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View Full Version : Help For The Junior Junkies - by Dan Duchaine



Sistersteel
02-21-2009, 01:14 AM
Nubain is the Dupont trade name for nalbuphine hydrochloride, a clear injectable liquid with analgesic effects equivalent to morphine on a milligram by milligram basis. Although it is a prescription drug in the US, it is not specially scheduled by the FDA. For this reason, Nubain is generally available and reasonably priced on the sports black market.

I think that it’s safe to say that Nubain use (or abuse) seems to be a problem only in the bodybuilding and powerlifting subculture. I can say with authority that a substantial number of the top-placing competitors in any national or international bodybuilding contest are using Nubain. In some years, eight out of the top ten competitors in the Mr. Olympia contest use this drug.

Although Nubain users don’t fit the typical drug user profile, Nubain use is definitely a problem within the “fitness” subculture. Although the health problems caused by Nubain are not immediately apparent, Nubain users do suffer from withdrawal symptoms if they stop taking their drug of choice. Nubain withdrawal resembles a bad case of the flu. Symptoms include fever, tiredness, body ache, diarrhea, sneezing, and anxiety. Some ex-users experience even more severe symptoms, which we’ll discuss shortly.

Why did bodybuilders and powerlifters, supposedly the epitome of health and strength, start taking Nubain in the first place? The answer goes back almost two decades. In 1984, many major steroid dealers had been arrested, and most of the black market was being serviced out of Santa Clara, California by a man named Steven Coons, who was also the front man for the so-called “designer steroids” made by Jeff Feliciano. Coons touted the sedative, pain-killing, appetite-suppressing, diuretic, and euphoric properties of Nubain. He said that Nubain would help bodybuilders to endure the pain of extreme workouts, and he put a bottle of Nubain into many of the steroid orders that he was shipping nationwide. Like many Nubain users, I was a very “clean and sober” person when I first tried it in 1985. I didn’t smoke, consume alcohol, or take recreational drugs. Nubain was supposed to be totally harmless, and even beneficial.

Nubain can be injected in three ways: intramuscularly, subcutaneously, and intravenously. Because the intravenous route does not cause a stinging sensation, most Nubain users eventually switch to IV injections. Bodybuilders and powerlifters who are used to injecting steroids, unlike the general potion, are accustomed to needles and injections, so IV Nubain use is not that big of a jump. Perhaps the stigma of IV drug use is the reason that Nubain addiction has sta in this subculture and not spread to the general potion---unlike GHB - gamma hydroxybutyric - , which began as a bodybuilding and longevity drug, and was later adopted by reckless teenagers.

The wholesale price for 10 cc of generic, 20 mg/ml nalbuphine, made by Astra or Abbot, is about $15. The retail price of Nubain, over the counter in Tijuana, is about $35. In Mexico, all nalbuphines are prescription drugs, and Mexican-made Nubain is only available in a 10 mg/ml dose. However, most Tijuana pharmacies buy 20 mg/ml of Astra nalbuphine from San Diego wholesalers and smuggle it in to Mexico.

Although Nubain is not specially scheduled by the FDA, the dosing patterns of Nubain users indicate that it is a powerfully addictive drug. Users typically inject between 10 mg to 20 mg every two to four hours. A Nubain habit can be very expensive. Some users go through a whole 10 cc bottle every day---about $250 a week! And that’s in Southern California, where Nubain is relatively cheap. In some areas of the country, such as New Jersey, the retail black market price is close to $100 a bottle.

Intravenous drug users tend to favor certain injection sites. After months of consistent injections, the skin in this area becomes scarred, leaving “track marks” like those of heroin addicts. Some Nubain users routinely have a cosmetic surgeon cut out the track marks, because the scars from cosmetic surgery are less noticeable than the scars from the drug injections. A few bodybuilders use Stadol or Torbugesic instead of Nubain. Both Stadol (butorphanol tartrate) and Torbugesic (the veterinary version of Stadol) are about ten times stronger than Nubain. Two mg/cc of Stadol has the same effect of 20 mg/cc of Nubain! Although they are not scheduled by the FDA, these two drugs are more difficult to find on the black market than Nubain.

Researchers have shown that Stadol has greater effects on women than men. When I read about this effect, I postulated that women would have greater withdrawal symptoms coming off Nubain. I have found this to be true. Women definitely have more severe withdrawal symptoms than men. Of course, there are always “junior junkies” who grovel, beg, and drive hundreds of miles to avoid a Nubain withdrawal. Personally, I think that they are acting like big babies. I’m afraid that I may have had a part in encouraging these “junior junkies” to use Nubain. Because I’ve never had problems with withdrawal symptoms---or because I was too proud to show any weakness to my friends and relatives---I didn’t present the worst problems caused by Nubain addiction. To repair any damage I may have caused by my cavalier way of dispensing information about Nubain, I’m going to tell you how to get off Nubain (or Stadol) with absolutely no withdrawal symptoms.

First, a little science. Narcotic drugs attach to one or more of the three opiate receptors (delta, kappa, and mu). The most potent of these analgesics hit all three receptors, while Nubain primarily binds at the kappa receptor, and has a mixed agonist/antagonist action at the delta receptor.

The first step is to break the habit of intravenous injection. Many habitual Nubain users find it pleasurable to inject the drug. It’s a comfortable ritual that Nubain users miss in the same way that ex-smokers miss the whole ceremony of lighting up and inhaling a cigarette. What we need to take the place of Nubain is a non-scheduled oral analgesic.

Our prime candidate is tramadol hydrochloride, known in America as Ultram, which comes in a 50 mg tablet. It is also available in 50 mg capsules in Mexico as TRADOL, and costs about $20 for ten capsules. NOBLIGAN, another version of tramadol, is a real buy at $10 for ten capsules if you can find it. It was when Oliver Star and I previously discussed withdrawal protocols, when he mentioned that he had found an oral sedative to replace Nubain, the Ultram.

To start the process of withdrawal without symptoms, immediately stop using all Nubain, and start taking 50 mg of tramadol, three times a day. Tramadol only binds at the delta receptor, so it makes Nubain withdrawal much easier. You won’t feel any euphoria, but you also won’t feel the flu-like symptoms of an unassisted withdrawal. For the first week, take three 50 mg doses of tramadol a day. For the second week, take two per day, and take only one per day during the last week. After three weeks, you will feel relatively normal. The only side effects that may linger are sneezing or coughing, and perhaps a slight feeling of tiredness.

Tramadol is not strong enough for some female Nubain users. They need a stronger oral analgesic before they progress to tramadol. The best choice is TEMGESIC (buprenophine hydrochloride) sublingual tablets from Mexico. (Although there is an injectable version in the US called BUPRENEX, you want to avoid injectable compounds.) Temgesic is Schedule V in the US and prescription-only in Mexico. Unfortunately, it’s not cheap---about $25 for ten tablets in Tijuana pharmacies.

After complete Nubain cessation, women should use only one Temgesic sublingual (each tab contains .2 mg). Temgesic binds at the delta receptor for a very long time, which makes it effective for up to up to 24 hours. Use the Temgesic once daily for a week, and then switch to the tramadol protocol.

Is Nubain addiction a big problem? Well, compared to cocaine, marijuana, tobacco, and alcohol---in a word, no. More people are addicted to and die from the effects of these drugs than have even heard of Nubain. However, for the small corps of overly dependent Nubain users, I hope that this protocol will help to break the habit without unnecessary suffering.

Do we have a subculture Nubain problem, and should we do something about it? I believe that the problem is relatively minor. Nubain, from a medical standpoint, is pretty much inoffensive, other than the stigma of injectable drug use. Unfortunately, illustrating the problem in the media will probably rise too much interest, and we would end up with more people experimenting with Nubain, spreading it out of the subculture. There is a small core of Nubain users who are overly dependent on this drug, and we could debate the morality of such recreational drug use. It certainly is safer than marijuana, cocaine, tobacco and alcohol. Now that I have developed this Nubain withdrawal protocol, I’m hoping that all those who want to break the Nubain habit, can now do so with no suffering.

Aaron Singerman
02-21-2009, 02:44 AM
I agree with Dan... Nubain withdrawals are very mild compared to almost any other pain killer...

SonOfPluto
02-21-2009, 04:54 AM
Tramadol is easy to purchase off the internet. It can be bought for as cheap as $85.00 for 180 pills. All you do is answer a bunch of questions and the doctor will write you a script and ship it out fed ex for next day delivery. If anyone is struggling with opiate addiction, and need links to a few reputable places you can PM me. I hate to see another struggling with this personal hell..

One has to be very careful with Tramadol if they have an addictive personality. The physical withdrawals are much worse then Nubain and compare in effect to coming off Vicodin. Now ignorant doctors won't tell you they. They have been brainwashed by the pharmaceutical companies that claim Tramadol has no addictive properties. By perpetuating this lie, they are able to still sell it readily as a non-controlled substance. However, because Tramadol is longer acting, the withdrawal effects typically last longer then Vicodon or even Oxycodone and Heroin, the worst being over after 4 to 5 days. If anyone has any questions about this drug, then I'm the one to ask! For such people with extremely addictive personalities, I've found that Phenibut works really well in easing opiate withdrawal symptoms. And even with this compound, one has to be really careful. Tolerance is developed extremely fast, usually within 1 to 2 days of continued use, and one often vomits when first withdrawling from it. It works somewhat like zanax, but binds primarily to GABA B receptors, and causes the simultaneous release of Dopamine too, while at the same time, inhibiting the release of the stimulant neurotransmitter PEA. I think its this inhibition effect that is responsible for the vomiting produce when one withdrawals after developing tolerance. Phenibut is over the counter for now, but it wouldn't surprise me if the FDA eventually pulled it off the market.

Sistersteel
02-21-2009, 08:47 AM
Tramadol is easy to purchase off the internet. It can be bought for as cheap as $85.00 for 180 pills. All you do is answer a bunch of questions and the doctor will write you a script and ship it out fed ex for next day delivery. If anyone is struggling with opiate addiction, and need links to a few reputable places you can PM me. I hate to see another struggling with this personal hell..

One has to be very careful with Tramadol if they have an addictive personality. The physical withdrawals are much worse then Nubain and compare in effect to coming off Vicodin. Now ignorant doctors won't tell you they. They have been brainwashed by the pharmaceutical companies that claim Tramadol has no addictive properties. By perpetuating this lie, they are able to still sell it readily as a non-controlled substance. However, because Tramadol is longer acting, the withdrawal effects typically last longer then Vicodon or even Oxycodone and Heroin, the worst being over after 4 to 5 days. If anyone has any questions about this drug, then I'm the one to ask! For such people with extremely addictive personalities, I've found that Phenibut works really well in easing opiate withdrawal symptoms. And even with this compound, one has to be really careful. Tolerance is developed extremely fast, usually within 1 to 2 days of continued use, and one often vomits when first withdrawling from it. It works somewhat like zanax, but binds primarily to GABA B receptors, and causes the simultaneous release of Dopamine too, while at the same time, inhibiting the release of the stimulant neurotransmitter PEA. I think its this inhibition effect that is responsible for the vomiting produce when one withdrawals after developing tolerance. Phenibut is over the counter for now, but it wouldn't surprise me if the FDA eventually pulled it off the market.


The one and only miracle drug for opiate withdrawals is suboxone/subutex.
Probably a lot harder to come by. You can always find a friendly psychiatrist to prescribe some. Very easy to abuse though.I am very interested in tramadol though. I would like to start a thread about it and your contribution is very welcome. Thank you for posting.

Dr. Joel Nathan
02-21-2009, 09:52 AM
As a certified Addiction Medicine physician, I have personally treated two men who came to me specifically because of not being able to stop using nubain. They both are examples of extremely healthy guys who eat, train and live a healthy lifestyle. They help others attain their goals both in the gym and with help in a huge way their families and others. Both had no idea it was addicting.

I have treated one with Suboxone (buprenorphine + naloxone) sublingual tabs and the other with Subutex (buprenorphine only) sublingual tabs. The second is on Subutex because he gets ill when he takes Suboxone.

Suboxone IS an amazing med. Although, it is an addicting opioid (man made opiate), it is not an exciting drug. If one's opiate of choice is like milk chocolate, then Suboxone is like dark chocolate (well, it's not enjoyable but it sure works well to stop cravings and I don't finish my month's supply way ahead of time).
Is this trading addictions? Yes, you're going from one opioid (agonist/antagonist) to another addicting drug. However, Suboxone is long acting, stops craving and works well for total detox or for maintenance.

Opiates turn on you. Ususally for the "jock" it gives them the ability to focus and relax at the same time. It give a big boost in energy. This is why it is so cunning. However, it becomes your master, you need to take more over time and you have to take it to even feel normal after a while. Craving increases. Then, Yelp, it's time to do something about it.

Stay informed. It's your health, take control of it.

SonOfPluto
02-21-2009, 08:52 PM
As a certified Addiction Medicine physician, I have personally treated two men who came to me specifically because of not being able to stop using nubain. They both are examples of extremely healthy guys who eat, train and live a healthy lifestyle. They help others attain their goals both in the gym and with help in a huge way their families and others. Both had no idea it was addicting.

I have treated one with Suboxone (buprenorphine + naloxone) sublingual tabs and the other with Subutex (buprenorphine only) sublingual tabs. The second is on Subutex because he gets ill when he takes Suboxone.

Suboxone IS an amazing med. Although, it is an addicting opioid (man made opiate), it is not an exciting drug. If one's opiate of choice is like milk chocolate, then Suboxone is like dark chocolate (well, it's not enjoyable but it sure works well to stop cravings and I don't finish my month's supply way ahead of time).
Is this trading addictions? Yes, you're going from one opioid (agonist/antagonist) to another addicting drug. However, Suboxone is long acting, stops craving and works well for total detox or for maintenance.

Opiates turn on you. Ususally for the "jock" it gives them the ability to focus and relax at the same time. It give a big boost in energy. This is why it is so cunning. However, it becomes your master, you need to take more over time and you have to take it to even feel normal after a while. Craving increases. Then, Yelp, it's time to do something about it.

Stay informed. It's your health, take control of it.

How much suboxone did you treat them with. I went through rehab for my tramadol addiction and I got by on only 4mg/day. It seems like with bain, one could probably get away with even 2mgs a day, and then cut the tablets up from there. Cold turkey with suboxone is no joke I found out. Some of the guys there that had huge oxycotin habits where started out at dosages as high as 24 to 32 mgs a day! I can't imagine having to come down and taper off that starting dose. Plus, the stuff is expensive as all get out, fortunately, my blue cross covered it.

SonOfPluto
02-21-2009, 08:56 PM
The one and only miracle drug for opiate withdrawals is suboxone/subutex.
Probably a lot harder to come by. You can always find a friendly psychiatrist to prescribe some. Very easy to abuse though.I am very interested in tramadol though. I would like to start a thread about it and your contribution is very welcome. Thank you for posting.

That's a good idea, I'm sure I'll have quite a bit to post there and would be more then happy to answer everybody's questions. I do know a lot of the tricks of the trade for combating withdrawal symptoms. I've even had success with using OTC cough syrup when I couldn't get a hold of anything else. I think a very low dose of zanax combined with tramadol is the best way to go. At night, you'll most likely be somewhat restless the first week, so upping the dose of zanax is temporarily recommended. I don't recommend using suboxone in order to withdrawal off nubain. Its much stronger then what is needed in my opinion, thats why I would stick with tramadol. Plus suboxone is very expensive and its typically not coverd by insurance, while tramadol is relatively inexpensive and easy to obtain legitimate prescriptions for off the net. Having withdrawn from various opiates: including vicodin and high dosages of codeine, I would rate the physical withdrawal symptoms as moderately severe at most, certainly not as bad as 'full agonist' opiates such as the ones mentioned. I think the psychological cravings are by far the worst for nubain! Anybody that has been hooked on it can attest to that wonderful feeling of starting off your day with a shot! When you go off it, waking up really sucks! At least at first...

Dr. Joel Nathan
02-21-2009, 11:32 PM
Suboxone/Subutex is very tightly bound to the opiate receptor. It does not come off until the receptor actually deteriorates. When one decreases a dose, the change can be felt by the next day; however, by day 3 after the change, usually you feel well.

Suboxone/Subutex is extremely strong at low doses. The longer your doc keeps you on this the harder it is to actually get off of it completely. If someone is not going to be going on maintenance, then I keep the detox to a 2-4 week period only.

The dose is individualized. My posting about dosing is not appropriate, in my opinion, as a doc.

Sistersteel
02-21-2009, 11:41 PM
That's a good idea, I'm sure I'll have quite a bit to post there and would be more then happy to answer everybody's questions. I do know a lot of the tricks of the trade for combating withdrawal symptoms. I've even had success with using OTC cough syrup when I couldn't get a hold of anything else. I think a very low dose of zanax combined with tramadol is the best way to go. At night, you'll most likely be somewhat restless the first week, so upping the dose of zanax is temporarily recommended. I don't recommend using suboxone in order to withdrawal off nubain. Its much stronger then what is needed in my opinion, thats why I would stick with tramadol. Plus suboxone is very expensive and its typically not coverd by insurance, while tramadol is relatively inexpensive and easy to obtain legitimate prescriptions for off the net. Having withdrawn from various opiates: including vicodin and high dosages of codeine, I would rate the physical withdrawal symptoms as moderately severe at most, certainly not as bad as 'full agonist' opiates such as the ones mentioned. I think the psychological cravings are by far the worst for nubain! Anybody that has been hooked on it can attest to that wonderful feeling of starting off your day with a shot! When you go off it, waking up really sucks! At least at first...

Xanax really never did much for me coming off opiates. I had the shakes so bad and a horrible dry cough that would creep up on me and I would agonize in pain and vomit for days. I use to buy my suboxone off the street for ten bucks a tab and all it took was 3 or 4 pills to help me come off heroin binges that lasted months. Benzos on the other hand came in very handy coming off the uppers.

I would not call it a wonderful feeling though having to get up every day to a shot just to get out of bed. It became a chore. Something I had to do to stay alive and out of jail. I remember the first thing on my mind every morning was..."I am going to run out soon and need money to stock up".

No one can live like that. F* that.

Sistersteel
02-21-2009, 11:43 PM
Suboxone/Subutex is very tightly bound to the opiate receptor. It does not come off until the receptor actually deteriorates. When one decreases a dose, the change can be felt by the next day; however, by day 3 after the change, usually you feel well.

Suboxone/Subutex is extremely strong at low doses. The longer your doc keeps you on this the harder it is to actually get off of it completely. If someone is not going to be going on maintenance, then I keep the detox to a 2-4 week period only.

The dose is individualized. My posting about dosing is not appropriate, in my opinion, as a doc.


What is your opinion on Methadone as a form of maintenance doc?

SonOfPluto
02-22-2009, 12:35 AM
Xanax really never did much for me coming off opiates. I had the shakes so bad and a horrible dry cough that would creep up on me and I would agonize in pain and vomit for days. I use to buy my suboxone off the street for ten bucks a tab and all it took was 3 or 4 pills to help me come off heroin binges that lasted months. Benzos on the other hand came in very handy coming off the uppers.

I would not call it a wonderful feeling though having to get up every day to a shot just to get out of bed. It became a chore. Something I had to do to stay alive and out of jail. I remember the first thing on my mind every morning was..."I am going to run out soon and need money to stock up".

No one can live like that. F* that.

I agree that its not a way of life. When I mentioned the wonderful feeling, I wasn't referring to the stronger opiates like heroin, only bain. I'm glad I never heroin, otherwise I would have been a street junkie for sure. You really sound like you've been through hell and back with your addictions, mad props to you for staying clean.

SonOfPluto
02-22-2009, 12:38 AM
I agree with Dan... Nubain withdrawals are very mild compared to almost any other pain killer...

For me, it was the psychological withdrawals from Nubain that really did me in.

Sistersteel
02-22-2009, 12:56 AM
I agree that its not a way of life. When I mentioned the wonderful feeling, I wasn't referring to the stronger opiates like heroin, only bain. I'm glad I never heroin, otherwise I would have been a street junkie for sure. You really sound like you've been through hell and back with your addictions, mad props to you for staying clean.


I have a room in hell reserved just for me actually. lol
Statistically over 85% of IV users relapse and die. Everyone I knew did. I have come a long way since. So I am grateful.

Dr. Joel Nathan
02-22-2009, 03:09 PM
Methadone is not for everyone. If someone is going to share needles, has many more psych issues than average, or is in an unstable living situation, Methadone would be a good choice if Suboxone is not possible.


Methadone gives you a "clouded" head. (Some like this clouded effect.). In addition, with methadone, you have to piss test in front of someone on a regular basis to show you are only using the methadone and no non-prescribed narcotics.

Each person has to weigh the pros and the cons and make a decision that works for their situation. Talking with someone who has experience in addiction treatment can give you food for thought.

It's you Health-take Control of it.

Sistersteel
02-22-2009, 03:15 PM
Methadone is not for everyone. If someone is going to share needles, has many more psych issues than average, or is in an unstable living situation, Methadone would be a good choice if Suboxone is not possible.


Methadone gives you a "clouded" head. (Some like this clouded effect.). In addition, with methadone, you have to piss test in front of someone on a regular basis to show you are only using the methadone and no non-prescribed narcotics.

Each person has to weigh the pros and the cons and make a decision that works for their situation. Talking with someone who has experience in addiction treatment can give you food for thought.

It's you Health-take Control of it.


I know many addicts that were saved via methadone. I think it's a wonderful medication, but I think that's it's vastly overprescribed by many addiction specialists. I know some people "can't ever get clean" according to some specialists, but I question their qualifications for that classification of addict. Methadone is great for detox... and the whole point of getting clean (IMO) is to rid yourself of a chemical dependency. Methadone doesn't have the high of H (or other opiates), but it's still an opiate... a very strong one at that.

When someone with a 30 year smack addiction can go through a methadone detox and recover... and another person with a much smaller history by comparison can't... there's something wrong there.

I think recovery and dealing with life on life's terms needs to be pushed... not a drug substitute.

Dr. Joel Nathan
02-22-2009, 11:35 PM
When you wrote: "life on life's terms needs to be pushed... not a drug substitute." You nailed it. Recovery does not come from anything that can be seen. There's tools to get one through ANYTHING. In these difficult times, having that support already in place has been helpful to the people that I help.

What I find is amazing is that when I'm spiritually fit, I also am able to workout with more focus and strength. It all takes practice and learning from mistakes.

Sistersteel
02-22-2009, 11:50 PM
When you wrote: "life on life's terms needs to be pushed... not a drug substitute." You nailed it. Recovery does not come from anything that can be seen. There's tools to get one through ANYTHING. In these difficult times, having that support already in place has been helpful to the people that I help.

What I find is amazing is that when I'm spiritually fit, I also am able to workout with more focus and strength. It all takes practice and learning from mistakes.


Coping skills. We develop them as a survival mechanism.
When I am not in touch with my higher power, my mind starts to wander. I know its time to take a step back and connect with the Lord again, Catch a meeting, call my sponsor. Its when I do NOT take initiative to shoot that monkey on my back that is a huge tell tale sign that something is wrong.

47ronin
02-25-2009, 12:46 AM
[quote=Sistersteel;40430] In some years, eight out of the top ten competitors in the Mr. Olympia contest use this drug.

Now I know why so many pro bodybuilders wear fanny packs- so they won't be w/o their bain and needles.