Explaining this can be a bit tricky. In fact, one of my former treatment providers had such a hard time understanding what I was saying that they thought I was trying to teach patients how to overdose—but that was on them for not fully understanding the mechanism of buprenorphine. To be clear: I’m not recommending that anybody relapse while on buprenorphine. Using a short-acting opioid while on buprenorphine can be really dangerous. Buprenorphine blocks the euphoric effects of opioids, but it’s still possible to experience respiratory depression and overdose. Some users want to get high so badly that they will take higher and higher doses of a full opioid in an attempt to overcome the blocking effects of the buprenorphine. In fact, that user was once me. I took a much larger hit of heroin because I knew my buprenorphine would block my normal dose. The next thing I remember is my husband on the phone with a 911 operator, as I slowly regained consciousness because of the naloxone he’d given me. I came very close to dying that day. If there’d been no Narcan in the apartment, I might not be writing this today. No way am I recommending that anybody relapse while on buprenorphine.
That being said, lapses happen. If you or someone you know has lapsed on an opioid while taking buprenorphine, it’s important to know that you can go right back to your treatment regimen. This only applies, however, if there is still buprenorphine in their system. Buprenorphine is a long acting drug, so it lasts about 48-72 hours. If it’s still filling up those receptors and helping to keep a person from experiencing withdrawal, then taking another dose will not result in precipitated withdrawal—even if there are other opioids in the person’s system. This applies even if enough opioids were taken to overcome the blocking effect. Buprenorphine will only clear out the other opioid. It won’t displace itself. So whatever effect that other opioid is having will go away, but the buprenorphine will continue to work. If it’s still in your system and helping to keep you out of withdrawal, you can go right back to taking it. If someone goes on a three or four day binge without taking buprenorphine during that time, then they will probably need to go into withdrawal before re-starting the bupe.
Kratom while on Suboxone?
It is likely that Suboxone blocks the effects of Kratom. Kratom is a Southeast Asian tree that naturally activates the brain’s opioid receptors.
What is Precipitated Withdrawal?
This is an intense withdrawal that happens when the individual takes buprenorphine before other opioids have had a chance to leave the body’s opioid receptors.
How to Stop Precipitated Withdrawal?
By using microdosing on patients, it’s possible to stop the symptoms associated with a precipitated withdrawal. If these medications are administered on a continual basis, it could be enough to override withdrawal symptoms.
How Soon Can You Take Subutex?
Subutex can be taken at least 6 to 12 hours following the last dose of an opioid.