Bupe Suboxone/Buprenorphine FAQ and Megathread v.1; 2007 - 2010

[johanneschimpo]

^ I have the PDF, but its slightly too large to fit as an attachment. If anyone is interested, PM me for the full text.

 

[N0cturnal]

Suboxone and diphenhydramine (Benadryl)?

I read the post in the Other Drugs Directory about shooting Suboxone with diphenhydramine, I have no desire to inject it but I was wondering if diphenhydramine will still increase the effects of Suboxone regardless of method of administration.

I've been on Sub for about 5 months and currently take 24 milligrams a day. When I first started taking it, 2 milligrams would give me a mild euphoria, now I have to use 32 milligrams at a time to get the same effect .

I'd like to try it with some diphenhydramine just for the hell of it, I'm not expecting much but I do have a bunch of extra pills and I'm bored out of my mind . What would be a good starting dose of diphenhydramine? 75 mgs? 100 mgs?

 

[Unknown]

Um, it will help with the itching. Diphenhydramine IV will have effects on its own, such as drowsiness. I have only had it IVed once, in the hospital. As far as oral, I dont really notice a difference if effects. I have taken up to 100mg with suboxone.

 

[johanneschimpo]

If you dn't take diphenhydramine often, and have no tolerance, I'd say 50mg right before your suboxone does, then 25-50mg more as needed. I wouldn't go above 100mg in a 4-6 hour period if you don't take it often, as it can feel kind of weird.
It should take away the itch, and add to the nod/drowsiness a bit. Good luck.

 

[N0cturnal]

Ok, I took 50 milligrams of diphenhydramine, and about 10 minutes later plugged 32 mgs of Suboxone using a 10 ml syringe, four 8 mg pills dissolved in 40 ml of warm water, I know its not the most attractive method of administration, but very effective nonetheless. I used to snort Suboxone but trying to snort 32 mgs is well ... a lot of powder, too much, and I think plugging it (on an empty colon) is stronger by a good bit.

About 30 minutes later I took another 25 mgs of diphenhydramine, I actually feel some euphoria from Suboxone for the first time in a while, I never thought that an over the counter sleep aid would have any potential.

I learn something new and interesting on a regular basis here.

Thanks for the advice johanneschimpo.

 

[Mr Blonde]

Merging question about suboxone and diphenhydramine into the sub megathread.

 

[njevad]

Ok, here is something that is totally puzzling me.

A little background info..
I have been using heroin daily roughly for a year and a half now, a year with IV use. At one point I was using roughly 15-20 bags of NJ heroin daily so it's safe to say I had a hell of a habit. Lately I've cut it down to using about 6 bags a day.

I saw a doctor and was prescribed suboxone 3x a day(24mg). I mainly saw this doctor because of family/ legal issues but I personally was not ready to drop the dope completely at that point in time so I had been using it mainly as a substitute for those days when the money wasn't there.

Anyway, after somewhat of an intervention with the police, I had decided I was going to try to give up the dope. My last dose of H was this past Saturday at about 7pm. I then dosed 1 8mg suboxone tablet sublingually at about 9pm Sunday night.(26 hours later) Since then I have not used heroin or re-dosed suboxone with no signs of withdrawal or discomfort. I actually feel fine.

Is it safe to say I kicked the habit? It's now Wednesday and I have yet to re-dose sub(62 hours) or heroin(88 hours) since. Why am I not feeling any discomfort? By this time the bupe should most definitely be out of my system. Is there any logical explanation? Why are some people on it for months or years at a time and I have had success(somewhat) with one 8mg dose?

Thanks for any replies in advance.

 

[DudeImnotDAVE]

Six, can you add that Withdrawl chart I had posted in the other thread? (COWS chart)

It would help alot of people who are dosing WAY too early aviod precipitated wds.

 

[DudeImnotDAVE]

Clinical Opiate Withdrawl Score- you want 25 or more

For each item, write in the number that best describes the patient’s signs or symptom. Rate on just the apparent relationship to opiate withdrawal. For example, if heart rate is increased because the patient was jogging just prior to assessment, the increase pulse rate would not add to the score.

[Mod Note: Its pretty self explanatory, but obviously this test is usually administered by a doctor. I think most of us know ourselves well enough to be able to do this on our own, just make sure that you arent over exaggerating the symptoms. I know in a doctor environment, its kind of second nature to exaggerate the severity of the symptoms, but when you are doing it on your own, who do you need to fool? No one. The reason I say this is because if you do exaggerate the severity of the symptoms, you could come up with a result that may or may not cause you to dose too early, which in effect, makes taking this whole exam pointless. - 6/7]



Patient’s Name:___________________________ Date: ______________
Buprenorphine induction:

Enter scores at time zero, 30min after first dose, 2 h after first dose, etc.

Times: ______ ______ ______ ______

Resting Pulse Rate: (record beats per minute)
Measured after patient is sitting or lying for one minute

- 0 pulse rate 80 or below
- 1 pulse rate 81-100
- 2 pulse rate 101-120
- 4 pulse rate greater than 120

Sweating: over past ½ hour not accounted for by room temperature or patient activity.

- 0 no report of chills or flushing
- 1 subjective report of chills or flushing
- 2 flushed or observable moistness on face
- 3 beads of sweat on brow or face
- 4 sweat streaming off face

Restlessness Observation during assessment

- 0 able to sit still
- 1 reports difficulty sitting still, but is able to do so
- 3 frequent shifting or extraneous movements of legs/arms
- 5 Unable to sit still for more than a few seconds

Pupil size

- 0 pupils pinned or normal size for room light
- 1 pupils possibly larger than normal for room light
- 2 pupils moderately dilated
- 5 pupils so dilated that only the rim of the iris is visible

Bone or Joint aches.
If patient was having pain previously, only the additional component attributed to opiates withdrawal is scored.

- 0 not present
- 1 mild diffuse discomfort
- 2 patient reports severe diffuse aching of joints/ muscles
- 4 patient is rubbing joints or muscles and is unable to sit still because of discomfort

Runny nose or tearing Not accounted for by cold symptoms or allergies

- 0 not present
- 1 nasal stuffiness or unusually moist eyes
- 2 nose running or tearing
- 4 nose constantly running or tears streaming down cheeks

GI Upset: over last ½ hour

- 0 no GI symptoms
- 1 stomach cramps
- 2 nausea or loose stool
- 3 vomiting or diarrhea
- 5 Multiple episodes of diarrhea or vomiting

Tremor observation of outstretched hands

0 No tremor
- 1 tremor can be felt, but not observed
- 2 slight tremor observable
- 4 gross tremor or muscle twitching

Yawning Observation during assessment

- 0 no yawning
- 1 yawning once or twice during assessment
- 2 yawning three or more times during assessment
- 4 yawning several times/minute

Anxiety or Irritability

- 0 none
- 1 patient reports increasing irritability or anxiousness
- 2 patient obviously irritable anxious
- 4 patient so irritable or anxious that participation in the assessment is difficult

Gooseflesh skin

- 0 skin is smooth
- 3 piloerrection of skin can be felt or hairs standing up on arms
- 5 prominent piloerrection



Total scores

Score:

5-12 = mild;

13-24 = moderate;

25-36 = moderately severe;

more than 36 = severe withdrawal

 

[sixpartseven]

Ok, here is something that is totally puzzling me.

A little background info..
I have been using heroin daily roughly for a year and a half now, a year with IV use. At one point I was using roughly 15-20 bags of NJ heroin daily so it's safe to say I had a hell of a habit. Lately I've cut it down to using about 6 bags a day.

I saw a doctor and was prescribed suboxone 3x a day(24mg). I mainly saw this doctor because of family/ legal issues but I personally was not ready to drop the dope completely at that point in time so I had been using it mainly as a substitute for those days when the money wasn't there.

Anyway, after somewhat of an intervention with the police, I had decided I was going to try to give up the dope. My last dose of H was this past Saturday at about 7pm. I then dosed 1 8mg suboxone tablet sublingually at about 9pm Sunday night.(26 hours later) Since then I have not used heroin or re-dosed suboxone with no signs of withdrawal or discomfort. I actually feel fine.

Is it safe to say I kicked the habit? It's now Wednesday and I have yet to re-dose sub(62 hours) or heroin(88 hours) since. Why am I not feeling any discomfort? By this time the bupe should most definitely be out of my system. Is there any logical explanation? Why are some people on it for months or years at a time and I have had success(somewhat) with one 8mg dose?

Thanks for any replies in advance.

No, its not safe to say you kicked the habit. That is going to take a long time. As long as you stick with a steady dose of suboxone and DO NOT use any heroin, you could eventually taper your suboxone dose down and jump off. THEN you will have kicked a heroin habit, but that does not mean youre safe. You have to change your lifestyle to stay clean. Its a life-long process.

Youre not feeling any discomfort because the whole point of suboxone is to keep you from feeling any discomfort. The only reason suboxone would cause discomfort is if you took it way too early, but in your case, you took it at the right time (at least 24 hours after your last heroin dose.)

There is a logical explanation for why some people stay on it longer than others. Some people can adjust to the new life of being sober and abstaining from drugs. Others arent so good at that (like me.) There is no standard time for how long you should stay on suboxone, so dont worry about how long or how short someone else was on it. Do what is good for YOU. Stay on as long as you find it necessary. Ive been on for 15 months, and I dont think Ill be getting off anytime soon. There is nothing wrong with that, its just that if I were to get off sooner than now, I would have probably relapsed. That isnt a problem for other people. They are more confident in their ability to stay sober.

Like I said before though, you have not had success with ONE tablet. Its impossible. As soon as that suboxone wears off, the withdrawals will start again, and you'll need to redose. Quitting dope is sometimes a very long process - depending on the person - and suboxone is just a TOOL to get through that process; it is not a CURE.

My advice, take suboxone when you start to feel the discomfort set in for as long as you need to. When you feel like youre ready, start gradually lowering your dose (tapering) till you get it down to less than 1mg. When you get below 1mg, then youll be able to jump off the suboxone with very little, if any, withdrawal symptoms. You still wont be cured though, like I said. Staying clean requires a life-long change to your lifestyle. I suggest at the time of getting off suboxone, you seek therapy or counseling to get help in adjusting to this new lifestyle of sobriety.

 

[johanneschimpo]

^ Fucking A++. Everyone on bupe or considering bupe should read this post. Hell, everyone should read it p.e.r.i.o.d.

 

[malfunkshun]

Here's a question. Does taking suboxone lower your opiate tolerance? The reason why I ask is I snorted 8 mg yesterday (I have a pretty high tolerance I guess, because all it did was kind of relax me) and today, about 20 hours after I snorted it, I took my usual dose of tramadol to keep me from going into withdrawals (I try to keep it at a daily maintenance dose, but every few days I slip and just fucking get high on em) and the regular maintenance dose almost gave me a buzz.

I haven't taken any tramadol since the day before yesterday, I decided to just snort the sub yesterday to keep wd's at bay and maybe catch a buzz, and today I noticed wd's creeping up and took the low dose of tramadol that usually won't do shit except keep me straight. And now I swear I'm feeling just a touch of a buzz. It usually takes about 5 times more tramadol than my maintanence dose to catch a buzz.

So, my question is: will taking suboxone once in a while lower my tolerance for other opiates, making it easier to taper more quickly?

 

[Ds]

Well suboxone is ment to block the chemicals that stimulate the u-opiod recepotors(sp) in your brain. Maybe the bupe is blocking the tramadol. Try taking less subox and more tramadol.

 

[malfunkshun]

i think you misunderstood my post. it seems like my tolerance went down after taking suboxone.

 

[sixpartseven]

Theres a theory that low doses of naloxone/naltrexone can lower opiate tolerance if taken with other opiates. So by that logic, taking the naloxone with the suboxone should lower your tolerance some.

Even if that isnt the case, I have noticed that your tolerance does tend to shrink over time when on suboxone. I dont know if it can happen over just a few days, but it can definitely happen over a larger time span (multiple months) if you dont over-do it with the suboxone. My tolerance to heroin now is smaller than it was 15 months ago.

 

[malfunkshun]

i'll find out for sure tomorrow. i'm waiting for all the suboxone to get out of my brain before getting high again. i'll be able to notice for sure if my tolerance really went down because it has only been going up little by little, never down.

 

[StaffWriter]

I've been on sub for about 4 months now and when I had surgery, I found that sub had increased or kept my tolerance high. I had access to lots of oxycodone, hydrocodone, dilaudid, tramadol and IV shots in the hospital. I never really got high. All of it has seem to really have lost it's magic. It's a good thing, I guess. I'm never tempted to jump off and go get high. But I would say my tolerance has increased.

 

[psychedelicious]

It's because tramadol's FX are not caused only by its opioid receptor activity and it "works" with suboxone. I hope to independently verify this soon.

What I would think is happening is that there was a very fair amount of buprenorphine in you still (half-life is ~37 hours, meaning, by hour 37, 50% of the initial dose has been metabolized away), and the tramadol was able to latch on, and its mild agonism of the mu opioid receptor worked with buprenorphine's similar action to give you a nice effect. Tramadol also affects the serotonin and norepinephrine systems regardless of its affect on the mu-opioid. You can take both and feel both.

 

[kneeco]

Tramadol + Suboxone ??

So I am a current heroin addicted [phyiscally] and I have to quit doing all drugs because I have to start taking Government ordered UA's so my question is if I was in w/ds far enough to take a suboxone but took tramadol before that do I have to wait for the tramadol to wear off? Lamently, will the tramadol throw me into precipitated withdrawals if I take the suboxone after I take the tramadol?

Also if I'm high on tramadol will it potentiate heroin?

thanks.

 

[Mr Blonde]

I'm gonna merge this into the sub mega thread.

1) If the tramadol puts your WD off, then yes you should wait until you are back in them to start the sub.

2) As to whether it potentiates smack... could very well do, depends on if you like tramadol or not.