Bupe Suboxone/Buprenorphine FAQ & Megathread v3; 2010 - 2022

[funkee]

Dilaudid can be used to break through Bupe. In most cases of serious trauma, bupe patients may receive fentanyl. It is very risky, so it is seldom done.

For individuals who take a low dose (<8mg) and do not dose regularly, it would be much easier to "break through." For people who take more than 8mg or take it daily, the necessary dose may be higher and they would need to be put on a pump until the bupe in their body is mostly metabolized.

Most of the buprenorphine that you take becomes bound to blood proteins and is inactive. Only the unbound portion can cross the BBB and activate receptors. It is mostly unbound after ingestion, and then becomes bound and is slowly release over the course of several days. In this way, a BMT patient may titrate small amounts of bupe from their protein-drug reserves in their blood. Hydromorphone is short acting, so whether it wears off or is forced off by bupe is hard to say. If one is able to break through with a longer acting opioid, the effects would be short-lived because of the unbinding of bupe. For these patients, a PCA pump with or without a continuous rate may be necessary. The problem becomes more complex with high dose BMT patients, because the level needed to break through can be very close or even higher than the lethal dose.

 

[haden]

Wow this is exactly what I was looking for! Thanks! Not to sound ignorant or dumb, but from what you wrote it sounds like with methadone, some one on a low dose of bupe could take it and get high, but the duration of the high would be much shorter?

 

[Captain.Heroin]

I understand this, but I am wondering if dilaudid is particularly effective at shooting through bupe... I know that when trying to achieve an opiate high while on BMT, IV is the best roa. I just snorted this dilaudid (intentionally refrained from IV for fear of a quick downward spiral).

I am wondering if a drug like oc or methadone would have a less pronounced effect... (hypothetically the oc snorted (like the hmorphone) and the methadone taken orally)..

If this is an unanswerable question, I apologize for wasting everyones time, but I thought there might be someone out there that has experimented with this. Perhaps someone who has tested on themselves which drugs, in roughly equivalent doses, are best at breaking through a 2mg or lower bupe dose.

I have no idea to be honest with you. When I was on bupe and wanted to use something else, not only was this a long time ago for me, but 99% of the time it was heroin.

Other members here might be able to help you.

Wow this is exactly what I was looking for! Thanks! Not to sound ignorant or dumb, but from what you wrote it sounds like with methadone, some one on a low dose of bupe could take it and get high, but the duration of the high would be much shorter?

Once you take the methadone it will be difficult to go back to bupe because of the fact that methadone is a very long lasting duration.

 

[haden]

I have no idea to be honest with you. When I was on bupe and wanted to use something else, not only was this a long time ago for me, but 99% of the time it was heroin.

Other members here might be able to help you.



Once you take the methadone it will be difficult to go back to bupe because of the fact that methadone is a very long lasting duration.

Yeah I don't think I am going to risk it. At least I should wait a while before I totally fuck up a good opportunity for improving my life and mental health- there is a reason I am on subs!

 

[ss2brandon]

Thanks Captain H. Always helpful and informative and you're never one to judge. Kudos in my book. The reason i ask is that oxycodone, fentanyl, oxymorph, dilaudid, and every opiate or rather opioid i've used (don't even suggest H, because i'm not going down that road) is no longer giving that high that i long for. most of the time i just pass out from potentiating with muscle relaxers or diphendyr. i find myself just not wanting to hurt. I'm scared of suboxone/subutex road too b/c i had a horrible, horrible detox from methadone before. i don't want to become addicted to suboxone but its a drug that i take as little as possible b/c it provides relief but no substantial high. ya there's that weird feeling, but no blanket warmth. so i guess i need maintenance again. i've tried CT several times and everytime i break down around the 7-10 day due to insomnia. i literally don't sleep at all during this time and i break down. literally crying for no god damn reason. skin feels like its burning and freezing at the same time. i have a handful of suboxone. maybe i should stabilize and then do a fast taper? then again i've been using 100mcg to potentiate my opes when i don't have quite enough. i believe i've destroyed bupes ability to control my cravings. how can i get bupe to work again. seriously whoever coined the term SBB (suboxone boredome blues) hit it dead on the head. sorry for ranting and raving but i just want to be off of this shit (opioids)d already.

i posted this on page 34 but no one responded. can someone please help me out. and to clarify i'm an oxy addict, but use subs whenever i absolutely have to. ie. when i'm dry or when i'm really low i use 100 mcg to potentiate.

 

[SubDude]

Thanks, guys. Yeah, I suppose checking my levels first would make most sense. My problem is I also have an iron deficiency and anemia (low white blood cells, I think). I had an iron infusion two years ago, but I may need another. I need to get everything checked, actually. I used to get blood tests every three or four months, but it's been about six. Need to see my liver enzyme levels as well. I also have an autoimmune disease that affects my liver (sclerosing cholangitis).

I'm thinking of making a graphic with a photo of myself with a diagram showing what's wrong with each part of my body for when I see new doctors. It's a lot to explain.

First off you must have good dr's and excellent insurance because the only liver test my primary care dr gives is the PSA blood test. I'd like to get a scan or something more revealing. I'm assuming you couldn't get the diagnosis from a bood test?

I also like the idea of graphic/drawing of body with pointers and/or descrptions of symptoms of each area. The only drawback is I'm afraid my dr would diagnose me as a "Hypochondriac"...

So I am a bit ashamed to say after just three weeks on suboxone I slipped up. A random cat offered me an 8mg dilaudid and for some reason I couldn't refuse.

However, I do not wish to be judged, flamed, told "I abused my treatment", etc...

I was on a steady dose of between 1 and 3mg of bupe a day for three weeks. About 6 hours after taking the bupe I snorted the 8mg of hydromorphone. I got really high. It lasted about 40 minutes of the normal gradually increasing euphoria of dilaudid. It was actually a bit intense.

My questions are:

How did this happen? Any opinions? I assumed I would feel nothing from it...

Would 70mg of methadone be felt, or is dilaudid just a really strong opiate that breaks through? I was thinking maybe only dilaudid would get me that high while on bupe, but am now wondering if that isn't the case after some research on both dillies and dones.

Please let me know what you think!

It's nothin to beat yourself up about. It happens. In fact I'm on .33-.50mg subs and I usually do some oxys once or twice a month just to get some feeling in my life. I agree with CH on the methadone... don't want to fuck with that while on subs maint. I personaly don't see anything wrong with an occasional "slip" while on subs even if it's planned. But thats just me... some would have big problems with this and would screw up their recovery.

 

[need some help]

First off you must have good dr's and excellent insurance because the only liver test my primary care dr gives is the PSA blood test. I'd like to get a scan or something more revealing. I'm assuming you couldn't get the diagnosis from a bood test?

I also like the idea of graphic/drawing of body with pointers and/or descrptions of symptoms of each area. The only drawback is I'm afraid my dr would diagnose me as a "Hypochondriac"...



It's nothin to beat yourself up about. It happens. In fact I'm on .33-.50mg subs and I usually do some oxys once or twice a month just to get some feeling in my life. I agree with CH on the methadone... don't want to fuck with that while on subs maint. I personaly don't see anything wrong with an occasional "slip" while on subs even if it's planned. But thats just me... some would have big problems with this and would screw up their recovery.

Hello Sub Dude. When you have your planned slip do you find yourself craving more the next day? Are you able to just enjoy the high and move on, like non addicts? i'm always really curious about people who can do this, i think just because whenever i have the slightest bit of anything in my system i find myself thinking o.k, now how do i get more.... Why are you on Subs, was it getting to costly with the OCs? i think in a previous post you mentioned a family. If any of this is too personal, you may feel free to tell me to piss off. i like to hear other peoples stories, why they started, why they quit, and all the things in between. Brain function is fascinating to me as well, how some people can jump off and on and be fine while for others, one slip and its over. Anyone else who feels like answering this, please do. i think i can receive personal messages if you don't want yourself spattered all over the thread. Ok, take care everyone.

 

[need some help]

So I am a bit ashamed to say after just three weeks on suboxone I slipped up. A random cat offered me an 8mg dilaudid and for some reason I couldn't refuse.

However, I do not wish to be judged, flamed, told "I abused my treatment", etc...

I was on a steady dose of between 1 and 3mg of bupe a day for three weeks. About 6 hours after taking the bupe I snorted the 8mg of hydromorphone. I got really high. It lasted about 40 minutes of the normal gradually increasing euphoria of dilaudid. It was actually a bit intense.

My questions are:

How did this happen? Any opinions? I assumed I would feel nothing from it...

Would 70mg of methadone be felt, or is dilaudid just a really strong opiate that breaks through? I was thinking maybe only dilaudid would get me that high while on bupe, but am now wondering if that isn't the case after some research on both dillies and dones.

Please let me know what you think!

Glad you can be honest. So far no one here has really judged anyone else for what they do. i don't think it would go over so well. It helps when posts like yours pop up. Obviously people are going to slip. Take care.

 

[jnicolas1980]

First off you must have good dr's and excellent insurance because the only liver test my primary care dr gives is the PSA blood test. I'd like to get a scan or something more revealing. I'm assuming you couldn't get the diagnosis from a bood test?

I also like the idea of graphic/drawing of body with pointers and/or descrptions of symptoms of each area. The only drawback is I'm afraid my dr would diagnose me as a "Hypochondriac"...

Yeah, blood tests only indicated a problem. I had to undergo an ERCP (scope down the pipes) and colonoscopy (ugh) before a diagnosis was made.

I have a PPO plan through my employer, otherwise I'd be all kinds of fucked, mostly because of the meds I need to slow the scarring of my liver and all the tests/office visits would bankrupt me. Fucking bullshit health "care" system.

For many years, I thought (and was told) I was a hypochondriac. I used to have fears that my liver was messed up because I drank Robitussin as a teen. I went to a few doctors when I was 18/19 to check it out, but they never found anything wrong. Three years later, after I finally got over my liver fears, I find out they were real.

 

[jnicolas1980]

Haden,
Slipping up is nothing to be ashamed of. I slipped a few weeks ago... almost broke my wrist (kidding). But seriously, I had planned a "vacation" with some 30 mg oxys and my plan went to shit 'cause my parents decided to visit on the days I had planned to get back on subs (meaning I wanted to be alone). Because of that, I ended up having to stay on oxy the whole next week, and my sub doctor was quite disappointed. This was all within the past month, and I'm back where I was, so it wasn't really much of a setback.

Moral: you'll be OK as long as you can keep it in moderation. The trick is understanding what moderation is, and being honest with yourself

 

[daddysgone]

Haden,
Slipping up is nothing to be ashamed of. I slipped a few weeks ago... almost broke my wrist (kidding). But seriously, I had planned a "vacation" with some 30 mg oxys and my plan went to shit 'cause my parents decided to visit on the days I had planned to get back on subs (meaning I wanted to be alone). Because of that, I ended up having to stay on oxy the whole next week, and my sub doctor was quite disappointed. This was all within the past month, and I'm back where I was, so it wasn't really much of a setback.

Moral: you'll be OK as long as you can keep it in moderation. The trick is understanding what moderation is, and being honest with yourself

Sorry....this is complete bullshit.
Before anyone jumps down my throat, let me explain that I am aware that slip ups do happen and I am not at all judgemental. During recovery, there can be many unexpected situations which pop up which may lead to a short relapse.

However, understanding this does not mean that it is OK to allow yourself these little vacations whenever you like. Note that I am referring to people who are serious about wanting to get off of full agonists.

It's absurd to think that an addict has the ability to use in moderation without the SERIOUS risk of falling back into addiction.

Again, I am jot judging here, but if the ultimate goal is to get your life together and stay off of full agonists, you can't seriously think that these planned "vacations" are a legit approach.

 

[jnicolas1980]

[/B]

Sorry....this is complete bullshit.
Before anyone jumps down my throat, let me explain that I am aware that slip ups do happen and I am not at all judgemental. During recovery, there can be many unexpected situations which pop up which may lead to a short relapse.

However, understanding this does not mean that it is OK to allow yourself these little vacations whenever you like. Note that I am referring to people who are serious about wanting to get off of full agonists.

It's absurd to think that an addict has the ability to use in moderation without the SERIOUS risk of falling back into addiction.

Again, I am jot judging here, but if the ultimate goal is to get your life together and stay off of full agonists, you can't seriously think that these planned "vacations" are a legit approach.

Yeah, I suppose it's better to have a no-tolerance attitude, but it depends on if you're ready to quit altogether. Some people aren't, and they need to test the waters first. I certainly did, but now that I've gotten past that, and have an experience that was a pain in the ass, I can see the road ahead a lot better.

 

[bben]

Do most sub doctors force you into a rehab before they write for sub or do they usually just write out a script and thats it.

 

[lasthurrah19]

No rehab, I've never heard of one making you go to rehab. Some require outpatient therapy, though.

 

[cj]

^^
You wont get high for long doing that. The problem with increasing your dose chasing a buzz is that bupe has a ceiling effect so eventually its gonna stop working and you will have a massive tolerance.

 

[funkee]

i posted this on page 34 but no one responded. can someone please help me out. and to clarify i'm an oxy addict, but use subs whenever i absolutely have to. ie. when i'm dry or when i'm really low i use 100 mcg to potentiate.

Suboxone and Methadone are quite different. The buprenorphine is a partial agonist, and as such you will need to find a dose that covers your symptoms and cravings and leaves you feeling at or slightly above baseline. You have most likely developed a tolerance to the dose you were taking, which is quite small. Then you will need to stabilize on it for some time to allow your brain starts producing dopamine normally. Stabilizing means dosing often throughout the day rather than all at once.

For most individuals switching to bupe to detox, they will find a comfortable range between 2 and 8mg. Some are able to get by on a smaller dose, while others need a higher dose. I am in the latter group. The ceiling of effect is at 32mg, and the drug produces diminishing returns as the dose goes up.

Once you are stable, which means no euphoria but no withdrawals, you can start thinking about a taper. You want to make sure that the drop in dose does not cause any new symptoms to appear. The two factors to consider is to drop by how much, and to drop how often. What has worked for some has been 10% every 1-2 weeks, but it can vary between individuals. Depending on the starting dose this taper can take a few months to a few years. Pair it with a strategy that addresses your triggers for craving, and you will easily beat your addiction.

Generally speaking, a short bupe detox will only address the physical symptoms and leave many at a high risk of relapse. For your best shot at recovering fully you'll want to address every aspect of addiction, which includes craving and its triggers (stress, access, environment) and find ways to include pleasureful activities to help your brain to produce dopamine on its own again.

 

[skylines7]

http://www.ncbi.nlm.nih.gov/pubmed/2323306

I have read many times on here that when taken sublingually, the naloxone is INACTIVE. This publication states the exact opposite.

Thoughts?

 

[HdoubleODeezy]

http://www.ncbi.nlm.nih.gov/pubmed/2323306

I have read many times on here that when taken sublingually, the naloxone is INACTIVE. This publication states the exact opposite.

Thoughts?

that is just naloxone.. yes naloxone will reverse full agonist opiates even when taken sublingually. But when it is in combo with something with higher binding affinity (like buprenorphine) the bupe will be the thing causing w/d's and when taking suboxone for maintenance the naloxone is out competed by the bupe causing the naloxone to be ineffective when combined (again) with something with higher binding affinity(buprenorphine). Example= Suboxone.

EDIT: For what you said in your post: it's not INACTIVE when taken sublingually.. it is INERT (still enters your body but does nothing, so thinking about it again... i guess you could call it inactive lol) when taken sublingually with buprenorphine for the reason i stated above.

EDIT again: i suck at explaining things.. i just read my post over and over again and KNOW it can be said better than i said it, but can't figure out how(thanks to me dropping outta school at 14).. so if anyone wants to take a swing at it PLEASE do.. (and i dropped out for a reason, i had my first kid lol)

 

[skylines7]

I understand what you are saying. You explained it pretty good, I already had a pretty general understanding. I am just looking for peoples thoughts. I can't believe all the misinformation given about subs when I read about them...you would think information given to us by our government would be accurate. I do have a grudge against naloxone, if you haven't been able to tell by my last couple of posts lol.

 

[lightitup]

Hey, so I need a little help with suboxone and dosages. I have been doing dope for a while, and that is pretty hard to judge how good compared to everyone elses and stuff. I know that I could eat about 90-120mg of oxy and get a slight nod. I usually smoke (completely quit IV, though used to) 1-2 bags of really good brown powder (after using lots of different stuff out here, this is much better, takes 2-4 of other).

Anyway, I got two pills of suboxone because I'm really sick of all this shit, and honestly want to stop. I realize I should have grabbed more, but I couldn't find it, and I took what I could get. Since I heard a lot of people talking about how low their dosages were, I figured I would probably be fine. I really just want to use it to cease withdrawals.

So if I take 2mg increments, that is 8 increments. Now since the bioavailability of snorting is much better, I figured I would just do that. My question is, will it last significantly less time this way, or take any longer to kick in? I want to make this as efficient as possible since I have such a small amount.

So eating it I could get away with 4-6 days if I taper well I figure, and it will be much easier to kick then my dope habit. Will snorting be the same case or will I probably have to use twice in a day to start?

Any other tips to make this as easy and painless as possible are welcomed, I am prescribed benzos so that will probably help with the dosage also.

Thanks!

PS: I realize this isn't as good as a long taper, or being on a program that will help. I'm not at that point and wanted to try to do it on my own if it was possible. I really want to take a long break from this shit though, and am motivated, so I just need to address the physical side at the moment.