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PostPosted: Sun Feb 21, 2010 9:14 pm 
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This is strickly hypothetical and me just wondering. I am not suggesting anything but to call 911 in an emergency!


SO.....

If someone is dependent on Full Agonist Opiates (i.e. Heroin, Oxycodone, Morphine, Hydrocodone, Hydromorphone, etc etc etc), and I mean truely dependent as in taking them on a regular basis, especially at large quanitites, and they took a dose of dope, or snorted some pills, ate some pills, or whatever...... and if they started to OD, or are overdosing, could you administer Suboxone (of course only because of the Buprenorphine in it, not the Naloxone) or Subutex to counter act some of the Full Agonist Opiate actions and revive them enough so that they did not die by the time they were able to get to the hospital? Ok, this is probably way confusing. Basically, if someone is OD'ing (which in this case would be from Respitory Arrest/Depression (SPELLING!!!! I suck, I know))...would the Buprenorphine in the Suboxone / Subutex knock the Full Agonist off of the receptors enough to prevent death?? My logic is because if one is dependent on Oxy or whatever, and they start Sub treatment, they will be thrown into precip w/d if the Sub is taken too soon after the last Oxy dose. So, if they are definitely dependent on Full Agonists and are OD'ing, why wouldn't the Sub precipitate the w/d like usual?? Meaning, ok, maybe it wouldn't be like getting a shot of Naloxone and instantly revived, but would it allow them to breath a bit just so who ever is with them could either call 911 for an ambulance, or drive them to the hospital to save them???
I know that 'knocking off of the receptors' is overly simplified. I am sure that there is a bunch more going on, but in lay-mens terms thats what I understand , bupe knocks other opiates off of the mu (and kappa??) receptors, and that is what causes precip w/d.

For the sake of this thread, I will assume that the half life of Bupe won't matter in the sense of having to deal with Bupe intoxification after the Full Agonist has worn off. Lets assume that they will be fine in that sense and focus on the OD'ing aspect, know what I mean??

My GUESS (and that is all it is!) is that it may possibly prolong death just enough. I am sure one could place a Suboxone in such a way that the person OD'ing would absorb the medicine through their mouth (under tounge) like we do now. I could be wrong...believe me that has happened before! It could be that the Sub would just add to the breathing problems and make it worse. I don't know. But would love to hear what others think and have to say.

Thanks for reading my madness.......I hope I made some sense and you guys get what I am trying to figure out here. Thanks again!

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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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