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Bupe Suboxone/Buprenorphine Mega Thread v. 19

sekio

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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. .25-1mg(max) is a typical recreational dose for someone with no tolerance. Bupe is incredibly potent and those with no tolerance report many ill effects like vomiting, sweating, headaches, etc, if exceeding those doses. 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: 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


12mg Suboxone Film Strip


8mg Suboxone Film Strip


2mg Suboxone Film Strip


Temgesic, 0.2mg


Buprenex Ampules


Zubsolv 1.4mg/.36mg and 5.7mg/1.4mg


Zubsolv vs Suboxone Comparison

Locate a doctor that prescribes Suboxone.

Suboxone Assistance Program - Free Suboxone for Low Income Patients

[/QUOTE]

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"

Old threads 17+18 were accidentally merged and are availiable here
 

~QuirKyNai~

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I WAS wondering on if it was possible.to get off suboxone.with.a.shorter acting,higher potency opiate.or any shorter.acting opiate.
I was trying to bring this thought to fruition as of late...I acquired,free of purchasd mind u,a.bumch of sizeable.samples.of rc's..which.were.3cmc(which i.threw.away),ethylone,abfubinaca,ab-chminaca,and lastly some.acetylfentanyl..

I had dabbled lighty the first day.testing the.acetylfent.i had.took my last dose.of suboxone in the a.m...and i started dabbling.the.acetyl around 7pm same day..i must say that it had no problem cutting thru the suboxone,i only take 1mg.in the a.m. and one.more at.night.there are times i.can skip the night.dose...anyway,i ended up just finding a dose that i felt enuff physically,amd took.that for 2-3days all the while not taking any.suboxone..the whole time taking the acetylfent,after.it.wud wear off in about am hour,i wud feel withdrawl and smell that opiate.detox.smell prettg strongly..I was confused at this point..I jad not taken my sub.dose in 2 days,and i was keeping well.with.dabs.of.acetyfent..but i wasnt sure if the withdrawl i was feeling was.from not taking my.suboxone or from the acetyl being.so damn short.acting,and.thats what i was smelling and feeling..Or was the witjdrawl after each acetyl dose as.it wore off plus the fact that i was slowly.withdrawing fromy suboxone the reason i kept feeling crappy.after each.dose of.acetylfent wore.off...
Thankfully i only.dis this for two day,as.i.didnt want to.mess.up my tolerance.bit.all the while i had pondered.if i cuda kept doing small doses of the acetylfwnt enuff for enuff days.to.g3t.to a point.in my suboxone withdrawl where ill feel comfortable.to stop the acetyl...but i think that may ne too strong of an opiate,and WAAYY too short acting..i cudnt believe that an opiate cud last so.shortly.I guess thays.why fentanyl is.ideal in a.surgery setting..
 

~QuirKyNai~

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Also i.havd.been finding that my normal suboxone.dose isnt holding me the same..either that,or it isnt lastimg as.long.Or simce my amxiety is.bad on.suboxone anyway,that the suboxone.itself gives me.anxiety which i correlate with withdrawl.And so it feels as.if no matter how much suboxone.i take,im.stuck with this antsy feeling im my whole body and.anxiety,which.drives me.crazy.

I wonder if all the years of opiate abuse ,and other drug abuse.have fried my nervous system to the point.where.my.body.doesnt.produce.the.necesarry natural.chemicals that it uses to regulate pain,and quell feelings.of.anxiety.
 

nealcassady

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Throughout the past two threads, I've seen at least 4 separate patients mention being left out to dry. Aka their doctor had their license 'suspended' or the practice was 'shut down by the Feds'.

I'm a decade long opiate user who only recently, four months as of now, has turned to a local sub doc for help. Can anyone elaborate on the likely hood of ones own doctor catching the same fate?

I ask bc I'm very happy with how my maintenance is going thus far. 'Honeymoon phase' be damned, I'm content with how life is at the moment. The doctor I see seems to be fairly strict in her guidance, modest in her choice of words during my appointments, all the other signs that she obv doesn't hand the stuff out like candy nor is irresponsible in her instructions.

I'd never imply that ones doctor got shut down simply bc of an irresponsible action; but I'm not sure what the hell goes on at a practice that has met this situation?

In the end I'm kind of confused on how a normal, run of the mill, sub doc can have a license revoked. Has there been data published on the percentage of doctors that lose licenses per year?

I may seem paranoid; though in all reality my maintenance will probably trod along in it's usual, boring fashion -but I can't be the only one worried about having to find a new doctor at the last minute.
 
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The Doc.

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It all depends on where you live really it seems the USA has lots of patients who lose their doctors and end up unable to get their meds I see it every week or so on here it seems. Here in Canada this would never happen they only give it out at methadone clinics and if anything ever happens to a doctor whether they are retired or lose their licence etc. A new doctor is there to write the script, if for some reason no doctor can be found in time if a patient goes to the ER then they can get a script so they are not sick. If you live in the states there is a good chance that your doctor may one day not be there leaving you to worry about getting opiates yourself. In my opinion its because the states really need to put more restrictions on Suboxone. The way they have it where they give addicts a month supply's at a time without having any doses supervised is causing problems with people selling their scripts and abusing the system. Now cops are cracking down on doctors making sure they are not seeing anymore patients then they are allowed making sure they are following proper protocol etc. This seems to be how doctors are mainly losing their licences and the fact that some sub docs work like "pill mills" except with Suboxone and the docs doing this are only in it for the money. This is what can happen when medication like this is allowed to be given out in a outpatient way instead of only being special doctors who can prescribe it for matinence (such as methadone doctors).
 

Captain.Heroin

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Also i.havd.been finding that my normal suboxone.dose isnt holding me the same..either that,or it isnt lastimg as.long.Or simce my amxiety is.bad on.suboxone anyway,that the suboxone.itself gives me.anxiety which i correlate with withdrawl.And so it feels as.if no matter how much suboxone.i take,im.stuck with this antsy feeling im my whole body and.anxiety,which.drives me.crazy.

I wonder if all the years of opiate abuse ,and other drug abuse.have fried my nervous system to the point.where.my.body.doesnt.produce.the.necesarry natural.chemicals that it uses to regulate pain,and quell feelings.of.anxiety.
You're dependent on buprenorphine; so the effects will fade due to tolerance.

You should try addressing your anxiety and see if that helps.
 

~QuirKyNai~

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I know I'm def. dependant on the buprenorphine.Its just been hard getting off.

If I've been taking 1mg in the morning and another 1mg at night roughly 12 hours later how much would roughly be in my system at all times?Because I know it accumulates.Id like to know how long it will take for the buprenorphine to be.completely out of my system.

As of last night I decided to take .5mg and stick to those size doses to further drop down the amount in my sytem at any given time. I think I will try and get.down to .25mg before I decide to either jump off or go a few days and take .25mg,then go another few days without and do that for a while I guess until I can go without...?

I'm really not too sure how ling it takes for a dose to stabalize after a drop down.Any suggestions on this wud be appreciated...I really wana get off this stuff.
 

~QuirKyNai~

Bluelighter
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I don't know why but its been difficicult to drop from 1mg down to .5mg..anybody know why that drop seems so much more significant,than from say 8mg to 4mg..?
 

The Doc.

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Everyone reports this I believe its partly due to the fact the half life of Suboxone is largely dose dependant meaning low doses will not hold you as long and your plasma levels get really low quickly. Whereas large doses like 8 or 4mgs are lasting so long that you hardly even notice when you drop your dose. Another thing is your dose is being cut down by 50% although people can usually cut a large dose in half with no problem, with smaller doses its not the same it becomes hardest to taper around 2mgs or so usually. So try easing the transition by dropping by say 0.2mgs each time.
1mg
0.8mgs
0.6mgs
0.4mgs
0.2mgs
 

Captain.Heroin

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The dose effects curve is unique. After 0.1 to 0.3 mg IV, you've essentially reached maximum effects. Only slightly more effects can be gained by exceeding this amount.
 

FixinMyditch

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Subutex Detox

It's a F'in nightmare! Worst drug in the world, really. It would've been so much easier to just deal with the opiate w/d back in the day....but here I am, after taking subs for years...still fighting the demon. It's never actually a problem as I use it to "maintain"...UNTIL I have to take a drug test. It's HIGHLY frowned upon in my line of work so just putting it down and showing my prescription won't fly. I tried to kick the habit once, but after 17 days clean (Yeah, SEVENTEEN)...I still felt like pure hell, diarrhea, the whole nine yards...and it was my son's birthday...so I caved and took one...which led to another one...and another....and now here I am trying to study for a test again.

Little story for anyone interested because I've seen all over the web people ask, "How long does it take to get out of your system?" Well, I had been a heavy user for a long period of time so that factors in..(16-24mg daily for...well, years) but anyhow, during my 17 day period of 'sobriety' I decided that I needed a benzo. I thought the whole reason I abused drugs in the first place was because I was anxious! I really am, btw. So, it was logical to me to kick the subs and seek a benzo. Most doctors won't prescribe benzos while you're on subs (with the exception of klonopin) so I stalled my appointment with the doctor I was seeing about my anxiety long enough that I was sure the subs would be OUT of my system. So, I go to the doctor, pay my money, piss in a cup.....and the lady says, "Mrs. Red lips, your test came back positive for bupe" It had been NINE DAYS since I had taken anything. NINE! I was shocked. So, when people say online that it takes 3-4 days blah blah...um, no. I'm sure the fact I had taken a high dose for a long time factored in.

Today makes day 7 that I haven't taken any. The withdrawals aren't bad at all this time, but I do have the help of klonopin this time which I didn't before. I've had a little diarrhea and of course the occasional moment where I've thought, "fuck it, i'll just take someone else's piss to the test!" aka cravings. otherwise, I feel fine. I feel like the klonopin has been a lifesaver through this detox. Anyhow, I took an at home drug test a few days ago which I ordered online. I ordered 5 bupe tests online for about 9-10 bucks shipped to my door. I took one on day 3 which came back positive and was really just a waste. I took another on day 5 which came back positive. I'm gonna take another on Friday which will be day 10 and hope for the best. I have to get this shit outta my system.

I plan on posting pics of my FAILED tests as a little guide/diary for anyone searching about how long it takes because I've seen so much conflicting info on the web. Maybe it'll help someone.
 

pingg

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Hey peeps.apologies if I do this wrong..first post..been on the street b for months this time. Got px of 8mg bupe today. Feel like death.and.im 8stone! Any comprehensive ideas bout long this hell will last or the b wil effect me again? Many thanx x
 

wezface

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Hey peeps.apologies if I do this wrong..first post..been on the street b for months this time. Got px of 8mg bupe today. Feel like death.and.im 8stone! Any comprehensive ideas bout long this hell will last or the b wil effect me again? Many thanx x
If it's your first ride through detox (and I'm guessing it is), the acute phases shouldn't last more than 4-6 days depending on your use (amount, duration, etc), your metabolism, and how quickly you can flush it out. Keep in mind your brain "forgot" to produce endorphins as the opiate bound to the endocrine receptors that are usually for that, so the sickness is your body re-learning that it needs to produce endorphins. Hence, exercise, orgasms, food, anything that can help with endorphin production helps. This will probably sound ridiculous today but give it a few and you'll feel like getting out again. Drink lots of water. If you're vomiting, get some nutrient supplement shakes to help keep your body nourished. Good luck, godspeed
 
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