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PostPosted: Mon Mar 20, 2017 9:12 am 
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Swim was on Subs for 7 years and finally got off using ibogaine. Afterwords I suffered extreme leg and arm pain, neuromuscular and am still trying to figure out why. My guess is from being on bupe for too long that it may have side effects we don't know about and nerve damage could be one of them. It's unbearable so I ended up relapsing 3 months after I was finally clean. Now, I've got limited options and am trying to get back on bupe, but all there is around is H with fentenyl which seems to linger and linger for days on end.

My question is why am I experiencing precipitated wd when I'm waiting 48 hours, I'm in medium wd and then I take a quarter, 2mg., but I'm still getting thrown into hell? Then I have to use again to get out of it. There's no straight H and can't afford oxy...the pain is unbearable. I've been taking imodium to slow my use and I'm also almost out of money.

I know there are lots of different topics here and I'll write posts but if u have questions for me please ask. If u can help me, please do.


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PostPosted: Mon Mar 20, 2017 11:20 am 
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I can't answer everything about your question, but I do know that fentanyl is stored in the fat cells of the body and therefore sticks around for a long time. Dr. Junig, the psychiatrist and recovering addict who created this forum had a terrible time detoxing from fentanyl because it stays in the body for so long.

I've never thought about this before now, but what if heroin is being cut with fentanyl for this exact reason? To make the withdrawals last longer, so more people relapse back on heroin. Maybe others have thought of this a long time ago, but I'm just making the connection now.

I hope one of our doctors comes along to answer your questions!

Amy

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PostPosted: Mon Mar 20, 2017 2:42 pm 
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Anybody ever have a post all ready, but delete it instead of posting it? Bummer, so I'll try again.

My guess is from being on bupe for too long that it may have side effects we don't know about and nerve damage could be one
If this is your belief why would you go back on Suboxone? Just a rhetorical question but puzzling and not meant to fuel a flame war.

...the pain is unbearable

When you say pain, do you mean your chronic pain, (Suboxone may not help that much) or the agony of withdrawal?
Regarding your question: The problem may be twofold. The fentanyl can sit around awhile and cause precipitated withdrawal. It is not time dependent. Use the COWS and get into deep the severe range before dosing. May require 2-3 days to get deep enough.
http://www.naabt.org/documents/COWS_ind ... _sheet.pdf
The other can be a tolerance mismatch. You probably have a very high tolerance from the heroin/fentanyl and will not be covered by the Suboxone. It can take a few days to bring your tolerance down to what the Suboxone will cover. This is one of the reasons it is so hard to transition from heroin to Suboxone and why methadone is often recommended. No withdrawal necessary with the transition to methadone. Further discussion here:
http://suboxonetalkzone.com/avoiding-pr ... ithdrawal/
Either way you will probably be in for a bumpy ride for a few days but if you ride it out you can come out the other side feeling better.
Amy, around here the heroin is being laced with fentanyl and/or carfentanyl. A very bad business model in my view. No repeat customers if they expire.


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PostPosted: Mon Mar 20, 2017 3:41 pm 
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Prec-ip

It's never a great idea to follow a post by one of the two docs.But i'll try. I had a very high tolerance after 12 years of daily opium use (main ingredient is morphine along with various other opiates courtesy mother nature).

You'd be better off waiting til severe WD sets in.
This will likely be enough to avoid the worst of the PW. At that point, if you do have some
PW it probably won't be as bad. And it likely won't last as long.

I didn't wait long enough....just edging into moderate after some 32 hours I think it was...and
had some PW. It only lasted a few hours then felt about 50 percent better. It was tolerable.

Each day was better after that until the 4th day when I felt as close to 100 percent well as I'm ever going
to.

Just hang in there. Keep trying. If you go into PW don't go back to the H. Ride it out. Keep dosing as
per you dr. instructions. YOu'll come out the other side, I promise.

By the way, that was doc's way of expressing skepticism that the bupe caused any nerve damage I think
you said you might have.

Best wishes,
Godfrey.


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PostPosted: Mon Mar 20, 2017 3:51 pm 
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Yes-- I'm tempted to go off on a rant about why you would blame buprenorphine-- a medication that's been prescribed literally millions of times now, with no evidence of toxicity or 'nerve damage'-- instead of blaming ibogaine (!), which came by boat from an Asian country, probably treated with herbicides and pesticides, not to mention peed on by at least one of the people in the chain. What do you think the people who sell ibogaine think about 'American drug addicts'? Do you picture them carefully tending to the plant, protecting you from harm?

But I won't say all that... I will mention, though, the spouse of one of my patients who was taking ibogaine for pain, paying about 20 grand per year for the 'good stuff'-- he had grand mal seizures one morning in front of his kids, his face landing in his cereal before he fell on the floor. All they could determine, after a lengthy work-up, was that there was an unidentified toxin in his bloodstream that damaged his brain, heart, liver, and kidneys. They know that it came from the ibogaine, because they found the substance in his 'stash'-- and mass spectroscopy provides a 'fingerprint' of the drug, but they never were able to match it to a known drug. The docs figured it was an unidentifiable pesticide of some sort.

About the fentanyl, yes-- it causes precipitated withdrawal for a long time because of the long half-life of fentanyl. Many people think it has a short half-life, but that's because it redistributes into fat cells after peaking in the brain. That pulls it from the blood and brain, and then it takes much longer to be metabolized by the liver. I recommend people stay off fentanyl for a good week before starting buprenorphine.

As for ibogaine, if you live in a rainforest and grow it in your garden, maybe you can find a way to use it-- although there willl be differing amounts of active opioid agonist compounds depending on the part of the plant, the amount of watering, the flowering cycle, etc. If you are buying it from an importer, or worse, from a head shop, then you don't know what the heck you're taking. Might be oregano with heroin sprinkled on top.


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PostPosted: Mon Mar 20, 2017 7:28 pm 
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docm2 wrote:
Anybody ever have a post all ready, but delete it instead of posting it? Bummer, so I'll try again.

My guess is from being on bupe for too long that it may have side effects we don't know about and nerve damage could be one
If this is your belief why would you go back on Suboxone? Just a rhetorical question but puzzling and not meant to fuel a flame war.

...the pain is unbearable

When you say pain, do you mean your chronic pain, (Suboxone may not help that much) or the agony of withdrawal?
Regarding your question: The problem may be twofold. The fentanyl can sit around awhile and cause precipitated withdrawal. It is not time dependent. Use the COWS and get into deep the severe range before dosing. May require 2-3 days to get deep enough.
http://www.naabt.org/documents/COWS_ind ... _sheet.pdf
The other can be a tolerance mismatch. You probably have a very high tolerance from the heroin/fentanyl and will not be covered by the Suboxone. It can take a few days to bring your tolerance down to what the Suboxone will cover. This is one of the reasons it is so hard to transition from heroin to Suboxone and why methadone is often recommended. No withdrawal necessary with the transition to methadone. Further discussion here:
http://suboxonetalkzone.com/avoiding-pr ... ithdrawal/
Either way you will probably be in for a bumpy ride for a few days but if you ride it out you can come out the other side feeling better.
Amy, around here the heroin is being laced with fentanyl and/or carfentanyl. A very bad business model in my view. No repeat customers if they expire.


No, I know that. Yes, customers are lost if it's too strong, but I imagine it's an art more than a science. I'm sure the dealers are not trying to kill off their customers. So they may be thinking that fentanyl is something else to make withdrawing from heroin terrible so that their customers relapse. I keep up on the news, especially when heroin/opioids are the subject. :)

Amy

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

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