Heroin how to best approach my Suboxone induction

[DustnRoses]

So I have just a tiny bit of dope left, with the ability to get more, but really trying to avoid it. I have .5 mg of alprazolam, and 1 mg of clonazopam. I have a limitless amount of Subs. I also have a drug test coming up, its a saliva test, on Wednesday (about 36 hours from now) so I know I need to be careful what I take...I want to stop taking any heroin now, knock myself out with the benzo's I have, then start taking sub. The toughest part about starting sub is figuring out when you're ready, since the mere though of precipitated WD is enough to just about make me curl up in the fetal position and cry.

I figure I can sleep ok tonight, wake up tomorrow, approximately 12 hours from my last dose of heroin, take the .5 alprazolam to calm my nerves a bit, then start taking sub, in small amounts, around lunch/afternoon tomorrow...approximately 16-18 hours from my last dose of heroin. It's tough to gauge how long I need to wait...as my heroin habit is at record highs, for me, at around 1 gram a day, of fairly potent stuff. I wish I could just stop taking everything right now, go to sleep tonight, wake up tomorrow, take nothing, tough it out for the whole day, and take my first dose of Sub 24 hours after my last heroin dose, without the help of any benzo's...I just don't think I can.

And the whole thing about "wait until you're in WD to take sub" is so vague...it's hard to tell how much you're in WD when you're at that point...in the past, I've sat around, staring at my sub tablets, wondering if I'm "sick enough" to take them....I've never experienced precipitated WD, though, and plan to keep it that way....but in the event that I do, how long do they last? From what I've read, most people seem to say that it only lasts for about 30 minutes to 2 hours....so, while I'm sure that's a very uncomfortable 2 hours, that's really not a very long time.

So does taking benzos when I have a saliva test the following day sound like a bad idea? I know it would help me tremendously in ensuring I wait long enough to dose my sub...because if I don't, I'm just gonna be sitting staring at my subs all day, watching the clock....but I really don't wanna shoot myself in the foot and fail a saliva test just because I couldn't resist taking them.

 

[sekio]

It depends on whether or not your saliva test is checking for benzos and bupe. (we don't discuss drug tests though)

I wish I could just stop taking everything right now, go to sleep tonight, wake up tomorrow, take nothing, tough it out for the whole day, and take my first dose of Sub 24 hours after my last heroin dose, without the help of any benzo's...I just don't think I can.

You can do it. Keep yourself busy and the time will fly. Seriously, concentrate on something else than drugs and you'll be fine. Go for a walk or something.

Realistically just because you can dose sub after 16-18 hours when your habit was smaller does not neccesarily mean you can pull that off with a much bigger habit. If you increase your dose, the drug will hang around for longer. But on the other hand if yor dope has worn off after 1h it may eb possible to do some subs and get away with it.

P/W's last as long as it takes your body to get adjusted to the lower level of opioid agonism. Varies between people. Generally they only kick in when you are still feeling some of the 'peak effects' of a full agonist opioid. If you're sober (but not neccesarily in full blowln withdrawal) it's probably safe to pop a sub. Taking lower doses of subs (less than 1 mg) will help reduce the intensity of p/w somewhat too.

The first signs of opioid withdrawla are vaiable in people. Some get a vague feeling of unease, some get a runny nose, some get restless, some get stiff and sore, some feel like they have the Flu.

 

[Alex000]

I really don't know a ton about using buprenorphine to taper, but I would suggest lower doses than one might often employ so that there is less severity in any percipitated wd's as sekio said, as well as less severity of any natural opiate wd's, because at lower doses bupe acts less with its antagonistic features. Less really is more, in a lot of cases, with bupe, even if the opiate tolerance is really large. I would probably wait until you start feeling not just a craving for opiates, but some marked malaise (general feeling of unwellness and uneasiness), and probably at least mild physical wd symptoms such as a lot of lacrimation (tearing), or runny nose, or maybe general body pain. You would want to get to the malaise, first, though, definitely - feel cravings, okay, feel shitty and feel cravings and mild physical symptoms = go time for bupe, but at a low dose. Try just 0.5 mg to start, or even 0.25 mg. It might very well put your symptoms at bay, or really help them, at least. I would suggest, for maximum comfort, LOW doses of bupe taken FREQUENTLY - not once a day, or even two times a day. Try for at least 3 x day for the bupe (4 x day could be better), because that will help with a more consistent relief, and at low-doses will be acting, as mentioned, more as an agonist like any other opioid. It will act more like substitution than anything, I'd guess if you did a 0.5 mg bupe 3 x day or 4 x day, with PETITE doses of benzo only in the peak of wd's, as you don't have a whole lot. I'd use the alprazolam and clonazepam on an as needed basis, probably focusing to help with sleep more than anything. At the peak of your wd's symptoms, you could try 0.375 mg clonazepam for the two worst nights, leaving you with 0.25 mg clonazepam to use as a PRN at some point, and 0.5 mg alprazolam to use as a PRN at some point, but I'd be a bit hesitant of using the whole 0.5 mg alprazolam in one shot, since that is all you have - same kind of thing with the clonazepam, but 0.125 mg clonazepam is a very low dose, though still will produce effect - maybe just not really noticeable. Of course, when I am talking about these benzos, I am assuming you haven't got a benzo tolerance, in which case these doses might be worthless or near worthless, as I have laid them out. But, I still think the answer is within the bupe - very small, but very frequent doses. Just my advice - hope it goes as well as it can - it might not be as bad as you think. Remember warm/hot baths, frequently, help, too - a lot. I know a lot of this repeats what sekio has said above, but often several different messages with common themes can help for better understanding to the one who is asking for help/advice.

 

[DustnRoses]

thanks to you both for the replies. I do not have a benzo tolerance, as you asked. I took .5 mg clonazopam a few days ago, but that was my only benzo use in probably a year.

When I say it's hard to gauge where I am at in WD, thus it is hard to determine when it would be OK to take my first dose of sub, what I mean is that I will tell myself "it's been XX hours since my last hit of dope, I'm probably gonna start feeling ill now...or do I already?" Since I know the estimated half life of the drugs, it makes me very conscious of my body, noticing every little thing...and yes, like you said my first tells are usually watery eyes, yawning, nd just a general feeling of discomfort...but sometimes it's so subtle, I'm not sure if it's just natural, or the WD...

I've even read reports of people taking tiny doses of bupe while still using, to build up blood levels, making the transition even more smooth when completely transitioning from short acting opiates to bupe. Basically you just take tiny bits of bupe after you do heroin, not enough to produce precipitated WD, but enough to establish low levels of the drug in your blood, then after a few days of this, you can just stop taking heroin and continue taking sub, and there's no WD period at all...sounds very enticing, but still, I and many others as well, I'm sure, are very apprehensive, because of the possibility of precipitated WD. So I haven't tried this method. Anyways thanks again for the replies. I'm really going to try to stay away from the benzos until after my saliva test, as nothing is more important than getting a job...it's just a matter of making it to tonight without taking anything.

 

[Znegative]

^I really wouldn't want to try that experiment.

IME, as long as Ive been in moderate withdrawal, than I have been okay to take the suboxone. However, sometimes when I waited less than 12-14 hours I would experience mild precipitated withdrawal symptoms which would last around 30 minutes and then fade away. 24 hours though, has always been a sufficient amount of time (unless we are talking about transitioning from methadone) for a seamless induction.