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PostPosted: Sat Jun 07, 2014 2:25 pm 
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So, my boyfriend, after being on methadone for about six years straight, has decided to make the jump from methadone to Suboxone. :) I'm really happy about it, because the clinic really is in the way of him moving on with his life. (This is because of the clinic structure, including 10 hours of treatment a week, and no, they don't work with you and are totally inflexible. This isn't how every clinic is, certainly, but his is particularly awful.) By him switching over to Suboxone, he will be able to go back to work, not to mention that we will be able to sleep in on the weekends. :) I'm so excited for him (and me!).

So here are my questions.....I'm coming on here "for" him because he doesn't come onto this site....

For the last year+ he's been at 60mg or below. He dropped down to 50mg around maybe December, then 45mg maybe in February, 40mg about a month ago, and then 35mg five days ago. He's going to make the jump at 35mg. (He would have gone down lower, but he literally has had to wait sometimes six weeks to get in and see the doctor, the doctor calls out all the time, and the doctor won't order any dose decreases ahead of time; each time, you need to SEE the doctor to go down -- these are all examples of how awful his program is, BTW.)

His last day of medication will probably be Thursday or Friday (which will mean he'll have been on the 35mg for about ten days then).

The plan, as of now, is to supplement with "comfort meds" (Klonopin and possibly Catapres, maybe Immodium, etc.) while he is waiting to be in enough withdrawal before taking the Suboxone. I know that we will use the COWS too. I think he should start off with a VERY small dose (maybe 1mg), then build up. He can always take more, right?

What are any suggestions? What is a typical timeline when someone has been on 40mg or less for about six weeks? How long would you suggest that he wait to take the first Suboxone dose? Do you think that 1mg is a good "test" dose to decrease the chances of PW?

I am grateful in advance for any suggestions or feedback! Thanks!


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PostPosted: Sat Jun 07, 2014 2:39 pm 
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To be on the safe side, I'd make sure he waits 3-5 days. He needs to be in real/ full withdrawals. not just the beginning, sweaty/ anxious stage. Everyone is different though and you never know who will get lucky. If he would like avoid PWs, better safe than sorry. I believe starting with a low, 1mg dose helps to test the waters but it's not fool proof.

There are a lot of good threads here with tons of info. It's very cool of you t be helping him with this. Best of luck, we're around if you need anything.


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PostPosted: Sun Jun 08, 2014 4:35 pm 
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I'll just add that 3-5 days is better than 1-2, but it is still not the safe side! The longer off methadone the better-- and I've seen patients struggle even after waiting over a week, with 40 mg methadone tolerance. The longer the better-- the same is true in people taking large amounts of fentanyl for many days (where it has had the time to build up in the system).


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PostPosted: Sun Jun 08, 2014 7:08 pm 
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I only speak from my experience as I'm actually transitioning now! I took my last 34mg dose on Froday @8am and the following day I took 2mg suboxone (26 hours after my last methadone dose). Everything went well in regards to PW's and such, but for that first day I only took 3mg suboxone altogether. I was very physically anxious and fast heart beat but no other uncomfortable withdrawals. That night I slept like a baby. Today when I woke up, I took 1mg suboxone and then 2mg more a few hours later and then finally 1mg more later on. Still extreme anxiety but no other withdrawal. I decided to take 3mg klonopin today and the anxiety is gone and I feel fine now. I plan on taking the klonopin until I have stabilized (or at least until the anxiety goes away from making the switch!)


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PostPosted: Mon Jun 09, 2014 9:33 am 
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Just after last Christmas I switched from Methadone to Suboxone; my Methadone dose was at 25 Mg/per day, and I waited 72 hours until my first Suboxone pill. The switch went fine.

The 72 hours in between was dead easy btw, and I'm the worst baby in the world when it comes to dealing with withdrawal. Mostly I just took it easy and watched vids the whole time. By the time it was over, I was thinking, 'I was worried about this?'

-- JI

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"Past and future veil God from our sight; burn both of them with fire."
-- Rumi, Sufi poet and teacher


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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