Smoking Suboxone is a huge waste of Bupe aside from being fairly terrible for your lungs. While IV Suboxone does have the higher BA, it doesn't last as long and many complain that the up & down is far more difficult to manage. On top of that there is no rush from IV Subs/Bupe, but all the hassle of micron filtering and maintaining fresh supplies (when done properly). It's also been said by many that Subs are esp hard on veins.I'm experimenting with my suboxonne,IV and may try to smoke it,what's your thoughts?
I think this graph sums up the difference between i.v. and other RoA pretty nicely
I crush my pill and mix with a few drops of water. There is a thread somewhere around here with evidence that you absorb of of the drug, hence making it stronger. I personally would lower your dose a bit before trying. Plus I only have to hold it in my mouth for about 5 to 10 mins vs 10 to 20 with taking the pill normally.What is the best way to do Suboxone snort it or iv or under the tongue
https://www.ncbi.nlm.nih.gov/m/pubmed/10354966/?i=3&from=/10462093/relatedThe bioavailability from the tablet was approximately 50% that from the liquid and was not affected by saliva pH.
Don't use Loperamide as a bridge between the MS and Bupe, it has a long half life and will make the induction rough. There's two schools of thought on induction, one says that you can switch after 12-18 hours and if you have PWD's then just ride them out with more bupe. The second is to get up to a really high COWS-(Clinical Opiate Withdrawal Scale) score and then go through induction as it has a much lower incidence of PWD's.*I will have to go through a day or two without the MS Contin before starting the suboxone?
*How long will I have to go without any medication?
*Could I take some Loperamide during that time?
Buprenorphine Training Activity v5.0 For PhysiciansWhen patients have a mild to moderate COWS score of 12 to 16, they are ready for the first dose. Some providers go as low as 5 or as high as 24 on the COWS scale, but ideally > 10. Abstinence timing for short-acting is 12-16 hours. Guidelines suggest that withdrawal symptoms are the more important indicator than a specific number of hours of abstinence. Maximum first day dose is now 16 mg/ previously it was 8 mg.
Precipitated withdrawal (withdrawal from not having gone long enough without the opioid of dependence before starting buprenorphine) can be managed in two ways.1) Continue induction with additional doses of buprenorphine until withdrawal abates, up to the recommended target dose of the formulation you are using. 2) Or stop induction and treat withdrawal symptomatically as above (especially clonidine, antidiarrheals, nonsteroidal anti-inflammatory drugs). Have your patient continue abstinence from the opioid of dependence and re-induce on buprenorphine the next day.
Conversion of chronic pain patients from full-opioid agonists to sublingual buprenorphine.There is considerable between subject variability in sensitivity to buprenorphine's antagonist effects. Low, repeated doses of buprenorphine/naloxone may be an effective mechanism for safely dosing this medication in persons with higher levels of physical dependence.
After initiation of buprenorphine SL therapy for more than 2 months, the mean pain scores on a scale from 0-10 decreased by 2.3 points (P < 0.001). Patient Quality of Life (QoL scale) was not significantly affected by buprenorphine SL therapy (P = 0.14). The success rate was highest for patients using morphine, oxycodone, and fentanyl before buprenorphine SL induction.
These patient groups had a 3.7 point decrease in pain for those taking morphine, a 2.5 point decrease in pain for those taking oxycodone, and a 2.2 point decrease for those taking fentanyl. Patients taking between 100-199 mg morphine equivalent per day experienced the greatest reduction (2.7 points) in pain scores.Patients previously taking morphine, oxycodone, and fentanyl had the greatest decrease in pain after conversion to buprenorphine SL.