Misc I need help suboxo+fentan

[tellmystory]

Ok so my friend has been on Suboxone for about 2 years - he has been taking between 4mg and 8mg.

He is currently taking 4mg once a day. He has been sober this entire time, no alcohol, no weed NOTHING. He decided to take some fentanyl two days ago (a tiny piece, just one "hit"). The next day, he experienced withdrawal even thought he took his suboxone first thing in the morning.

The first night (the night of him using the patch), he woke up at 6am... This is very unusual for him. The next day - the day after using - he felt like utter crap, even though he took his suboxone in the morning as he usually does (he works and was tired that day as he didn't sleep enough, but felt so restless he couldn't sit still in his office and had to take frequent walks to get rid of the restless feeling - his office meeting was equally difficult because of the restlessness). I also want to mention that he took 2mg on the day he did the fentanyl (half of his dose), but continued his regular dose the next day. The following night, after a day of feeling like CRAP at work, he wanted to go to sleep at 8pm (couldn't even eat dinner), he had insomnia and intense anxiety the entire night. He felt intense restlesness and had a feeling like he wanted to "jump" out of his body. He is feeling better this morning, and he took his suboxone again (4mg). He is feeling almost completely normal (still a bit of restlessness in the legs). What happened to him? He never experienced such discomfort after a little bit of "partying" (it wasn't really partying, he was noticeably high for about 15 minutes).

 

[pinpoint]

Wait so you took Suboxone right after taking fentanyl? Your Suboxone was probably being blocked by the fentanyl which AFAIK has the higher affinity. Perhaps it took a day or so for your receptors to clear up enough for the buprenorphine to bind effectively. Just a guess.

Edit: Sorry if this was really your friend, but I always assume people are swimming.

 

[tellmystory]

Wait so you took Suboxone right after taking fentanyl? Your Suboxone was probably being blocked by the fentanyl which AFAIK has the higher affinity. Perhaps it took a day or so for your receptors to clear up enough for the buprenorphine to bind effectively. Just a guess.

Edit: Sorry if this was really your friend, but I always assume people are swimming.

Yes it was my friend (best friend). I am also on suboxone, however. So he took 2mg of suboxone in the morning. Then around 7pm he took some fentanyl. The next day at 8 am he took 4mg of suboxone.

 

[pinpoint]

He can't be taking high affinity partial agonist opioids in conjunction with high affinity full agonist opioids - it's going to be a competition at the receptor site that will result in either a blockade of bupe or precipitated withdrawal, both being unwanted. Wait at least 24 hours to switch between the two - that is, if he does this again. I'd also caution against using fentanyl, but that goes without saying.

 

[tellmystory]

He can't be taking high affinity partial agonist opioids in conjunction with high affinity full agonist opioids - it's going to be a competition at the receptor site that will result in either a blockade of bupe or precipitated withdrawal, both being unwanted. Wait at least 24 hours to switch between the two - that is, if he does this again. I'd also caution against using fentanyl, but that goes without saying.

Much appreciated! It makes sense, but I thought it was strange he was going through this because I used to use opioids and take suboxone... But I used every day, it wasn't a one time thing like it was for my friend... anyway, I didn't use fentanyl, I used heroin, but I guess heroin would cause the same problem - its a full agonist. I am also on a higher dose between 8-16 mg, which is probably why I didn't feel sick when I used and took suboxone.