Opioids Is Suboxone the only substitute?

[Altered Perception]

Once you're low enough, try an opiate 12 hours after your bupe dose. Don't expect 100%, but if you feel most of it, then you're ready. If not, lower your bupe dose a little until you get it right. It's a tricky balance, but it keeps you well and allows you to chip a little without damage, assuming you don't overdue on that "chipping" dose.

Great explanation! Thanks again.

 

[Znegative]

When you say time release, are you refering to the slow release Oxycontin? The Oxycodone I am using is 20mg capsules containing fine white powder of instant release "Oxycodone Hydrochloride".

The reason I can't use Oxycontin slow or extended release is because how sensitive I am and all the adverse reactions I've had which only last for 1-2 hours thank God, otherwise having a long lasting adverse effects on an extended release would have been much more risky.

Thanks for all your advice.

My bad my man,
Even so, your opioid tolerance is still rather low. Start off low with the suboxone, effects usually peak after three hours, and begin to hit you after 45 minutes. I wouldn't do more than 1mg to begin with, but I think it would be a better bet to start lower like .5mg. I would not use buprenorphine for pain honestly, if I could choose something else

 

[Jabberwocky]

Buprennorphine is a partial-agonist opiate meaning it doesn't bind to all of your Opiate receptors (including the one that causes euphoria) however does bind to some. It has a VERY strong binding affinity. With that being said, if you decide to try to take other opiates, they will not be able to get you high because they can not overcome the strong binding affinity of Buprenorphine. It really doesn't have any pain relieving benefits but the first few days or week you're on it you should be able to feel a bit of an opiate high; especially the first day. After that, your tolerance sky rockets and it just helps prevent withdrawals. You will start to feel more normal then high. So it is a very good drug to help but you have to be committed. Some people stay on Suboxone maintenance for most there life and others will take it for a period of time and then taper off it. Tapering off could result it relapsing though when you are off the Suboxone. I just realized that I was saying Suboxone but the same goes for Subutex.
Hope thats helps

Okay, this is kind of correct, but there are some minor and major mistakes.

The main and only practically significant drug in suboxone AND subutex is Buprennorphine, correct, although the way it is really spelled is "Buprenorphine." And yes, I like to be a dick whenever I get the chance

Yes, bupe is a mixed opioid agonist-antagonist. The following will explain the real meaning and significance of bupe being a mixed agonist-antagonist opioid.

What this means is basically that, in the sense that bupe is a partial opioid agonist, it will have some of your standard, morphine-like opioid effects (causing analgesia and euphoria for instance). Most, if not all, opioids used to treat pain or chronic pain are full opioid agonists, such as oxycodone. But remember, bupe, unlike oxy, is only partially an opioid agonist...

Thus, as it is only a partial agonist bupe's agonist properties, such as euphoria and analgesia, are not as pronounced as they are with a full agonist, such as oxycodone (thus people can easily catch a nice nod with oxy but it's rather hard if not impossible to do so with bupe, although it certainly will still make you feel damn good).

[The best known full opioid antagonist is Naloxone, best known as Narcan, which I discuss briefly a couple paragraphs below.]

In the sense that bupe is a partial opioid antagonist, thanks to its extreme high affinity (think of bupe a REALLY strong magnet) to your opioid receptors, it prevents (the vast majority) of other full opioid agonists (think of something like hydrocodone, for example, as a much weaker magnet) and full opioid antagonists (Naloxone/Narcan) from attaching to your receptors in significant numbers.

Bupe has such a high affinity for your opioid receptors that it will even kick off and dislodge previously attached full agonist opioids from your receptors. This is the cause of precipitated w/d (happens when you take bupe before all other agonist opioids are out of your system), and why you must wait 12-48hrs (depending on the full agonist opioid in your system) before you can begin taking and titrating your dose of suboxone/subutex.

Thus while bupe is in your system, it's antagonist action, thanks largely to it's extraordinarily high affinity to your opioid receptors, prevents other opioids from having much if any effect on you. But remember it's still only a partial antagonist, because as I mentioned previously it also has morphine like agonist properties.

That is why we call bupe a mixed/partial agonist-antaognist opioid. BTW, opioid means any morphine-like drug (as in chemical structure and/or effects).

For your average lay person all that takes a bit of thought to wrap your head around, but it's not really all that complicated to understand once you've figured it out.

Here's the big problem with your post: Suboxone/Subutex IS PRESCRIBED for pain managment in certain populations (i.e. if you're an addict and also suffer from chronic pain).

Naloxone is the drug in Narcan, which alone, as a full opioid antagonist, is used to treat people who have overdosed on opioids. Naloxone is thought to deter abuse of suboxone (it's not in subutex), however it does little to nothing to actually do so. This is because the bupe in the suboxone renders it useless, out-competing the naloxone. The bupe in suboxone just doesn't give the naloxone any chance to attach to your opioid receptors.

(Narcan is also used to treat bupe overdoses, rare though they might be given it's ceiling effect, but you have to use much more Narcan than you normally would when treating someone who has overdosed on a full agonist; Narcan will probably have to be administered multiple times as well to treat a bupe overdose.)

(Notice how, with a big enough dose of Narcan you can treat a bupe overdose, just as how you can get high while taking bupe as long as you use a big enough dose of a full agonist?)

Thus, it doesn't really make a BIG difference whether you're on suboxone or subutex. Doctor's mistakenly believe that it's the naloxone in the suboxone that makes it "abuse proof," when this is absolutely not the case (as the naloxone doesn't really do anything, unless you're allergic to it I mean, and in that case you also will probably be allergic to the bupe itself). People can still shoot, snort, plug or take suboxone however they please. In terms of pain management, both suboxone and subutex work pretty much as well as one another.

Taking full agonist opioids (hydrocodone, oxycodone, morphine, hydromorphone, etc. etc.) while on suboxone or subutex is highly impractical. To do so effectively you'll need to take many times your normal dose to achieve any effect (because the bupe is out competing them, thus blocking and preventing them from attaching to your opioid receptors in significant numbers), and as Zneg notes such high doses can pose risks to the user themselves. (That being said, I have been able to get high from both heroin and oxycodone by taking much, much more than I normally would have while I also had bupe in my system.)

But given bupe's ability to treat many forms of chronic pain, other opioids are generally not needed for pain management when a patient is using bupe. Tramadol is often prescribed in conjunction with bupe, as it does not work like classic opioids and thus is not affected by the bupe. Of course if you need some sort of medication to treat break through pain that is stronger than what tramadol can handle, you can work out a viable option/dosage of suboxone/subutex to make another opioid possible (I believe there are other opioids with an affinity to your receptors that comes pretty close to if not surpassing bupe's affinity).

The best point in the above quote is that suboxone/subutex should only really be used by those who plan to stay the course, and use it long term. It is not the kind of drug that lends itself to just taking once in a while to treating chronic pain, although I do know one individual who's successful for the most part in so using it.

By the way, although most do not get "high" from it after the first day or two they're on it, many do feel a positive, analgesia and euphoria from suboxone/subutex EACH AND EVERY time they take it (such as myself). So until you try it out and get used to it, you can't really predict how well it will work for you. But honestly this goes for ANY and EVERY drug...

Again, I want to emphasize, bupe is a great tool at treating chronic pain in certain populations (especially those who have chronic pain and are also former opioid addicts or habitual abusers of their pain meds). Of course it doesn't work as well for everyone, and its efficacy at managing chronic pain will depend largely on the type and severity of your symptoms. But this is for your and your doctor to work out.

Altered Perception: My friend, please use the edit function to add to your preexisting post instead of just creating a whole new post in the future. Double, triple and especially quadruple and quintuple posting is frowned upon for a variety or reason (namely it forces one to scroll more than necessary).

Shit, when I get going about suboxone, I sure do get going...

 

[Swain]

Subutex will not work for you OP. You will risk precipitated withdrawls by switching from oxycodone to Subutex.

Also, the Subutex has very little pain killing effects, especially compared to oxycodone.

Plus, even if you managed to work out the timing to avoid precipitated w/d, Subutex will raise yourtolerance to oxycodone, or at least keep it the same, but it definately won't lower it. Subutex is a very potent drug even though it has little euphoria, by regularly taking subutex, you will continue to raise your tolerance.

IMO/E, you're better off just tapering down the oxy to where your comfortable. And on days you don't need it for pain, just take as little as you need to not get sick. Since Subutex won't get you high anyway, there's really no difference between taking subutex, and taking the minimum dose of oxy needed to keep you from going into w/d. And as stated before, you're more likely to experience some type or degree of w/d if you start taking subutex, b/c you'll need to be in w/d everytime you switch from oxy to subutex....

Just my 2 cents from years of subutex, oxy, H, and Methadone...goodluck to ya

Some of this is true but I don't agree with other parts.

Subutex does have very little pain killing affects if you are on a daily dose of the OP's size or greater (not that it's abnormally large or anything, because it is not, it's just that bupe's (short for buprenorphine, active ingredient in sub) pain killing effects only exist with very small doses like .2mg, and if you already have a tolerance to opiates like your case, a dose that small will not do anything. Bupe might be a good painkiller for someone who has absolutely no opiate tolerance, and keeps their daily dose somewhere between .2 and .4mg bupe maximum daily. It is precribed for pain in some countries at those low doses.

You are by no means guaranteed preciptated withdrawal going from a full agonist to bupe. In your case, 80mg of oxycodone is a considerably small daily dose.. it could probably be handled with 1mg bupe maybe 2mg maximum daily. I know that when I started out my addiction I was doing 3-6 30mg oxy IR's daily, and I had absolutely no transition to bupe. I would wait 12-16 hours after sniffing my last dose, and the bupe would actually get me high/give energy. I felt great like 110%. That is nonexistant for me now though... I reached a point after switching back and forth and throwing IV heroin there that no matter what I have to go through a transition when i get back onto bupe.

Precipitaed withdrawals? That is up to you, no one HAS to go thorugh them. Just wait unitl you are moderately to extremely sick before you take your dose. That being said, I do just that, wait up to 36 hours after my last dope dose, and while I dont get PW's I don't get much releif. It takes 3-10 days to feel 100% on bupe dependin how long my run was. i use WAY more.

And there is no reason why subutex would raise his tolerance unles he is doing a dose which outweighs his oxy dose. Yes, if he takes 8mg daily that will raise his current 80mg oxy daily tolerance. But if he is on 1mg his tolerance would likely go down. Actually in the past few years I have never had the problem of my tolerance going up from bupe..it's always gone down. But again, that relies on you not taking more than you need to. What you can do is start out with 1mg, wait 1.5 hours, if yo have to dose another 1mg. After the first few days you can start to decrease your bupe dose as well causing your tolerance to fall.

Wait 24 hours + befoer you dose the bupe. Yes you will feel like dying, but remember the longer you wait the more releif you will get. And I am willing to bet you will fall into the 'bupe works GREAT no transition for me!' category. If you feel sicker you took it way too early, or if you feel better but still shitty it's going to take you a few days to adjust to bup ebefore you feel 100%.

 

[a|240fav]

people say whatever you want, ive been on and off of suboxone several times. The last time i took 8 30 mg roxies the night before, woke up 8 hours later, snorted my last roxy, 1 hour later i snorted 2 mg of suboxone. I was absolutely fine. I think the naloxone/withdrawal thing is a myth to scare people that they cannot use opiates while one suboxone. I regularly used to take sub i nthe morning and handful of hydrocodone after work and be fine. Also under the tongue method IMO is absolute shit. 2 mg snorted does 10 times more for me than 12 mg under the tongue. Just my personal experience, for like 2 years so definity have tried every way, combination possible, and since ive discovered snorting 2 mg is the MAX i take. i can get by on 1 mg a day. With the cost and having the choice to feel like shit all day , feel like im halfway detoxing , depressed and overall feeling of shit, not to mention the cost of taking 16 mg a day, snorting 2mg is definitly worth it. Since snorting i KNOW that since i quit im going to make it.

 

[Fire&Water]

You will be able to use oxycodone for pain if you are on 2 - 8mg's of subutex

 

[Fire&Water]

Subutex will not work for you OP. You will risk precipitated withdrawls by switching from oxycodone to Subutex.

Also, the Subutex has very little pain killing effects, especially compared to oxycodone.

Plus, even if you managed to work out the timing to avoid precipitated w/d, Subutex will raise yourtolerance to oxycodone, or at least keep it the same, but it definately won't lower it. Subutex is a very potent drug even though it has little euphoria, by regularly taking subutex, you will continue to raise your tolerance.

IMO/E, you're better off just tapering down the oxy to where your comfortable. And on days you don't need it for pain, just take as little as you need to not get sick. Since Subutex won't get you high anyway, there's really no difference between taking subutex, and taking the minimum dose of oxy needed to keep you from going into w/d. And as stated before, you're more likely to experience some type or degree of w/d if you start taking subutex, b/c you'll need to be in w/d everytime you switch from oxy to subutex....

Just my 2 cents from years of subutex, oxy, H, and Methadone...goodluck to ya

Sorry, wrong...

 

[speedygonzalez]

IMHO as a patient who has been addicted to specifically "Suboxone" for 5+ years: I have made several observations that many should be aware of before beginning Buprenorphine (Suboxone) Treatment!!!

Long-term studies indicate: (and I have found this to be true personally as well!) Withdrawal from any form of Suboxone, Subutex, etc. CAN BE UP TO 50 TIMES WORSE THAN HEROIN To elaborate: after about 6-12 months of steady use, I formed a rock-solid dependency on the med and after as little as 12-24 hours after my last dose of Buprenorphine I begin to have horrendous withdrawal symptoms! By day 2-3 the headaches, body-aches, nausea, and general "sickness" really sets in... 7 days without Buprenorphine is absolute hell (and I used quality heroin heavily for 2+ years prior to starting my treatment!) Once physically and mentally dependant on Bup. the withdrawal symptoms after 10+ days are at least 20 times worse than normal opiate withdrawal!!! So if you are reading this and are considering Bup. treatment please take it from me you DO NOT want to use Bup. for more than 6 months!!! If you begin Bup. treatment for opiod addiction, for God's sake try to step down your using within the first 6 months!!! I promise once you're addicted like me you'll be willing to give/do anything to be free of it! Consider this a warning for Bup. like you would consider a warning about a bad RC (research chem.) because I'm dead serious... I wish I were using 2-4g of black tar qd again because that was so much easier to quit. The longest I've been without Bup. in the last 5+ years was approximately 45 days!!! and you know how I said 10+ days withdrawal is hell? Yea, well imagine that opiate withdrawal feeling at its absolute worst... exponentially growing every few days... until you have insomnia and go 2-3 weeks without sleep just rocking yourself back-and-forth in agony wishing someone would just blow your brains out!!!! The one and only time I've attempted suicide was about 35-40 days without Bup! If you are addicted and need to quit - simply think about my experience: locked up in San-Bernandino County, CA awaiting trial for months on a fucking marijuana possession charge (yup you can't get your narc. meds when you're facing a drug charge!!!) Everyone calling you a pussy, cry-baby, etc. because like I said, all you can do is spend countless days and nights passing the time MINUTE BY MINUTE, A FEW SECONDS AT A TIME, COLD TURKEYING THE STRONGEST OPIATE WITHDRAWALS I THINK ARE KNOWN TO MAN! (Seriously, the 50x worse withdrawals statistic was not made up... It is entirely FACTUAL; you can find it on the SUBOXONE home-page as it is common knowledge for those who take Bup long-term...!
(or at least it should be common knowledge to us...)

If this description of my experience/s was not complete enough for you feel free to contact me via PM or email [email protected] with your questions! and I shall read, answer, and post Q/A on this thread for those who seek more Bup. knowledge!

Thanks for reading my (hopefully-informative) rant/rave. I pray that my struggle with Bup. addiction will not go unnoticed/unspoken!

Good Day fellow Bup. addicts =]