Bupe Will ANY low dose of bupe allow for acute pain relief via full agonist?

[ReversiblePulpitis]

Hello all.

A very long story short, I'm recently back on subutex for pain management (2nd try at-it for that purpose).

However, I have a couple conditions: kidney stones and acute pancreatitis, that flare up no less than a couple times a year. In fact, I am recovering from acute pancreatitis, day #4...
I suffered through the first 48 hours until a prescription that I had for Percocet FINALLY started to provide relief (albeit at 30-50mgs vs 10-20).

Is there ANY amount of bupe that I can take (daily, even once every other) that WILL allow a full agonist to bind any provide SOME detectable amount of relief in a very acute, very intensely painful situation? I'd rather NOT to pray to rely on some attending ER physician to feed me 12mg IV hydromorphone or 300+mcg IV fentanyl just to TRY break through bupe -- Id rather maintain on a dose that could possibly allow a full agonist to provide some detectable relief at a "standard" dose-ish.

I was able to suffer through the acute pancreatitis -- but next time I have a kidney stone, if I had to wait 48 hours? Unthinkable. Unimagineable. I'd hope that the ER would infuse propofol just to get me to stop screaming.

 

[tricomb]

I'm pretty sure that you would be fine if you kept your doses below 1mg, it's prescribed for pain in other countries at doses of 200 and 400 micrograms per dose, so.... splitting your subutex into doses of 0.25mg (250 micrograms) you could give that a try, as for whether your other full-agonists will work at this dosing, I'm not sure, but remember that buprenorphine is extremely potent and part of it's mechanism of action is raising your tolerance so high that other opioids are not worth taking, however this is mainly a concern at maintenance doses, I'm not sure how it would play out in your case.


YMMV

If others have information on this, please chime in, I think Fire&Water might know about this.

I'm also on oxy and don't get enough relief, so if I could take <1mg of buprenorphine a day and have my oxycodone still work, I'd be one happy chronic pain patient.

 

[HaZeX]

I'm pretty sure that you would be fine if you kept your doses below 1mg, it's prescribed for pain in other countries at doses of 200 and 400 micrograms per dose, so.... splitting your subutex into doses of 0.25mg (250 micrograms) you could give that a try, as for whether your other full-agonists will work at this dosing, I'm not sure, but remember that buprenorphine is extremely potent and part of it's mechanism of action is raising your tolerance so high that other opioids are not worth taking, however this is mainly a concern at maintenance doses, I'm not sure how it would play out in your case.


YMMV

If others have information on this, please chime in, I think Fire&Water might know about this.

I'm also on oxy and don't get enough relief, so if I could take <1mg of buprenorphine a day and have my oxycodone still work, I'd be as happy as a pig in shit.

Fixed.

 

[tricomb]

Thankyou

 

[bronson]

I know in other threads I've read on here in the past I've heard a few others say that doses of bupe .5mg and under do still allow for some binding (though not full) with a full agonist opiate.

Just keep in mind that once you do reduce your dose on bupe it's still going to be around a couple of days before you would start getting any pain relief benefit from other opiates so it might need to be a thing of planning a bit in advance if possible.

Just what I'm aware of for now, hopefully some more people with actual experience on the subject can add more.

 

[ReversiblePulpitis]

I know in other threads I've read on here in the past I've heard a few others say that doses of bupe .5mg and under do still allow for some binding (though not full) with a full agonist opiate.

Just keep in mind that once you do reduce your dose on bupe it's still going to be around a couple of days before you would start getting any pain relief benefit from other opiates so it might need to be a thing of planning a bit in advance if possible.

Just what I'm aware of for now, hopefully some more people with actual experience on the subject can add more.

Therein lie the issue at hand: acute pain. Specifically, and for example, a kidney stone. Obviously these cannot be necessarily a planned event, but maybe anticipated at best if you know that you have some in active formation thanks to a KUB or CT. Which for anyone who has ever suffered from/through one that is "lodged" in the ureter, pain-relief is not something that you want to wait for.

 

[DooMMooD]

Also have to take in consideration the massive damage that buprenorphine will do to your tolerance, even in small doses.

 

[marley01]

RP,

I think I've had more than my fair share of kidney stones so i can understand where you are coming from. I am currently on suboxone for addiction treatment so I can tell you about my experience. I only require aprox 0.5-1.0mg of sub per day (it comes in 8mg strips so it is hard to measure) to keep from withdrawing. At that doseage am able to experience pain relief from a full agonist. Because of the receptor blocking that the sub causes I still need an increased dose but I am able to get the necessary relief at a dosage level a doctor is willing to give.

I really hope this helps you.

 

[Fire&Water]

Hello all.

A very long story short, I'm recently back on subutex for pain management (2nd try at-it for that purpose).

However, I have a couple conditions: kidney stones and acute pancreatitis, that flare up no less than a couple times a year. In fact, I am recovering from acute pancreatitis, day #4...
I suffered through the first 48 hours until a prescription that I had for Percocet FINALLY started to provide relief (albeit at 30-50mgs vs 10-20).

Is there ANY amount of bupe that I can take (daily, even once every other) that WILL allow a full agonist to bind any provide SOME detectable amount of relief in a very acute, very intensely painful situation? I'd rather NOT to pray to rely on some attending ER physician to feed me 12mg IV hydromorphone or 300+mcg IV fentanyl just to TRY break through bupe -- Id rather maintain on a dose that could possibly allow a full agonist to provide some detectable relief at a "standard" dose-ish.

I was able to suffer through the acute pancreatitis -- but next time I have a kidney stone, if I had to wait 48 hours? Unthinkable. Unimagineable. I'd hope that the ER would infuse propofol just to get me to stop screaming.

The reason I use a small amount of Bupe' is to help combat the "rebound effects" of being on chronic pain meds'
It helps your body/mind when the full agonist pain meds' wear off. The pain doesnt immediately return with such
a biting vengeance. (this is the only reason I know of why anyone would use it alongside CPM)...

 

[phatass]

...

 

[Fire&Water]

The best form of you pain relief you could receive from Buprenex (intamuscular injection) would be approximately 0.3 - 0.6 mgs. (pertaining to any form of bupenorphine formulations)

 

[livetheopiatedream]

Low doses of bupe enhance highs for some...
But I have no trouble getting high/ pain relief when on subs at below a quarter mg.
Avoid bupe doses after u take ur agonist obviously as the affinity is so much higher
Depends on the person but obviously the rule is the longer u wait post bupe te more effective the agonist.

I need to drink poppy tea so as to avoid the sick so that's it for now sorry kinda add post

 

[ReversiblePulpitis]

RP,

I think I've had more than my fair share of kidney stones so i can understand where you are coming from. I am currently on suboxone for addiction treatment so I can tell you about my experience. I only require aprox 0.5-1.0mg of sub per day (it comes in 8mg strips so it is hard to measure) to keep from withdrawing. At that doseage am able to experience pain relief from a full agonist. Because of the receptor blocking that the sub causes I still need an increased dose but I am able to get the necessary relief at a dosage level a doctor is willing to give.

I really hope this helps you.

I appreciate all of the feedback from everyone, but a special thanks to Marley. You nailed the answer that I was looking for, and I am feeling absolutely relieved to hear it. If you dont mind me asking, Ive got a couple questions. Do you dose just once per day I assume?
I am hospitalized for kidney stones no less than once a year, and no less than twice a year for acute pancreatitis. The thought of not obtaining pain relief during a ureter lodged kidney stone is terrifying. However I also have no problem dosing with 1mg or less of my subutex per day, so thanks to you I have some hope.
What is it you say to the attending ER physician or nurse to communicate your increased dose needs due to the bupe? Do you ever take any documentation or literature to provide? Can you give an example of a particular med and the IV-push dose that you would need or have received upon arrival to the ER for a stone that has provided relief? And to what degree of relief?

I've switched to bupe, just today, because I'm finishing dental school this year and am going into practice with family. They made it clear that I would not have a place at my father's practice while on the Opana/Dilaudid, but agreed with bupe. I'm not against giving it a try, but I may end up needing to suffer through some of my chronic pain as a result. Considering what's at stake, it's worth trying. In the meantime, while still engrossed in the rigors of dental school, I don't have to worry about withdrawal... So, I'm good with that notion too

 

[bronson]

i think you can take tramadol at the same tme as bupe and not have the preciptated withdrawl problem (i thnk)....

but bupe s a strange option for pain treatment, even at high doses it wo't provide as much relief as a full agonist mike morrphinne or oycontinn

This is correct, bupe does not stop tramadol from binding to the receptors that it acts on which differ from the other opiates and opioids. Though this is not to say that taking the two in combination is safe, and from my understanding regular use of tramadol has a host of nasty potential side effects in the long run.

 

[joebob87]

Soo I'm new here and need some advise. Hopefully this is the right forum. This this morning before boat duty, I jumped in the shower and found a quarter small piece of an orange suboxone took it. Any ways, how long do I have to wait until I can take my trammies, even though it was a small piece.ontop of it all I was cleaning the boat before the morning river runs, and I found a Tylenol bottle filled with 7.5s.just my luck

 

[Fire&Water]

Soo I'm new here and need some advise. Hopefully this is the right forum. This this morning before boat duty, I jumped in the shower and found a quarter small piece of an orange suboxone took it. Any ways, how long do I have to wait until I can take my trammies, even though it was a small piece.ontop of it all I was cleaning the boat before the morning river runs, and I found a Tylenol bottle filled with 7.5s.just my luck

Many find a synergy between Bupe' & Tram'...easy on the "trammies"

 

[maxmommy636]

I took a quarter of the generic 8mg suboxone last night 12am.Then another quarter at noon today.About an hour ago I took 15mg oxycodone and I feel all of it.So apparently its either no longer blocking the opiates or the dose of oxy is higher than the amount of bup in my system.Just wanted to share my experience because I am totally shocked I can feel the effects but I could tell the bup was wearing off hours ago my throat started hurting which is always the first signs of w/d for me that's the only reason I took the oxy.I think it being generic bup has something to do with it too.