Subutex (Buprenorphine) on top of oral Naltrexone

[photonamp]

Hi, this is my first post in this forum and I think its great theres a place like this to share our experiences.
Im writing this with regards to attenuating tollerance while staying on
subutex. I dont care what anyone says subutex is addictive physically
and in my experience more so mentally. my mind is very foggy as im
writting this so im sorry if it sounds jumbled.



After being clean for a year from methadone, i slipped and started
taking very low doses of opiates like codeine/dihydro. I was amazed how
much my tollerance dropped. I was only on about 120mg / 180mg Dhc per
day for maybe 2 months. But anyway decided to go to a clinic for
treatment and so exgagerated my addiction to the specialist 8 fold. I
have a stack of subutex saved up and i like the way it zones me into
managing tasks, better than full agonists. (the clinic noted i may have
adult ADD and im waiting to see a specialist which will take time, but
thats another story). The weird thing about the bup is after 25mg
naltrexone and 12 - 15hours later, 1mg buprenorphine still has a
motivating effect. Definately no high but it clears the fog. I also see
my pupils have become smaller. Since xmas on average i take 0.5mg - 1mg
bup/daily but very roughly as i have to cut the 2mg pills. Iv been
given naltrexone but was told not to take it for at least 3 days after
my last bup dose. Me being impulsive and impatient I dropped 12.5mg
Naltrexone with some hot tea for fast absorbtion around 6 hours after
my last bup dose. Then nothing significant, though a definate shift in
my mental state. 1 hour later I did another 12.5mg naltrexone. Then I
felt the FOG, dysphoria and felt my bowels moving. But no aches or
pains, just the shits really. I consider myself fucking lucky. (this
was nothing like my DIY detox naltrexone assisted recovery from
methadone 1 year earlier).



i take 25mg naltrexone at night and the worst effect I get is primarily
the bowel movements. I fucking hate this, Imodium wont work because its
an opiate.



So now I have a mega supply of Subutex which could in theory last me 6
months maybe more if i can find that magic dose ratio for
buprenorphine/ naltrexone.



Q: if i continue to take the naltrexone with subutex would my
tollerance never increase?



Iv been on opiates on and off for 5 years and they arnt get high drugs
for me, they help me function and this seems like a possible solution
to get out of the terror of physical dependance.



Please someone help me out here. But i think there maybe promise of the
naltrexone holding down tollerance to bup. because essentially at 0.8mg
a day its acting like a full agonist am i right? thats equivilent to my
previous measly 200mg DHC. I get the same motivating effect + long half
life it would be perfect.



I Would greatly appreciate someones input on this, everyone I asked
thinks its an odd combo but i differ. Theres no way in the world a
measly 1mg buprenorphine could cut through 25mg naltrexone and its
increased antagonist in my brain but the bup is doing something.



Appreciate you all thank!

[adzket]

you realy should not take naltraxone and subutext together they both should saturate you opiate reseptors in your brain but whiles subutext still has opiate init naltraxone does not and makes you ill if you take opiats whilst on it. a close friend of mine also got physicaly addicted to subutext and found it hard me i am back on meth you have to find what workes best for you but try not to do them both together naltraxone with other opiates could kill you. which is not good is it?

[smilla]

DO NOT TAKE SUBUTEX OR SOBOXONE WITH NALTREXONE...YOU CAN GO INTO COMPLETE AND FULL WITHDRAWEL!!!!!i am on naltrexone and i have takin it with opiates in my system and it is not fun at all omg! i was on buprenorphine but i alwasy went back after the bup...naltrxoine is the only thing that has worked for me...completely detox yourself and look into gettin a naltrexone implant. go to www.thecolemaninstitute.com for more details

[anna]

Naltrexone implant might not be effective and even dangerous, cause with implant you either get too little of it or too much, it rarely worksright. Naltrexone is a very effective drug but only if takenin tablets, with a right dosage and for the right period of time, it willtotally freeyou of the craving. You may find more info at www.megama.com.


Good luck!

[JBRONCFAN]

Is it the bup or the naloxone in suboxone that kills the
cravings? People at another board are telling me it's the bup, I
thought it was the naloxone.

[adzket]

subutext kills craving but makes you feel compleatly normall naltaxone is generaly given when you have been clean from all opiates as a blocker to stop relapse.

[Silver Fox]

Hey Photonamp,

You really need to be clear in your own mind what it is that you are trying to achieve.

Are you trying to come OFF the opiates, or are you still enjoying playing with opiates anp popping pills to try to make you feel better?

Let's take a look at what these different substances do:

naltrexone (Nalorex) - this is a full opiate antagonist, which has a very high affinity for the opiate receptor. That means, if there are opiates in the system, it will tend to displace them and give 'cold-turkey' effect. It has a long half-life; a 25 mg dose will propbably have effects in your system for about 12h, with lesser effects up to 48h.

naloxone - similar to natrexone, a full opiate receptor anatgonist that will displace other opiates; only lasts for about 2h in the body.

buprenorphine (Subutex) - this is an unusual synthetic opiod, which has a partial agonist/partial antagonist effect on opiate receptors. If there are other opiates in the system such as heroin, morphine, dihydrocodeine, it acts as an antagonist - ie. it will displace these and cause cold-turkey; however, if you are in withdrawal, the subutex will act as an agonist, and make you feel good and reverse the withdrawals.

The reasons that subutex is now being when in therapy are instead of methadone:
1) subutex does not depress the central nervous system as much as full agonists do, therefore it is (theoretically) more difficult to overdose on subutex.
2) because it is a partial agonist, it has a slightly more euphoriant effect, ie. methadone is not a feel-good drug, whereas subutex is OK.
3) it is much, MUCH easier to detox off subutex than methadone.

It sounds as though you were given subutex for maintenance, with a view to cutting down and detox. Using subutex on a reducing dose regime is a very comfortable and manageable way of doing this; absolutely minimal withdrawals.
People are then given naltrexone 3-5 days after their last dose of subutex,to block the opiate receptors, so that further use of opiates will have no effect, ie you don't get a hit off them. The normal dose of naltrexone, to have full blockade, is 50mg per day.
When you have detoxed, whether it be off heroin, methadone, DHC, subutex, whatever - you are clean, and have NO opiate tolerance. ie. it is as though you have never used opiates before, and your body is extremely sensitive to any low doses of opiates; if you were to use high doses, you would easily overdose.

The fact that you are getting some sort of effect from the subutex, despite taking the naltrexone, would suggest that the opiate agonist affects are overriding the effects of the naltrexone.

My question to you would be, WHY are you taking both? as they are counteracting each other.
Do you want to be ON opiates, and pissfarting around,
or do you want to be OFF them?

If you have only been using intermittently over the last 5 yrs, coming off and staying off should be a breeze for you. All you need to do is to slowly reduce the subutex, and then use 50mg natrexone daily for blockade to stave off the tempation to use again.
You are only on a very small dose of subutex; it gets difficult to divide 2mg tabs, so you could use Temgesic instead - that is buprenorhpine in 0.2mg tabs. Try cutting down from 1mg to 0.8mg to 0.6mg (ie. decrease by 0.2mg every 5 or 7 days).

Hope this is helpful,
Silver Fox

[Robsa]

Nails, heads.. Silver Fox has hit it right there

I was baffled by the fact you are doing both these drugs together - it shows a fundamental lack of understanding about what you are taking. When you are playing with opiates that is a big no-no. Yes, I know, some have all taken ridiculous risks with opiates but that is usually when we have tolerances that would drop a rhino.

It is also true that you seem to be totally unsure about why you are using. You say you take opiods to help you focus and this means you probably won't get hooked. This is, well, frankly misguided at best. Addiction will wrap its foul wings around you finally my friend! I used heroin for 10 years before it got me. Getting off it was the hardest thing I have ever done. Actually, that isnt true. Getting of Methadone was! (NEVER use that stuff! It is quite astonishing how evil it is!)

My honest advice to you would be to maybe think hard about why you use. Go to NA or another support group and talk to a few people - they dont bite and you may then understand a little better the nature of your own problem. Oh, and listen to Silver Fox as he seems most wise!

Good luck - I really hope you get off the opiods as they SUCK. For me, a cup of tea when I wake now, clean, is 1000x more satisfying!

-Robsa

[rustupid]

im supposd to be starting naltrexone and am getting my 1st injection on monday. they said dont use opiates 7-10 days before hand yet in my case it will be 6 days and 12 hours since i used about 0.1 of heroin. should i tell my doctor or will i be ok?

[Robsa]

You will be OK. They say 7-10 just to be extra sure as the reaction is so adverse. Having said that, the usual procedure is to dose you first with a small quantity and watch your reaction. Unbelievably I have known people who have used 3-4 HOURS before and then pretended they were fine when they were given the initial low-dose. Once they had been given the full dose surprise surprise they ended up in hospital! They were in a terrible mess.

Anyway, I digress. Yes, you would probably be fine 72 hours after - I think I took my last meth dose about 3 days before I took Naltrexone. I was a bit nervous but was totally fine. Hope it all works out for ya as some people dont get on with it but it is an excellent way of ensuring you stay clean for a while!

[oggy]

Totally agree with Silver Fox and Robsa about methadone being evil and much worse.

Quote Robsa: Getting of Methadone was! (NEVER use that stuff! It is quite astonishing how evil it is!)

Swim got a negitive for saing the exact about methadone being evil in his "help me escape thread"!

Are Swims not aloud to have an opinion?

[moda00]

Originally Posted by oggy

Totally agree with Silver Fox and Robsa about methadone being evil and much worse.
Quote Robsa: Getting of Methadone was! (NEVER use that stuff! It is quite astonishing how evil it is!)
Swim got a negitive for saing the exact about methadone being evil in his "help me escape thread"!
Are Swims not aloud to have an opinion?

If someone is moralizing about any drug or saying drugs are evil, it is unacceptable in my opinion. In occasional threads here on the forum, a member will be reprimanded for comments such as "I would snort coke but would never smoke it, crack is evil." Or "I can't believe you would inject opiates, that is stupid." While stating risks or possible negative effects is okay, moralizing and generalizations are not, whether or not these are technically "opinions." Opinions should be stated in ways that are clear and meaningful, not play on semantics and the negativity that surrounds us all the time anyway. Stating an opinion is one thing: "Methadone didn't work for me." "I found the negative effects of methadone outweighed any benefit." However, some of the statements made cross the line imo. You certainly may believe methadone was harmful to you, and back that up with personal experiences, or that it is harmful in general, backed by citing scientific studies, but you need not make broad negative generalizations about any substance without proving them- and "methadone is evil" is a moralizing statement and value judgment which cannot be scientifically proven. Words like evil imply good and bad, righteousness and sin, and reinforce the negative generalizations surrounding drugs in general. The use of value laden or judgmental words and the stating of opinions without proper qualifications make posts useless and occasionally offensive. Any issue and any opinion can be discussed (with the forum exceptions of drug distribution, self-incrimination, etc.) but it is important to think about how you convey your ideas.

Thus, stating your opinions and experiences effectively in the appropriate thread is absolutely fine by me and everyone else, as is sharing factual information, but this thread is about naloxone and subutex. If your goal is to help people by sharing your opinion on methadone, add studies to the DF archive about the topic, or other treatments. Help others struggling with addictions. But do so in the appropriate place- if you feel a rating is inappropriate, contact a Mod or Admin by all means, but a thread is not the place to discuss this. Also, just a tip for future use, if you want to quote another's post in your reply, you can use the code [ quote ] placed directly before the text and [ /quote ] afterwards (without the space between the [ and the word quote or /quote, and between quote and ] -I had to do that to keep it from auto-formatting.. computers are confusing lol)

Reputation Comments on this post:

Well said, Swim found it evil for himself IHO, and should not tell others what it is and isn't.

[moda00]

As for subutex and suboxone, I will make a clarification. Subutex contains buprenorphine only as an active ingredient. Suboxone contains buprenorphine as the active ingredient, but this is mainly to prevent injection, as it will precipitate immediate withdrawal if injected. Now, naloxone is sublingually active, but only very slightly, so its main action is to prevent abuse and not to have its usual agonist effect (although buprenorphine does have slight antagonist properties, further confusing things)

So given in normal doses, naloxone will cause withdrawal- severity of which depends on which opiates the user is using, what the doses are of both the opioids and the naloxone, the user's tolerance, etc.

But I have heard of this- just yesterday I was having a discussion with an acquaintance, and she mentioned something she heard recently about small doses of naloxone with opioids to reduce tolerance. Now, she referenced users doing this to prevent addiction- not addicts doing this while on maintenance, but apparently the concept is the same- I am looking into this more, but for now it is "word of mouth." She knows I do a lot of reading on opioids and maintenance so asked me if I knew anything about the use of small doses of naloxone with concurrent opioid administration. I was surprised, and asked if she was referring to the commonly misunderstood naloxone formulation of Suboxone, but she said no, that the concept was administration of miniscule (ie. microgram) doses of diluted naloxone along with opioid use, and something about receptors being affected in a way that minimized tolerance. Now obviously this is not proven, and normal doses of naloxone are not a good idea when taking opioids, but am interested in learning more.

That said, if the OP's goal is to reduce tolerance, minimizing addiction and reducing required dosages, this is probably not necessary. I mean, do what works for you, but since one's preferred opioid drug is buprenorphine, this is likely unnecessary, as buprenorphine is one opioid that has a 'built in' partial/slight antagonist effect, reducing addiction and overdose potential, and since it is quite strong in terms of per milligram dose, and one has quite a supply, naloxone will not likely aid one's quest to prevent ever-increasing doses and conserve supply. More research is needed, and it is possible that this sub-milligram thing could have something to it, but it could also be a rumor or a misconception, as there are many surrounding suboxone/subutex.

Of course, I also think that it is good advice to think about when and why swiy uses, and if there are underlying issues like ADD good to get that addressed before proceeding. That said, it is also important to answer the question for the sake of letting swiy make their own decisions based on all available information. Good luck and will let swiy know if I find out more!

[oggy]

Originally Posted by oggy

Totally agree with Silver Fox and Robsa about methadone being evil and much worse.

Quote Robsa: Getting of Methadone was! (NEVER use that stuff! It is quite astonishing how evil it is!)

Swim got a negatived for saying the exact about methadone being evil in his "help me escape thread"!

Are Swims not aloud to have an opinion?

Ok Swim never meant it as in the drug is evil but the drug lead Swim to behave badly and not have a care in the world, like when he was zoned out while his mother tried to talk to him if she was upset, Swim simply didn't care while being on methadone. Swim felt emotionless on it. He would ask his mother for money to pay for bills but this was a pure lie, the money was for drugs/ heroin, Valium and this happened many times. Swim believes he had done an evil deed for drugs. Including buying street methadone to top up.

Swim wishes he never got put on methadone and got treated with subutex. Swim was trying to help by advising people not to use methadone. He should have said use subutex instead.

Sorry for that.

[sarbanes]

Bup on top of (equivalently lower dose Naltrexone, over naloxone), shows great promise. Not only are the side effects of Suboxone minimized (sweating), but since the relative therapeutic index/compound is greatly reduced, (but Naltrexone has a much longer half life, enabling it to work in minute levels as a pure antagonist) (ie, fooling your body into believing all mU opioid receptors are blocked), with the rebound 3-400% increase in endogenous endorphin production resulting later (feedback mechanism). This is why, if done correctly, ULDNTX, on its own, can make quitting any opioid, outright, easier than even a taper, or with buprenorphine. You take your (up to 1000 uG NTX) at night with a couple valiums, and the next day, you feel better than if you had real drugs in you (i.e. endorphin surge). Drugs like buprenorphine are so interesting, as on the one hand, they behave like etorphine (for which they are clearly very closely related), but on the other hand, have that competing cyclopropyl group on the tert-nitrogen (clearly antagonist model). Bup really is almost two molecules in one. Morphine acts as one molecule, because it (technically) is a weak opioid. Of course, if you develop huge tolerance to morphine (allowing huge doses), some of the other effects will become noticeable (effects which are noticeable with lower doses of more potent, mixed agonist/antagonist like bup). What an interesting area. Out of curiosity, it turns out that either etorphine (the hugely potent pure agonist), or Naltrexone (the moderately potent, even purer antagonist), behave similarly in ultra low dose schemes. Its just much easier to get a tablet of Revia (or generic), than obtaining the dangerous, expensive controlled Immobion. Now, combining ULDNTX & clonidine & low dose benzo & phenytoin/oxcarbamazepine, one might be curious as to weather all these drugs (which help greatly, on their own), will (in appropriate combination), make acute WD that much easier. The answer is sometimes yes, but most the times no. If you just mix all these opioid WD aids, usually (even with careful dosage adjustments), the effects are not as efficacious than just using one or two schemes. However, there are certain combinations which seem to work remarkably well. One of these (alluded to earlier), is ULDNTX/diazepam type. As a full and restful sleep will help guarantee the maximal rebound endorphin surge the next day. Also, some DL-phenylalanine caps the next morning.

BTW: yes, naltrexone can be used to hold down tolerance to opioid agonists, but the amount of tolerance reduction is directly proportional to the reduction in pleasurable effects. Oxytrex shows very little abuse potential, and tolerance to its pain relieving effects occurs very slowely (if at all). There is no pleasure without tolerance.

[Orchid_Suspiria]

Truth be told naltrexone isn't really even all that active orally or neccessary.I think the big secret is the pharma company would have no market for this drug other than to er's without suboxone.This is a nasty and unpredictable chemical why would anyone want to put it in their body?Thats right keep those junkies hooked just make sure its those nasty orange pills with a sword on them that makes you feel like shit and might give you hepatitis.

[moda00]

You referring to Suboxone orange w/sword pills? Main active ingredient is buprenorphine, also contain naloxone (no naltrexone) What do you mean?? And hepatitis?? Reference please.