Bupe Suboxone/Buprenorphine FAQ and Megathread v.1; 2007 - 2010

[ruffneck81]

keep in mind that i do not swallow the suboxone after it has disolved.

 

[~--Slushed--~]

its been two full days since my last dose of bupe....

Now i have used bupe before for longer and made it out pain free but i was wondering if this is a viable solution for people strapped for cash, and don't want anything on medical files and such

 

[~--Slushed--~]

no that was also the case with me. I also agree whole heartedly about staying on them for a short period of time. But everyone is different.....

 

[e12dsm]

yea i used to take a few mg's of bupe before i would go to work if i didnt have dope, and 6-8 hours later i would do a nice .2-.3 shot and get almost the full antagonist affect, of course it was quiteee as strong as if it would be without any bupe in my system, but yea usually if i only took a few mg's like 2-4, within 12 hours i would be able to break through and get a nice high.

 

[skarekr0w]

throughout my suboxone trial, of 1 year.. i had a lot of relapses... i noticed the more oxy or whatever your relapsing on, pushes the bupe out of your receptors, letting you get high... at least thats how i looked at it.

 

[ruffneck81]

quick question.

does it matter whether or not i swallow the suboxone once its disolved...even if i leave it in my mouth for over 10 to 15 minutes?
does anyone know anything certain about this?

 

[e12dsm]

yea i kinda always looked at it like a battle between the Bupe, and w.e your opiate of choice was( mine being heroin) when i wanted to get high i would actually say in my head, aight Dope, were gunna kick this bupe's ass right off of my receptors. The bupe usually wins in the higher dose range, but no matter how big my habit was a couple mg's of bupe would usually be sufficient enough to hold me over for atleast 12 hours, i would always try to dose as little as possible so i didnt run out, because bupe was harder for me to get then dope.

 

[Z Y G G Y]

some people metabolize drugs faster. The average half life of suboxone is 37 hours, from 20-70. I was also able to get high 24 hours after a 4mg dose. 4mg is a low dose, any higher and u probably wouldn't be be able to get high.

 

[MikeyMike125]

Yup the average is 37.5 not everyones body metabolizes suboxone as fast or slow. its just a Mean number. Man what the hell am i supposed to do day 7 almost 8 off subs and im getting antsy is it me being sober now? I cant sit around this house anymore than i have. I was lucky to get unemployment funds after my company closed shop on me but this is the worst vacation i have ever had lol. oh well cant turn back now i been too freaking far blahhhh

 

[Captain.Heroin]

some people metabolize drugs faster. The average half life of suboxone is 37 hours, from 20-70. I was also able to get high 24 hours after a 4mg dose. 4mg is a low dose, any higher and u probably wouldn't be be able to get high.

4mg is a high dose for me. Even when I was first detoxing, I only took 2mg at a time, and wouldn't exceed 6mg/day for the first few days of acute heroin withdrawal. Past day two, I didn't need anything more than 4mg for an entire day, and I wouldn't take 4mg at a time. I quickly tapered down from 2mg at a time, as it in itself is a high dose to me still. I found with a moderate opiate tolerance, 0.5mg to 1mg was a good dose, and with a low opiate tolerance, 0.3mg is a good dose.

 

[Captain.Heroin]

I still happened to stay up all night, it's 5:30 AM and I've been up for longer than 36 hours now...I wonder how I didn't fall asleep already...

 

[subisjustokay]

Yea I'm sure someone HAS answered this question but I can't seem to find it so please Captain.Heroin or someone else who sounds smart answer this one:

So I know that if you were to take say 80mg Oxycontin and 2 hours later pop a 8mg Suboxone you would be sent in to Precipitated W/D... BUT, what I don't understand its if you pop 8mg of Suboxone and THEN 2 hours later take 8mg Suboxone you would be fine.... NOW to the question:

Lets say you take 8mg Suboxone in the morning and then Later that night you take 80mg Oxycontin, then the next morning you pop another 8mg Suboxone... would you be sent into Precipitated W/D then?? If not, why? That always confused me and I haven't seen it discussed on here...

edit: I think I asked that right but I must admit it sounded a lot better in my head...

 

[ruffneck81]

exactly what i want to know??? also if you DON'T swallow the bupe/saliva after totally disolved wouldn't that take out the naloxone?

 

[cire113]

^^^^I usually spit out the sub after its done dissolving to make sure i dont swallow the nalaxone...Not even sure if it makes a difference... but lately ive been getting massive migraines from sub... its also pointless to swallow so might as well spit it out

Lets say you take 8mg Suboxone in the morning and then Later that night you take 80mg Oxycontin, then the next morning you pop another 8mg Suboxone... would you be sent into Precipitated W/D then?? If not, why? That always confused me and I haven't seen it discussed on here...

--You will only go into precipated w/d's IF YOU are physically dependent on opiods and take BUPE while another opioid is still attached to the receptors in your brain... Because bupe rips out the receptors and only partially fills some of them (mostly the Mu receptor)...


If there is bupe already in your system and you take oxycontin later that day and then take Bupe the next morning you will not go into instant withdrawals most likely because of how long of the half life of bupe is and how strong its affinity is to the opiod receptors

But mostly because its still attached to your receptors....

But depending on how much bupe you've taken .. taken that oxy was probably a waste....

This has been my experience ...As long as the bupe doesnt completely leave your brain you could techinically take other opiates inbetween bupe doses without going through instant w/d but it would be a waste because the bupe blocks it


i tried

 

[Eight0Eight]

Well, I went to the clinic yesterday - to have a talk with a more exoeriance doctor about getting help with my Subutex reduction.

I've got down to 1.2mg, but was waking up in WD at around 4am everyday. I put myself onto daily pickup so I wouldn't start eating into my pills. But t still isn't nice starting each day with 5 hours of WD before I could get my dose then go to work.

I started to find that it was effecting my mood during the day ass well, as I KNEW that it wouldn't be long before I was in bed shaking and sweating :/ .

Anyway, the doc was actually quite good. My first suggestion was clonidine/Lofexidine. He agreed that this was a good idea, but said it would require my blood pressure be checked everyday. Given the distance between me and the clinic at the moment (summer uni break) this is VERY difficult.

We decided to continue with my reduction schedule - but he has scripted me 40mg Diazapam for the first couple days of a reduction. He has also scripted me Mirtazipine to be taken every night. Hopefully these two will take the edge of the WD's and make it a bit more bearable.

What do you guys think? Anyone here ever use mirtazapine to help sleep?

I know the benzos will definitely help the first couple days of a subutex reduction when the WD is at its worst.

The doc said that if this doesn't work, he will talk to my pharmacy - and se if they would be OK with taking my blood pressure. I get on with them very well, and see them every day so I can't see it being too much of an issue. They have often said that they can see I'm making a real effort with this..

 

[Opiyumphile]

One single 16mg dose...

16mgs per day for 11 days...

Here is a taper chart....

 

[Captain.Heroin]

Yea I'm sure someone HAS answered this question but I can't seem to find it so please Captain.Heroin or someone else who sounds smart answer this one:

So I know that if you were to take say 80mg Oxycontin and 2 hours later pop a 8mg Suboxone you would be sent in to Precipitated W/D... BUT, what I don't understand its if you pop 8mg of Suboxone and THEN 2 hours later take 8mg Suboxone you would be fine.... NOW to the question:

Lets say you take 8mg Suboxone in the morning and then Later that night you take 80mg Oxycontin, then the next morning you pop another 8mg Suboxone... would you be sent into Precipitated W/D then?? If not, why? That always confused me and I haven't seen it discussed on here...

edit: I think I asked that right but I must admit it sounded a lot better in my head...

Taking buprenorphine isn't going to create preicipitated WD's in someone who is dependent to buprenorphine. Buprenorphine can only throw off an opiate that is weaker than it from the mu-opioid receptor.

If you have leftover oxycodone or metabolites still in your system effecting you, you will go into precipitated WD's. With that being said, make sure you are in sufficient WD (very uncomfortable, rather unpleasant, even for an oxycodone user) before taking buprenorphine. If you try it earlier, you're treading a thin line.

also if you DON'T swallow the bupe/saliva after totally disolved wouldn't that take out the naloxone?

No, that won't "take out" the naloxone. It is absorbed at the same speed and rate as buprenorphine is.

The fact is that buprenorphine is more potent than naloxone, and will almost always out-compete the mu-receptor for it. Also, naloxone's half life is much shorter than buprenorphine, so while you're still feeling great from buprenorphine, naloxone will begin to fade away, even though it's already inert (so it's inert overall).

Naloxone has nothing to do with suboxone other than being an inert, filler ingredient meant to just jack up profits.

Buprenorphine is everything you feel when you take it to feel better, or even if you take it and get precipitated WD's. It's buprenorphine which will clear your mu-opioid receptors and cause precipitated WD's in the first place.

^^^^I usually spit out the sub after its done dissolving to make sure i dont swallow the nalaxone...Not even sure if it makes a difference... but lately ive been getting massive migraines from sub... its also pointless to swallow so might as well spit it out

Many things cause a migrane.

Naloxone has nothing to do with what you feel from suboxone.

Because bupe rips out the receptors and only partially fills some of them (mostly the Mu receptor)...

Incorrect.

Buprenorphine is a thebaine derivative with powerful analgesia approximately twenty-five to forty times as potent as morphine,[11] and its analgesic effect is due to partial agonist activity at μ-opioid receptors, i.e., when the molecule binds to a receptor, it is less likely to transduce a response in contrast to a full agonist such as morphine. Buprenorphine also has very high binding affinity for the μ receptor such that opioid receptor antagonists (e.g. naloxone) only partially reverse its effects. These two properties must be carefully considered by the practitioner, as an overdose cannot be easily reversed (although overdose is unlikely in addicted patients or people with tolerance to opioids who use the drug sublingually as meant in the case of Subutex/Suboxone, especially if there are no benzodiazepines involved), and use in persons physically dependent on full-agonist opioids may trigger opioid withdrawal that also cannot be easily reversed and can last over twenty-four hours, as the drug's mean half-life is thirty-seven hours.

Buprenorphine is also a κ-opioid receptor antagonist, and partial/full agonist at the recombinant human ORL1 nociceptin receptor.[12]

Buprenorphine hydrochloride is administered by intramuscular injection, intravenous infusion, via a transdermal patch, as a sublingual tablet or an ethanolic liquid oral solution. It is not administered orally, due to very high first-pass metabolism. Buprenorphine is metabolised by the liver, via the CYP3A4 isozyme of the cytochrome P450 enzyme system, into norbuprenorphine (by N-dealkylation), glucuronidation and other metabolites. The metabolites are further conjugated with glucuronic acid and eliminated mainly through excretion into the bile. The elimination half-life of buprenorphine is 20–73 hours (mean 37). Due to the mainly hepatic elimination there is no risk of accumulation in patients with renal impairment and in the elderly.

The main active metabolite, norbuprenorphine, is a δ-opioid receptor and ORL1 receptor agonist and a μ- and κ-opioid receptor partial agonist. However, buprenorphine antagonizes its effects at the k-opiod receptor.

Buprenorphine is mainly a mu opioid agonist/antagonist.

Buprenorphine is also a kappa opioid receptor antagonist, and this helps with withdrawal symptoms. Kappa receptor antagonism helps reverse nasty WD symptoms, whereas kappa receptor agonism leads to not the most pleasant sensations. Kappa opioid antagonism has also helped some with depression.

and Norbuprenorphine, the main active metabolite, is a delta opioid receptor and ORL1 receptor agonist, and a mu and kappa opioid receptor agonist. It's a rather efficient mu-agonist, yielding buprenorphine a rather valuable drug in many, many different ways.

Buprenorphine does not "rip out your receptors", that's just made up.

At quite high doses, buprenorphine actually spills into (almost all) other brain receptors, and starts screwing with your brain chemistry in a way that will limit monoamine oxidases, typically leading to uncomfortable side effects.

Buprenorphine's method of effect extends far beyond mu agonism.

The doc said that if this doesn't work, he will talk to my pharmacy - and se if they would be OK with taking my blood pressure. I get on with them very well, and see them every day so I can't see it being too much of an issue. They have often said that they can see I'm making a real effort with this..

I'm sure you are well aware not to become dependent on benzos. I wouldn't use 40mg of diazepam a day unless it's absolutely necessary and actually helps quite a bit with tapering.

You should try to not take the diazepam every day, nor quite often, so as to help keep your tolerance down, yielding it an effective medication for time to come.

But yes, diazepam during a come down is a god send. When I'm trying to taper from buprenorphine, alprazolam or lorazepam or flurazepam are perfect (for me). Diazepam definitely helps, but isn't one of my top favorites. When I was trying to kick dope, a friend of mine, who understood my situation and sympathized with me due to me almost losing me and my girlfriend's lives and being homeless and all gave me about four of the 5mg valiums, and I only ate one a day (and spread them out for the "worst" of the come down). Every 5mg helped me enormously. The first one, I felt horrible. I took a shower, and afterwards took one - perfect. I felt like a new man afterwards.

If you take benzos sparingly, they are great tools for when you *really* need them.

 

[Captain.Heroin]

To those who post their questions here and to whom I have yet to respond to:

Please post your inquiries again, if anything I've posted for other people help you please learn from it if possible. I missed a lot of posts (sorry) while I was at the SEP. I got 600 clean needles (mostly 30g, 28 1/2 g, 27 1/2g, 27g, some 29g), tons of sterile water, condoms, lube, cottons, cookers, triple antibiotic ointment, bandaids, alcohol wipes, rubber gloves, all this amazing stuff. And soon they're going to be getting naloxone! I can't wait.

I'm going to take a picture of everything I got just to share.

But anyways, the state I live in doesn't have this lovely SEP, a bordering state does, and it is a PAIN IN THE ASS and takes ALL DAY even when speeding 80 miles an hour down the highway there and back. And, there's a LOT of walking to and from the metro just to get to this place. So, I have taken for the better part of the last few days, a hiatus.

So, if I haven't gotten to you, please, post again and I will try my hardest to get to you. I don't mean to ignore anyone who reads and or takes time to post serious inquiries, it's just that life takes up time, but I'll always be able to come back here and help you all out.

We're doing great job guys, hang in there! I hear of a lot of people doing well on buprenorphine, whether maintenance or tapering. Good job! For those finding difficulties in maintenance or tapering, hang in there, trust me it's worth it to stay on the straight and narrow. If anyone is having a hard time in life, they're welcome to PM me and talk about it.

I know we can all get clean together if we care about ourselves hard enough. I know I care about myself enough and one day I will be clean. It will just take a while and I'm doing GREAT thusfar. I've passed the 9 month sobriety mark with heroin. No relapses, and I've been clean for 9 months. I'm really proud of myself.

If anyone wants to post how they're doing, how long it's been for them, how they feel about it, etc, I think it would be really helpful for us all.

 

[Opiyumphile]

Here's a list of side effect's from both suboxone and Subutex.

SUBOXONE

Very common sideeffects (over 10%): Nausea, Insomnia, headaches, increased sweating, constipation

Common sideeffects (1-10%): Weightloss, weakness, flulike symptoms, diarhea, throwing up, loss of appetite, stomachpains, periferal edema, vasodilation, high blood pressure, rhinitis, pharyngytis, coughing, chestpains, artragia, myalgia, legcramps, dizzyness, MIGRAINE, pain, itchy skin, rashes, urticaria, visual hallucinations, decreased libido.

SUBUTEX

Very common sideeffects (over 10%): NONE

Common sideeffects (1-10): Weakness, nausea, constipater, orthistatic hypotension, headaches, dizzyness, insomnia.

Quite the difference, eh?



The increase in side effects is due to the only difference in the two drugs being the presence of Naloxone.
While Naloxone isn't orally very active it does still work it's magic on other receptor in the body and has a good deal to do with problems people experience in their GI tract.
It is becoming common practice to put people who are planning to detox off suboxone on subutex. It is generally accepted that it is easier to get off subutex rather than suboxone.
The way I got off subs was to go on a month long bender using roughly 15-20 bags of heroin a day and then I went to detox for 7 days and while there I did a 4 day taper with subutex. It was not a comfortable experience in the least but it was far better than cold turkey.
Maintenance with suboxone, to me, is just a bad idea. It has more potential as a detox med. Just not more profitability.

 

[Cane2theLeft]

^I wonder how many of those side effects are actually withdrawal symptoms in a population either not held completely by sub or on too low of a dose.

Look at a lot of those side effects- weakness, diarrhea, vomiting, loss of appetite, stomach pains, hypertension, myalgia, leg cramps, pain, insomnia are all withdrawal symptoms for opiates.