This could very much be related to something called Serotonin Syndrome (SS). Some people are just more susceptible to it than others. Many people do not know this, but some medical professionals say that after moderate to long term use of buprenorphine, symptoms can begin to occur. Especially if other drugs or alcohol are involved. If my hunch is true, this will only get worse over time. It is one of the reasons that I cannot be on suboxone for any longer than about 3 weeks. Other opiates can invoke this as well, but particularly suboxone. You can search the internet on the topic. Note that some of the lesser known medical info sites may have more detailed information. There is one medication that is prescribed for bouts of Serotonin Syndrome when they occur. It is called Cyprohepdatine. I usually keep it close by since I do not always know how meds or alcohol will react with me. It is an elusive thing. One study I read said that anyone who is on opiates for a long time will develop some form of Serotonin Syndrome. A great percentage of those people will never know it because symptoms will not be enough to raise any real concern. I am on the high sensitivity end of this syndrome, and must always tell a doctor before he/she prescribes new medication. I have had times where I felt like "this could be it, I'm going to croke", and I am not the type who scares easily or runs to doctors.
Severe episodes of this have lead to death. Fatality is pretty damn rare. No need to worry too much but do take it seriously. Prevention is fairly easy. If you happen to notice a re-occurrence when you are partying or have been prescribed a new drug, it very well could be SS. Drugs that are to be avoided and perhaps cause the worse episodes while you are on sub are... SSRIs, SSNRIs (psych meds), muscle relaxers, various health supplements.
I have had bouts of this that caused vomiting and very uneasy nausea for up to 36 hours. Massive headaches and neuropathic twitching also, there were times that I was in a real mess. Like emergency room mess. That was before I got the Cyproheptadine. You only need to take it when necessary and one bottle could last you a few years. Don't forget to take at least 12mg for SS as you need a fair amount to fight off an SS episode. Don't expect to feel better until after a few hours and back to normal possibly the next day. But having had this form some time now, I realize that the ER will do nothing but give me Cyproheptadine and cost a lot of money. Another way to know if this is SS or not is if the nausea meds of Promethezine and Zofran etc do not help your nausea. SS related nausea is usually not stopped by these types of meds. BTW, Cyproheptadine is a safe non-narcotic drug that is well tolerated by most people, still need a script though.
By and large, this is an easy thing to avoid. The less drugs you take or meds you are on, the less chance of this to pop up and get you.
