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Buprenorphine dosing for tapering to butrans for pain?

Architeuthis Dux

Greenlighter
Joined
Mar 3, 2016
Messages
5
I am not sure where this post belongs I am new to BlueLight but i didn't think it belonged in basic drug discussion.

I will do this in separate Paragraphs/sections. 1'st being my alcohol solution method and reason for using it the second is my question for further tapering. I have asked my doctor but he is not very reliable on the pharmacokinetics of buprenorphine i am looking for someone who is. Sorry if I am a little hard to follow in some of this but it it is late/early here. I can site studies for my Facts and conclusions on things if anyone would like them. I am looking for help though in tapering further so I can eventually switch to Butrans or Buprenex. My Pain doctor and I have been trying to work our way toward that I do have real pain issues that are life long and buprenorphine works better for pain at those lower doses.


So first my alcohol solution. The technique for making and reason for doing it. This may be helpful to others.
This first started out as me trying save money by increasing the B.A (Bio Availability, ability of drug to be absorbed, in case this thread is of use to others). Later this helped in trying to taper my Buprenorphine/Subutex dose. My Problem was while tapering getting a correct dose. Not a problem at higher doses but lower doses it is. The pills are not scored and I am not sure about the drugs conformity throughout the pill and the 2 mg are more expensive. People on other threads have talked about increasing the B.A. using alcohol so like them I started by just adding a small amount of alcohol to my mouth like many people but found that this causes me to salivate horrendously and since B.A. is based on a contact gradient (The amount of drug coming into contact with your mucous membrane in this case.) not good. Higher proof alcohol is actually not better because of this salivation problem. I have found 30%/40% best and has been used in studies on B.A. of Buprenorphine. I prefer 30% Not a huge saliva increase but definitively increases B.A. So in the past i made a solution from my generic Subutex (Buprenorphine). Like Captain.Heroin's thread on micron filtering i did the same thing only instead of only water i used alcohol as well. I tried vodka alone but the alcohol caused the pills to dissolve strangely in the mixture taking forever to get the inactives to fall to the bottom (they never fully separate like water) causing clogging problems even with a lot of cotton in a 10ml syringe I micron filter as well to get as clean a solution as possible. So i started doing a CWE basically same as one would do for I.V. only trying to get as high mg/ml as possible aiming for 16 mg per Ml so i could a good contact gradient (less fluid=higher gradient=higher absorption) . Knowing that Buprenorphine Hcl is soluble in water to only 17mg/ml in perfect conditions getting higher mg/ml requires alcohol where as the solubility in perfect circumstances is 42 mg/ml. when you get to lower doses not a concern but depending on the pill things like mannitol or other water suluble inactives can affect Buprenorphine solubility. I do this by back-loading pills a few at a time into a syringe with cotton at the bottom and then dissolving in R.O. filtered (Reverse osmosis) water. Because the corn starch absorbs a lot of water a few pills at a time is necessary then lots of pressure to compact corn starch and cotton and get as much water as possible out. this is before micron filtering. Save each leftover pill crumbles and start with extra water do to some loss then using same solution till fully saturated with buprenorphine to 16mg/ml or lower) Save the leftover pill disc (it will be a disc if you use enough pressure) from above cotton. you will need it. After i was done with the water I ran Everclear 151 proof (highest allowed in my state i no longer have access to 95% ethanol) through the same syringe i had used for water using the pill leftovers (The discs) letting them redissolve to make sure that i got all the Buprenorphine from them. Then a last pass with a little more alcohol to be sure then mix alcohol and water, micron filter and store in a 10 ml vial. Its a lot of work but worth the effort I have a lot of time on my hands being disabled. So, i would have 20, 8 mg pills in 6 ml of water and 4ml of alcohol or a 30% or so alcohol solution. I got my dose low enough that i only needed 4mg/ml. (The lower the ml/mg the easier it is) Taking a .5 ml dose 2 times a day. Now i am lower than that.

Now my question?
I know at lower doses less than 2 mg sublingual the half life of buprenorphine becomes shortened do to the increased B.A. of my alcohol solution i have just started running into that problem. i was wondering if anyone has experience with this and can help me out with personal knowledge or point me to studies i cant find or access. I know it will involve some experimentation on my part do to B.A. of alcohol solution and my own metabolism and tolerance but any help would be greatly appreciated. If i have to jump to butrans and deal with som W.D.'s it may be so. But I am hoping to get further down on my dosage. Unless others made the switch and can tell me it worked. My pain is only going to get worse with time and i want to avoid going back to full agonists. i already get nerve blocks and other treatment but this is my main focus right now. Getting to butrans or finding a doseage regime that will work effectivly. I have to deal with a lot of pain. Especially as young as i am and know going backwards is not living.

Thank you for your time and consideration, Dux

P.S. I hope i have posted properly, respectfully and do believe this is in the interest of Harm Reduction and Better Quality of Life. I dread going back to full agonists I have my demons there like many others andwould hate to fall back into old habits.
 
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Now my question?
I know at lower doses less than 2 mg sublingual the half life of buprenorphine becomes shortened do to the increased B.A. of my alcohol solution i have just started running into that problem. i was wondering if anyone has experience with this and can help me out with personal knowledge or point me to studies i cant find or access. I know it will involve some experimentation on my part do to B.A. of alcohol solution and my own metabolism and tolerance but any help would be greatly appreciated. If i have to jump to butrans and deal with som W.D.'s it may be so. But I am hoping to get further down on my dosage. Unless others made the switch and can tell me it worked. My pain is only going to get worse with time and i want to avoid going back to full agonists. i already get nerve blocks and other treatment but this is my main focus right now. Getting to butrans or finding a doseage regime that will work effectivly. I have to deal with a lot of pain. Especially as young as i am and know going backwards is not living.

Thank you for your time and consideration, Dux

P.S. I hope i have posted properly, respectfully and do believe this is in the interest of Harm Reduction and Better Quality of Life. I dread going back to full agonists I have my demons there like many others andwould hate to fall back into old habits.[/QUOTE]

Not sure if I can help, however I am 6'4 with a very fast metabolism. I was smoking tar for about a year and just recently quit. I went through hell for a few days (taking 8mgs one day and 4mg the rest of the week of subs)

On about day 10 I had tapered down to about 2mgs, I am on day 27 and I tapered down to about .13 mgs (been on the dosage a couple days)

I just quit suboxone 2 days ago and I feel OK. still chills and my body weighs a ton...

When I was on 2mg or less I did notice that the beup only lasted about 5-7 hours at most before I started feeling chills and shivers... PAWS? or Sub withdrawals?

suboxone doctor gave me clonidine, buspirone and zanaflex for night. Not sure what to ask for on monday if symptoms become worse.

I am in this with you. We will beat this! It's just a bump in the road.
 
Thanks for the encouragement. Im 6'4" 285 lbs with a raging metabolism started on Subutex 2 years ago at 24mg and before that 240mg of methadone for over 4 years. I used that to come off 240mg of morphine with 90 mg roxi's for breakthrough at my highest point 4 years to get that high of a dose that stopped being a useful pain management regiment. I have been on painkillers since age 15 in some form or other. I have had fibromyalgia since i was young. I have destroyed my body through extreme sports and 2 very bad car crashes. Have severe nerve damage, no cartilage in my knees or hips, need a shoulder replacement, have broken over 100 bones and had over 900 stitches that was all before 25. I dont think my body naturally makes its own painkillers any more. I'm hoping to try an get down to Micro gram doses of Bupe. The lower my dose has gotten the better my pain. I'm only 32 but use a walker on good days and a wheelchair on bad ones. I cant quit subs without switching to something. Tried it with methadone and full agonists before it. The pain is too much i can deal with PAWS I deal with severe pain every day. I just want to be able to get out of bed. That's why i came off full agonists. Wanting to be able to have a life of some kind not just nodding all day.. My first doctors told me i would be in a wheelchair for life i proved them wrong. They almost had to amputate my left leg at one point. I keep kickin on though 1 day at a time Just trying to see if anyone has dealt with transferring high levels of bupe to butrans or buprenex or knows of how to properly. My Pain doctor has never brought someone back down to these low doses. He is researching as well but i like to do my own. Got to use my degrees for something.
 
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I am currently on Butrans 10mcg/hr for pain management and have been for about 6 months. Before that, I've been on a range of opiates/opioids both medicinal and recreational. I have been pleasantly surprised with how well Bupe has been for pain at such a low dose. Although I'm not sure how best to suggest you make that leap from 2mg to the patch (highest dose is 20mcg/hr and I believe you can be prescribed two patches at a time). I've noticed that my pain starts creeping back at about the 5th day, as you wear them for 7, and insurance will not pay for you to get 6 patches a month (every 5 days) instead of 4 (7 days).

Where this post might be helpful to you in making that transition, is figuring out how much of the drug is in your system at a given time given that the transdermal system is pumping Bupe in on an hourly basis for a consistent blood level of the drug. You stated before that Bupe at lower doses has a shorter half-life, which I had not heard before. I tried doing a calculation (I believe I've read Bupe's half-life ranges from 48-72hrs) and with the 10mcg/hr patch I believe I have a consistent level of slightly under a milligram of bupe in my system at all times. However, the shorter half-life at lower doses information changes that considerably.

After typing all this out I see the thread died a few months ago, but hope this helps someone!
 
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