subutex without methadone?

Discussion in 'Opiate & Opioid addiction' started by hyperchronic, Oct 31, 2004.

  1. hyperchronic

    hyperchronic Newbie

    Reputation Points:
    Oct 31, 2004
    hi there, i need some advice. i have been on heroin for the past two or so years and have recently been trying to get off it. after a handful of attempts at cold turkey and failing i am now ready to get some professional help. can someone tell me, is it possible to go straight onto subutex without going through the whole methadone process? i ask this because i have heard some very horrific stories about anyone i know who has tried methadone programs.

    although my habit is bad enough for me togo back to itevery time i have cold turkeyed, my body does not go through extreme pains like i have known other people to go through which is why i feel i dont need to go on meth.although i have been a daily user for quite some time now i have never been a very heavy user and my body is still fairly healthy and recovers fairly well. so is it possible for me to ask to be put on a subutex program rather than having to go on meth first?

    any help would be greatly appreciated as i really do want to beat this once and for all!!!
  2. Silver Fox

    Silver Fox Silver Member

    Reputation Points:
    Oct 9, 2004
    from Australia
    Yes, it IS possible to go from Heroin straight to Subutex. However, what you need to consider is Why do you want to do this. Do you want to 'stabilise' on Subutex, or do you want to use Subutex as a 'step-down' method to detox. Either, or both, are possible.

    Below, I have outlined briefly how Subutex works; then I have outlined the priinciples of how one would transfer from Heroin directly to Subutex. Subutex can then be used as a 'maintenance therapy', in a similar way to methadone maintenance; or as an effective and relatively stress-free means of detox, simply by reducing the dose incrementally. In detox-ing, some people find lofexidine helpful in reducing withdrawal side-effects. I would recommend seeking profesional help, as then the Subutex (+/- lofexidine, +/- adjunctive medications) would be prescribed, and a detox regime could be taylored to your needs. However, it is certainly possible to do it on your own.

    How Subutex works:
    Subutex (generic name buprenorphine)is a partial agonist/antagonist at the opiate receptor. That means, it attaches to the same receptor site in the brain and nervous system as does Heroin (and other opiates - morphine, DHC, DF's, codeine. However, there are some important differences in the way that Subutex affects the body, as opposed to Heroin:
    1) It is a Partial antagonist. That means, it only has some of the affects that Heroin does. It does not give a great high, but it can make you feel good, and it will certainly stave off withdrawals.
    Subutex does not have such a marked effect on the circulatory and respiratory system as Heroin does. Heroin causes heart-rate and breathing rate to slow down, even to stop, which is what happens in overdose. An interesting characteristic of Subutex is that even at higher doses, it does not tend to depress the heart rate or breathing in the same way.

    2) It is a partial Antagonist. This means that Subutex will block the effects of other opiates and you will not get a high.

    3) Subutex has a very high affinity for the opiate receptor, more so than Heroin. What this means is that Subutex will preferentially bind to the opiate receptor. If there is any Heroin in your system and you take Subutex, the Subutex will displace the Heroin from the opiate receptors in your body, and you will be almost instantly precipitated into withdrawal. Furthermore, Subutex will remain active at the receptor for up to 72 hours. Any further Heroin (or other opiates) that you try to use on top, will not work.

    The way that people are induced onto Subutex, after using Heroin, methadone, or other opiates, is to cease using for 48hrs. This means that at 48hrs you would be in active withdrawal. This is the time that Subutex is introduced. The Subutex will attach to the opiate receptor and lessen the withdrawal symptoms. The dose can then be slowly increased over a few days in order to stop withdrawals and stabilise for maintenance therapy, (eg. as an alternative to methadone maintenance); this is often a good way to go, as it gives you time to get the rest of your life together - look after your health, sort out your finances, get a job if you don't have one, get away from the using crowd, put a support network into place...before considering detoxing completely.
    Normally, when starting on Subutex with a view to detox-ing straight away, again - you would increase the dose gradually over a few days to a point where you felt comfortable - no withdrawal symptoms, and then start decreasing slowly - it can be done over 10-14 days fairly comfortably, or over a longer period of time if necessary.

    This is an outline of how it is done; I hope it is useful to you.
  3. adzket

    adzket R.I.P. Gold Member

    Reputation Points:
    Mar 10, 2005
    37 y/o from U.K.
    you should be able to get subutext from you g.p or drug treatment sevice and you can use it without meth but subutext will make you feel compleatly staight and normall if your ready for this go head and use subutext if not i strongly recomend methidone