Morphine Injections after Suboxone?

[is_today_monday]

Originally Posted by Duckfeet

To me, one of the major problems, of having a little knowledge about "half-life" and "blocking" and other terms we now throw around...is that it can lull us into thinking we can predict accurately what a drug will now do in our own bodies, and how safe it is. To me, it's bullshit. Everybody's so different, and our bodies process drugs so differently. I mean I've had personal experience, of one junky on the same dose of methadone, me, overdosing, while my pal, on same dose, for same length of time, pretty much, took me to the hospital. It's *so* subjective and dependent upon body types and intangible factors to be almost useless, and why I worry when we give out numbers and facts and figures as tho that will protect you when you dial out, or ensure a buzz, when we haven't got a clue... You better learn your own tolerance and limits, thru personal experience and observation, and be very skeptical of anything we post on here, just because it sounds learned...

I definitely agree, Duckfeet - My reason for including the amounts was for my own personal experience. In the past, before I got on the Suboxone, 100mg MS Contin, or even 80mg Oxy wouldn't do shit; however, while being on Suboxone, the MS Contin sent me into an OD, and less than a full 80mg Oxy was felt. Tonight I did a full 80, and I felt it, but I also have the nausea associated with higher levels of opiates, because of the Bupe.

If you are going to use on Suboxone, or Methadone, or indeed just mixing different full agonists, it's best to start small and work up, because you never know how your body is going to cope with the interaction of drugs.

Duckfeet, if I caused any offense, I do apologise. I wasn't writing this as a guide as to what you can feel if you do X amount of this and Y amount of that; I was just stating my experiences of being able to use on top of Suboxone, that I don't seem to have the blocking effect that so many people hear about, or experience.

Guys, don't count of the blocking effect to be there; like I said, work up slowly. When I overdose with the morphine, it was because I took the blocking effect into account, as well as trying to be careful because I knew that, although bupe is only a partial agonist, it is still a CNS depressant.

[Duckfeet]

Oh no, not at all, I do the same thing: post what I know and what's worked for me, and was just throwing out my usual harm reduction chatter. You know how it is, some people will read something on here, and think, o.k., I read it on Opiophile, it must be cool...

Nope, I find your posts informative as hell, and I like reading them...just making sure the newbies realize there's no sure thing with this stuff...

All the best!

Originally Posted by is_today_monday

Duckfeet, if I caused any offense, I do apologise. I wasn't writing this as a guide as to what you can feel if you do X amount of this and Y amount of that; I was just stating my experiences of being able to use on top of Suboxone, that I don't seem to have the blocking effect that so many people hear about, or experience.

Guys, don't count of the blocking effect to be there; like I said, work up slowly. When I overdose with the morphine, it was because I took the blocking effect into account, as well as trying to be careful because I knew that, although bupe is only a partial agonist, it is still a CNS depressant.

[Dirtyrockstar]

narcan doesnt affect bupe, so if you od with subutex in your system, and they shoot you up with narcan theoretically you wouldnt go into instant withdrawal coz you still have subs floating around.

so what do you give for a bupe overdose?

[is_today_monday]

Originally Posted by Dirtyrockstar

narcan doesnt affect bupe, so if you od with subutex in your system, and they shoot you up with narcan theoretically you wouldnt go into instant withdrawal coz you still have subs floating around.

so what do you give for a bupe overdose?

Narcan does affect Bupe, they just need a hell of a lot more to have any effect. When I started on the programme, I was given a card to fill out and carry in my wallet. It serves two purposes; the first, if I'm in an accident or something, they can give adequate pain relief (they usually need more to overcome the effects of Suboxone; and secondly, it warns that, in case of an overdose, 15 - 20 times the amount of Narcan will be needed to reverse the overdose.

It's very rare to overdose on Suboxone - usually it only happens when it's mixed with something else, like heroin, morphine, oxy, barbiturates or alcohol. Some of those have their own antagonists, which they will most likely use first, and then if you're still not coming around, use very large doses of narcan until it has an effect. It's so difficult to overdose on Suboxone alone though, which is why they use it (especially in Australia) much more than Methadone where applicable. It has a much less lower overdose and side effect profile.


P.S - Thanks Duckfeet! I'm glad to hear that my posts aren't too much of a waste of reading time

[laudaphun]

Monday,
I'm very intrigued at your experiences with bupe and full agonists, you are probably the first person I've came across that actually had their agonist effects intesified by bupe... Given the pharmcological properties of buprenorphine, that shouldn't happen. However, everyone is different. Just like some are born genius and other born mentally handicapped. I'd love to know what it is that makes your experiences with mixing bupe and full agonists different than most. I do not doubt you, i'm just very interested. Maybe you have a super fast metabolism of bupe, maybe ... who knows.

Anyways I have a suboxone/subutex package insert here I keep in my medicine cabinet and for overdoses it states in capital letters, which i will exclude:
"in the case of overdose, the primary management should be the re-establlishment of adequate ventilation with mehcanical assistance of respiration if required. naloxone may not be effective in reversing any respiratory depression produced by buprenorphine."

...underneath that in lowercase it says:
"High doses of naloxone hydrochloride, 10-35mg/70kg may be of limited value in the management of buprenorophine overdose. Doxapram (a respiratory stimulant) also has been used."

Well, I guess we are getting off topic a bit but Duckfeet is also very very correct and I couldn't agree more about not gauging your dosages by something you read on the internet. I've seen some posts on different forums of people who claim to have consumed huge amounts of certain drugs and not felt it or whatever and to me that endangers a lot of youngsters out there surfing the net looking for some information before experimenting with a particular substance. I know that is exactlly what i did growing up... Before I ever consumed any substance, even if ti was not a controlled substance, I looked it up on the internet and read everything i could find about it before taking it. My appologies if i seem long winded... that's how i talk irl also hehe.

[Dirtyrockstar]

i presume that OD'ing on suboxone would be more difficult because of the narcan included. presumably that would remove any traces of agonists before being metabolised or brushed aside by bupe molecules binding away with great affinity.

i have heard of someone going over with plain subutex, but they did a shitload of it on purpose and helped themselves along with 30 or 40 serepax. sad really.

who cares if it goes off topic. im sure the total of threads that do so you could just about squeeze into the grand fucking canyon. in full agreement tho, noone should base their use on what they read on an internet forum, even if it was opiophile and what was written sounds accurate

[Inspektahdek]

personal experience= 48 hours, roughly give or take depends on your dose, wait until u have watery eyes and runny nose, no deside to eat food, thats when I can get blasted and blatant

[is_today_monday]

First of all, let me begin this by saying that I've always been known as some kind of medication/drug freak. No matter what medication it is, I seem to get the opposite effect to what I should be experiencing, or it clears out of my system a lot quicker (as evident by medications which needed close blood monitoring to make sure I was in therapeutic levels) and other times, the slightest increase, even as small as 10% could be way to high; a reduction of the same amount could have the (opposite) reaction.

I'll also type out what is in the card I carry, that was included in the book and paperwork I received when I began the programme;


To the Medical Personal Treating Me in an Emergency
This patient is taking the drug buprenorphine/naloxone (Suboxone), a combination partial opiate agonist and antagonist.

Patients taking buprenorphine/naloxone may have a diminished response to opiate medications (including those for the management of cough or pain). Opiate-containing preparations should be avoided when non-opiate therapy is available as an alternative.

In an emergency situation requiring pain relief in patients taking Suboxone, a suggested plan of management is regional anaesthesia, conscious sedation with a benzodiazepine, use of non-opioid analgesics or general anaesthesia.

In a situation requiring opiate analgesia, the dose of opiate required may be greater than usual. A rapidly acting opiate analgesic which minimises the duration of respiratory depression should be used. The dose of opioid medication should be titrated against the patient's analgesic and physiological response, with close monitoring by trained staff.

Overdose with buprenorphine/naloxone alone is very uncommon. In a situation that a patient taking buprenorphine/naloxone has overdosed and is unconscious, high doses of naloxone (up to 10-15 times normal dose) may be required to reverse the opiate intoxication. It is recommended that naloxone doses be titrated upwards until the desired response is achieved. The patient should be monitored for at least several hours afterwards.


Ok, so there's the card that I have to carry around in my wallet. It means I can be treated with adequate pain relief, if the situation arises (genuine, I should say) and in case of overdose, they are able to understand better how that can be achieved.

I do have an extremely fast metabolism when it comes to drugs (of the illegal or otherwise variety) which means I usually have to dose more often than most people do. That's not to say I don't get extra doses of Suboxone from the clinic. Unfortunately, I'm stuck with what they give me. I think that's part of the reason I 'supplement' my sponsored addiction by doing other opioids.

Laudaphun, I don't know the exact why this works for me, when so many other people don't share the same experience. I'm grateful each time I use though, because I'm not taking for granted that I'll always be able to do and feel this. I'm always on the look out (feel out?) for the day the blocking effects of bupe are there in full force, but I would think after being on the programme for three months on 12/24mg (depending on a single or double dose) that I'm not going to run into dramas anytime soon. Once again though, I'm not going to count on that as a 100% guaranteed thing.


Dirtyrockstar, when taken properly, as in dissolved under the tongue, very little Narcan enters the system for it to make any difference whatsoever. It's only if you inject it that it causes issues, and even then, only if you've had any other opiates previous to that (unless of course you've only taken bupe - if that's the case, injecting narcan won't do much at all, not in the very small doses that are in the pills).

As for the person you know who overdosed, you said yourself that he/she had taken a shit load of oxazepam along with it. Buprenorphine alone is very difficult to overdose on. I read a study, I'm not sure where it was now, that said the only people who died from suboxone were those who partook in one of the three B's as well - Benzos, Barbiturates and Booze.

Now, I've probably gone wildly off topic, and I do apologise for any thread de-railing I've done; It is possible to overdose on Suboxone, but extremely unlikely unless you miss it with other CNS depressants.

Finally, I'm going to put in that harm reduction warning that people are probably sick of seeing, but I need to say it - the information I've written above is part information (from the official Suboxone guide book) but I have to say that a lot of this is unlikely to result in anything except trouble for a lot of you. It doesn't matter how careful you are, hell, I OD'd doing this shit. It's rare that people can feel anything, especially at the dose I take. There is no need to take a huge dose to try to 'overcome' that barrier. Suboxone is a partial agonist - it means it STILL has some depressant effects on the central nervous system. Mixing more CNS depressants is just asking for trouble. I'm just a freak who can use less than I could when I had a full habit and still feel something. Take the word of everyone around - it may be possible, but I'm just one person...

If you have any more questions, feel free to ask

P.S - sorry for the insanely long post - I broke it up into small paragraphs to hopefully make it a bit easier on the head and eyes.

Originally Posted by laudaphun

Monday,
I'm very intrigued at your experiences with bupe and full agonists, you are probably the first person I've came across that actually had their agonist effects intesified by bupe... Given the pharmcological properties of buprenorphine, that shouldn't happen. However, everyone is different. Just like some are born genius and other born mentally handicapped. I'd love to know what it is that makes your experiences with mixing bupe and full agonists different than most. I do not doubt you, i'm just very interested. Maybe you have a super fast metabolism of bupe, maybe ... who knows.

Anyways I have a suboxone/subutex package insert here I keep in my medicine cabinet and for overdoses it states in capital letters, which i will exclude:
"in the case of overdose, the primary management should be the re-establlishment of adequate ventilation with mehcanical assistance of respiration if required. naloxone may not be effective in reversing any respiratory depression produced by buprenorphine."

...underneath that in lowercase it says:
"High doses of naloxone hydrochloride, 10-35mg/70kg may be of limited value in the management of buprenorophine overdose. Doxapram (a respiratory stimulant) also has been used."

Well, I guess we are getting off topic a bit but Duckfeet is also very very correct and I couldn't agree more about not gauging your dosages by something you read on the internet. I've seen some posts on different forums of people who claim to have consumed huge amounts of certain drugs and not felt it or whatever and to me that endangers a lot of youngsters out there surfing the net looking for some information before experimenting with a particular substance. I know that is exactlly what i did growing up... Before I ever consumed any substance, even if ti was not a controlled substance, I looked it up on the internet and read everything i could find about it before taking it. My appologies if i seem long winded... that's how i talk irl also hehe.

[Dirtyrockstar]

oh yeah. subs go under the tongue. my bad. it just slips my mind that not everyone is a dirty needle freak. i am but again thats off topic.

[mikells43]

heres something to toss into the mix. its an annuals about treating acute pain in bupe/methadone matenence patients. heres the link http://www.annals.org/cgi/reprint/144/2/127.pdf also i seen someone say something about bupe being unaffected by narcan, and thats the truth. i have read tons of info on bupe and talked to several doctors about it, and infact if narcan or something for overdose is needed there is going to need to be cont. iv infusions of high dose narcan, or aka iv bags full of the shit lol. cause bupes binding affinity is so strong, its like sperm in the shower, and if ur a guy u kno what sperm in the shower is like to say the least lol. sorry but thats the only thing i can compair it to lol. anyhow to get the law passed supposedly the drug company(rikett benkister(sp)), had to make the drug sorta abuse resistance, but the people doing this must have forgot or not known the power of bupe on the receptors and that tiny dose (2mg) of narcan they put in suboxone is not going to do it to make the user sick if injected, and i kno all of u heard and seen my posts of what it does if injected, but anyhow the plan backfired and that 2mg does not take the bupe off of the receptors. mabey if that person was shooting that pat. sub for the first time and has not taken bupe oraly before that, but most docs induce in office with subutex, most i say. but read that guys, pay close attn to the misconceptions, they are intresting. and have a good one.

[Dirtyrockstar]

bupe is like sperm in the shower, totally, that shit just wont come off. thats almost poetic

damn right about the narcan too, i do IV my suboxone, i know im norty, and even on the rare occasion i have two tabs the 4mg of narcan does sweet fuck all to stop the subs. doesnt do anything really. even IF im dumb enough to still have a trace of morph in the blood (this only happened once) then it just feels tingly for 30 seconds or so while the narcan boots that out and the subs take over.

SWIM (seriously) did IV an 8mg suboxone having only had a 40mg oxy 4hours previous, the narcan threw him into instant withdrawals wretching and shivering the full nine, but after about 30mins it subsided as the bupe had now bound to the newly cleaned receptors, he had another 4mg's of sub and felt great.

spose this all goes to show just how relative each drug is to the individual

too late to quote so italics will do.
is_today_monday "No matter what medication it is, I seem to get the opposite effect to what I should be experiencing"

i get this alot too, dexies and whizz put me to sleep, codeine does not make me constipated and any form of anti-vomit medicine makes me spew.

[Saint]

In my case 12 mgs of subuxone blocked methadone for almost 4 days. Took my last 8 mgs in the morning and first 10 mgs of methadone the next evening. I didn't feel shit the first 3 days. It was only during the afternoon of the fourth day that I started to feel the methadone kick in a little. Next day i took 15 mgs and really felt it (almost no pain, hurray!).
But it all depends on the person, lenghte of addiction, daily dose etc. etc. etc. There simply are no specific rules!!!
(I'd never guessed the blocking would take that long though, I was really very surprised!)

[chopstix]

Originally Posted by Saint

In my case 12 mgs of subuxone blocked methadone for almost 4 days. Took my last 8 mgs in the morning and first 10 mgs of methadone the next evening. I didn't feel shit the first 3 days. It was only during the afternoon of the fourth day that I started to feel the methadone kick in a little. Next day i took 15 mgs and really felt it (almost no pain, hurray!).
But it all depends on the person, lenghte of addiction, daily dose etc. etc. etc. There simply are no specific rules!!!
(I'd never guessed the blocking would take that long though, I was really very surprised!)

You've been taking it for awhile and I bet it had built up in your system, methadone does the same thing. Glad you're feeling better..

[Saint]

Thanks Chopstix. I was surprised how little methadone I needed after coming off 12 mgs of subuxone. I'm sure 10 to 15 mgs of methadone would be enough to withdrawals away. For pain I still need to increase my dose a little though but I'm afraid of overdosing so I'm still extremely careful.
In my case subs absolutely lowered my tolerance so please be careful everyone when hopping from subs to the 'real' thing..

[Saint]

And yes, both build up in your system. I still must have had 0.75 mgs of buprenorfine in my blood 150 hours after taking my last dose of 12 mgs subuxone. Maybe more because I was on a higher dose a few weeks before that.
It's my third day on methadone now (well, seventh but 3 since I can actually feel it) and although on the same dose I feel some difference (a good side-effect is that I almost stopped taking any benzo's completely: I finally get some good sleep now that I'm on methadone again)