Bupe need help re suboxone

[Kamov Isaov]

okay the short story is this; I am on the suboxone program in Australia taking 10 mg of suboxone a day for the last few years. in Australia they don't allow you to have more than one or two days of takeaways and so every second day excluding weekends I have to visit the chemist to pick up my medicine. Further I am tied to a single chemist and cannot transfer to another chemist temporarily so that I can go away on holidays.

I am going away on a holiday and assumed my doctor would just give me takeaways or transfer me to a chemist where I am going but have learned otherwise. also I cannot transfer doctors as I live in a remote location and there is only one doctor here that does the program.


What options do I have?


I am thinking of transferring myself from suboxone onto codeine for the holiday then back onto suboxone when I get back.

Is this possible? I know suboxone blocks codeine. How can I break through the suboxone so as to transfer onto codeine without withdrawals or without bad withdrawals in a short time?

Are there any other options I have that I haven't thought of?

Would it be easier to break through the suboxone using stronger street drugs like oxy or morphine or even heroin?

I am going away for a week, and need a solution for one week. Please assist me.

 

[Lorne???]

Codeine isn't going to do shit with your tolerance.

How long are you going to be on holiday, and how many take-homes do you get until then?(I know nothing of Oz's ORT programs.)

Your only choice here(aside from the obvious) is to cut your dose in half and save the carries to take on holiday. But again, I need to know how long you will be gone???

But if you are using suboxone/Subutex tablets, there is hope. By dissolving the tablet in water prior to administration, you can literally make you dose 1.5-2x stronger. So it would only take 6-7mg to hold you, instead of 10. But using this method, you can cut your dose in half and notice no discomfort.
But please, provide more info.(How long the holiday, can you save a couple carries if you use the above method, etc.)

(Oh I get it now, you go in every 2 days or so to pick it up). Yeah, you need to immediately start dropping your dose. Combined with the water method I posted below, you can easily cut your dose in half; if you can get to 4mg per day, you should be able to save plenty. But even with the water method alone, you can go down to 6mg and literally notice no difference whatsoever(due to the much better BA) so at least you can save up some extra buprenorphine to take on your trip)

 

[J3MOd-h3NOW-X3S]

I would start taking only 2mgs, that way you can stock up on what you need, furthermore, there's really no need to dose 10mgs, 2-4mgs is still a lot.

 

[Lorne???]

http://www.bluelight.org/vb/threads...ions-for-Higher-BA-With-Sublingual-Use/page10


The thread linked above will you info on the basic principle of dissolving your subs in water, thus increasing the bioavailability, and so making them significantly more potent. This will help you to reduce your sub dose, thus giving you some breathing room on your trip.

However, YOU DO NOT NEED TO USE ALCOHOL. That info is outdated. I only link the thread to help explain the basic principle, but water is just fine.

But in the end, you have to stop and ask yourself: Is your "holiday" really worth all this trouble? You won't be able to function if you can't save some buprenorphine, and using dope would be taking a step backwards.

Just saying man, think about it.

 

[Kamov Isaov]

I will be gone for one week. I live in tropical north queensland and am going to the NSW snowfields which are 2000 km away. I have been saving for a year, me my wife and two kids are going and there is no way I can fuck up their holiday which we haven't had for years over my medicine. I have to go. My asshole doctor wont just give me one weeks worth of subs, when Ive been with him for years, always been honest with him, told him when ive relapsed (last time a year ago) even when I didn't have too because there were no marks or evidence, and now he treats me like a junkie.

Doing the right thing has me more trapped than if I was on street drugs. I wish I has chosen methadone because that is compatable with opiates.

I will be able to get maybe 3 days dosage to take with me as I will leave just before the weekend and the chemist is shut over the weekend so they have to give me takeaways.

I take the film version of suboxone. Will dissolving it in water increase its bioavailability?

I will be gone 7 to 9 days including travel time. Will have probably three days worth with me.

 

[Kamov Isaov]

Anyway my current plan includes saving whatever I can over the next week, I leave at the end of the week, stretching it out using dissolving method thanks for that guys, and also trying to break through the suboxone using opiates.

Is there a way to break through using codeine? How many days without suboxone to go onto codeine? Codeine is easy to get and cheap as its OTC and I can take massive amounts orally rather than have to use a needle.

 

[Kamov Isaov]

Reading that thread it seems they achieve a BA of around 50-60 percent.

IV gives a BA of 100%

I don't like IV but if I use it maybe I can double my suboxone that way?

 

[daveykronick]

You will not be able to break through the Suboxone with merely codeine. Heroin and oxy's at higher doses, yes, but I wouldn't advise this because it could really derail your progress and set you way back as far as cravings go and every time you go back and forth it is harder to get back on the sub each time and the sub becomes less effective overall (not to mention you could easily OD and die). If you want to use codeine or even heroin and oxy's you are going to need to stop taking 10mg at once and go down to 1-2mg for a week or two, depending on how much time you have, then jump off the 1-2mg and wait till your in withdrawals (2-3 days) then you can start taking codeine or another opiate, otherwise you will have to use ridiculously high dosages. 10mg is a helluva lot to be on and most people find 2-4mg to be enough to hold them. I was never too successful in breaking through even just 4mg and even just 2mg made me have to increase my heroin dose by 2-3x.

 

[d1ahp]

Anyway my current plan includes saving whatever I can over the next week, I leave at the end of the week, stretching it out using dissolving method thanks for that guys, and also trying to break through the suboxone using opiates.

Is there a way to break through using codeine? How many days without suboxone to go onto codeine? Codeine is easy to get and cheap as its OTC and I can take massive amounts orally rather than have to use a needle.

The issue is that 10 mgs of Suboxone is a lot. You don't realize it, but by taking that much Suboxone you have raised your tolerance(if it wasn't up there before Sub) so much that you'd need a ton of Codeine to do anything for you. With a daily 10mg of Sub it'll take about 2-3 days for you to somewhat feel your Codeine, IF you take enough of it. There is not magic way to break through using Codeine. I highly doubt you'll achieve what you're looking for with Codeine, you'll keep the withdrawal away at best.

One thing about Suboxone is that a lot of people don't notice the slightest difference if they take 12, 10, 8, or 4mg. This is very well documented, people actually intentionally lower their Suboxone doses down to around 2mg and less because that's where it feels the best. The bigger the amount of Suboxone you take, the less fun it is because of its side effects, without getting too technical about it. So tomorrow, take 4-6mg instead of your 10mg and see how you feel. Some people will actually feel that they're taking less and will need to take more, but a lot of people don't feel any difference.

 

[Kamov Isaov]

you'll keep the withdrawal away at best.

That's all I want. Im long past the stage of needing or even remembering what it was like to get high and all I want is to be able to go on holiday with my family and enjoy myself without suffering withdrawals.

I am going to do both. I am going to save my subs and then use say a third of a dose a day but injected to stretch it out and also I am going to attempt to prevent withdrawals using codeine. First I will save suboxone and take codeine and if codeine doesn't stop withdrawals then I will begin injecting my stockpile of subs which I should have 30-40 mg of by the time I have to leave.

Thanks for the suggestions guys. I cannot think of any other options I have at the moment. If anyone has any other radical options I welcome them as a plan C.

 

[d1ahp]

That's all I want. Im long past the stage of needing or even remembering what it was like to get high and all I want is to be able to go on holiday with my family and enjoy myself without suffering withdrawals.

I am going to do both. I am going to save my subs and then use say a third of a dose a day but injected to stretch it out and also I am going to attempt to prevent withdrawals using codeine. First I will save suboxone and take codeine and if codeine doesn't stop withdrawals then I will begin injecting my stockpile of subs which I should have 30-40 mg of by the time I have to leave.

Thanks for the suggestions guys. I cannot think of any other options I have at the moment. If anyone has any other radical options I welcome them as a plan C.

You do know that injecting Suboxone significantly reduces its half life? Also, are you aware of Precipitated Withdrawals?

 

[Screaming_Skull]

Codiene is not going to help at all with a bupe tolerance or keeping withdrawls away really...since you already said it and I'm not suggesting it I would just save your Bupe and Inject it safely as possible while you are with your family...the time it last is shorter but 2mg a day that way(maybe less) should keep the w/d away while you are with your family..

 

[Lorne???]

If you're willing to IV your buprenorphine, then you will have no problem. IV is literally several times more potent than sublingual, so even with the (much shorter) half-life, you will use only a fraction of what you use normally.

I would start with just 1mg IV. That should be plenty, at most it might take 1.5mg.

But because of the shorter half-life, you will need 2 doses per day. Stil, 2mg per day IV will cover you. You can do 2 1mg shots, or you can do 1.5 in the morning, and 0.5-75 at night.

That is the simplest plan, I just hope you don't end up becoming fixated on the needle.

(And FYI: codeine will never work, you see, codeine is a pro-drug that has to be converted to morphine by the liver to reach full effect. However, the liver can only metabolize so much codeine at a time. Thus, codeine has a ceiling effect, after which increasing the dose has little(if any) more effect. And with you're tolerance being as high as it is, you will reach the ceiling long before you ever get any real relief.)

 

[The Doc.]

no need to IV it if you don't want to I would've thought after so long with carries you would've made a stockpile by now for emergencies such as this most addicts do I get 8mgs prescribed but only take about 2mgs so if anything happened to my doctor or anything I have enough to last me probably over a year just at home. all you need to do is start tapering take say 2mgs twice a day and you should be fine with hardly any discomfort then you have enough to continue doing so on vacation. when taken twice a day or 3 times a day it makes you need a lot less than normal as it spreads the bupe out over the day. the thing with iv is it doesn't last nearly as long but you can use a lot less at each time you kind of have to weigh it out the pros and cons. with the strips you will get a bit better B/A by dissolving it in water like lorne said but not much cause the strips are already around the 50 percent range in terms of B/A.

 

[Lorne???]

^^^ Yeah, using the strips complicates things. I agree they are stronger, BUT no studies have ever compared the BA's(that I know of, they may have).

However I know it's not 50%, or else they would have decreased the dose a la zubsolv.

(Come to think of it, FDA regulations require that they prove bioequivelance, so they had to have studied it. I'm going to check now!!!)

 

[Lorne???]

Absorption:
In pharmacokinetic studies, the 2 mg/0.5 mg and 4 mg/1 mg doses administered as SUBOXONE sublingual films showed comparable relative bioavailability to the same total dose of SUBOXONE (buprenorphine and naloxone) sublingual tablets, whereas the 8 mg/2 mg and 12 mg/3 mg doses administered as SUBOXONE sublingual films showed higher relative bioavailability for both buprenorphine and naloxone compared to the same total dose of SUBOXONE (buprenorphine and naloxone) sublingual tablets. A combination of one 8 mg/2 mg and two 2 mg/0.5 mg SUBOXONE sublingual films (total dose of 12 mg/ 3 mg) showed comparable relative bioavailability to the same total dose of SUBOXONE (buprenorphine and naloxone) sublingual tablets [see Dosage and Administration (2.6 and 2.7)].

I could only find 1 study, and for some reason I can't access it.

However the above is from the official site. It appears the 8mg and 12mg strips have a slightly higher BA, but it is still lower than Zubsolv. If my understanding is correct, they would also be subject to the equivalence regulations, which means they could be, at most, 125% BA relative to the tablets.

So dissolving in water will definitely still increase BA, but the difference might not be as dramatic as with the tablets.

 

[Crankinit]

in Australia they don't allow you to have more than one or two days of takeaways and so every second day excluding weekends I have to visit the chemist to pick up my medicine.

Which state are you in? I'm in South Australia and this is patently untrue here (and I've been told the same thing by people in Victoria), and there's no limit to how many take-aways I can take at once, I've been told I could get all 22 of them at once if I wanted to deal with spending the last week of the month going in daily.

Unfortunately, sometimes chemists/doctors either intentionally or unintentionally give suboxone patients false information to try and control them, to keep them in compliance. Do some research and find out if it's really true that you can't take more than 1 - 2 TA's at a time. I'm not sure how much this varies state to state.

Further I am tied to a single chemist and cannot transfer to another chemist temporarily so that I can go away on holidays.

This also is not true in at least South Australia. I've personally witnessed a friend transfer to another chemist for a holiday. Look up the actual rules around these things, call the Drug and Alcohol Services for your state (who may or may not be helpful). It sounds to me like you're being misled, although again there's a chance your state has different restrictions. But I don't see why they would.



Finally, the codeine thing. My experience (as someone on 24mg of suboxone) is that codeine at high enough doses is sufficient to prevent withdrawals if you go without your suboxone. You'll want to experiment with this first to make sure it works for you, but it did for me.

Remember, the codeine doesn't actually have to break through the suboxone to have it's own effect (although it eventually will as the subs drain out of your system over the week), it just has to be there to fill the receptors when they're vacated by the subs. Likewise if you try with stronger opiates. You'll just start experiencing less bupe effects and more effects of the other opiate as the bupe leaves your system - although when you go back onto the bupe, you'll have to wait until you're in full withdrawals again from whatever other opiate you take, otherwise you'll go into precipitated withdrawals and feel like hell.



Another option, probably a better one if your the timing allows for it (and I recommend this to everyone on suboxone), is that with every takeaway between now and your holiday, you skip as much of your dose as possible, stash it, and build up a supply. If you're on 10mg a day, you could easily survive a single day of TA on 5 - 8mg, and then store the 5mg somewhere safe. These will build up, and you'll have an emergency supply for situations just like this.


One thing to consider - if you go off the program for a week, is the doctor just going to put you back onto it when you get home?

 

[Lorne???]

^^^ All of that.

Ha, I was actually wondering if you'd see this, Crank, as I know nothing of Oz's policies, but it did sound a bit crazy to me.

 

[The Doc.]

^^^ Yeah, using the strips complicates things. I agree they are stronger, BUT no studies have ever compared the BA's(that I know of, they may have).

However I know it's not 50%, or else they would have decreased the dose a la zubsolv.

(Come to think of it, FDA regulations require that they prove bioequivelance, so they had to have studied it. I'm going to check now!!!)

Yea I read somewhere its up around there and I don't think they lowered it they just put a warning on the box if I'm not mistaken warning the user that it may have a stronger effect as a lot more of the drug is absorbed versus the pills.