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Combinations - can you mix methadone with subutex?

Discussion in 'Drug combinations' started by DontSleepYourLifeAway, May 2, 2012.

  1. DontSleepYourLifeAway

    DontSleepYourLifeAway Newbie

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    Hey! I'm sorry if there already is a thread about this but first time on this forum and diddent find any in the search option,
    so here is my question: I'm ben wearing a subutex "plaster" 10 microgram/h (don't realy know the name of it in English) for some days now and so far i think it sux compared to the 20 mic/h plaster that i tried before and now i wonder if its an good idea to take some methadone to get an better effect or will the sub block out the effects of the methadone? have searched around on some Swedish forums but no one had a good answer to that. some say that they will block each other out and some say that you just will get sick if you take the methadone after the sub but not if you take the methadone firs. so is there any one out there that have tryed this or know the answer feel free to tell me.

    Ps. sorry if my English isint the best atm just got home from working 13 hours and the sub/xanax may have crippled my writing skills :p
     
  2. TheBigBadWolf

    TheBigBadWolf Apprentice Sorcerer Palladium Member Donating Member

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    DontSleepYourLifeAway,

    (who the f*** has thought out that screen name?)
    Firstly be welcome on Drugs-Forum.

    I am no pain patient, just a substituted ex-heroin user, all my knowledge about the substances in question comes from maintenance therapy.

    I suppose I know why you can't get sufficient answers. I believe no one has ever thought about combining a buprenorphine patch with methadone.

    And even I have no real clue about which patch 10 or 20mcg/h gets how much buprenorphine on your receptors.
    Which is the problem as you will see when you follow me to the next paragraph.

    When used as a substitute for opiates (maintenance therapy), buprenorphine ( I write bup from now on) is given in doses of 2mg up to 16mg, in some rare cases even more.
    This is way beyond the doses that are used in pain management.

    Bupe, unlike methadone, which is a full opiate agonist, is a partial agonist/antagonist, means it has different properties on the receptor site.
    Methadone acts like any normal opioid does, it simply bonds to the receptors and that is that.
    Bupe is able to throw other opiates off the receptors, to bond there itself after having done so. And it bonds! Near to not removable, that stuff,- due to its long half life time.

    This means when your receptors are filled with bupe, other opiates have no chance to get through to the receptors, this is the so-called "blocking effect" of bupe.

    When your receptors are filled with methadone, bupe is able to throw methadone off the receptors, thus causing the so-called "precipated withdrawal syndrome" which no one wants to experience.
    (I have been there, done that - by accident- and I reassure you that you don't want to experience this. It is multiplied withdrawal with raging diarrhoia, vomiting, cramping intestinies, headache, RLS,- what is normally experienced over a time of several days then is compressed in five hours.

    So the answer to your question depends on how much of the bupe is actually on your receptors. And now we are back where we began.

    I only could give you information on part of your issue, now you know how bupe and methadone work.
    I hope some of the more knowledgeable members have a satisfying answer for you, this might take a while, we have very many posts per day, but you got a good chance..

    One thing is sure: should you be dosed high enough on bupe to have all your receptors filled, taking methadone won't have an additional effect on the pain.
    If your receptors are only partly filled with bupe, methadone on top should work.

    What I never heard anything about is whether the bupe-patches you mentioned really DO fill up your receptors. So,- lets hope for someone wiser than me.

    TBBW
     
  3. roddyr

    roddyr Newbie

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    you'll regret it.
     
  4. Ontario

    Ontario Silver Member

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    Useless, please explain why.
     
  5. hookedonem

    hookedonem Silver Member

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    You won`t feel the meth at all buddy, anything over 4mg subutex and you won`t really get any hit at all of any opiate. You will be wasting it pal, don`t bother.
    Sorry guy`s not much scientific talk here, just plain old facts,lol.
     
  6. curious_38

    curious_38 Silver Member

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    It sounds to me like your taking a patch form of Buprenorphine. If that's the case than it depends on how long you have been taking the 'bupe' patch? If it is anymore than 2 weeks then consider taking the patch off for at least 36 hours (which is the mean half life of bupe). Then it will be safe to take methadone. I am not too familiar with the bupe patch, but what I know is that is less than 2mg absorbed per day. If that is the case I do not believe that combining methadone with it will cause precipitated withdrawal syndrome, but if you have been on the patch for more than 2 months you would need a lot of methadone to feel any effect if at all? It is impossible to feel a buzz, if that's your aim?, while taking buprenorphine treatment! It sucks, I know! Peace my German brother!
     
  7. Eesa

    Eesa Newbie

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    In a nutshell..! I was gonna post more or less the same thing.
     
  8. Blindbraille

    Blindbraille Newbie

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    Good to see even 5 years ago people still had no idea what they were talking about. If anyone stumbles upon this thread like I have just know that subutex DOES NOT induce precipitated withdrawal. Bupenephorin simply forms a strong bond with the opioid receptors. This decreases the effects of any actual opiate you take directly after the bupe, at least until it clears your system. SUBOXONE not SUBUTEX is the bupe/naloxone combo that causes withdrawals. Naloxone is the drug that's gonna mess you up. So you can basically disregard everything this person had said at that time.
     
  9. Dizzyshell83

    Dizzyshell83 Newbie

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    No because subutex had s opiate blocker so if you use any opiate - tramadol codiene methadone herion will be useless if you've taken subutex in the last 32 hours .
     
  10. Hardstepa

    Hardstepa Silver Member

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    You say here that people don't have a clue what they are talking about but I must turn that around and say that to you. I have seen it happen to a couple of people in the past. It was subutex not suboxone. I agree that sometimes it doesn't happen but on methadone it always seems to happen and with heroin it does but only if you have a bigger habit and have a lot in your system. It even happened to me from a tiny dose of bupe on top of my methadone. This was before subutex was being prescribed in my country and it was from a temgesic 0.4mg tablet. Since subutex was not well known at the time I had no idea that this would happen. I was on 60mg of methadone at the time when I snorted the tablet and it brought a physical withdrawal which lasted for close to 24 hours.

    I have also seen some people use it without withdrawal but usually it's when they haven't took any for a a couple of hours and not such a high user. The last person I saw with it was a dealer who had a massive habit and he snorted an 8mg tablet about half an hour after his last hit and it put him into a bad rattle for a good while which wouldn't go away even with taking more heroin on top of it.

    It may not happen to everyone but it is a fact that it happens.
     
  11. JonnyBGoode

    JonnyBGoode Titanium Member Donating Member

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    Subutex DOES cause pre-cipitated withdrawal if you take it too early. The buprenorphine pushes all the opiate receptors out of your system and binds to them, meaning you instantly feel like utter shit and are left in withdrawal until such time as the subutex has gotten properly into your system and the withdrawal has worn off, usually at least 48 hours later.
     
  12. Dizzyshell83

    Dizzyshell83 Newbie

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  13. stasia

    stasia Newbie

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    taking subutex (or suboxone, of course) too soon after methadone (the time frame will depend on how long you've been using methadone, but if you've had it in your system for more than a few days you'll need to wait at least 24 hours, maybe more) will result in the two basically fighting it out in your brain for the opiate receptor. it will be bloody and it will hurt until buprenorphine effectively kicks the methadone off. this is precipitated withdrawal. it's worse than regular withdrawal. this combo is not worth risking.
     
  14. stasia

    stasia Newbie

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    for the record, the "opiate blocker" naloxone will prevent you from getting high if you try to use an opiate too soon after you've taken suboxone. incidentally, subutex doesn't contain naloxone, so subutex won't prevent a high from other opiates (unless you're just still high on subutex and can't feel), but it *definitely will* cause precipitated withdrawal if you take it too soon another opiate.
     
  15. TheBigBadWolf

    TheBigBadWolf Apprentice Sorcerer Palladium Member Donating Member

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    @stasia,

    the presence of naloxone in suboxone is NOT to blocking anything, it is (along the manufacturer) to prevent suboxone be injected, (which is nonsense, as buprenorphine has a stronger (and faster) affinity to bind to the receptor sites than naloxone does.)

    in my country suboxone is not prescribed. Subutex and its generics are.

    I guess the real reason for inventing a combo preparation is a copyright for it and the money to be made from it.

    BBW
     
  16. Dizzyshell83

    Dizzyshell83 Newbie

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    Do you guys know about that drug that apparently stops withdrawals? I'm under a clinic I've been on subutex 15 years no using ever but I forget the name of the drug that aids withdrawals anyone know ?
     
  17. aemetha

    aemetha Insomniac Member Silver Member Donating Member

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    Repeating what has already been said. Methadone is a full agonist with less affinity for the mu opioid receptors than Buprenophine which is a partial agonist with more affinity for the mu opioid receptors. If you think of them as scissor lifts, Methadone is a small lift set way up high, buprenophine is a big lift set down lower. If they drive into each other Buprenorphine will knock Methadone out of the way, and the man on top will fall (precipitated withdrawal).

    bupemeth.png
     
  18. Hardstepa

    Hardstepa Silver Member

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    Is it lofexidine?? I got that on an inpatient detox once I got my methadone down to 10mg. Doesn't do a great deal to be honest but it does maybe help a wee bit.
     
  19. Dizzyshell83

    Dizzyshell83 Newbie

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  20. Dizzyshell83

    Dizzyshell83 Newbie

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    Apologises .