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Bupe iv subutex- question that I just can't find the answer to

RevRane

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Joined
Jul 14, 2010
Messages
15
This is my first post here so if it's in the wrong spot, forgive me.

I am dying to get of subutex. I am just not the same person on it as I am when I am sober (won't bore you wit the back story but been battling heroin for 10 years, this time on Sub for a few months, feeling totally ready to be drug free)

Please don't respond it you are going to say "don't you know the dangers" or "you should stay on it so you don't relapse" or "talk to your Dr. (who obviously knows significantly less than anyone with personal experience)

I have been making 4mg last almost a week for 2 weeks now but I am still constantly in a cold sweat and really irritable. I have been iv-ing the crushed pill and noticed that it lasts for a very short amount of time. So question #1 is about that- does anyone know how long it stays in your system if it's shot? Why it would be different than sublingually?

Question #2 is prolly going to get differing opinions- would it be best to wait until I am getting through the day without suffering before dropping to even less or none or would it be best and prolly not that much harder to just stop. In other words am I just dragging this out? Every time I shoot this am I gettin another day further from my goal?

I have had EXTREMELY long sub detoxes in the past and I am scared. The doc gave me a large amount of Xanax to help, and it does, but I am scared of getting addicted to anything else. Question 3 is @ that- how long does it take to get physically dependent on a benzo?

My hope vs. My reality

My hope is that since I am shooting the sub and it seems to last only a few hours - my hope is that the way I feel when I wake up is as bad as it's going to get (which I could totally tough out)

What is the reality? Your experience?
 
So question #1 is about that- does anyone know how long it stays in your system if it's shot? Why it would be different than sublingually?
It stays in your system the same amount of time. Half life is the same regardless of ROA used. The reason why it seems shorter is since iv is instant onset. There's no gradual absorption.
In other words am I just dragging this out? Every time I shoot this am I gettin another day further from my goal?
Every time you use you're extending. The reason gradual tapers are preferred is due to the fact that they're more successful. You want to avoid as much discomfort as possible. Your chances of using/relapsing are much higher when you're in full on withdrawal, as opposed to often times slight discomfort, if any, when you're doing a long gradual taper.
how long does it take to get physically dependent on a benzo?
IME, longer than it does for opiates. I can't put a number on it, though.


My advice is to stop shooting your pills, not just from the HR standpoint, but from the standpoint of what's more likely to help you get off of them.

If you really want off, cold turkey is the quickest way to get there. It's not the easiest though.

Good luck.
 
Thanks Phrozen, I appreciate the re.

Another Question:

Let's say I want to cold turkey it but there are a few upcoming occasions that I need to be functional for- does it make any sense to stop and endure w/d for a few days, then take a peice of a pill to attend a function OR does that mean I endured the w/d for no reason and made no progress?

I am having trouble writing what I mean - I hope this makes sense

In other words will I make any progress or suffer needlessly if I know that I need to take a peice in a few days? Does taking that peice totally wipe out any progress I made?

Thanks
 
Also- I am about to see the DR in an hour- she is awesome and will write for anything I ask for- is there anything that I should ask for? (anything else I mean) I currently have on my list ambien, xanax, trazodone (i have to take it wit ambien or ambien gives me terrible anxiety)

any other perscription meds I haven't thought of that have helped anyone?
 
Let's say I want to cold turkey it but there are a few upcoming occasions that I need to be functional for- does it make any sense to stop and endure w/d for a few days, then take a peice of a pill to attend a function OR does that mean I endured the w/d for no reason and made no progress?
You'll make progress, but it will be set back by your dose for those occasions. Depending on how much you dose, it can be a small set back or a large setback. If you're going to do this, take as little as possible and don't take anymore after those occasions.

any other perscription meds I haven't thought of that have helped anyone?
The benzo's will help with the anxiety and should help you get some sleep. The only other thing I could think of is clonidine, which does help with CNS withdrawal effects.
 
The only other problem I can see with you shooting it, besides what has been posted and obvious harm from especially shooting sub (there are posts here with studies, quite gross), is that you are repeating ritual.

Ritual is part of the psychological addiction. You probably used to IV H, so now that you are using sub as an H replacement, you are probably shooting it to fulfill the psychological ritual you were missing with H.

Before stopping the sub, I would try to just normalize out by taking it orally, then starting a taper. If you can break yourself free of that phsych ritual, then defeat only the physical symptoms of the bupe taper, you should be in a much better place than if you tapered via IV, because after you stopped, you would be missing that IV route ritual, which would be an easy route back to a H relapse.

At least if you form a ritual via oral admin, you can replace it once you stop by popping a jolly rancher or wtv under your tongue.
 
Actually, IV Subutex will not last as long as taken by other routes (sublingual, plugged). The reason for buprenorphine's duration lies in its affinity to blood proteins. Taken sublingually 96% of the buprenorphine binds to proteins in the blood shortly after the peak plasma levels are reached. Only the unbound portion of the drug is active, and the protein-drug matrix slowly releases small amounts of buprenorphine over the course of 72 hours (roughly). By IV'ing bupe you are dumping a large amount of bupe into your bloodstream, almost all of which is unbound initially. Some, but not 96% of the drug binds to your proteins giving you a shorter duration. As Phrozen pointed out, the half-life of the bound portion remains the same. The accepted half-life accounts for the drug's high protein binding affinity. However less of the drug is bound, and a larger portion (compared to other routes) is initially metabolized and the duration is lessened.

You are entering withdrawals quickly because your tolerance is high compared to the dose you are taking. If you IV 0.5mg to get high most of that is metabolized and the remainder trickles from the matrix. That remainder is insufficient to agonize your receptors to the degree you need to avoid withdrawal symptoms. The long detoxes you had in the past, were they from IV use? Oral use will stave off withdrawals for longer, but they will be more drawn out.

I would stay away from Xanax like the plague. You will find comfort in it for sure, in its ability to help you sleep. But the likelihood that you will like benzos as a substitute for opiates is high. And the withdrawals are far more unpleasant and dangerous than opiate withdrawals.

I've banged Subutex in my time and I must say that it is an exceptionally dangerous pill to shoot. The starches in the pill harbor bacteria and are one of the common causes of abscesses. The other drawback is that if you get yourself deeper into addiction on a full-agonist, and will require bupe to detox it will be less than effective. You will end up having to take a higher dose, and shooting it will result in no euphoria. The detox from a dose as high as mine (32mg/day) is unfathomably long and painful.

EDIT: In addition to the other meds mentioned in the thread Loperamide will also help ease the GI symptoms of the withdrawals. Xanax can be used for a few nights, but the risk of dependency in my opinion is too great. In most detox clinics, patients are given Trazadone. It is a very effective sleep aid for opiate or benzo withdrawals, it can be used repeatedly with very little addictive risk. The worst withdrawals you may experience from it will include a night of insomnia, and even then with some melatonin it is possible to sleep if you get your body into a rhythm.

Get consistent with your daily routines so that your body knows what to expect. Try to eat as much as you can, although I doubt you will have any hunger. Exercise is hard to do, but if you enjoy shooting hoops or playing tennis, force yourself to do it. The adrenaline will mask your symptoms and the dopamine that is released will give you a nice halo effect which reduces the symptoms for a few hours. Of course forcing oneself to go out and exercise in the midst of withdrawals is very difficult. But you will need to occupy your time well, because the psychological aspects of withdrawal, like depression, need to be addressed to successfully detox.
 
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Funkee- I sure hope you come back online- Finally someone is pickin up what I am puttin down! I knew these w/d s that come on a few hours after I dose were not in my head!

Actually, IV Subutex will not last as long as taken by other routes (sublingual, plugged). The reason for buprenorphine's duration lies in its affinity to blood proteins.


Taken sublingually 96% of the buprenorphine binds to proteins in the blood shortly after the peak plasma levels are reached. Only the unbound portion of the drug is active, and the protein-drug matrix slowly releases small amounts of buprenorphine over the course of 72 hours (roughly). By IV'ing bupe you are dumping a large amount of bupe into your bloodstream, almost all of which is unbound initially. Some, but not 96% of the drug binds to your proteins giving you a shorter duration. As Phrozen pointed out, the half-life of the bound portion remains the same. The accepted half-life accounts for the drug's high protein binding affinity. However less of the drug is bound, and a larger portion (compared to other routes) is initially metabolized and the duration is lessened.

You are entering withdrawals quickly because your tolerance is high compared to the dose you are taking. If you IV 0.5mg to get high most of that is metabolized and the remainder trickles from the matrix. That remainder is insufficient to agonize your receptors to the degree you need to avoid withdrawal symptoms. The long detoxes you had in the past, were they from IV use?

The past long detox was from oral use- I am talking close to a year before I felt close to normal and Months of not moving from the couch- seriously, months. It was as close to hell as one can get- just awful- and depression so bad I just sat there and cried. I had been taking 32/day as instructed then dropped to 8 then stepped off. Now I know 8 is far too high to step off but this was like 5 years ago when I didn't know better.


Oral use will stave off withdrawals for longer, but they will be more drawn out.

This is what I really want to know about. Can you elaborate at all? I am already at week 2 of IVing 1-3mg/day. I am in a tolerable state of w/d all day- mostly just irritable and ice cold soaking wet skin with chills - with the exception of a few hours after administration.

What is weird to me is that I seem to be getting less tolerant or the w/d is getting worse and I am wanting more bupe as the days go on instead of stabilizing at this low dose.

It makes me wonder if- being that it wears off so quickly- if I could just abstain completely I would start to feel better. Am I just keeping myself in a steady cycle of use w/d use w/d use w/d?

I suppose to get an answer to that I will have to take it sublingually- or abstain- (or you give me the answer :)

I would stay away from Xanax like the plague. You will find comfort in it for sure, in its ability to help you sleep. But the likelihood that you will like benzos as a substitute for opiates is high. And the withdrawals are far more unpleasant and dangerous than opiate withdrawals.

Yeah- I feel you and I am really wary of that. I have a high dose (4mg/day) that I try not to take more than a few days in a row. the Dr. today told me it would take @ 3-4 months for me to develop a physical dependence on Xanax but I am wary of that advice and more likely to listen to experience.

My plan is either going to be A) take subutex with no Xanax or B) stop taking Sub and take Xanax for a few weeks more till the w/d are almost over.

That time I had months and months and months of w/d I don't think will happen cuz I was on it for a much shorter duration this time. I really hope I am not wrong @ this.

The detox from a dose as high as mine (32mg/day) is unfathomably long and painful.


Oh yes it is!

My Dr. just assured me that slow and steady wins the race and I should do a slow taper- but given the length of my past w/d I am just so anxious to get off this shit before it turns to that.

Thanks for the input- please tell me more!
 
i dont see you as someone ready to quit drugs. you will relapse. the fact that you are shooting up your subs goes to show how you are so not ready for this. youre still trying to get high.
 
i dont see you as someone ready to quit drugs. you will relapse. the fact that you are shooting up your subs goes to show how you are so not ready for this. youre still trying to get high.

It's kind of hard for you to make that call but you're certainly entitled to think that. That wasn't my question either. I am trying to make my detox as easy as possible. I am not trying to be a dick but the forums are so overrun with these types of answers and I don't know why people bother posting them. A post like that isn't going to make me see the light or change my mind. I am just trying to get information. Will I relapse? Maybe- Maybe not. Like I said- I hate who I am on opiates- sub included and I want off.

All I want to know is how my ROA is going to effect my w/d- that's it. I'm sure you mean well but these types of posts are just clutter. But thanks for bumping my thread.

ps- I've been in w/d for 2 weeks with cash and a car and time on my hands without relapsing. See, now you've made me feel like I have to justify myself to you when all I want is some REAL INFO- ya know, the reason this site exists.
 
Clonidine is a wonder drug for withdrawals;beware being sleepy. It lowers your Bp.

Really? A wonder drug? I haven't noticed it really make a difference. Maybe the diff is negligible compared to the way I feel. I know that clonidine is a bp med but what symptoms does it knock out for you?
 
Every time you experience withdrawals, your body "kindles" or becomes sensitized to its effects. The other side of the coin is that you come to expect those symptoms and they aren't as mentally traumatizing.

The fact of the matter is that you are desensitizing yourself to buprenorphine as well by injecting it. If you choose to get clean, you will still use buprenorphine. Going cold-turkey off any dose greater than 0.5mg every other day is going to be hell. However, know that taking bupe won't get you high any longer. The highs and lows aren't helping you in any way. You will slowly taper off of bupe, but before you can do that, you have to stabilize your dose at a level where you experience no symptoms. Taking your subs sublingually, and frequently is your only option. Whether that is 6mg (2mg x 3 times a day) or 12mg (4mg x 3 times a day) or anywhere in between, your body must maintain a consistent level of the drug, for a long period of time until you can start reducing your dose. The two things to keep in check when tapering is how long between each taper and how much is your dose reduced. Generally speaking anything greater than 10% per month is going to create symptoms.

The goal is to allow the partial agonism of bupe to do its magic. Because it doesn't agonize the receptors fully, your receptors are given a chance to heal more-or-less. When you get high and then get low, you are only doing greater damage. And as I'm sure you know, if you take bupe when there's a fair amount already in your system, it doesn't get you higher. You will not experience any withdrawal symptoms, but you will experience no euphoria; the euphoria you get from it is harmful to your recovery. Very harmful in different ways. I did the same thing you did, and I kept pushing my dose higher and higher; eventually bupe became almost worthless to me unless I took the ceiling dose 32mg and even then I experienced symptoms. And as a tool to get clean it is the best around. Forget about methadone, there's almost no kicking it. But do not abuse bupe if you want to get clean.

You put yourself in a lot of danger by quitting cold turkey, both in terms of relapse and overdose. As you know the psychological symptoms of withdrawal are drawn out. You may be in the clear in terms of physical w/d in the near future. At your dose you maybe have another week or less until things start improving. But you're putting a lot of pressure on yourself. Some succeed, but they are very few and of the strongest will. You should begin taking your medicine orally; once you get to a baseline where your symptoms are gone, you need to continue taking that dose for months if not years. I've been on my current dose for close to a year. You wrote that you've done sub detoxes before. It's apparent to me that it hasn't gone your way in terms of staying clean. Statistics show that the relapse rate for users who have been on bupe for 5 years goes down to 20%, and 10% at 10 years. I don't know the stat for cold turkey, but I imagine the relapse rate is very high.

In order to properly recover, you need to let your receptors heal. By quitting cold turkey and leaving your receptors severely impaired, you are asking them to heal on their own. They may do so, but it will take a painfully long time for everything to get back to normal.

If you want to push through it, there are ways to speed up this process. Eating right: lots of fruits, and exercising: in particular aerobics. As well as sleeping well; the more you sleep, the faster you will recover. You need to get a good sleep-aid; ask your doctor for trazadone, it is quite strong and hardly addictive. While you are still withdrawing, it's going to be very hard for you to exercise. But know that it can just about eliminate all of your symptoms for a period of several hours.

It is clear to me that you want to get clean. So, you should do it in the way that gives you the best chance of staying clean. I'm sure you've realized, much like the rest of us, that we aren't invincible and we get addicted like everyone else. I think you should start taking your medicine as its prescribed. Some doctors don't like to do Bupe maintenance (for 5-10 years), but I believe it is the best way to get clean and stay clean. A generic is available, so thankfully you won't go broke. Doctors will guide you through the process and find a better dosing schedule than anyone on the internet. A good sleep-aid prescribed by addiction doctors is Trazadone. Some people don't like it, but for me it works just fine and is hardly addictive. However, be aware that if you tell them you've been banging subs, they will most certainly put you on suboxone. Also know that they will test you and do a full screening, so they will know you're on bupe. Some insurers cover suboxone, however some do not. And there is no generic for that as of now.

Another thing that is rarely spoken of, when you are stabilized, and you choose to increase your dose for any reason, know that you have to "taper up". This is important because your brain creates a locally synthesized antagonist called beta-arrestin2. If you increase your dose too fast, you increase your tolerance very quickly. You do not want that to happen because bupe gives diminishing effects as your dose increases.

Bottom line: Start taking your medicine as it's prescribed. Plan for a long program with no symptoms and no euphoria. A slow taper after many years at a stable dose is your best chance at getting clean. The way you have quit is putting you in unnecessarily high risk.
 
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Excellent post above, by funkee.

I agree wholeheartedly that for your BEST chance of success.....the slower the better, again, as funkee said. Start taking the Sub as prescribed (including the ROA), find the right dose and stabilize yourself, then start a VERY slow taper...again, the slower the better. many people report that they still have w/d symptoms even after being only on a crumb of Sub every other day, but certainly, the severity would be decreased, especially if you are utilizing other tools (healthy lifestyle, exercise, diet, etc) to help you along.

Lastly, find an aftercare type program that will work for YOU, whether it be a support group, NA/AA, counselling, visits with clergy, whatever type of method getting to the root of some of the addiction issues will help...and stick with it. I know not everyone supports the aftercare idea, but I sincerely think it is another valuable tool in helping to KEEP one clean. Getting there may be a lot easier than STAYING there for many.

The very best of luck to you on your recovery.
 
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