Citation: providedFor. "Some Facts: An Experience with Buprenorphine (exp26845)". Erowid.org. Feb 11, 2004. erowid.org/exp/26845
Because opiate use can lead to significant tolerance (requiring higher doses for the same effects), the dose used by a first time user is significantly smaller than that used by a regular user. It can be extremely dangerous to choose ones dose on the basis of the amount taken by someone else. Overdoses of opiates can be fatal.]
Since there is next to no information on this site about this substance I've decided to submit a report as I have been prescribed Buprenorphine as a substitue for illicit narcotics.
Buprenorphine is a partial opiate-agonist, this is different to full opiate agonists (heroin, morphine, methadone etc) in that it also has some of the properties of opiate antagonists such as naltrexone (a substance that stops opiates binding to the receptors in your brain, used in overdoes etc).
For this reason, is is prescribed to addicts as a substitute to heroin. The theory being, that it gives an addict a high that satisfies them but also stops any street narcotics that they may take from working.
Before treatment commences, it is recommended that the patient already be withdrawing. The main reason for this is due to the fact that buprenorphine has such a high affinity for the opiate receptors. If a patient has another opiate in their system and then has a dose of buprenorphine, it competes for the receptors, and as it has a higher affinity than heroin it will win and it rapidly displace the heroin, precipitating acute withdrawals (very unpleasant).
Buprenorphine IS still addictive (after about 10 - 14 days daily use). Although the withdrawrals are much more mild. Some people use buprenorphine in the short term to break their heroin addiction. This is done as follows
1) patient waits till early withdrawals
2) patient takes buprenorphine for 10 days
3) patient tapers off the buprenorphine, with little or no withdrawrals. Thus the bup has prevented heroin withdrawrals, but the patient stops taking the bup before they are addicted to it. Thus, withrwarals are avoided and they can then get support (counceling etc) to stay off without having to worry about withdrawals.
However, most seem to use is as a long term substitute.
The dose given in the erowid notes puts 600µg as being equivalent to 10mg of morphine. My dose is 16mg (sublingual), which isn't a particulaly large dose. I started on 4mg which was increased to 16mg over several days. Some people at the clinic I attend take 22mg, I dont know how high it goes, that's just the highest I've heard.
The Buprenorphine I take comes in 2mg tablets which are crushed by the clinic and the powder is taken sublingually (dissloved under the tongue). The effects of increased doses plauteau quite quickly, so taking more after a certain amount won't give a greater level of intoxication, it will just prolong the effects.
The effects are pretty much the same as heroin and other opiates, but not as intense. Buprenorphine also has some effects that are different from heroin. Many patients (including me) report that it makes them a bit speedy or buzzy... Chatty and full of energy. Some peope find it hard to sleep while taking it. I had difficulty the first couple of nights but have no problems now.
Buprenorphine is extreemly long lasting, some patients can comfortably dose only every 3 days (as opposed to heroin which lasts 4 - 8 hours). For me the full effects last about 10 hours, but I am comfortable for 24 hours (after this I do not know, I've never skipped a dose)
Effects can be felt after about 20 mins, and peak at about 4 - 6 hours.
As with all substances, there are side effects. The first day of treatment I was nauseus, but as with all opiate nausea, this is relieved by lying down. I threw up a few times when I had to get up for whatever reason. I also had a headache for a few days.
Constipation is another side effect that is common to all opiates for some people.
BUPRENORPHINE AND OTHER DRUGS:
There are several drugs that should NEVER be taken with buprenorphine, I was warned very strongly about a few in particular.
-Benzodiazapines or Barbituates should NOT be taken when taking
Buprenorphine. Apparently this can lead to death (porbably as they are both depressants.)
-Lage amounts of alcohol apparently can also cause very serious problems. From what I understood it is only excessive amounts. So yes, drinking till you pass out could well be the end of you. Just take it easy on the piss while on bup.
*note* This is not a complete list, just the ones I know. Please do your research and be careful.
It seems to be okay to smoke marijuana while taking bup (the doc said so ;)
Overdose on buprenorphine alone is uncommon, however it is possible to overdose on another opiate if the buprenorphine is wearing off. I'll try and explain why, Buprenorphine has a high affinity for opiate receptors, and also blocks the action of other opiates. If one was to take heroin whilst on bup, they would not feel much at all as the heroin is prevented from binding to opioid receptors, and perhaps one would use more and more. As the bup wears off it's affinity for opioid receptors drops. As soon as its 'binding power' drops below that of heroin, all the heroin will instantaneously displace the buprenorphine and bind to the receptors. As there is an abnormaly large amount in the system, the patient will overdose.
Buprenorphine seems to be a much better option than methadone, and I've little doubt that before long methadone will be much less common. This substance has given great results for people trying to control their addictions (including me) I enjoy the high and it lasts and lasts. Thumbs up.
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