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Bupe Suboxone/Buprenorphine Mega Thread and FAQ v13.0

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Captain.Heroin

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phrozen said:
What: Suboxone = buprenorphine/naloxone. Bupe is a partial agonist(mu) and antagonist(kappa). Bupe has higher mu affinity that most opiates, including some antagonists(naloxone, naltrexone). Its higher affinity allows you to shoot suboxone tablets. It also may cause precipitated withdrawals if you are dependant on other opiates. Also, its higher affinity blocks the affects of other opiates when taken in conjunction with bupe.

Dose: Depends on tolerance. 1-2mgs is a typical recreational dose for someone with no tolerance. If you're using bupe to taper off of another opiate, you should dose once you're experiencing wd's(typically 36-48 hrs. for most opiates). Start with 2-4mgs and dose at 2mg increments every 30-45minutes until a dose holds you. Most people take their full dose once a day.

Withdrawal: Typical physical and psychological symptoms associated with opiate withdrawal. Insomnia, chills, diarrhea, depression, anxiety, lacrimation, sweating, increased heart rate, etc. They are not as strong as a full agonist's symptoms, but may last longer. Physical symptoms last 1-2 weeks on average and psychological symptoms may last months.

As most opiates, it's recommended to taper down to the lowest dose possible before stopping. <1mg is ideal. The best way to dose at that level is to crush up a tablet and divide the powder into lower doses.

Ceiling: 24-32mgs

Bioavailability:
jasoncrest said:
Buprenorphine bioavailabilities:

intraduodenal: 9.7%

intrahepatoportal: 49%

intramuscular: 68%
"The observed mean intramuscular bioavailability was 68%"
"Studies of buprenorphine bioavailability have also examined the intramuscular (bioavailability, 50%–100%)"


intranasal: 50%
"Studies of buprenorphine bioavailability have also examined the [...] intranasal (bioavailability, 48%)
"The bioavailability of buprenorphine, HCl (BPP) in sheep after nasal administration of two formulations has been studied. 0.9 mg BPP in 150 microl was administered nasally and compared to 0.6 mg i.v. The test solutions were formulated with 30% polyethylene glycol 300 (PEG 300) and 5% dextrose, respectively. The bioavailability for PEG 300 was 70% (S.D.+/-27%, n=6), whereas the bioavailability for 5% dextrose was 89% (S.D.+/-23%, n=6)."
"Mean intranasal bioavailability was 48.2 +/- 8.35% (mean +/- s.e.m.) of the intravenous value"


intrarectal: 54%
"bioavailability of the drug was found to be: [... ]intrarectal (54%)..."
"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] intrarectal, 54%..."

intravenous: 98%-100%

oral: 10%
"the oral bioavailability for buprenorphine is state to be 10%"
"due to extensive first-pass metabolism, buprenorphine has very poor oral bioavailability (10% of the intravenous route) if swallowed"


sublingual: ~30%
"Buprenorphine is well absorbed sublingually, with 60% to 70% of the bioavailability of intravenous doses"
"Study results indicate that bioavailability of sublingual buprenorphine is approximately 30%"
"Literature on bioavailability of sublingual buprenorphine presents variable numbers ranging from. 19–58% of the administered dose."

"Relative to the 100% bioavailability from the intraarterial route the mean bioavailabilities were [...] sublingual, 13%"

transdermal: 15%


Other Notes:


Images:

Subutex


Suboxone


Generic Subutex Manufacturer: Roxane


Generic 2mg Manufacturer: Teva | Generic 8mg Manufacturer: Teva


Suboxone Film Strips


Temgesic, 0.2mg


Buprenex Ampules

Locate a doctor that prescribes Suboxone.

Suboxone Assistance Program - Free Suboxone for Low Income Patients
 
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Captain.Heroin

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Frequently Asked Questions

Q: How long after my last bupe dose can I take an opiate and feel its effects?
A: It depends on what dose of bupe you were taking and how long. The short answer is 36-48 hours, though it may certainly be less, or more than that. Caution should be used when dosing, as you will still have a tolerance but it will not be as high as it was when you first got on bupe.

Q: I'm thinking about switching from methadone to bupe. At what methadone dose should I be when I switch?
A: Most places recommend being at 30-40mgs of methadone when switching. That may be hard to achieve since that level is lower than the recommended therapeutic maintenance level. Also, you'd have to wait at the very least 36-48 hours before your last methadone dose to switch in order to avoid precipitated withdrawal.

Q: Is bupe good for depression/anxiety?
A: Yes, it may help with depression and anxiety. It is not currently prescribed for either and its effectiveness has not been studied for long term use for either. You may be able to get it prescribed off label for depression/anxiety, but its not likely to happen. Here is an article on PubMed about a study on bupe being used to treat depression.

Q: Is bupe recreational?
A: Yes. Although it is rarely the preferred opiate for people who have experience with full agonists, a few people do prefer it to full agonists (i.e. morphine).

Q: Can you overdose on buprenorphine?
A: Yes you can, but typically not by itself. Buprenorphine causes respiratory depression which may lead to death, but typically wouldn't do so in a healthy individual, unless you combined other CNS depressants with buprenorphine, like benzodiazepines, alcohol, barbiturates, and other downers. The person most likely to OD on bupe has a low(if any) tolerance to opiates and may have taken another depressant. A buprenorphine overdose may not be reversed by naloxone(or naltrexone for that matter) due to bupe's higher affinity. Diprenorphine may reverse the overdose, but it is not regularly stocked by emergency personnel or hospitals. If a proper antagonist isn't available, the person suffering an overdose may be maintained with assisted respiration.

Q: Can I still get high on other opiates if I'm on bupe?
A: This depends on what dose of bupe you're on. You will most likely be able to shoot through a low dose of bupe (1-2mgs). Though some might be able to expect the full effects of the opiate you're shooting through with, it is often only partially felt for many people. Even at higher doses, if you take enough of the opiate you may feel it. This is not recommended, as you may overdose before reaching the desired recreational effects. It is better to wait until bupe is no longer effecting you, or to stick the course with bupe treatment.

Q: How come you can IV Suboxone? Isn't naloxone going to put you into withdrawal?
A: No, naloxone will not put you into withdrawal. If you are using heroin or a full agonist, and then use Suboxone, you will go into precipitated withdrawal if you don't wait for regular withdrawal first. If you are otherwise already on buprenorphine, IVing Suboxone will not put you into withdrawal. This is because buprenorphine has greater receptor affinity than naloxone does
http://www.bluelight.ru/vb/showthread.php?t=541906
. There is no functional reason why naloxone is in Suboxone, and for all intensive purposes, Suboxone and Subutex are the same thing - both can be used with any route of administration.

Q: Is Suboxone safe to IV?
A: In essence, you should not shoot Suboxone. Unless you have enough patience and money to afford and use micron filters, Suboxone or Subutex, like any other pill, has risks when IVing. Missing a shot of Suboxone or Subutex may be more detrimental to your health, when compared to shooting out of a sterile ampule, or pure drugs in sterile water. Please read up on injection complications regarding pill based drugs, like Subutex, in the Case Studies thread. It is better, if you are truly intending on IVing buprenorphine (outside of the ampule version Buprenex), to read up on my Micron Filtering Mega Thread and FAQ and then purchase the necessary supplies to help enable a safer shooting experience for yourself.

Q: How good is bupe as an analgesic? What are the pain-killing properties like in comparison to other opiates?
A: This may vary from individual to individual, but what I can say for the average person, you will probably find that it is about half as good feasibly speaking as an analgesic (pain-killing) medication, compared to an equipotent dose of heroin, morphine, oxycodone, and so on. I have talked to several people who are pain patients, and they have a general consensus that while full agonist opiates are much better in the pain killing department, buprenorphine does help considerably when taking off the edge in mild to somewhat moderate pain cases. For people with moderate to heavy or severe pain issues, buprenorphine can do but only so much.

Q: If I am a pain patient, can I utilize buprenorphine?
A: Yes, it is possible. It will be most likely you will combine a compatible drug, like tramadol with it. However if you are going to combine full agonist opiates like morphine, hydrocodone, oxycodone, heroin, and so on, you are probably going to want to take a dose of buprenorphine first, and then once the effects are going, you can use other full agonist opiates on top of buprenorphine. However, you can't take another dose of buprenorphine until the full agonists have left your system. This is why if you're already dependent on full agonist opiates, it's better not to use buprenorphine as well (as you may go into precipitated withdrawal). If you have mild to moderate pain at best, and it flares up sometimes but doesn't at others, then you may be able to combine both buprenorphine and a full agonist on the days you need to, and then on the days you don't, you can stick to strictly buprenorphine.
 

Captain.Heroin

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Suboxone Mega Thread Directory - Other links about buprenorphine in Other Drugs

Alcohol and Suboxone - Alcoholic Solutions for Higher BA With Sublingual Use**
Buprenorphine and Antihistamine IV FAQ
Buprenorphine as a recreational drug?
Buprenorphine dosages commonly prescribed are unnecessarily high
Buprenorphine for depression?
Buprenorphine patches
Buprenorphine withdrawals?
Ketoconazole Potenation of Suboxone
Mephedrone and Buprenorphine
Micron Filtering Mega Thread and FAQ - How to Micron Filter Suboxone
Nasal Administration of Suboxone - Issues
Rectal (Plugging) Buprenorphine
Suboxone in place of Naloxone in the event of an opiate overdose*
Suboxone sublingual film official thread
Subutex has gone generic
Tramadol and Suboxone

Discussion in the Suboxone mega thread goes along quite quickly, so we have a few other threads to promote intermediate/advanced discussion of buprenorphine and its formulations. These threads are meant to divert some of the more advanced discussion that otherwise becomes buried in the mega thread.

If there's another link you think which would go well in this list of related buprenorphine threads, please let me know. We're trying to reserve extra threads on buprenorphine for more intermediary/advanced discussion mostly to reserve the mega thread for a place for questions that can be answered quickly, and the other threads for a place for questions which will otherwise not get the same discussion going on in the mega thread, due to its quick pace.

If you have an idea for a new thread on buprenorphine, it's probably best to figure out by talking to a moderator first to see if it's thread worthy or should be discussed in the mega thread.

*Not Advised. Opiate antagonists are the only safe thing to do in case of an opiate overdose. Please do not give people Suboxone if they have overdosed.
**also known as "6/7's method" or "SixPartSeven's method"
 
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Captain.Heroin

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Welcome

Welcome to Version 13 of the Suboxone/Buprenorphine mega-thread, by Captain.Heroin!

Please remember, that the rules applicable to Other Drugs and Bluelight are all enforced, especially in this thread. Before posting in this thread, or in Other Drugs, please be familiar with the following resources:


The Frequently Asked Questions as well as the directory which links other major threads related to buprenorphine in Other Drugs - will have a lot of information which will be able to help you out. Searching yourself through these resources will often answer most questions quicker than posting a new thread in Other Drugs, since you would have to then wait for others to reply instead of going through previous discussion which has answered most common inquiries.
 

Captain.Heroin

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What's New? | Picking up where we left off...

The only new thing that I did was to change the image for the Suboxone film strips; the other Suboxone mega threads have pictures of demonstration film strips, which are the inactive ingredients without the active ingredients.

I have added a picture of an actual Suboxone film strip, the front side. The back side has identifiable information which I just didn't feel like editing out. I don't think anyone "needs" to see what the back looks like so I'll just include the front picture.

I also added a quick reminder to please use the FAQ and Suboxone Directory to help in assisting your questions.

Finally, I removed a dead link.

do your docs have you on benzos? do they prescribe them to you? is it normal to be on a low dose benzo while on suboxone? i am planning on asking my doctor to prscribe me a benzo such as diazepam to combat all of te negative emotions i have been running from, going to ask him to start me out at 20mg a day...anyone think this is a bad idea?
It's common for both to be prescribed together. I have had benzodiazepines prescribed by separate doctors while on Suboxone without issues.

Some doctors are assholes and won't let you be on them, so you just want to ask about this before going to a doctor, or, before switching doctors.
 
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Herbal~Jah

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I have never seen or heard of ANYONE being prescribed suboxone and benzo's at the same time. Even though it is completely safe in my experience, it seems like all doctors fear prescribing benzo's with suboxone like the plague!
 

Captain.Heroin

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I have never seen or heard of ANYONE being prescribed suboxone and benzo's at the same time. Even though it is completely safe in my experience, it seems like all doctors fear prescribing benzo's with suboxone like the plague!
Yes some doctors are very fearful of prescribing benzos to ex-heroin addicts. There seem to be a lot of people who like to abuse benzos, whether or not heroin was their thing.

In my case, I do not particularly care for benzos. I only use them when I feel it's necessary to have anxiety relief or a good night's rest. This is probably only once a week to once a month at the very most.

If you already have a medical history of being on them, and you call ahead to confirm, a doctor should still be able to prescribe you both.
 

ILikeSub

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re solidify

I am trying to find a way to resolidify my Suboxone films.
Any ideas anyone?

About 30 minutes ago I took 1/16th of a strip,broke it down in water and then drew it up into a rig.
I then squirted it onto some glass and added some calcium pill powder to it.
Currently it is drying.
Im hop[ing it will dry into a powder that will crush completely,or crush enough,to be snorted.
I knw you can snort tiny strip pieces or break i down in water and snort that but that is not NEARLY as enjoyable as snorting a powder imo.
Plus I feel that soemtimes the stri misses my membranes or whatever and sticks to the inside of the nose where the hairs are.
The entracnce of the nostril.
I also have others told me that snrting strip pieces doesnt work as well as snorting tablet powder.
I agree with them despite the purity of strips being higher.

EDIT-
I added another .1 units of water containing about 0.75mlgs of Bupreorphine strip to the powdery goop.
I really hope it turns into a snortable solid.
Itd be awesome if it came out solid like a real pill.We shall see.
If it doesnt work its no biggie I guess cuz Ill jus filter and blast off into my bloodstream as usual.
[/I]
 
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ILikeSub

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Idk if anyone has kept up or will read what I wrote above but here is an update.

I have about 1.25-1.5mlg of Buprenorphine[from the film] mixed with that calcium powder still drying up in a spoon.
It has dried out pretty decently and took a very small amount out and attempted to crush it.
ANd it broke up just like a pill so Im thinking this mite work.
The rest of the mixture isn't completely dry and I work in less than ten hours and havent slept so imma kick back.
Ill post results later!
 

bwanajzj

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Yes some doctors are very fearful of prescribing benzos to ex-heroin addicts. There seem to be a lot of people who like to abuse benzos, whether or not heroin was their thing.

In my case, I do not particularly care for benzos. I only use them when I feel it's necessary to have anxiety relief or a good night's rest. This is probably only once a week to once a month at the very most.

If you already have a medical history of being on them, and you call ahead to confirm, a doctor should still be able to prescribe you both.
Any time I would ask my bupe doc about benzos towards the end of my taper, he would get a funny look in his eye, and then say, "no, we don't prescribe that sort here." Either this was because he knew about my heroin history (addictive behavior and tendencies) and had been with me throughout my ORT with bupe, or whether they actually are just a methadone/bupe clinic... I think the latter, but that look he had when I asked has me thinking otherwise. Anyways, probably for the better that they are reluctant to disperse benzos, but then again, I just went to the streets to get them, so what is better in the end?
 

Znegative

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Well I'm starting to hate fucking reckitt Beckinser or whatever the hell they're called. my suboxone costs are really just fucking everything up. It's bad enough that my mom lost her job, my dads been demoted, and I have only minimal freelance work, but my fucking insurance doesn't cover suboxone either!

Then even worse (IMO) I found out that if I changed over to my mother's freelancers' union health insurance, they will cover generic subutex but not suboxone. knowing that my psychiatrist believes that the nalaxone in suboxone makes it impossible to inject (even though I've told her multiple times in the past that I've done it and it indeed works) I asked my mom if she could wrestle with the doc about this issue because these fucking strips are sinking us into a financial grave.
Now maybe to some of you this sounds like a typical addict move to try and get subutex to shoot them up, and I will admit I am a needle fiend, however I prefer suboxone or subutex sublingual now, so I really am just looking at this from an economic stand point. With that aside, my mom did talk to the doc, who finally admits that yes, you can inject both suboxone and subutex, but that the reason that subutex can't be prescribed unless it's an unusual situation is because subutex, UNLIKE suboxone (remember this is my doc's words) doesn't have a cieling dosage because there is no naloxone, and so in that way, it would be just like taking heroin or oxycodone.

Obviously most people on this board know that that's a complete load of bullshit, and I'm living proof. In the end its me taking the meds, not the doctor.

I'm just fucking sick with the confusion and lies about fucking buprenorphine. I can't wait until these mother fuckers lose their patent and suboxone goes generic, though I'm sure they'll fight to the very end to come up with a way to renew it, like some kind of rectal depository, or eye drop. The amount I pay now, each 8 mg strip is worth the same amount I pay for a bag of dope. I feel that that's a travesty.
 

Pegasus

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^What an ass, can you find a different doctor? The ceiling dose is definitely from buprenorphine itself, I think it actually says that in the insert IIRC. If not, show him this link:

http://buprenorphine.samhsa.gov/about.html (note that it is the US government page for buprenorphine)

"The agonist effects of buprenorphine increase linearly with increasing doses of the drug until at moderate doses they reach a plateau and no longer continue to increase with further increases in dose—the “ceiling effect.” Thus, buprenorphine carries a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, in high doses and under certain circumstances, buprenorphine can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream."

...Your doctor is not only wrong about the naloxone, he doesn't even seem to understand that high doses are what make bupe work as an antagonist...
 

ellua

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znegative - find a doctor who isn't an idiot. i don't know what i'd do if my insurance stopped covering sub, it costs more than my half of our mortgage!! that's certainly a dangerous thing for an addict to have to deal with, like you say it's about the same amount you pay for dope anyway-- would bringing that up to your doctor help? it doesn't sound like she's into thinking logically though, so that might just make her freak out instead.

makes me thankful my doc is pretty awesome, he busted me for shopping and is still amazingly supportive. he's a rare find but still i bet it'd be easy to find someone a bit more educated on bupe than your current doc.
 

DeLee

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Znegative I really feel for you man.
This kind of shit gets my blood pumping, the "so called" professionals that think they have the answer to anything and never admits to being wrong about something and IF by a rarity they do admit being wrong - what does she do - She throws some other bullshit in your face about the ceiling doses in belief that you have no idea what it means so she could hide behind that.

What a fucking thing to do, you should absolutelly show her the facts so she can learn something.

I tell you, am I glad I live in Sweden where everybody gets the same care no matter of social status and our Bupe and Methadone are free to us in the programs.
 

ILikeSub

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My concoction solidified nto a hard substance which is just like a pill.
It was a success!!!

I used a little too much calcium powder I think but it worked.
The powder mixture was hard to scrape outta my spoon and is pretty hard to break up too.
For the most part tho it breaks down like an excetionally hard pill.

SO IF ANYONE WANTS TO KNOW HOW TO TURN THEIR SUBOXONE FILM INTO A SNORTABLE SOLID READ MY ABOVE POST OR PM ME AND I WILL GIVE YOU A MORE IN DEPTH DESCRPTION OF HOW TO DO IT!
GOOD DAY TO YOU ALL!
 
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suessmayr

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I live in Australia and it's bizarre reading about how much money you guys blow on this shit! It's totally free here.

I have to say that in my opinion, although your doctor is clearly misinformed, it's a bit rich of you to expect her to give you subutex after telling us that you're a "needle fiend" and telling her that you have injected your suboxone. Subutex is for people who have medical reasons not to be on suboxone and it's not strictly relevant that you could inject your suboxone now as things are. It would be illegitimate for a doctor to prescribe a medicine on the basis of what is more desireable economically. I think it would be even more illegitimate for an insurance company to cover things like methadone and suboxone which are clearly only necessary to the extent that a person generates and persists with addiction.

S
 

suessmayr

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I mean that the people (in my country anyway) who run dosing centres have all sorts of little restrictions and concessions that they use to reward or punish good behaviour: if you behave well for 3 months you get take home doses, and so on. Considering that everyone would prefer subutex to suboxone, it would be illogical for a doctor to swap somone from one to the other when they know that the person is an injecting user.
 

Pegasus

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It would be illegitimate for a doctor to prescribe a medicine on the basis of what is more desireable economically.
Really? A doctor has no responsibility to not to cause a patient waste money they do not have?

I think it would be even more illegitimate for an insurance company to cover things like methadone and suboxone which are clearly only necessary to the extent that a person generates and persists with addiction.
Is addiction not a medical condition like anxiety or depression?
 

suessmayr

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On the first point, no, a doctor does not have any responsibility as such to consider a client's finances, but only to prescribe and administer the most medically appropriate treatment. Or rather, it is reasonably expected that most doctors would not be this indifferent, but that's really only how things are in practice, and an advantage, so to speak; doctors go through medical school learning how to comply with the medical ethics and which considerations are legitimate and which are not.

Secondly, and I say this as someone who has had, and is only now recovering from various addictions, no - addiction is not a medical condition in the same sense as anxiety of depression. I would have thought that this is pretty plain. There is obviously a physical component, but addiction in all its aspects is totally self-induced. If we're being honest, there are a set of choices that lead any person to addiction, throughout the course of which a person's volition and ability to freely decide does, admittedly, diminish. But the first steps, at least, are totally voluntary, and addiction doesn't just come down upon a person; as I said, they have to really persist and make changes to their life.

I understand addiction better than most and have been in some horrible places, but I just can't bear to listen to people abdicate responsibility like this and claim misadventure and all the rest of it. We all have choices, at least initially. The day I began to get clean and to recover from my numerous addictions was the day I stopped playing the victim and always expecting things from the medical profession; it's set up in a way that nurtures the addict, and the whole idea of initiative and choice has just evaporated. I, for one, only got worse during all the long years of indignance about doctor's 'lack of compassion' and so on.

I hope this doesn't invite hateful comments as I'm just explaining things as I see them.

S
 
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