• Select Your Topic Then Scroll Down
    Alcohol Bupe Benzos
    Cocaine Heroin Opioids
    RCs Stimulants Misc
    Harm Reduction All Topics Gabapentinoids
    Tired of your habit? Struggling to cope?
    Want to regain control or get sober?
    Visit our Recovery Support Forums

Bupe Subutex vs Nucynta for Pain Management

Stacianica

Bluelighter
Joined
Sep 30, 2011
Messages
56
Wondering what people's experience and wisdom might be with be regarding bupenorphine vs tampentanol. I've just been taken off Nucynta 50's and given Subutex 8 mg for chronic nerve and back pain. Years ago I've taken bupe, but after being on Nucynta for three years, cut off, placed on hydrocodone to stave off WDs, I'm wondering how it will compare seeing that I have more tolerance now. Will bupe put me into precip. Wds if I dose too soon? How soon, looking for perimeters, guidelines, fyis, experience and wisdom. Thanks!
 
I couldn't find the exact potency, but I've read numerous reports on peoples experience with the drug, and it seems that 100mg of tapentadol is more or less equal to about 10mg of oxycodone.

I would honestly imagine that for the first two days, you are going to get really loaded off of the buprenorphine, as it's much stronger mg for mg. The only problem is that buprenorphine is a partial agonist, and therefore it's analgesic efficacy will plateau at a certain point, and increasing the dosage will do nothing but build up more buprenorphine and keep withdrawals at bay for longer. I'm not a pain patient, but I have a lot of experience with bupe and opiates, and IMO buprenorphine's value as a painkiller is pretty limited. The best way to make it work is to stay on a very low dosage (<1mg). For more info on bupe, check out the Bupe Megathread.
 
Thanks, ZNeg! So far, I'm not digging it. I checked out. The bupe thread a little (I'll do some more checking in a bit). I only tried about 1/16th of an 8mg and I'm really thinking of dosing again. I'm only about 45 minutes into it, drank 2 mugs of grapefruit juice and feeling like I've ripped myself off. I feel the pain, zero euphoria and a sense of general aggravation so far. could it be because I dosed hydrocodone only four hours ago?
 
You could be experiencing mild precipitated withdrawals. A common misconception (sometimes spun by medical professionals even) is that the naloxone in suboxone is what causes precipitated withdrawal when taken too soon after the last full dosage of a full agonist opiate. While naloxone certainly can cause precipitated withdrawals by itself, when in combination with buprenorphine, it is actually the bupe causing this, as buprenorphine has a much higher affinity to our opiate receptors than naloxone does. Basically, naloxone is an inactive ingredient that R&B use as a scare tactic to try and deter abuse, and IMO to keep their patent on this formula of buprenorphine now that subutex has become a generic medication.

So basically buprenorphine, being a partial agonist, can act like an antagonist if taken too soon in an opiate Dependant person. Like naloxone, naltrexone or any other antagonist, it rips the full agonist off of the receptor sites causing a very violent onset of withdrawal. However, these symptoms do subside as the buprenorphine begins to fill the receptors which had previously been occupied by the full agonist.

It is often recomended that someone transitioning from a full agonist to bupe wait at least 24 hours, or until they are in moderate to sever withdrawal. Seeing as you took hydrocodone only four hours prior to the buprenorphine, it is possible that you are experiencing what sounds like a mild case of precipitated withdrawal. For this reason I would suggest trying to wait it out a little longer. Bupe, like methadone can take quite a while to kick in. Taking more subutex may help, but by the time the additional dose kicks in, I'd imagine you'd already be feeling the effects from the .5 mg you took.

All that being said, you do have a tolerance to opiates, and it's possible that you will need more than .5mg of subutex to feel relief. You may want to start off with a slightly higher dosage, say 2 mg, and then gradually taper down from there. The good thing about buprenorphine is that it's relatively easy to lower your dose as long as you do it gradually.

ONE MORE EDIT//

Just to expand on what I said in my first post.

Buprenorphine definately is used in pain, and (like I said above) it is offten in such instances used in much lower dosages than when it's used for replacement therapy. The reasons for this are mostly due to the fact that bupe has a cieling effect, and at lower dosages, their is more of a spike each time it is taken than when the daily dose is above the point where analgesic effects plateau (due to the fact that once you're significantly above this point, you feel no withdrawal symptoms until enough time has passes and enough of the drug has been eliminated that it dips below this cieling. Basically, at these dosages, the receptors are saturated, creating a sense of normality for people who took opiates recreationally. This is a problem for pain patients though, because no only will taking more buprenorphine be ineffective, but it will also block the effects of other opiates.)
 
Last edited:
Thanks ZNegative, you've put into elegant and clinical empathetic words exactly what I was genuinely concerned about. Luckily, I chained smoked a few cigarettes and...get this, Forgot to redose! Forgot! What?! Who does that?! Not me! Not Anyone! By the time I realize this, I'm happily feeling the fuzzy bliss that I was hoping for. Additionally, my pain isnt too bad. Not as relieved as with the Nucynta, but with that opiate bliss we all know and love, I didn't care too much about what usually has me completely distracted and in utter agony. Thanks for kind of walking through it with me!
 
All in all, thus far...I think the bupe is successful for right now as far as helping my trigeminal neuralgia and effed up spine. It's helped me feel kind of nice, tolerate pain so that I was functioning on the level that I was able to clean the kitchen and even vacuum! Yeah, for the first time since my accident, I'm not only chipper, but doing normal people things like keeping a tidier home. I don't want to fool myself here, because I naturally expect an axe to fall at any minute, but I'm going to enjoy this for as long as it stays. My rational side tells me that, tolerance will build quickly and this will be short lived. Anyone have any insight as to how quickly Subutex tolerance builds when taken appropriately, well less than appropriately and for use in pain treatment vs weaning and/dependency issues? Anyone?
 
Top