Bupe, upcoming surgery, surgeon wants to ween me then use Talwin
Any opioid dependant or addicted person can take Pentazocine (Talwin), provided they wait until the full agonist they are dependant or addicted to is more or less out of their system, and are experiencing mild to moderate withdrawal symptoms.
With long half-life full agonists like Methadone, you have to wait 3 - 5 full days without any Methadone before you can safely take a partial-agonist. Taking Methadone everyday results in a buildup; if a non-dependant person were to take a single dose of Methadone, they wouldn't pass a UA for 3 or 4 days. An MMT patient would have to go 6 - 9 days without a dose of Methadone to pass a UA.
This is why it is standard procedure to taper MMT patients down to at least 30mg (or ideally less) a day, then having them go 3 days without a dose, before transferring them to Buprenorphine.
Sorry to resurrect this, but it is highly relevant for me. In 2 months I will have surgery, the doctor told me since i'm on suboxone, she will have my sub clinic drop my dose very fast in about 2 weeks, i'm at 12 mg, i'm already asking to be dropped to 10 next month and then she'll have me drop 2mg per week and i'll have to endure 5 days without anything then have surgery. Am I going to feel the Talwin's painkilling effect ? Or will I have to shoot them ? (In Canada Talwin is just Talwin, not Talwin NX, there is no Naloxone in them, and only one dosage exists, 50mg). She told me I would have to take 4 or 5 of the Talwins everyday. She uses Talwin on people who are on suboxone but necessitate surgery, does that make sense? Also, Talwin is not a partial agonist like bupe, it's a pure agonist with slight weaker antagonist effects with some Demerol-like (and probably Levo-Dromoran...man I'd love to have the 2mg pills of that stuff, it's still here) hallucinations because it's also an NDMA antagonist (btw, why doesn't methadone cause anything funky to happen?).
I'm asking this because I think bupe even if a partial agonist, taken long term like I am doing, it's been what, since august 2013 that I'm on bupe, never raised my dose of 12mg, it takes care of everything with my benzos (another point for letting people take their benzos while on suboxone, even the booklet doesn't say to stop them, it says dose reduction, to consider). The benzos make the methadone (before the suboxone) and now the suboxone mean I need less opiates (never went higher than 60mg of methadone on my meager 20mg of valium a day). Will something with mild antagonist effects, even if it's strong in the agonist department work well on somebody like me? The reports I read on how opiate receptors of people who take sub at high doses (although 12mg isn't that much when I think of all the people at the clinic who tell me they are on retarded doses of 20mg+..sorry, that's my final decision on this, like people on more than 100mg of methadone...unless they are people who were on bupe and went back to methadone because the root of it all is pain issues and then noticed how bupe raised their tolerance even more than methadone ever did).
Because, listen (please don't do this), when I was on 45 to 60mg of methadone, I have shot some Dilaudid 4mg pills, since the high is so short and it's all for the rush, I was surprised to feel them and I was glad. I managed to put my hands on a huge jar of 4mg Dilaudid (100+ pills) for almost free while on my suboxone treatment and I stupidly out of boredom tried to shoot some after not taking bupe for 24 hours, shooting up to 20mg of dilaudid barely caused a rush, then I got major respiratory depression, pulled my Symbicort inhaler and used it like crazy, it was the first time ever I felt this dreaded respiratory depression, and I felt it while completely awake! I looked at a graph about how bupe doses "pile up" on each other according to time, and I don't know if 5 days without any bupe will be enough to feel the Talwin, while I'll be in serious pain. I asked her if anything else was in option, and she said "I'd be really surprised" with a smirk. But hell, if the pain is crazy from a surgery...what is the equivalence of 50mg (1 pill) of Talwin(pentazocine) to say oxycodone orally. We got generic oxycontin here, if I can get at least 60 reds I know I'll be fine, it's the only thing that saved my ass when I lost my box of suboxone one time after just 2 days (we get it weekly like methadone in canada), so after calling everyone i know I managed to find APO-Oxycodone CR 60mg (Apotex generic oxycontin) and I slept all day after 4 days of nothing.
Any insight from someone who's knowledgeable regarding opiates (more than me)
help out please