Opioids precipitated withdrawl question

[Branggen]

Ive always wondered why taking partial antagonists causes the dreaded "precipitated withdrawl" I understand that due to it high affinity it rips off the full agonists but are the receptors not immediately at least "partially" replaced. I mean if taking subs while in withdrawal generally makes you feel fine and occasionally euphoric (so im told) why would they not have that effect? Is it just to drastic of a change to quickly or does it take time after ripping away the previous opiod before attaching itself? And this wouldnt have anything to do with the nalaxone in the pill would it?

 

[speedballs_over]

B/c the agonist effects of bupe vs. a lot- almost all common ones - is weaker BUT bupe binds tighter. Hence, once the dope is very quickly ripped of by a weaker mixed-agonist/stronger binder + it's antagonism doesn't help one bit, makes it much worse = precipitated withdrawal. Short version. Search for better answers.

 

[fukme]

This topic depends 100% on your tolerance to your drug of choice, and the dosage of bupe you take/have been taking (cross tolerance applies give or take) If I take less than 2mg per 24hours for example there is little to no antagonism, the higher the dose of bupe, the more antagonism. Works the same for everyone.

 

[LilikoiMoon]

I've never waited 12/24 hrs (I usually wait 8 hrs, or when I begin to feel worse) before taking suboxone, and I was fine, never went into immediate withdrawals. Can't really take subox often, as it causes major migraines for me.

For me, it normally takes about 20 mins for subox to take effect. During that time period, I don't eat, smoke, or drink anything. With subox, I dose twice daily because after several hours of eating, drinking, after initial dose, I begin to feel withdrawals. Dosing twice daily keeps withdrawals at bay.

IMO I believe the Nax prevents OD while on subox. There were various cases in the media where people were using subox on a recreational level and died from subox intoxication. Case: two guys go to a party in a park, took too many strips, died. Toxicology showed subox intoxication/toxicity. Seems that Nax was added not long afterward.

Sorry to ramble....

 

[d1ahp]

^^ Naloxone is next to useless in Suboxone because Buprenorphine has higher affinity for opioid receptors.

 

[solerso]

Yeah I always supposed they added Naloxone to extend the patent (or get a new one or whatever).There is absolutely nothing the Nalaxone provides , therapeutically, additionally, to the Buprenorphine. Nothing. Not only does the Bupe have a much higher binding site affinity (than Naloxone/Narcan) it resides in the body much longer.

 

[hydr0m0rph]

I have been into precipitated withdrawal once. i took suboxone maybe 6 hours after heavy oxy abuse for many days... i had snorted the suboxone pill so idk if that had something to do with it.. but it was HORIBLE. i started shaking and sweating profusely. most intense feeling of withdrawal i ever felt. this lasted 30 - 45 mins after a hot shower i felt that the bupe kicked in, and i was fine. i believe the naloxone was absorbed this time because i swallowed the drip, i usually spit it out. naloxone doesnt really last long and bupe is a stronger binder to opiate receptors anyway so as soon as the bupe kicked in i was good.. although in my later years of H abuse, suboxone does nothing for me until day 3 of withdrawal

 

[dopamimetic]

Naloxone gets absorbed very quickly and with good bioavailability when snorted ... they put it in to keep the people from shooting, so I thought as well, but learned the hard way. There is few that feels as worse as acute precipitated withdrawal.

I even suspect that naloxone (or any high-affinity opioid inverse agonist, naltrexone etc) - if absorbed fast enough, e.g. through the nose - will be strongly dysphoric to everyone, creating minor withdrawal-like symptoms even in opioid naive persons.... because they displace the body's own endorphins as well, and since they are inverse agonists, the action is stronger than what a pure / silent antagonist would do.