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Benzos Regarding sublingual use of benzos (diazepam in this context) - is there a specific technique?

BourbonMac

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Jan 14, 2022
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Hey there, just joined. I had some questions about sublingual diazepam use. I'm not too experienced with taking things sublingually.
In the mornings I will generally take it orally as I'm on an empty stomach and I understand bioavailability is high. I opt for sublingual use after meals or if I know I'm going to eat soon.

So far it seems that sublingual use has worked for me each time, however, I'm not sure if I am doing it optimally or what options I have to help speed up the process. I'm on diazepam 5s for reference, though I will usually only use half of one. I only recently started taking benzos for anxiety (short term, definitely not trying to use as a long term treatment as they are definitely addictive, love this feeling). So I don't have much of a tolerance. I've been battling with severe sinus issues / chronic headaches and my anxiety has been through the roof the past month, especially after a course of prednisone that had me going totally haywire, which led me to going on valium for a bit.

I started at 2mg, then after a couple days off I had it upped to 5mg. I may use these in an on and off fashion but it's unlikely. I normally medicate with THC but it aggravates my sinuses at the moment likely due to some kind of mild allergy. Missing it so much. I have general anxiety and C-PTSD and cannabis helps keep me grounded and evaluate my life and the world around me in a way that is nothing short of magic, been smoking for almost 11 years now (just turned 28 )

Anyway back on topic. I try to let the pill sit below my tongue in a pool of saliva for as long as I can, but these damn things take FOREVER to dissolve. I know some like to crush it up first but I don't want to potentially lose out on some meds by crushing it, maybe I'm just paranoid though.

Earlier it took well over 30 minutes to even get close to dissolving, I had to just press it around very gently with my tongue tip until it started dissolving, and also to keep it properly under my tongue. I didn't know if this was wasting any medicine, maybe a little bit? But I tried to mostly just press it around with the back of my tongue rather than the tip. I had my jaw clenched very uncomfortably this whole time to make sure I wasn't swallowing the saliva.

Also was shifting my head around to make sure the pill stayed under my tongue and not too close to the back gum line of my bottom teeth, but I'm not sure if it matters too much / if it's still very vascular there. It's really difficult to keep it in one place when there's all that saliva in there. I heard swallowing any of the saliva is bad and is basically the same as taking it orally (to the extent of which X amount of mg are lost). Probably barely anything

So that also leads me to wonder, can you just press the tablet down with the tip of your tongue against the back of your tongue until it's dissolved? I've heard of this being a strategy for certain pills, but those are generally meant to be taken sublingually. I did this at least once the other week and it seemed to still work but it might have just been similar to taking it orally, my stomach was pretty empty.

Lastly, is buccal absorption viable with these? Like, sticking it on the side of your gums till it dissolves? I never really saw anything about this with benzos, but I've read about it being doable with other drugs. That would be nice if so.
 
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jhjhsdi

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I know some like to crush it up first
I normally snap mine into 2 or 4 pieces
I had to just press it around very gently with my tongue tip until it started
Yeah I do this, really speeds it up
can you just press the tablet down with the tip of your tongue against the back of your tongue until it's dissolved?
Yeah
Lastly, is buccal absorption viable with these?
Pretty sure it is. Sometimes I'll snap into 4 and put 2 pieces under my tounge and a piece between top gum and lip on either side, not sure ive ever tried it without some under my tounge though. Takes longer to dissolve this way btw.


Powderizing them really speeds it up, get a pill crusher from ebay for like £2 then you can just tip the powder directly under your tounge. Sometimes ill take a small sip of something fizzy (usually beer or cider but sometimes pepsi max) and let that sit under my tounge with the benzo, dissolves quicker than with saliva this way.

👍
 

hydroazuanacaine

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Messages
8,352
swish it around in your mouth. it will absorb through your cheeks, gums, etc too. don’t worry about accidentally swallowing some; that will absorb as well. valium is too big a pill to hold under tongue, as you are experiencing.

this isn’t necessary. oral valium will kick in quickly even after a meal.
 

BourbonMac

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Jan 14, 2022
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According to this on pg 2: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf

"After oral administration >90% of diazepam is absorbed and the average time to achieve peak plasma concentrations is 1 – 1.5 hours with a range of 0.25 to 2.5 hours. Absorption is delayed and decreased when administered with a moderate fat meal. In the presence of food mean lag times are approximately 45 minutes as compared with 15 minutes when fasting. There is also an increase in the average time to achieve peak concentrations to about 2.5 hours in the presence of food as compared with 1.25 hours when fasting. This results in an average decrease in Cmax of 20% in addition to a 27% decrease in AUC (range 15% to 50% ) when administered with food."

That's where I got the idea food delays it or lowers bioavailability, but everyone's different. I know when I ate after feeling it intensely earlier it definitely lowered the buzz, although to be honest I was a bit overwhelmed and almost nauseous from how sedated I was, so I didn't care too much. I guess it probably just depends on the meal. If it's like a small breakfast vs. eating 2 burgers and fries, I'm sure the latter would hinder absorption the most.
 
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BourbonMac

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Jan 14, 2022
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Thanks! I've lurked around this forum for around a decade. I was 17 when I went from complete straight edge to stoner the summer going into my senior year and I was rapidly becoming interested in psychedelics and would often find myself here reading about LSD and other psychedelics

Trying again with a half pill broken into 2 stuck on each side of the under tongue frenulum, but I guess I won't worry too much if it gets close to the gumline. I keep checking in the mirror to make sure it hasn't moved lol. Hopefully it will dissolve quicker than the full half tablet this way, it seems like quarter tablets tend to dissolve quicker. It's good to know pressing it around to break it down more is OK though.

So pressing it down with the tip of your tongue doesn't mess with it at all then? It does seem like these quarter tablets are dissolving much quicker although I got some stuck to my teeth, tried to just lick it back under my gums. I have OCD so sometimes I have weird oral tics/habits like half gagging myself, just did it now and that's how it ended up on my teeth lol. Luckily diazepam is tasty. Once I see just a pool of yellow film, should I just press that down with my tongue rather than letting it hang there till it's completely gone? I'm way too paranoid of losing effectiveness lol.

Saw your posts about ket btw, congrats on being off it.

Edit: was meant to be a reply to "Welcome BTW!" but I'm not sure if it worked?
Oh wait, I was supposed to hit reply... been a bit since I was active on a forum.
 
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JTemperance

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swish it around in your mouth. it will absorb through your cheeks, gums, etc too. don’t worry about accidentally swallowing some; that will absorb as well. valium is too big a pill to hold under tongue, as you are experiencing.

this isn’t necessary. oral valium will kick in quickly even after a meal.
I agree. For me, taking diazepam SL wasn't much better than (or even different from) taking it PO. Though part of the reason for this is because it already hits so nicely taken PO under normal ("orogastric"?) conditions.

With clonazepam, I found taking it SL gave a faster and somewhat "nicer" onset than PO did. With alprazolam, I noticed a faster onset, especially on a full[ish] stomach but no real increase in enjoyment to speak of. With lorazepam, the 2mg tablets were big and chalky, so I almost always took them PO when I had it prescribed.
 

BourbonMac

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Jan 14, 2022
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Hmm maybe I misread that study then (see post above). I thought it meant bioavailability went down by 20%, but maybe that's simply meaning a delayed peak time. I know when I first took it a few weeks ago a couple hours after eating a hot dog (a long, fattening one mind you) it took quite a while till I felt it. But man was it a relief. I'd been suffering debilitating stomach cramps all night and then bam, they were 100% gone. My stomach took a serious hit from a recent course of antibiotics, or several in the last few months.
 

Keif' Richards

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Hey @BourbonMac :)

Sorry to hear about the sinus problems. I was born with sinuses that have never worked right and have led to at least a dozen infections in the course of my life along with copious amounts of surgery. I know it blows, so I hope it's not something you've gotta struggle with for too long.

Don't get too anxious about using proper technique sublingually. You are likely already doing the best you can. There are a few tricks to keep in mind.

- Make sure you don't have a dry mouth. You also don't want to be totally drooling either. Use common sense

- You should't need to crush anything. These pills are commonly used sublingually in a clinical setting, so this is nothing radical

- Once the pill is under your tongue, agitate it with the underside of your tongue a bit to hasten the dissolving process

- Don't stress out about it. Literally anything that doesn't get absorbed under your tongue will be absorbed buccally or by your gut in short order.
 

BourbonMac

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Jan 14, 2022
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Hey @BourbonMac :)

Sorry to hear about the sinus problems. I was born with sinuses that have never worked right and have led to at least a dozen infections in the course of my life along with copious amounts of surgery. I know it blows, so I hope it's not something you've gotta struggle with for too long.

Don't get too anxious about using proper technique sublingually. You are likely already doing the best you can. There are a few tricks to keep in mind.

- Make sure you don't have a dry mouth. You also don't want to be totally drooling either. Use common sense

- You should't need to crush anything. These pills are commonly used sublingually in a clinical setting, so this is nothing radical

- Once the pill is under your tongue, agitate it with the underside of your tongue a bit to hasten the dissolving process

- Don't stress out about it. Literally anything that doesn't get absorbed under your tongue will be absorbed buccally or by your gut in short order.
Yea I definitely do stress about it a little much, I guess because my supply is rather limited. I tend to stress about wasting things in general, I'm that guy who's always packing every single crumb into a bowl and my friends always made fun of me for it lol. Can't waste a granule of THC!!! Sounds like my technique has been pretty good though, although I'm currently doing sublingual again even though I only ate a small sandwich like 4 hours ago, so it's probably pointless. I doubt it really hits "harder" considering the time it can take to dissolve, unless pushing it against the back of your tongue with the tip will still work just as well.

But maybe that's what you meant by underside. I've been agitating the dissolving process with the back tip of my tongue which I know is a bit less vascular, but I do it very very gently. I know I'll likely be on and off of these between periods because A. they are definitely addictive (though I find THC moreso), 2. They're extremely beneficial to me during bouts of intense anxiety, and D. doctors/psychs don't like to give them out much these days.

Although my primary care doctor is kind if ignorant and would basically give me anything I want, He offered me diazepam when I first started seeing him in fall 2016, and I instantly said no because I knew of the addiction potential (I was pretty hooked on drinking at the time (2 years sober as of 3/7/20) and knew it would likely not be a good road). Although I thought it diazepam was xanax which kind of dissuaded me a bit itself.

BTW on another note, does tagamet actually potentiate the effects or simply lengthen the half-life? I happened to have some heart burn earlier and noticed I had cimetidine so I was like, let's try it lol, I took 400mg of the tagamet, but I've seen others suggest 600-800mg but I was afraid of some kind of bad stomach reaction. Maybe it wouldn't really matter.

I know this supposedly potentiates opiates (and kratom, although there is evidence that GFJ and cimet actually make kratom not work as well and that was true the one time I tried it). I doubt it would result in much of a difference. I took 2.5mg roughly 7 hours ago orally on empty stomach before work, which I quickly regretted because I got very sedated. So I figured my next dose I'd be a little tolerant to, I was definitely more tolerant to my 2nd dose yesterday evening around the same amount of time after. Needed to drink almost 200mg of caffeine which really felt like 50mg and my caffeine tolerance is at zero from cold turkeying it last month in the middle of antibiotic related stomach issues.

Tolerance is definitely going up a bit faster on valium 5s compared to when I was on the 2mgs, so I'll have to stave and skip some doses when I don't need them. I didn't really need any this morning and kind of regretted it overall.

Edit: it almost seems like tagamet has made the valium LESS effective, tbh. I only have a slight tolerance and don't feel what I normally would. I know it for sure killed my afternoon kratom dose and I feel nothing at all, but I could've seen that coming. I think with kratom, anyone who thinks tagamet potentiates is probably placebo'ing based on so many reddit posts about it potentiating lol. The kratom subreddit is actually full of crazies

Anyway I read "coadministration of diazepam with antacids or a standard meal reduces the rate o.f absorption but does not reduce extent of absorption"
So maybe that just means it takes longer to kick in with an antacid?

Source if anyone is curious: I'm honestly not super familiar with how to read studies like this https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1002/cpt1978245600
 
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BourbonMac

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Jan 14, 2022
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So slight update:

I'm pretty sure my last dose didn't hit me well mostly due to caffeine from earlier. My caffeine tolerance as mentioned is basically none at the moment because I quit drinking coffee last month. I was too sedated off my morning 2.5mg dose before work (a calm magenesium gummy probably didn't help, those can sedate me a bit too. been irregular) and grabbed a dunkins iced french vanilla bottle (186mg of caffeine). This was consumed around 10:30am, and if caffeine has a half life of 5-6 hours, I took my 5mg valium dose around 4:30pm. So at least 80-90mg of caffeine was still active in my system and probably countered much of the valiums effect. This is the first time I've really consumed valium after caffeine with the exception of yesterday, but I'd only had a small K-cup (80mg I believe) and this was several hours after that, so I only had 20-30mg left in me (had also taken 100mg L-theanine which largely counters caffeines stimulating effects).

So yeah overall, I think the caffeine sorta killed my buzz earlier. I know my tolerance has gone up a bit but doubling my dose from this morning should have at least resulted in the same effect, I wasn't even slightly sedated. Probably not gonna mess with the tagamet potentiation either way as it's getting into the realm of recreation/abuse and these valiums are really only meant to be used as needed. I just love to experiment with different drugs whenever they can come my way, really. But opiates are one that I've never been keen to get into, though I use kratom fairly often that is quite far off from H or oxys)

My headaches have largely improved lately so I'm gonna yolo it tonight and hit a distillate vape pen. So far in the past monthish I haven't been able to successfully ingest THC without at least some kind of added sinus pressure, but there was one day when I was having a panic attack so bad I said fuck it and smoked anyway. My head hurt, but my mental health improved almost instantly even into the next day. I miss THC so bad... can't believe I'm practically substituting it with a benzo. What a weird stage of my life. Using pharms because my regular medicine aggravates my sinus condition.


Update #2: Ok, tagamet DEFINITELY, 100% extends diazepams effects. Hard to comment on potentiation since I still had a decent amount of caffeine in my system during my 2nd dose today. If it was a potentiator it probably would have been noticeable through the caffeine, so I think it's mostly about extending the effects. I'm sure that would lead to more rapid tolerance development for sure, so I'm not likely to try this too often unless I'm down to a couple pills. Luckily I can't get these very often because damn, they make me feel good. But I can't lie I felt guilty and kind of ashamed of myself earlier because I know that despite being prescribed these for legitimate anxiety, I'm also enjoying getting high off them. I suppose that guilt helps protect me from getting deeper into this, I just love experimenting with different drugs

Once the caffeine fully wore off, suddenly I was feeling it, hours later. I guess I know in the future not to drink coffee until well after it's kicked in, then I can get a nice synergy without overstimulation which I was feeling quite nicely at work. Was moving around all over the place staying busy, just feeling good in general.
 
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BourbonMac

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Jan 14, 2022
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Sorry for triple post but wow... I actually felt nauseous from my last 2.5mg dose, like it sedated me so much that I felt like I was gonna faint and I immediately had to eat something. That's kind of what happened to me before my dinner last night when I subbed. Though I hadn't eaten much today to begin with, basically just dinner. I should note I staggered 900mg gabapentin and got a very stimulating high. I just wanted to talk to everyone on earth. I actually thought that was the valium coming back on after the caffeine wore off, but it wasn't. Once I took the valium I became extremely sedated and lost that nice high. So long story short, I think I prefer gabapentin lol. I find they both feel similar, but valium is much more sedating and gabapentin stimulating. I find mixing them is kind of awkward. Maybe the gabapentin just potentiated the crap out of the valium. I am suuuuper sedated right now and don't even know what's going on to be honest. I'm basically not even awake as I'm typing this.
 

Robi

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Thanks! I've lurked around this forum for around a decade. I was 17 when I went from complete straight edge to stoner the summer going into my senior year and I was rapidly becoming interested in psychedelics and would often find myself here reading about LSD and other psychedelics

Trying again with a half pill broken into 2 stuck on each side of the under tongue frenulum, but I guess I won't worry too much if it gets close to the gumline. I keep checking in the mirror to make sure it hasn't moved lol. Hopefully it will dissolve quicker than the full half tablet this way, it seems like quarter tablets tend to dissolve quicker. It's good to know pressing it around to break it down more is OK though.

So pressing it down with the tip of your tongue doesn't mess with it at all then? It does seem like these quarter tablets are dissolving much quicker although I got some stuck to my teeth, tried to just lick it back under my gums. I have OCD so sometimes I have weird oral tics/habits like half gagging myself, just did it now and that's how it ended up on my teeth lol. Luckily diazepam is tasty. Once I see just a pool of yellow film, should I just press that down with my tongue rather than letting it hang there till it's completely gone? I'm way too paranoid of losing effectiveness lol.

Saw your posts about ket btw, congrats on being off it.

Edit: was meant to be a reply to "Welcome BTW!" but I'm not sure if it worked?
Oh wait, I was supposed to hit reply... been a bit since I was active on a forum.
yeah welcome to BL, someone here told me about grapefruit juice , wait maybe that was for opioids, ugh, but glad to have you on board with us, i take xanax but i like it so much...to feel NORMAL, is amazing after the time i spent wrecking my brain on fent, so i do my best only to take them when i feel like imma fight or flight and seems my anxiety is going away, as in not anxious just sitting quietly, sure i get anxious when shit hits the fan, but seems things are getting manageable, and just for meeeee glad i didnt follow thru with SSRI`s and SARI, but yep i just stick under my tongue, bitter doesnt bother me much, but i personally didnt feel any diff from just swallowing , just .5s . bright blessings to you and yours
 

Nas47

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Hey there, just joined. I had some questions about sublingual diazepam use. I'm not too experienced with taking things sublingually.
In the mornings I will generally take it orally as I'm on an empty stomach and I understand bioavailability is high. I opt for sublingual use after meals or if I know I'm going to eat soon.

So far it seems that sublingual use has worked for me each time, however, I'm not sure if I am doing it optimally or what options I have to help speed up the process. I'm on diazepam 5s for reference, though I will usually only use half of one. I only recently started taking benzos for anxiety (short term, definitely not trying to use as a long term treatment as they are definitely addictive, love this feeling). So I don't have much of a tolerance. I've been battling with severe sinus issues / chronic headaches and my anxiety has been through the roof the past month, especially after a course of prednisone that had me going totally haywire, which led me to going on valium for a bit.

I started at 2mg, then after a couple days off I had it upped to 5mg. I may use these in an on and off fashion but it's unlikely. I normally medicate with THC but it aggravates my sinuses at the moment likely due to some kind of mild allergy. Missing it so much. I have general anxiety and C-PTSD and cannabis helps keep me grounded and evaluate my life and the world around me in a way that is nothing short of magic, been smoking for almost 11 years now (just turned 28 )

Anyway back on topic. I try to let the pill sit below my tongue in a pool of saliva for as long as I can, but these damn things take FOREVER to dissolve. I know some like to crush it up first but I don't want to potentially lose out on some meds by crushing it, maybe I'm just paranoid though.

Earlier it took well over 30 minutes to even get close to dissolving, I had to just press it around very gently with my tongue tip until it started dissolving, and also to keep it properly under my tongue. I didn't know if this was wasting any medicine, maybe a little bit? But I tried to mostly just press it around with the back of my tongue rather than the tip. I had my jaw clenched very uncomfortably this whole time to make sure I wasn't swallowing the saliva.

Also was shifting my head around to make sure the pill stayed under my tongue and not too close to the back gum line of my bottom teeth, but I'm not sure if it matters too much / if it's still very vascular there. It's really difficult to keep it in one place when there's all that saliva in there. I heard swallowing any of the saliva is bad and is basically the same as taking it orally (to the extent of which X amount of mg are lost). Probably barely anything

So that also leads me to wonder, can you just press the tablet down with the tip of your tongue against the back of your tongue until it's dissolved? I've heard of this being a strategy for certain pills, but those are generally meant to be taken sublingually. I did this at least once the other week and it seemed to still work but it might have just been similar to taking it orally, my stomach was pretty empty.

Lastly, is buccal absorption viable with these? Like, sticking it on the side of your gums till it dissolves? I never really saw anything about this with benzos, but I've read about it being doable with other drugs. That would be nice if so.
Never ever tried to use valium sublingual.I dont know about his sublinguai/bucall bioavailavility nothing.Oral way is with high and fast absorbtion.Also in the past used ampules-im(it hurts,cause the spirit) and iv.As i know there is no sublingual diazepam in our pharmacies.Snorting the crushed pill does not give any effect at me....
 

BourbonMac

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Jan 14, 2022
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Hmm so it seems like for most of you it doesn't matter whether taken before or after food?
I've heard of the term "lipophilic" regarding diazepam and midazolam but I wasn't entirely sure what it meant in this context. It seems basically that it means oral bioavailability is the highest with these two benzos in particular or something, so it shouldn't really matter as it can bind to fats. Just want to be sure I'm clear on that.

I've continued using these sublingually but it honestly does not seem to make any difference and it can make my jaw/head hurt to keep it positioned in such a way for the pill to stay still and such. It seemed like a good way to take it on a full stomach if I want it to work faster, but it sounds like it should work the same regardless and just take like, an hour longer to kick. But yeah I hardly notice any increased "rush" compared to empty stomach.
 
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