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Bupe Suboxone/Buprenorphine Mega Thread and FAQ v14.0

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Albion

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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:

  • Bupe is CIII in the US.
  • Metabolized by CYP3A4(see potentiation thread for potentiators).
  • Half-life: 37 hours.
  • Drug tests: Not detected by regular 5 panel tests.
  • A interesting thread by 'medicine cabinet' about a new version of Suboxone that's currently being tested can be found here.
  • Buprenorphine gets metabolized into norbuprenorphine and into conjugated buprenorphine and norbuprenorphine.

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
Alcohol and Suboxone - Alcoholic Solutions for Higher BA With Sublingual Use**
Buprenex - should I IM or IV?
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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burn out

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Shouldn't you post a picture of the film strip itself and not just the packaging, or no?

ANyway, I have a Q about suboxone. I find that if I take a large dose like 4 mg as i am coming off a heroin habit i cannot lSleep at all (due to the WD) however, although the suboxone helps a lot it causes me to have all these crazy closed eye visions/hallucinations like flying through strange worlds sometimes resembling something you might find in a video game. Does anyone else have this happen? It really bothers. I

Anyway I am wondering what dose I should take next time to try to prevent that from happening? I find that, when I am coming off heroin suboxone gives me partial relief to my WD symptoms, like it makes me feel 50% better but not 100%. Taking more suboxone doesn't matter. I mean I think I took 19 or 22 mg one time and I felt no better then wehn I'd taken 4 mg. So I'm wondering, what do you guys think would be the lowest effective dose for helping one to come off heroin? I current.ly have an $80 a day heroin havit but I plan to try to raper down to $20 $30 a day before switching to suboxone.
 

XTCAKE

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This was discussed in a different thread in the OD Forum, but I personall think it would be a better place to discuss here. Does anyone get prescribed the Suboxone gelatin/gummy-type squares? I'm not referring to the Suboxone strips. I'm curious because I honestly had NO clue they existed until today. I did some research and found some information on another forum posted in 2009 discussing these things!

Shouldn't you post a picture of the film strip itself and not just the packaging, or no?

ANyway, I have a Q about suboxone. I find that if I take a large dose like 4 mg as i am coming off a heroin habit i cannot lSleep at all (due to the WD) however, although the suboxone helps a lot it causes me to have all these crazy closed eye visions/hallucinations like flying through strange worlds sometimes resembling something you might find in a video game. Does anyone else have this happen? It really bothers. I

Anyway I am wondering what dose I should take next time to try to prevent that from happening? I find that, when I am coming off heroin suboxone gives me partial relief to my WD symptoms, like it makes me feel 50% better but not 100%. Taking more suboxone doesn't matter. I mean I think I took 19 or 22 mg one time and I felt no better then wehn I'd taken 4 mg. So I'm wondering, what do you guys think would be the lowest effective dose for helping one to come off heroin? I current.ly have an $80 a day heroin havit but I plan to try to raper down to $20 $30 a day before switching to suboxone.
Are you planning on doing this whole "recovery" thing without any medical professionals? I'm just wondering. And, hey, I played the "taper down my. Dope dosage" game before I quit, too; if you can really do it, congrats! I couldn't.
 
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Captain.Heroin

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Shouldn't you post a picture of the film strip itself and not just the packaging, or no?
Why, so Bluelighters can start making fake 8mg films? No thanks... ;)

The Captain has literally just had two IM buprenorphine shots today and feels amazing. Walking around in below 60° F weather doesn't bother me at all as it normally would. Tapering has been going splendid!

By the way, that 8mg film wrapper was personally scanned in by The Captain. I can tell based on the photobucket account.

New Mega Thread has dead links....

https://www.mja.com.au/public/issues/176_04_180202/cla10539.html - dead

It doesn't take all that long to test out links. ;)

xHippiexchildx

Buprenorphine is not 50 times as euphoric as morphine. Nor is it 50 times as addictive as morphine. So why does 50x the potency mean that much bad things to you?! Heroin/morphine is by far worse than buprenorphine, and I don't need to sit here and argue it to you. (Theoretically, not literally...) Get a heroin addiction. Get on Suboxone to get off heroin. You'll enjoy life on Suboxone more, I think everyone here hated their life as a heroin addict. I don't think a single one of us will think about using heroin and say only positive things about it. Get real. OK?
 
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xHippiexchildx

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(Continued from previous thread)

People can and WILL overdose on suboxone if they don't use it right. The percentage of people overdosing from suboxone is a lot higher then people like to think, or admit for that matter.
 

XTCAKE

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(Continued from previous thread)

People can and WILL overdose on suboxone if they don't use it right. The percentage of people overdosing from suboxone is a lot higher then people like to think, or admit for that matter.
So, what's your point? Is this still part of your "Suboxone should be banned" arguemen"?
 

specialrelativity

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Mushrooms are boring.
They don't really work.
 

jazz hands

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(Continued from previous thread)

People can and WILL overdose on suboxone if they don't use it right. The percentage of people overdosing from suboxone is a lot higher then people like to think, or admit for that matter.
You can't deny though that it is far harder to overdose with buprenorphine than it is with any other pharmaceutical opiate.

They work, it's just that they have the worst withdrawals because they last for fucking decades.
You'll feel better soon. I've kicked bupe a few times and while it does linger, it will go away. Maybe try a little kratom here and there to get through especially difficult times.
 
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xHippiexchildx

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I did taper. I tapered all the way down to 2mg, but obviously it wasn't enough, and after 3 months i'm definitely not starting to take it again. Fuck that.
 

XTCAKE

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I did taper. I tapered all the way down to 2mg, but obviously it wasn't enough, and after 3 months i'm definitely not starting to take it again. Fuck that.
Well, yeah, you should've continued to taper down lower than 2MG's before just stopping completely! No wonder you're a Suboxone hater.
 

tricomb

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I did taper. I tapered all the way down to 2mg, but obviously it wasn't enough, and after 3 months i'm definitely not starting to take it again. Fuck that.
I can understand why you didn't benefit from Suboxone. Do you?

You needed to taper down much lower than 2mg. You know how potent bupe is, yet you decided to jump off at a high dose??? Would you stop using heroin cold turkey after lowering your tolerance from 10 bags a day to 5 bags a day? No.

You wouldn't have had such a hard time if you had tapered off properly, like down to 100-200 micrograms before jumping off completely.
 

brokenpinky

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I did taper. I tapered all the way down to 2mg, but obviously it wasn't enough, and after 3 months i'm definitely not starting to take it again. Fuck that.
That is a high dose to jump off at. I'm tapering down myself right now. I started at 10mg in the middle of January this year. I'm at 4mg now, I'm going down to 3mg tomorrow.. I want to get down to .25mg then start skipping days. So far it has been a breeze for me, I keep waiting for the other shoe to drop every time I drop down in my dose but it never happens. I might get the sweats, but that about it so far for me.

I can understand why you hate suboxone, but if it wasn't for it I would be dead right now. I went from having a towel tied around my neck with the other end over the closed bathroom door, feet dangling, face red , lips blue. To taking my 8 year old son fishing today. I would of never kicked my habit with out Suboxone or got my life back with out it. Done my drug or choice for to long at a way to high amount to quit. I'm happy I got my life back to some degree.
I hope you can get yourself feeling better too.
Have you tried some hardcore aerobics? I mean if you able. exercise as much as you can I mean not just a few minutes a day I mean hour or so. Just move and don't stop. The human Body is amazing thing. The more you work it the more it responds to the hard work. You will heal..
Peace.
 

Znegative

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I did taper. I tapered all the way down to 2mg, but obviously it wasn't enough, and after 3 months i'm definitely not starting to take it again. Fuck that.
All the way down to 2mg?? I'm sorry but your problem with suboxone is your own fault (as well as your doctors). getting down to 2mg is not even that hard, it's when you get below that dosage that it becomes more of a challenge, as you are by that point definately under the cieling effect-meaning more pronounced drops and peaks in blood levels. I don't really believe that you can avoid withdrawal completely, but you can certainly lessen the severity. The people I know that had an easy time kicking, jumped off at about .125mg.

Buprenorphine is prescribed for pain in dosages of .2mg tablets, so how can you expect an easy time from jumping off at a dosage 10 times that ammount?? There is a lot of misinformation fed to patients by their prescribing doctors regarding buprenorphine, but in this day and age, you have the ability to seek out the truth regarding medications, and since that's the case, your the one to blame for your suboxone withdrawals as you obviously didn't even try to research it. Had you tapered down more, your experience would have been a lot less miserable.
 
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