Heroin Sister started suboxone...but took it too soon...advice please!

[Gretchen']

Hi guys,
I just stumbled across this website and am hoping you can help.
My sister started on the Suboxone program today and was told repeatidly to wait 12 to 24 hrs before her first dose as she had last used heroin at 6am this morning. Well, she waited 12 hours just and then took it. She was then instantly sick as she has put herself into rapid withdrawal. She's gone home from work and is at home withdrawing.
Her chemist is closed tomorrow so i can't even go and see them for advice.
How long will this withdrawal last? Once the heroin is out of her system will she start to feel better? What will happen if she stupidly decised to try and use again to stave off the withdrawal?
I'm really not happy right now as it's taken a while to get my sister to get onto the program and now I'm stressed that she won't want to touch Suboxone again after this reaction!
I've also done more research and there's no way she should have touched that film until at least 18hrs or longer! So annoyed!
Thanks in advance for any advice or info,
Kelly

 

[illmantos]

From what I understand your sister was supposed to wait until she went into withdraw to take it .,

Use in persons physically dependent on full-agonist opioids while not already in withdrawal may trigger an extremely intense form of opioid withdrawal - called "precipitated withdrawal" or "precipitated withdrawal syndrome." This does not occur in all persons tolerant to full-agonist opioids, but rather depends on the severity of addiction and time elapsed from their last dose. -http://en.wikipedia.org/wiki/Suboxone

If you want to get some more info on the drug here She will most likely feel better once she gets into taking suboxone to routine.

 

[bronson]

Yes, for future reference it's always best to wait until full withdrawal sets in with suboxone or you end up with the precipitated withdrawals as in your sisters case.

Once that happens I'm not really sure how long they last. (I will let someone who has experienced them answer that.) One thing I can be sure of is to not dose any more heroin as it will be blocked by the suboxone and could make the withdrawal get even worse.

Just wait it out, and they will resolve eventually. Hope she starts feeling better soon.

 

[waldo777]

Yup been there before, sucks--sorry to hear it.

It will last anywhere from 2 - 24 hours, but will be throu the worst of it by the 2-3 hour mark. Take some benzos if you got em (ur sis that is) such as valium, xanax, klonopin, ativan, etc... Not a lot, just a pill or two. It will help a lot. Ambien is also helpful so is weed.

Heroin won't make it worse now, it will actually help a little bit if your already a few hours into the Suboxone dose. BUT, DO NOT TAKE IT UNLESS YOU ARE ABSOLUTELY DESPERATE TO STOP THE AGONY, LIKE VERY VERY LAST RESORT.

I say that b/c your sis already took the 1st step, why do it all over again? Keep up the good work! After about 4-6 hours of these precipitated withdrawls, they should be gone or very very mild. IF THE W/D is GONE, then I would take a very small dose of suboxone again. It will make her feel better once she's gone through the precip w/d. At that point, take a very little bit to test the waters, maybe 1mg, then wait 45 mins. If all good, the another 1mg, and wait 45 mins. She should be completely better at this point, and can take a normal full dose, and this time, it will make her feel GOOD. (The 1mg is okay if the Rx'ed dose is 8mg, if its less then use less than 1mg accordingly)


Also, if she uses more heroin now, she'll have to wait until she's back in w/d from the heroin to try the suboxone again. So just wait it out, take more Bupe later and everything will be OK

 

[livetheopiatedream]

Yea hate to break it to u but aside from more heroin there's nt much u can do but ride it out. Precipitated wd is the worst I should know. But right after a long habit like she (I'm assuming) had (anywhere over a month) u should wait more than 18 hrs more like24-36. Gotta wait till all the H has left the receptors otherwise bupe and naloxone (active ingredient in sub) will boot it all off the receptors causing immense pain cuz of higher binding affinity. Taking more will make it worse but speed the process and u will recover faster. After about 50 mins the naloxone will be inactive due to its short half life so shell feel better after that unless it's wayyyy too early (sorry in this case it may be) and bupe is causing most f the pain. However once she is done her precipitated wd more sub will only make her feel better so if u can convince her to take a second dose MUcH later (first dose once she stops wd ing should last a least 12 hrs to 36 hrs...keeping her well I mean). Just it's always better to take it later when ur in FULL withdrawals or else PWD is always a huge risk (only a risk after takin a full agonist like heroin, just redosing subs u would never get PWd) and it is never worthit lol. Best of luck and feel free to PM me any questions as I'm very well versed in subprime treatment and pharmacology cuz its what I'm in school for ( ie got a bachelor of science in pharmacology and neuroscience double major) so anyway happy to help and subs can be a lifesaver after the initial transition so if she can mentally bear thru this she's out of the woods! I personally prefer a short sub taper (ending in 7-10 days) to avoid addiction to sub (unless she can't stay clean without it on which case it's better to take it long term than relapse ) cuz sub wd can last a month (but nowhere near as intense as h withdrawal it's just LOnG as fuck and that's mentally exhausting for someone that lacks any happy transmitters due to the brain needin to restart its own opiate production) ... But a quick taper in under ten days can make getting off H nearly painless if u can avoid the precipitated wd (PWD 4short). Best wishes! She can do it! Try and be there for her it's nice to have someone to talk to thru this. For now, to deal with the pWD take some loperamide (Imodium) this won't fuck up the subs don't worry as long as ur not takin like 20+ mg (I take 4-6 mg) and benzos if ya got em or strong sleepinmed like seroquel (quiatepine fumarate)....

 

[Znegative]

I wouldn't recomend serequel or anti histamines for opioid withdrawal. They seem to make me more restless, and increase my heart rate.

Unless youre switching from methadone, precipitated withdrawals should last no longer than five hours, followed by a day of feeling kind of lethargic and worn out in some cases. Ive experienced it several times. The first time was transitioning from IV oxymorphone and it was a truelly horrific five hours followed by a day of dysphoria. Benzo's did not help much.

The other times have been less extreme. Usually I would experience an hour or two of uneasyness with stomach cramps and hot/cold flashes. These would dissipate, quickly though.

How much suboxone did your sister take? Some people advice not to take any more bupe when precipitated withdrawal occurs, but for me, adding an extra 4mg (if I started with say, 2), can shorten the duration of the withdrawals as well as the severity. Best bet is to wait it out, as painful as it might be-it will end.

Also, once the precipitated withdrawals end and your body has adjusted to the buprenorphine, you do not have to worry about taking suboxone the next day. Precipitated withdrawals can only occur when dosing buprenorphine following a full agonist opioid (heroin, morphine, dilaudid etc..).

 

[Gretchen']

Thank you all SO much! I have really appreciated your very prompt and thourough answers! I'm yet to speak to my sister this morn, she's still sleeping, but I'm pleased to know she should technically be over the worst of the pain.
She has 3 morn take away strips to get her through to Monday. Should I advise her to take the next one in a few hours?? How long is a good time to wait before taking more Sub?? She had it at 6pm last night (so it's now 14hrs later).
Thanks again everyone, I'm really happy I've found a forum where people actually have experince in what my sister is going through, and will be going through and can help give me the answers we don't know yet. xxx

 

[BiggDirty01]

Well if she is still sleeping (or sleeping at all) at this point then most likely she has gotten through the worst rather unscathed. Opioid Withdrawal usually does not equal sleep for the first few days.

Yes, have her continue taking the suboxone as directed so it can build in her system and continue making her feel better.

 

[tricomb]

Yes, have her continue taking the suboxone as directed so it can build in her system and continue making her feel better.

This.

 

[Babygurl828]

The only thing that works is doing more heroin. It just happened to me like right now and that's what I did. I did a couple bags and it worked.

 

[LiaJohnson]

^^ That's horrible, someone's trying to beat their addiction, and you're just telling them to do more heroin?