hello world.
this is the voice of dr evi...
greetings. i would like to present my evidence against your assertion on the naloxone talk page that;all so-called naloxone side-effects are not related to the drug itself and therefore irrelevant.
i presume you mean this; The addition of naloxone to buprenorphine in Suboxone tablets is intended to prevent misuse and abuse by injection. However, the naloxone in Suboxone does cause side effects in some people. These side effects include, but are not limited to, asthenia, chills, headache, infection, pain, abdominal pain, back pain, withdrawal syndrome, vasodilation, constipation, diarrhea, nausea, vomiting, insomnia, and sweating.[citation needed] Because of these side effects, the FDA recommends that doctors begin any chemical detox using Subutex, which does not contain any Naloxone. In this way, if for some reason the doctor moves the patient to Suboxone and the patient begins having side effects related to naloxone, the doctor can easily move the patient back to Subutex.
well i've been proscribed subtex for about 5 years. ive most recently been at a private clinic which offers take aways on suboxone. after many months of stability, during which i received 1st class honours in a bsc majoring in math, the end of the year came and because of the newyears public holiday i was offered takeaways, but i would have to switch to suboxone. i took the takeaways and as soon as i put the dose in my mouth i started to feel chills and unease. although i only took this one dose i was unable to sleep for 3 nights. for this entire period i felt many of the above symptoms including chills, nausea, but particularly a definite sense of weakness. i lacked the will to summon drive and resolve, and felt like i was enfeebled and emotionally and physically vulnerable, and that i could not defend myself.
i could not imagine how anyone could pay to take a medication that would make them feel like that. and refused to take suboxone. of course because the regulations regarding subutex are so anal i have to visit my clinic every day which takes a considerable amount of time. i am now proceeding with a phd program and i greatly resent the people who with no personal experience proclaim that because the first pass metabolism is recorded as so high for naloxone that it must be impossible for it to be the cause of any reports of side effects. surely you will tell me i was suffering from a placebo effect. well as i have since spoken to other people who protest at the clinic that the subutex makes them feel terrible that they are certainly not dose equivalent, but because these people will not stand up for themselves and take their money elsewhere but instead cave in to the smack talk from the clinicians and accept inferior medication in exchange for greater personal freedom all similar patients must suffer the predicament. the private clinics win either way, after all they charge extra for takeaways even though they do not have to provide any service or for that matter have any cost to themselves as they receive all medications from the government for free. (they make a point of claiming that the printed label with our name in it costs $2, as some justification for charging $13/day. on days when you are required to attend there is the cost of travel, plus the time which can be over an hour in the most valuable part of the day).
well i wont waste anymore of your time but i implore you to open your mind to the possibility that you are wrong. i can suggest one explaination, perhaps the liver pathway used for naloxone first pass metabolisation is impared in certain individuals.