Opioids How many days on a full agonist lead to precipitated withdrawals when dosing Bupe

[Zerwas]

Hey fellow BLers,

I am currently on about 0,8mg Buprenorphine/day. Now i acquired some Levomethadone and took that instead of my Bupe dose for the last two days and today (Doses being 15mg, 10mg and 5mg today). Now is this enough time to experience PW when I switch back to my Bupe tomorrow or even today?

I ask because I experienced heavy fever-like symptoms last evening and night. Not withdrawal but very unpleasant, slept for 12 hours and have terrible headaches synchronized with my heartbeat. Is this a side effect of Levomethadone? Because switching fom Bupe to a full agonist should theoretically be no problem right?

So would it be a problem to take 0,5-1mg Bupe now or should I wisely wait until tomorrow?

Any input is appreciated.

Z

 

[Znegative]

Would it be possible for a full agonist with a higher binding affinity to cause precipitated withdrawals when taken at a dose inequivalent to the amount of buprenorphine someone has in their body? I'm just wondering, cause I was just looking up levomethadone and trying to find out its binding affinity relative to buprenorphine, because levomethadone is supposedly twice as potent as methadone is, and methadone's binding affinity at the mu receptor, while not really that close to buprenorphine's, is a lot closer than most other full agonists, and I wonder if levomethadone has an even higher binding rate than regular methadone. Not that it would really matter in this case, as the first dosage is about equivalent to the agonist activity of buprenorphine (which is supposed to be equipotent to something like 30mg of methadone, and if l-methadone is 2x stronger, than 15mg would be equivalent to 30mg regular methadone).

Regardless, definitely wait until tomorrow, in fact, I'd try to wait longer if you can hold out, as levomethadone has a really long half life too (18 hours), I'd try to wait 36 hours, just because of all the full agonists to slip up on while on buprenorphine, methadone, or anything similar (L-methadone, LAAM) are some of the worst ones to choose because of their potency and long ass half life. Also, the longer you wait, the more chance of success you'll have with getting relief off of .5-1mg of buprenorphine because the levomethadone might have raised your tolerance a bit.

 

[Zerwas]

Thank you guys.

I got these fever like symptoms again yesterday night, weakness, hickups, hot flashes, sleeping a lot, dreaming crazy stuff...coughing etc.
Feels pretty bad man. I hope that my Bupe dose will cure it now and I will never take Levomethadone again. While the recreational effects were great it all went downwards in the evening and it is not worth it. The headaches alone are from hell...

I am getting my Subs from the street by the way. I was at a Bupe clinic last year but it costs more and is also much more of a hassle (urine tests, having to go there every day for my tiny dose...etc)