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PostPosted: Fri Sep 17, 2010 7:10 am 
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I have a crazy story about an Altoids tin full of dope and me trying to hide it before I got busted. I'll save that one for when I know you guys a little better. I told the story when I was leading an AA meeting once. Half the room was laughing their asses off and the other half had a look of confusion on their faces. In light of what Junkie said I will let you use your imagination. Ah...the memories.

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PostPosted: Wed Sep 22, 2010 11:41 am 
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You are not crazy to think you are getting more out your dose. intrarectal administration has a much higher bioavailabilty then sublingually. Here is a comparison I came across from a study. To each his own, if you have trouble due to a botched surgery, well you have to do what you have to do.

Bioavailabilities:
intranasal: 50%
intrarectal: 54%
sublingual: ~30%
sublingual in Ethanol solution: 50-70%


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PostPosted: Wed Sep 22, 2010 11:50 am 
Hi hpchris - Just wondering if there is a link to this study and if so, can you post it. Thanks.


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PostPosted: Thu Sep 23, 2010 3:17 pm 
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Lilly wrote:
Hi hpchris - Just wondering if there is a link to this study and if so, can you post it. Thanks.


I should have been more clear...Those figures are from a few different studies. Here is a few of them.

http://www.ncbi.nlm.nih.gov/pubmed/6115924

http://grande.nal.usda.gov/ibids/index. ... row=588303

http://www.sciencedirect.com/science?_o ... af33e793e6


I can personally attest to the sub and ethanol solution working much better. The first time I was on sub. when i tapered down to a low dose I had to crush the tablets in order to measure very low doses and I then did a liquid taper but with grain alcohol instead of water. Pretty much high proof vodka and sub mixed together in small amounts. I got much more out of my dose then by just taking it normally much more of it was absorbed. This method was recommended to me by my doctor of that time. I think it was the Doc. here that commented to or about someone that used mouthwash right before they dosed and they felt as if they got more out of it, anyway mouthwash contains alcohol so it was being absorbed better due to that.


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PostPosted: Thu Sep 23, 2010 5:07 pm 
Yikes! the first study has sublingual as 13% - that sounds really low. I've been concerned about absorption lately because I've been taking 2mg doses, and sometimes the tab is gone really quickly and I worry that I swallowed to soon or somehow didn't really get the full dose. Yesterday I tried dissolving it in a couple mils of ethanol(40%) and putting the solution under my tongue. It burned like hell! I think I'm going to ask my doc about the film.


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PostPosted: Thu Sep 23, 2010 8:37 pm 
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It wouldn't surprise me if sometimes I only got 13% from sublingual. Timing is difficult since I work and smoke and eat. Sometimes I pop that sucker in and it is dissolved in less than 2 minutes and I know I swallowed most of it with the saliva. Such a total waste. I am looking forward to the film, but tonight I am going to try the mouthwash technique and see what happens. I need to dose right about now seeing as I normally do at around 8-10 am and the day is almost over. We shall see how this works.

Cherie

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PostPosted: Thu Sep 23, 2010 10:34 pm 
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I think the mouthwash does make it work better. I tried it. Swished with mouthwash for about 5 minutes. Waited about 5 minutes. Put one 8mg under my tongue. Was rather annoyed at first because my mouth was watering way too much from it and was pretty sure I was losing the majority of it. But, it was done in about 10 minutes. I held the spit in and swished it around for another 3 minutes and then swallowed. But in about 20 minutes I could tell I had taken it and it made me kind of sleepy which generally only happens when I absorb it really well. (I only get sleepy when I am just sitting around watching tv. If I am working or doing yard work or whatever that doesn't happen). But I still feel like I got a really good dose so I am going to take the mouthwash to work tomorrow for when I dose then too. I am going to try just taking 4mg and see if that doesn't sustain me through the day doing it this way. I will know because as soon as I drop too low my pain levels increase significantly.

It was worth trying for sure.

Cherie

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PostPosted: Fri Sep 24, 2010 1:59 pm 
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Jackcrack wrote:
I think the mouthwash does make it work better. I tried it. Swished with mouthwash for about 5 minutes. Waited about 5 minutes. Put one 8mg under my tongue. Was rather annoyed at first because my mouth was watering way too much from it and was pretty sure I was losing the majority of it. But, it was done in about 10 minutes. I held the spit in and swished it around for another 3 minutes and then swallowed. But in about 20 minutes I could tell I had taken it and it made me kind of sleepy which generally only happens when I absorb it really well. (I only get sleepy when I am just sitting around watching tv. If I am working or doing yard work or whatever that doesn't happen). But I still feel like I got a really good dose so I am going to take the mouthwash to work tomorrow for when I dose then too. I am going to try just taking 4mg and see if that doesn't sustain me through the day doing it this way. I will know because as soon as I drop too low my pain levels increase significantly.

It was worth trying for sure.

Cherie


I never thought to use mouthwash until I read about it as well, I always just used grain alcohol which as Lilly says tends to burn. Using Mouthwash before dosing most certainly works better than normal sublingual dosing I am not sure how much better BA there is as mouthwash tends not to be as strong as say a high proof vodka. Regardless though it works much, much better than normal.

Some studies say that the BA for an alcoholic solution is close to 70% higher than tablets alone. Done this way will literally make 4mg feel as if you took your normal say 12mg+ dose. I do it quite often if I need to stretch my Sub. do to money issues. Instead of just mixing the 2 and letting the solution sit under my tongue I let it soak into a piece or 2 of cotton and let that sit under my tongue until they are white again. This minimizes the burning and the amount swallowed.

Couple links to some studies regarding it:
http://cat.inist.fr/?aModele=afficheN&cpsidt=15628024
http://www.naabt.org/education%20pharma ... rphine.cfm

The first study does not give figures. The second does however.

Relevant info from second link:
Quote:
Buprenorphine has poor gastrointestinal (GI) bioavailability, and fair sublingual bioavailability. FDA-approved formulations of the drug for treatment of opioid addiction are in the form of sublingual tablets that are held under the tongue and absorbed through the sublingual mucosa. Studies of sublingually administered Buprenorphine have employed either an alcohol-based solution or a tablet formulation of the drug. Confusion may result when reviewing the literature on the effectiveness of Buprenorphine at various doses because most early trials and clinical studies of Buprenorphine were performed with a sublingually administered liquid preparation, whereas the oral formulations marketed in the United States are sublingual tablets. Studies have shown that the bioavailability of Buprenorphine in sublingual tablet form is significantly less than via sublingual liquid solution – about 50 --70 percent that of the liquid form, so the dosages of Buprenorphine sublingual tablets must be significantly higher than those used in the liquid form to achieve the same therapeutic effect.



At normal BA, 1mg = about .3mg. At the alcoholic-solution BA, 1mg = about .7mg


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PostPosted: Fri Sep 24, 2010 5:08 pm 
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I just thought I would say that I tried "plugging" my morning dose o subs and was happy with it. I really dont have or want to make time in the morning to wait 20 minutes, so I tried this today and am happy.


Thanks for the info!

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PostPosted: Sat Sep 25, 2010 7:50 am 
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hpchris -

So then what would be the BEST way to take it using mouthwash or alcohol? I am not sure I understand the whole cotton thing you just mentioned. And if you were just using the mouthwash then what would the best method be? I'm just looking not to lose potentcy. I am not necessarily trying to gain a whole lot of it, but don't want to take a dose and know that I got nothing and will have to take another 1/2 later and then skip some on another day. The balancing act sucks. If I could just get it to work the same every day, that would be fine.

Cherie

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PostPosted: Sat Sep 25, 2010 10:44 am 
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Jackcrack wrote:
hpchris -

So then what would be the BEST way to take it using mouthwash or alcohol? I am not sure I understand the whole cotton thing you just mentioned. And if you were just using the mouthwash then what would the best method be? I'm just looking not to lose potentcy. I am not necessarily trying to gain a whole lot of it, but don't want to take a dose and know that I got nothing and will have to take another 1/2 later and then skip some on another day. The balancing act sucks. If I could just get it to work the same every day, that would be fine.

Cherie


Alcoholic solution is the best and gets youmost of the dose, mouthwash only contains on average of 5-11% alcohol. If using just mouthwash use the rinse as normal then take your dose as normal. I found that just dumping some vodka or gin in your mouth then the pill to be ineffective as 1: it burned to much 2: I swallowed it. Below is the cotton thing I talked about.

You will need:
- high proof alcohol - unflavored/spiced vodka or rum.
- a bottle cap or spoon
- Q-tips


Step 1: Crush desired amount of Suboxone in a bottle cap or spoon.
Step 2: For every 1mg of Suboxone, use roughly 25ml alcohol (If you have no way to measure eye it out. less is best you just want it dissolved0. If you're using 3mg of Suboxone, that would mean you'd need .75ml.
Step 3: Add alcohol to the Suboxone in the cap or spoon. Stir till it is dissolved well. Let it sit for 5 minutes.
Step 4: Bunch the cotton up into a few pea-sized pieces.
Step 5: Place cotton into the cap or spoon until it is all soaked up by the cottons. Try to use as few pieces as possible.
Step 6: Place the cotton under your tongue, leaving them in until they are completely white again, which is usually at about the same time you are no longer able to taste the alcohol, while trying not to swallow any of the alcohol. Eventually you can, but for the first 5 - 10 minutes, try to hold as much in as possible.

This way all of your dose is contained along with the alcohol, thus making a contained alcohol solution of Sub. that can very easily be taken sublingual.


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 Post subject: Which is it?
PostPosted: Sat Sep 25, 2010 4:37 pm 
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I'm confused. At first you said to use 25 ml or 25 cc (they are the same) of alcohol per milligram of Suboxone. That really is a huge amount of liquid. BUT, then you said to use .75cc for a 3mg - which would mean .25. Is that what you meant the first time but forgot the decimal point? There is a huge difference between .25 and 25 ml (like 100 times the difference). You can probably see how a medication dose error can happen - a decimal changes everything. That's why in medicine you should always put a zero in front of the decimal - 0.25 ml rather than .25 ml.

I am very intrigued by this information - especially the data that seems to clearly show much greater absorption using alcohol. I just don't see how I can get 100ccs or mls of vodka in my mouth to take 4mg of Sub. I also don't want others reading this to get it wrong as well. Please let us all know what the correct amount is as I'd love to try this. Is it 25 or 0.25? Thanks.


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PostPosted: Sun Sep 26, 2010 7:44 am 
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I'm assuming .25 since he said just enough to dissolve the sub. It also sounds gross putting cotton in my mouth for that long. The patch sounds easier, although I may attempt this method simply out of curiosity.

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 Post subject: Re: Which is it?
PostPosted: Sun Sep 26, 2010 10:26 am 
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donh wrote:
I'm confused. At first you said to use 25 ml or 25 cc (they are the same) of alcohol per milligram of Suboxone. That really is a huge amount of liquid. BUT, then you said to use .75cc for a 3mg - which would mean .25. Is that what you meant the first time but forgot the decimal point? There is a huge difference between .25 and 25 ml (like 100 times the difference). You can probably see how a medication dose error can happen - a decimal changes everything. That's why in medicine you should always put a zero in front of the decimal - 0.25 ml rather than .25 ml.

I am very intrigued by this information - especially the data that seems to clearly show much greater absorption using alcohol. I just don't see how I can get 100ccs or mls of vodka in my mouth to take 4mg of Sub. I also don't want others reading this to get it wrong as well. Please let us all know what the correct amount is as I'd love to try this. Is it 25 or 0.25? Thanks.


0.25

Yes mistakes can be made in dosing because of a decimal, my apologies, but like you said 25ml is a big amount.
You wouldnt need to put all of it in at once, you can take 1mg at atime so , 0.25ml alcohol soaked into a small ball of cotton, then repeat.

@JackCrack
It really is a small amount of cotton. Think a q-tip head bunched up into tiny pea sized balls. So small it is not even really noticeable while taking.


EDIT: It will not let me edit my original post to fix it and add the decimal, can a moderator please do that.


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 Post subject: Useful info
PostPosted: Tue Oct 19, 2010 11:50 pm 
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I am a physician who prescribes buprenorphine. I have suggested rectal suboxone administration to several patients, especially with complaints of the taste or of dental pain from the sublingual tablet. (Oh, you don't like the taste - well just stick it!) No one has admitted taking me up on it.

Thanks for sharing your experience with rectal administration.
This is the most information that I found anywhere about the topic.

Speaking as a guy in recovery, if you choose to use this I recommend telling your physician about the pr (per rectum) ROA, if for no other reason than to keep it clean (your bup use, that is). "Rigorously honest" - I think it applies here, to err on the side of keeping the bup therapeutic.

-MLKBr


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PostPosted: Wed Oct 20, 2010 3:56 pm 
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Ok, so, I'm not sure I would ever try this method but was wondering if anyone has tried plugging the new film strips or if it is even possible..?


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PostPosted: Thu Oct 21, 2010 2:49 pm 
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I'm certainly intrigued about this alcohol method. I've never, ever had a problem with booze, so it would not be an issue for me to try this.

However, I have had HUGE issues with IV heroin use and it kind of messes with my head to even think of handling a syringe, so, with that in mind, assuming a dose of, say, 5mg (2 full and 1/2 of a 2mg tablet daily) how would I approach measuring the right amount of vodka to use? Just eyeball a couple of drops?


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PostPosted: Thu Oct 21, 2010 3:59 pm 
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ILLCadillac wrote:
Ok, so, I'm not sure I would ever try this method but was wondering if anyone has tried plugging the new film strips or if it is even possible..?


I have plugged the strips and it seems to work fine...probably better than the tabs as it dissolves easier. I have found I need less of the strips to get the same effect. Just dissolve in a bit of water and suck it up with syringe/device. Sticking the strip directly in the syringe with water usually results in the strip getting stuck to the side of the syringe and gels up...it will work as well, but takes some time to get it to dissolve).


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PostPosted: Fri Oct 22, 2010 7:22 am 
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Update:

I decided to go ahead and give this a try this morning. Here's what I did:

1. Crushed up 2 and 1/2 tablets (2mg tabs of suboxone)
2. Placed crushed tabs in a spoon
3. Poured a small amount of vodka into the cap of the vodka bottle
3. Used an eyeball measurement to add vodka to the powdered suboxone
4. Mixed it up with a toothpick and waited 5 minutes
5. Took both cotton ends off a Q-Tip and placed them in the solution
6. Soaked up as much of the solution as possible then used a toothpick to skewer them and place under tongue
7. Licked the spoon clean using the bottom of my tongue

Subjective Observations:
--If you wait too long before adding cotton, I think the solution will coagulate into something more like paste.

--It's a bit difficult to get ALL of the solution to absorb into the cotton (maybe I used too much vodka?)

--Slight burning sensation when placing cotton under tongue

--Suboxone "hit me" a LOT faster than it does when I just take them the regular way

--I will confirm that I definitely "feel" like I took more than 5mg, compared to taking it the regular way. There is no doubt of this

--If my wife sees me doing this, she will not like it at all, because of how it looks (kind of like I'm fixing dope)

--Mentally, I'm not sure this is something I want to continue doing, because it reminded me quite a bit of fixing dope


Overall, I think this works as has been described in this thread. I think using suboxone this way might be a behavioral "slippery slope" for some people (particularly former IV drug users like me) but if you are not a problem drinker and you want to get more absorption, I think this method achieves that goal.

I would like to know what Dr. Junig's thoughts are on this. I suspect he would not approve due to the behavioral component, but who knows?


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PostPosted: Sun Nov 07, 2010 5:34 pm 
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Ok, I'll admit it,I tried plugging for the first time yesterday, and this is def. the way to go! Ive been taking 16mg a day for the last couple years under the tongue, but yesterday I plugged 2mg and it was way better than 8 mg under the tongue. Now I just stuck the pill in there without dissolving it. Is that OK? Or does it work better with a syringe?

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