Suboxone to Subutex

[terminer]

I was sent to detox at an in-patient facility and was given subutex (buprenorphine only) for withdrawal and it gave me your typical opioid euphoria.

After three days of subutex detox, I was put on a maintenance dose of suboxone (buprenorphine with naloxone, a type of opioid blocker) which I figured was the same thing...it was, but without the "high". I stayed on suboxone for a year.

Recently, my new suboxone doctor noticed side-effects I shouldn't be having from the suboxone and he figured the culprit was the naloxone in the suboxone. As a result, he switched me to 8mg of subutex (buprenorphine only) daily.

I figured the naloxone from the year's worth of suboxone would be out of my system in a few days and the buprenorphine "high" would present itself with every dose of subutex.

I've taken a subutex a day for 21 days since my last suboxone and can't figure out why the euphoria isn't manifesting as it did long ago. Can someone tell me what's going on?

Does my body need more time to get rid of that year's worth of naloxone or do I need to stop taking the sub for a few days to let those weird little antagonist, agonist, blocker things clear out or...what do I need to do to get the original subutex efect back? (I always take them sublingually.)

Is this normal? What's going on?? Please help me.

E-mail me at vespafly@gmail.com if you have any clue, I check my e-mail at least once an hour. Or, just reply here and I'll check daily.

Thanks in advance to those who can contribute anything helpful!

[Robert_325]

I was sent to detox at an in-patient facility and was given subutex (buprenorphine only) for withdrawal and it gave me your typical opioid euphoria.

After three days of subutex detox, I was put on a maintenance dose of suboxone (buprenorphine with naloxone, a type of opioid blocker) which I figured was the same thing...it was, but without the "high". I stayed on suboxone for a year.

Recently, my new suboxone doctor noticed side-effects I shouldn't be having from the suboxone and he figured the culprit was the naloxone in the suboxone. As a result, he switched me to 8mg of subutex (buprenorphine only) daily.

I figured the naloxone from the year's worth of suboxone would be out of my system in a few days and the buprenorphine "high" would present itself with every dose of subutex.

I've taken a subutex a day for 21 days since my last suboxone and can't figure out why the euphoria isn't manifesting as it did long ago. Can someone tell me what's going on?

Does my body need more time to get rid of that year's worth of naloxone or do I need to stop taking the sub for a few days to let those weird little antagonist, agonist, blocker things clear out or...what do I need to do to get the original subutex efect back? (I always take them sublingually.)

Is this normal? What's going on?? Please help me.

E-mail me at vespafly@gmail.com if you have any clue, I check my e-mail at least once an hour. Or, just reply here and I'll check daily.

Thanks in advance to those who can contribute anything helpful!

First of all you've been on all the buprenorphine for too long. It's time to start a taper down so you can get off the subs and be drug free. The naloxone causes side effects for lots of people. It shouldn't linger for too long though as the naloxone has a half life of only a few hours. It should have been gone from your system long ago.

I work with people on subutex/suboxone all the time. If you need some help tapering down off the subs I will be glad to help if you want. Just let me know.

You can read tons of sub threads on this forum. You will see what I am talking about. God bless.

[terminer]

I agree, I've been on the stuff too long, having only tapered down once (16mg daily to 8mg daily). The problem is, as long as I have buprenorphine prescribed to me, I have no desire or need to obtain illicit substances. So, I'd like to stay on it to avoid relapsing to the heavier stuff. But...maybe I could handle being off of it.

Anyway, I still am curious as to why the subutex hasn't produced the original effects it did before my year of suboxone treatment. If the naloxone is gone, what is keeping the buprenorphine from creating a buzz. Tolerance? Something else?

[Robert_325]

I agree, I've been on the stuff too long, having only tapered down once (16mg daily to 8mg daily). The problem is, as long as I have buprenorphine prescribed to me, I have no desire or need to obtain illicit substances. So, I'd like to stay on it to avoid relapsing to the heavier stuff. But...maybe I could handle being off of it.

Anyway, I still am curious as to why the subutex hasn't produced the original effects it did before my year of suboxone treatment. If the naloxone is gone, what is keeping the buprenorphine from creating a buzz. Tolerance? Something else?

No way I can know for sure but I would say that most likely since buprenorphine is an opiate just like any other opiate you have probably developed a tolerance to it over time. Taking buprenorphine for so long is bad news. It isn't for long term maintenance. That is not what its for. You are going to have challenges stopping it as it is.

You've been taking too high of a dose for maintenance anyway. 8mg is a dose to be taking at first when you first start on it. People who do this for maintenance should be on no more than 2mg per day. It's just not for the purpose you are using it for. Makes no sense whatsoever.

It makes me mad that some drs allow their patients to even do this. It's no different than taking vicodin if you're going to do it for over a year. Buprenorphine should be used for six weeks up to two months. In rare cases maybe six months. But that is it. Anything over that and you are asking for problems just like you are having problems with it now. God bless.

[musicman48]

I was sent to detox at an in-patient facility and was given subutex (buprenorphine only) for withdrawal and it gave me your typical opioid euphoria.

After three days of subutex detox, I was put on a maintenance dose of suboxone (buprenorphine with naloxone, a type of opioid blocker) which I figured was the same thing...it was, but without the "high". I stayed on suboxone for a year.

Recently, my new suboxone doctor noticed side-effects I shouldn't be having from the suboxone and he figured the culprit was the naloxone in the suboxone. As a result, he switched me to 8mg of subutex (buprenorphine only) daily.

I figured the naloxone from the year's worth of suboxone would be out of my system in a few days and the buprenorphine "high" would present itself with every dose of subutex.

I've taken a subutex a day for 21 days since my last suboxone and can't figure out why the euphoria isn't manifesting as it did long ago. Can someone tell me what's going on?

Does my body need more time to get rid of that year's worth of naloxone or do I need to stop taking the sub for a few days to let those weird little antagonist, agonist, blocker things clear out or...what do I need to do to get the original subutex efect back? (I always take them sublingually.)

Is this normal? What's going on?? Please help me.

E-mail me at vespafly@gmail.com if you have any clue, I check my e-mail at least once an hour. Or, just reply here and I'll check daily.

Thanks in advance to those who can contribute anything helpful!

No offense to you but the fact that you are looking for a buzz is not a good sign.I hope you have a support group to help you.Yes you have built up a tolerance to the euphoric side effects of subutex.It has been in your system a year now.Even though the blocking agent is gone the tolerance is there.I guess you started this to get clean.Why not try to get clean from the sub too.Its gonna be hard since you have been on it far too long.But is is possible to do.Good luck to you

[terminer]

I think this sub docs are in in for some sort of cash reward...they seem sneaky, like they're linked to the mob....anyway, I still carave a high, I admit that, and I'm afraid I'll relapse once I get off bupe. I'm not sure what to do. I do attend NA meetings however.

To be clean and happy is my goal. Right now I'm not clean or happy...

[musicman48]

I think this sub docs are in in for some sort of cash reward...they seem sneaky, like they're linked to the mob....anyway, I still carave a high, I admit that, and I'm afraid I'll relapse once I get off bupe. I'm not sure what to do. I do attend NA meetings however.

To be clean and happy is my goal. Right now I'm not clean or happy...

I think sub doctors are money motivated too.If you are not clean or happy you should try being really clean from sub and everything.Just give it a shot.Worst case is you will still not be happy but at least you will be clean and not happy instead of on sub and not happy.Good luck to you ! I should probably add that alot of the depresiion could be atrributed to your prolaonged drug use...such as the case was with me...I am past 2 1/2 months clean and the depression issues I was having are getting better and better now that I am clean and clear headed.It was rough for a while though.

[terminer]

Hmm, I shall heed your advice...besides, buying subutex without insurance is so expensive.

[Robert_325]

Hmm, I shall heed your advice...besides, buying subutex without insurance is so expensive.

Considering the amount of subutex/suboxone you've been using you and for how long you will most likely have a challenge if you jump off too quickly or at the wrong dose. If you need some help let us know. God bless.

[ramboj70]

First of all you've been on all the buprenorphine for too long. It's time to start a taper down so you can get off the subs and be drug free. The naloxone causes side effects for lots of people. It shouldn't linger for too long though as the naloxone has a half life of only a few hours. It should have been gone from your system long ago.

I work with people on subutex/suboxone all the time. If you need some help tapering down off the subs I will be glad to help if you want. Just let me know.

You can read tons of sub threads on this forum. You will see what I am talking about. God bless.

I was heavy into pain meds from all the surguries I have over the last two years. My questions are. I am addicted to pain meds I was put on suboxone from doctor at 16mg day. I was taking the 16mg all together in afternoon. I started at 8 then went to 16mg. Within about 4 weeks I woke one night shivering like crazy had chest pain from hell and blood pressure was 215/120. I had a mild heart attack that night. While still on the 16mg all at once not thinking suboxone did this to me I keep getting short breathed, shivering, high BP and I do not feel like myself. I feel as I am going to have a painc attack or even another heart attack. This has never happened in my life. I never even had a panic attack and I am a war veteran that has seen combat and also have been shot. Is it possible that the Soboxone is causing this? I have heard that Nalaxone can do this. This problems only usually happen at night. I asked my doctor to change to Subutex, is this a good decession. I really need help with this. I am tired of the doctor guessing game and saying its not the suboxone. I read that the withdrawls from the nalaxone can be hell, just like whats going on with me. Please any advice will help. If you can please email with help. hansenj70@aol.com

[Robert_325]

rambo ... I don't know enough about your using history with drugs in general to properly answer your question. Please share more about what drugs you've done over the past years and in what quantities. I would want to rule out the heart problem was caused by the previous drug abuse before I said that it would likely be the suboxone. Talk to me. God bless.

[Ken_2001]

rambo ... I don't know enough about your using history with drugs in general to properly answer your question. Please share more about what drugs you've done over the past years and in what quantities. I would want to rule out the heart problem was caused by the previous drug abuse before I said that it would likely be the suboxone. Talk to me. God bless.

Robert, if you could help me, I would really appreciate it. I am new to this forum and when I have some more energy, I will give everyone some of my background information and history, but right now I'm on my 3rd day of Suboxen and I have noticed that you've given great advice to many people here.

1st off, I've been bad with the painkillers since 2 car accidents in 2003 left me with herniated discs and carpel tunnel in both hands. Since then I have been on again off again with Vicodin ES, 10mg, and Percocet 10mg. For the last 2 years it's been mostly on, and the last year almost every day with about 10, 10mg percocet. Everytime I was running out I promised myself I would taper to avoid the horrors of detox...but you know how that can go.

In October I went cold turkey and survived 3 weeks of horror only to relapse back...something I'd swore I'd never do after finally beginning to feel normal again. Alas, I got involved with a business venture and some family drama while I was still too fragile (I had given up alcohol and cigarettes as well) and had a bad relapse going through 270 pills in about 7 weeks.

This time I came clean again to my wife and family and we decided to go to the walk-in clinic nearby on Sunday as I had been well into the first 24 hours of bad wd's and the diarreah was unbearable with the worse yet to come.

I asked for Suboxen and the doctor obliged although I am sure he was not well versed in the treatment. I had heard about it thanks to Artie Lang (Howard Stern show) and some other friends and knew that if it could get me past the horrors of the physical detox, then this would be my ultimate kick time.

So far I was right. He gave me the first 8-2mg sub in his office at about 2PM and sent me home with a prescription for 60 more advising me only that I take 2 a day and come back in a month.

Now I've done alot of online research and have found that this treatment requires much more advisement than that, but I don't fault him. He actually saved my life that day (figuratively).

I took a second pill at 5pm sunday and felt perfect except I couldn't sleep for more than about 2 hours that night. I also found a program written by a nurse who had been doing studies at yale and had laid out a very instructional plan. But I still have some questions..

Based on my abuse pattern do you think I need 16mg per day? And should I take both pills at one time or break it to twice a day? Monday I took one at 8AM and the second at 4PM. I felt some light heart palpatations and anxiety throughout the day, but nothing terrible. At 1am this morning I woke up freezing and my temperature was 97 with a pulse rate of about 120.

I finally fell back to sleep at 4am and awoke at 9 feeling a bit of the opiate hangover so I assumed the dosage was too high (mind you I've called my dr twice since mon and havent been able to reach him) and only took 3/4 of the 8mg pill and so far I feel fine today although some of that wd anxiety seems to be kicking in.

Also I want to taper off the suboxen as fast as possible without compromising my strong desire to be free of this stuff once and for all with any withdrawals or long term damage.

I hope this makes sense and would strongly value any advice you can give to a 32 yr old father and husband who has managed to keep his life together and is determined to become opiate free for real this time.

Thanks so much and sorry if I put this post in the wrong place.

Ken

[Robert_325]

Ken.... I appreciate your position and your questions. I don't agree with the way you are taking the suboxone or the dose. Of course you've received no advice at all to speak of so I don't blame you. I'm glad you posted while just beginning on the subs. It's much easier to correct a mistake before it becomes an ongoing habit. You're not following any type of established regimen that I can see and yes I think you are taking too much, too high of a dose.

Go to the top of this Featured Drugs category and look at my post titled Suboxone/subutex therapy. It's there for information to all new people with questions about sub therapy. I ask you to read this post closely as it will answer most of your questions so I don't have to repeat the same answers over and over and over again. That is why it's posted with a permanent sticky. Then we can go forward from there. You will see instructions for exactly what you should do from the point of induction and moving forward. Then feel free to ask any questions you have.

I will watch for your replies after you read the aforementioned post. It should help you with the general information you have asked so far. Then we can work together as needed. Take care and God bless.

[Cats Meow]

To answer the OP's question briefly and simplistically, it's because buprenorphine is a partial agonist and targets and partially antagonizes the μ receptor, at first because of it's strength in comparison to almost all other opioids you don't notice it's antagonizing effects, once it starts binding in your receptors it's effects start to attenuate. The naloxone isn't even a factor in how you feel the Subs effects, unless of course if you try and inject it.

I have to wonder why you're missing the euphoria, I mean that's the whole purpose of taking it in the first place, the desire to quit narcotics, maybe you should still take it, if you're never willing to give up euphoria then why quit or use bup? You're a relapse waiting to happen. You can't have your cake and eat it to. What ever therapy you're getting isn't working, you need to try something else, as in counseling or someone better, your mind needs set in a different direction. You have to want to give up getting high.

[UNEEK1]

I have been suffering from severe depression for quite of few months now and I am currently on 60mg of Cymbalta (15 months), 4mg of Suboxone (8 months) and 200mg of Wellbutrin (2 weeks). My question is do you think it is possible the Naloxone in the Suboxone that is giving me these nasty depression feelings? My Psychiatrist said that this could be a possibility but then she never said another thing about it and I forgot to ask again about it before I left her office.

[Robert_325]

I have been suffering from severe depression for quite of few months now and I am currently on 60mg of Cymbalta (15 months), 4mg of Suboxone (8 months) and 200mg of Wellbutrin (2 weeks). My question is do you think it is possible the Naloxone in the Suboxone that is giving me these nasty depression feelings? My Psychiatrist said that this could be a possibility but then she never said another thing about it and I forgot to ask again about it before I left her office.

Hi UNEEK1 ... I have seen some depression with suboxone, more with suboxone than with subutex which would lead me to summize it's the naloxone. I have made that claim for some time.

I really think you should taper down and off the suboxone. You know that we've talked about this before. You have great insurance and what not and I think the drs are keeping you on the meds when it's not necessary any longer.

Get off the suboxone and I bet you ten to one odds that you will feel much better. It served it's purpose, but now it's time finally to move on. I promise you that I am right. God bless.

[UNEEK1]

I know you are right about the taper. I am scared to have withdrawal symptoms from the Suboxone. It was so easy to drop to 4mg, but I don't think it will be that easy from there. I am really scared to taper...

[Robert_325]

I know you are right about the taper. I am scared to have withdrawal symptoms from the Suboxone. It was so easy to drop to 4mg, but I don't think it will be that easy from there. I am really scared to taper...

I know you're scared but you were scared when you started the subs too. I remember back almost a year ago when you began posting. You and two or three others talked throughout the day every day helping each other get through this. I read you all's posts daily and replied myself some too. I know you remember. We've talked about it before.

You can do this. We've been so successful with these tapers just doing them slowly. I don't mean that you should taper off over two weeks. This will take a little longer period of time for you after taking the subs for 8 months. But you haven't been at such a high dose that it will be that bad. I promise that I can help you get past this. I just hate to see you getting milked by the medical professionals because you have good insurance. These people aren't helping you any longer, they're hurting you. It's so obvious and I know you're bright and can see what I am saying is right.

Just think about this over the weekend. If you will give this an honest shot starting Monday (give yourself a few days to get psyched up) I will work with you on a daily basis. Doesn't matter how long it takes, I will be here. We can do it very slowly and I promise you there won't be a bunch of pain for you. I know how to do this.

You might have a little anxiety, possibly a little depression after 8 months on subs. But it won't be that bad, nothing like a cold turkey off opiates. NO WAY! Let me know what you think. What better way to start out the new year than to get TOTALLY clean off all opiates including the subs. Let me know if you are ready to end this craziness as the subs are now starting to bother you, they aren't helping you any longer. God bless.

[UNEEK1]

Just let me absorb it some more over the long weekend and try to prepare myself. My next Suboxone appt. is January 9. So I'll have plenty on hand to taper down. Happy New Year. You are amazing...

[Robert_325]

Just let me absorb it some more over the long weekend and try to prepare myself. My next Suboxone appt. is January 9. So I'll have plenty on hand to taper down. Happy New Year. You are amazing...

Makes me happy that you've made this decision. Just relax and don't freak out over this. It won't be that bad. You got past the RX pain pills and you will get past this too. Just have faith in yourself. Then it's all done and you will never have to use any of this stuff again EVER.

I agree it's a good idea to get your script refilled so you have an adequate amount of medication to proceed. And for what it's worth it's my opinion that we should do this right here with no outside help. These guys have been draining your insurance and doing what's best for them for the last five months at least. I'm referring to the dr of course. You should have been off this medication a long time ago by now. So I wouldn't permit them to determine how I was going to taper. We can do this and we will be successful right here with no help. Just get your script refilled and we can do this by ourselves without anyone else's advice. That is my opinion at least. Good luck and God bless.

[UNEEK1]

After I taper all the way, Wouldn't it be great for me to go in to the Dr. and tell him I tapered down without his help and I won't be back... Plus it costs me $167.00 a month for 30 8mg pills. (Thank god my insurance reimburses me, but I don't always have that much cash available when it is time for a refill.)

[Robert_325]

After I taper all the way, Wouldn't it be great for me to go in to the Dr. and tell him I tapered down without his help and I won't be back... Plus it costs me $167.00 a month for 30 8mg pills. (Thank god my insurance reimburses me, but I don't always have that much cash available when it is time for a refill.)

I think that would kick butt!! You're getting yourself psyched up now. This is very cool. Give yourself a few more days and you're going to get really excited about this and you'll be ready to do it.

All you need is just a little time to get your mind made up that this is it. You'll be successful at this just like you were with the RX pills when you went on the subs. You will be so proud of yourself when you look back and realize that you are no longer on the pain pills, no longer on the subs, no longer on anything at all. You will get there! Just believe in yourself. God bless.