Subutex Question For Someone That Really Really Really Knows! (Page 2)

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???

REPLY

REPORT

Maybe it is better said another way. Since bupernorphine is only a partial agonist it doesn't hit the receptor as hard as say oxycodone. It does kick the oxycodone out of the receptor but doesn't bind as fully. It is like you have a push button. The oxycodone pushes it all the way down but then you introduce bupernorphine which gets the oxycodone out of the way but only pushes the button half way down (just a silly example). So the massive withdrawals some people feel is due to the lack of total affinity. Their body is used to having the full agonist effect and some are used to their receptors being 100 percent activated all the time for years at a time. Suddenly you introduce a partial agonist and the receptors feel (if they had feelings) like they are missing what they need and throws a temper tantrum( withdrawls) at the patient as a response. As some people have already stated it is a person to person thing. Everyone's chemistry is different. After the receptors have been clear for 24 hours the receptors are more likely to accept the partial agonist as a replacement just to give them at least some of what they are expecting to have there. I have known both types of people..one friend went into massive withdrawl within a few minutes because her fentanyl patch was just removed only minutes before the subutex was introduced and then another friend whp was off other opiates several hous and felt nothing as far as withdrawls after the subutex dose. Sometimes in the science of pharmacology the why isn't always known, understood, or the same for every person. I hope that made a little sense. I went to pharmacy school and took an elective course of drug abuse and the treatments. This was my best attempt to explain what I was taught about subutex and precipitated withdrawls.

REPLY

Was this helpful? 8

Curious80 (# 19) --

Good Answer Curious 80 well explained right answer!!!

REPLY

Was this helpful? 1

RAWDOG (# 20) --

Thank you Rawdog. I tried my best to answer in a way for everyone to understand. The person who asked the question was very specific about how he wanted the why explained and they felt no one was doing that. I only hope i helped a little .

REPLY

Was this helpful? 1

first I would think that the Dr. would WANT you to be off whatever is you're taking (a lot of addicts have a tendency to "embellish" their use and what they use, and they need first to monitor your withdrawal symptons, as in how bad so they can properly prescribe to you, rather than take your word for it. There are protocols to follow some won't make much sense to you-so there's part of your answer. And to the lady whos baby died in the womb in which Im very sorry to hear, but of course those narcotics cross the blood brain barrier and would absolutely affect the baby in many different ways. That was tragic and the fault would be hard to pinpoint without a very extensive autopsy.

REPLY

Was this helpful? 1

Re: Me (# 7)

The occupancy of endorphins receptors by a partial agonist will precipitate withdrawal like reaction.
It is like lowering the action of endorphins suddenly in a normal person.
Similarly Naltrexone (an opioid antagonist) can cause increase pain sensation (Hyperalgesia) and even pain with non-painful stimulation (Allodynia).

REPLY

Was this helpful? 1

Re: WillChillRNMS (# 5)

I must concur, it is a totally different chemical structure,like almost all meds are,both OTC and RX. I also believe that it also has a lot to do with our"chemical make-up" . Buprenorphine is not even close as potent a drug as oxycodone...But, again, I suppose it has to do with one's response and other factors...

REPLY

Was this helpful? 2

Curious80 (# 19) --

You did great :) and I agree the answer may very well be nobody knows the "why"

REPLY

Was this helpful? 1

A few hours is all needed for Perks..Try a few hours later with long halflife opiate like Methadone

REPLY

Was this helpful? 1

Re: RAWDOG (# 2)

Yes, I just waited 48 hours since last dhoti dermal n was put in pwd for 10 hours until I couldn't stand anymore. Silicone, subutex & zubsolv have all put me in pwd. Even on my 3rd day without dosing it's terrible. Wait till u r full-grown sick n take 2mg pieces at a time to evade it. It does put u in pwd. The more u take, the longer and more severe pwd will be.

REPLY

Was this helpful? 0

Re: MrB1982 (# 10)

Okay, listen to me, I know what the f*** I'm talking about! Subutex contains zero naloxone!!! Naloxone is what will get you sicker than death itself. Suboxone if taken after u took an opiate will make u feel not too bad. If u take Suboxone then take a opiate like roxycodone you wish u were dead! If u took a Subutex after a oxycodone you will feel fine! No naloxone, No bad withdrawal that's why many doctors don't prescribe it unless u r pregnant and or u r very sensitive to naloxone. Back in the day talking (T's) and blues a type of speed pill were the best thing that was around. They put naloxone in the talwin so u couldn't abuse it too bad. So, listen to me, take Subutex not Suboxone and without naloxone and u will have zero problem's with getting sick. It will however prolong your drug addiction and defeat the purpose of making recovery a realistic goal. I'm 44 yrs old, I've been taking meds for 25 years and have a college degree as a P.A. physician assistant and I know more than most doctors know. Take it or leave it but in the end you will wish u listened. Take an enema at minimum once a week to pass the rock hard s*** in your colon! Your friendly doctor.

Editor's note: We do not verify the credentials of our users and nothing stated in our forums is intended to be taken as medical advice.

REPLY

Was this helpful? 0

Re: Winston Dr (# 30)

I believe you've got that backwards. If you take any Buprenorphine product before you take a full agonist opioid, you will not feel much of anything. If you are prescribed Suboxone for example and you take Percocet afterwards, the suboxone has blocked the receptor for the Percocet. On the other hand, if you are regularly taking say Percocet, and take suboxone on top of it before the Percocet has worn off, you will have an episode of withdraw based on what you had taken closely before the suboxone...Naloxone was simply placed into Suboxone to be a deterrent away from IV use. Buprenorphine drugs are amazing for people who truly want to get well and either stay on maintenance or come off completely by transitioning to extremely low doses to curb high dose agonist withdraw..

REPLY

Was this helpful? 2

Re: Addxn Doc (# 31)

No offense but I don’t have anything backwards, I explained it exactly as it was explained. And unfortunately doc, you just went on to do what I was speaking posters to not do :) All you did was explain to me how it works and really did not address my question whatsoever, as guessing you glanced over my question and didn’t want to read the long version which is what I think happened, but you answer does not apply in any regards to my post.

REPLY

Was this helpful? 0

Re: Master Plumber (# 32)

For someone who has been in pain management for 12yrs, I just yesterday took off a 25mcg Fentanly patch and had my last two oxymorphone 30mg ER's. 5hrs later was not feeling that good. So I had 3 suboxone not subutex pills and took three quarters of one. 2hrs later PRECIPITATED WITHDRAWALS!!!!! YUP Friggin horrible, only the 5th time this had happened in 12yrs. My god I thought I was gonna die. 4 hours later I took the other quarter and started to feel better. 5 hrs later, another half and 5 hours after that another half. I just finally started feeling better 30hrs later, so that's my story!!

REPLY

Was this helpful? 0

Re: Master Plumber (# 9)

LMAO!!! So you think my post was about “singing the attributes of Suboxone”??? Wow...not even close!!! And this thread is just perfectly fine and wondering why you even bothered posting?

REPLY

Was this helpful? 0

Re: Winston Dr (# 30)

Oh wow!!!! I apologize, as I did NOT see your prior post, only the short one that I got an email alert for. So I do stand corrected AND...I think you have NAILED at least one aspect of the issue and you have indeed provided a possible answer and makes PERFECT sense now that you explained it :)

However I will add that my wife has always been on Suboxone and NEVER Subtex so your answer would not address her. So only way to figure that out is to take a poll and see if the ones that went into precipitated withdrawal were on Suboxone and not Subutex.

Still...I like what you said :)

REPLY

Was this helpful? 0

Re: Winston Dr (# 30)

Stand corrected didn’t see prior post as you made two! Wrote long reply but under review and may take few days to show.

REPLY

Was this helpful? 0

Re: Master Plumber (# 32)

That post was in response to #30 specifically, regarding mechanism of action of agonist- antagonist drugs, and not to the original post.

REPLY

Was this helpful? 1

Re: Master Plumber (# 36)

I bet if we took a poll all PERCIPATED withdraws would be due to Suboxone NOT Subutex I'd bet my life on it cause all 5x's were on suboxone not subutex. I've done the same with subutex(only waited 5hrs) and had no Perc. WITHDRAWS so hope that helps

REPLY

Was this helpful? 1

Re: Addxn Doc (# 37)

I know I know I’m an idiot!!! I make that mistake constantly because I’m not really a regular here.

And to make it worse??? Look below at post # 34. Talk about STUPID. I actually read my OWN response to someone else and THOUGHT it was a response to me and then replied to myself about how stupid the response was!!!!! LMAO.

REPLY

Was this helpful? 1

QUESTION, WHY? WHATS THE REASON FOR YOUR WORRY? DOES IT REALLY REALLY MATTER? THAT'S LIKE A CHILD ASKING WHY THE SKY IS BLUE! Are you trying to ask a question nobody has asked? If someone answered it, is it going to make a profound change in your life? Why spend hours and hours typing all this crap for “really... nothing”. Point is “DOES IT REALLY MATTER!!!!”

REPLY

Was this helpful? 0

I have been on subutex 54 411 white 8mg Tablets for almost 2 Years now, If you do not want to be on another pain medicat...

2 REPLIES

Please! Not a med seeker. I just need to manage my pain with strong pain killers and need to get something for energy as...

9 REPLIES

How long do you have to wait to feel an opiote after taking Subutex? ## Subutex only contains the active ingredient Bupr...

2 REPLIES

I am on day 10 of a Subutex detox and I still feel kind of crappy and my head is really cloudy. I have to go for a job i...

2 REPLIES

I took my 1st 1/2 of an 8mg subutex sublingually this morning at 10. I felt some pain relief in 20ish mins, felt safe en...

1 REPLY

Does medicaid in Alabama pay one day early on suboxone? I have a thirty day supply for 4mg suboxone twice a day. Will me...

14 REPLIES

I live in Fort Meyers fl. I am currently on Suboxone and looking to be put on Subutex. I am pregnant and my doctor will ...

2 REPLIES

I been on subutex for past 5yrs for pain management. I'm allergic to the naloxone in the suboxine films. I just move...

11 REPLIES

I know people in wv who go to pa to get scripts of subutex and sell them. They wont give up any info about the doctor th...

220 REPLIES

My partner was recently given an injection and three day prescription of Buprenorphine/Subutex for severe pain during an...

2 REPLIES