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

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Pregs+opiates are a great but HR is important so dangerious combo possible. Pregs I believe play on the opi receptor a bit so they intense things so watch out. Pregs are wonders for wd's.
 
be careful what you say to a doc. Yes be honest but sometimes they can cut you short or mess you about. If you're an addict you'll sing and dance for your DoC. I have been on maintence for 6 years. I am currently on 16mg buprenorphine and starting to improve alot. However I have to goto a pharmacy and pop it under my tonge infront of them 7 days. They moved me from my local pharm which gave me Sunday take home and checks wern't as big however this new pharm has pros of being open 9/10am-9pm but sat 7pm sun 5pm

If I can do better with my use I can test clean and tell them I'm not using and see if I can at least get a few days take home. You know the pharm is a 4mile walk heh and losing weight isn't important to me right now.
 
I was wondering if anyone who's on Suboxone and relapsed has told their doctors? I want to, because I've been doing H again after having cravings and dreams, but I'm afraid that he'll just kick me out. I've been on 8mg/day since last August (2011) and only ran out early 1 time (that he knew about). I don't know if my dose isn't high enough or if I would be better off going back on methadone. Although, given my history of relapsing, I've learned enough to know that the problem is ultimately with me, and my tendency to get bored after not using my DOC for so long.
Anyways, I know I digressed quite a bit; but I really just wanted some advice on how to handle the relapsing and whether to tell my doctor. I just don't want to get cut off and be completely SOL. Thanks, everyone! I've spent many late nights on this site!
 
mydrugbuddy said:
Sorry to be asking such a basic and obvious question - but I cant find an answer to it....What is the basic point of sub/bupre ? I mean what is the advantage of switching to this from whatever opiate a person may have been on before hand ?
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Well it's mainly used to treat people for opioid dependence. It's a synthetic opioid that binds the the opioid receptor and blocks it, tricking your body to think it's on an opiate. While it is actively blocking the receptor, other opiates taken while Buprenorphine is active are rendered useless, as these chemicals cannot properly bind with the receptor, which is blocked in this case.

I have heard about how some doctors are also prescribing Buprenorphine on a "pain management" basis. I guess some doctors are against traditional opiate treatment?
 
So8e said:
Well it's mainly used to treat people for opioid dependence. It's a synthetic opioid that binds the the opioid receptor and blocks it, tricking your body to think it's on an opiate. While it is actively blocking the receptor, other opiates taken while Buprenorphine is active are rendered useless, as these chemicals cannot properly bind with the receptor, which is blocked in this case.

I have heard about how some doctors are also prescribing Buprenorphine on a "pain management" basis. I guess some doctors are against traditional opiate treatment?
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Cheers for the reply. But i hear that the physical withdrawls from this stuff can last up to 2 weeks, which is way worse than most other opiates. I still dont really get what the advantage is of switching to this stuff, and why it's considered 'treatement' and not just another synthetic opioid...
 
Because buprenorphine is a very powerful agonist (well, partial agonist) at the mu-opioid receptor. This means that, at high enough doses (usually 3-4mg, higher for some people) it has a blocking effect. This means that buprenorphine, just like methadone (again dosing is important here) blocks other opiates from the receptor. So if you're on bupe maint. you can't (in theory) get high off your original DOC. Buprenorphine also has a "ceiling effect"...somewhere around 24-32 mg...at which point dosing higher won't get you any higher.

In regards to buprenorphine being used as pain management...well, it is an opiate. I fail to see the difference between using buprenorphine for pain management vs. using other opiates. In many respects, buprenorphine is a better choice for pain management because it has a long half life and requires much lower doses due to its high potency.

In theory, any opioid/opiate could be used for Opioid Replacement Therapy (ORT). Suboxone (buprenorphine + naloxone) and methadone are the only approved drugs for ORT in many countries. The idea being ORT (be it with buprenorphine, methadone, dihydrocodeine, LAAM, or even, in some rare cases, pharmaceutical grade heroin) is that opiate users are going to use opiates no matter what. Replacing their habit with a pharmaceutical grade drug in a medical treatment setting vs. a drug they buy on the street is the goal here.
 
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So8e said:
Well it's mainly used to treat people for opioid dependence. It's a synthetic opioid that binds the the opioid receptor and blocks it, tricking your body to think it's on an opiate. While it is actively blocking the receptor, other opiates taken while Buprenorphine is active are rendered useless, as these chemicals cannot properly bind with the receptor, which is blocked in this case.

I have heard about how some doctors are also prescribing Buprenorphine on a "pain management" basis. I guess some doctors are against traditional opiate treatment?
Click to expand...

Buprenorphine does not render opiates useless, as the analgesic properties of opiate/oids are still effective...it just drastically reduces the euphoric feeling (more-so for people w/ a tolerance)
 
^Also to add one thing to NTs post, they also use Morphine ER for maintenance in other countries. IIRC, predominantly in Europe patients are given the usual methadone/bupre first and if that fails, they try morphine maintenance, and if that fails, a very limited number of folks get approved for heroin maintenance.
 
mydrugbuddy said:
Sorry to be asking such a basic and obvious question - but I cant find an answer to it....What is the basic point of sub/bupre ? I mean what is the advantage of switching to this from whatever opiate a person may have been on before hand ?
Click to expand...

I know the questions been pretty much answered here, but I thought I would chime in as well as I've used both buprenorphine and methadone for maintenance and detox. There are a few advantages that buprenorphine has over other opiates for maintenance:​

  • Long Half Life:Buprenorphine has a half life of 36 hours on average. This allows for once/day dosing and achieving a state of stability (I.e. after 11 days of consistant and continual dosing the patient will have the same amount of opiate in their system at all time. The fact that buprenorphine only requires once a day, or sometimes twice a day administration breaks the habit of consuming a drug multiple times a day to feel okay-basically it gets a person out of the ritualistic behavior that opiate dependency causes.) The longer half life does mean a longer withdrawal period, but it also makes it easier to taper down, and if done properly, the withdrawal can be relatively smooth compared to shorter acting opiate agonists like morphine or oxycodone.

  • High Affinity and Partial Agonism of the Opiate Receptors:Buprenorphine is a partial opiate agonist. This means that past a certain dosage (which seems to differ for some, but its around 4-8mg) the opiate effects (sedation, resperitory depression, euphoria, etc..) will plateau and continued administration is basically only causing more of the drug to accumulate in the users system. This makes buprenorphine less abusable that more conventional opiates, as well as much safer due to its ceiling effect on resperitory depression (NOTE:The only reports of buprenorphine overdoses have been when the deceased either injected subutex/suboxone while intoxicated on another CNS depressant, or administered buprenorphine through any means along with a benzodiazepine. It should also be said that nearly all these cases involved people with little to no opiate tolerance.) Buprenorphine also has a very high affinity to our opiate receptors, and like NHT said, at high enough dosages (usually above 3mg), it will block other opiate agonists (and render commonly used antagonists-Naloxone & Naltrexone- useless at normal dosages). Basically buprenorphine attaches to the receptor like super glue, and when you try to get high by say, injecting heroin, the smack will not be able to attach to the receptor as it is already being agonized (partially) by the suboxone/subutex. In this way, buprenorphine acts similarly to opiate antagonists, but it also makes the drug risky in the rare case that one does overdose on it, as common antagonists such as Naloxone nor Naltrexone will not be effective unless administered at much higher than normal doses. And just in case you're wondering about what opiate has a higher binding affinity, there are none that are widely available by either prescription (not even fentanyl) or the black market. Some fentanyl analogues like sufentanyl or another Bentley compound like etorphine.
 
alleycat4714 said:
I was wondering if anyone who's on Suboxone and relapsed has told their doctors?
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I have, he's also caught me with a drug test at least once. He basically told me that he would only kick someone out if they seemed like they had just completely given up on getting clean or if they kept lying over and over about being clean.
It probably depends on your doctor (mine's super sweet) but any dr who know anything about addiction, should understand you're going to relapse and they would probably appreciate you being up front about it.
 
I never had more than 5 months clean on suboxone over the two and a half long period that I was prescribed it. My doctor never once mentioned kicking me off.

I've heard some are not so nice.
 
Is it possible for suboxone to get less effective without your tolerance to opiates going up?
I've been on subs for two years and probably done dope at least once a month that whole time. I was on 16 mg a day and am now down to 8. I used to be able to do dope for a day or two and get back on the subs with almost no problem, but now i go through two days where i'm more or less out of commission, although it's way better than cold turkey would be.
This summer i ended up doing dope for almost 2 months straight and when i tried to get back on the subs, I was absolutely in hell, I took at least 32 mg the first day, and I hardly felt any better, on the third day I started to feel better so I know it's better than cold turkey would have been, but it was hell. The thing is, I wasn't doing a whole lot more dope than I was when I first got on subs (shooting like a bun a day), and when i first got on them they worked like a charm
 
That's been my experience, as well as many others..

I just think your body starts to get worn out from switching back and forth, perhaps the fact that its so used to constant levels of an opiate has something to do with it. After a 6+months on subs I noticed a diminished effect from all opiates to be honest, even when I'd taper down to a dose more than low enough to break through (.5mg). I'm sure there is a more scientific explanation for it though.
 
^ the thing is i have no problem getting high from dope, if anything my tolerance is gone down since i lowered my sub dose
 
tricomb said:
^Also to add one thing to NTs post, they also use Morphine ER for maintenance in other countries. IIRC, predominantly in Europe patients are given the usual methadone/bupre first and if that fails, they try morphine maintenance, and if that fails, a very limited number of folks get approved for heroin maintenance.
Click to expand...

Wow. Sounds a bit like how it was in the 1970s. According to Keith Richards' autobiography, all the heroin users used to be given pure heroin and cocaine (to keep them functional) on the NHS, for a while, until that policy was stopped. I didnt know you could still get it. Sounds like you would have to go to hell and back in order to get it though.

Also thanks to NT and ZN for providing additional interesting info.
 
I believe that treatment is really limited and only in a few European countries like Poland. I know that Canada ran its first trial of Diacetylmorphine (heroin) maintenance this year with some success, and it is still available (though limited) in the UK.

I think in Amsterdam they also tried out Palfium (a highly potent short acting opiate) for a while as a possible maintenance therapy.
 
Does alcohol increase suboxone? Just asking bc my bf ALWAYS has to have like 4 beers/day. Its not like he gets drunk but buzzed just enough to be an asshole. Really he has 1-2 Steele Reserves but idk if everyone knows what that is so its about 3-4 beers. Asking bc im on done & HATE alcohol. Just wondering if its different for subs.
 
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