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Addiction - How long after taking heroin can you take suboxone safely?

Discussion in 'Heroin' started by wonder411xx, Dec 1, 2011.

  1. wonder411xx

    wonder411xx Newbie

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    How long after doing heroin (injecting), is it safe to take a Suboxone/Subutex & have it work properly? I've seen online 12 hours, but is it okay to go 8 hours?
     
  2. TheBigBadWolf

    TheBigBadWolf Apprentice Sorcerer Palladium Member Donating Member

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    That might depend on the dose of Heroin injected.

    I would wait as long as possible with taking the buprenorphine to be sure the heroin is out of the system. Precipated withdrawal is not fun at all.

    So 12 hours+ should be on the safe side.

    Beware of taking the bupe too quick, you dont want to experience the bupe throwing the rest of heroin off the receptors.

    TBBW
     
  3. runnerupbeautyqueen

    runnerupbeautyqueen Palladium Member

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    I had a doctor the made me wait 48 hours once. Twice in detox I had to wait 24 hours. One time I did a very small shot and I took 2mg of suboxone about three hours later because I had forgotten about the shot and I ended up being fine every time. Of course no one would ever recommend only waiting three hours but at that time I was using very irregularly and very little amounts. I've had friends who only waited ~8 hours and they ended up terribly sick.
    I agree with TBBW - wait as long as you can. In my opinion 12 hours should be the absolute minimum. When I was detoxing myself at home I would try to rate my pain on a scale of 1-10 with 1 being the best feeling and 10 being the worst. I would wait until I was at least a 9, take it, and in 30-40 minutes I would get down to 3. But if you only wait until you're like a 5 and then take it there's a good chance that it will turn your 5 into a 10. I hope that wasn't too confusing. Congrats for deciding to quit the dope and good luck with your detox!
     
  4. catseye

    catseye Gold Member

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    as TBBW and runnerup say, it is best to wait as long as possible. You really want to be feeling the wd's before taking bupe.
    With short acting opiates like heroin 12-24hrs is the recommended clinical guideline (at least it is here in the UK).
    If you haven't seen one of these already, I'd suggest looking at the Clinical Opiate Withdrawal Scale (COWS) file HERE - it is the scoring system clinicians will use when deciding its ok to start induction bupe induction and avoid precipitated wd's.
    Its a pretty clear guide of what to look for in your own symptoms and how to rate them on a scale so you can gauge how long to wait.
    Good luck :)
     
  5. 604weedbag

    604weedbag Silver Member

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    when I started suboxone he had waited until he was in full blown withdrawals almost 36 hours since last dose of heroin.

    I was also able to get high in the afternoon 4pm after taking about 4mg in the morning7am... But when he was going back to suboxone he would wait until he was feeling multiple withdrawal symptoms(bone pain in knee down, RLS, runny nose, yawning, cold sweats) and let them melt away like the tablet...
     
  6. theLdragon

    theLdragon Silver Member

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    24 hours is completely safe for fast acting opiods such as dope and snorted or banged oxy. The higher your tolerance the longer you have to wait. At 24 hours though it is simply medically almost impossible to go into precipitated withdrawal. I've heard and read of people still going into prep w/d. This is most likely because their first bupe dose was too high or their dope was cut with a longer acting opiod. Also if you can make your last dose a smaller one your gonna be much safer. I just (last 24hrs) swapped from a bundle a day, 5 bags/shot dope habit to subs. I started w/ding 6hrs after the shot, a little anxiety and chills, with restless legs. At 12hrs I was crampin, sweating, chills, the runs etc. I stuck it out for 12 more tho. After 2mgs I felt 75% better. At 4mgs I felt 99% better. 6mg made me feel somewhat good, but slight residual W/D effects such as sweating, the occasional chill is to be expected.

    People can get away with as little as three hours. It honestly depends on your dependence. You can most likely get away with 12 but as stated above 24 should be your goal. This can be hard but if your goal is to quit the breif withdrawal is a nice kick in the ass to remind you of why your swapping over. keep that in mind while your goin through it. The more W/D your in as well the more relief you'll get from the bupe.

    One of the MOST IMPORTANT things is how you take it. You want to start small. Take 2 mg at the 24 hour mark. This is crucial. Taking 2mg as opposed to 8mg is much safer as far as precipitated w/d. Over the next half hour you should feel the W/D melting away like the pill. At the half hour mark if your still feeling crappy, take 2mg more. Continue this but you really shouldn't take more than 8mg in the first 12hrs of induction. There is a lot of literature out there that shows higher doses of bupe increase its antagonist attribute. Its also remarkably strong and even off 4mg for heavy addicts, you'll probably find in an hour or so your w/d are gone and your feeling great. Less is very much more with subs.

    This information is from personal experience (i've done the transition about 4-5 times) and from conversations with my doctor. After explaining my situation he suggested 19hours. I told him I could stick it out for 24. He said 19 was about 95% safe and 24 was 100%. If your gonna get prep. w/d its gonna happen fast as well. Within 5 minutes (more like 1-2 though) of taking the subs, probably before its all disolved. Sometimes you'll get some weird w/d effects after the sub. For instance my restless legs disapeared instantly but I got this deep chill about 20mins after the sub. This is not prep w/d though and it resolves itself quickly. If your very dependent your going to still be in somewhat w/d (no where even close to what it'd be like otherwise) for a couple hours after startin the subs. Your brain is just gonna have to adjust to the lower baseline receptor activity. I'm talking very heavy habit though as bupe is very strong.

    I hope this all makes sense. This is my first post and I'm tryna get as much info out there even tho its a little long an unorganized. Good luck tho and god bless!
     
  7. TurboGolf

    TurboGolf Newbie

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    sorry to bring this up again but had a question.. got some subs handy and at 25 hours mark but don't feel in complete w/ds.. the guy above said its almost impossible to go into PW .. if i took 2 mg now, will i be fine , i want to wait til its safe but i just want that instant gratification of not feeling as bad as i am now, i have mod chills, some hot flashes, runny nose, but no runs or nausea or no restlessness yet but i also took advil and ibruprofen so not sure if thats helping or not
     
  8. Frmrjunkie

    Frmrjunkie Titanium Member

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    You should be in moderate withdrawal; which it sounds like you are. Although I sure as shit don't want to be responsible for putting you into precipitated withdrawals!

    Click the link Catseye (post 4 above) provided regarding the COWS scale... you should score around 24-26 before taking buprenorphine. Also, please start slow; 2mg at a time waiting 30-45 minutes between 2mg dosages.

    Do you know how to properly take the suboxone; sublingual? My friend who keeps relapsing from heroin to subs takes his subs by plugging as he HATES the taste, leaving it sit under your tongue for 10 minutes & swears it's more effective.

    Good luck & CONGRATULATIONS on kicking that dope! :vibes:
     
  9. TurboGolf

    TurboGolf Newbie

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    i hear you man.. beetween 24 hours and the roughly 32 hours its been i'm still sticking it strong, i've consumed a few ambiens to try and deal with life and it sped up some time but ii've felt like i've been sitting here for longer then i have, if i can't fall alseep by midnight with ambien i'm gunna try doing 2mg of a sub cause usually i wake up in chills and would like to sleep thru that, but if this is the worst it will get i will try n stick it thru cause i don't wanna end up on subs, just a backup thing

    TurboGolf added 329 Minutes and 57 Seconds later...

    waited 38 hours, had to give in just now, the restless ness across the whole body wass too strong to sleep with , hopefully the 2mg will help
     
    Last edited: Mar 4, 2013
  10. Midnite

    Midnite Titanium Member

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    In my experience, taking subs before the 48- 72 hour mark threw me into HORRIBLE w/d's. I have waited the suggested 24 hours before and after taking it, felt like I had got ran over with a bus while having West Nile virus or something. I ended up going to the hospital b/c I felt so bad. I would wait at LEAST 3 days, dude, before taking ANY kind of opiate blocker. Subutex included. (subutex was just as bad for me.)
     
  11. theLdragon

    theLdragon Silver Member

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    I'm almost 100% sure your not taking powdered oxycodone/hydrocodone or heroin that has not been mixed with something else in that case. it simply doesn't make biological sense for you to be going into prep. w/d 48+ hours. The only other scenario I can think of is your tolerance is so extremely high that the bupe just isnt strong enough or that there's still just too much dope floatin around in the blood stream. But that theory has its own problems. you sure you're not taking methadone? Because with methadone I've heard of people waiting 3-5 days and still running into prep-w/d

    Considering my doctor and my experience can both attest to 24hrs being 100% if any W/D are present, and that 24hrs is the upper "at least" limit of almost all literature online, i stand by that statement. I've taken bupe even when not being in any real form of W/D after 24hrs, maybe the odd yawn or watery eyes and still had no problems. I used to not get W/D for 36 hours after blowin OC (in the early days) and could still take bupe at 24 hours. I'd actually get a little high from it back then.

    OF course everyone's different and there's always exceptions to the "rule" I suppose
     
  12. Jumpbunny

    Jumpbunny Silver Member

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    I'm sorry but I'd have to disagree with some of the posters giving a certain amount of hours that are ok before you dose. The one poster who mentioned the clinical opiate withdrawal scale is correct - score of 26 is the safest time to take it. A few of my friends who used dope waited over 24 hours, even 36 and were put into harsh precipitated withdrawals. I've been through suboxone clinics before and went into precipitated withdrawals after waiting 16-24 hours from short acting pain medications.

    Starting suboxone is gauged on SYMPTOMS and SEVERITY not time. Of course there are those lucky ones who only need to wait 12 hours but in knowing many people through my past experience at the suboxone clinic, friends doing it on their own, and my own personal experience I'd wait until your score is a 26. My girlfriend told me she waited 32 hours before taking it and she went into full withdrawals from suboxone. A lot depends on the quality. Some types of dope only keep you well for 6 hours and others can keep you well enough 16-24 hours so I can understand why there is so much variation.

    This time Around JB waited over 36 hours. She was uncomfortable at around 16 hours but her symptoms weren't scoring high enough on COWS so she waited and she's glad she did. Anyone whose been through precipitated withdrawals never wants to experience it again. Good luck, remember you only need to do it right once so why chance it.
     
  13. 604weedbag

    604weedbag Silver Member

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    on topic of cows scale I think it was 10 or higher than your safe to take suboxone without risk of precp. wd's

    I'd suggest hitting up a suboxone forum to more info.
     
  14. labcoatbud

    labcoatbud Newbie

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    I started on 2 8mg strips of subs Tuesday am, after waiting 16 hours and went into horrid precipitated withdrawals.... My dr upped me to 3 strips/day when I called & said I couldn't keep a sip of anything down... I was still SO Ill that I have in and used at 5pm today- now my Dr wants me to come in at 10:45am to dose me in the office & see what happens... I'm so scared to go back into precip wds, but if I admit slipping up (just to be able to keep in fluids & avoid going to the ER as the Dr suggested) I could be kicked out of the program & I can't let that happen :( I hope I didn't just ruin everything.... I have a stomach condition so hopefully they'll chalk it up to that reason if I get sick in their office? I'm so upset with myself, but the hospital near where I live treats addicts like diseases, not people... And I've gone there during a detox a few years ago so I know they would have even less sympathy this time :/ Could I be ok? I'm so worried :/
     
  15. 604weedbag

    604weedbag Silver Member

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    this makes me so damn happy that I found the doctor that I did... crappy part she isnt taking on new clients as a family doctor otherwise I'd totally choose her... Does everything I ask for and more, and she still treats me like a normal person even though I told her my IV heroin addiction cause I had to get my abcesses looked at finally now they did a test and found out one turned into a staph MRSA which is fucking scary considering I only use brand new works for thing I mean I dont even use the same cooker twice!! let alone filter or syringe I use everything thats new and indiv sealed and sterile water ampules..


    but yeaaaah I wouldn't wait less than 24 hrs and there should be NO reason your at 24 mg/daythat is WAY to much fucking sub man..... I was using half gram at as a dose (nasally) of some HIGH potency heroin, like it was no joke extremely good/strong sometimes I'd accidently snort a little to much and just puke my guts out and this was from half a point too much and I started at 12mg for the induction, then week later I was able to get down to 8mg and weeks later 4 mg and so on until I got down to 2mg I had kept stockpiling all the extra suboxone I had 180 tablets stockpiled when I came off suboxone lol
     
  16. gman2858

    gman2858 Silver Member

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    To add to that I think a lot of these guys going into precipitation wds might be doing dope with fentanyl in it. Fent has like a 36 hour time release. That would certainly explain that. A lot of dope is cut with it. Cost affective and does the job