Bupe Using Suboxone like Narcan?

[charmcity.exile]

I thought that Buprenorphine had a long half life. Maybe I'm wrong. Isn't Naloxone the same thing as Narcan? I know I've heard that from different reliable sources... as well as reading about it. I have been given Narcan before, and the feeling I got from shooting Suboxone was for all intents and purposes the same feeling - much milder thank God!

Like I said, I have never gone into precipitated withdrawal from straight buprenorphine/Subutex.

At the clinics they always warn you about the possibility of precipitated withdrawal, but neither myself or others experienced it. Like I said, the only time I've seen that was in the case of people on methadone.

I guess it all has to do with what kind of habit you have. By the time I went to detox, I usually was in the process of minimizing mine. Although I did check into a detox that used Suboxone in Ft. Lauderdale - not my decision- and I was zooooooted that morning. I knew I was going and wasn't all that happy about it. I had to have still been high by the time I was admitted/medicated, but I felt fine afterward.

A guy I used to get random pills from told me that if you swallow Suboxone that the antagonist isn't absorbed into your system. I never cared enough to test his theory.

My question: Does the method of ingestion have any effect on how each of the drugs in Suboxone effect you?

With regards to the dosage of the bupe shots they used to give at the clinics, I believe they were between 10-15mg if my memory serves me correctly. Does that sound right? It was definitely done in multiples of 5. Its been a while...

 

[Tommyboy]

The below quote is from parentalunderground.com It is supposed to be wriiten by a recovering addict in order to make parents aware of warning signs and treatment. However, the author is not a professional as far as I know and does not cite any sources. Also he writes that shooting suboxone leads to withdrawal which has been proven wrong by bluelighters, so take the below info as you want.
"Nalaxone is similar to Naltrexone which is used by hospitals when a user overdoses. Nalaxone and Naltrexone will completely whipe all other opiate completely off the receptor's in the brain. In some cases when a person overdoses on heroin, they can be saved if someone else crushes up a Suboxone, puts it in water, filters it through a cigarette filter, and shoots them up. It is not recommend unless there is no other option".

I just came across this, it was not the reason I started this thread

 

[Captain.Heroin]

Welcome to BL!

Yes, buprenorphine has a long half life, and a fairly long duration. However, effect and half life are two separate things. The drug can have stopped effecting you, but it'll still be in your system for a while longer (hence why you can be sober but still fail a piss test).

Naloxone is the active ingredient of Narcan, yes. Also, naloxone has a shorter half life than buprenorphine. So, if you wanted to use an opiate on top of buprenorphine, you could still do that - it's just smart to wait out the first 2 or 3 hours after you take Suboxone (so that you can enjoy two peaks one after the other). So, while buprenorphine will out compete naloxone for the receptor, the naloxone will also be fully metabolized before the buprenorphine.

If you swallow Suboxone, you only get 10% of the BA of buprenorphine - so it's somewhat wasteful. Naloxone will still get "into your system", but it won't effect you with any ROA.

The ROA will only change the duration of buprenorphine, and the effect is much more pleasurable when IV'd (with a low opiate tolerance).

Wow, multiples of 5mg in shots? That's insane! Each dose I have is 150mcg and I don't go through more than 600-900 mcg in a day (1000 mcg = 1mg).

One final example about the difference between half life and duration: if you IV an OC, the effect is 2 hours or less. If you orally take an OC, the effect is much longer (6 to 8 hours or longer I guess?) - in any condition, oxycodone's half life is the same. It takes just as long for the drug to entirely be metabolized out of your body so you will pass a piss test.

I brought up the difference between duration and half life in another thread, so I hope that made sense.

BTW since I haven't said it yet, welcome to BL charmcity.exile, and thank you for not trolling! I guess I just had a hard time believing clinics were giving out buprenorphine for IV.

"Nalaxone is similar to Naltrexone which is used by hospitals when a user overdoses. Nalaxone and Naltrexone will completely whipe all other opiate completely off the receptor's in the brain. In some cases when a person overdoses on heroin, they can be saved if someone else crushes up a Suboxone, puts it in water, filters it through a cigarette filter, and shoots them up. It is not recommend unless there is no other option."

Naloxone is a shorter acting antagonist, naltrexone a much longer lasting one.

Opiate antagonists will kick opiates off of the receptors - but not all of them. Buprenorphine is one of the opiates which can't be "knocked off" by an antagonist. I'm sure that there are other examples but maybe not?

You never really want to use a cigarette filter to filter an IV solution...that's nasty.

If it's the difference between life and death, and the ambulance isn't going to show up in time, why bother with filtering Suboxone?

Just my 2 cents. I am aware you copied that from a website somewhere.

 

[charmcity.exile]

They definitely gave the bupe shots (intramuscular) in multiples of 5(?). I can only assume that they were in mg. Dosage was based upon your habit. They were reasonably knowledgeable, or should I say surprisingly knowledgeable about what was on the street. As I said, it has been a while, but I can't remember if they took a urine sample there. They did when I finally got on methadone and based my dosage on concentrations in my urine as well as the info I gave during an interview. I stopped my methadone dosage at 80mg, and they told me as long as I peed clean that they wouldn't raise it(!?!).
Anyway, with that said, I told the people at the bupe clinic what and how much I was using, and I'm pretty sure they gave me at least 15 of whatever measurements they were in. They double dosed me because I was unable to come back for my second dose as a result of my work schedule. I think they medicated for a minimum of 3 days, but may have extended it if necessary.
Arent the larger Suboxones 8mg? Outside of oxy/roxy I am not that versed in the specifics of the pill world. Growing up where I did, a $10 bag of dope was probably as strong as a few OC80's (I left NYC in 97) so none of us had any use for pills.
It wasn't until I moved back to Fla a few years ago that I ever even saw OCs et al.
Now, the whole tri-county area (P.Beach/Broward/Dade) is flooded with pills thanks to the trillions of pain clinics. (Even Rush "send the drug addicts out to sea" Limbaugh has fallen prey to the madness LOL).

And thanks for the welcome Captian. Sorry, I neglected to include that when I posted this.

 

[Captain.Heroin]

They definitely gave the bupe shots (intramuscular) in multiples of 5(?). I can only assume that they were in mg. Dosage was based upon your habit. They were reasonably knowledgeable, or should I say surprisingly knowledgeable about what was on the street. As I said, it has been a while, but I can't remember if they took a urine sample there. They did when I finally got on methadone and based my dosage on concentrations in my urine as well as the info I gave during an interview. I stopped my methadone dosage at 80mg, and they told me as long as I peed clean that they wouldn't raise it(!?!).
Anyway, with that said, I told the people at the bupe clinic what and how much I was using, and I'm pretty sure they gave me at least 15 of whatever measurements they were in. I think they double dosed me because I was unable to come back for my second dose as a result of my work schedule.
Arent the larger Suboxones 8mg? Outside of oxy/roxy I am not that versed in the specifics of the pill world. Growing up where I did, a $10 bag of dope was probably as strong as a few OC80's (I left NYC in 97) so none of us had any use for pills.
It wasn't until I moved back to Fla a few years ago that I ever even saw OCs et al.
Now, the whole tri-county area (P.Beach/Broward/Dade) is flooded with pills thanks to the trillions of pain clinics. (Even Rush "send the drug addicts out to sea" Limbaugh has fallen prey to the madness LOL).

Hm, I see what you're saying. Subjectively speaking, do you remember how long an IM dose of buprenorphine would last you?

And yes, Suboxone comes in 8mg. That's the larger pill. The smaller one is 2mg. The 8mg Suboxone is one of the most potent opiates available (in terms of active ingredient per pill).

 

[charmcity.exile]

And yes, Suboxone comes in 8mg. That's the larger pill. The smaller one is 2mg

So then 15mg basically translates to 2 pills.
Here's another question for you (as I pay the price for that midnight espresso): Why include Naloxone at all in Suboxone?
For at least a half decade, Subutex/Bupe seemed to be working effectively. Why the addition?
Based upon what you've stated in previous posts, I can't see the pharmaceutical company's logic in doing this.
Conversely, based upon what I have heard/experienced previously, the buprenorphine alone isn't the one way ticket to WD. Then again, it is also entirely possible that the dosages of Subutex I have had were much lower dosages than Suboxones ended up becoming.
Most of the articles I have read regarding buprenorphine in any form were either in The Baltimore Sun, or The City Paper (also Baltimore), both of which are Pulitzer Prize winning papers, and I would venture to say that my reading comprehension isn't too shabby. Although I can't pull the dates of the articles out of my ass, I do somehow seem to remember reading that the naltrexone was added to prevent recreational use of Suboxone.
So what is the story?

 

[Captain.Heroin]

So then 15mg basically translates to 2 pills.
Here's another question for you (as I pay the price for that midnight espresso): Why include Naloxone at all in Suboxone?
For at least a half decade, Subutex/Bupe seemed to be working effectively. Why the addition?
Based upon what you've stated in previous posts, I can't see the pharmaceutical company's logic in doing this.

They added naloxone into the pills basically to make it seem as an "abuse proof" pill. People who are IV heroin addicts (or other IV opiate users) are the most prone to shoot pills. They decided adding naloxone in it would scare them off - because that's what you would be scared of if you're a heroin user - you know it alleviates opiates on your mu-agonist receptors.

They just expected people not to know that buprenorphine has a higher affinity for the receptor - epecially at a 1mg - 0.25mg proportionment of buprenorphine - naloxone (each shot I take has 37.5mcg naloxone - I am sure 37.5 micrograms of naloxone is not enough to alleviate heroin overdose, and is impossible to remove buprenorphine) - plus, even if you IV'd a large amount, you're only getting 2mg max by shooting a whole 8mg pill (which is entirely too much for IV purposes).

It helped the FDA pass their products for the specific use of opiate withdrawal, buprenorphine had been around a while and was likely being used off-label for it. However, opening Suboxone/Subutex to the market made it essentially a medication designed for opiate withdrawal (designed to scare off IV users, though not the smart ones).

I hope that made sense.

Does anyone know how much naloxone you administer to a typical heroin/opiate OD?

I do somehow seem to remember reading that the naltrexone was added to prevent recreational use of Suboxone.
So what is the story?

Naltrexone is a different antagonist, naloxone is in Suboxone. It was added for that IDEA but it's actually pointless. It creates a pill which every moron in the FDA believes is to "prevent addicts from IVing their pills" in effect, so they are OK with it being especially prescribed for the purpose of treating opiate addiction/withdrawal. The truth is, many, many, many people world-wide (a lot in europe, but around the world really - look at the case studies thread) shoot Suboxone and Subutex regularly. And none of them would regularly do such a thing if it gave them precipitated WD's. Precipitated WD's, or regular WD's are unpleasant. You wouldn't want to repeat that experience. A rush and a high are pleasant. Hence, that is why people repeat such an experience - not because they are going through precipitated WD.

 

[charmcity.exile]

Naltrexone is a different antagonist, naloxone is in Suboxone

Sorry, I inadvertanly mixed up the two drugs.

 

[Captain.Heroin]

Sorry, I inadvertanly mixed up the two drugs.

It's OK, I just wanted to put the correction there so everyone didn't get confused. People frequently confuse the two.

 

[Cane2theLeft]

Charmcity.exile... I found some evidence backing up with C.H is saying about the buprenorphine causing the precipitated withdrawal.

The link below is from the National Alliance for Advocates of Buprenorphine Treatment (NAABT). The document is in .pdf format so I couldn't copy and past all of the text but below is an excerpt of the relevant information and you can click the link to see the document in its entirety.

More precisely, precipitated withdrawal can occur when an antagonist (or partial-agonist such as Buprenorphine) is administered to a patient who is dependent on full agonist opioids. Due to the high affinity but low intrinsic activity of Buprenorphine at the mu-receptor, the partial-agonist displaces full agonists from the mu-receptors, but activates the mu receptors to a lesser degree than the full agonist which results in a net decrease in agonist effect, thereby precipitating withdrawal. LINK

 

[SteeleyJ]

This is a nifty in theory, but i wouldn't chance a friends life fucking around preparing a suboxone for injection. You should have the ambulance called and be admistering CPR.

Originally Posted by ranunky
The only thing I'd be worried about is if it doesn't wake them up that suboxone has higher affinity that Narcan, so if you ODed them on subs then narcan wont work.

Very good point. In case of buprenorphine overdose my med pharmacholgy book says you give doxapram (a respiratory stimulant) * and breathing support, things we can't do on the street *....which to me means that bupe hasto be the top of the food chain in terms of affinity for antagonists.

 

[morphonorconic]

I have often thought about this idea. I almost started a thread a while back on just this, as I thought it would be an interesting topic if nothing else. Definitely doesn't seem like the best idea, but it does, in theory, seem plausible.

 

[dankstersauce]

Subjectively speaking, do you remember how long an IM dose of buprenorphine would last you?

I had straight IM shots of bupe at a detox 4-5 years ago. They wouldn't tell us the dosage, but they'd shoot us up every morning (IM in the butt cheek) and every night, exactly 12 hours apart. I swore it got me kind of buzzed 15 or so minutes after the shot too. It was one of the better detoxes I've had.

 

[smokeymcpot42088]

Damn it I was gunna bite my tongue, I feel like king of the idiots right now.

Ok so for scientific purposes I have to admit I have seen someone OD on IV H, go cold hardly have a pulse than received a shot of suboxone (ON THE WAY TO THE ER!!!) CPR was continued untill we arrived, by the time we got there the guy was waking up groggily....I think the shot ended up going IM because the shooter reported my driving too bumpy to register. EGH HORRIBLE...glad im on subs.

NOT SAYING THIS WORKS OR YOU SHOULD DO IT....OR EVEN THAT IT NECESSARILY WORKED IN THIS CASE, COULDA BEEN ANYTHING, COULD MAKE IT MUCH WORSE AND KILL SOMEONE

 

[Eight0Eight]

They added naloxone into the pills basically to make it seem as an "abuse proof" pill. People who are IV heroin addicts (or other IV opiate users) are the most prone to shoot pills. They decided adding naloxone in it would scare them off - because that's what you would be scared of if you're a heroin user - you know it alleviates opiates on your mu-agonist receptors.

They also added the Naloxone so they would have a new compound to copyright and market.

 

[sixpartseven]

I have heard people claiming to use suboxone similiar to narcan, in order to prevent overdosing? Has anybody heard of this or done this? My friend always kept a suboxone on him incase of overdose, since it is supposed to induce precip withdrawal. I have read about many bluelighters saying that they wish that they could get narcan (either on the "street" or at a needle exchange, and was wondering if suboxone could be used in the same way. This would allow many people that cannot get narcan to use suboxone the same way. And if this does work, how does it have to be administered (sublingual, IV, IM etc)? Also was wondering if this would apply to the thread about reducing withdrawal time by inducing withdrawal by using narcan.

I've done it. I had to reverse my now ex-girlfriends overdose once with Suboxone. The whole story can be found somewhere in the forum, I have no idea what thread since it's been over 2 years since I posted the story, but it does work.

I did this while in a car, on the way to the hospital while giving CPR, by the way. I would never have relied solely on the Suboxone. In this case, we got extremely lucky that she woke up before we made it to the ER. No one should risk someones life by not calling EMS or taking the person to the hospital.

The only problem is, it doesn't work quick enough. The way I did it was to crush up an entire Suboxone into fine powder and kind of pour it into her mouth, under her tongue (no, it does not need to be IVed to work. Anyone who knows anything about buprenorphine knows that it will cause precipitated withdrawal if other opiates are present no matter how it is administered). It took about 10 minutes to bring her back. If you were to IV it, it would take longer to prepare, but would come on quicker, so it would take about 10 minutes as well, unless you have some secret method to prepping a safe shot of Suboxone in under 10 minutes.

It's not the best method to use to reverse an OD. You are better off calling EMS, but in a pinch or if you're extremely paranoid, it works.

The only thing I'd be worried about is if it doesn't wake them up that suboxone has higher affinity that Narcan, so if you ODed them on subs then narcan wont work.

Overdosing on buprenorphine is next to impossible, unless you have no tolerance. The buprenorphine will kick whatever opiate it is you're overdosing off of, replacing it on the receptors, causing precipitated withdrawal. Please explain to me how precipitated withdrawal will turn into an overdose.

Expecting drug users to be able to use a drug like Narcan on their own seems pretty pointless. Administering suboxone for an opiate OD would be a terrible move, even though it contains a bit of nalaxone, the buprenorphine would simply compound the effects of the on board opiate and likely kill the person.

Buprenorphine would not compound the effects. It would totally negate the effects of the agonist, causing precipitated withdrawal. Buprenorphine also has a low risk of OD since it causes little-to-no respiratory depression. Even still, if buprenorphine OD did occur, and you were able to tell this to the physicians over-seeing whoever it was that ODed, they do have antagonists that will reverse the buprenorphine OD. Nalmefene. It isn't used unless the doctor/nurse/whoever knows it's needed, which in most cases, they do not, since the person ODing is unable to tell them what they ODed in (unconscious).

In theory it would work if you had a prepared shot and someone to give it to you. The problem is how much needs to be administered is anybodies guess. I have heard anecdotal reports of people successfully doing this.

It does not need to be given via IV to cause precipiated withdrawal. How much needs to be administered is not anybodies guess, either. A small amount of buprenorphine (2mg, IV, at the most) would cause precipated withdrawal, except for with someone who uses an outrageous amount of heroin. Also, the amount of naloxone in 2mg of Suboxone would be enough to reverse a moderate OD (again, via IV, it will take more if given sublingually).

Still, as I said, it should never be your first choice for helping someone who has overdosed. Call EMS or take them to the hospital yourself if you must.

 

[Oxymorphone]

I've done it. I had to reverse my now ex-girlfriends overdose once with Suboxone. The whole story can be found somewhere in the forum, I have no idea what thread since it's been over 2 years since I posted the story, but it does work.

I did this while in a car, on the way to the hospital while giving CPR, by the way. I would never have relied solely on the Suboxone. In this case, we got extremely lucky that she woke up before we made it to the ER. No one should risk someones life by not calling EMS or taking the person to the hospital.

The only problem is, it doesn't work quick enough. The way I did it was to crush up an entire Suboxone into fine powder and kind of pour it into her mouth, under her tongue (no, it does not need to be IVed to work. Anyone who knows anything about buprenorphine knows that it will cause precipitated withdrawal if other opiates are present no matter how it is administered). It took about 10 minutes to bring her back. If you were to IV it, it would take longer to prepare, but would come on quicker, so it would take about 10 minutes as well, unless you have some secret method to prepping a safe shot of Suboxone in under 10 minutes.

It's not the best method to use to reverse an OD. You are better off calling EMS, but in a pinch or if you're extremely paranoid, it works.



Overdosing on buprenorphine is next to impossible, unless you have no tolerance. The buprenorphine will kick whatever opiate it is you're overdosing off of, replacing it on the receptors, causing precipitated withdrawal. Please explain to me how precipitated withdrawal will turn into an overdose.



Buprenorphine would not compound the effects. It would totally negate the effects of the agonist, causing precipitated withdrawal. Buprenorphine also has a low risk of OD since it causes little-to-no respiratory depression. Even still, if buprenorphine OD did occur, and you were able to tell this to the physicians over-seeing whoever it was that ODed, they do have antagonists that will reverse the buprenorphine OD. Nalmefene. It isn't used unless the doctor/nurse/whoever knows it's needed, which in most cases, they do not, since the person ODing is unable to tell them what they ODed in (unconscious).



It does not need to be given via IV to cause precipiated withdrawal. How much needs to be administered is not anybodies guess, either. A small amount of buprenorphine (2mg, IV, at the most) would cause precipated withdrawal, except for with someone who uses an outrageous amount of heroin. Also, the amount of naloxone in 2mg of Suboxone would be enough to reverse a moderate OD (again, via IV, it will take more if given sublingually).

Still, as I said, it should never be your first choice for helping someone who has overdosed. Call EMS or take them to the hospital yourself if you must.

Very interesting, as for the "secret method" for quick IV suboxone prep some people here have pre-prepared doses of filtered IV suboxone stored in vials for regular use.

 

[sixpartseven]

^ Wonder who gave them that idea?

 

[Free_Man**]

^ lol

 

[Free_Man**]

i have a question

would NALTREXONE work if it was added to bupe instead of Naloxone ?

and by work i mean stop people from shooting the suboxone... ?