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  • AADD Moderators: swilow | Vagabond696

methadone, buprenorphine and other opioid pharmacotherapies

Well, I didn't agree that getting off hydromorph only to get addicted to bupe was a good option, and since they weren't dealing with any of my mental health issues at the clinic, or even talk to me about the fact that I'd been craving HM the whole time I'd been there, I signed myself out today. I was meant to be on Subonxone until tues. I basically spend 2 days going through HM WD'S in the clinic and the 3 days on suboxone (still feeling like shit), so today I spat out my 8mg pill before it dissolved and brought it home with me. That place was making me so miserable. Just being there made me want to kill myself. So I decided I was better off at home. Stupid me, as soon as I got home, I dissolved and micron filtered 4mg of the suboxone and booted it. I just wanted to see if there was any drug that would ever get me high.

I've never felt euphoria. Ever.

Nothing happened. Nothing. 4hrs later, I got another chance to be alone and I dissolved, micron filtered and booted the other 4mg. Still nothing. So there you go. My body refuses to let me get high on anything.
I imagine I now have a few days of feeling a bit shit left over. WDs from the suboxone. But because I was only on it for 3 days, I've heard it's a lot easier than WD from than something much stronger (like hydromorph, or fentanyl) or even a lightweight like Oxycodone. I have some of all of these drugs still tucked away but if I don't need them for pain anymore and I can't seem to get high off anything, they're a waste. I'm sorry I can't give them to one of you who'd actually appreciate them... :(

Anyway, I might have a rough few days ahead, but they cant be worse than the last 3 weeks have been, so bring it on.
I can't wait to be completely free of this shit. I'll never trust a doctor again to do the right thing by me. And now I know that when I am desperate for pain relief, I will go to great measures, I can keep that under foot as well. Now that I've had my surgery and I have kicked my HM habit, I am getting a new GP and a psych to sort out some shit with.
I'd like to put this part of my life behind me now and more on with things.

Thanks for all your advice over the past couple of weeks guys. I really appreciate that you were out there listening when I really hit rock bottom and didn't know what to do.
Cheers.
 
Thanks tentram. I wasn't sure if anyone was still reading. I'm doing ok at home now. The WDs havent been too bad.
I've still got an 8mg suboxone & I am chasing this illusive 'euphoria' that everyone else seems to feel on opiates & is the reason for their use/adictions.

I was reading on a conversion chart that bupe is about 40 times stronger than morphine while hydromorph (oral, not Iv), is only about 5 time stronger. So I thought, ok, if I'm ever going to find out what this is all about, this little suboxone pill is the key. I already know my tolerance is high from IVing the hydromorph, but bupe is so much stronger, so was certain this was the answer.

But you know what? I slowly dissolved, micron filtered & then booted about 4mg, and nothing.... I waited an hour, now i feel a tiny bit sleepy (bored?) maybe but that's it. No happiness, no warm glow. Nothing. So I dissolved 2mg under my tongue as well. Still nothing.

I give in. My pain is gone finally, so it's no longer blocking the effects of the opiates. Why can't I get high off them?
Do you guys know anyone else like this? Clearly it's not just a tolerance problem, if bupe is meant to be that strong. I realise its only a partial gonist but everyone else on bluelight who have had bupe seem to report feeling good for the first couple of days a least...

I dunno. I guess I'll just take the last 2mg sublingually tomorrow, in case it is helping with the WDs.
Then I'm done with opiates forever! Which is a great thing really. Its brilliant considering the ordeal over the last couple of years , but I just wish I could have had that feeling once... Just once. So I'd know why people want it so badly... :S
 
bupe is not a suitable candidate to get high on when youve got a tolerance, and for a few reasons.

youre hindering your plan to get your dependence in check by chasing a high that is never going to be there! so stop for your own good and look towards healthy and more rewarding alternatives, especially throughout this stage and time throughout recovery.

or smoke some weed to get high and relax if thats a viable option as it is for me :D
 
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You'll be chasing that feeling "just once" for the rest of your life if you're not careful.
 
I agree with tentram that bupe isn't a good option to get high on. I've never felt anything off them and I do actually think that's the more common experience, it seems to me that the people who feel anything off them are those with no, or lower, tolerances.

Just be careful with them too, you've taken 6mg today which is a significant amount. I'm not quite clear on what your dosing schedule has been but I'd be concerned you're not actually over your WDs yet, and that taking larger amounts may risk putting you back a step. Since bupe has a long half life, many people report that WDs from them don't fully kick in until 3 days after their last dose. So just be aware that even if you've had a few days between doses and haven't felt too sick, that that doesn't necessarily mean that you're completely done with WDs. I don't want to discourage you or anything because it seems like you're well on your way, but I probably wouldn't use your last 2mg sublingually tomorrow. I would save it in case you feel sick, and then break it into 1mg or even .05 doses, so that you can taper down your blood concentrations of bupe more gently, and thus hopefully have a more comfortable ride.

It is odd you don't feel euphoria off opioids, though I have always found them a bit hit and miss, and it took awhile before I got anything good out of them. I find that even more so with opioids like heroin or oxy (I've never tried hydromorph), that for no apparent reasons, some sessions are disappointing. I can get all the signs that I'm on an opioid, pinned eyes, drowsy and so on, but no good feeling. It took until I had a bit of a tolerance on other opioids to enjoy heroin, as prior to that I would just feel tired, nauseous, and as if I'd been hit over the head when I took it.

I think you might have mentioned it somewhere else, but is it just opioids that don't give you euphoria?
 
My CADS Doctor is trying to push me on Methadone or Suboxone for 150mg daily Codeine habit right after I just cut back from 380mg... I mean WTF! He told me his other patient who was on roughly the same amount is now on 8mg Suboxone and is doing 'fantastic' I asked what about when he wants to come off Suboxone, the Doctor said 'oh he will likely stay on it for the rest of his life' yeah no shite because he's going to wish he tapered or C/T off Codeine compared to Suboxone.

Another thing that pisses me off is Subutex is available here but only under 'extreme circumstances' shouldn't anyone who doesn't IV or snort or sell medication be eligible for that over Suboxone? Also I suffer from seizures and Naloxone shouldn't be used in people with such a history. Unfortunately Sustained Release Morphine inst available here which is sad. I don't know why they also can't offer Codeine Maintenance to people like me, I mean he put me on Codeine Maintenance once I dropped from 380mg then took it away from me because I started to become really happy and pleased with my situation so I must of been really high he said....BS BS BS
 
I've never heard of codeine maintenance before, that's interesting. I think you also mentioned DHC, is that dihydrocodeine maintenance? Another I've never heard of either.
 
Codeine Maintenance to a certain degree. Its to keep you stable for a while after coming off a 'large amount' till you get into a normal routine. Then once you are comfortable you can start reducing. Yes they even offer dihydro-codeine Sustained Release pills for maintenance but those made me so sleepy. I wish we had Slow Release Morphine pills here, I would take those for maintenance until time to come off. We need more treatment options I reckon.

Germany did a study on Codeine Maintenance. Some of them have up to 800mg of the stuff:

http://www.ncbi.nlm.nih.gov/pubmed/9813897
 
That explains the DHC. Cheers.

I dont know why you say theres no sustained release available to you as its prescribed there.
 
tentram said:
That explains the DHC. Cheers.

I dont know why you say theres no sustained release available to you as its prescribed there.
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They won't prescribe sustained release Morphine as its not one of their 'treatment options' Yes they will do the Sustained Release DHC but it makes me too sleepy.
 
when i first jumped on the program (m`done) in melb few years bak i was told by my dispensary's main pharmacist that benzos make ur dose less effective.
is this true?
id think the opposite
tho ive prob had some sort of benzo in my system the whole time since i stasrted. tho ive cut that down a shit load (*12+mgzan down to 30mg diaz daily) .

so i havent really had enuff of a break to notice if the `done is boosted once benzos r 110% out of me
 
leigh12 said:
when i first jumped on the program (m`done) in melb few years bak i was told by my dispensary's main pharmacist that benzos make ur dose less effective.
is this true?
id think the opposite
tho ive prob had some sort of benzo in my system the whole time since i stasrted. tho ive cut that down a shit load (*12+mgzan down to 30mg diaz daily) .

so i havent really had enuff of a break to notice if the `done is boosted once benzos r 110% out of me
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I would have thought that benzos and bupe would synergise well together, but maybe, because they're both CNS depressants, bupe's antagonist properties take effect as a result of using benzos similarly to other opiates.

opi8 said:
I've never heard of codeine maintenance before, that's interesting. I think you also mentioned DHC, is that dihydrocodeine maintenance? Another I've never heard of either.
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When I went to the hospital's ATODS (Drugs Service) they ignored my poppy seed tea use and the lady said I was going to be put on suboxone on account of the codeine I'm taking as well.
 
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No benzos dont effect the metabolisation of methadone in a negative faction.

How else would all the overdoses with methadone and a benzo in the system be explained. 'done n xanax is one of the most common mixes which cause an overdose according to mamy statistics.
 
tentram said:
No benzos dont effect the metabolisation of methadone in a negative faction.

How else would all the overdoses with methadone and a benzo in the system be explained. 'done n xanax is one of the most common mixes which cause an overdose according to mamy statistics.
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I think he/she meant buprenorphine, although neither was mentioned in the question. What the pharmacist said sounds like a load of crap to me, but with buprenorphine I wouldn't be surprised seeing as how unique it is in comparison to other opiates.
 
goonbag said:
I asked my pharmacist to split my script into weekly lots because I can't trust myself with whole boxes and he was happy to do that. Then he turns around and suggests maybe I should see my doctor about going on a short term methadone program.

I always though methadone was a long term substitute?

So are you expected to be off benzo's when on a maintenance program?
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There are plenty of people who are prescribed both benzos and methadone or buprenorphine, e.g. people receiving agonist substitution pharmacotherapy for both opioid and benzodiazepine dependences, people with co-ocurring pain/anxiety/addiction issues, etc. The idea a few posts back that benzos prevent methadone or buprenorphine from "working" is, as far as I know, false - as several others have pointed out, they actually synergise (sometimes dangerously). But it's very unlikely to be dangerous for people with high tolerances taking the same regular maintenance doses of each medication (to which they're tolerant) every day. The danger in would be if you weren't tolerant to one or the other (either the opioids or benzos), i.e. just starting one, or just using one irregularly, or or if you took a higher-than-usual dose (or more "efficient" route of administration) of one or both of the two, in combination. Or of course, using extra additional things on top.

You're right that methadone is generally a long-term program. "Short term methadone program" is a rather unusual phrase that I'm not sure I've heard before. My understanding with methadone is it can take a while just to find the right dose to stabilise you on, then they typically have you on the "stabilised" dose for a while longer, and only then perhaps tapering off. Maybe there are exceptions, but it seems short-term tapering is typically done with buprenorphine if anything.
 
shoo-bop said:
There are plenty of people who are prescribed both benzos and methadone or buprenorphine, e.g. people receiving agonist substitution pharmacotherapy for both opioid and benzodiazepine dependences, people with co-ocurring pain/anxiety/addiction issues, etc. The idea a few posts back that benzos prevent methadone or buprenorphine from "working" is, as far as I know, false - as several others have pointed out, they actually synergise (sometimes dangerously). But it's very unlikely to be dangerous for people with high tolerances taking the same regular maintenance doses of each medication (to which they're tolerant) every day. The danger in would be if you weren't tolerant to one or the other (either the opioids or benzos), i.e. just starting one, or just using one irregularly, or or if you took a higher-than-usual dose (or more "efficient" route of administration) of one or both of the two, in combination. Or of course, using extra additional things on top.

You're right that methadone is generally a long-term program. "Short term methadone program" is a rather unusual phrase that I'm not sure I've heard before. My understanding with methadone is it can take a while just to find the right dose to stabilise you on, then they typically have you on the "stabilised" dose for a while longer, and only then perhaps tapering off. Maybe there are exceptions, but it seems short-term tapering is typically done with buprenorphine if anything.
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my old man is prescribed high potency benzos while being on the bupe program....benzos make no dif to those substances
 
goonbag said:
I don't want to get into my full story. Since being on fentanyl and then high doses of oxy for legitimate reasons I have gotten my habit down myself to a manageable point almost to where I hope to give them up entirely in the next 6 weeks or so by reducing the mg content and how often I use them. I asked my pharmacist to split my script into weekly lots because I can't trust myself with whole boxes and he was happy to do that. Then he turns around and suggests maybe I should see my doctor about going on a short term methadone program.

I always though methadone was a long term substitute?
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Docs just seem to lurve pushing people onto opioid maintenance 8)

You can do methadone or bupe short term but there's really no benefit to switching to methadone in your case, IMO, and I reckon it'd actually make things a lot worse. It sounds like you're doing well dropping down and are committed to sticking to the plan, evidenced by asking for your script to be dispensed, so why the doc would want to change that is beyond me. If it ain't broke, don't fix it? I reckon there's a much bigger chance you'd end up getting stuck on the methadone or at least spend longer tapering down than if you stuck to your current plan, as done has such a long, drawn out wd. Just my 0.02...
 
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