots have a built in taper if you decide to stop. Because the pharmacokinetics of depot buprenorphine allow blood levels to gradually decline over months. For most people this means they don't experience much discomfort or withdrawals

This is what I did, and it worked very well. I even forget that technically I was detoxing from buprenorphine. It really was that painless.
Thanks. This was the plan when I went to the doc for suboxone, but I never ended up starting it because of what I described in my previous post.

Once I successfully get on the strips, the plan is to transition to the injections.
 
Why would you go through precipitated withdrawals when there is no need and you aren't going to end up clean (On suboxone) anyways??

Trust us on this one -- I would REALLY ASK YOUR DOC WHY ON EARTH THAT WAS EVER PART OF THE PLAN!

Cruelty or ignorance are the only two answers I can see ---- do you see a third?

Feel free to answer these questions it will further your understanding (Which I presume is what brought ya here)

RE: The suboxone shots -- HONEST TO GOD, only reason I haven't got them is PRECIPITATED W/D is a POSSIBLE side-effect and frankly id rather cold turkey than risk that
(Not knocking the shots, emphasizing the seriousness of precipitated withdrawal)
 
Why would you go through precipitated withdrawals when there is no need and you aren't going to end up clean (On suboxone) anyways??

Trust us on this one -- I would REALLY ASK YOUR DOC WHY ON EARTH THAT WAS EVER PART OF THE PLAN!

Cruelty or ignorance are the only two answers I can see ---- do you see a third?

Feel free to answer these questions it will further your understanding (Which I presume is what brought ya here)

RE: The suboxone shots -- HONEST TO GOD, only reason I haven't got them is PRECIPITATED W/D is a POSSIBLE side-effect and frankly id rather cold turkey than risk that
(Not knocking the shots, emphasizing the seriousness of precipitated withdrawal)
There's a chance of PWD's when transitioning from strips to shots, or just in general?
 
in general no; a negligible chance of it happening -- rare side effect type thing --- It was to emphasize how serious precipitated withdrawals suck.

The shot is probably the better option but even that negligible chance of PWD keeps me away from em.

answer the questions in the previous post and I will continue to provide information but those are questions you NEED TO ASK *Yourself at least* and be able to articulate why you would go through precipitated withdrawal instead of just waiting for NORMAL withdrawl to start (Use the COWS scale) than take suboxone with NO HORRIBLE SICKNESS PERIOD -- just check the cows scale and when you are about 24 hours from your last fent (If your sure its fent only) dose and start the suboxone.

You will feel pretty alright.

Precipitated withdrawl is like normal withdrawal 10xish idk -- WAIT A SECOND, Did you know the difference between precipitated and normal withdrawl or did you think that not taking fent for 24 hours was in fact "Precipitating withdrawal" because I could see one interpreting it that way....
 
I think you're confusing me with the OP. I'm not the guy with the doc trying to initiate PWD's, I just responded asking about the Bernese Method and the time needed to wait to start suboxone.
 
You are correct, my apologies!!

Lol I was getting frustrated someone would have the willful ignorance to just go through precip for no reason...

Yup confusion right from page one when the OP dipped out to have a real bad time im guessing...

I think the chance of precipitated switching from strips to sublocade (or w/e) is pretty negligible but it was enough to keep me on the pill taper plan.
 
No worries at all. Hell, I appreciate the feedback, nonetheless.

I agree with you. I can't get why anyone would intentionally go through PWD's, even for an hour, especially when there are safer options. The fear of PWD's is what's kept me from starting suboxone. I've had it on hand for 5 months now but just can't pull the trigger.

When you tapered off the pill, how'd that go? I've tapered down from 120mg of methadone down to 20mg, but fucking relapsed and am back on h/fent. I would like to start the strips then eventually taper off those.
 
Well shoot I may be an odd duck but it has been over 5 years and I have went from about 8mgs to 1mgish -- can't seem to get lower than that without feeling sick 24 hours after so I can only imagine how Id feel on day 4.

So I am looking at the shots as an option but I do not think they have them in variable doses(??) So I would have to go back up to 8 mgs a day and start over which does not sound ideal. SR-1718 (I think im tryin to memorize the #'s) seems to provide a route to coming off opi's with 0 withdrawal -- there must be some discomfort but check out some reports on the site if you are interested.

Do you also know your heroin to be just fent? No nitazenes or xylazine -- or just street dope who knows? I ask because sometimes sub will not break through nitazenes-- some fent habits can be so large even the ceiling dose of bupe won't cover it.

You could switch from 20mg a day methadone -- but you would have to wait a FEW days as methadone has a long halflie.

What I would do is wait until I was in w/d's as bad as I could stand than take 2mgs suboxone -- wait an hour, take another 2 or 4 if you have to (idk you got a better feel for your tolerance than me) .... and if you are still (after 24mgsish) sick you know you been gettin hit with xylazine or something else you have to address seperately from fent/suboxone
 
From what I've read on some medical sites, you can taper off of sublocade by taking lower dosages, under the supervision of a medical professional. So that may be an option for you. I've also read that if you just stop, the WD's can take around a month or two to fully set in, so you could potentially get a false sense that you're not going to experience any those first few weeks and can last for months. But that's if you don't taper, from what I understand.

I have one source and his stuff is usually pretty consistent. When I was getting tested, the analysis came back positive for fent or fent and morphine, so I'm thinking it's pretty much just fent and h. Although, I don't think they test for nitazenes or xylazine. I did get some that I believe had one of those in it a year or so ago, based on what it did to me. My guy's regular source was out and he picked up from a random. I did not know that at the time, but I still should have been smart and did a sample before taking my regular size dose with new stuff, but I did not. It knocked me out. I can normally function on my regular dose, but this absolutely knocked me out. My muscles were very weak and it took a lot for me to walk. I'm almost certain it had xylazine in it because it felt similar to what a tranquilizer would do. My guy is good about swapping it with something different if I don't like it, so I guess that's a plus.

Once I relapsed, I stopped taking the methadone, so nothing to worry about there.

What you described is similar to what the doctor told me about starting suboxone...take 2mg (or less) wait an hour then take 2 more, etc.

Other testing it, is there any way to tell if it has natizenes or xylazine in it? Taste, smell, side effects?
 
I am not positive to be honest I think there may be reagent strips to test for nitazenes xylazine but I am not sure.

Sounds like you articulated the difference between 'tranq dope' and fent dope fairly well with that experience.

Was not aware there were different size shots I will have to look into that!
 
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