Precipitated withdrawals are severe withdrawals that happen suddenly. This is caused by a medication that removes the opiates in your body from the opiate receptors, causing severe and rapid withdrawals.
One of the most common causes of precipitated withdrawals is taking suboxone too soon after using your drug of choice.
Buprenorphine the active ingredient in Suboxone and Subutex is a partial agonist of the mu-opioid receptor, which means that it binds to and activates this receptor to a lesser degree than a full agonist like fentanyl or heroin. When buprenorphine is taken, it binds to the mu-opioid receptors in the brain and produces some opioid-like effects, including pain relief and feelings of euphoria, but because its only a partial agonist these effects are generally milder than those produced by full agonists.
If someone takes buprenorphine too soon after using a full opioid agonist like fentanyl, the buprenorphine will compete with the other opioid for binding to the mu-opioid receptor. Because buprenorphine has a higher affinity for the receptor than many other opioids, it will "kick off" the other opioid from the receptor and bind to it instead, but becasue its a partial agonist it won't stimulate the receptors as much. This displacement of the other opioid from the receptor causes the sudden onset of withdrawal symptoms, which can be very severe and uncomfortable.
This phenomenon is known as "precipitated withdrawal" because the withdrawal symptoms are precipitated or brought on suddenly by the introduction of buprenorphine. The severity of the withdrawal symptoms will depend on the amount of opioids still present in the individual's system, as well as the dose of buprenorphine that is taken.
To avoid precipitated withdrawal, it is important to wait until the other opioids have cleared from the body before starting buprenorphine treatment. This requires a period of opioid detoxification, during which the individual abstains from opioid use and experiences some degree of withdrawal symptoms. Once the opioids have cleared, buprenorphine can be safely initiated to help manage withdrawal symptoms and cravings.
With fentadope the waiting period for the fentadope to clear from the receptors can be more than 72 hours. This makes suboxone induction from fentadope very difficult.
If your a fentadope user you can avoid precipitated withdrawals by using a method called the Bernese method for starting your suboxone.
Feel free to leave your stories and experiences with precipitated withdrawals in the comments below or in our forum.
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