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Bupe Suboxone/Buprenorphine Megathread and FAQ v10.0

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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



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. 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.
 

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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**
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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infamousryan

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my buprenorphine/suboxone detox.. for you..lowered my tolerance alot

hey yo. I would just like to post my sub experience.
I have had vasodilation (swelling of the feet) from suboxone before. but at 34mg which i would never take again

now no matter what dose i take my feet swell

so this is what i did. i went from 8mg to 4mg to 2mg and jumped in 4 days i've been on suboxone 4+ years(you can do this more slowly)
(plus whatever was built up in my system was still lurking from 4 years plus taking)

I went out and bought a SHIT TON OF SUPPLEMENTS
Acai Berry
Cranberry Extract(take lots)
Apple Cider&Vinegar Extract
Regular Centrum vitamins
Fiber capsules ( a must - take lots)
Protein Shake
Super Green Tea Extract
Biotin(optional)
Omega 3-6-9 Fatty Acids(optional)
Colon Cleanser(optional)
anything with antioxidants
Lutein(optional)
Flaxseed Oil
Beta Carotene

For 2-3 days i used time release 120mg dihydrocodeine after jumping off of sub. after 3 days i was able to get COMPLETELY FUCKED UP off of 200mg of codeine. that means my tolerance dropped over 400mg!

2mg of bupe = 660mg of codeine = 60mg of hydrocodone.


after i was done doing this, i tried sub again.. 1mg under the tongue had me completely fucked up. i am now doing the detox over again cause' i succumbed to the suboxone.

here are some more great things that will help you. one is the acai(first link), another is a super fruit extract super antioxidant blend.
http://www.amazon.com/gp/product/B001RYM9XE/ref=oss_product

Fruit Juice Extreem TM HIGH POTENCY Amazon ACAI, Blueberry, Goji Berry, Mangosteen, Hawaiin Noni, Black Cherry, Resveratrol, and more, high antioxidants

http://www.amazon.com/gp/product/B001RYM9XE/ref=oss_product

drink milk to help coat your stomach. remember - fiber and antioxidants are a must - this is how opiates are removed - urine and feces. antioxidants also cleanse the body.

another optional thing, you might laugh, is the kinoki cleansing detox pads.


check it - i totally detoxed with this stuff in under a week. i was on subs for 4 years! with a 4 month break and a 1 month break! I was started at 34mg! hope this works for you

i have more to add like i only ate rice pudding and stuff even though i was not nauseas, just not hungry.
ibuprofen for headaches
something to goto bed if you need it
something for the runs if you need it (Immodium AD,Pepto,Etc)

if you're widthdrawals are really that bad, do all this, check with your doctor, and take a shitload of tranqs and knock yourself out for the last few days of the major withdrawn symptoms
-------------
Tips for overcoming W/D symptoms:
1. DISTRACT YOURSELF
I could not possibly stress this enough. Those of you who've ended up on this website are probably a) somewhat intelligent (or at least computer-adept) and b) somewhat introspective / intraverted. This means that you're probably going to spend most of your day thinking about how you're feeling and catalouging the symptoms you're experiencing. The problem with this is that the mere process of self-analisys is creating and amplifying your symptoms!!!
2. CREATE YOUR DEFENSE
What I mean by this is; Arm yourself with whatever will possible help you get through this, both physically and psychologically. Get yourself some relatively benign medications (aspirin, etc) and when you are experiencing pain, take one. (not more than is medically sound). This helps not just because of the actual effect of the drug, but because you feel as though you've got the edge now. You're not trapped, you've got your little army of medications (aspirin, melatonin(sleep), chamomille tea(also sleep)) to help you get through this.
3. STAY ACTIVE
This is pretty self explanatory, and it helps in multiple ways. First off, while you're active, you're hardly ever thinking about your symptoms. When I went through my methadone withdrawal, I spent 8-12 hours each day chainsawing through trees, and during those hours, I felt (relatively) alright. Staying active also helps because it will increase your odds of getting a good nights sleep.
4. EAT HEALTHY
Remember that everything you put in your body is helping to get the toxins out of your body. Every trip to the bathroom means slightly less opiates in your system!
 
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SkagKush

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2mg again today, i really do plan on going down soon, Ive been stabilized here for quite some time.....but IN gives me headaches (good high in small doses).... so i will just go down to 1mg chunks which are really easy to make with a razor......Subling btw....

even then its not a full 4 pills a months......
 

Captain.Heroin

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2mg again today, i really do plan on going down soon, Ive been stabilized here for quite some time.....but IN gives me headaches (good high in small doses).... so i will just go down to 1mg chunks which are really easy to make with a razor......Subling btw....

even then its not a full 4 pills a months......
Awesome man. It's weird you get headaches from snorting it, I haven't heard that frequently before (some people get headaches with any ROA however).

If sublingual works for you then that's great!

I know what you mean though, I have been stabilized for a while too and am considering going down or just staying here, since I am probably going through 1 pill or slightly less per month.
 

SkagKush

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id be curious what you decide.... your on a whole new level of a low dose......

have you tried taking a break like JB? im just curious, no attack.......

i think ill drop down to 1mg after my three 2mg chunks are gone, in three days..... even tho i could make them 1mg
 
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Captain.Heroin

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id be curious what you decide.... your on a whole new level of a low dose......

have you tried taking a break like JB? im just curious, no attack.......

i think ill drop down to 1mg after my three 2mg chunks are gone, in three days..... even to i could make them 1mg
I have not tried taking a break. I have incidentally gone 12 to 24 hours without dosing before, but that's about it.
 

jamesBrown

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and when you went those 24 hours without dosing, did you get any signs of WD or sickness?
 

Captain.Heroin

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and when you went those 24 hours without dosing, did you get any signs of WD or sickness?
In the past, yes, now a days, no. The only WD-like symptoms I have now are just feeling slightly tired when I'm coming down. Kind of like how you feel happy but tired after eating a very satisfying meal.

I really enjoy IVing buprenorphine too much to forego using it longer than that. If I had a really heavy 2 day + psychedelic experience going on, I could definitely forget to use it/have it not be on my mind, but that's probably the only way I would go that long without it lol! That, or if I took enough sedatives to be asleep for quite a long time.

OH, also, I am 110% pissed :)X) that the site I order my needles from nearly doubled the price for the type of insulin syringe/needle I use. It's no big deal, seeing as the 1/2 CC version is the same price, but they all used to be $14.99 per 100ct box; then they were $19.99 per 100 ct. box; now my favorite ones are $30+ for 100, though the 1/2CC and 1CC are still $19.99.

The ultimate resolution to this conundrum is moving out west where needle exchanges regularly carry 31G insulin syringes. But until then, I will have to move up to a 1/2 CC syringe.
 

jamesBrown

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i wonder what the needle exchange carries at my methadone/sub clinic.....

also wonder what the safe inject has....
I wonder when the state I live in will allow needle exchanges.

It enrages me so much, but I know that anger doesnt solve problems so I decided that when im a little older and have more spare cash, im gonna buy a bunch of boxes of syringes(the boxes with 10 packages of ten rigs in each, meaning 100 needles) and then go to places known to have HIGH IV drug use(the west and south side in my city) and pass out the 10 packs one by one to different people who need them. Ill even go to the "dope houses" and drop off a box to them and tell them ill keep bringing them needles as long as they give them out to everyone who makes a purchase.

I dont really care about the risk too much. I was able to make heroin purchases all over the city I live in thousands and thousands of times, so I dont think its to much of a risk to hand out needles. And if I get arrested, I wouldnt mind cuz hopefully I prevented someone from getting HIV or something like like that.
 

jamesBrown

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When I use to IV heroin all the time, i would witness people ALL over the place(especially in poorer areas) that just have one needle that they use until it breaks apart or is basically non functional anymore, and then they go and try to find another one. Ive seen people pick needles up off the street and use them. It was so disgusting and yet pathetic that these addicts dont have the option of going to a needle exchange.
I even use to re-use my neeldes up to 30 times because I was poor and addicted to heroin so you can imagine where all my money went. So i know how hard it is to live in the state I live in and be an IV drug user.....thats why I want to give these drug addicts the opportunity to be more safe, sterile, and help prevent the spread of deadly diseases throughout our community.
 

jamesBrown

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i cant Imogene using a needle till it falls apart

thats haggard....
Where I live, thats pretty much how everyone does it unless your rich.

i dont evenwanna think about the diseases being spread and all the other complications resulting from no needle exchanges. It enrages me so much.
 

SkagKush

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ya fair enough, i dont tend to associate big bucks with rigs because its free here, as long as you acquire one first......

yo james bro, how are you feeling? r u alive homes?
 

jamesBrown

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ya fair enough, i dont tend to associate big bucks with rigs because its free here, as long as you acquire one first......

yo james bro, how are you feeling? r u alive homes?
Im still in horrific pain and am going to the hospital tommorow morning. They will more than likely have to perform surgery. I dont want that so im gonna do my best to have as many bowel movements as possible between now and then.
Im seriously contemplating just manually pulling the shit out of my rectum. I know that sounds disgusting but if it will relieve my pain I would do it without a second thought.
I basically just spend my time rolling around on the floor moaning in pain, and then getting up to take my medications and then go back to the floor. Im not gonna lie, sometimes I cry it hurts so bad. And sometimes when i am allready up from getting my meds, i think I might as well log onto BL just to see whats up because it kinda distracts me from my pain a little bit. I mean, im still in horrible pain, but even just a slight decrease in pain would be a godsend.

I guess I will let you know tommorow(or maybe longer depending on how long im in the hospital) how im doing.
 
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