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how long before i take subutex should i wait after taking my last dose of heroin,realistically
Last edited by DavidS; 17th, December 2009 at 12:14 PM.
Moderator
The drug agency will tell you this.
johnep
Loyal Member
The first dose
The timing of the first dose is important..
If you are taking heroin - you take the first dose of buprenorphine at least eight hours after taking your last dose of heroin.
The reason for these timings is because, for buprenorphine to work well, you need to take it when your body has low levels of heroin or methadone. So, the aim is to take the first dose only when you feel some withdrawal symptoms starting. This tends to be about eight hours after the last dose of heroin, and longer after the last dose of methadone. If you take buprenorphine sooner, it can actually cause withdrawal symptoms suddenly to develop.
Top-Class Member
I have noticed two or three (there may be more) topics like this one where members of the public post questions that are replied to by pharmacists on the forum. I cannot imagine any problem with the advice given here but with a couple of the others there might be (advice on safe injecting of buprenorphine springs to mind).
Would it not be advisable for the forum admin to post a disclaimer stating that Pharmacy-Forum cannot be held responsible for the content of any post made by its members nor for any harm that may result from members of the public acting upon such advice.
Just a thought.
Moderator
Good idea. See it all the time after posts made by MOCs etc.
johnep
Member
If using methadone, leave a space of 24 hours at the very least (preferedly36) or you'll go into withdrawal and be pretty unwell. With actual smack not as long but still as long as you could possibly bear it, I would suggest at l;east 12-14 hours. howevever its very likely you'd feel a whole lot better if you could leave it to 18-20 maybe even 22 hours. Under no circumstances use while using subbies as you will again just feel pretty unwell. In fact subutex should be given some respect and used to the letter. Anything less will result in you experiencing the worst cluck you could imagine coupled with the fact you could'nt remedy the situation for at least 24 hours. Be careful and good luck. CASTLE606.
Member
Heres a question if you are accepting questions from heroin addicts/substance users, a pharmacist should know:
if you are on diconal and have been for many years (since the 1980s when clinics, private doctors and CD cupboard burglaries made it easily available), is it safe to switch to dihydrocodeine and Phenergan (not cyclizine, it's not easy to get this either as p'cists often won't sell it although the law permits OTC.)
i know quite a few Dike users who cannot obtain this any more, there are still people with arthritic conditions and cancers getting it but even their scripts seem to be getting changed to morphine or fentanyl now. does promethazine reduce the histamine/sickness effects of opiates in the same way the cyclizine did?
Top-Class Member
Regarding promethazine, it is not just drug abusers that pharmacists have to consider. BTW remember that a pharmacist must be satisfied that anything they sell - even something that could be sold freely elsewhere - is not likely to be abused or to cause harm. We are not there, as your post gives the impression by saying that the law permits it, simply to supply something or not.
Promethazine is used as a hypnotic (sleep aid) but it is really unsuitable for this as its effects are very long lasting - well into the next day and it has other effects that the user will not be aware of (anti-muscarinic and possibly extra-pyramidal). Taking it for a long time would make someone's problem worse.
It is also misused to sedate young children. This is my main worry as there have been deaths that might have been related to this. For this reason it is no longer licenced for use in a child of under 2 for any purpose.
Promethazine is a potent anti-histamine (even, I have read anecdotally, for treating scorpion stings at a dose of 50mg) but its anti-emetic properties are not very strong.
Please anyone feel free to correct my pharmacology - I'm writing this while watching the Uruguay/Ghana match.
Member
Hi, I'm talking about CYCLIZINE that pharmacists refuse to sell due to "smackhead scum" who they only seem to take on so they can get PAID extra for watching them take their green juice (never tablets or amps now!) under supervision like little children with their Mum checking they've had their Medised. And things will only get WORSE with the new Government going on about abstinence instead of maintenance.
The attitude of pharmacists to recreational and addicted drug users is VERY negative. I know about promethazine, I can get this at Boots (but not Lloyds who won't sell it without an Rx) and I don't know any chemist that still sells Valoid OTC. Maybe one in the Outer Hebrides without an injector in a 20-mile radius? I know you don't HAVE to sell anything just because the law allows it but when 99% of chemists say no to cyclizine, codeine linctus, Gee's linctus etc. there is no point in having them OTC any more.
Better to sedate your babies with Phenergan than Physeptone mixture (parents have been sent to jail for the latter several times in recent years- an argument in favour of offering injectable methadone again!) I know phenergan is not for sedation, I am asking if it is all right to use it for an anti-histamine for 40/50 somethings who can suddenly no longer get Diconal and have been dependent chaotic poly drug users since the 1980s. As they are switching back to Morphine/ Dihydrocodeine which means they are itching and sometimes feeling nauseous, which the Cyclizine in Pink painkillers stopped.
Top-Class Member
The majority of pharmacists are employees or locums. They get paid NOTHING for supervising consumption. The large financial concerns that own the pharmacies get the money. Whether tablets, liquid or ampoules are supplied has nothing to do with the pharmacist. It is decided by the clinic. Also the pharmacist does not decide whether methadone is to be supervised or not. The prescriber does this and it is to prevent methadone being sold and to reduce the risk of overdose.Originally Posted by pharmacrat
Only with those who demand to be served immediately when you are in the middle of a shipping order, are threatening, physically or verbally abusive (happens more than you probably think), who shoplift, are clearly intoxicated, who smell or who try on one of the scams we have all heard hundreds of times. There are many addicts that I get on O.K. with and chat and joke with.The attitude of pharmacists to recreational and addicted drug users is VERY negative.
These drugs are all "pharmacy only" medicines but there have been calls for them to be made prescription only. In the USA you cannot even buy co-codamol for instance as this category does not exist over there. If pharmacists did not make every effort to prevent their recreational use they would have been taken off the market years ago.I know about promethazine, I can get this at Boots (but not Lloyds who won't sell it without an Rx) and I don't know any chemist that still sells Valoid OTC. Maybe one in the Outer Hebrides without an injector in a 20-mile radius? I know you don't HAVE to sell anything just because the law allows it but when 99% of chemists say no to cyclizine, codeine linctus, Gee's linctus etc. there is no point in having them OTC any more.
Better not to sedate babies at all.Better to sedate your babies with Phenergan than Physeptone mixture (parents have been sent to jail for the latter several times in recent years- an argument in favour of offering injectable methadone again!) I know phenergan is not for sedation, I am asking if it is all right to use it for an anti-histamine for 40/50 somethings who can suddenly no longer get Diconal and have been dependent chaotic poly drug users since the 1980s. As they are switching back to Morphine/ Dihydrocodeine which means they are itching and sometimes feeling nauseous, which the Cyclizine in Pink painkillers stopped.
The tragedy of addiction is that the body over-rules the mind and the addict no longer has any say in what they do but few of you can see this.
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