Switching from Heroin to Buprenorphine

[Azrael]

This is a post mainly for the person who maybe is somewhat new to bupe, or recently got themself in a situation where they developed a very decent sized habit and is now going to bupe or thinking about going to bupe.

I am curious how many of you were still in partial-detox after dosing bupe coming from a large heroin habit? I find it strange that it is not talked about more... people with huge habits wonder why they only feel somewhat better when inducing bupe. It seems pretty obvious to me, but bupe is not a simple chemical. For one, you are replacing a full-agonist with a partial-agonist (I know norbupe is a full-agonist), but in that sense you are still going to be in partial detox until your body adjusts. Then there is the ceiling effect. Every doctor I've talked to says that if you have a large habit (1/2g or more of fire shit per day), just take more bupe. This is logical based on what all doctors know about opiate dependency and drugs, etc. However IME, it doesn't work. Me for instance, I hit the ceiling effect really early.

Let's say I've been doing a lot of dope, I could do close to a gram of strong ass dope in a day if I wanted to without breaking much of a sweat. My tolerance is through the roof and I've been using for three months daily. If I stop doing dope, let myself go into withdrawl, and take some buprenorphine, I know I'm only going to feel somewhat better for about 3 days, with each day being better than the last. This makes sense since the worst of a cold-turkey heroin detox is over in 3 days. I also know that taking any more than 6-8mg subL, 4mg Insufflated, or 2mg IV, is not going to do a goddamn thing. By day 4 or 5 on bupe I feel like a human again.

So to anyone who has a tolerance high enough that God is shaking his head at you, remember you are going to need to wait it out for a few days before you start to feel decent again if you are commited to staying off of heroin or other opiate DOC. Bupe is not methadone.

And while it is very difficult on heroin to taper yourself down, the transition is much smoother if you can lower your heroin tolerance before the switch. I remember the first time I went on bupe. I had tapered myself down to like 10mg of morphine IV 2x per day. That was a painless transition. I felt great after my first dose of bupe.

All to say, even better than lowering your tolerance prior to switching, don't let your tolerance get out of control to begin with! I don't understand why I couldn't just use for 3 days and then switch back without much of a hassle, but no I have to use for a month straight and then have to take days off work just to stabilize on bupe. Ridiculous.

Anyway, I'm at day 6 on bupe after being severely strung out since June. I'm feelin' great. I finally put my sobriety above work (unfortunately had to quit my job), and now I'm ready to get back to the things I love in life that are not heroin.

Peace from PDX,
Az

[miked138]

good post, i have to agree with lowering your tolerance before starting bupe helps a lot, i also found the one time i switched from dope to oxy for a week before switching to bupe it was a much easier transition that going straight from h to bupe. but that being said bupe just doesn't agree with me no matter how i do it,i mean it holds me physically just fine, but it just seems to shut off the pleasure center of my brain altogether so no matter what i do while i am on them i find no real pleasure or joy in it, leaving me easily extremely angered and/or depressed.

[Thanat0s]

i dont think ANYONE with even moderate habit has a few rough days transitioning to bupe,
due to both its partial agonism and for some the ceiling effect of bupe if their habit was large enough to bump against it.

not talked too much about i guess because its common, well known, and expected by most of us that going from grams of dope per day to bupe is of course gonna hurt(tho sub makes it 100% more tolerable)...

hope the 'feel good' lasts for you on bupe...
might wanna work down to 2mg insuff or 1mg IM/IV if ya dont wanna burn the bupe out too quick...

[Azrael]

i dont think ANYONE with even moderate habit has a few rough days transitioning to bupe,
due to both its partial agonism and for some the ceiling effect of bupe if their habit was large enough to bump against it.

not talked too much about i guess because its common, well known, and expected by most of us that going from grams of dope per day to bupe is of course gonna hurt(tho sub makes it 100% more tolerable)...

hope the 'feel good' lasts for you on bupe...
might wanna work down to 2mg insuff or 1mg IM/IV if ya dont wanna burn the bupe out too quick...

I know it will. I had two years off dope on bupe. Then I found the dope scene in the place where I moved to. I am actually already down to the dose you recommend. The dosage I listed in my post is simply where I hit the ceiling.

--- auto merge ---

If I know I am cleaning up for the long haul, my instinct is to get as high as possible before I have to quit. While this is fun, doing $40 of potent diamorphine the day before you have to switch to buprenorphine is not wise. Get yourself down to $10 a day, and the transition will hurt less and you will therefore be more likely to stay the course during the important first week off.

[Amc6825]

I have my tried this but what if for your final 3-4 days of dope use you dose a small amount of bupe first thing in the morning (1-2nd, which should bot be enough to do much blocking) and then still do dope. Then when you are ready to go on bupe full time it will already be somewhat built up in your system. Would that work?

[bl4cklabel]

Bupe has been a life saver in the past.
I used to have a much much larger habit than I do now.

Yet, for some reason bupe doesn't even touch me these days.
My tolerance is about half what it was when bupe was working.


Could it be that I take Subs and I've become sensitive to the Naloxone?
Shit just doesn't make sense. Now days I'd rather just go CT than suffer with bupe. Bupe will actually increase my anxiety/insomnia.

[Seedy]

something i've noticed with bupe (bare with me, early morning here, having trouble formulating my thoughts...), is that the potency (binding affinity, i guess) of the opioid one is dependent on prior to the switch has more influence on the effectiveness of the bupe than the length and size of the habit. this is mainly based on the fact that i got onto subs after about 5 years of daily pst - at the time of my switch i would have needed about 180mg of morphine or 120mg of homebake to maintain as comfortably as i was on the seeds. so i guess that's about 0.5g of average street dope. i found the switch completely painless. my friend who had been on homebake on and off for about a year was up to about 100mg of homebake a day (equiv of about 0.4g average street dope), had a much more painful switch.

it seems pretty obvious now i've typed it out, but i'm guessing that morphine users (including pods/pst) and oxy users, even with fairly sizable habits, are going to have an easier switch than h (or fent, oxymorphone, etc) users, even with an equivalently smaller habit. can anyone concur with this?

[Azrael]

something i've noticed with bupe (bare with me, early morning here, having trouble formulating my thoughts...), is that the potency (binding affinity, i guess) of the opioid one is dependent on prior to the switch has more influence on the effectiveness of the bupe than the length and size of the habit. this is mainly based on the fact that i got onto subs after about 5 years of daily pst - at the time of my switch i would have needed about 180mg of morphine or 120mg of homebake to maintain as comfortably as i was on the seeds. so i guess that's about 0.5g of average street dope. i found the switch completely painless. my friend who had been on homebake on and off for about a year was up to about 100mg of homebake a day (equiv of about 0.4g average street dope), had a much more painful switch.

it seems pretty obvious now i've typed it out, but i'm guessing that morphine users (including pods/pst) and oxy users, even with fairly sizable habits, are going to have an easier switch than h (or fent, oxymorphone, etc) users, even with an equivalently smaller habit. can anyone concur with this?

Yes, this has absolutely been my experience so I can concur. Going from morphine or oxy to bupe has always been painless, while for the last year heroin has been the easiest thing for me to obtain, and everytime it's been kind of a bitch. The caveat being a 3 day binge of heroin then back to bupe is a lot easier than a 3 week binge.

[tch2296]

I have the same issues switching when I'm using large amounts of oxy (like 300-400 mg per day). I'm about to make the switch to bupe from about 160 mg per day oxy and I'm hoping it won't be too bad since I've got benzos and ambien to help with anxiety and insomnia.

[nutmeg]

the first few times i attempted the transition i totally failed. i just remember no amount of Subs helping my aches and pains. recently, my dealer has sucked complete ass and sells shit only slightly better than the shit sold in the TL but for the typical $10 a point. being broke this month basically forced me into a real withdrawal process, and luckily a friend supplied me with like 5 8mg sub pills. normally i would try 6mg + for an attempt at relief, but since i heard less is more, i decided to start small and add more if i needed it. lucky me! 2mg put me to sleep the first night, and only got progressively better each day. without the forced taper i doubt the switch would have gone nearly as smooth, and like we junkies say. when you get a chance at clean break, TAKE IT!! i cant remember the last time subs provided any relief, and now that they do, i feel like i have an incredibly likely chance at getting clean.

[Indy]

I agree, I think a lot of people disappointed in bupe expect to be feeling 100% right away. If you have a larger tolerance, it takes a couple days to adjust, where you'll feel kind of "off". It helps to wait as long as you can before taking the bupe in my experience; if you get any precipitated withdrawal, it seems like that makes it take longer for the bupe to really start working for some reason.

[mainline]

IMO, when you're balls to the wall sick, the relief from dosing bupe is amazing, Might not be 100%, but my first time on bupe (from 40ish mg IV HydroMorphone/day) I felt fine at first dose.


I've been back on bupe now for like a week, (also Rx'd4mg klonopin/day), and was finally feeling perfect aroud day 2. (coming from about 600mg Morphine IV a day, or Heroin equivilant. And was on Methadone for 8 months pior as well. Switched to M and H from done'. then onto bupe. Was finally feeling fine and what do I find inside some socks? a cellophane with 5 90mg Avinzas. Being on a lower dose of bupe (around 3mg, still tapering lower) I said fuck it and did a shot last night, slight effects. Then one just now at 60am, and felt it fine. I will dose .5mg bupe during the day sometime, finish the MS, and go back to bupe like nothin happened.

bupe has always been nice to me.

[dride]

I have my tried this but what if for your final 3-4 days of dope use you dose a small amount of bupe first thing in the morning (1-2nd, which should bot be enough to do much blocking) and then still do dope. Then when you are ready to go on bupe full time it will already be somewhat built up in your system. Would that work?

anybody i was looking for the answer to this as well i have a physical cust service type job i just cant seem to make a smooth transition anymore with my rediculous habit