Subutex Question For Someone That Really Really Really Knows! (Page 3)
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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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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.

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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.

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

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Curious80 (# 19) --

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

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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...

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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).

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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.

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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 .

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Curious80 (# 19) --

Good Answer Curious 80 well explained right answer!!!

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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.

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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: 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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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: 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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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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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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GHOST (# 10) --

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

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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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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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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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