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

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First off, from every doctor I have talked to, they have informed me that buprenorphine's peak agonist effects are equipotent to around 30-40 mg of methadone. The reason conversion charts always give such insanely high numbers with full agonist's compared to buprenorphine (partial agonist), is that they are not taking the cieling effect into consideration. Sure, .3 IV bupe is = 10 mg of IV morphine... but only up to a point.

Secondly, what you plan on doing is pretty dangerous. I know you dont want to be dissauded, but just think about it for a second. Both methadone and buprenorphine are very potent opioids. 8mg is barely a blocking dosage, and after 24 hours, you will most likely get pretty fucked up off of 50 mg of methadone, though there will still be some bupe left in your system. Unlike buprenorphine, which is a partial agonist, methadone has no cieling on resperitory depression, making this combination potentially, well, certainly, life threatening...

Lastly, you have to consider that it's going to be a real bitch waiting for that methadone to leave your system so you can take the suboxone again. With other opiates/opioids, it's a lot easier to switch back and forth, but with a hefty dose of methadone like that, it's going to be a pain in the ass. Sure it hasn't built up in your system, but due to the long half life, you still could run the risk for precipitated withdrawal when you get back on bupe, and you will almost certainly be raising your tolerance, unless you wait a few days for the suboxone.
 
Thanks z

Yeah I know it's pretty dangerous hence why I want to be cautious and try and get a bit more info on the subject before I jump in, I've seen a friend drop from 5mg of methadone (no tolerance, he was fine but it was really scary) and had my own problems when starting maintainance on it. I got started at 20mg which was fine considering the dose of h I'd just come off but moved up to 40mg after a couple of days and became very very sick. I remember I couldn't piss, swallow, my breathing was laboured and when I'd wake up in the morning my eyes would literally wander in their sockets, I've never experienced anything like it since, i could feel them independently moving around in different directions. Thanks for the info, I'm well versed on both drugs however finding an equipotent dose has been tough seeing bupe is a partial agonist and theoretically has a ceiling dose of around 32mg (which I personally think is actually probably to high, in terms of actual intoxication anyway, perhaps a dose of 32mg would last longer than a dose of 12mg but at least for me anything above about 8-12mg feels no different to 32mg, but everybodys different. One piece of interesting evidence is, again everybody is different but I recently reduced in dose from 20 to 12mg in one go without any withdrawal effects or perceptual changes in the feeling or duration of the dose at all, in fact the headaches I had been getting went away and I actually feel better on a lower dose. But i digress..) however with 'done the sky is the limit. I recently skipped an 8mg dose of sub and railed .4g of good quality heroin and didn't feel the effects all that much, in fact it was quite disappointing. I have always had trouble switching between maintainance opiates and heroin, Ive only once had a decent high of h and that was from out of the blue amazing quality heroin, it's a blessing in disguise really but I've snorted up to half a gram of good h while on low doses of both 'done and sub and never really gotten anything out of it. Annoying at times but ultimately a blessing. This is why I'm interested to see if anybody has an idea of what dose of methadone I should be taking; I definitely plan to be on the safe side but I still want to actually enjoy it if it's at all possible considering my past circumstances. Anyway thanks for the info z, and anymore would be much appreciated, I'll post back and let you know how it goes.
 
mdmantpa said:
Just for some added information, I saw in the V.13 thread that people were saying Suboxone doctors will never RX benzos with subs or any other controlled medicine. I just recently got on subs, my 2nd appt was today, and from day one My doctor STARTED me off with 24mg Bupe per day, 30mg Diazepam per day, 200mg Trazadone per night, 300mg Buproprion XL per day, and he told me to let him know if the Trazadone doesnt work well and I can switch to either 30 or 60mg Temazepam per night instead as I originally requested. So next visit in controlled substances my one doctor will be RXing 90x8/2mg Suboxone strips each month, 90x10mg Valium tablets each month, and 60x30mg Restoril Capsules (Temazepam) each month. This was the first doctor I went to see as he was the closest to my school and I told him the meds that worked for me in the past and he just agreed and wrote out the scripts at the dosages I requested. <NO PRICE DISCUSSION> Way better deal than paying that same amount to get one 30mg Oxy IR pill or a .1 of dope, lol its crazy that I can be satisfied legally for a month for the same cost as maybe 1/3rd of a fix that would last 4 hours max....
Click to expand...

I don't see that doctor keeping his career much longer.
 
fifteen pages and nobody's mentioned the headaches? i've only been on my script three days now (supervised by the pharmacist in the uk), and have just started getting those familiar sinusey headaches, like i used to get with the dfs. am guessing an antihistamine would be the best bet to try, that was recommended on here for the dhc, and worked pretty well. unfortunately, dont have any left knocking about (boo!). cant remember which brand/flavour antihistamine i was using before.

any recommendations would be gratefully taken on board.

thanks

b xx
 
headaches are usually from taking too much and will go away with a few days...

also try spitting out remaining sub after its been dissolved via your mucus membranes in the mouth
 
I've been on Subs for four years, dealing with legitimate chronic pain, depression and addiction, my doctor thinks it's better to just stay on a ultra slow taper until I get to a dose low enough to function on without being drugged to the gills. At one point I was up to 32 mgs a day, post back surgery, because I was doing 400mgs of Oxy and eating 75mcg fentanyl patches up until a week before my surgery, the recovery was pure agony as the morphine drip did exactly zero and the vicodin they sent me home with may as well have been necco wafers. So my sub doctor had me on a super high dose just to get back to work. I worked my way down to 24 mgs...got in trouble abusing it, had to work my way back down down down and I'm now at 12 mgs a day.

Here's my issue: I still have a runny nose nearly every day. I'm sniffling and blowing my nose CONSTANTLY and I don't have allergies, I'm not sick, it's just clear discharge, just a little bit, but enough to piss me right off. Whenever I mention it people tell me it's a result of opiate withdrawal. OK, I've been on this drug every day for four years...i'm not STILL in withdrawal. I don't get it. Is this normal at all?
 
I've definitely heard of headaches, migraines even, being worsened by suboxone, although IIRC maybe the naloxone had something to do with it?

Have you ever tried subutex?

and to the poster above me, have you ever tried diphenhydramine for runny noses? works for me. But I know this is not the solution to your problem, just a temporary fix.
 
I usually try diphenhydramine for sleep issues, 100mgs. Maybe a quarter or half dose won't knock me out but will stop the nose? I'll give it a shot.
 
Even 25-50mg should be fine for the runny nose, and if you aren't used to DPH, you'll get sedation at 25-50mg too, you may not need 100mg right off the bat.
 
Oh no, I'm used to it. i started using it years ago when I was pregnant for sleeplessness and restless legs. I'm trying to cut back, but I'm going to see what it does for the ol' schnozz.
 
i usually take between 48-56mg of suboxone.
mixed with any and all others. couldnt guess as to an amount that was the highest dosage. i know in 36hrs i ate 120 10mg oxy and was still coherant. but again, im 30, since i was 14 i've had a rediculous tolerance for any and all meds
 
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You take 56mg suboxone? You realize that above 32mg, it does absolutely nothing more? It has a ceiling effect....

And that it is actually more effective in lower doses?
 
If I took 1mg of buprenorphine rectally today (05.05) at 7am, when can I try morphine without bupe blocking it?
 
to ensure full effects, wait 24 hours, though the ammount of bupe you took was not enough to block. The main issue I'd be worried about would be the combination of the two possibly causing suppressed breathing.o
 
Suboxone Maintenance: Timeframe, Dosage etc

I would like to know what were everyones experience with using Suboxone as Maintenance Therapy. How long are/were you on it, what dosage(s) were used, benefits/drawbacks while on it etc...

The reason for me asking is that I am currently on a Suboxone short-term taper for a short-term Oxycodone addiction. I have read that there currently are studies involving bupe as an anti-depressant. I have been suffering from depression for my entire life which is the main reason I have been self-meditating for the past 30 years, changing from drug to drug to drug. This past year coming off a 15 month run of a very high opiate addiction I was diagnosed with Major Depressive Disorder and was also hospitalized for a week do to it. I have tried several SSRI's over the past eight years and nothing seems to be working. This past year while trying to live a sober life I my depression reached an all time low. I have been unable to work, enjoy things I used to, have isolated myself from family and friends and have almost given up hope of me ever being normal again. This was the reason for my relapse after abstaining from any and all drugs for a year. I have been doing everything to get better, IOP, attending AA meetings daily, therapy, exercise and everything is just a chore to do. It feels like my world is crumbling around me and I can't do anything about it. So I am thinking MAYBE I should give BMT and try and get some sort of a life back, some normalcy because I am not living, just existing.

So please tell me your experiences of how Suboxone has helped/hurt you and also how long have/were you on BMT. I have read that many people feel MMT is much better for long-term use, but going to a clinic on a daily basis isn't something I could get used to and would interfere with my employment once I do become employed. Thanks everyone in advance.
 
Hi there, I'll be glad to reply to your post. I was started on Suboxone as maintenance therapy to deal with an IV oxy and Dilaudid addiction that made me hit rock bottom hard. I've personally found that as a med, Suboxone goes through very distinct phases. When you're very first put on it, you'll notice that it has a distinct energetic feel to it. I found that it made me talkative and energetic and was great for anxiety. As I progressed with the treatment, with subsequent dose increases, I found that about 2 hours after I'd take the dose, I'd get an *extremely* strong anti-depressant effect from the bupe. I was full of energy, in a great mood, outgoing and very highly motivated. Now, I must stress that I wasn't high from the bupe. There wasn't any euphoria or a distinct buzz as if I had banged some oxy, but there was a definite antidepressant effect. The Suboxone had this rapid-acting and noticeable antidepressant effect for about 5-6 months and then nothing. I essentially felt no improvement in mood, and actually felt a little empty. The worst part is that without my sub, I'd get dopesick, yet with it, I'd get sick as well (HORRIBLE headaches, nausea and dizziness). Throw in the fact that I personally found that Suboxone induced insane constipation and the fact that it's pretty high risk when it comes to situations where say conscious sedation would have to be used in a medical emergency and Suboxone suddenly seemed a lot less favorable. Here in Canada, depending on the doctor, even if you're on Suboxone, you have to go to a methadone clinic every week and do a piss test. I'm up to 6 carries now (the maximum my doc will allow in his practice), yet I hate Monday mornings where I have to go sit in a grimy methadone clinic to piss in front of 5 cameras (I'm not even exaggerating that number :P ).

In hindsight, I'd personally have gone with methadone over Suboxone. Methadone costs a whole lot less and at least with my addictions doc, anyways, has the exact same regulations as Suboxone. Granted, in Canada, any doc can prescribe Suboxone, but looking at the sheer amount of side effects that I go through, I'd say that methadone is the better choice of the two. Just one thing though, check the laws of your state when it comes to MMT. If the laws are really strict, you'll likely want to go with bupe instead, to save yourself the hassle. Just my 2 cents.

One last thing, the first 6 months where the Suboxone has a strong anti-depressant effect are crucial in that you actually feel positive and motivated during the early phases of your recovery.

tl;dr Suboxone is initially a good med, but soon becomes a pain in the ass. I'd personally go with MMT instead. Oh, and I've been on Suboxone for nearly 2 years now.
 
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