Subutex Question For Someone That Really Really Really Knows! (Top voted first)

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

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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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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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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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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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: 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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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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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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GHOST (# 10) --

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

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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: 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..

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Re: Master Plumber (# 46)

Says the guy who answered himself thinking it was somebody else.

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Re: RustedOne (# 49)

Blah blah blah. Whatever. Not worth responding to, cuz no logic whatsoever in your post. Not sure why ones like you bother posting if your only here to make trouble.

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Re: Master Plumber (# 41)

Do u realize how seriously stupid u sound? Duh, I don’t give a flying s-:()” what u do or how u do it YOURE STILL GONNA HAVE W/D PERIOD! From the sounds of it you haven’t been on subs for very long or u WOULD understand how w/d are ! I don’t care if u taper down to a tiny tiny crumb of sub! ITS GONNA HURT THE SAME AS IF U WERE ON 8 mg! And there’s no difference in subutex and suboxone except for suboxone sucks because it stops u from being able to take other p/m with it. So like the guy said bla bla bla,
Nope, I GUESS IM STUPID FOR NOT UNDERSTANDING YOUR MILLION WORD QUESTION!!! Maybe if u shortened it then just maybe,,, SOMEONE COULD ANSWER IT! On the other hand you’re such a smart a”” why don’t u figure it out! And I guarantee U one thing if u ever had the balls to speak to me face to face You’d be more like a dead animal! Now that’s a FACT!

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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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Curious80 (# 19) --

Good Answer Curious 80 well explained right answer!!!

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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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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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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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Curious80 (# 19) --

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

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