sub maintenancy and fentanyl/PWD

[cranky_messiah]

I've been on suboxone for about 3 years now, taking anywhere from 2 to 4 mg per day. However, I'm having a really rough time right now, and I need something to help me through. I've read all about PWD, ive searched the site high and low, but I can't find an answer to this specific question: can I take fentanyl (nasal) about 15 hours after my last sub, and will going back to my subs tomorrow morning send me into PWD? I can't find a clear answer on whether PWD is only for your very first suboxone dose, or if it can also happen when you've been on it for years but briefly (1 time, maybe) do something else.
Thanks in advance.

 

[Damoxy]

I think I can answer this.
I have been on subutex for 2 years. The last year I too have been on 1.6 to 2.4 mg (I get the 0.4 pills, I'm in England).
I have in the past had little breaks. Now what I have found is that as long as you have some on your receptors, no pws will be felt. Pws occurs because bupe pulls all the full agonist off and because bupe takes an hour to attach you will have a period with no occupied receptors, you feel the pws until the bupe attaches. If you aren't dependent on full agonist opiates then there are no withdrawals to feel. You will just stop feeling the effects. Now to try get to the point. Yes taking the fent after is fine (how much will be felt is dependent on a lot of things which you will probably be aware of) and getting back on will not cause pws as a, you are only dependent on bupe, not the fent and b, bupe is still attached. Another plus is fentanyl has a short half life. My advice would be to leave 12 hours after your fentanyl to dose bupe again. To be extra safe take your 2mg in increments of say 5x0.4mg hourly. I have had two weeks of agonist use and still got back on with little problems. I was taking bupe throughout just to keep some on my receptors. I have never had pws.
Just yesterday noon I used heroin. When I got up today I had 0.4 bupe, then at 10am I had 120mg oxycodone. I'm not feeling it loads but it's still nice then tomorrow I will take sub again. If you just use for one day you will be fine. Because of the long half life of bupe, no withdrawal from bupe will be felt so waiting won't be uncomfortable. Hope this helps and sorry for rambling. Stay safe always. Good luck