Opiates.. the same but different ?? Two questions.

[Brighty]

What is the difference between opium, heroin, and all the different opiate prescription pills ? I only know some are stronger or longer acting... but once addicted aren't they all the same ?

[EC was here]

Opium is what they make morphine codiene, oxy, dilaudid and all the opiate pills from, there is a  big difference to being addicted to heroin than vicoden. so no. they are all not the same, the stronger the opiate, the worse the with draw will be, and the more euphoria.

[Suboxer]

They are all opioids, and once addicted to one, all other opioids (in sufficient doses) will prevent withdrawal. All opioids have different potencies and half lives (the time it takes to remove half of the drug from your bloodstream). The severity of withdrawal is a function of length of addiction, dose used, drug potency, and half life. All else being equal, drugs with higher potencies will have a more intense withdrawal, and drugs with longer half lives will have a longer one. These come together to form the perfect disaster in the drug Methadone (which is wonderful for people addicted to heroin and STRONG painkillers - oxycontin high doses [>350mg a day], Dilaudid, Opana, etc., but not for people addicted to vicodin, percocet, etc. - you are actually trading one susbstance for a more addictive one), which is a very potent drug with an extremely long half life.

Drugs also have different potencies depending on the route of administration: for example, a 10mg dose of oxycodone by mouth is equivalent to 15mg morphine by mouth. A dose of 10mg oxycodone intravenously is equivalent to 7.5mg of morphine intravenously. Half life is roughly the same no matter what ROA.

If you are addicted to a low dose (say, 100mg morphine equivalent PO [by mouth] daily), I believe cold turkey* is the best option. For a higher dose than that, I believe Suboxone is the best option. If you are on extreme doses, like I was (1000mg morphine equivalent intravenous daily), Suboxone will help with the withdrawal, but will not completely get rid of symptoms for a few days to a week. If you can deal with it, Suboxone is a better medication to be on, since the withdrawal is easier, and you don't have to go to a clinic every day, compared to methadone. If you can't deal with the symptoms and you used an extreme amount of opioids like I did, methadone maintenance might be the best option.

*Cold turkey does not mean absolute COLD TURKEY. Consult with your physician and s/he will likely prescribe you some clonidine (to help with the high blood pressure and sweating), a benzodiazepine (to help with the inevitable extreme insomnia, restless legs, and extreme anxiety and panic attacks [even in people with no prior anxiety], and a prescription anti-diarrheal to deal with the diarrhea - you can substitute triple and quadruple+ doses of Immodium AD for this last medication. Google "The Thomas Recipe" for more information.

[candothis247]

great post there!

[candothis247]

i just realized this is a super old post from april 1, 200, but non the less, i think everything you said is true, suboxer. Any idea what the success rate of people getting off oxys and staying off oxys is? i suppose it would depend on just as many variables......

[Suboxer]

The lifetime success rate for (strong) opiate addicts (heroin, oxy, fent, etc. - I have no idea about codeine, propoxyphene [darvon] etc.) staying clean without replacement therapy is below 1%.

www.suboxonetalkzone.com is a very good site for people who choose to use suboxone maintenance.

Recent research literature indicates, and doctors are starting to believe/follow, that a maintenance regimen is needed for most junkies who want to rebuild their lives. Some people have a desire to be 'completely clean' - even of prescribed maintenance medications. EVERYONE thinks they have the willpower to do it. EVERYONE thinks they are different. We are all junkies: none of us have it. I have never known or heard of anyone with five years clean under their belt after tapering suboxone or methadone.

The urge always is there, and never leaves us - so without a chemical blocker in place, we can use. On sufficient doses of suboxone or methadone, not only are our w/d s/x alleviated and our cravings somewhat, our opioid receptors are filled to capacity - in the case of methadone, by increasing your tolerance to pure agonists to a point where it would take a gram of pure heroin in one shot to get off, or, in the case of suboxone, by it's mixed agonism/antagonism.

Methadone has no ceiling dose and can be used to control any severity of withdrawal with NO symptomology. Suboxone can only be used up to habits of a certain size with complete comfort; my habit was way beyond the suboxone zone (I was using 2g of heroin a day, or 800mg oxycontin/morphine, IV), so it took a few days for it to make me pretty comfortable - but in the first days, it alleviated the worst of the physical w/d s/x.

Suboxone has a ceiling dose, depending on the source, a dose of 6mg suboxone is equal to anywhere between 40 and 100mg of methadone. There are no further agonist effects after 6-8mg of buprenorphine; the reason doctors induct us onto such high dosages (16-32mg) is to keep us from getting high. 8mg of suboxone will alleviate your w/d s/x as well as 24, in most cases - in most cases, as well, 4mg will do the same as 8. But a high enough dose of pure agonist (oxy, morphine, fent, meth, h, etc.) is going to be able to overpower it and get you high. On a dose of 16+ mg (I take 24) no dose of any opioid is going to get you a buzz without quitting your suboxone for 5 days and being sick for three of them - your opioid receptors have been almost completely filled.

Remember, Suboxone is a very high potency opioid - around 40x as potent as morphine - and it's analgesic effects have a cap around 4mg = 160mg morphine PO = 80mg methadone PO. Used to treat pain patients, buprenorphine (suboxone's active constituent) comes in .2 (1/10)mg tabs - for SEVERE pain. For junkies, it comes in 8mg tabs.

PM me if you want any sources for my statements, advice, or to share experience, junkie to junkie.