First Dose of Suboxone - How Long Must You Wait After a Dose of Methadone, Oxycontin, Heroin, Oxycodone...?
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Buprenorphine works great and it can help you overcome an addiction while avoiding the pains of withdrawal. But you have to listen to your doctor and you have to wait until you're feeeling a little bit sick before taking that first dose. Here's why...
Suboxone is a partial opiate type medication that can be used as a substitute for drugs of abuse, like heroin, oxycontin, Percocet or other opiate drugs. By substituting onto buprenorphine (the active ingredient in suboxone) a physically dependent (addicted) person can switch to Suboxone, and if it is taken correctly, they will feel little or no withdrawal pain.
Suboxone works very similarly to methadone (but has several advantages over methadone) unlike methadone though, if Suboxone is taken incorrectly, or if it is abused, it can cause strong and even immediate symptoms of opiate withdrawal and detox.
Before you take a first dosage of Suboxone, you will have to abstain for a while from all other opiates, and you will have to be feeling the beginnings of withdrawal pain. If you do not abstain, or if you take Suboxone too soon after taking another opiate, you can enter into precipitated withdrawal (an immediate symptom of detox pains).
Why does taking Suboxone too soon after another opiate cause withdrawal pains?
Suboxone is said to have high affinity but low activity on the opiate type receptors in the brain (mu receptors).
High affinity means that it is very able to fill and activate the opiate receptors in the brain, and since it has a higher affinity for these receptors than other opiates (like heroin or methadone) if you take suboxone and another opiate together - it will even bump these other drugs out and fill the receptors instead.
Suboxone has a low activity at these receptors though. Although it will bump out other drugs, it cannot activate these receptors in the brain as strongly.
So…
If you take a drug like heroin, and then too soon after take suboxone, the suboxone will kick out the heroin, but it won’t be able to turn the opiate receptors on as well as the heroin. The brain (and body) experiences an immediate drop in the effects of the opiates. This drop in opiate levels of activation causes an immediate sensation of withdrawal.
When your doctor advises you to abstain from opiates for a certain period prior to taking a dose of Suboxone, it is very much in your best interest to listen and follow instructions. If you try to take another opiate drug too soon before your scheduled first dose of Suboxone, you will be making things much harder on yourself!
How long do you have to wait?
Your doctor will advise you on how long you will need to wait prior to taking a first dosage of Suboxone. In general, you will need to wait at least until you are feeling the initial sensations of withdrawal before you can safely take your first induction dosage.
The waiting times will vary depending on the drug of abuse. As a rough guideline, you can expect to have to abstain from:
- Heroin – 12- 24 hours
- Percocet, Vicodin, or Oxycodone – 12-24 hours
- Crushed Oxycontin – 12 – 24 hours
- Oxycontin 24 hours +
- Methadone (must be at low dose) 36 hours (at least)
Source *National Alliance of Advocates for Buprenorphine Treatment http://www.naabt.org/faq_answers.cfm#21
It is in your best interest to follow the advice and instructions of your doctor, and wait until you are truly in the early stages of withdrawal prior to taking a first dosage of Suboxone. After you take Suboxone under supervision in the doctor's office, you can expect to feel much better within a very short time.
Suboxone can also create this precipitated withdrawal if abused by injection, due to the naloxone contained within.
COWS Test
- Clinical Opiate Withdrawal Score (COWS Test)
Your doctor will most likely evaluate your symptoms and the severity of your withdrawal symptoms using this clinical test chart.
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Comments
I think this is great info. and anyone looking to make the switch to suboxone should read this.
Hello,
When would it be safe to start taking suboxone. I take Oxycontin at about 300 mg daily. After a 10-12 hour wait would it be alright to do the normal starting dose of 2 mg and so on.
Any and all help at all would be greatly appreciated.
Many Thanks, rusticradio
This is the most imformative piece I've found after two days of searching. I don't have to wait in this misery as long as I expected!
great page, i found more information on here than anywere else. I have been taking hydomorphone and oxymorphone for the longest time and just started suboxone 2mnths ago and its working great and after 6-9 hrs of taking it i can still take my reg. meds for pain and they still work for me
I waited 14 hours once to take Soboxone coming off oxycotone and got deathly ill and weny into complete w/drawls. How long do you hqve to wait when coming off Heroine? I cant ever have that happen to me. Words cannot describe what I went thru.
I've been reading alot of what you guys are saying..I am 23 years old, I started doing Oxys at 16 or 17, 2-4 80's daily, when I was 20 I tried heroin(shootin it), opiets are what allowed me to live. once i was hooked, by like 17 years old, i couldnt function in society w/o bein high. i'd get really uncomfortable around people and start sweating, even if i had just gotten out of rehab and wasn't sick. I've tried everything to get sober. I was on the methadone program, 120 mgs for 2 years, let me tell you, unless you plan to be on methadone your whole life, its not the answer. its the hardest thing in the world to kick..but it can be done. I was kicked out of my house and moved to a different state and did it cold turkey. I was sick ( 10x's worse then anything else i ever felt ) for atleast 60 days. no joke. Then I relapsed..I went on suboxone, 24 mgs daily, I did that for 7 months...then i was hooked on that, i was scared to not take it. I had to go to rehab to kick the subs, well they couldnt detox with suboxone obviously, so i was not having it, and i left after 3 days. I came home n used that day, within the hour. then about 6 months ago, after being beat down enough, i checked into rehab again. i had a heroin habit, i was detoxed with subs, 8 mgs daily for 3 days. i stayed for 35 days. i got out, got to a meeting ( AA-NA ) THAT NIGHT, and remained clean and feeling GREAT ( no lie, i felt normal, confident, i didnt feel that uncomfortable feeling at all ) for about 5 months. I was doing great. I got back together with my x girlfriend who i love, she relapsed, soon after i relapsed. but i want u to know, if u wanna get clean, go inpatient, and have an open mind. a maintence program is only for you if you are not ready to live life free of drugs. only you know that. good luck, and wish me luck on my road back to recovery.
I have been on and off of everything from herion to oxys. I have been clean for about a year now. I have been on suboxone the entire time. The problem is that I abuse the subs just like everything else. Every month when I fill them, they only last for like 7-10 days. This last little bit without the subs, I hooked up a few perk 10s and a couple valium. The problem is that I just filled my subs and am afraid to take them because I have been taking the perks for the last 3 days. Not real sure what to do, I am going to try to hold on for another day or two and then start my suboxone...
I have been addicted to oxycontin since September of 2008 and just yesterday i began taking suboxone. before yesterday i had been doing 2-3 80mg pills a day but yesterday i woke up at 10 am snorted 5mgs and snorted 3mg or so more at 1230 and 10 more at 245 basically just to keep the aches and chills away until i could take a suboxone. i took 6mg of suboxone around 615 or 630 pm that same day and it got rid of all withdrawal symptoms except a little leg and lower back pain, but surprisingly 4 200mg ibuprofen did the job and i felt as tho i had done 20 mgs of oxy it was amazing! suboxone made me realize theres an alternative to either being on oxy or feeling like death.
Great info on suboxone! I do have some more info on suboxone that I will be sharing in the near future. I need a little time to get it together before I can share. Thanks
So I've gone through suboxone maintenance for slamming heroin several times and waited a little over 24hrs and it worked great. Once for methadone which I was in withdrawls for three days before I could take my first dose. However, now I'm detoxing again though for the first time I'm coming off from smoking H instead of slamming it, and was curious about the time I had to wait. I've had a few friends go through clinics that had them wait 12hrs from their last dose, but I'm terrified of taking it early. I took it 19hrs after slamming once and instantly got 10x worse. Is there really that much of a difference in the time you have to wait between smoking and shooting? I'd like to take it as soon as possible to put my family through as little hell as possible. I'd rather not spend the latter 12hrs sweating sneezing and flopping all around their living room floor like a pitiful fish. ya dig?
thanks for all the info guys its been a great help. im just starting on the suboxone today after smoking heroin for only 6 months it not been a long time but sufferin the withdrawls bad. any way thanks again and good luck to u all
so was doin 40mg dones for about 2 years now and got some suboxone and quit for 3 days and tried to take first dose and got real sick. so what i did was took 50mg of dones because i couldnt take bein sick and it helped a little surprisingly. then i got some short acting got some h and it will be another 72 hrs since i took my last dose of dones after takin suboxone that day first and am hopin that tomorro i can start first dose and not get sick so altogether in the last six days have only takin 50 mg. n e one try that and if so did it work? this is my first time postin
I have done Suboxone therapy to kick my year long methadone habit. I took 80mg a day. I just want everyone to know how important it is to wait until you take your first dose of Suboxone. YOU WILL become very ill. I have even known people to end up in the hospital. It's no good. Methadone was reccommended to wait for 36 hours. They say the longer you can hold on and wait...even though withdraw sucks, the better your Suboxone will work. I waited almost six days and as soon as I took my first dose I felt completely normal. Absolutely amazing stuff. I am done with my treatment now and I had to quit cold turkey because it was so expensive. I had NO withdraw off of the suboxone. My doc said I was lucky but I had gotten down to such a low dose anyway. I originally detoxed off my methadone because it was too strong for me. I took it for chronic pain. I didn't like it, so I had to detox off of it and start over with my pain management. I am taking opiates again but nothing nearly as strong and my tolerance is much lower. Suboxone is an amazing drug and a life saver for so many of us. I know I had no problem saying, "sure I'll quit taking the methadone, but I AM NOT going through the withdraws." Suboxone helped me in so many ways otherwise I would still be taking the Methadone. If anyone has questions, please feel free to email me at nr_douglas21@yahoo.com. Good luck to you all.
Q: I have been taking Oc 80s and Roc 30 for 2 years now but they just arent doing it for me anymore it basically just puts me to sleep and makes me feel normal during the day. So Im tired of not getting any affects off of what im taking and im def not gonna start doing H so I think the time has come to give it a rest for a little so im gonna start subs what i want to know is how long should i wait to take me first dose and how much should i take ? another Q: I have is I go see my doc very soon and i know im gonna prob start doing them again but how long after taking the sub is it safe to take an opiate im not looking to waste anything or get sick so any info would be much appreciated thanx
I just took a quarter of a sub right now, and I feel normal with a little high. I've been taken all sorts of opiates for the last year on and off, but mainly norc's. Subs are good, but one thing everyone fails to mention is that you will get mild w/d's comin off subs also. That's what's made me relapse 4 times now, because I thought it's just goin to get bad again. I guess what I'm tryin to say is stick it out after the sub's...I heard it's a mild w/d for a few days nd then u'll be fine. This drug is very much mentally addictive as it is physically, so keep your mind off it as much as you can. Shit, I even have dreams about takin this shit nd I don't need a dream dictionary to tell me what that means. Good luck to all. This shit is a good way to get youself killed so stop it until your like 90years old nd go out like a G then.
wow hearing all of this is surprising. i have to say. me and my boyfriend of a year got hooked on snorting roxys over the last few months. i am so sick of it i am always broke and we cant pay our bills we barely scrap by. well not anymore i found 4 suboxone and im done. i just dont know if he is he was the worse hed lie to me about takin them get 100 dollars in fronts it almost ruined us. so yesterday was our last day and today is a new day we are gonna get clean.
For over 5 yrs now, I've been on a pretty high dose of opiates every single day (I'm a 30 yr old female, btw). I progressed from sniffing and popping Oxy's to shooting heroin over that time period. A few wks ago, I chose to use Suboxone to kick my 2g a day heroin habit. Before taking my first dose of Suboxone, I waited about 24 hrs and was in complete withdrawals. A few friends and I have used Suboxone to kick opiates a number of different times and I've learned you should not ONLY judge when to take your first Suboxone dose based on the number of hours that pass since your last opiate use (eg; 24hrs usually), but you should also use the strength of your opiate withdrawal symptoms to determine if you're body is ready to accept Suboxone. In other words, you HAVE to wait to take your first Suboxone dose until you are in complete withdrawals from opiates. I tell people to wait until they start consistently yawning, sneezing, OR their nose is running (you don't need all three symptoms to occur; most people are plagued differently during withdrawal. For me, when I start the heroin sneezes, I know I'm ready for my first dose of Suboxone ). Once you begin feeling full withdrawals, you can take Suboxone immediately and I guarantee you will not experience precipitated withdrawals. This advice is based on at least 15 personal experiences with myself and friends. I've only had 1 friend experience precipitated withdrawals from Suboxone and he DID NOT listen to my advice, but rather chose to take Suboxone at the first hint of withdrawal symptoms. Bad decision.
there is a new but old opiate, but not advertised as so, ultram, i've tried almost every other drug and kicked myself, but with this one,wow, up for 4-5 days straight, restless legs, irritable, sweaty, hot flashes, the runs, terrible, dont let docs talk u into this crap.
I have been down all the roads posted previous here. Oxy, perc's, vic's, heroin, you name it. I am the guy my friends call to identify a generic pill cause i know all the codes. I have used sub's many a time to come off of opiates, and not sayin you should, but i have taken sub's right after oxy's, bangin heroin, all of it, and never had anything bad happen.. I have noticed though that sub's start working better in a day or two, so maybe something to it. Take it from me... Use Sub's to come off of opiates. But do not stay there! Taper down, till your taking a speck of sub's, and then quit. No more than five days. If you do, you will withdraw from sub's just as hard. If you taper, withdawls are mild and you can deal with it. I been doin this god awful dance for 9 yrs.. In the end it all is the same. From vicodin, to heroin, to suboxone. An opiate is an opiate. Sub's however do not get you high, (some say they did the first time) But it wont for long. So in my opinion is the reason why you can wean down with it. I have tried to ween with other drugs and unless you have an amazing will power, this will not work. The reason is you know if you take more of the vic's, perk's heroin, whatever your flavor is, you know it will get you high. Sub's will not, and just keep you from being dope sick. I have many tip's and tricks to make it a lil easier if you want my help. leave me your email and i will help anyone. Im not a doctor, or a drug specialist. Im an addict.. I know what your going through from first hand experience. And alot of study, and trial and error. In the end, you decide to quit or not. I still fight with it. The relapse rate for opiate users is around 90%. So if you do relapse, dont just say fuck it! Its gonna happen, and you have to keep movin! Drew
Drew: I would like to talk to you about how I should use subs to get off methadone. I know I will need to wait at least 72 hours or more...but I am wondering how to use the subs short-term so that I can avoid a long withdrawal from the actual subs. I need to be drug free in order to get my nursing license reinstated. Methadone and subs are not allowed. I take 22.5 mg of methadone daily. (10mg in the morning and 12.5mg in the evening) I have tapered down from 80mg a day over the past few months. Please email me at melanievictor@gmail.com Thank You! I would be so grateful. I didn't see an email for you.
i have chronic pain in my ankle from acute septic necrosis of the tallus. i've been on opiates for 6 years, and am now at 3 30mg imm rel oxys/day.....however, whenever my tolerance gets high and i start taking 4-5 per day, i detox w/ suboxone to lower tolerance/risk, etc.
i'm a pain management patient, and it's "management" not a bottom less well. unfortunately it's hard to get both drugs and have a doctor who will work with you on your chronic pain, and it's also expensive as all get out.
regardless, i can spend 10 days on suboxone and go from a 120mg oxy/day down to 60mg oxy/day, and it usually takes at least 2 months before I start to have tolerance issues again, so i do this song and dance of detoxing for anywhere from 7 days (shortest) to 30 days (longest) about 5x/year.
i refuse to seek opiates from dealers on the streets. fuck those misery pushers. if you're going to get involved with high dose opiate useage whether it be recreationally or for chronic pain, expect to spend time off of opiates so you dont build a tolerance where you're popping 10 roxy's/day....just to feel....normal.....and if you want to feel "good".....you have to rail 3 30mg's.......which is a waste of the med in the long term.
suboxone is a great tool for keeping your tolerance low, but you have to accept the fact that detoxing and not being on opiates every day of your life is a must if you plan on not living a life that is centered around opiate use.
-Tex
I've been doin this opiate thing way too long to. I was given massive amounts of subox for almost 2yrs, what a mistake that was. And, of course was never warned about the withdrawl. So, when I just could pay for it anymore, I stopped and in 3 days I was dying!! So, knew where I could easily grab some roxy and am screwed again! I am going to try the subox thing one more time, short term. Lots of good info so far. DREW-I would like any pointers you have too--sfysunshine@aol.com. Thanks and God bless.
i have been slamming 8-10 bags of heroin daily for about a month and a half. I know I have to taper down off the heroin so that I can start on the suboxone. I dont have the luxuary of tapering down slowly so i am going to try it like this. please tell me what anyone thinks. Tomorrow i will do only 6 bags, then 4 bags then 2 bags and finally 1 bag. I am doing this in 4 days. I plan on taking the 1 bag at 06:00am and then waiting 32 hours god willing i can do it before taking my first dose of soboxone. I am planning on taking a half of stick of xanas to help me sleep off most of the withdrawl symtoms. Does anyone think I am doing this the right way or am I wrong. I have tapered down before from heroin but I was using about 6-8 bags and I tapered off in about 7 days before starting the soboxone. Pleas if anyone can help me with this it will be greatly appreciated. Thank You.
i have been slamming 8-10 bags of heroin daily for about a month and a half. I know I have to taper down off the heroin so that I can start on the suboxone. I dont have the luxuary of tapering down slowly so i am going to try it like this. please tell me what anyone thinks. Tomorrow i will do only 6 bags, then 4 bags then 2 bags and finally 1 bag. I am doing this in 4 days. I plan on taking the 1 bag at 06:00am and then waiting 32 hours god willing i can do it before taking my first dose of soboxone. I am planning on taking a half of stick of xanas to help me sleep off most of the withdrawl symtoms. Does anyone think I am doing this the right way or am I wrong. I have tapered down before from heroin but I was using about 6-8 bags and I tapered off in about 7 days before starting the soboxone. Pleas if anyone can help me with this it will be greatly appreciated. Thank You. you can email me at willie9433@optonline.net
I was born with a very rare bone disease called SCFE where your hips become displaced and they are no longer in the sockets"" if you will, with this being said they are only held together by my muscles which luckily are very large. with this being said it is very easy for me to get large amounts of pain killers, i have gone through several surgieries with the outcome only being worst i am 28 and have been in pain since i was 10 i started taking opiates at the age of 22 i found that they worked great for all kinds of things besides pain. well with all that being said it is not easy coming off these things and it became a problem. so i turned to subs and they helped i decided i wanted to live opiate free and i never abuse the subs, honestly pointless after a while the less you take the better you actually feel. The down side: i had yet another surgery and the asshole doctor thought it be best to cut half of my hip off, now i am in the worst pain in my life i have scars all over my body and the opiates barley help and i feel it is because of the suboxone. it actually made my tolerance higher. if you look at an opiate chart the active ingredient in the boxes are about 200x stronger then percs and in my latest time takin the sobos i took it early and went into the worst widthdrawl i have ever had. many doctors have told me that i will be on pain pill forever unless i find other ways to cope, i have and do goto spas acupuncture and other types of hollistic healing and yes you do feel better but it still fuckin hurts. i dont exactly have a point and i am just sharing my story and i am planing on taking my 30's again and going on the same old story.
sometimes you feel like why me. it honestly makes me feel so depressed that i cant even work or do anything, i always am going on vacation"" to fill my scripts early and i give my doctors 500 dollar watches just to keep them happy
all in all no one here gets out alive so why live in pain for all your days just do what you do and dont think of yourself as a junkie because you need pills to cope thats the american way. this is all food for thought
thanks for listening
Herion ruined my life, and ever since I started buying Subs, they just help me stay in my addiction. I go back and forth with heroin and subs on the daily, however I usually start out my day w. 4-8mg of sub and move on to a 10th or two later in the day...today I started my day with tar.. and I'm trippin cuz I got some subs...startin to feel achy and shit but I don't want to feel worse...now I'm wonderin do I get some more tar or..do I wait it out...? Damn I should be worrying about school and the holidays commin uo not this bullshit....sometimes I think it would be better to just put a bullet in my head and start over in another life....dueces
Resource Information on Buprenorphine and Treatment
- Barnstable District CourtCape Cod Times2 days ago
In court Friday:
- Heroin use has sharply increased in Capital DistrictThe Troy Record2 days ago
ALBANY — The number of people seeking treatment locally for addiction to heroin and other opiates has increased rapidly in recent years, according to St. Peter’s Addiction Recovery Center and Albany County District Attorney David Soares.
- Lake County woman fights over her right to medicineKPAX Missoula2 days ago
A court date has not yet been scheduled in a federal lawsuit filed by a Lake County woman who says she was denied critical medicine while being held in the county jail.
Dan says:
15 months ago
This is a great article. aktho very short, the author has been able to not only clearly answer the question, but explain why suboxone works the way it does. it is also very easy for some one that doesnt understand lots of chemical terms to understand.
i give it 5 stars