Subutex Question For Someone That Really Really Really Knows!

Looooong read. I warn you now :) Ok. PLEASE don't explain how it works or what it does. Save yourself the time. I am extremely familiar with how it works and what it does. But I have a question that's been on my mind for many moons, forever actually (10 plus years) and I can't seem to get a straight answer to it no matter how many times I ask it and where I ask it. I am asking it here for the first time. Just always get the usual, familiar rhetoric explaining to me how it works and where it binds and what it does, blah blah blah, but no one ever can explain the "why" behind all this wonderful science! And at the end have one first hand case PROVING what I'm questioning to be true. Ok so follow. So if buprenorphine is stronger than and has a higher affinity than let's say Oxycodone as a real life example, and will kick off that opioid from the receptor, this meaning it "replaces" it and fills it, then WHY bother waiting to take it? Immediately or 24 hours later, either way, it's going to sit in that same receptor and do the exact same job!!! I'm so tired of reading about this precipitated withdrawal crap. Now, tired of reading about it does NOT equate to not believing it. You would be an ***** not to believe it because there are just too many cases of it to be ignored so it's a real thing. I just don't understand WHY it's a real thing? Because I cannot POSSIBLY imagine why having the opiate kicked off the receptor immediately, or having the remains of it kicked off 24 hours later, can produce such drastic night and day results? Heck, I've know addicts that were given Narcan to reverse overdoses who didn't go through such pain as you read about some people trying to come off with Subutex or suboxone too soon and not waiting long enough! 24 stinking hours? Seriously? I mean I just don't understand WHY it would be ANY more painful OR horrible OR agonizing to just take the Subutex at anytime you want whether it's during opiate intake, an hour after Intake, or 24 hours after opiate intake, either way, no matter WHEN it is done, it is going to perform the exact same function. It's going to kick it off and replace anything that's in its way! So why if you took it too soon would you go into agonizing withdrawal? You should NOT be going into ANY withdrawal whatsoever even if you take it immediately, because it immediately fills the receptor and prevents withdrawal. I mean that's the entire purpose of this drug is to prevent withdrawal. That's what it is designed to do. That's what it's made to do. Whether you take it immediately or 24-36 hours later? I mean if it took a couple weeks after you stopped taking opioids to go into withdrawal and then you could use Subutex maybe I could understand why it would matter if you did it immediately but 24 hours? That's absurd to my brain! Now for the proof I was speaking of. After enduring watching my wife going on and off Suboxone a dozen plus times, each and every time having to watch her in agony as she detoxed off Percocets for 24 hours first. (Heavily researched this drug before I tried to put her on it for the first time and had that SAME question THEN 10 years ago) Sitting back and watching her do something that I had ALWAYS considered to be useless, what I ALWAYS considered to be needless and what I ALWAYS considered to be nothing more than a ploy the doctors PURPOSEFULLY do as well as the manufacturer, that is to put the patient into DEEP detox so they can become their NEW PIMP, and heroes and rescuers, I ran across a small psychiatrist in Texas.. Giving up on explaining my theory to him as I had already convinced myself there was no need to detox first, was only being done to hook the patients on a very expensive product, the psychiatrist started laughing when I asked him about the usual 24 hour detox. He became my white knight in shining armor when he said "no that's ridiculous, Suboxone will immediately replace the opiates and there's no advantage one way or the other to doing a detox first" Smiling from ear to ear but refraining from telling him I have always thought that, for the first time after dozens of times I gave it to my wife WITHOUT waiting and guess what? Yep that's right, she immediately responded, felt great, and took up right where she left off after just doing a couple Percocets a couple hours before, thus proving that she NEVER needed to do that 24 hours first as I have always thought. But my question remains, I have seen far too many documented stories of precipitated withdrawal as well as read tons of agonizing stories that were NOT precipitated but just more or less people who went through living hell by doing it too soon... when there's absolutely no medical or scientific reason why they should have??? What gives???

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REPORT

I didn't go into any withdrawals before I started taking my Suboxone, for the 1st time at the doctor's office.

He had me take a drug panel before giving it to me and said I still had Oxycontin in my system, after not taking any for 30 hours. My pain was coming back, but that was before taking the Suboxone. I took 2 strips and walked out fine, not sick at all.

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Not sure but it has happened to me 3-4 times in 10 yrs!!! N yes it does suck, dont know the WHY but im living proof n my best friend has happened to him same amount of times over the same period of time. Maybe they were just bad Strips or bad suboxone pills I wish I knew why so I could avoid it happening. Hope this is slightly helpfull.

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I've been on buprenorphine for a year after being on norco, morphine, fentanyl, all of them... over a period of years. I also have cancer, hepatitis c, and osteoarthritis. There's not a day that goes by that i haven't been in pain. My spine was damaged by osteo myelitis. Buprenorphine has been the best pain reliever on the market. When i dont have to take it i suffer no withdrawals or insomnia. I also take 8mg/2mg tablets 3 times a day. This may not sit well with those who are trying to take their medications recreationally. If you choose to do so the effects will last around 12 hrs. in and out of sleep. I would really recommend to move with caution and not drive on it. At times it will cause a catatonic zombie effect. Peace.

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I have taken subutex and suboxone 3 hrs after taking opiates like oxy 80 or morphine and it has never happened to me. I wonder if it is certain people. I have done it more than I can count and never had precipitated withdraws

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Subutex has a different physical structure (as in chemical) so it DOES NOT have the same stimulation as Oxycodone or any other narcotics. Is that the answer to your why?

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Re: Mike84 (# 4)

I absolutely agree with you but it seems we are in a very very small and minuscule category of people :)

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Re: Master Plumber (# 6)

My husband took Morphine, Opana, for 4 years before his hip replacement 3 years ago. His hip and back were killing him...this man doesn't complain. I gave him less that 1/4 of a strip and he threw up and felt like s*** for almost 2 days.

So with no opiates in his system why would this happen to him?

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Re: WillChillRNMS (# 5)

Unfortunately not :) that's not taking it a step further. The point I'm trying to make is that scenario is the exact same in one hour or 24 hours. It doesn't matter that the chemical structure is different. The structure remains the same at one hour or 24 hours

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Re: kasiyama (# 3)

I appreciate your reply, but this is the wrong thread to post it. Doesn't have ANY relevance whatsoever to the question being asked and singing the attributes of it belongs on a general thread about Subutex where it would be more appreciated.

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Re: Master Plumber (# 8)

Opioid modulator is buprenorphine, which is a partial agonist of the µ-opioid receptor and an antagonist of the -opioid receptor.[1] And naloxone is an opioid antagonist so when you have your opiate receptors full and decide to kick out half the party and mix a full opioid agonist to share a receptor with naloxone the body goes into immediate withdrawal. But it’s the worst most intense detox but the kick is only 24-48 hours obviously depending on the person usage etc

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The person with the opioid dependency will respond the way their system uniquely responds. Their metabolism of say "oxycodone" may well be faster or slower than another persons. So, genetic makeup of an individual will have an effect on their response when buprenorphine is induced. Oxycodone will occupy 100% of the opioid receptors. Buprenorphine will occupy between 70- 90 % of the receptors. An analogy could be you are driving a car at 100 MPH and you suddenly slow the car to 75 MPH. So no the response is not horrible but is noticeable. It also has to do with how many times a given person has gone through withdrawal and what dosage of opiates a person has been taking. If it is someones first time and they are a heavy user of say Methadone at 180 mg daily for 4 yrs, they are going to have a nasty, nasty withdrawal. If it is someone that has been on 60 mg of Hydrocodone for 6 months, the withdrawal is going to be less severe. So if you look at this in the context that patient information is generally given to advise people of worse case scenarios. I always advise patients that the longer they have been off, the less likely that any withdrawal will occur. You do make a very good & valid point. Everyone is going to be a little bit different in their experience. Hope this helps!

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Too much. Too much words. It's so simple. If you take opiates and u want to switch to Suboxone, easy, look up the C.O.W.S. (clinical opiate withdrawal scale) worksheet. Follow it exactly. To not take suboxone unless you hit the appropriate number on the cows worksheet if you take it too early and your number is too low you will go into precipitated withdrawal which is withdrawal x's 100. Have some Imodium AD(has opiates in it to help ur body and stomach problems, doesn't break thru to the mind barrier), Xanax and or any benzo diazepam, Ambiens or other medicines that will help you sleep. vitamins, water, try to exercise even 4 10 mins a day. That's it you're fixed! Forget all the other ppl that want to hear themselves talk. NO BOOK NEEDED.

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GHOST (# 10) --

Gee, that answered absolutely nothing. And since it wasn't even TRYING to answer the question, that means only YOU like listening to yourself talk...

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GHOST (# 10) --

Oh yeah, Xanax and Sub can produce a FATAL reaction!!! KNOW before you talk!

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MrB1982 (# 9) --

Your reply deserves a longer response than I can give you right now because I'm driving For the next 8 hours :) but quickly keep in mind that Subutex doesn't have Naxalone in it so even if that was true it would only apply to Suboxone only :) But it was a fantastic response!!!!! :)

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Buenos Dias "Master Plumber" ref post Fri Dec 8 2017 Conversation Starter

I will be very blunt and brief. I'm a retired airline employee, and, in my past I took "Temgesic" which was a low dose pack of pills of Buprenorphrine, I bought OTC in Bangkok Thailand, in year 2004, and also in Puerto Vallarta Mexico in 1998.

Both occasions I used the two mg (2 mg) sublingually, for lower back pain and for Plantars Facia. Results: It was very effective in stopping all of my pain, BUT the side effects, that began by no longer max than day 3 was a DX of a Spactic Colon that was even MORE painful. I had severe pathological constipation, as a direct result of taking Buprenorphine! By day two, or day three, I would get in the fetal position in my hotel room laying on the carpeted floor in intense pain from the pressure from what felt like a very bloated colon and a inability to pass any stool! I was then age 52 and later age 55 when I had this happen!

I would not take any buprenorphine, in the high doses it is offered in the USA for any level of pain with higher dose Subutex or Suboxone!

This is not addressing your question but, I have discovered I have a serious immediate allergy to hydromorphone (Diluadid 1 mg) from passing a kidney stone only 2 yrs ago in ER, Again Morphine Sulfate, or Dilaudid 1 mg IV stopped by intense pain in ER and I was released from ER after being observed for about 5 hours. The next day, I (again) was at my home and I was in the fetal position, for almost 7 hours, in pain due to another spastic colon and I eventually passed
stool with the help of a OTC enema and lots of water, and Senokot laxative!!

This last ER event occurred in March of 2015 @ age 65.

I have taken USA Percocet 5 mg with 325mg of APAP 1/2 tab twice a day from the year 2006 until the year 2010, with no side effects, never a spastic colon, nor any constipation, and I took the Percocet likely 10 days at a time with a 5 day break then another 10 days for a five year run!! I also am allergic to codeine and hydrocodone especially, and that Vicodin obtained in Germany caused me more Spastic Colon and severe IBS issues!!!

The only narcotic for bona fide pain such as described above is either oxycodone 20 mg for a heat stroke in the year 2011, Santa Fe NM, and, I got no side effects but total relief from intense pain!!

The only pain med I can use without a spastic colon most unfortunately has been phased out in many countries of the world in tablet form that is called the pain med Pentazocine HCI 50 mg tablets I used to get, in the CZ Republic, or in Belgium, as "Fortral" and as "Sosegon" with my trips to Spain, and in Canada as "Talwin" PX as Pentozocine Without any Naloxone, like has been combined in the tablets of USA 50 mg Talwin since the year 1983. I am so angry that drug got abused, in the 1970's in the USA, and worldwide, as it was as EFFECTIVE for intense pain for me, since I was in my late 20's until my late 50's BUT USA Talwin NX makes me very, very sick and is ineffective. It is very very difficult to now obtain Pentazocine hydrochloride tablets worldwide, now, in the past 6 yrs!

Hasta Manana!

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Re: Ridgerunner007 (# 16)

Just wanted to throw my 2 cents in. I was on fentanyl for over 18 years. I was up to 150 mg. The only reason I stopped was because im an alcoholic and I relapsed after 18yrs. I know it sucks but I went to rehab n the part of the hospital did not allow any narcotics so they put me on 8mg 3 times a day of suboxone. U know they said I was going to go through horrible withdrawal from being on fentanyl so long. Well I didn't at all. I was even surprised, but my psych. Dr told me he wasn't suprised. He goes, u have to be one of the worst chronic pain patients I know. He said, u fell 30 feet. U are so lucky to be alive. But that happened in 1992 when they told me that I would never work again. I bought my own bread route, cause no company would hire me after they gave me a physical. I have a lot of scares. I worked for 20 years even on artificial hips, knees, pins in my ankles, lost my right wrist, fused lower back. 36 operations. I only stopped cause I was putting too much stress on my hips and knees. Either I keep working or wheelchair. Anyhow the dr. Told me that when u are taking meds that your helping your body v.s. taking meds recreationally. It's a lot easier to get off of drugs u need, but I hated that suboxone. Do you know that is more addictive than most drugs? I just stopped taking it. My dr said I was lucky I didn't go through a bad withdrawal. When I got out of rehab I got back on fentanyl and I tried to not take anything cause I like to prove dr's wrong. I didn't want to believe that I had chronic pain but omg I do. Back on just 50mg fentanyl which is not working and the dr just put me on percocet 10/325. I hate them. But be careful with suboxone. It does work with withdrawal but then u have to get off those. Sorry for babbling...

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Re: Ridgerunner007 (# 16)

Well, as you did freely admit, your post has no bearing on this topic whatsoever and surely doesn't help to explain anything relating to it, other than maybe you get a spastic colon when you take it! LOL

That said, you sound like a VERY interesting fellow that's for sure!!! I just wish there was a proper forum in which we could continue your conversation outside of this topic!

Maybe you can start your own thread entitled "Side Effects I Encountered Taking Subutex" and I promise to be your first reply so we can discuss your post more in detail :)

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Re: AddixnDoc (# 11)

How did I miss this wonderful and insightful reply? SMH! It's funny because I posted this question on another website as well and after getting some really good responses, I finally basically said what you just said.

Which is it looks like what it comes down to is simply this. A 3 way combination of a persons own bodily chemical structure, combined with how high of levels of whatever drug as well as how long they have been on it, combined with how powerful the drug is it self.

Are they using it to get off Ultrams, hydrocodone, oxycodone, morphine or god forbid Fentanyl?

As of this moment I still firmly believe that the 24 hr detox is simply not needed and many people have replied over at the other website that they themselves didn't wait either and had no adverse effects.

I don't think I would be exaggerating by saying I firmly believe that probably 90+ percent of every person who walks in the door does not need to go through a 24hr detox and can simply wait a couple of hours and go for it.

I know my present system is meeting in the middle. Everyone has to sleep. So I give her her last dose at bedtime, and when she awakes anywhere from 8 to 12 hours later, I start her on it in the a.m. So far it has worked like a charm!

Unfortunately, because of the severity of precipitated withdrawal which can actually land people in the emergency room, 10 percent is a fairly HIGH figure and is probably just not worth the risk to put people through it if they happen to be in that 10 percent and so it's probably just a much safer bet to tell everybody wait 24 hours and that way we are compass 100 percent of everyone!

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Buprenorphine is the drug that attaches itself to the receptors and the naloxone is to block overdosing. Detox varies from 7 days or 21 days. To mix/misuse this drug with other opiates is foolish. You don't have to be critical of people who are trying to help. In fact if you did your research and discuss the matter with a registered addictive therapist you wouldn't be so frivolous and asinine. Thank you for your time...

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Re: Me (# 1)

I believe it is really each person is different so not everyone will. I used to be a hard core iv Oxy user and then they came out with suboxone and nobody knew how they worked. Me and everyone I knew learned the hard way that of we started taking the subs before going into actual withdrawals, we automatically go into them and they were worse. Now I do not if this is accurate but this I why I think it happens. When you abuse opioid your brain stops producing its own, right? So if you are dependent on the opiate to make you feel normal, then if you stop abruptly you will be sick, right? Right! So, if you take your last dose of oxygen, then take a sub an hour later, your receptors are pretty full of the oxys, that you sub comes in and fights it and pushes it off that receptor because he's just bigger. But, it has problems attaching himself to the receptor because it's not exactly like the oxygen. They are similar, but subs are bigger. So it tries to get on but is just too big and gets lost in the commotion of all the other receptors fighting with eachother and get taken away or reabsorbed with the oxy. So now you don't have oxygattaching, you don't have subs attaching, and you are not making your own. Hence, precipitated W/D. Again I do not know if that's true but that Is how I imagine it working. Some people though have no problem and can take subs immediately after. Everyone is different.

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Re: Ridgerunner007 (# 16)

Anything ending with Caine will lower oxygen levels in you body. This can affect your lungs & heart. Turn you blue. Circulation problems.

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So, it's actually 8 hours after taking something like a pain pill, but it's supposed 2 be at least 24 hours after taking another opioid. After the allotted amount of hours, the level of the drug isn't as high & has already basically left the receptors in your brain. The drug may be in your system for a week, but it leaves the receptors after a certain amount of time, insert cravings, not withdrawal, but cravings. That's when your brain is telling u "Hey. I have no more happy stuff in here! Gimme more!" So if u don't wait those hours, there is a possibility u can go into DT's bc the naloxone is pushing everything out of your system at once & making way 4 the buprenorphine 2 enter. I can take it as soon as I've taken something else & be fine, but I've watched people take it too soon & go into SEVERE automatic DT's. They also have to give whatever drug time to get into your system, attach itself to the receptors & then start 2 leave. They have an intense detox system that gets u clean in just 3 days. They hook u up 2 an IV of 100% naloxone & it just literally pushes all the drugs put of your system, so a 2 week detox happens in matter of hours & apparently it is f***ing painful. But that is the why. The drugs leave your receptors within hours of taking it & if Suboxone is used before it has had time 2 completely vacate the premises, then u have a forced eviction

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I don’t remember waiting to take suboxone when I switched over.

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If you get the white pop out under the tongue that you slide out with, read the how, what, when and why... It will answer all your questions.

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Hi, thank you for writing about this issue. I've been on subutex since 2007 8mg x 4 daily. So I also have alot of knowledge about buprenorphine. A few times I did try to get detox off with no luck. My last attempt was in june. I decided this time to go back to a pain management dr... He gave me the usual detox meds along with percocet 10s x 4 daily. I took my last sub in the morning a few hours later when my script was filled I didn't have to wait any period of time he said even if I told my last sub in the morning to take it whenever I can...so 9 days later and didn't finish the detoxing off subs. He gave me my subutex script and said go get it filled and start taking your subs anytime you want..the drs. Back when I started buprenorphine treatment in 2007bthey always all said you have to wait to take your new scripts when your in deep detox. There is no need to wait...the newish doctors now a days don't seem to follow that old rule anymore. I've helped alot of people with new buprenorphine treatments. And their dr. gave the medicine right away, no waiting 24 hours anymore. You have written this so well. I hope others are read this because there is no reason to put yourself through the hell of detox.

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In my experience it seemed methadone was the med that would send u into withdrawals if mixed within 72hrs. I lied to the Dr. about my time frame and I paid dearly for it! It had only been about 26hrs! The Dr. could have “slipped me a micky” knowing I’d get sick. And like u say, the next day he comes they like a hero with the super drug! But it’s always methadomes to Suboxe not Suboxe to methadones. Being on domes first so it’s actually in ur system for some time.

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Re: Matty b (# 62)

Thank God, we are back to normal replies before those last half-dozen or so!!!

Hello Marty :) I guess my question would be that let’s assume all of that is correct and it sounds correct to me. The question still remains as regardless of what transpires when you take it, the exact same thing is going to take place 24 hours later as well. The question I am trying to ask is what is the difference between now are 24 hours from now? That’s what it all comes down to.

So what you’re really saying is that the sub is only going to knock the oxy off one receptor which means the other two receptors will stay full which is all the MORE reason to believe that there’s no need to wait 24 hours.

In theory waiting 24 hours will actually be worse because then you’re going to have two extra receptors that are empty and only one when you take it where as doing it immediately all three are full. So again something is still not right :)

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How’s everyone doing!? Subutex is only a partial opioid. There are 3 different receptors that I know of. Buponorphine only has an affinity for one as full opiates bind to all the receptors. Taking subutex is stronger when binding to the specific receptor kicking in off the weaker oxy ect... throwing the body into a chemical imbalance hence precipitated withdrawals can incur

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Re: Kim (# 60)

I changed my mind. You’re not stupid and mentally unstable. You’re evidently 12-years-old after that last post!

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