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  #1  
Old 07-03-2012, 02:45
Cynder Cynder is offline
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i took suboxone correctly yet still sick!! what can i do for my heroin detox?

I was a heavy heroin user for 2 years plus oxycontin for 3 year prior to that. I stopped heroin Sunday noon, used nothing until Monday noon, I felt sick but finally took my 16 mg suboxone. Howver I gradually felt worse, and had severe withdrawals all Monday day and night. Weird, and precipitate withdrawals last up to an hour i hear, so what happened? I'm not doing anymore Suboxone! Its now Tuesday night 10pm and finally feeling better. Why would this happen? I may try morphine/fentanyl taper insead, I started the fentanyl patch last night. When will the one-time 16mg dose suboxone wear off and fentanyl kick in? Any advice?
maybe the subs are already wearing off and the fentanyl working?? No idea, I'm lost.
I also have liquid concenctrated morphine sulfate (oral, but I may inject), when can I start this to use as a taper? Along with the fentanyl patches already put on me since last (75 mcg/hr for 72 hours).
  #2  
Old 07-03-2012, 05:29
bman1 bman1 is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

It sounds like you took it to early. One should stay away from all opiates. tapering can prolong the sickness and severity. And lead on to other addictions. If you can go one day try two days next. And if you can make it two days go for three and so on. Did swim talk to his/her doctor about the sickness?

Why does taking Suboxone too soon after another opiate cause withdrawal pains?

Buprenorphine is said to have high affinity but low activity on the opiate type receptors in the brain (mu receptors).

High affinity means that it is very able to fill and activate the opiate receptors in the brain, and since it has a higher affinity for these receptors than other opiates (like heroin or methadone) if you take suboxone and another opiate together - it will even bump these other drugs out and fill the receptors instead.

Suboxone has a low activity at these receptors though. Although it will bump out other drugs, it cannot activate these receptors in the brain as strongly.

So…

If you take a drug like heroin, and then too soon after take suboxone, the buprenorphine will kick out the heroin, but it won’t be able to turn the opiate receptors on as well as the heroin. The brain (and body) experiences an immediate drop in the effects of the opiates. This drop in opiate levels of activation causes an immediate sensation of withdrawal.

When your doctor advises you to abstain from opiates for a certain period prior to taking a dose of buprenorphine, it is very much in your best interest to listen and follow instructions.

If you try to take another opiate drug too soon before your scheduled first dose of Suboxone, you will be making things much harder on yourself!
How long do you have to wait?

Your doctor will advise you on how long you will need to wait prior to taking a first dosage of Suboxone. In general, you will need to wait at least until you are feeling the initial sensations of withdrawal before you can safely take your first induction dosage.

The waiting times will vary depending on the drug of abuse. As a rough guideline, you can expect to have to abstain from:

Heroin – 12- 24 hours
Percocet, Vicodin, or Oxycodone – 12-24 hours
Crushed Oxycontin – 12 – 24 hours
Oxycontin 24 hours +
Methadone (must be at low dose) 36 hours (at least)

Source *National Alliance of Advocates for Buprenorphine Treatment http://www.naabt.org/faq_answers.cfm#21

It is in your best interest to follow the advice and instructions of your doctor, and wait until you are truly in the early stages of withdrawal prior to taking a first dosage of buprenorphine. After you take Suboxone under supervision in the doctor's office, you can expect to feel much better within a very short time.

Suboxone can also create this precipitated withdrawal if abused by injection, due to the naloxone contained within. Why does taking Suboxone too soon after another opiate cause withdrawal pains?

Suboxone is said to have high affinity but low activity on the opiate type receptors in the brain (mu receptors).

High affinity means that it is very able to fill and activate the opiate receptors in the brain, and since it has a higher affinity for these receptors than other opiates (like heroin or methadone) if you take suboxone and another opiate together - it will even bump these other drugs out and fill the receptors instead.

Suboxone has a low activity at these receptors though. Although it will bump out other drugs, it cannot activate these receptors in the brain as strongly.

So…

If you take a drug like heroin, and then too soon after take suboxone, the suboxone will kick out the heroin, but it won’t be able to turn the opiate receptors on as well as the heroin. The brain (and body) experiences an immediate drop in the effects of the opiates. This drop in opiate levels of activation causes an immediate sensation of withdrawal.

When your doctor advises you to abstain from opiates for a certain period prior to taking a dose of Suboxone, it is very much in your best interest to listen and follow instructions. If you try to take another opiate drug too soon before your scheduled first dose of Suboxone, you will be making things much harder on yourself!
How long do you have to wait?

Your doctor will advise you on how long you will need to wait prior to taking a first dosage of Suboxone. In general, you will need to wait at least until you are feeling the initial sensations of withdrawal before you can safely take your first induction dosage.

The waiting times will vary depending on the drug of abuse. As a rough guideline, you can expect to have to abstain from:

Heroin – 12- 24 hours
Percocet, Vicodin, or Oxycodone – 12-24 hours
Crushed Oxycontin – 12 – 24 hours
Oxycontin 24 hours +
Methadone (must be at low dose) 36 hours (at least)

Source *National Alliance of Advocates for Buprenorphine Treatment http://www.naabt.org/faq_answers.cfm#21

It is in your best interest to follow the advice and instructions of your doctor, and wait until you are truly in the early stages of withdrawal prior to taking a first dosage of buprenorphine. After you take Suboxone under supervision in the doctor's office, you can expect to feel much better within a very short time.

Suboxone can also create this precipitated withdrawal if abused by injection, due to the naloxone contained within.

Post Quality Evaluations:
excellent advice here but note that the self incrim rule changes AGES ago ;)

Last edited by Smeg; 18-08-2013 at 02:26. Reason: Removal of the "Swim" information, plus replacing the trade name with the actual drug name.
  #3  
Old 07-03-2012, 06:26
brettjv brettjv is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

It's called an induction phase, man.

It DOES take awhile for your brain and body to 'stabilize' on subs.

Waiting 24 hours to begin Bupe therapy is usually plenty of time (esp. after a short-action opioid like heroin) to not cause severe precipitated withdrawals, but there is still DEFINITELY a time period after that you have to 'tough out' where you'll still feel uncomfortable/not entirely 'well'.

I've been through exactly what you're talking about, more than once, so I know the whole scenario, brother

But I bet you that if you really think on it ... after the first few hours of being on subs (which are generally rough unless you've been off dope for about 2 days), you didn't feel WORSE than you would've had you taken nothing at all, did you? Were you really hanging out worse than you've would've been? I bet if you're honest, after the first few hours, you DID feel better than you've would've in a state of a cold-turkey kick, that many hours into it. So they were STARTING to work ...

Right now, you are probably stable on the subs. You still have PLENTY of it in your system. If I were you, I'd HIGHLY advise ripping off that fentanyl patch, and dosing again with the Subs (although it's probably best to wait, again, til you start feeling crappy). I *guarantee you* that Subs WORK, and work WELL ... it just can take up to 2 or even 2.5 days after your last hit of real dope before you stabilize. Surprised nobody told you this.

Once you do get stable, if you stick with Subs (and ONLY them) your life is going to change for the better my friend ... very quickly. Unlike what will *probably* happen with an attempted fentanyl and morphine taper.

Also ... doctors are supposed to start people on Subutex (pure bupe, no naloxone) just in case, cause a small percentage of people can actually absorb a bit of Naloxone through their tongues, with will of course precipitate w/d's hard and fast. But Bupe alone will still do this to some degree, so I'm not saying that's 'the problem' here.

Oh, and don't swallow your spit/Suboxone mixture after you've sucked the pill ... the bupe is destroyed by the stomach anyways, and you're just risking getting naloxone in your system.

Also, I'd tell your doc what happened with the Suboxone and what I said about how you're supposed to be inducted using Subutex. If you DON'T get totally 'well' from your next dose of Suboxone, I'd lobby for Subutex for the first week if I were you.

And if you're assigned 16mg/day, I'd do 8mg in the morning and 8mg in the later afternoon ... and I'd also taper as QUICKLY as possible. You should be able to drop to 12 mg within a week, 8mg within another 1-2 weeks after that with MINIMAL discomfort. Subs are not Methadone, you don't have to take tiny baby-steps. I've dropped my dose to 35% of what I took the day before ... without batting an eye.

Just keep WORKING DOWN on your dose, soon ... cause you'll wanna get all the way down to like .5mg/day before quitting. The longer you stay on high doses of bupe (and 16mg/day is a lot), the bigger hassle it is later on.

Post Quality Evaluations:
good advice
great advice regarding the tapering, and very encouraging post

Last edited by brettjv; 07-03-2012 at 15:02.
  #4  
Old 13-03-2012, 02:38
Cynder Cynder is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

Thanks for all the info. I gave someone my subs and they "lost" them but they're helping taper me down with fentanyl patches, using less each day ( he knows how they work and how to do it) I still feel a little sick but not as bad as before, that was a day of HELL. In 3 more days, ill be on nothing, hopefully won't be too sick and complete the process. Surprisingly, the harder part now is mental cravings and awful depression, hopefully that'll pass too...
  #5  
Old 14-03-2012, 04:35
brettjv brettjv is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

I promise you that god-awful depression should pass in about a week, Cynder. The mental cravings ... I'll be honest, that's a bit more 'variable' in terms of a time frame, but ... the really bad, consuming-your-every-waking-thought (iow, your every thought) type of cravings ... they should pass within about a week as well.

I'm not saying you'll be 100% in one week like you never took a hit of dope in your life, but I am saying ... coming off short-acting opioids like fentanyl ... the worst is over in about a week.

At that point the symptoms go from 'soul-crushingly awful' ... to a mild annoyance for the most part. And think about how quickly one week normally passes ... it AIN'T that long to suffer for. Esp. not with all the benefits that come from finally being off that crap, and getting a real LIFE again

You can DO IT!!!

Hell, if I can, anyone can. Trust me
  #6  
Old 19-03-2012, 05:35
EncyclopediaHumanica EncyclopediaHumanica is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

I took subs for about a year... Self incrimination my ass, I never committed any crimes so I'll "swim" another day.
I experienced the same thing. Doctors will tell you precisely what doctors have been told themselves. What doctors have been told comes from the company that manufactures suboxone... conflict of interest maybe? In actuality it takes more like 48 hours for subs to not give you withdrawal effects. After that, they will mostly satiate your appetite for opiates.

However, I noticed that buprenorphine has a particular affinity for causing withdrawal, ironically. Although it is a very long acting opiate it stimulates opiate receptor production more than it actually stimulates opiate receptors. This is why i personally feel I was always under the gun of withdrawals while taking sub. This is my own interpretation based on what I know of opiates and neurology. While taking buprenorphine, I'd often get sick in between doses though they were always the same amount and always the same time in between.

The problem with buprenorphine is as follows.

There are more than one type of opiate receptor. Every opiate antagonizes these receptors to a certain degree in a certain ratio. Every receptor has a different effect on a body. Opiates ALL have different ratios of what receptor they favor so why would the discrepancy be any different between heroin and buprenorphine?
While you were taking heroin you were igniting a specific group of neurons and now your igniting a whole new one with buprenorphine.
You are going to feel partial withdrawal of the receptors that aren't being taken care of bybuprenorphine.

Withdrawal is largely what it feels like to experience the death of extra opiate receptors. Imagine, the death of a pleasure sensor, no wonder withdrawals suck. But the point is, very soon, you will stop feeling the mild withdrawal associated with switching from one opiate to another and only have to deal with the ramifications of buprenorphine.

Your doc wont tell you this. You will go through very, very slight heroin withdrawal while taking buprenorphine but it wont be bad at all. In fact, you'll feel fine except a few noticeably opiate related syndroms like yawning and watery eyes. I transitioned almost seamlessly, almost.

Be careful coming off that stuff, the DTs are tough because they last so long. Its not even close to as bad as heroin, literally nowhere NEAR as bad but the sheer duration is agonizing.

Last edited by Smeg; 18-08-2013 at 02:45. Reason: paragraphing, line-spacing plus insertion of correct drug names for clarification.
  #7  
Old 19-06-2013, 17:49
labcoatbud labcoatbud is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

I started on 2subs/day -2 days ago and am very ill... Idk WTD at this point, I can't keep a sip of anything down :/ would a small amount of opiates help my stomach? I know I won't feel them but would they help my stomach?
  #8  
Old 18-08-2013, 00:08
jimmypins jimmypins is offline
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Re: i took suboxone correctly yet still sick!! what can i do for my heroin detox?

it happened to swim last week.they waited about 18-20hrs from their last use of heroin,felt the WDs coming on and took an 8mg strip and within an hour was in full WDs for the next 2 days almost.

they're giving another try tomorrow but with a smaller dose,like 4mg after their 20th hour.hopefully the sickness will be enuff to where the subs kick in and take away the sickness and does what it's supposed to do.
never had problems in the past.always waited around 16-18hrs before taking a sub and would only need halves at that for 3-4 days...hope it works this time.hate seeing them feel like that cause nothing you can do to alleviate the symptoms once you introduce buprenorphine into the body...nothing.

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Please don't use "swm" here. Just click on it to see why.

Last edited by Smeg; 19-08-2013 at 16:57. Reason: Paragraphing, line-spacing, plus correct generic drug name that won't be misunderstood.

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