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OD Moderators: Keif’ Richards | negrogesic
Bupe is mixing suboxones n xanax dangerous during heroin withdrawal
- Thread starter Deeeso
- Start date
Znegative
Bluelight Crew
Technically YES, it is dangerous to mix any CNS depressants- but it can be done in a responsible manner as long as you know your tolerance and don't go overboard with it. Benzodiazepines are often given in addition to suboxone (IME) in detox facilities.
Do you have a tolerance to xanax or benzo's in general? How much Suboxone are you planning on taking, and How much heroin had you been smoking?
If you have no tolerance, I would use .5mg of xanax to begin with, no more than 1mg. The likeliness of you overdosing is very slim in this situation (especially since suboxone has a cap on respiratory depression, but it should be noted that the few cases of reported buprenorphine overdoses have included the use of a benzodiazepine or similarly some other GABAergic drug/depressant).
Do you have a tolerance to xanax or benzo's in general? How much Suboxone are you planning on taking, and How much heroin had you been smoking?
If you have no tolerance, I would use .5mg of xanax to begin with, no more than 1mg. The likeliness of you overdosing is very slim in this situation (especially since suboxone has a cap on respiratory depression, but it should be noted that the few cases of reported buprenorphine overdoses have included the use of a benzodiazepine or similarly some other GABAergic drug/depressant).
Ive been smoking black tar for 8 months(almost a g a day), i dont have a tolerance to xanax but i build a fast tolerance. Ive taken xanax before but been off of them for almost a year. When u say dont go overboard, are u talking about not taking too many xanax bars? Or the subs?
Also you mentioned to not take more then 1mg of xanax to start out with, but in how long? 1 a day or?
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A couple points:
- Suboxone/Subutex (buprenorphine) is an opioid much stronger than most anyone will give it credit for - it is very potent in its opioid properties, including respiratory depression and general CNS depression, which can get out of hand and become dangerous without using caution when dosing and knowing your tolerance, starting slow and slowly increasing if needed. I have had dope addicts tell me bupe put them into a stronger opioid nod-state, almost paralytic, and inducing much nausea and vomiting. And, low doses of bupe always work better than higher doses, despite what your Sub-doc is telling you. I am emphasizing that even if you can tolerate dope very well, that does not necessarily mean bupe will not affect you significantly and even at lower doses. Be careful with bupe, alone.
- Now, your in opioid w/d's, and the bupe should be doing you just right, provided you didn't jump to a high dose to quickly. Know your body and your limits. So, with regard to the Xanax, I would argue that it is potentially quite risky and dangerous in the inherent properties of the drugs and their synergistic CNS depressive properties, BUT you are in w/d's, and benzo's are often used with fairly good success, it seems, alongside bupe, so I would say figure out your sweet spot of bupe-dosing (the lower, the more pleasurable and opioid-esque) and then think to lower doses of Xanax, if really needed, even if you have a benzo tolerance. For true therapeutic result, a dose of 0.25 mg Xanax is usually sufficient in rounding out the edges of acute anxiety episodes or inducing fair relaxation to help insomnia trouble, as well. Some persons actually benefit from a dose of half of that, 0.125 mg, for therapeutic relief. If you would be inclined to go higher, realize your judgment will become shifty and you may go even higher in your dosing - it is not a shame of anyone, just a side-effect of the drug. So, if more than a dose of 0.25 mg Xanax is taken, I would advise not to exceed 0.5 mg, and try to use the lowest dose possible, even if that means 0.375 mg (the half-way mark). And, I would, really, advise to listen to your body, use other calming means of grounding yourself in this trial of kicking dope. And, good for you, if it is for you.
- One last thing: As the BL community always stresses, you can always take more, but you can never take less.
- Suboxone/Subutex (buprenorphine) is an opioid much stronger than most anyone will give it credit for - it is very potent in its opioid properties, including respiratory depression and general CNS depression, which can get out of hand and become dangerous without using caution when dosing and knowing your tolerance, starting slow and slowly increasing if needed. I have had dope addicts tell me bupe put them into a stronger opioid nod-state, almost paralytic, and inducing much nausea and vomiting. And, low doses of bupe always work better than higher doses, despite what your Sub-doc is telling you. I am emphasizing that even if you can tolerate dope very well, that does not necessarily mean bupe will not affect you significantly and even at lower doses. Be careful with bupe, alone.
- Now, your in opioid w/d's, and the bupe should be doing you just right, provided you didn't jump to a high dose to quickly. Know your body and your limits. So, with regard to the Xanax, I would argue that it is potentially quite risky and dangerous in the inherent properties of the drugs and their synergistic CNS depressive properties, BUT you are in w/d's, and benzo's are often used with fairly good success, it seems, alongside bupe, so I would say figure out your sweet spot of bupe-dosing (the lower, the more pleasurable and opioid-esque) and then think to lower doses of Xanax, if really needed, even if you have a benzo tolerance. For true therapeutic result, a dose of 0.25 mg Xanax is usually sufficient in rounding out the edges of acute anxiety episodes or inducing fair relaxation to help insomnia trouble, as well. Some persons actually benefit from a dose of half of that, 0.125 mg, for therapeutic relief. If you would be inclined to go higher, realize your judgment will become shifty and you may go even higher in your dosing - it is not a shame of anyone, just a side-effect of the drug. So, if more than a dose of 0.25 mg Xanax is taken, I would advise not to exceed 0.5 mg, and try to use the lowest dose possible, even if that means 0.375 mg (the half-way mark). And, I would, really, advise to listen to your body, use other calming means of grounding yourself in this trial of kicking dope. And, good for you, if it is for you.
- One last thing: As the BL community always stresses, you can always take more, but you can never take less.
Znegative
Bluelight Crew
The xanax are more of a concern but look, you got a sizable habit and have had one for a decent amount of time, the suboxone most likely isn't going to 'fuck you up' like it does during the induction phase for users with small tolerances, so I think you would be fine just as long as you start off with dosages of .5mg of alprazolam, give it an hour and if you feel like that didn't help you can up your dose. Suboxone as you probably know has a ceiling effect in terms of euphoria and CNS depression so it's not like other opiates where you have to worry that if you take a higher and higher dose that you'll OD, basically if you're cool at 8mg, taking any more isn't going to produce anymore typical or dangerous opiate effects.
This is, frankly, not safe nor sound advice.
Depends on several factors, but primarily if you are tolerant to Xanax and other benzodiazepines and have a fairly high opioid tolerance. However, even if you have a high tolerance to both opioids and benzodiazepines, it may still be dangerous due to the fact that both are CNS depressants, along with Xanax being among the strongest benzos available. If you were to try taking benzos with suboxone, choose something with weaker effects and a longer half-life, such as a low dose of diazepam. Also, keep in mind that if you start taking a benzo with your suboxone, you'll have to kick the benzo later on, and that's not gonna be easy. In short, I'd advise against combining the two.
I actually didnt have any tolerance with xanax but only with opiod like heroin. I took my last hit last night at 12 and plan to switch over to suboxones at 12 tonight. I just thought id use xanax to help with switching to subs.
Znegative
Bluelight Crew
okay so we all agree that mixing benzo's and opiates (including suboxone) is dangerous, this is all true and good, but at the same time I think that its safe to say .5mg of alprazolam combined with suboxone is not going to kill anybody. Just understand the dangers, keep your dosages of the benzo's low. I actually think it's better to use a drug like xanax in this situation as its got a shorter half life and thus eliminates the danger of the drug accumulating in the users blood over time and stacking up, which could result in problems with CNS depression.
I agree about the shorter half life reducing the risk of the drug accumulating in the body, but the problem is that shorter half life, combined with being one of the strongest and most euphoric benzos, makes Xanax one of the hardest benzos to kick. While .5mg combined with suboxone probably won't kill you, it'd be shooting yourself in the foot, since you'd be saving yourself from a little bit of pain from the switch over to Suboxone now in exchange for going through a lot of pain to get off of Xanax later on. And using any benzo with sub still makes it easier to overdose, especially if you relapse and use a more euphoric opiate. All I'm saying is that using benzos with opiates in ANY situation is highly advised against because of the implications for the CNS. Also, the switch to sub from heroin from what I hear is usually fairly painless (other than some minor withdrawal symptoms that will go away within a few days of switching).
Enlitx
Bluelighter
- Joined
- Feb 11, 2004
- Messages
- 735
I honestly appreciate how careful some bluelight posters are to advise caution and how they are very cautious giving dosing suggestions, I just wonder sometimes how applicable they are in these types of scenarios. I fully realize that everyone responds differently to medications and caution is the word of the day, but I really don't see how starting at 1 mg of xanax mixed with 2 to 8 mg of suboxone would pose any significant threat to someone. Coming off that amount of such a strong narcotic will wreak havoc on the nervous system, and I would guess that in a lot of cases at least 1 mg will be needed to provide any relief that is worth taking the pill for in the first place. This is assuming that the suboxone is not fully covering the withdrawals, for whatever reason, but if it is covering the withdrawals so the person is comfortable then the benzo should not be used in the first place.
I also think the debate about the half life is much to do about nothing. Having used benzos multiple times in conjunction with opioid replacement therapy, unless someone is coming off something akin to methadone with regard to half life, the benzos won't be needed after a week of being clean. This is usually true even if suboxone or methadone is not available, and they are usually not needed at all in such cases. I think that simply stating the benzos should be limited to 7-10 days of use to eliminate the potential for a new addiction would help clear things up. Instead of implying that any usage, without regard to specific dosage or duration of use, will create a new addiction during withdrawals, people need to realize that it is perfectly fine to use benzos for a week straight and that there will be no physical addiction from this type of use. Of course everyone needs to be ever mindful of the psychological threat of addiction developing, and for this reason I think medications such as clonazepam are preferable since their long half life reduces any type of pleasurable "buzz" that might be achieved during the up and down phases of redosing more euphoric benzos such as xanax.
Don't get me wrong, I am not disparaging anyone's advice or comments thus far, I just think that because of purely good intentions sometimes the advice becomes cautious to the point of being useless. If withdrawal symptoms are bad enough that a dosage of suboxone is not covering them, I doubt 0.125 mg of alprazolam will do much to help. In rarer cases it might, and in rare cases 1.5 mg of alprazolam might even be dangerous mixed with 8 mg of suboxone on an individual withdrawing from a sizable heroin habit, but it would serve everyone better if people started qualifying their statements indicating that the vast majority can and have taken much larger doses than .125 mg to sustain relief during withdrawal with no ill effect, even with mixed with a moderate (2 - 8 mg) dose of suboxone. I will even take my own advice and qualify my entire post by saying that my comments should in no way be interpreted as the safest possible medical advice, rather instead that my post is simply stating that for the majority of people there will be no problem with the things I have suggested. Of course consulting an MD and taking medication under the supervision of medical care or at least with access to medical emergency treatments is always strongly encouraged
At the same time, don't freak out thinking that bumping up to .75 mg of xanax from 0.25 mg while on 4 mg of suboxone will pose any real threat to your health, you are very very likely going to be just fine.
Znegative
Bluelight Crew
I honestly appreciate how careful some bluelight posters are to advise caution and how they are very cautious giving dosing suggestions, I just wonder sometimes how applicable they are in these types of scenarios. I fully realize that everyone responds differently to medications and caution is the word of the day, but I really don't see how starting at 1 mg of xanax mixed with 2 to 8 mg of suboxone would pose any significant threat to someone. Coming off that amount of such a strong narcotic will wreak havoc on the nervous system, and I would guess that in a lot of cases at least 1 mg will be needed to provide any relief that is worth taking the pill for in the first place. This is assuming that the suboxone is not fully covering the withdrawals, for whatever reason, but if it is covering the withdrawals so the person is comfortable then the benzo should not be used in the first place.
I also think the debate about the half life is much to do about nothing. Having used benzos multiple times in conjunction with opioid replacement therapy, unless someone is coming off something akin to methadone with regard to half life, the benzos won't be needed after a week of being clean. This is usually true even if suboxone or methadone is not available, and they are usually not needed at all in such cases. I think that simply stating the benzos should be limited to 7-10 days of use to eliminate the potential for a new addiction would help clear things up. Instead of implying that any usage, without regard to specific dosage or duration of use, will create a new addiction during withdrawals, people need to realize that it is perfectly fine to use benzos for a week straight and that there will be no physical addiction from this type of use. Of course everyone needs to be ever mindful of the psychological threat of addiction developing, and for this reason I think medications such as clonazepam are preferable since their long half life reduces any type of pleasurable "buzz" that might be achieved during the up and down phases of redosing more euphoric benzos such as xanax.
Don't get me wrong, I am not disparaging anyone's advice or comments thus far, I just think that because of purely good intentions sometimes the advice becomes cautious to the point of being useless. If withdrawal symptoms are bad enough that a dosage of suboxone is not covering them, I doubt 0.125 mg of alprazolam will do much to help. In rarer cases it might, and in rare cases 1.5 mg of alprazolam might even be dangerous mixed with 8 mg of suboxone on an individual withdrawing from a sizable heroin habit, but it would serve everyone better if people started qualifying their statements indicating that the vast majority can and have taken much larger doses than .125 mg to sustain relief during withdrawal with no ill effect, even with mixed with a moderate (2 - 8 mg) dose of suboxone. I will even take my own advice and qualify my entire post by saying that my comments should in no way be interpreted as the safest possible medical advice, rather instead that my post is simply stating that for the majority of people there will be no problem with the things I have suggested. Of course consulting an MD and taking medication under the supervision of medical care or at least with access to medical emergency treatments is always strongly encouraged
This is kind of what I was getting at in terms of the safety, it's good to educate about the risks of mixing the two drugs, but in cases like these where the opioid in question is suboxone and the OP is only talking about using small doses of xanax, I really don't think theres too much to worry about. In my personal experience however, I've found myself getting addicted to benzodiazepines like clonazepam much quicker than I do to shorter half life benzo's. Clonazepam is also deceptive because it doesn't usually show withdrawal symptoms for 48-72 hours, so you'll be thinking your fine 'oh I can use it every other day', but then you run out, can't get more, and all of a sudden after a few days you're wondering why the hell you feel so fucking terrible. Again this is my experience, and there is an argument to be made that psychologically speaking alprazolam is a more addictive substance due to its fast onset and whatnot. In the end getting addicted to any benzo sucks, but if you're just using them sparingly for treating opioid withdrawal symptoms for a week or so, then there is very little to worry about. You would have to use pretty high dosages of xanax to get addicted physically in just a manner of days.
And as an ending I also agree that .125mg is a bit ridiculous, I don't even think that would have any therapeutic effect, or if it did it's the lowest dose that would do anything (I realize the .25's are scored so imagine that it can do something, but for most a quarter of a milligram of xanax is the bare minimum to get any effect), that's why I suggested a half a milligram to start with- I know that even with a benzo tolerance I can almost always get something out of .5mg of alprazolam or clonazepam if I'm in benzo withdrawal (unless I've really dug myself into a hole with tolerance). I also have seen at multiple detox facilities patients given 8mg of suboxone along with 2mg of clonazepam, granted that they were under supervision of a medical staff, but they were fine. The instances in which people have overdosed off of suboxone and benzodiazepines usually involve people injecting subutext AND a benzo (in most cases I'm pretty sure it was temazepam which in Europe for a while-I don't think anymore-had come in gel capsules) in a solution.
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manboychef
Bluelighter
I think what folks are getting at is if you truly want to get clean from opiates it is best to use as small a dose as possible from both to save you a little trouble when you try to get off the medications you are taking to get off the original drug.
Honestly the best thing you can do for yourself is just have someone around when you dose. This will protect you from harming yourself if you do have an adverse effect from the combination.
Xanax is okay but I would get a longer acting benzo like diazepam or clonazepam. They will hold you a lot better and you will not need to keep redosing.
Good luck OP. Something to do while you are on your subs and benzos is start a recovery plan so you don't end up going back to heroin. This is an extremely important part of staying stopped.
Honestly the best thing you can do for yourself is just have someone around when you dose. This will protect you from harming yourself if you do have an adverse effect from the combination.
Xanax is okay but I would get a longer acting benzo like diazepam or clonazepam. They will hold you a lot better and you will not need to keep redosing.
Good luck OP. Something to do while you are on your subs and benzos is start a recovery plan so you don't end up going back to heroin. This is an extremely important part of staying stopped.
If you use a benzo with sub, then you'll want to use either diazepam or clonazepam. Both have a long half-life, and aren't as potent as Xanax. And clonazepam is a little bit less euphoric than Xanax, so it's a little less risky as for the potential of causing a new addiction. Out of the two, clonazepam's probably the better option. I don't know much about dosage for most benzos, but in general, start with the lowest dose that has any effect and go up by a small amount if needed. Also, it's important that you take things VERY slowly when coming off of the benzo. Even in the short-term, I don't recommend that you risk it and suddenly stop whatever benzo you end up taking. Have you switched over to sub yet, OP?
What I always tell people from my experience with bupe is to start as low as possible (start at 1-2mg, increase by .5-1 mg every 2 hours as/if needed till you find the right amount to keep you out of WD). IMO, do not take more than you need it will make tapering down a much easier process when you're ready to come off. Save your extras for a day down the road, you may very well need them when you start your taper process or if you would ever relapse. Everyone is different, but the mental aspect of WD is much worse to me than the physical part. Also, you're not going to experience any or much euphoria from bupe at a high dose, the euphoria is more pronounced at a lower dose, less than 2mg iirc. I am sure someone will correct me if I'm wrong.
The mental part stuck around for me for years and no drug can totally take that away. Benzos help but then there's another possible addiction in waiting. With Xanax, from a HR perspective, of course the lowest amount should be used. It works fast so there is really no reason to not start with a low dose (.25-.5) and re-dose .25 every 15 min till anxiety is gone. If you keep doses of both low you should be fine, but caution should always be used when mixing any amount of these 2 IMO.
The mental part stuck around for me for years and no drug can totally take that away. Benzos help but then there's another possible addiction in waiting. With Xanax, from a HR perspective, of course the lowest amount should be used. It works fast so there is really no reason to not start with a low dose (.25-.5) and re-dose .25 every 15 min till anxiety is gone. If you keep doses of both low you should be fine, but caution should always be used when mixing any amount of these 2 IMO.
At the moment the big question is what happens when you will take the bupre.
Possible outcome ranges from feeling fine and a bit nodding, to going into full WD, depending on your level of opiate addiction.
As Hoe says, you should build it up taking little by little.
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It is (pretty) dangerous to be high on opiate and take benzos too.
But it's not if you are far away from the level of an OD on opiate. In the case of Deeso, I'll be more worried by bupre throwing him into WD
ValiumTorenceSkyHi
Bluelighter
Mixing suboxone with heroin is highly Dangerous and will send you into rapid withdrawels! I have actually seen this happen first hand!
Taking Xanax during opiod withdrawel? Thats not as bad IMO! I would just say to take a low dose of xanax because suboxone is a strong drug! and mixing can cause Respitory depression! The main Danger!
Stay safe!
Taking Xanax during opiod withdrawel? Thats not as bad IMO! I would just say to take a low dose of xanax because suboxone is a strong drug! and mixing can cause Respitory depression! The main Danger!
Stay safe!
ValiumTorenceSkyHi
Bluelighter
Im currenly on 16mg Suboxone and 70mg Diazepam (valium) I feel fine! but i have an extremely high tolernece for benzos! I could take 50 and still be fine! honestly!
But yae be safe and watch out dont over do it and dont mix sub with heroin! EVER
peace
But yae be safe and watch out dont over do it and dont mix sub with heroin! EVER
peace