Bupe My god, Has ANYONE successfully tried and done the Bernese method or microdosed onto Suboxone from opioids?????

[tweakette]

I want to start this method where you microdose suboxone while still taking opioid of choice over 7-14 days depending.

If you don’t know what it is look up Bernese Method.

I was prescribed this method by my doctor but I can’t seem to find one SINGLE PERSON THAT HAS DONE IT that can tell me their experience. My god I am losing my mind here!!!

I have read every study out there.

I need to get on suboxone and because of the way fentanyl is it doesn’t matter how long you wait you will go into precipitated withdrawal and I’m sick as a dog by 18 hours so I can’t wait 48 hours.

Is there not one soul in this whole forum that has done it???????

 

[Joey]

You need to go to a hospital or detox. Thats about the only method I can think of which could work for you. The hospital can sedate you through this and keep you more comfortable then. Detox is rougher but its somewhere to be thats safe.

I dont see this as a taper situation. Just have a feeling about you that you NEED off of this NOW.

Heres the thing about suboxone sublingual dose. The naloxone doesnt activate. Its just there to prevent you from using it IV. Sublingual naloxone is extremely unbioavailable.

Low absolute bioavailability of oral naloxone in healthy subjects - PubMed

The mean oral absolute bioavailability of naloxone in this study was ≤ 2% at doses ranging from 5 mg to 120 mg.

pubmed.ncbi.nlm.nih.gov

https://www.researchgate.net/publication/295473054_Bioavailability_of_oral_and_sublingual_buprenorphine_and_naloxone_tablets

There is no number higher than 3% here while buprenorphine is more in the 40s. Youre not going into precipitated withdrawal. Youre just not able to handle the low doses these methadone / suboxone doctors always start people at. You need to detox.

Fentanyl is serious stuff. Check yourself in.

 

[darvocet21]

I haven't personally tried it but I have every reason to believe that it works well, especially with shorter acting opioids, for which the transition is much shorter/simpler. Never heard of a 7-14 days induction before. It seems unnecessarily excessive considering the the half-life of fentanyl means you don't have any of it in your system, certainly not in quantities that are exerting an effect after just a few days, when you should already be taking a sufficient dose of Suboxone to suppress your withdrawals.

Microdosing induction is a strategy to avoid PWS especially on the first day of switching to Suboxone for patients dependent on short- to moderate-acting opioids whose last dose was within ~6-8 hours. Although I think it's a good strategy for anyone beginning Suboxone treatment to titrate their dose on day one, because the research suggests it reduces the chances of experiencing PWS and reduces the time required to abstain from the opioid of abuse. A win-win.

I agree that I'd like to hear some first-hand experiences whether in a clinical setting or by self-administration.

As a side note do you know what the medically indicated treatment is for patients in the hospital who are found to be dependent on heroin or other opioids either due to obvious clinical symptoms or PWS due to a narcan challenge? .3mg Buprenex-Buprenorphine by deep IM administration (preferred, although slow IV suffusion can also be used) hourly until symptoms of withdrawal are sufficiently suppressed without excess sedation, followed by PRN dosing every 4-6 hours and gradual tapering if patients are admitted for longer periods.

There's a lot of propaganda, misinformation about this issue and anything related to simpler and more effective uses for suboxone. I don't know if you're ready or not but 7 to 14 days should be the maximum for a Suboxone detox in order to quit entirely or else switch to a less harmful ROA or a less potent opioid like kratom.

This excellent summary of successful microdosing induction addresses switching from fentanyl/heroin as well as special considerations for patients on methadone maintenance.

A Review of Novel Methods To Support The Transition From... : Canadian Journal of Addiction

e and concerns regarding the need for withdrawal before initiation. Purpose: We aim to present several unique methods of converting individuals from methadone and other full opioid agonists (prescribed and illicit) to buprenorphine/naloxone SL as well as describe novel buprenorphine induction...

journals.lww.com

 

[Joey]

I haven't personally tried it but I have every reason to believe that it works, especially with shorter acting opioids, for which the transition is much shorter/simpler. Never heard of a 7-14 days induction before. It seems unnecessarily excessive considering the the half-life of fentanyl means you don't have any of it in your system, certainly not in quantities that are exerting an effect.

There's a lot of propaganda, misinformation about this issue and anything related to simpler and more effective uses for suboxone. I don't know if you're ready or not but 7 to 14 days should be the maximum for a Suboxone detox in order to quit entirely or else switch to a less harmful ROA or a less potent opioid like kratom.

This excellent summary of successful microdosing induction addresses switching from fentanyl/heroin as well as special considerations for patients on methadone maintenance.

A Review of Novel Methods To Support The Transition From... : Canadian Journal of Addiction

e and concerns regarding the need for withdrawal before initiation. Purpose: We aim to present several unique methods of converting individuals from methadone and other full opioid agonists (prescribed and illicit) to buprenorphine/naloxone SL as well as describe novel buprenorphine induction...

journals.lww.com

I have a strong feeling the OP is wanting to attempt this on his or her own and after all this reading misunderstands the basic action of suboxone. I always thought subs were precipitated too until my suboxone doc explained it to me recently. I just kicked them too. I have a feeling this person wont be able to manage without help. Something about the desperation here bothers me so Im advocating medical attention 100%.

 

[negrogesic]

You can wait long enough into fentanyl withdrawal to take buprenorphine and not precipitate withdrawal. Problem is you'll have to wait until you're very sick.

I don't have experience with it either but it should work. Might not work so well for ultra high level habits (like 20mg+ of fentanyl sized habits).

If you are addicted to high doses of fentanyl you'll want to taper down a bit to bring your self closer to where other things will help.

 

[Xorkoth]

I have heard repeatedly on this forum that due to fentanyl sticking around in fats, it takes much ,longer before PWD won't happen than it should. Have heard of people getting it after 3 or 4 days even, and not just once or twice have I heard this. It's possible it's actually some fent analogues that do this though, which people just refer to as "fent", they're synonymous in the street drug scene.

Sorry OP, I don't know about the Bernese method, but you should be able to look it up, that is indeed what it is called.

 

[DeathIndustrial88]

I have done it with heroin & suboxone. Take an absolutely tiny piece of a strip under the tongue each morning, while continuing to take the heroin and tapering down from it over about 4 or 5 days, with each day increasing the sub dose ever so slightly. By day 5 I took the tiniest amount of heroin that I had left (not even enough to get well) and then took 4mg of suboxone under the tongue and actually caught a shitty sedation/buzz from the subs and had to take a nap.

It was good raw, powder heroin too, so maybe I just happened to get lucky. I also only used the heroin for 4-5 days rather than having been dependent for months/years at the time.

Everyone's experience is different I guess though. And if you take even the slightest bit too much of that sub, you'll go into precipitated withdrawal. So it's a very tricky thing to accomplish and I can't recall the exact amounts of sub I took, since they were such small pieces. But you definitely want to start small, like micrograms and work your way up while simaltaneously tapering the heroin.

Fentanyl is a different story like Xorkoth said. It lingers around in your system a lot longer than regular ol' heroin. The bernese method might not be possible with fentanyl. Your best bet is to wait until your really sick from withdrawal from the fent and then take suboxone and just stick with the suboxone no matter what. Or you may need the help of a hospital.

Best of luck to you OP.

 

[darvocet21]

I have done it with heroin & suboxone. Take an absolutely tiny piece of a strip under the tongue each morning, while continuing to take the heroin and tapering down from it over about 4 or 5 days, with each day increasing the sub dose ever so slightly. By day 5 I took the tiniest amount of heroin that I had left (not even enough to get well) and then took 4mg of suboxone under the tongue and actually caught a shitty sedation/buzz from the subs and had to take a nap.

It was good raw, powder heroin too, so maybe I just happened to get lucky. I also only used the heroin for 4-5 days rather than having been dependent for months/years at the time.

Everyone's experience is different I guess though. And if you take even the slightest bit too much of that sub, you'll go into precipitated withdrawal. So it's a very tricky thing to accomplish and I can't recall the exact amounts of sub I took, since they were such small pieces. But you definitely want to start small, like micrograms and work your way up while simaltaneously tapering the heroin.

Fentanyl is a different story like Xorkoth said. It lingers around in your system a lot longer than regular ol' heroin. The bernese method might not be possible with fentanyl. Your best bet is to wait until your really sick from withdrawal from the fent and then take suboxone and just stick with the suboxone no matter what. Or you may need the help of a hospital.

Best of luck to you OP.

Is that right?

You know I think this precipitated withdrawal thing is overblown. I'm not dismissing it ( it happened to me early on in the age of Suboxone when I was given a box of 8 mg sublingual strips and took a whole one within 48 hrs of my last dose of methadone. It was like hitting the reset button, and though I didn't get classic withdrawal symptoms per se I had extreme dysphoria, skin exfoliation of my face, nightmares, agitation, paranoia... a deteriorating cascading situation that put me in a locked psychiatric ward for over two weeks. The doctor knew nothing. I called him up to tell him Suboxone was an evil plot and he insisted I take my medicine. I think now much of that could have been avoided had I just been told to cut up my strips into 1/16 squares and take them hourly on the first couple of days. ...although it didnt help that I was also abusing ritalin and benzos )
The amount of suffering required before one begins Suboxone seems as excessive as the recommended target maintenance dose of 16-32mg/daily. Given that dosing every other day is as effective as daily dosing once patients have reached consistent blood serum levels. Buprenorphine builds up due its spectacular affinity and half-life longer than methadone, and one only need read some of the harrowing experiences of sub detox to realize what a stubborn form of addiction it can produce

Regardless of whether you take it daily or every other day there are many brave physicians who have reported their clinical successes with off-label uses especially to mitigate needless suffering at the outset. (see earlier post with link to article: Review of Novel Methods To Support The Transition From Methadone and Other Full Agonist Opioids To Buprenorphine/Naloxone Sublingual In Both Community and Acute Care Settings)

 

[Eyecontact]

I just kicked a fentanyl habit, I was trying the bernese method but couldnt get it to work. I tapered down and then after 24 hours I took 4mg suboxobe and did not have precipitated withdrawals. I took gabapentin during day and trazadone to sleep and while I felt flat and lethargic the process wasnt that bad at all

 

[darvocet21]

Good to know. 24-hours seems sufficient but not excessive. I have no idea what the Bernese method refers to, I haven't looked into it. Just by the fact that it has a name like a trademark raises my suspicions. Stuff like that, cookie-cutter approaches, are usually injected into the debate by forces hostile to recovery. And don't think for a moment they don't exist. Who turned a blind eye to the mass prescribing of opioids ( in some cases enough to kill certain small towns 20 times over) and now turns a blind eye to China's key role in the industrial production of fentanyl precursors, traced to a chemical company headquartered in the city of... Wait for it... Wuhan

https://www.theatlantic.com/health/...-company-helping-fuel-opioid-epidemic/596254/

(Keep in mind this story dates back to August 2019.)

 

[n3ophy7e]

@darvocet21 there have been a few threads about the Bernese method in the Recovery Support forums lately if you are interested in reading about it. It seems good IN THEORY. I'm yet to hear from anyone who has been successful using it to get off fent. @DeathIndustrial88 is actually the first person I've heard of who's used it successfully with anything tbh.

 

[darvocet21]

Is there something I'm doing wrong, sometimes when I post a link it comes up as a preview box showing the title and beginning of an article. While other times(above) it just shows the URL. Is it a formatting issue or does it just depend on the link?

 

[darvocet21]

@darvocet21 there have been a few threads about the Bernese method in the Recovery Support forums lately if you are interested in reading about it. It seems good IN THEORY. I'm yet to hear from anyone who has been successful using it to get off fent. @DeathIndustrial88 is actually the first person I've heard of who's used it successfully with anything tbh.

Hi @n3ophy7e thanks I will look into it. I read the OP to mean 7-14 microdosing induction after *stopping* Fentanyl. As I said I have no experience nor have read about this so-called Bernese method. But I can't see what the pharmacological basis is for continuing to take even in smaller amounts a pure Agonist while initiating (even small dose) Suboxone. Why not simply taper as much as possible and then take your drug of choice one last time, wait as long as you can without undue suffering before beginning tiny doses of Suboxone administered hourly up to a first day maximum total dose of no more than 4mg. Followed the next day with hourly dosing up to a maximum of 6mg and so on. This takes advantage of the higher affinity bonding of buprenorphine to elbow out pure agonists slowly while minimizing exposure to the naloxone which though an antidote in normal people is a noxious substance to properly maintained opioid addicts.

Possibly it has some function in transitioning methadone patients on high doses for a long time who simply cannot or will not taper down to a small enough daily dose, but thank you I'll check it out.

 

[negrogesic]

I just kicked a fentanyl habit, I was trying the bernese method but couldnt get it to work. I tapered down and then after 24 hours I took 4mg suboxobe and did not have precipitated withdrawals. I took gabapentin during day and trazadone to sleep and while I felt flat and lethargic the process wasnt that bad at all

Yeah this seems like the best approach by far, hope it works out for you!

 

[tweakette]

You need to go to a hospital or detox. Thats about the only method I can think of which could work for you. The hospital can sedate you through this and keep you more comfortable then. Detox is rougher but its somewhere to be thats safe.

I dont see this as a taper situation. Just have a feeling about you that you NEED off of this NOW.

Heres the thing about suboxone sublingual dose. The naloxone doesnt activate. Its just there to prevent you from using it IV. Sublingual naloxone is extremely unbioavailable.

Low absolute bioavailability of oral naloxone in healthy subjects - PubMed

The mean oral absolute bioavailability of naloxone in this study was ≤ 2% at doses ranging from 5 mg to 120 mg.

pubmed.ncbi.nlm.nih.gov

https://www.researchgate.net/publication/295473054_Bioavailability_of_oral_and_sublingual_buprenorphine_and_naloxone_tablets

There is no number higher than 3% here while buprenorphine is more in the 40s. Youre not going into precipitated withdrawal. Youre just not able to handle the low doses these methadone / suboxone doctors always start people at. You need to detox.

Fentanyl is serious stuff. Check yourself in.

First off, no the hospital does not detox you. I know all about the naloxone…. This is why I said please look up the method I’m talking about… First off, YOU GO INTO PRECIPITATED WITHDRAWAL FROM THE BUPH NOT THE NALOXONE THAT IS A MYTH.

I’m trying to get on subs, your post is wrong and this is not the spot for it… my god.

 

[tweakette]

I haven't personally tried it but I have every reason to believe that it works well, especially with shorter acting opioids, for which the transition is much shorter/simpler. Never heard of a 7-14 days induction before. It seems unnecessarily excessive considering the the half-life of fentanyl means you don't have any of it in your system, certainly not in quantities that are exerting an effect after just a few days, when you should already be taking a sufficient dose of Suboxone to suppress your withdrawals.

Microdosing induction is a strategy to avoid PWS especially on the first day of switching to Suboxone for patients dependent on short- to moderate-acting opioids whose last dose was within ~6-8 hours. Although I think it's a good strategy for anyone beginning Suboxone treatment to titrate their dose on day one, because the research suggests it reduces the chances of experiencing PWS and reduces the time required to abstain from the opioid of abuse. A win-win.

I agree that I'd like to hear some first-hand experiences whether in a clinical setting or by self-administration.

As a side note do you know what the medically indicated treatment is for patients in the hospital who are found to be dependent on heroin or other opioids either due to obvious clinical symptoms or PWS due to a narcan challenge? .3mg Buprenex-Buprenorphine by deep IM administration (preferred, although slow IV suffusion can also be used) hourly until symptoms of withdrawal are sufficiently suppressed without excess sedation, followed by PRN dosing every 4-6 hours and gradual tapering if patients are admitted for longer periods.

There's a lot of propaganda, misinformation about this issue and anything related to simpler and more effective uses for suboxone. I don't know if you're ready or not but 7 to 14 days should be the maximum for a Suboxone detox in order to quit entirely or else switch to a less harmful ROA or a less potent opioid like kratom.

This excellent summary of successful microdosing induction addresses switching from fentanyl/heroin as well as special considerations for patients on methadone maintenance.

A Review of Novel Methods To Support The Transition From... : Canadian Journal of Addiction

e and concerns regarding the need for withdrawal before initiation. Purpose: We aim to present several unique methods of converting individuals from methadone and other full opioid agonists (prescribed and illicit) to buprenorphine/naloxone SL as well as describe novel buprenorphine induction...

journals.lww.com

Not true. The fentanyl these days stays in your fat and they are saying even people that have gone 36 hours and beyond are going in precipitated withdrawal.

 

[tweakette]

Th

I have done it with heroin & suboxone. Take an absolutely tiny piece of a strip under the tongue each morning, while continuing to take the heroin and tapering down from it over about 4 or 5 days, with each day increasing the sub dose ever so slightly. By day 5 I took the tiniest amount of heroin that I had left (not even enough to get well) and then took 4mg of suboxone under the tongue and actually caught a shitty sedation/buzz from the subs and had to take a nap.

It was good raw, powder heroin too, so maybe I just happened to get lucky. I also only used the heroin for 4-5 days rather than having been dependent for months/years at the time.

Everyone's experience is different I guess though. And if you take even the slightest bit too much of that sub, you'll go into precipitated withdrawal. So it's a very tricky thing to accomplish and I can't recall the exact amounts of sub I took, since they were such small pieces. But you definitely want to start small, like micrograms and work your way up while simaltaneously tapering the heroin.

Fentanyl is a different story like Xorkoth said. It lingers around in your system a lot longer than regular ol' heroin. The bernese method might not be possible with fentanyl. Your best bet is to wait until your really sick from withdrawal from the fent and then take suboxone and just stick with the suboxone no matter what. Or you may need the help of a hospital.

Best of luck to you OP.

The reason more and more doctors are prescribing the Bernese method is because fentanyl stays in the system forever… what is this myth of hospitals???? Hospitals do not help with detox, at least in Arizona. Call any hospital in Phoenix or surrounding and ask if they help with detox and they will tell you absolutely not. They just give you number to methadone clinic and say bye.

 

[tweakette]

Good to know. 24-hours seems sufficient but not excessive. I have no idea what the Bernese method refers to, I haven't looked into it. Just by the fact that it has a name like a trademark raises my suspicions. Stuff like that, cookie-cutter approaches, are usually injected into the debate by forces hostile to recovery. And don't think for a moment they don't exist. Who turned a blind eye to the mass prescribing of opioids ( in some cases enough to kill certain small towns 20 times over) and now turns a blind eye to China's key role in the industrial production of fentanyl precursors, traced to a chemical company headquartered in the city of... Wait for it... Wuhan

https://www.theatlantic.com/health/...-company-helping-fuel-opioid-epidemic/596254/

(Keep in mind this story dates back to August 2019.)

It’s Bernese because of where it was founded by DOCTORS in Switzerland! This is why I asked for people to look it up before arguing….. I just wanted someone that has done it. I have read everything there is on it, but personal experience is different than reading a study.

 

[Tbdr]

Not true. The fentanyl these days stays in your fat and they are saying even people that have gone 36 hours and beyond are going in precipitated withdrawal.

I don’t understand this. I get that fentanyl stays in your fat cells. But if it’s in your fat cells and not in your receptors, why would that cause PW symptoms? I get that the bupe knocks off what’s left on your receptors and that’s what causes the withdrawal. But if what’s left is on your fat cells, why does it still affect your brain that way? Sorry if this is a dumb question, but I’ve been curious about this, if anyone knows.

 

[tweakette]

I don’t understand this. I get that fentanyl stays in your fat cells. But if it’s in your fat cells and not in your receptors, why would that cause PW symptoms? I get that the bupe knocks off what’s left on your receptors and that’s what causes the withdrawal. But if what’s left is on your fat cells, why does it still affect your brain that way? Sorry if this is a dumb question, but I’ve been curious about this, if anyone knows.

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