Posted by steveb on September 8, 2004, at 6:50:02
In reply to Re: Questions about naltrexone; buprenorphine » steveb, posted by michael on September 7, 2004, at 17:13:47
Hi there,
I live in Switzerland and Subutex (buprenorphine) has been used here for many years to wean folks off heroin. It's preferred over other replacement therapies because of its long half-life (approx 24 hrs, so one dose a day) and because it can't be (ab)used intra-venously - pill turns granular when you try to melt it.
Subutex is used in 2 ways: 1) Withdrawal therapy: for folks getting off heroin, Subutex is administered in decreasing amounts over 2 weeks or so to alleviate heroin withdrawal symptoms; 2-3 weeks is pretty much the max before the body gets accustomed to the bup; and 2) Replacement therapy: continuous use over several weeks/months/years for long-term addicts. Here one illegal, expensive and "dirty" opiate is replaced by a cleaner and legal opioid, with full dependence & tolerance being passed from one drug to the other.
Although buprenorphine is classed as a "partial-agonist" - which means you don't quite get the same rush & "nodding-off" effect you'd get on most opiates, it is still a very powerful opioid, thus highly psychologically and physically addictive.
I agree that the "mileage migh vary" adage applies to most psycho-active drugs, particularly anti-dep or anti-anxiety drugs. But it's difficult to suggest that everyone's experience might be different on an opiate/opioid like Subutex. It's like saying everyone's experience may be different on heroin, oxycontin or morphine. Physical addiction is inevitable with all these drugs, as anyone who has ever used them can attest, and from my experience, withdrawal from Subutex is in NO WAY easier than withdrawal from any opiates - heroin, morphine, etc.
I hate knocking something as potentially useful as buprenorphine, and maybe opiate/opioid therapy is indeed the only solution for a small class of depressed folks. But if you go down this route do so with the knowledge that physical dependence will be your companion.
That is why my remaining Subutex is still in the bathroom closet, untouched now for over 12 months, and counting...
Be safe.
> Hi -
>
> I admit my knowledge on this subject/med is fairly limited - probably comes mostly from Elizabeth, who used to post here, and was pretty well educated/informed... and was on Bup for a period of time. Fwiw, I thought it was supposed to be a less "powerful" opioid, and was sometimes used to wean people from other stronger ones - of course, I may be Entirely wrong on that.
>
> My only other thought/comment is the standard ymmv - different people react differently to the same drug... Amphetamines have a bad reputation, but I take them almost daily - same dose for a few years now, and sometimes abstain for a few days at a time (w/o any withdrawal/craving/etc.).
>
> Others have had major problems getting off of effexor, which I was able to get off of easily & quickly - within a week, two at the most...
>
> In any case, I'm not advocating bup's use, & neither do I mean to discount your experience with it. Just trying to learn, myself... and saying that while your experience is probably more typical, others might find Bup to be just the med they need.
>
> michael
>
>
> > As per my post above, I've tried buprenorphine several times, and despite the fact that it was the only drug that ever offered me full remission from depression and GAD, I would STRONGLY recommend you stay away from it. It is a powerful opioid with all it's problems: side-effects, dependence, tolerance, withdrawal. I've lived through these enough times not to want to try again, despite the great feeling you get while on the drug.
> >
> > All the best
> >
>
poster:steveb
thread:386509
URL: http://www.dr-bob.org/babble/20040904/msgs/387948.html