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Bupe Suboxone/Buprenorphine Megathread and FAQ v7.0

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Captain.Heroin

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Thread version 1.0
Thread version 2.0
Thread version 3.0
Thread Version 4.0
Thread Version 5.0
Thread Version 6.0


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

I couldn't find photos of Tamgesic, and Buprenex just comes in vials

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.
 

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**
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?
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*
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 to v7.0!

Welcome to the new Suboxone Mega Thread!

I'll take this opportunity to quote what I typed in the beginning of the Suboxone Mega Thread v6.0.
http://www.bluelight.ru/vb/showthread.php?t=488232&p=8068014


We've tried to clean up this thread so that it's the most informative it can possibly be. If you think of vital information to add to the first post, or any other frequently asked questions that would fit well in the second post, please volunteer ideas here. title your questions as "ideas for the FAQ" or "ideas for the first post" so that a moderator, like but not limited to myself, can see that you all have ideas to expand upon this thread.

The idea behind making this more informational, is so that we don't have to merge all your Suboxone/buprenorphine questions into here. In fact, we're more likely than not going to quote the mega thread (if you post a question that has been answered in the FAQ) and then close the thread, so as to keep the mega thread open for more advanced discussions, and for people to expand upon the FAQ's if the answer is not fully explanatory or easily comprehended.

This way, we can have a more on topic, more productive, less repetitive mega thread for everyone. :)
For v7.0, I'd really like feedback on the first three posts of the thread. Is it informative? Does it begin to answer your question, or at least present a sub-thread you could bring up your discussion/ideas/questions in?

I've tried to incorporate all Suboxone related posts, or at least posts that may involve a specific discussion relating to Suboxone, or other formulations including buprenorphine. Does the Suboxone Mega Thread Directory work well for you? If there's any Suboxone/buprenorphine threads that should be added, don't hesitate to draw our attention to it. :)

Any positive feedback would be welcome. %)
 

Captain.Heroin

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Version 8.0... Coming to a thread near you!

I want to let you guys know that I'll be opening the new version of this thread, 8.0, later on when we finish this one off.

If you all have any ideas/comments, please don't hesitate to post them in this thread.

User feedback can be a really great way to know what changes to make, so please take your time to give us a few ideas and thank you in advance for helping us out!
 
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ashla

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suboxone and overdose potential

apologies for not putting this in mega thread and i wont lie i didnt search very much, i have been on suboxone two yrs i am not afraid i would overdose, and i dont believe there is a huge chance, but this is the reason i am asking.

i am the mother of a fourteen yr old girl, i am sure she has drank and i know she smokes(i was fourteen once also) but the other night her and her girlfriend were getting ready in my bathroom and i usually keep one pill only in medicine cabinet and rest of my meds in lock box (one of her wonderful friends stole a bottle of my adderal a while ago)

i dont really think she is into pills because she herself gets focalin and we have to force it in her

the problem was after i took them somewhere i came home and could not find my pill, then she came home and she was vomitting and sweating profusely, i know she wouldnt know you dont use the whole pill and i know she would think she could swallow it. i called the other girls mother and asked how she was and told her the situation but she was fine,

through all of this i did find my pill it fell behind something, but the reason i asked is for a just in case thing, i have talked to her about suboxone since then but like i said her friends have stolen my pills before , i am very cautious usually and i dont even keep alcohol in the house,

i am sorry if this is in wrong place, and the only info i got was people dying in europe by using benzo's with it, i just was hoping to here some people's opinions, not that i am gonna be leaving them around, but i wish that night i knew , i pretty much stayed up all night watching her breathing . i almost took her to the hospital but she already has been sent there for threatening to cut herself, and they also know me there, small town crap, then i found the pill

but like i said its not like i am expecting this to happen again, but there are suboxone pills floating around now like methadone used to just would like some opinions sorry if in wrong place and sorry such a long post and i really suck at punctuation but i love my daughter and want to know if anyone thinks there is overdose potential in opiate niave teens

thanks ashla
 

Captain.Heroin

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Let the games begin!

This is a final bump on the Suboxone Megathread and FAQ v7.0

Welcome to the new thread everyone! Hope you enjoy it here. I have been on Suboxone (and have tried brand name Subutex) for a little under 2 years now. I have been off of heroin for 18 months now. %)

If you have any ideas on the way we have discussions here, positive feedback, or constructive criticism is always welcome. :D

If you want to review the previous mega threads, they are in the OD Archive, and are linked above.

Enjoy!
 

Captain.Heroin

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Merging into the *brand new* mega thread

i dont really think she is into pills because she herself gets focalin and we have to force it in her
I wouldn't willingly take Focalin either...I wouldn't force your daughter to take it.

If she needs medication for ADD/ADHD, try getting something for her she will want to take.

the problem was after i took them somewhere i came home and could not find my pill, then she came home and she was vomitting and sweating profusely, i know she wouldnt know you dont use the whole pill and i know she would think she could swallow it. i called the other girls mother and asked how she was and told her the situation but she was fine,

through all of this i did find my pill it fell behind something, but the reason i asked is for a just in case thing, i have talked to her about suboxone since then but like i said her friends have stolen my pills before , i am very cautious usually and i dont even keep alcohol in the house,

i am sorry if this is in wrong place, and the only info i got was people dying in europe by using benzo's with it, i just was hoping to here some people's opinions, not that i am gonna be leaving them around, but i wish that night i knew , i pretty much stayed up all night watching her breathing . i almost took her to the hospital but she already has been sent there for threatening to cut herself, and they also know me there, small town crap, then i found the pill

but like i said its not like i am expecting this to happen again, but there are suboxone pills floating around now like methadone used to just would like some opinions sorry if in wrong place and sorry such a long post and i really suck at punctuation but i love my daughter and want to know if anyone thinks there is overdose potential in opiate niave teens

thanks ashla
There is potential that you can overdose on Suboxone, but the only way that would happen is if you mix massive amounts of CNS depressants with it, or have a pre-existing condition.

The best way to take care of this situation ashla, is to only take your meds out of the lock box when you need to. Chain the lock box down to something so you know it isn't going anywhere. This is the best way to take care of this situation.

We just got a new mega thread started, so your topic can be the first thing we discuss. :)
 

homeydontplaythat

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IV bupe dose

im wondering what the OPTIMAL dose is for IV bupe. im thinking that since it is supplied in 300mcg IV vials more than anything that this is indeed an ideal dose.

i should probably try .3mg x3 per day. that is only .9mg IV or 3mg sublingual but i think that is all i need. moreover, since its a partial agonist, it makes much sense that using more just allows the antagonist properties to override the agonist effects. the metabolite norbuprenorphine is actually what produces the agonist effects and i think keep a very low dose allows for this to predominate in what attaches to the receptors.

if you use a higher dose the actual bupe would be more prevelant and block the norbupe from binding, this sound right???

how much room do i have to play with before the antagonist effects kick in?

ill probably try volumetric measurments to get several .3mg doses and see how many times per day i end up using them. i may need .6mg in the morning but if i space the doses 8hrs apart i doubt that.

so anyone have any experience???
 

Captain.Heroin

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im wondering what the OPTIMAL dose is for IV bupe. im thinking that since it is supplied in 300mcg IV vials more than anything that this is indeed an ideal dose.

i should probably try .3mg x3 per day. that is only .9mg IV or 3mg sublingual but i think that is all i need. moreover, since its a partial agonist, it makes much sense that using more just allows the antagonist properties to override the agonist effects. the metabolite norbuprenorphine is actually what produces the agonist effects and i think keep a very low dose allows for this to predominate in what attaches to the receptors.

if you use a higher dose the actual bupe would be more prevelant and block the norbupe from binding, this sound right???

how much room do i have to play with before the antagonist effects kick in?

ill probably try volumetric measurments to get several .3mg doses and see how many times per day i end up using them. i may need .6mg in the morning but if i space the doses 8hrs apart i doubt that.

so anyone have any experience???
You can IV many milligrams before buprenorphine agitates itself at the mu-opioid receptor. There is never a need to use this much unless you have a high opiate tolerance.

I would recommend starting at 200 micrograms to get a feel for it.

We can discuss the optimal dose for IV Suboxone in the mega thread. :)
 

Ashley26

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so I haven't had any suboxone in over 48 hours, and been using vicodin instead. The first day I actually felt something from it, but now I'm feeling nothing at all from 20mg of hydro at a time.

I think i'm just going to go back to Subs tomorrow, like you said Captain. It just seems pointless. I don't feel a thing.

So strange cause last night when I took 20 mg I actually felt really high. Then I've taken about 40mg today and didn't feel any of it. grrr
 

homeydontplaythat

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cap H, ive been injecting suboxone and subutex for years now. 200mcg per shot sounds really low. i would think 300 mcg would be ideal since that is what the vials come in. i will experiment tomorrow. i also tried adding diphenhydramine to my shots and i do get a little rush from it, but nothing that really potentiates the bupe. makes me wish i had some real opiates, and i dont like that.

ideally, once i take this hair follicle test i can order some phenazepam and use that with some hash to get a buzz no and again. i dont want to go back to heroin. ive been having a glass of wine at night a few nights a week and it is not satisfying the urge to get a tiny buzz like once a week or so.

goddamn, i have to wait until the begining of may until i am clean enough to take this test. it goes back 3 fucking months!!! and im NOT going to test positive as it is tied into legal matters.
 

daddysgone

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so I haven't had any suboxone in over 48 hours, and been using vicodin instead. The first day I actually felt something from it, but now I'm feeling nothing at all from 20mg of hydro at a time.

I think i'm just going to go back to Subs tomorrow, like you said Captain. It just seems pointless. I don't feel a thing.

So strange cause last night when I took 20 mg I actually felt really high. Then I've taken about 40mg today and didn't feel any of it. grrr
Might I suggest that you get stabilized on bupe before you start messing around with other opioids. I know you have just begun your bupe treatment, and I think the best thing would be for you to only take bupe for at least a month. Let your body get used to it and settle into a good dose. Then if you want you can begin to "cheat" here and there. I just think its a bad idea to start messing around this early in the game. Good luck-DG
 

Ashley26

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I agree. Was a stupid move. I just got my hands on a bunch of vicodin and made the wrong decisions.


I plan on starting sub again tomorrow.

just curious though. Why do you suggest a month on sub before messing around again.
 

Captain.Heroin

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cap H, ive been injecting suboxone and subutex for years now. 200mcg per shot sounds really low. i would think 300 mcg would be ideal since that is what the vials come in. i will experiment tomorrow. i also tried adding diphenhydramine to my shots and i do get a little rush from it, but nothing that really potentiates the bupe. makes me wish i had some real opiates, and i dont like that.

ideally, once i take this hair follicle test i can order some phenazepam and use that with some hash to get a buzz no and again. i dont want to go back to heroin. ive been having a glass of wine at night a few nights a week and it is not satisfying the urge to get a tiny buzz like once a week or so.

goddamn, i have to wait until the begining of may until i am clean enough to take this test. it goes back 3 fucking months!!! and im NOT going to test positive as it is tied into legal matters.
Hydroxyzine potentiates buprenorphine nicely, but I prefer buprenorphine by itself most of the time. 200 micrograms is pretty low, I have gotten all the way down to < 100 micrograms per shot.

I have been IVing buprenorphine for about a year now, I started getting better effects at lower doses. 0.5mg was the highest dose I did with the best effects. Anything above 0.5mg was really overkill.

Now, I get just as good of a high with 0.2mg, just the same as using 0.5mg. Dpending on your opiate tolerance, you can only get but so high with buprenorphine in the first place. Dosing higher than that just increases the drug in your system, and inevitably (if taken in very high doses) the surplus of buprenorphine will spill into other receptors.

Everyone's different, some people never got "good effects" like a rush for example, from IV buprenorphine, even with 0.2mg IV.

I plan on starting sub again tomorrow.

just curious though. Why do you suggest a month on sub before messing around again.
Because that's enough time to have let your opiate tolerance drop down a noticeable degree, and you will likely have begun tapering off of Suboxone at least a small part of the way by then.
 

HdoubleODeezy

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new suboxone thread, cool. these things reach 1000posts quick..
really don't have much to add to this thread yet.
just that i stopped IVing my dose of .3mg 4-5x/day and went back to snorting for a little bit. i plan on going back to IV in a couple/few weeks.
i just felt i wanted to give my veins a break, and let some scar tissue heal.

if anyone is looking for something different to take with their bupe dose to make it more "fun"or to potentiate it, i suggest smoking some blue lilly. i just started recently and it feels nice. (i can't smoke weed cuz of anxiety/panic attacks :| ) so this is a good replacement for me. the effects aren't like weed, its kinda like a benzo high. it deff chills you out and is nice with bupe :) .
 

Captain.Heroin

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new suboxone thread, cool. these things reach 1000posts quick..
really don't have much to add to this thread yet.
just that i stopped IVing my dose of .3mg 4-5x/day and went back to snorting for a little bit. i plan on going back to IV in a couple/few weeks.
i just felt i wanted to give my veins a break, and let some scar tissue heal.

if anyone is looking for something different to take with their bupe dose to make it more "fun"or to potentiate it, i suggest smoking some blue lilly. i just started recently and it feels nice. (i can't smoke weed cuz of anxiety/panic attacks :| ) so this is a good replacement for me. the effects aren't like weed, its kinda like a benzo high. it deff chills you out and is nice with bupe :) .
Glad to hear you're taking a break man. :)
 

PhilaPunK

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this is insane, but 10MG of fentanyl under the tongue doesnt do anything now. I barely get high at all. It used to do the trick, but now after taking subs for 2 weeks i feel nothing but a moderate buzz. im upset about this i was looking forwar to getting high, but 10 mg of fent doenst do shit. it should kill me this is insane!
 

daddysgone

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this is insane, but 10MG of fentanyl under the tongue doesnt do anything now. I barely get high at all. It used to do the trick, but now after taking subs for 2 weeks i feel nothing but a moderate buzz. im upset about this i was looking forwar to getting high, but 10 mg of fent doenst do shit. it should kill me this is insane!
10mg of fentanyl??? are you serious??
Jesus, that is an insane dose. Are you sure you didnt mean mcg?

Also, why are you taking a dose that you state "should kill you"? -DG
 
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