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  #1  
Old 06-07-2012, 04:36
Cynder Cynder is offline
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Anyone feel better after taking an opiate while on suboxone?

My cat was a heroin user for about 2 years before going on suboxone maintenance. Even after starting suboxone on a high dose (16-20mg/day) which was later lowered (to 8mg/day) she still felt crappy, with some withdrawal symptoms, for awhile after beginning the suboxone. She had been kind of stupid and has stopped taking it here and there for a few days to do H again, and every time feels crummy again when starting up on subs. This time she wants to start again and stay on but has issues with feeling some withdrawal. There have been times in the past when she used on top of the suboxone and swore she felt better, is this possible or just in her head? Has anyone else used opiates while on suboxone and felt better, or that it still helped with pain? She has some pain too and doesn't want to feel any. She also wants to know because she has 4 bags left and wants to know if she should use them now, or save them to do little bits as needed while starting on subs again. Would this be a waste? Please let us know your experiences with this, thanks!
  #2  
Old 06-07-2012, 13:00
synonymous synonymous is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

There a wide variety of responses to the naloxone in suboxone. Some people swear it doesn't do anything and some people swear it gives them withdrawals.

It is barefaced lie to say it doesn't absorb if taken sublingually. I have taken subutex and suboxone many times and find subutex gives me a nice full agonist opiate feeling and almost completely diminishes my pain. Suboxone on the other hand gives me mild withdrawals, no pain relief and a bit of a head ache.

Have you tried Subutex? Can you get it?
Have you tried the ethanol extraction of the buprenorphine?
  #3  
Old 16-07-2012, 03:48
Cynder Cynder is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

I did some research and it looks like taking another opiate even while on suboxone will help with pain, anxiety, and depression, and maybe help other symptoms of withdrawal. There are actually 4 types of opioid receptors in the brain, my, delta, kappa, and norc something, I forget the spelling, but the mu receptors are what produces euphoria and pain relief, although delta/kappa receptors also produce pain relief when activated. Buprenorphine only binds to the mu receptors and blocks them, however taking another opiate will still bind and activate the other receptors and provide pain relief and such, but without euphoria. So when I start my suboxone tomorrow, I'm saving some of my opiates to take after for pain and WD, because for me suboxone alone doesn't take away my pain and all my WD and I'm tired of feeling crappy when I start on suboxone. I heard in europe they can prescribe suboxone for pain management and still prescribe other pain relieving opiates on top, I guess that's why. Just letting you know in case that helps anyone else who still feels sick or is in pain after starting suboxone. Thanks!
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Old 16-07-2012, 04:29
floatyheadz floatyheadz is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

Subutex is better because you don't have to wait until you're in withdrawl to take it whereas with Suboxone you have to wait to take it.i have many different patients that tend to prefer one or the other, so if you could try Subutex and find out which works better for you, that would be the most helpful thing you could do for youself.

Also, taking any kind of pain med while on suboxone will mess up things a bit. Let's say you take your 1st dose 24hrs from the last time you used, then a few hours later when the subs have kicked in, most but not all of your withdrawl symptoms are gone but there are mildly ones you can still sense so you take a pain pill. Now you can't take your next dose of Suboxone until later than you were originally planning because you've reintroduced an opiate into your system so now you need to wait until youre once again in full blown withdraw to take the sub again. Some doctors will give you Ativan 2mg to take because it calms you're body in general, calming your pain too & ativan can safely be taken with sub without causing problems. I hope this info helps and if youve ever tried to kick before you know that 1st off, thank God you even have suboxone instead of going cold turkey and really the worst of it is only 2-3 days, lingering about a week. The exhausted & fatigues feeling can last a lot longer because you body is trying to rebalance dopamine levels but my lil pony, she just came off a 1/2 to a g daily habit that lasted 9 months & she got 2 of the 8mg Suboxones that she used (and tapered) for the first 4days and that was really all she needed. She took a little ativan days 1-2 for restless legs and benadryl helps depress you as well. I'd try that, especially if you need to sleep. Hope this helps and i hope you can kick it for good. In 9 months, my lil pony had tried to quite sooo many times but never made it past day 2 of the kick until she got suboxone & realized the minor stuff you feel on subs is way better than how she felt cold turkey so she just stuck it out...hot baths or a jacuzzi will work wonders too!

Post Quality Evaluations:
your info is incorrect. Subutex will cause same PWD as Suboxone. check your facts before giving info that could cause harm
  #5  
Old 17-07-2012, 01:06
Cynder Cynder is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

I'm pretty sure from experience that you can take opiates while on suboxone and not have to wait until
Your in WD again to take your next dose of suboxone as long as its still in effect. I mean they prescribe Them (subs and opiates) to be taken together by pain mngmt drs in europe. Anyone else have experience with this?
  #6  
Old 17-07-2012, 01:32
(NS)-M-Lo-Reason (NS)-M-Lo-Reason is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

I was under the impression that when it comes to my receptors buprenorphine is still a better binder and worse activator than most opioids, and it is a better binder and better activator than naloxone. Therefore it is not the naloxone that causes precipitated withdrawal. I know that subutex will cause precipitated withdrawal if taken to early, I know people its happened to. So be careful about asserting that buprenorphine by itself won't cause this effect. It's not true.
  #7  
Old 19-07-2012, 22:02
floatyheadz floatyheadz is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

I'm sorry if I implied that Subutex will not cause precipitated withdrawl, because it absolutely can. Ive found that the majority of patients I've detoxed have responded better to Subutex, when introduced in low doses, causing less 'sick' feelings than Suboxone. Generally we start a patient on a relatively low dose of Subutex & monitor how they are handling it & if it is being tolerated ok, we will give them a little bit more, keeping them on Subutex for 2-3 days then switching them to Suboxone, to prevent abuse, for the remainder of their detox, typically lasting about 10 days, tapering the Suboxone the last 2-3 days of detox to avoid withdrawl symptoms from the bup. Suboxone is buprenorphine & naloxone but if taken as intended, sublingual, the naloxone has not been found to cause too many adverse effects, although some people do respond to it, it is generally felt more in people who take it via other routes- IV, orally, etc. The naloxone was added to the bup tablets to prevent misuse/abuse & has proven, for the most part, to be effective which is one of the main reasons doctors prescribe Suboxone over Subutex. Either way, both of these medications are buprenorphine and taking either of them can cause precipitated withdrawl. It is always best to wait until you are in mild to moderate withdrawl to introduce buprenorphine into your system (for opiates with a long half life, like Methadone, w/d can sometimes take 2-3 days to fully come on. But shorter half life opioids like heroin, oxycodone, hydrocodone, morphine- usually w/d begins 12-24hrs after last dose.)

Taking bup too soon after your last dose can without a doubt cause precipitated withdrawl & as most of us know, this can be worse than the regular w/d would've hit....depending on the severity of your addiction & how much time has passes since you last used will help determine how much subutex/suboxone you will need to start with...with most of our patients if using subutex, we start with just 0.5mg (cutting a 2mg into pieces) & increase as tolerated. If starting with suboxone, 4-8mg is usually sufficient to start, again increasing as tolerated. Buprenorphine has a ceiling effect so don't take more thinking it will help more, like with most opiates...for example, 60mg morphine is stronger than 30mg but with bup, taking 40mg is not going to be better or stronger than 32mg because of this ceiling effect....

I definitely understand that most people doing this at home dont have the luxury or switching between the 2 meds or even staying on a full 10 day detox with a taper because whether or not you have a prescription, this sh*t is expensive!!! But def worth every penny to have it while kicking versus going cold turkey- ugh...I've been on both ends of the spectrum- I've helped detox hundreds of people off long term opiate abuse & I've had my lil pony develop quite the raging poly-substance addiction, specializing in a long term love of opiates, mainly any/all/every narcotic pain pills she laid her hoofs on, until heroin came along & that's when sh*t got nasty out of control faster than you could even say the word "addiction" so I totally understand you saying that sometimes the suboxone doesn't seem to be enough- been there!

Speaking from both ends of the spectrum, sometimes if the suboxone doesn't seem to be working quite as well as you were hoping, it could be that the level of addiction became higher than you thought & the amount you took was not strong enough to mask the withdrawl...or you may not have waited long enough to take your first dose of bup- this is pretty common because let's admit it here, we don't like to feel the pain or extreme discomfort that's beginning to settle over our bodies & we're so accustomed to taking something, anything, as soon as any form of feeling begins to resurface so too many people (guilty here as well) take their 1st dose of suboxone too early after their last use and now on top of the regular crap feelings you were starting to feel, youre also starting to feel a very mild precipitated withdrawl. It's mild enough that taking an opiate with relieve the discomfort but taking more bup will make you feel worse...

Taking opiates once you already have buprenorphine in your system is generally ok. However, it IS a slippery slope...if you are genuinely attempting to detox & get off this crap for real, taking opiates is only taking steps backwards because bup is much, much stronger on your receptors than codeine, oxycodonr, hydrocodone, heroin, morphine, etc & if youre trying to get high or even feel it a little bit you will need a dose significantly larger than what you would normally take- which not only increases tolerance wayyyy too quickly but also increases your chance of OD'ing big time because depending on when you take the opioids, the bup will start to wear off & theres still a considerable amount of opioids floating around- which is why you'll see some people on suboxone do a fat shot & barely feel it at all but then a fee hours later they're in a heavy nod at the dinner table...so please be very careful if trying to get high....if youre just trying to take the edge off because the suboxone doesn't seem to be working 100%, 1st consider if you took enough based off how much you were using or if you took it too early & were not fully in an honest moderate withdrawl....many doctors have found thru testing that taking an opiate to take the edge off & too in where the suboxone has left off in feeling well, there seems to be a strong 'placebo effect' where its pretty much all in our minds that taking that extra opiate is doing anything significant....

Now that being said of the 'placebo effect' some people whole heartedly believe that it helps & even here in the US we have had some patients at the recovery center I worked at that were on suboxone maintenance for chronic pain management as well as taking mild opiates, such as Norco or Percocet- maybe x2 of the 10/325mg tabs twice a day and even the doctor I worked beside (he's been treating addiction for almost 40yrs) said that giving them those was mostly to pacify their subconscious anxiety over having been on something so long to switching to suboxone. He said the mind is a powerful thing & even though the bup is wayyyy stronger than those 2 percs, the mind isn't fully at ease until it knows it has in its system what's its been used to providing relief for so long now...

The best thing to take in addition to the suboxone is something such as Tramadol, Ibuprofen, Tylenol and/or Naproxen (pain reliever wise) but small doses of Benzos have proven to work very efficiently, Ativan, Valium, or if you must, low, low doses of Xanax....benzos are best used in days 1-3 of w/d both throughout the day and at night (a little extra) to help sleep....also, this is where the Vistaril or Benadryl comes in handy with a long hot shower to soothe muscles, nerves, & bone/joint aches and pains. If you have a heating pad, bring it to bed with you & alternate it between the tops of your legs & your lower back to maximize comfort while lying down....if you still insist on taking a few pills to even out your comfort, please do your bags before starting the subs otherwise you're just kind of wasting both the H & the subs and try to take any pill other than codeine as Codeine & Buprenorphine combined has an increased risk of respiratory depression, again increasing your chances of OD'ing....I hope you're able to kick it for real. Everytime my lil pony has attempted to kick, she either hasn't waited long enough to take her 1st sub or she hasnt taken enough which has pretty much resulted in relapse every single time so this last time she got her script of Ativan filled & would have been more comfortable with 2 of the 8mg subs to kick wit, but only having 1 sub & the ativan she made it thru the 1st 4 days which was really the worst & then tapered off the ativan from there & has been clean since...so I wish you all the best of luck...do the rest of your H before you start, including any 'rainy day' cottons you've got hidden away so than when you start to kick you can take your subs & actually do it & not screw it up with even something as small & minor as a cotton...its all just excuse anyway, your subconscious's way off saying you're not ready...just one more time...it never ends- all the time, gas, money, lies, etc to get it& now half the time what youre picking up you're not even getting high off, your literally paying money just to feel normal & well at this point...its the monkey on your back, trust me i know...but if youve got subs don't take 'em for granted & remember all the times youve tried to kick cold turkey & even the little bit of pain you're still feeling after taking the sub is nowhere near the pain of a cold kick...so really try the subs with a mild benzo...benadryl...tylenol or naproxen if needed....lots of water, daily vitamins & as much heat as you need to decrease symptoms & give it all youve got this time around. Heroin withdrawl won't kill you even if it feels that way....best wishes all around!! Keep us posted on your progress or if you need more help, there's lots of people here wanting to see you succeed )
  #8  
Old 23-07-2012, 05:25
Cynder Cynder is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

Bupe is a better binder to mu opioid receptors but I was talking about the other opioid receptors jn the brain that they don't bind to or don't bind as heavily. I wanted to make a correction, there may be some binding to either the kappa or delta receptors along with the mu receptors.
  #9  
Old 05-01-2013, 02:56
A Bitaddicted A Bitaddicted is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

I took 3mg of subutex and hour ago strictly for pain, if I take more will it give me better/more pain relief?

A Bitaddicted added 96 Minutes and 34 Seconds later...

I took a subutex about 3 hours ago for pain, if I take more will it reduce my pain or just be blocked?

Last edited by A Bitaddicted; 05-01-2013 at 02:56. Reason: Automerged Doublepost
  #10  
Old 20-01-2013, 08:18
moneyman5377 moneyman5377 is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

Quote:
Originally Posted by Cynder View Post
I'm pretty sure from experience that you can take opiates while on suboxone and not have to wait until
Your in WD again to take your next dose of suboxone as long as its still in effect. I mean they prescribe Them (subs and opiates) to be taken together by pain mngmt drs in europe. Anyone else have experience with this?
I just posted a new thread asking this same question. I have had experience with being able to dose sub after taking an opiate while on sub. But then again sub doesnt really seem to effect me so the reason I asked was to find out if there was any actual chemical/scientific information about this topic. Because while I have redosed sub shortly after using an opiate and didnt get thrown into precip wd it just doesnt seem worth the risk if you were to start feeling extremely shitty. Its just kinda hard to remember exactly how I felt when i did it because when i look back and remember withdrawals ive had theyre kind of a blur other than the fact I felt shitty and dont sleep ever ahah
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Old 26-01-2013, 01:51
apekat apekat is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

In my personal experience, i have taken suboxone AND subutex for extended periods of time. suboxone blocked ALL opiates from working NO MATTER WHAT DOSE! subutex did NOT! i believe it was the naloxone in the suboxone that blocked the opiates. subutex didnt have that effect at all. also, subutex didnt cause the massive headaches that suboxone did. ( thats the reason i switched) however, what works for some may not work for others. GOOD LUCK
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Old 30-01-2013, 19:54
jarlaxle jarlaxle is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

its a crapshoot to do something else on top of subs.... sometimes it can make it go into instant w/d and sometimes u can actually get high/feel better. i just wouldnt try using an opiate and then later that day taking a sub, that always is a bad idea.. but usually if i take my subs when i wake up and then later if someting temps me i can inject and it wont get blocked or most of it wont anyway... i have no idea about oral or snorting. i do remember once i snorted a hydrocodone 5 mg and then 4 hours later took half an 8mg strip and then threw up for hours.
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Old 09-04-2013, 18:31
Maryjane693 Maryjane693 is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

If subs are not helping enough perhaps you should try a short taper of methadone... Either way your probably gonna feel a bit shitty but I agree with FloatyHead, it's better than cold turkey. You need a lot of support for the post acute stuff--the cravings, phantom pain, real pain, etc... Maybe you want to consider methadone maintanence if you don't think you can kick. Just try to keep your dose as low as possible. Methadone is hard to come off of and they do a real gradual taper when your ready so less is best. I know people who say it saved their life, others think its a ball and chain. And it is, but for many the alternative of heroin is a way worse ball and chain that destroys everything good. But to answer your question, I think combining suboxone and another opiate is a waste of money because you won't get high and will prolong your acute withdrawal. Choose one and commit. Best of luck.
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Old 19-02-2014, 17:10
FuegoJohnson FuegoJohnson is offline
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Re: Anyone feel better after taking an opiate while on suboxone?

Quote:
Originally Posted by apekat View Post
In my personal experience, i have taken suboxone AND subutex for extended periods of time. suboxone blocked ALL opiates from working NO MATTER WHAT DOSE! subutex did NOT! i believe it was the naloxone in the suboxone that blocked the opiates. subutex didnt have that effect at all. also, subutex didnt cause the massive headaches that suboxone did. ( thats the reason i switched) however, what works for some may not work for others. GOOD LUCK
As we know, the difference between Subutex and Suboxone is the presence of naloxone, a well known and documented opioid receptor antagonist. What that naloxone actually does seems to be pretty unclear to a lot of people.

The blocking effect on opioid receptors comes strictly from the binding affinity of Buprenorphine, period. When taken sublingually, naloxone has a bioavailability of around 1-5%(varies from study to study) but what you really need to know is that it's rendered essentially ineffective when distributed through this ROA. So people, Naloxone is NOT what prevents you from getting high on your DOC, it's the fact that Buprenorphine has one of the highest affinities ever documented for the mu-receptor site. To demonstrate just how potent Buprenorphine is when attaching to receptors, it has also been documented that people can IV suboxone and not instantaneously experience w/d symptoms. Here, the naloxone bioavailability would 100% and it still cannot knock bupe off the receptor sites. Now, IV'ing Suboxone is a terrible idea in itself, and one I don't generally advise, but I thought I would use it as an example to show just how strongly Bupe binds to receptors(this has also been displayed in Bupe overdoses in opioid naive individuals. IV naloxone still has a hard time knocking Bupe off receptor sites, and needs to be administered multiple times so you first time users, please god don't pop 16mg and think you will be ok. It's dangerous!).

In short, your experiences with Subutex/Suboxone and the following "cascade effect" is probably dose dependent, time dependent, and user dependent. Suboxone has an average half life of around 36 hours, meaning if you dose continuously every day for multiple days it builds up rapidly in the system. Subutex is the exact same way. I've heard of people receiving generic forms of subutex and claiming "it's not nearly as effective" so this may be your cause, but has nothing to do with the differences between the two drugs when compared in full dosage forms because they are the exact same chemical, minus the naloxone(which does nothing anyway and is used as a deterrent for IV users ONLY, and even then there seems to be some wiggle room).

As far as taking a full agonist(oxy, hydro, morphine, ect) after taking a Buprenorphine dose of any kind(Suboxone, Subutex, or even high doses of temgesic, an RX Buprenorphine for pain management) it will block receptors at least partially for an average of 24-48 hours, and if you have been on a Buprenorphine management plan for a while(6+ months) it could take up to a week before a full agonist will be felt depending on how much you take daily. The blocking effect is due to the extremely long half-life of Buprenorphine, and is sometimes called the "cascade effect". Generally speaking, on doses 2mg or lower, the "cascade effect" is greatly diminished after 24 hours since much of the drug has been eliminated and is not in high enough concentration to cause the blocking effect it has at higher doses.

So in summary, you may as well treat Suboxone and Subutex the same because they are THE EXACT SAME DRUG. It has been noted that naloxone can cause headaches in some hyper-sensitive patients, which is generally why docs will switch maintenance users over to Subutex. However, the naloxone, especially when used sublingually, is a NON FACTOR. I don't care what others say. I posted this because i've seen an enormous amount of mis-information over the last few days, and while many on here do have it right, there is still a lot of bad advice floating around.

NOTE: If you want to receive a buzz while on Buprenorphine treatment(AND I DO NOT CONDONE/RECOMMEND THIS, i'm simply posting it for those who care and are gonna try anyway) you will need to account for the amount of Bupe remaining in your system from previous doses. EXAMPLE: If you dose 8mg one day, and 8 the next, you will actually have around 13-15 mg in your system on day 2, depending on the users metabolism, due to the extremely long half life as stated before. Continually cut your dose for 3 days(if you are on 8+ mg a day for several weeks, I wouldn't even try. The discomfort you will experience simply won't be worth the wait IMO) til the remaining amount of Bupe in your system is < 2mg, where the "cascade effect" seems to greatly diminish. This can vary wildly from person to person, but as a general rule, it seems to work for many. It may take a larger dose to feel the effects of the full agonist due to some receptor sites still being occupied by the Bupe, but the full agonist should "break through" the previously aforementioned barrier. Overdose is a serious concern here, so be sure to display some common sense, please. If you take double your normal "high dose" and still feel very little, it's probably in your best interest to call it a day instead of risking death.

Hope some or any of this helps out and sheds some light on how Buprenorphine actually works. It's an extremely complex chemical with a surprisingly little amount of research as far as addiction treatment is concerned.

DISCLAIMER: I am not a doctor, just someone who has been on and off suboxone for years and have studied the pharmacodynamics of Buprenorphine extensively, along with plenty personal trial and error over the years.

EDIT: Since Buprenorphine is a semi-synthetic derived from the opium alkaloid thebaine, I guess it would technically be an opiate? There seems to be some confusion here, even in medical experts, as to what exactly an "opioid" really is. Most say opioids are fully synthetics, meaning they act on opioid receptors but have no chemical similarities to natural opiates such as morphine or codeine. Depending on who you talk to, semi-synthetics(like bupe, or oxy, hydrocodone, or even diacetylmorphine) seem to "generally" be grouped in with opiates. I referred to Bupe as an opioid, so I apologize if I used to wrong technical term. Just thought i'd share this in case I was spreading misinformation, albeit a rather small bit.

Last edited by FuegoJohnson; 20-02-2014 at 13:59.

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