Given the possible variability of bioavailability of diffrent forms and different roas we have see the mystery. Also we need to look at what if any effect naloxone has in comparison to buepe. Naloxone is touted to have a stronger affinity to bind then other agonists.
Very strong agonists like methadone and bupe can overide the affinity of naloxone.
My Father is an ER dock retired and encountered a methadone suicide attempt that required ALL of the Narcan for multiple hospitals to reverse the methadone OD attempt. She made it, but literally took almost all the narcan from four whole hospitals to push through.
I know the ROA fixation. Is this the reason you are choosing to administer this rout despite negative results?