New Suboxone Forum

freudian55 · March 9, 2008 at 10:24 pm

Thank you for writing. Please consider cutting and pasting your comments at http://suboxforum.com also, as there are more people reading things there.
I don’t have a certain answer to the lack of euphoria, except to say that I have heard the same thing from at least 5 other people after similar periods of time. The most obvious answer is that either the suboxone is still around (it is highly protein-bound, but 7 days is a long time!) or your tolerance has become higher (unlikely, because after 7 days of sobriety it would have come down a bit, plus I have heard the comments even after very large doses of oxycodone).
It is very dangerous to take high doses of opiate agonists (vicodin, oxy, methadone, morphine, etc are all agonists) to overcome the blockade by antagonists like narcan or naltrexone, or agonist/antagonists like buprenorphine. It is done in hospitals if needed, say to do surgery on a person on an opiate blocker. But without close monitoring there is significant risk of respiratory depression and death. There are a number of ways that things can go wrong; one example is based on something called the ‘entero-hepatic cycle’. Some opiates get take out of circulation by the liver, and dumped into the intestine along with bile. As this dumped opiate moves down the intestine, it can get re-absorbed days later from the distal small bowel. In the case of a person on an opiate blocker, let’s say that the person takes a huge dose of opiate and gets a small high because of the blocker. The opiate gets dumped into the intestine, and then 2 days later, after the blocker has worn off, the patient has become constipated from the high opiate dose– the delayed passage through the intestine caused by the constipation allows a large amount of the opiate to be taken back up into the circulation. This could now be enough to cause death, especially if the person is taking other depressants like alcohol or Xanax.
Many times antidepressants are given either by people who don’t specialize in psychiatry, or by psychiatrists who don’t take the time to ‘get it right’. It is rare to have a depression that will only respond to opiates (but not unheard of). I encourage you to try a different doctor and find something that gets you feeling better. We have so many choices nowadays that depression is almost always treatable.
I will post your comments and my reply at suboxforum.com. Please come join us there!