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PostPosted: Sat Jul 31, 2010 9:13 am 
Well, i know this can be a huge problem for people if you dont get the proper absorption. I have been on suboxone for 14 months and i switched to subutex this past months making a total of 15 months. I switched to subutex bc i found out that i was allergic to the artificial sweetner in suboxone(Acesulfame K sweetner). Well, the only problem i ran into with the switch was the subutex tablets were hard as a rock compared to suboxone. They seemed almost impossible to absorb before i had a mouth full of saliva. Well, here's a technique i figured out. First let me say, the allergic reaction i was getting to suboxone was giving me canker sores and tongue blisters in my mouth. Well, i was told too rinse my mouth out with warm salt water, then spit it out a couple times a day. Anyways, i havent had any more sores since i switched. However, i remembered that when i would rinse my mouth out with warm salt water, it would dry my mouth out. Well, a few days ago i gave it a try. I swished warm salt water around in my mouth about 5 to 10 minutes before i put the tablet under my tongue. Oh my goodness, you would not believe the difference in absorption. Hardly any saliva builds up and something about the salt makes the tablet absorb so good. Its like the difference in night and day. Now, i know this technique may sound crazy but all i can say too you is, try it out and i would almost bet you that your absorption will increase dramatically. Im no doctor or profesional. Im only speaking from my own experience. I now swish warm salt water in my mouth before every dose. I really hope you all will give it a try and possibly let me know what you think. I really think you will be quite surprised at the difference. Well, i hope too hear from everybody. ~PEACE~


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PostPosted: Sat Jul 31, 2010 10:10 am 
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Thanks for sharing, lifesaver. I think it's great that you found a way to quicken the absorption, especially if the subutex takes longer than suboxone did for you. I can't say I'll try your method, but that's only because rinsing with salt water makes me gag! I know, I'm such a child.

I would love to hear how it works for others, too. And Dr. Junig - do you have an opinion with regard to this method?

Thanks again, livesaver. I'm glad it's working out well for you. Totally cool.....

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PostPosted: Sat Jul 31, 2010 5:15 pm 
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I'm reaching deep back into organic chem days... but I have an idea about why this might be working. I am dimly remembering the phenomenon of ‘salting out’, where the addition of sodium chloride to a polar solution reduces the solubility of nonpolar substances in that solution. As I think about it, I think this is probably what is happening. Buprenorphine is a lipid-soluble molecule that dissolves in water poorly. When you have a lipid (i.e. oil-based) chemical dissolved in a polar solution like water, the addition of sodium and chloride ions reduces the lipid’s solubility, forcing it out of solution. I remember using this technique to extract oils from plant or other materials... we would boil the material containing the oils in water, and then mix that water with a lipid-soluble liquid, for example ether. The addition of salt (sodium choloride) to the mixture forced the oils to leave the water, and move into the lipid substance. We could then let the mixture settle, and the two layers would separate, one on top of the other. The lipid layer could then be poured off, and after the ether evaporated the extracted oils were left behind.

If this is indeed what is happening, the buprenorphine is acting like the oils extracted in my experiment. The presence of sodium chloride ions dissolved in the saliva pushes the buprenorphine into the lipid layer-- which is in this case the cell membranes lining the oral cavity, called 'oral mucosa.'

As most of you know, I recommend a way of dosing that makes use of all of the surface area in the mouth-- i.e. getting the tablet dissolved and spreading it around inside the mouth, over all of the surfaces. I would expect the 'salting out' phenomenon to work even more effectively doing it that way, as all of the surfaces would offer lipid surfaces for buprenorphine to enter.

Very interesting... thanks for sharing!


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PostPosted: Sat Jul 31, 2010 7:57 pm 
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I am definitely going to try this as absortion is so important with this medicine. My sub doc clearly believes we do not get the amount we expect and I am interested in trying this and reporting to him on the results. He put together a chart in his office (clearly by hand) on what he believes the aborstion rate is for both bupe and naloxone are and he agreed with Dr J's method of maximum absorption......so I am excited to see if this does indeed work. If so what a help this will be to those that have to pay for this med out of pocket and truly are able to get the full effect of this medicine. Thanks for sharing this.........

Jim


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 Post subject: thanks for this!
PostPosted: Sun Aug 01, 2010 3:13 pm 
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Thanks for sharing this, I tried it today and it is amazing! I have always had trouble with my mouth producing TONS of saliva. I gargled with some salt water and broke my 8mg dose into 4 pieces and it was the best dose I've ever taken in terms of not having a mouth full of saliva! In the past I have felt not-so-good as a result of bad absorption (my best theory).

here is a quote from the "how do you take your suboxone" thread. I have tried this but my extra saliva made it work badly. I'm going to try this method tomorrow in conjunction with this "salting-out" tip- I barely produced any saliva at all today- just enough. I have wondered what Dr. J thinks about this method of crushing before taking sublingually:

chris55552 wrote:
I seem the only one using the crush method.
Im on 8mg a day, usually take half in AM, half in PM. When I do, I put the portion im going to use onto a dry clean spoon,
then using another spoon crush the tablet into a powder, take the spoon with the powder and dispense it evenly all around
underneath my tongue. I usually do it in front of my bathroom mirror with my head slightly leaned forward so I can see underneath my tongue and ensure the powder gets dispensed evenly in mornings and evenings.
I like the crushing the tablet down into a powder so my mouth can skip the process of breaking down chunks, then dissolving
Instead my mouth can start the absorption right away,

Let me know what you think?


many thanks,
Glen


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PostPosted: Sat Aug 07, 2010 9:25 am 
Thanks everyone for your replies. I am so glad to hear some positive feedback. I can say, i've used this method for a few weeks now and it has made all the difference. Im gonna continue too use this method indefinitely. I hope more people will give it a try. I think a lot of people will be pleasantly surprised. For me, i think the main reason it helps me so much is, it reduces the amount of saliva which in return raises the concentration. Regardless of what exactly takes place, its the best method i've come up with so far. Awhile back i did try the method Dr. J described but i always had a mouth full of saliva before i could get it absorbed. Well like i said, i really hope more people will give this method a shot. With that being said, i hope everyone has a great day!! ~PEACE~


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PostPosted: Sat Aug 07, 2010 9:38 am 
Something else i forgot too mention. The method i use is, i put the tablet under my tongue. Well, to better explain what the tablet actually does after rinsing with warm salt water. I rinse with warm salt water, wait five minutes or so. Put the tablet under my tongue and no joke, it starts absorbing like a sponge would aborb water. You can feel the tablet slowly disinagrating(mispelled). Before this method, i would usually mess up the absorption on a regular basis. Now, i havent had one single problem since. Anyways, hope too hear from everyone!! ~PEACE~


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 Post subject: Thank you!
PostPosted: Sat Aug 07, 2010 5:53 pm 
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Thank you, lifesaver! I am so happy to read that this ha worked well for you, and I really, really wish that I had waited to take my daily dose until now, but alas, I have already taken it. I cannot wait to try this tomorrow! I also have been having some issues with ulcers under my tongue (though nothing too crazy, or painful, just a little obnoxious. Don't think I have an allergy, maybe I am just a bit sensitive to something in the Suboxone), and I ALWAYS have to wait for at least 40 minutes for my pill to dissolve, however, it unfortunately turns into an orange, slobbery mess after about five. I am certain that I am not absorbing it as I should be. I have tried to spread it around, as the doctor suggests, but that seems to produce even MORE slobber. I have heard also of adding a pinch of ethanol to your daily dose as well, but with the ulcers that I have, well, I am afraid that the alcohol may agitate them:(

So I really appreciate you posting this, and I am absolutely trying it tomorrow! I hope it works! If so, thanks a lot for saving me time and money. That means a lot to me! I'm so glad that so many people here are intelligent enough to come up with such things....without you guys, I would be a dumb, lost animal.


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PostPosted: Sun Aug 08, 2010 9:28 am 
Hi Melsie! I really hope this method can bring you some sort of relief. I have a strong feeling that it will and that you will be quite surprised at how well it works. As far as the ulcers go, oh my goodness mine were horrible. I had them numerous times and i would get 2 at a time. I have another thread called, "Why isnt subutex covered under the patient assistance program". It explains the allergic reaction i was having. I was having a reaction to the artificial sweetner in suboxone(Acesulfame K sweetner). You may wanna look into it if your having ulcers more often than usual. Anyways, i hope you will come back and let me know how the salt water method works for you. Hope everyone has a great day!! ~PEACE~


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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