Opinions - Suboxone

[Ellis D.]

SWIM is getting prescribed 8mg/2mg(buprenorphine/naloxone) sublingual tabs and is wondering if there is any substance he could take to counter-act the naloxone making it impotent? SWIM is coming off a very large H habbit and is very worried this won't be nearly enough dope...

[Laudaphun]

the naloxone should not have an effect, unless you are hypersensitive to it.

[Ellis D.]

Yea people are over concerned about suboxone. SWIMs gone from heroin to suboxone, to heroin, to suboxone again in the past 2 days without any serious withdrawls.

My lab rat waited until it was in some withdrawls before switching to subs (12hrs inbetween maybe) and was fine. The rat also noted that doing sub in a morning will make euphoric opiates not euphoric for that day, you get kinda warm like usual and if you're withdrawing those go away but you won't get high.

So far suboxone seems pretty cool and easy going, SWIMs doc went way overboard with; "minimum of 3 days not using or you will end up in the hospital with withdrawls, it will be so bad" <--BS

[goatman]

How in the name of god can you say that naloxone will not have any effect? Not only will it displace whatever exogenous narcotics he might have in his body, but naloxone/naltrexone/nalline et al will displace and negate all endorphins your brain mighe produce. This is why nobody stays on any of these drugs, they create a stressful bare-ass attitude, friend to nobody. Knoll and others have been trying to patent some use for these things since the early seventies, without success. But they are very good to save an overdoses' life, but this is too small a market for profit.
NEVER allow any of these drugs inside your skin. In dental and outpatient anaesthesia they often use naltrexone or another of that ilk to snap you out of the Sublimaze/Valium sleep: they will not tell you before they use this drug, and with my maintenance program participation at the time that shot of naltrexone made me suffer so bad for three hours untill it wore off and the MD came back to comfort.
If anyone gets any anaesthesia for any reason ask first about the use of these hellish drugs: it is far better to just wake up gradually from a top shelf fentanyl stupor. goatman

[Ellis D.]

wups, SWIM went 3 days switching drugs, not 2

[goatman]

Hi;
Naloxone is and always will be a Very Evil Drug. Back in the 1970s there was a piece in Chem and Engineering News about "The drug problem" and the new wonder drugs, both agonist and antagonist. In the 1950s there was the Nalline test that Wm Burroughs speaks of in Junky or Naked Lunch, if you got high from it you were not a user, but if you got bad sick right away you were a junky.
Well some unholy chemists pulled that methyl off the bridgehead Nitrogen of Morphine and attached a cyclopropyl group, and there were allyl versions too. Nature abhorrs unnatural things by definition, and god herself never made a cyclopropyl group, and for anyone to willingly ingest one is the worst folly.
These antagonist drugs function by having a prefferential binding ability to the specific receptor site, and they are very strong but are typically of briefer activity. They will displace most all narcotics, the only good they are is in ERs for oversose, but that is not much of a retail market for Knoll, etc.
So for 50+ years they have been trying to come up with some marketing scheme to mass market their unholy antagonists, But why, you might ask, has it not worked better?
Because Nalloxone etc displace everything that binds to those receptors, including your God-given endorphins. And without them you go thru life with a tight jaw and a sense of bleak grey hostility. Folks just not feel good on Naltrexone, Nalloxone, Nalline, and they never will.
Look up the history of all the naloxone and naltrexone trials: all fail.
BTW, there is a curious interaction worth remembering: Methadone addicts will experience if given Metrazol, a 'speed' drug. do NOT mix.
goatman

[kevip7]

Swim has not had any bad effects from Suboxone.. slowly cut down to none and had no withdrawel or anything.. You can mix Suboxone with a benzo and you could feel pretty decent.. Swim was given methadone before and it didnt work 100mg a day and felt nothing, is that just this swim or is this normal.. this was months ago so just curious if anyone knows why methadone would have absoultely no effect on a pers

[upperdecker]

SWIM took tiny pieces of a 8 mg Suboxone pill and used it for about 3 or 4 days. SWIM hasn't used Suboxone in 2 days and is wondering if it is safe to use Methadone because he read that it can put you into withdrawal.

[upperdecker]

I forgot to add, is it safe for SWIM to use the Methadone?

[upperdecker]

Can someone please answer SWIM's simple question? SWIM searched the net so don't just tell him to look elsewhere. He's just asking you to use your 10 fingers to complete a sentence that answers SWIM's simple question. Thats all. And if you can't/don't feel like answering SWIM's post........well F u. If that gets me banned oh well. Its not hard! SWIM snorted a very small portion of a Suboxone 8mg pill (the one's that taste like rotten oranges) for about 3 days and hasn't had any for the past 2 days. If SWIM were to take Methadone now would SWIM experience withdrawal?????or should SWIM not feel the effects of the Methadone at all? Thats it, thats SWIM's only questions regarding the subject. SWIM respects everyone on this great site but when ignored, SWIM becomes a little ticked off. All SWIM wants is a simple honest answer from someone/anyone who knows the answer to what SWIM has asked, that is all.

Reputation Comments on this post:

UTFSE

[Handle]

I know it's a very late reply, but for people out there here's the rub.
If Sub first, anything goes
If Dope first, wait until it's all gone, before you touch sub
If Methadone first, wait a very very long time, or the sub could kick you off and then you can't get back on!

You can take ANYTHING you want, straight after subutex or suboxone, straight away, the worst that will happen is you feel nothing [and believe me, you feel nothing --NOTHING!] but you will be fine.
Just watch out though, don't take good stuff first and then rush out and take sub, very bad. Think of 3 days of WD's crammed into one hellish afternoon, and it is really really violent.
Also, methadone can be a real pest, because even though it might not feel as good as street stuff, boy does it linger, and so in one way doctors are right, because 3 days is needed if your last hit was methadone, it sticks around and you have to wait.
If you take even a small amount of suboxone or even subutex while there is still junk in your system, you will feel bad, but really be careful with methadone because you do have to wait a long time.
Heroin actually has such a short half life that often half a day is enough of a wait to get out of the danger zone [so if you are really hanging out, just lie and say it's been three days already, but if you still fell even a little bit comfy -watch out].
Look, with junk WD's, sometimes your body tells you when it's ready, sometimes you don't have to wait that long, just go by outward signs like pupils, if they're still small don't take sub, blood pressure, if it is low or high don't take sub -wait until it normalises, and obviously if you feel "good" do not take sub.
But with methadone the best advice is to wait anyway. If you don't take sub early enough, sure you may feel bad over time, but if you take sub to o early you will definitely suffer for it.

[goatman]

Hi
Here in Amerika the material you speak of, Suboxone does not seem to have made the PDR or the USP anyhow, but the way you speak of it it is one of those hellish agonist/antagonists like Talwin, phenazocine, with something other than a methyl on the bridgehead Nitrogen, a very unholy perversion of a God-given molecule.
I would not eat Suboxone on a bet. Goatman

[Orchid_Suspiria]

The naloxone in suboxone is not active unless injected.This is made to discourage opioid addicts from attempting to inject it.

[Handle]

Orchid Suspiria, you are correct, basically only miniscule tiny tiny amounts of naloxone can make it through unbroken buccal mucosa, so it is designed to deter injection, which causes large amounts to come in and do their dirty work.
Sorry, look, I really want to know why everybody's distracted from the question. Who knows, maybe upperdecker is long gone, but for future reference, the answer is :
if someone has ALREADY taken suboxone, then it doesn't matter. I repeat, if you have ALREADY taken suboxone, then nothing else you take to feel good will make you feel bad, alright?
If you have ALREADY taken suboxone, the worst that will happen is that whatever remains in your system will simply block out good feelings from other stuff, but you cannot go into withdrawal, I promise.
However, if you have taken anything else, you must wait until the effects are gone before you go anywhere near suboxone, and my only point was if you take methadone first, well then to be safe you should wait extra long.
Just repeating, if you have been on suboxone first, it doesn't matter what you take, even heroin, but just don't expect a good rush if there is still suboxone in your system.
However, if you have taken anything else, anything, do not rush out and take suboxone too early because it will mess you up [I really do know this from experience].
As for naloxone/suboxone being 'a travesty against god' or whatever, well, I don't know, but it sounds nasty. I'm not commenting on that, and I'm not commenting on whether suboxone is good, feels good, or is safe or strong or with no effect. I am simply saying that if suboxone is taken FIRST, then taking dope afterwards will not cause withdrawal, even if you miss out on euphoria.
And if you take any kind of dope first [including methadone] well then there is a big risk that if you back on suboxone too early, you will get a powerful accelerated withdrawal effect.

[goatman]

Dear Handle:

Thank for your coherent, well reasoned, and thoughtful response which, I believe, was to the idea of the mixing of Suboxone with other drugs. The very reason for taking that class of meds is to deter additional drug use, so I agree that the even possibility of the question defies logic. i.e. if it don't feel good then why do it?
My long term objections to this class of drugs is philosophical: it is un Natural in so many ways.
For starts, artificial drugs typically model natural ones in overall structure. this class of drugs introduces absolutely UnHoly and UnNatural structures to replace the simple, minimalist Methyl Group off the bridgehead Nirogen. They add Allyl, which I admit is found in some Natural Terpene products like Saffrole, and they further desecrate Natures crowning glory of Morphine chemistry, If I recall Bentley called it "Natures Chemical chamoeleon". Some pervert added a cyclopropenyl group to replace the Methyl one. Now where in gods' Nature would one look for a cyclopropenyl entity?
Thumb through the "Merck Index" the listing, catalog, menu,wish list, of all the rugs or there that have ever been used to cure or get a boost.
And you will not find one damn cyclopropenyl: so why, I ask, put any of that crap in your body. Morphine might bad, but at least it was God given and Natural, its design is part of a developmental continuum .
A healthy Natural Human Body produces a normal flow of penta-peptide endorphins. (Aldrich had them listed)
It is bad enough to use N drugs which screw up and inhibit their production. And when one is withdrawing from Ns and there are no endorphins to soften the curse it sounds truly bleak and dreadful.
These drugs might be short term lifesavers, but long term they are potent psychic tools that I suspect will be proved to have a long term negative effect on the health and happiness

[Handle]

Hey, Goatman, I should say the same to you, all along you've made a pretty consistent and persuasive argument, which is, what we know of it [except for OD's] is only bad, and we don't know what else it's capable of. That will take another fifty years.
Also, it is a very wise point that these bastards have been waiting for years to squeeze such a completely illegitimate poison into something more popular and profitable -bingo! Buprenorphine.
And I must say I was really worried, really freaked out, when I was looking up endorphins, to hear that even they, our own feel good molecules, many factors more powerful than morphine, are completely blocked out and reversed by naloxone.
That cannot be good. I've also heard of someone on naltrexone implants still living a rough life, with no easing up in sight, so that makes me doubt that there is any evidence that this family of drugs has any legitimate use, even for drug dependence.
And finally on subutex, I think back to the time I was on that, and I was plagued with anxiety, depression, and a lot of anger that I don't feel now on buprenorphine alone.
And I don't buy this notion that it doesn't get absorbed, I have already referred to this before, and I'll say why again. When I transferred, to bupe [as they call it here in Aus]
on its own, the doctors and everyone insisted that I didn't need as much in milligrams as I took while on subutex.
They said the reason was that pure bupe was not blocked they way it was [partially] when mixed with naloxone. So we all know that some of that stuff has got to pass through the lining of the mouth, and who knows what long term impct on mood it might have, I only imagine flattening, deadening and dysphoric.
No, I think Goatman is right, especially regarding the commercial interests and pressures behind its forcing on a captive market, that has no power to refuse. It all comes from this odd mentality that wants distrust and punishment -physical and mental- to prevail over drug users. I have heard many times from many practitioners that the drive is to eventually phase out methadone as much as possible, then who knows, maybe unadulterated bupe will be next on the list.
And they are using the carrot to suck everyone in, that if you just accede to suboxone everything will be alright and you'll get takeaways and your life will be so much easier. I for one, now feel that I'll be better off to just reduce off bupe over time, rather than hang out waiting like a good docile guinea pig, for a chance to take poison at home.

[jerbles]

so suboxone has nal in it but subutex doesn't?

[Handle]

Correctamundo. And since it is on precription and all perfectly legit, I can admit that I have been on both, but am now currently on plain old subutex. It's just that with subutex, one must put up with the inconvenience of constant visits to the chemist so they can see you take it, because it is liable to diversion otherwise.
See, it has been pointed out to me, and it is quite true, that buprenorphine must always be used under the tongue because it is broken down in the gut, and users realised that temgesic [the painkiller version of bupe given to like cancer patients etc.] were very easy to dissolve, because under the tongue or 'sublingual' pills, must not have a coating, gelatin, heavy binders like cornstarch etc, otherwise the drug could not be released properly into the mouth. Therefore they became one of the drugs that were well known as easy to dissolve for injection.
Now, look at oxycontin, I thought, who needs naloxone, look at oxy's they are basically impossible to dissolve and so despite their enormous popularity there is almost no ne who injects them, so I thought, why not make subutex like that? But then I realised that subutex must be appropriate for the mouth.
So, it is quite hard to think of a way to make subutex good for unsupervised takeaways but bad for injecting, without sneaking naloxone into the mix.
What about chewing gum, eh? I mean, look, every day they give people methadone liquid, and many dispensaries are now switching to clear less sweetened methadone without the red colour and I think with fewer preservatives or no sorbitol or something. Anyway, that new clearer stuff is much easier for people to inject, and they know for a fact that many people will take it home and shoot it up their femoral vessels. Also, everybody knows that methadone is bloody dangerous stuff, especially compared to buprenorphine. So my question is, why is it they are happy to hand out methadone in an easily fairly injectable form, even though it is almost solely responsible for OD deaths compared to bupe, and that most people would seek out methadone anyway, rather than bupe for several reasons not least of which the fact that methadone is a stronger narcotic by far, but on the other hand it is virtually impossible to get pure buprenorphine and take it at home as a normal law abiding 'reformed' drug addict.
And, if naloxone is supposedly so inactive by mouth, well then why don't they put that shit in methadone too?
These questions need answers.

[jerbles]

who the fuck cares about injection. If the subutex patient wants the full effect of the meds he's given, let him slam the shit outta them. So, with subutex, you go every day to get your tab? Is there anyway to keep it in your mouth without it dissolving so you can take it home?

[Laudaphun]

Most people take suboxone and experience no negative effects from the naloxone. However a minority of people are hypersensitive to naloxone and these people experience headaches, dysphoria, etc. Almost all of these people, if their Dr. would not switch them to subutex were able to avert these symptoms by spitting out the orange drools after allowing the suboxone to dissolve for the appropriate amount of time. This is because barely any naloxone is able to absorb sublingually... we all know that. However, some naloxone is able to absorb into the system via the lower digestive tract albiet a small amount. This is not a problem unless the person is hypersensitive to naloxone, in which case they either need to spit or switch to subutex.

And, if naloxone is supposedly so inactive by mouth, well then why don't they put that shit in methadone too?

basically because methadone is not taken sublingually and naloxone is not completely inactive when swallowed

Now, look at oxycontin, I thought, who needs naloxone, look at oxy's they are basically impossible to dissolve and so despite their enormous popularity there is almost no ne who injects them

SWIM isn't sure what your oxycontin looks like over there in Australia, but here in the U.S. our name brand oxycontin is commonly used I.V. There is at least one generic that is very difficult to prepare for I.V. though, but has been only very recently introduced into the market and will be soon removed from the market as rumor has it due to legal issues.

[Handle]

I would just pause here to go back to the original question. If it is a minority of users who experience hypersensitivity to the naloxone, the solution is to spit it out. Well, I think everyone should spit it out because once the stuff is swallowed, there is no further effect from buprenorphine anyway, and presumably people would want as little of the naloxone as possible. But look at it another way. If everyone's in agreement that naloxone basically does not go through the buccal mucosa/lining under the tongue, then since a majority of users are said not to experience sensitivity to the naloxone, so do not spit it out, the only place it's going is the digestive tract.
It doesn't matter how long you hold it in your mouth, if the drug company is telling the truth it is not absorbed, and ends up going via the stomach and small intestines.

Someone needs to answer this question.

If naloxone is not completely inactive by mouth, then why is it that only a minority of users are said to feel sensitivity to it in suboxone? If it has just been said that it is not absorbed through the mouth, well then sublingual users would end up with the same amount of naloxone in their gut as drinkers of oral liquid would. One fact must be correct, and one must be wrong.
You cannot say, naloxone is not completely inactive if swallowed
Therefore you cannot put it in liquid methadone
IF you also say it is not absorbed sublingually [because that means then that current suboxone users would be receiving a full oral dose]
So then they get it in their gut
So why is it only a minority of suboxone users would feel sensitive, if everyone gets the entire amount of naloxone bypassing the mouth and in the gut?
My point is, I am unaware at the moment of people spitting out their dose when they are finished with it, this is not yet an accepted practice, so that means that everyone who is on suboxone is actually getting naloxone constantly absorbed in small amounts through their gut, because those three statements [1.It is not absorbed through the mouth 2. It is not completely inactive when swallowed & 3.Only a minority of users spit it out] those three statements add up to the fact that suboxone continually gives a majority of users naloxone through the gut.
Yes, I know that methadone users do not have the liberty of spitting out their dose, but the real issue is, are suboxone users being told the truth? Nobody I know of was encouraged to spit their dose out, and not only that, when people transferred back onto plain old bupe, they were always told "You do not need the full amount. A given dose of bupe does not need to be as big as a dose of suboxone in order to achieve the same effect" When asked why, the women at the centre said that pure bupe was stronger per milligram than suboxone. This is a true story. That is what the nurses said to us, they were inflexible. This means they knew from somewhere that suboxone was slightly less effective per milligram, and this can only be due to the naloxone. I am not making this up. That is what they said to us.
I think we should all think about what Goatman and others pointed out, that people should look to the commercial and government pressures, the time constraints of medical & dispensing staff, and the pressure applied by lobby groups, including all the glib lines and guarantees that are made out to be scientific, but have the sole aim of getting widespread acceptance of this niche market, for a drug whose patents and rights to produce are controlled by a select few, who want to make more money by pumping this stuff out in a more profitable product.
Something many would question as unnecessary, concerns about long term mental effects and who it really serves, people are trying to have them swept away by putting this substance in a position to ride on the back of peoples treatment, using the incentives of convenience and a more manageable lifestyle for patients, to gloss over the fact that this is, as my doctor said, a lazy device, that promotes lack of goodwill and trust, for a health system that is being stripped of resources, so doctors, nurses and other dispensers who are all under constant pressure, are being urged to use this drug as it will make take aways easier, with no need to establish a better rapport with patients.
I do not blame the good staff who are subject to constant bombardment by these special interest groups.
I do NOT oppose the introduction of bupe in a way that is impossible to shoot up.
However, I do object to the cynical and skillful manipulation of these problems, to offer a solution that may only have the purpose of making more money off a drug that no one would want on its own, a very powerful drug with no legitimate use in the field of maintenance therapy. Yes, its a life saver for OD's. But in this case, it seems punitive, untrusting [as always] and above all, it is no solution to the need for proper consultation and honesty between patients and staff. My current doctor has likened it to rubbish like antabuse, because it starts on the wrong footing, one of suspicion, control and assumptions and the absolute control of people who in every way, are in a weakened position to bargain with the system. What you need is to figure out how your wishes coincide, establish honesty and the ability to fess up to mistakes with understanding, not hostility. Not straight off the bat deciding that a person is eternally no good, up to no good, and they must be sabotaged in their dastardly schemes.
I think perhaps they are suspicions, that is the culture that canny businessmen want to encourage so that they can then say, here, have a pill that does the policing for you. You know they are all untrustworthy degenerates, so why not give us a slightly better price as part of the government grant, for the new super pill to make your job easier.
I think that may be closer to the truth. Who knows, maybe reckitt benckiser get quite a handsome bonus for peddling suboxone rather than buprenorphine.

As for oxycontin, you may be right. I did hear something about legal action, but I can't remember. Was it because one company was infringing on the rights of another. Oh, yes, I vaguely remember they sort of had generics for a while, there was some dispute, so then the courts decided that the prestige brand would monopolise the production of the pills themselves, and give some "blanks" to smaller companies to market as generics, even though they are still made by the premium company, it's just that they won't be labelled or priced as such.
Nevertheless, you may be right that this will lead to an altered make up of the pill, and make it easier to inject than the previous generics. But it must be said, that dilaudid type small pills are easier to inject than extended release pills, which can provide various obstacles like wax, cornstarch, hard little time release balls etc. etc.
My only point originally, was to say 'why not make bupe like that' but I realised straight away that bupe is not to be swallowed like oxy's are, but to be dissolved in the mouth.
Of course, one final point. I know that for obvious reasons a sublingual pill will always share certain characteristics with injectable matter, as they both need to dissolve easily. One reason that this is actually desirable is because a pill that dissolves quickly is harder to divert, and has a definite beginning and end state, so the staff can see it has dissolved before they let people go. Chewing gum does not allow for this. BUT [and now here is the big difference] If the staff give you any sort of takeaways at all, clearly they are not concerned that you will give your dose to others. If they were, they would only let you take it where they can see it. Secondly, suboxone cannot prevent diversion anyway, under any circumstances. The only thing it is for is to prevent injection. So whether diverted from the dispensary or from take homes, it can still be given to anyone else for sublingual use. Do not underestimate that people are after opiates whether they can be injected or not. It is not true to say that just because you can't inject something, therefore demand for diversion will decrease. In fact, there have been studies that truly show that other forms are MORe attractive to some users, like patches, nasal spray AND SUBLINGUAL [to be used sublingually].
Many report that the non injectables appear more accessible, less stigmatised etc.
So, chewing gum, what's wrong with that? You could put the drug in as a freebase, as with nicotine. It would be no more dangerous around kids than methadone cordial which has fooled and killed many. Using the freebase would make it more permeable to the mucosa, and much harder to dissolve. Finally, since it would be inappropriate for a dispensary setting is alright, the only use would be for take homers anyway, keep using normal bup for the come inners, and avoid naloxone entirely.
Someone debunk my proposal. How would it be any worse than suboxone?

[Laudaphun]

You cannot say, naloxone is not completely inactive if swallowed

do some research... naloxone is absorbed into the system via the lower digestive tract, however it is a small amount. A small amount that does not have much if any effect on an average person. But, in the minority of people who are hypersensitive to naloxone it is enough of a dose to give them negative effects.

If naloxone is not completely inactive by mouth, then why is it that only a minority of users are said to feel sensitivity to it in suboxone? If it has just been said that it is not absorbed through the mouth, well then sublingual users would end up with the same amount of naloxone in their gut as drinkers of oral liquid would. One fact must be correct, and one must be wrong.

Barely any naloxone is able to absorb SUBLINGUALLY (by mouth), however eventually whatever is in the mouth must be swallowed or spit out. The vast majority of people swallow the left over saliva and have no problems. Insignificant amounts of naloxone are absorbed through the veins in the tongue, however small but significant amounts of naloxone are absorbed through the LOWER DIGESTIVE TRACT which is different than via the veins in the mouth. This is where the people with the hypersensitivity have problems.

Actually buprenorphine can be absorbed by the digestive tract if swallowed, it will just have to make a first pass through the liver and be broken down rather quickly as compared to as if it were introduced directly into the veins via sublingual. Also, SWIM has tried your very theory of spitting even though he isn't hypersensitive to naloxone and noticed that throughout the 24 hours, the bupe didn't seem to last quite as long, but he felt slightly better. Keep in mind this was a short term experiment of maybe a week tops

There were actually people in SWIM's area who did not know that suboxones were sublingual tablets (of course they were getting them from the street) and still getting strong effects... it was funny when it was first discovered that a certain SWIXYZ was swallowing suboxones.

My point is, I am unaware at the moment of people spitting out their dose when they are finished with it, this is not yet an accepted practice, so that means that everyone who is on suboxone is actually getting naloxone constantly absorbed in small amounts through their gut, because those three statements

Well, actually if you take a look at some forums out there dedicated solely to suboxone, then you will know that the hypersensitivity/spitting routine is well known amoung the suboxone community... but i'm not allowed to link to other forums or even any website that has anything resembling a forum.

And about your idea for making oxys like suboxone, with the naloxone in it, they are already testing an oxycodone pill with either naloxone or naltrexone in it, however clinical trials have not produced many positive results... i think there was a thread about it on this forum somewhere.

[Handle]

Hmm, you raised a few interesting points. To deal with the last one first, I too have heard rumours that there will be some non maintenance opiates tested for a suboxone type combo. Like, pain pills. Your point about not many positive results is interesting, because the delayed release style was not only developed to prevent abuse. Some of the additives have a dual function of making it difficult to get a good effect from snorting and make it difficult to inject, and they provide for continual release as well.
So, just say they left it as a continual release type pill, AND put naloxone in there, then your point about intestinal absorption would become even more pertinent. I'm just guessing, but that might be one explanation for the not very good effects with oxycontin/naloxone combo.
What I had just stupidly suggested at the start was not making oxy's like suboxone, but making suboxone like oxy's [If my suggestion was mixed up, I apologise]. Hmm, I wonder if you could do that, to give a time delay pill a keratinised coating, or whatever that stuff is, I think they call it 'duenteric' or something -to bypass the stomach. Then just have the bupe absorbed purely in the lower gut.That would be interesting.
On that note, your stuff about people swallowing the pills and still getting effects. The only explanation I can think of is that the medical opinion may be that bupe is only 'significantly weakened' by oral route, not completely destroyed. So again your point about the intestines comes into play. Even for experienced heavy opiate users, this could still be true. Like, I'm not just saying they have to be 'opiate naive' to feel effects from a residual dose that is left after swallowing and initial digestion. The reason I say this is that since everyone must be careful with bupe, and particularly suboxone if they have already used opiates before, is the induced withdrawal effect. So, even heavy heroin users, if they wait as advised before taking the pill, it creates a window of sensitivity during which they may feel the bupe quite strongly, even if they swallowed it.
I mean, the body in dire times like withdrawal, will be grateful for anything that makes it feel a little better, so even if swallowed I cannot discount your word.
Again, your point about people spitting, I must confess. I only saw suboxone for a year during trials. I am not at the same place now [it was a fairly big treatment centre in Sydney] and indeed I am the only person at my pharmacy even on bupe at the moment, let alone suboxone. Since I only used and saw the stuff during trials, I know that they try to keep things strictly by the book, and it being a new thing, it takes time for useful tips on how to troubleshoot, takes time for them to filter back into common usage. So who knows, maybe right now they have taken up the practice for the ones that do get problems from swallowing. I mean, I only got to use it and see it in the fairly limited context of a trial, so things change as people and institutions become more comfortable with a newish substance, that has new issues that are different from bupe on its own.
Finally Laudaphun, I just want to explain that although I wrote a few long opinionated rants that are fairly negative about suboxone, I did not mean to create an impression that I take issue with the points you raise. I'm just skeptical of the motives of drug companies, and the real reasons this stuff is coming into wider use. [By the way, good handle you've got there.]
One last thing I must clarify: I know that naloxone is not completely inactive if swallowed, but I must qualify that quote you've got where it looks like I'm saying "You can't say that'.
I was actually saying several statements together, I was saying you cannot say "[don't put naloxone in methadone because] Naloxone is not completely inactive by mouth"
IF,
you also say that it is not absorbed sublingually. I say this because if it is mostly not absorbed sublingually, AND if most suboxone takers don't spit it out, then that means most suboxone takers end up swallowing their full dose of naloxone.

You see my point? If the chemist/doctor/nurse/whoever gives you this pill, and there is naloxone in it, and you put it in your mouth and the naloxone is in your mouth, and your mouth can't take it through the mucosa/membrane, that means its still in your mouth.
So my point was, if you say its only a minority of users who experience sensitivity, that means it's only a minority who spit out, that means a majority swallow. Ok, so going back to the pill, you've just been given the pill, and your mouth won't take the naloxone, and say you are part of the majority who swallow, then you are swallowing naloxone, and you say it is not completely inactive when swallowed, that means it is partially active then. So my point is, if your mouth does not absorb the naloxone when you take subutex, and since I very much doubt that the mouth itself is able to break it down, that means a drinker of liquid methadone [if it did have naloxone in it] would be receiving no more naloxone in practice than the majority of suboxone users.
So I was saying "You can't say 'don't put it in methadone because' naloxone is partially active by mouth IF you also say that its not absorbed by the mouth, AND yet you also say that most suboxone users swallow it AND are not sensitive to it."
I know it's a mouthful, but if you follow the train of statements, my point was that you cannot make a defence and say this is a reason you can't put it in methadone, because if you apply that reason to bupe, well then you should not put it in bupe either. If you are saying 'don't put it in methadone because it's still partially active by mouth' then why are the majority of suboxone swallowers lumbered with it, since by logic they too must be getting a regular dose, by mouth, of naloxone that is not 'completely inactive'.
When you said 'naloxone is not completely inactive by mouth', I wasn't saying 'you can't say that'. My point was, you cannot first say 'it's not inactive by mouth' if you then in your next breath say 'but it's not absorbed from the mouth either'. Because if it ain't absorbed by mouth, then suboxone users who swallow [the majority] are getting the full naloxone dose of each pill by mouth. I mean, it can't disappear somewhere between the mouth and the stomach. Don't get me wrong, I don't have some insane agenda to get naloxone added to methadone as well, like 'what's good for the goose [bupe] is good for the gander [methadone].' But I'm just saying why is it that bupe, which is all round basically a safer drug, why is it the one that must have naloxone in it?
I think that there would be an outcry from patients if naloxone were added to methadone, so instead it is introduced by stealth, first as a trial, then for takeaways, then who knows maybe one day they will try to phase out normal bupe entirely, then they may restrict newcomer's access to methadone programs and try to shunt all new people onto suboxone. Then before you know it, the captive naloxone market becomes firmly entenched with no hope of going back to the way things were.
Laudaphun, I am not trying to criticise you, I promise. I am just trying to at least ask the question, why has buprenorphine been singled out for naloxone, it is no more injected than clear methadone, it is a safer drug, more predictable, etc. fewer deaths related to it, so what good argument is there for naloxone being put in there except as a giant guinea pig program to prove their new product and try to phase out the competition. I think the biggest argument against interfering with existing methadone is just that there would be too much resistence to it from the vast majority of legit users who just want the same old normal stuff. I think this argument that suboxone users are somehow taking naloxone, [which even you say is partially active by mouth] yet it magically disappears for some reason, is just a myth made up by reckitt benckiser.
I think they know that suboxone users are constantly exposed to naloxone, it goes in your mouth, your mouth won't take it, you swallow and it ends up fully in your gut, and you say it is still partially active. I think they know this and they just don't care.
This may even be the first mass test of the mental effects of long term low dose naloxone by people who see the happiness, moods and emotions and mental health of patients as purely expendable in their quest to establish their new product as the way to go.
Laudaphun, you always raise interesting points in response, I find your contribution.......
[wait for it] laudable!!!!!!!!!!!!!!!! Bada-boom-tisch! I'm sorry, I just couldn't help the lame-o inside me. But seriously, I have no dispute with you, it's just good to thrash out these things and as you proved with the spit/swallow dealie, and nalox in oxy's there are things that you know that I don't, and they are all good points.

[Laudaphun]

"You can't say 'don't put it in methadone because' naloxone is partially active by mouth IF you also say that its not absorbed by the mouth, AND yet you also say that most suboxone users swallow it AND are not sensitive to it."

When I say inactive by mouth, I'm referring to the absorption of the buprenorphine while it is still in the mouth... I guess typically when we say by mouth we mean a swallowed pill, I guess I should be more clear.

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