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PostPosted: Wed Apr 18, 2018 6:27 pm 
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Please let me first express the incredible emotion that comes along with this post. I couldn’t get through an induction. I waited the prescribed hours. Followed the COWS assessment, and always became horribly ill when I took buprenorphine. I took it in every form that is available via Rx. My Dr said I was the <1% that was not a Buprenorphine candidate and I should consider methadone. I’ve only been wrapped up in this addiction for 18 months following spinal surgery. A move for my career found me in a new area of the country, and with that foolishly heroin entered the scenario. What to do?

Well I am on suboxone for the past month. I’m at 8mg a day, down from 16mg. I look forward to being done in the coming weeks. So how did my dozens of induction attempts finally bring success? I’ll tell you.

I didn’t wait the usual 24hrs. I waited 14hrs and took 1mg to see how I’d feel. It had minimal affect. So I took 3mg more. WD’s set in, and I used enough of heroin to have the WD’s disappear. The next day I took 8mg about 14hrs since my last use. I had some WD symptoms, and took a small about of heroin to subdue the WD’s. The next day I woke up and took 8mg’s. That was it. 12hrs later I took another 8mg, and I was on Suboxone. Never touched another opiate since.

It dawned on me that every time I tried my induction, after an hour of WD’s I’d take heroin to pull myself out of the withdrawals. Well suboxone accumulates in the system. Two days of taking suboxone and a full opiate agonist afterwards, allowed the suboxone to build up in my system and not experience any WD symptoms.

So, take 4mg of suboxone first on the first day, then your DOC once the WD’s start.

On the second day take 8mg first, and when mild withdrawals set in, take enough of your opiate of choice to curb your WD’s.

On the third day just take the suboxone at your Dr’s prescribed dosage.

No Dr will recommend what I did. There is a study and a method called the Bernese Method that was developed in Switzerland. It is pretty much what I explained, but their schedule is over a 6 day period. They had a case where the patient was taking heroin and methadone at the same time, meaning on the same day, as the Buprenorphine. The patient was fully on Buprenorphine treatment with in a week.

This worked for me, and both my dr and I thought I was a hopeless cause. This should be further studied and be the standard of care in the induction of Buprenorphine treatment.


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PostPosted: Thu Apr 19, 2018 1:31 pm 
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Hello, Suboring.

Welcome to the Suboxone talkzone.

Let me just start by saying that you shouldve been in withdrawal for at least 24 hours, if not more. Also, buprenorphine is a partial opioid agonist, meaning it doesn't saturate your receptors 100%, it's saturates the opioid receptors just enough so that we don't feel the cravings & all the other crap that comes with being addicted to opioids. Buprenorphine isn't meant to be consumed with other full opiate agonists. It defeats the entire point of why bupe was created in the first place.


Regarding the "Bernese Method", do you have any scientific data or studies to back this statement up? Also, where did you hear of this method? Did you read about it on the internet? Or did someone tell you about it? I'm sure the moderators here would love to see the studies.



Ash

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PostPosted: Thu Apr 19, 2018 2:29 pm 
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With the transition from heroin to buprenorphine, it can be a little bit more difficult than other opiates. Ur tolerance was high because of the heroin which can lead to a little bit longer to feel total relief of withdrawal after ur induction to buprenorphine. There’s also the possibility that the heroin u were taking had fentanyl in it, and that runs the possibility of precipitated withdrawal if u do not wait long enough before ur first dose of suboxone.

Waiting 14 hours (or 12, I can’t remember what exact time u said) was definitely not long enough. The best way to keep urself in track with ur induction is to just keep dosing ur regular prescribed dose of suboxone and u will most certainly start feeling better shortly.

I know it would be difficult to be in withdrawal (I waited 32 hours) and not feel near immediate relief during ur induction, but unfortunately that’s how it happens for some ppl who’s not waited long enough. I suffered pretty bad waiting that 32 hours and thankfully I did feel better very quickly. If I had to go through more withdrawal and not understand what was happening and thought something was wrong, I would have worried myself greatly about it. But ppl knowing that this could happen if u don’t wait long enough or someone’s tolerance is super high, as long as they know if they just keep dosing as prescribed, they will feel better soon. Taking more heroin or whatever their drug of choice is not the answer.

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PostPosted: Thu Apr 19, 2018 9:14 pm 
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I’ve been drug tested many times during this period. I’ve never been positive for fentanyl, so the heroin didn’t have any in it. I realize I needed to wait longer than 12-14 hours. Many times I’ve waited 24-30hrs and still was sick. I weaned down to using just enough heroin to not be sick before I started the Bernese method. It can be found on PubMed.gov. The national institute of health library for medical studies.


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PostPosted: Thu Apr 19, 2018 9:20 pm 
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959756/

The Bernese Method Study


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PostPosted: Thu Apr 19, 2018 9:24 pm 
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I don’t understand why heroin is always called a short acting opiate, but people have to wait 24-36 hours before induction. When I was on oxy I was in withdrawal in less than 24hrs. There’s a lot of conflicting info out there. Some say wait 12hrs and some say to wait over 24hrs. I did what I found worked for me. It may work for others who are being told they are not buprenorphine candidates.


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PostPosted: Fri Apr 20, 2018 1:51 pm 
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Suboring,


How are you feeling now? Are you doing any better from before? Also, how are you taking your Suboxone? Maybe it's an absorption issue? I'll tell ya how I take mine. I wake up, drink my coffee, cuddle with my fur babies, then I drink water & make sure there's noooo saliva in my mouth & it's not watery. You want your mouth to be as dry as possible. Take the film/tablet & place it under your tongue, close your mouth & put the tip of your tongue on the top of the sub that's underneath. Try to "paint" the other side under the tongue with the sub. Then chill for an hour. The longer you have the sub in your mouth, the better the bioavailability. Whatever you do though, Suboring, don't EVER take extra from your subs. It will be a waste, & it won't do anything for you. Stick with your dose that youre on now.


Looking forward to hearing back from you,


Ash

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PostPosted: Fri Apr 20, 2018 2:15 pm 
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Hi Ashlee:

I know I'm not in the right thread to ask this, but I saw you are online, and I am terrified of what's going to happen when I start my Sub induction. Can I ask you a few questions, and should I post them here or PM or email you?

Paige (Dillycat)

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PostPosted: Fri Apr 20, 2018 2:20 pm 
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Absolutely

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PostPosted: Fri Apr 20, 2018 2:21 pm 
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You can post them, message me, whatever you feel is right!


Ash

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PostPosted: Sun Apr 22, 2018 4:35 pm 
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Hi Suboring:

Thank you so much for sharing. As a pharmaceutical rep for J&J for 16 years selling chemotherapy and support meds, I totally understand Phase III clinical trials. I also know that studies can be powered to reach whatever results companies and researchers desire. That being said, accolades to you for listening to your body, considering the data, and going with your instinct. Drugs are prescribed off label all the time with beneficial results.

Your shared experience here may well help others. It’s great to hear you’re doing well.

This is my second attempt at Sub under very different circumstances, the first time almost two years ago. I am scared. I hope to make it through my 2nd attempt at the first 24 hours this weekend starting an hour ago.

Again, thank you for your experience and not being afraid to think outside the box.

Best regards,

Paige

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PostPosted: Tue May 15, 2018 2:43 pm 
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Wow! Suboring! Thank you for the article on the Burnese Method of induction for heroin users! This could give hope to many people who are afraid to go through buprenorphine induction in fear of PWs.

I'm almost positive that Dr. Junig, who created this forum, has discussed how to use full agonists for surgical pain relief while still taking a small dose of buprenorphine every day. I think that the two subjects are interrelated.

I will bring up this method the next time someone mentions transitioning from heroin to buprenorphine. Good info.

Amy

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