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Suboxone induction

L

Laquintahusker

Greenlighter
Joined
Feb 27, 2016
Messages
3
Ok I know this has been asked but I need PERSONALS help from that dude that is always around on these forms and helps people with induction onto suboxone. I don't remember his name. Maybe Robert? I am trying to induce onto suboxone as soon as I can, before I work tomorrow. I took my last shot this morning around 7am. And I believe I work at 4pm tomorrow. And I NEED to go to work tomorrow. If anyone has advice. I know I gotta wait until I'm in moderate withdrawals or whatever which is exactly what I'm planning on doing. But I would like someone to help me get through the bullshit and make sure I'm inducting at the right time so I don't go into PW's. Anyways not sure where this was suppose to go, since this is only like my second post ever. Any help is appreciated.
 
Hey dude. I've used subs in some form or another several times, always to get off H. Most of the time, I rapid tapered off and then got back into H and had to get back on subs, etc. I've precipitated withdrawal by taking subs too early many times.

What I've learned is that you have to WAAAAAIIIIITTTT until you are in FUUUUULLLL withdrawal before you dose your sub. So wait until you're in withdrawal, then wait for a long tie after that. You'll have to suffer through a few hours of diarrhea, kicky legs, runny nose and eyes etc, but if you can wait until w/d's have been kicking your ass for several hours, THEN dose your subs, they will be the most effective.

You want to take them on barren receptors.

If this helps, I successfully use large doses of gabapentin when I'm first withdrawing to lessen the kicky legs (which to me is the most annoying symptom aside from insomnia) which helps me get through that early stage of withdrawal.

What you DON'T want to do is take the sub the second you feel a bit ill. If you do that, you will likely plunge into precipitated w/d and have hell to pay for it. Just suffer a little and you'll feel GREAT 30-45 minutes after you take the first sub.

Wait.
 
Yeah, usually the sweet spot is 30-36hours for a heroin habit. Since heroin is fast acting and leaves your system quickly. But opiates like methadone, you have to wait days to transition to subs since it is long lasting.

But here is a trusty tool I use when I want to know if I am ready to take suboxone and avoid PWs. The COWS sheet (Clinical Opiate Withdrawal Scale) Google Search this, and have someone score you so it's honest. If you score into high moderate to severe withdrawal, you are likely ready to take suboxone. And I would advise waiting 24hours after your last shot of heroin to use this scale.

Another trick I learned is if you are sick and think you're ready and you scored yourself on the COWS sheet, take a small piece of the sub. Like 1mg, and see what it does. If it does cause PWs, they should be mild and go away in ½hour to an hour, and the bupe will settle into your receptors, and you may start feeling better. Then from that point after an hour or so take another 1mg, and so on until you feel no more withdrawal. I hardly ever get past 3mg when I feel better.

Yeah so that's how I do it with heroin habit going to subs.

1.) wait 24hours after last heroin use
2.) rate myself on COWS sheet into high moderate to severe withdrawal
3.) dose small and slowly with the suboxone til I feel better

I do this and PWs hardly are an issue. And OH yeah! DONT INJECT THE SUB when first inducting. If you are not ready this will cause very intense PWs.

Good luck on inducting!
 
Everybody's body chemistry is different, so there isn't an exact time.. if you have a fast metabolism, you'll be fine at 24 hours, and you don't need to put yourself through misery of being in full WD, once you have teary eyes you're good to go. And lol I know who you're talking about, "Robert365" I believe, but he wasn't on this site..




- HS
 
For me with an up to 500mg daily oxy habit i turned up to the clinic and after my interview which was in the afternoon i had yet to take my arvo evening dose of 150-200mgs, i was told to skip that and turn up tomorrow morning for induction - as long as it's been 24hrs since my last dose I'll be fine. The morning i went in, thanks to Lyrica i just wasn't sick enough, i wasn't even yawning or sneezing etc so i was worried about PWD but the chemist there said as long as it's been 24hrs you'll be fine.

So induction starts with a 2mg sublingual dose, they ask you to sit down and wait half an hour, a little slight warm tingle went through my body and i was released with another 4mgs under my tongue and i was perfect! Absolute seamless transition, i was completely amazed. I was told that my Dr finds it easier to stabilize folks with huge H habits as opposed to huge pharmaceutical habits but especially codeine which I found interesting. He's also an advocate for more IV or subcut morphine for pain patients rather than oxy and it's cousins as it were. I totally agree.
 
As many people have already said, it's best to wait as long as possible before inducting oneself. However, the amount of time can very due to the half lives of different opiates. For example, methadone has a 36 hour half life and it's recommended that patients taper down to a dose below 30mg and then wait 3 days before getting on buprenorphine, whereas with hydromorphone or fentanyl, someone could probably induct oneself after 12-16 hours after the last use. It sounds like you're using heroin though, and IME I always tried to wait at least 12 hours, though the longer the better, preferably 24-36. Basically, the longer you wait, the more effective the suboxone is going to be, and less likely are chances of precipitated withdrawal. If you dose the suboxone at 7 a.m tomorrow morning you should be totally good to go.'

Also, although precipitated withdrawals are really terrible, they only last a couple hours at the most (assuming you're not transitioning from methadone). If you can get ahold of some Gabapentin like Phil stated, along with some clonodine/catapress, you should be able to fend off the worst of the withdrawal symptoms, clonodine is especially effective in terms of a non narcotic withdrawal medication, it's very under-rated.

I'm not sure what your habit is like, but assuming you're able to wait 24 hours, I would start with 2mg, and give that a good hour to kick in, after which you can asses how you feel, if you need more, or if that dose was too high etc. I'm not sure if you're just planning to do a quick detox, or whether you're getting on subs for maintenance, but either way, the lower the dose the better IMO, though sometimes the first few days people need higher dosages like 8mg before they stabilize, and for some I suppose the fact that at high dosages Bupe can block full agonists can help with temptation as well.

Also Check out this thread, for information on how to more efficiently absorb buprenorphine via sublingual administration by creating an alcoholic solution. The thread provides a lot of good information on how to boost the bioavailability of sublingual buprenorphine by creating an alcoholic solution. If affording the subs is a difficulty, or you want to stretch the subs out more, or just get a more consistent 'effect' through sublingual suboxone, it's really useful information.
 
I just inducted yet again today, I have an appointment I must pass a drug test for in a week. I took 1 dose of almost 4mg of suboxone 22½hours after my last dose of heroin/fent mixture likely, and barely felt any PWDs very slightly if there was any at all. I don't feel great, but I'm not sick either. I also took .1mg clonidine, 25mg promethazine, and 2000mg gabapentin to help while waiting, but it worked for me and PWDs weren't an issue.
 
I totally agree with everyone that suggested a gradual induction of 1 or 2 mg at a time until cessation of w/d symptoms.

I usually include that as part of my advice but completely forgot. Its a great way to avoid pwd. Someone might wait 30+ hours, are in w/d, put a whole 8mg sub under their tongue and STILL plunge into pwd.

Gradual dosing prevents this (the 1st mg knocks off the remaining full agonist on your receptor sites, the rest fill them in).

Good work on giving it another go, sm0kes. Hope everything goes well for you, bud.

What's up with you, OP? Did you get to work last week or what?
 
PW is no joke. I feel like I have PTSD from the one time I injected 3mg of sub too soon. I'll never forget that shit... It was a mindfuck coming for my soul in the form of an IV rush like a freight train. If you've never felt the terrifying dizzy type head warp right after it happens.... Believe me, you dont want to.

What I learned from the experience is that no matter how sick you've felt before nothing compares to precipitated withdrawal because every symptom hits you 100% all at once. Where as in full dope withdrawal your legs will bother the hell out of you, then the pain, then the anxiety. You really dont realize how bad it is to have it all hit you in the form of an IV rush all at once until you've been through it. By far the worst Ive ever felt in my life.
 
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