Opioids Guy on Fentanyl, heroin etc injects suboxone and DOESN'T get precipitated WDs!? How!?

[ILikeToEatPeople]

I know a guy who wears Fentanyl patches at literally all times (50mch/h Duragesic brand name). He also occasionally injects heroin and he also has breakthrough medication. I am soooo confused though... sometimes he doesn't have anything available besides the patches he wears but has plenty of suboxone films. Now... here is what's weird. I've seen this guy while having his fentanyl patches on, inject some heroin and take some breakthrough pills and then 4 hours (yes FOUR hours) later he says he's not feeling very high anymore and then INJECTS suboxone films and he DOES NOT go into precepitated withdrawal. I asked him about this and he said that as long as the suboxone dose is big there is nothing to worry about and that he does this all the time. He says he's never been in precipitated withdrawal and that it's a greatly over-exaggerated thing. wtf?

It was my understanding that if you take subs too soon after taking other opioids or while having them in your system (i.e getting high 4 hours previously) that you would go into precipitated withdrawals and be in absolute hell. How in the name of all that is holy is it that this guy can have Fentanyl in his system around the clock, get high on other opioids and then 4 hours later inject some suboxone and be totally fine? What could possibly be going on here? Is he a genetic freak or something? What is the deal? ANY ideas?

For the note, he injects 12mg+ of suboxone films at a time. He doesn't use the pills or whatever, just the strips/films. He dissolves the strips in water, filters with cotton and then injects as you would expect.

Now... just to make it clear I am absolutely sure that this guy is truly taking all the meds/drugs I've mentioned and then the subs. I have literally witnessed this. There is no fake drugs, no weirdness with the RoA, nothing out of the ordinary etc (other than him not going into precipitated withdrawals).

Seriously... what could be going on here? Is he just a lucky genetic mongoloid or what? Is precipitated withdrawals actually exaggerated? Is there just some kind of way to avoid the precipitated withdrawals if you get doses precisely fleshed out? Whhhhhhhhhhhhhhhaaaaaaaaaaaaaaaaaaaaatttt!? I'm confused.

EDIT: Formatting - upon submitting the board put <br> instead of actual new lines (weird)

 

[Ilove2nod]

Well if that is so, then yes, it is very weird indeed! PWD is no joke, its not over-exaggerated and it happens all the time, when people take sub too soon after full agonists.. I really don't see how this is possible! Very weird!!! I have no possible idea how this could happen, unless he has like a fucking light speed metabolism, and the full agonists are out of his system that quickly, but that is very uncommon if so, in fact I don't even know if anyone has that fast of a metabolism, I have never heard of such a thing, so don't take that idea into to much consideration, I just don't see how else something like this could be possible... all I can say is, I would never attempt to do what this guy you speak of is doing! very dangerous, considering PWD, amongst other things...

 

[Amaraline]

Holy God, I would have sworn that such a thing was physically impossible. Literally. Have no idea how this guy can manage that without ill effects.

 

[ILikeToEatPeople]

Well if that is so, then yes, it is very weird indeed! PWD is no joke, its not over-exaggerated and it happens all the time, when people take sub too soon after full agonists.. I really don't see how this is possible! Very weird!!! I have no possible idea how this could happen, unless he has like a fucking light speed metabolism, and the full agonists are out of his system that quickly, but that is very uncommon if so, in fact I don't even know if anyone has that fast of a metabolism, I have never heard of such a thing, so don't take that idea into to much consideration, I just don't see how else something like this could be possible... all I can say is, I would never attempt to do what this guy you speak of is doing! very dangerous, considering PWD, amongst other things...

My thoughts exactly. However, as far as metabolism goes I've known this guy for quite some time and before he started using opioids (or anything for that matter) about 10 years ago while he was in college he did distance running and ate 6 meals a day. So basically he does have a fast metabolism but I really don't see how that could metabolize and excrete opioids in 4 hours especially WHILE he has a fentanyl ON his body. I mean, it's just so weird I can't wrap my mind around it.

I've seen him use 24mg of suboxone at a time so is it possible that at that big of a dose that the receptors that the full agonists that are in and get pushed out are so flooded by the buperenorphine that it simply prevents the precipitated withdrawals!?

I'm just trying to come with a theory about this. Anything that MIGHT be possible haha. It's just so damn weird and I wish I could do what he does lol.

 

[ILikeToEatPeople]

Holy God, I would have sworn that such a thing was physically impossible. Literally. Have no idea how this guy can manage that without ill effects.

The only theory I can really think of that might be possible is that at LARGE dose of subs the receptors that the full agonists are in and get pushed out but are then so flooded by the buperenorphine that it simply prevents the precipitated withdrawals. Does that even make sense? Is that possible? Like, let's say you were to inject 24mg or more of bupe could it just push everything else out of the receptors and because there's so much of it flooding the receptors you just wouldn't get sick? I dunno though... sounds pretty ridiculous.

It's like he's been divinely blessed by an opioid deity and has holy powers to allow him to do this.

 

[SS373dOH]

The fentanyl's binding affinity could be strong enough to withstand the rush if bupe.. Or since he's wearing a patch, if the bupe does 'knock' the fent off of the receptor site, more fent is absorbed from the slow release patch, occupying the site.

 

[ILikeToEatPeople]

Or since he's wearing a patch, if the bupe does 'knock' the fent off of the receptor site, more fent is absorbed from the slow release patch, occupying the site.

If that was the case, wouldn't he go through a short period of bad discomfort until the fentanyl from the patch got back into the receptors?

Also, if it's the case that the binding affinity of fentanyl was strong denough to withstand the bupe then wouldn't the bupe just not really have any effect thus making the whole thing pointless? He seems to enjoy himself with the bupe so it's all just weird. I mean, I've seen people royally screw themselves over with precipitated withdrawals and this guy seems to just be immune. It's like the fundamental laws of physics are being broken by unnatural powers haha.

 

[tacodude]

It's probably because he has fentanyl entering his system constantly so he may go into pwd, but the fentanyl unlike other opiates can knock the bupe off so it's like he undoes the fentanyl only for it to renter and reverse the bupe causing the effect to weaken and return to the regular state shortly after so they end up with a percieved effect even though it's not like they are feeling anything more than they were before the bupe possibly less.... That's my only guess

 

[motiv311]

fentanyl and suboxone are both similar and can be taken together, but i don't know how he could heroin and then suboxone... although i have been taking subs the same day as heroin, and it seem sto work fine for me too

 

[hammer967]

Ive been on fentanyl patches 10 + years if I run out early which happens time to time I'll take a suboxen after about 12 hrs I put the fentanyl patch on depends on my withdrawals at time everyone withdrawals differently a 72 hr patch might not last 72 hours let cowls scale guide you through suboxen timing

 

[hammer967]

Also if your already on subs you can't get precipitated withdrawals maybe he's just trying to blast through the suboxen very dangerous never should be tried by even pros

 

[Keif' Richards]

Everyone is unique and their are always going to be statistical outliers in these situations. There are people who use Opioids for years, get high and don't experience any withdrawl whatsoever. So, anything is possible. I've actually heard of many folks who don't get precipitated withdrawal from Buprenorphine.

 

[Solipsis]

Yeah the fent competing was the same as I was thinking... but if the bupe stands that little chance to cause considerable antagonism then I don't see how it can do much good either?

 

[bukweat]

Because the fentanyl is waaaay more potent. Measured in micrograms vs milligrams

. Needle fixation perhaps.

 

[crzydiamond]

Two things come to mind: the fentanyl overrides the bupe, as previously stated

The other--he's already got sub in his system. If he's taken it within the last 72 or so hours it's already in his system and thus wouldn't go into precip wd. That's the case regardless of fentanyl.

Somehow either, both, or a combo of the two is what I think is happening here

Just to the general audience--don't go trying to IV 12 mg of bupe right after doing heroin. You'll be in a world of pain....

 

[Treefa]

Ya' know, the human body is pretty miraculous.

Are you saying that this guy is combining 4+ different opiates/opioids? Does fentanyl actually absorb well thru patches? Even if so it would be all slow and drawn out like continuous release right? Could be the culprit....or could be the mixing of 3+ opioids.

If that's the case then it's really no fucking wonder, he's probably got enough agonists on his receptors that precipitated withdrawals should be the least of his worries.

First of all if you can't wait 8 hours between doses(at LEAST) then i'd hazard you might have a pretty fucking serious dependency/addiction!
....wait did I say "might"....this guy has a serious fucking habit, lol.

Precipitated Withdrawal is insanely over-blown, at least as far as frequency, severity....I mean I understand it's supposedly like "15 straight minutes of the worst withdrawal you can possibly fucking imagine!" from what I hear, but ffs people can you not stick it out and roll on the floor for 15 minutes??

If you can't take the heat, stay your ass outta the kitchen!
Am I wrong here?


Seriously though the guy OP described sounds like somebody who has had a very, very serious habit for a very, very long time...and it kinda sounds like he's finally made like the sound settings on a Sony T.V., and just adjusted to his circumstances.

So either he's so used to it by now he doesn't notice, or his system is so saturated by so many various opiates that it doesn't even phase him.

Bottom line is this; If you're taking say Fentanyl, Hydro, and Morphine simultaneously, it's not gonna matter if you take 8mg sub because the infra-additive effects of the combined full agonists is PLENTY enough to cling to your receptors without being able to get kicked off by the sub/nal.
Although for all anybody here knows the little bit of naloxone, and the little bit of bupe-induced-antagonism is the only thing keeping the dude from a serious OD! Wouldn't that be ironic?

Now if you've taken 500mg codeine 3X a day, for 3 years, and then switch to sub, you seriously might have PWD, just because of the fact that codeine doesn't bind as strongly as bupe, or fentanyl.

In case everybody on BL doesn't already know, mixing different opiates/opioids is the bees knees , as long as you don't do it with bupe, yuck.....but mixing full agonists is the jumpin' jack flash....not...uhh..recommended.
I would love to recommend it but sure enough some poor bastard would die and there i'd be.

So fuck it, happy Thanksgiving everybody.....1 hour and 20 minutes left in my thanksgiving so fuck this i'm outta hear haha.


P.S. Completely unrelated but does anybody know why Hydro/Apap is the ONLY opioid in the PDR that has a potential side effect of "permanent hearing loss"? I just think its so weird that the most Prescribed drug in the U.S. has more side effects than Morphine, Hydromorphone, etc...Tylenol the culprit?

Fuck the internet I got shit to do tonight damnit!

 

[crzydiamond]

^ not sure where you got the idea that precipitated wd is 15 min long...

Maybe that's what happens to some lucky people for whom the bupe then takes over

When it happened to me, I experienced HOURS of the worst wd ever. Like the kind that made me literally want to kill myself. (And I've never been suicidal). I tried everything. Finally about 5 hours later was able to get some dope and it took about triple my higher-end dose just to feel somewhat better. Def wasn't high; wasn't even normal, but I didn't feel like I was being tortured.


And the kicker is i started with 1 mg, felt instantly cold blooded and shaky, had read that more helped...took another 1 mg ...it got so much worse. I shudder to think how I'd have been with a whole strip...

Moral of story: don't play around with precip wd. It's not a myth

 

[Coolwhip]

Injecting 12-16mg of bupe could last 2+ days, so if he is doing this more than twice a week then he is ALWAYS on bupe on not feeling the fentanyl or heroin(which is why he would say he wasn't high after taking a shot of heroin and taking breakthrough meds etc)

Wearing a 50mic/h patch wouldn't come anywhere close to competing with a few milliigrams of bupe, let alone 12+...it would take shooting at least half the patch just to stop the pwd from that, if then.