Bupe Suboxone or not?

[cornflakes]

Hi guys, I've been addicted to codeine for about 10 years now. Currently I am restricted in being able to obtain it, and can only buy a packet of 40 over the counter codeine/paracetamol just once a week. I'll take 20 tablets in one hit, and 20 the next day. That's 200mg of codeine, and a whopping 10 grams of paracetamol each time. Not good. I went to a drug and alcohol place today and they immediately suggested suboxone. What I want to know is, would I be trading one (fairly minor) addiction for something worse? Can anyone advise me on this?

 

[Zerwas]

That depends on the Sub Dose you would take. With 200mg of Codeine a day (which equals about 20mg of Morphine) you should only need 0,5-1mg of Buprenorphine max.
The problematic factors are that Bupre is generally much more potent and a partial agonist. You would have to wait ~48h after your last Codeine dose before you can take the Suboxone or you risk precipitated withdrawals.
Another factor is the long half-life of Bupre. If you don't want to taper off fast and stop the opioids it could lead to a potentially worse addiction but in my opinion 10g of Paracetamol are much more unhealthy to take regularly.

The thing is that if you take the Suboxone for longer it is pretty hard to come off. Some people can taper it very well when they stop and others struggle a lot so better get more information.
And definitely do not let someone put you on 8mg of Suboxone. That is massive overkill and will result in a worse addiction. 1mg (equals about 30-40mg Morphine) should be more than enough!

Good luck!

Z

 

[Prescottdave]

After being addicted to poppy pods for 7 years I took a trip to New Zealand. Before I left I tapered down somewhat getting ready to try and go cold turkey during the trip. Well that did not work. On the trip I located a number of boxes of 15mg OTC codeine tabs. Instead of doing a CWE for doses above 60 mg I just took 15-30 mg per day. I was able to comfortable maintain this way for a number of months. Years later I got on Suboxone and quickly ramped my dose up way above the ceiling dose of codeine. Moral of the story. If you find yourself using large doses of codeine whats to stop you from getting on 16 mg of Suboxone each day for 1-20 years.

In the end you risk a serious dependence to an even more physically addictive narcotic which can be hellish to taper off of. Try and taper your codeine dose before going on opiate replacement therapy. It will be much easier then tapering the Suboxone. The doses you require at the moment are in the microgram range and you will have to employ a liquid dosing technique or else you risk raising your tolerance.

 

[keeping]

You would have to wait ~48h after your last Codeine dose before you can take the Suboxone or you risk precipitated withdrawals.

do you really have to wait that long to start suboxone? i'm on subutex (and i know the difference) and i only have to wait six hours after my last narcotic, or 24 hours after my last dose of methadone.

 

[chelle216]

I'd give ---XYZ---to trade places with you. I think I'm speaking for a number of people in saying that. Maybe not the acetaminophen part, but seriously, try to taper off of what you've got. Withdrawal-acute- all too often seems harder than it is, but you'd only be trading what you're working with for a potentially worse addiction, and more mentally unnerving withdrawal. Unless you were to go inpatient, it's unlikely that a sub Doctor isn't going to allow you to stay on indefinitely so long as you can meet the costs; no one wants to leave something that makes them feel well.

Why not try reducing your dose? You've got access to 40 pills, maybe go 15,10,10,5? Withdrawal is withdrawal is withdrawal and it's not going to be easy, but it can be made manageable.

 

[Kittycat5]

Are you planning a quickish taper or maintainence? For staying on it for awhile (the latter), I have no issue. But, and I know my fellow pillpoppers and junkies are going to yell, I would rather cold turkey than short taper ever again. Thing is, it works fucking great. Even at low doses, I felt as good, if not better than my rather high dose oxy habit. But within 24 hours of stopping Suboxone, I felt emotionally dark as I ever felt in my life. I would have blamed straight withdrawal but I also CT'd an even bigger habit about 4 years before this and never felt as depressed as when I came off Subs. Knowing the pharmacology of bupe, it makes sense, but still didnt expect it.

 

[Jabberwocky]

If it wasn't my need of opiates to function and move normally I woulda stayed away from methadone when I quit an oxy habit of 100-200mg a day. The detox was hell and instead of the circle of running out/dope sick/pain I went for a long acting opiate.
if you plan to quit and don't need them to function(disease) i would just take the week of sickness and run. My condition is killing me so methadone addiction is my last worry. If you don't need it I would just taper and stop

 

[cornflakes]

Thanks for the replies. If I was being honest I'd say it was more of a psychological addiction to the codeine - I am only able to access 40 tablets a week which I eat in 2 days, leaving the next 5 days with nothing (before my access was restricted I'd take 20 every day, but I haven't been able to do that for about a year). So in reality, I'm not taking much. The thing is though, I'm in a really bad place emotionally and mentally, and I crave codeine for its relaxation effects (I'm self medicating - I don't drink or smoke). When I dont have it I constantly think about it. I am anxious and shitty ALL THE TIME. And because of my addiction problems my GP will NOT prescribe anything for my anxiety. Prick.

So would suboxone be overkill for such a small habit? Or might it help level me out and get rid of these constant cravings?

Also, what is it like being on suboxone? Will I be able to relax on it?

 

[WARDMAN3]

That amount of acetimonphen is so bad for you, as you already know. I had a 200 mg oxycodone habit for the better part of 10 years. I went the sub route 3x before I finally did it again in May.. I NEVER needed more than 8mgs to stablize, and that was only for 3 days... Right now I am on 2-3 mgs a day and my goal has always been to slowly taper off it.. So you need to weigh all your options but you must stop either way due to the amount. Take others advice as well to the amount of sub you take.. You should never need more than 8mgs and that should only be for a few days before you taper down.

 

[Prescottdave]

8 mg sub would be way overkill. Take a look at an opiate equivalency chart. Actually take a look at the Belbuca opiate conversion chart. Given your dose of 200mg codeine about 0.5-1 mg of SL bupe should be equivalent. Your potential sub doc should be prescribing you the 2mg tabs. You will likely actually feel more sedative effects from keeping your dose well below 2 mg. Just something to think about. Then when it comes time to taper off the sub it will be much smoother or if you stay on it for life you will be less likely to get bad side effects. Ow ya and i still felt anxious and shitty on 8mg of sub. Even suboxone has those shitty side effcts that many other opiates have.

 

[Prescottdave]

Why are you not doing a CWE on the codeine tabs? For gods sake man. Most people would die in a couple of weeks from taking 10 grams of APAP each day. CWE is easy. Just crush tabs put in a cup with cold water and stir it. Then place in freezer. Come back in an hour. Strain off 90 percent of the liquid and leave the APAP at the bottom. Filter the resulting cold water through a coffee filter. No more APAP problems.

 

[Prescottdave]

do you really have to wait that long to start suboxone? i'm on subutex (and i know the difference) and i only have to wait six hours after my last narcotic, or 24 hours after my last dose of methadone.

In most cases yes especially if the addiction has been going on for over a decade. Now if a person has a low tolerance and has only been using for a couple of years they may be able to switch over much sooner. I now always wait at least 24 hours given the possibility of PWD. I waited 72 hours one time after getting off 30 mg of methadone and I still went into mild PWD.

 

[cornflakes]

Why are you not doing a CWE on the codeine tabs? For gods sake man. Most people would die in a couple of weeks from taking 10 grams of APAP each day. CWE is easy. Just crush tabs put in a cup with cold water and stir it. Then place in freezer. Come back in an hour. Strain off 90 percent of the liquid and leave the APAP at the bottom. Filter the resulting cold water through a coffee filter. No more APAP problems.

I have tried CWE, but I was never certain I was getting all the codeine out. It just seemed easier to eat them whole. I don't know why but my liver just keeps on ticking over whatever I do to it.

I'm seeing the drug people in about an hour and I'm still not certain about what I should do. I feel like suboxone would be trading a minor addiction for something bigger. But on the other hand, I'm basically poisoning myself on a regular basis, all for a short-lived, relatively mild hit. And then hanging out for a week. It's no way to live.

If people are interested I'll let you know how I go.

 

[cornflakes]

...Then when it comes time to taper off the sub it will be much smoother or if you stay on it for life...

Can suboxone be something that you stay on for years at a time? Even a lifetime?

 

[WARDMAN3]

Many people do stay on it...Depends on one's circumstances.. It does haves some very good pros, along with its cons. For me, it has stablized my thinking and totally freed me of that horrid pill counting and always planning that I do not run out.. I have been working more and steady since I went back on it in May ( same job for 17 years). I do not get any kind of high from the 1mg dose I take 2-3 times a day.

Someone else asked about having to wait long before taking it after an opiate. I experienced my first precipitated withdrawals in May from taking it too soon and it was a scary scary feeling. I had always been able to switch 6-8 hours after my last opiate.... Well, not this time!

 

[SKR]

My transition was seamless from up to 500mgs of oxycodone daily to 6mg Suboxone. I was told just to wait 24hrs since my last dose of oxy then was given 2mgs Sub, observed me for 30mins then got the go ahead to have another 4mgs......6mgs easily held that habit despite me increasing to 32mgs for a while in an attempt to control my pain but now I'm back down to 15mgs and falling.

It's a great mood stabilizer especially when you've come from the ups and downs of shorter acting opioids.

 

[Opiatehell85]

Hey, I was addicted to codeine and was put on subutex, but my dosages were so much higher than 200mg. 1200mg a day at my worst. Would never look back now, subutex has saved my life. Private message me if you need advice, much love x

 

[Opiatehell85]

When you say u take the 40 tabs in two days, what do u do for the rest of the week? As if you're able to go five days without codeine then I wouldn't suggest you needed suboxone.

 

[cornflakes]

When you say u take the 40 tabs in two days, what do u do for the rest of the week? As if you're able to go five days without codeine then I wouldn't suggest you needed suboxone.

Yeah see, that's the thing. I can 'survive' those five days without, but there's constant cravings, all made worse by simultaneous anxiety. All I can think about is when I'm getting my next fix and how it will make me feel a little better for a little while.

Edit to add; I simply *have* to go without for five days at a time because I am seriously restricted in my ability to obtain codeine. If I was able I would take codeine every day. So basically I'm going through a mini withdrawal every week.

 

[cornflakes]

It's a great mood stabilizer especially when you've come from the ups and downs of shorter acting opioids.

That's what I'm hoping for. Considering my regular but minimal use (400mg codeine over 2 days and nothing else for five), do you think I would benefit from suboxone?