Naltroxone is?

[Cruella]

Is naltroxone the same thing as subutex/suboxone? If not, which would be better for detox from methadone? SWIM is still trying to figure out the best way to do this thing!

[ex-junkie]

no they are not the same thing!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

taking naltrexone to detox from methadone is something they do in special clinics/hospital, its called rapid detox.

buprenorphine is the better option in swims opinion, because its not so harsh on the body. rapid detox puts the body through quite a trauma. they generally knock you out to do it.

PLEASE DO NOT TRY THIS AT HOME!!!!!!

naltrexone is better to use once the body is clean of all opiates, therefore not provoking terrible withdrawals. it blocks opiate euphoria. it takes up to 4 days to wear off (in tablet form), thus eliminating "impulse use".

the buprenorphine will give you a faster detox than cold turkey, but over the period of 7-10 days. it more or less holds you whilst killing off the extra opiate receptors that opiate abuse created, resulting in smaller and smaller doses each day. usually after a buprenorphine detox, if the patient wants to go onto naltrexone, theyll give you some narcan to make sure theres nothing left in your system, and if the detox went according to plan (ie- no opiate use), then the most you can expect is some chills and maybe some diarroeah. after theyre certain youre body is opiate free, and youre not reacting to the narcan, you can start on naltrexone.

naltrexone also comes in injections and implants, depending on which path you decide to take.

[Cruella]

Whew...SWIM is so glad YOU were paying attention! SWIM was supposed to pick some up tomorrow to take home and start "in conjunction" with a smaller dose of methadone. Per SWIM's physician! I think SWIM needs a new physician huh? Well...thanx again for stopping a potential disaster. Back to the board.

[Dickon]

Naltrexone is what is known as an opiate agonist, and taking it when you have a habit will precipitate the most unpleasant withdrawals imaginable. With a baby habit and about a third of a 50mg pill, my cat had a terrifying experience. It works by binding to the opiate receptors more tightly than nearly all opiate drugs, and in fact displacing any already in the receptors. However unlike opiate drugs, the naltrexone does not stimulate the receptors, so provides no opiate-like effects, rather the complete opposite.

In those rapid detox places, the naltrexone is provided under heavy sedation or anaesthesia, the theory being that you don't consciously experience or remember the withdrawals.

Subutex contains buprenorphine, which is what is known as a partial agonist. It binds tightly to the opiate receptors, tighter than normal opiate drugs, and partially stimulates them. In an opiate naive person this increase in activity is felt much like an opiate, but in someone with a habit who is used to their receptors being filled with full agonists (i.e. normal opiate drugs), the buprenorphine will bump out the full agonists, and replace them with partial agonists, thus leading to a precipitated withdrawal. Presumably this precipitated w.d. is not quite as awful as one precipitated by naltrexone due to the partial agonism, but it is nonetheless vile if some reports are to be believed.

Finally suboxone is a combination product of buprenorphine and naloxone. Naloxone is like naltrexone in that it is an opiate agonist, however it is not effective orally, and so adding it to suboxone is meant to deter people from injecting it. There is some evidence to suggest that it is not all that effective for this, because buprenorphine sticks to the receptors so tightly it is not displaced by the naloxone. This stickiness is refered to technically as the "binding affinity" of the molecule in question.

I hope that clears things up. One final point, because suboxone/subutex/buprenorphine can precipitate withdrawals it is impoprtant to reduce to as low a dose of the original opiate as possible before making the switch (for methadone one should ideally be down to 20-30mg day), and then only make the switch after waiting for withdrawal symptoms to manifest.

Dickon

[ex-junkie]

swim played around once when she was on naltrexone. she went off her tablets for a day or two, used heroin, then the next day she swallowed a whole tablet without any adverse reaction. she got a little cocky and tried to do the same again... only this time she went into proper spasticated torturous withdrawal. she scored some smack, injected it, and it took the withdrawals away- but she didnt feel the euphoria.

weird.

swim has also done buprenorphine detoxes off 50MG methadone and higher, using temgesic, and in some other cases subutex/followed by temgesic once the dosing became smaller. the temgesic experience in swims case, the first 24 hours were uncomfortable, then after that it started to get easier. of course there are still the night sweats, chills/hot flushes, and feeling like youve consumed a shitload of speed- very alert, hyperactive, HORNY. lulz.



should be noted that when swim did the temgesic detoxes, she wasnt successful, and she suffered quite a bit more than when she did her final detox. her final detox was started with subutex, taking 2MG when needed. by the end of the week, she was only needing to dose with the 0.2MG temgesic. combined with promethazine (drowsy OTC anti histamine) and chlonodine, she was by far very comfortable considering and slept an average of 5-7 hours unbroken each night. there was only one night she didnt sleep properly, but this was purely excitement.

buprenorphine shouldnt be taken with methadone. neither should naltrexone. just in case that stupid physician tries to tell swiy otherwise...

use the buprenorphine to detox, then ideally when detoxed, use the naltrexone to safeguard swiy from those impulse relapses. cause lets face it, a relapse can occur in ten minutes if you call your dealer to your house. (if they arent running on "methamphetamine time", lulz).

glad swiy posted this before they went through any suffering...

[tyranny4u]

Originally Posted by Cruella

Is naltroxone the same thing as subutex/suboxone? If not, which would be better for detox from methadone? SWIM is still trying to figure out the best way to do this thing!

TT's not sure if you talk about Naloxone or Naltrexone, but what i write
applies to both substances, so you could replace "Naloxone" with
"Naltrexone"

In short: Once someone is detoxed from opioids / opiates and he / she
thinks that it would be rather impossible to stay clean, then Naloxon
could be given for maybe a period of a year, as it is an antiagonist.
as an antagonist it binds at the receptors, but has no opiate-like
effects. further, it blocks taken opiates, a shoot of H would feel like a
shoot of water. it makes consuming useless.
so one could see it as a kind of "self protection" from the own weakness.

It is not a substance for detoxing*. If you take it while on Methadone
or H, it will give you strongest WD effects immediately. Its the same
with Buprenorphine (Subutex) = take it while on H or Methadone, you
will get WD at once, but the other way works. Taking H or Methadone
on Subutex could have some effect, it depends on the dosage of
Subutex (low) and the taken opiate (high). That is one of the reasons
"they" developed Suboxone: Shooting or snorting it will cause WD,
taking H or Methadone or any other opioid is useless, as Suboxone is a
combo of Buprenorphine and Naloxone.
Also Naloxon it is not a substance to taper down with.

Naloxone also is used in emergency to save of opiate overdosed
patients lifes, after injecting it, it "removes" the opiate from the
receptors and binds to them itself. So the opiate effects will be blocked
and the patient comes back to life
(well, not everytime ...)

* only in the rapid-detox it is used, while the patient is narcotised and
doesn't feel the very strong withdrawal.