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PostPosted: Sun Dec 25, 2016 9:44 am 
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Hello everyone I am a 32 year old male that has been on methadone maintenance for some time now I am 72 hours into my last dose I know that your supposed to come down to 30mg of methadone before trying to make the switch unfortunately that was not a luxury i had. So how long should someone in my case wait. Today I took 25mg of vicodine to help with the wd symptoms and it actually did help some. So with this information what would you recommend my wait time be I also have to back to work on tues. Thanks in advance for any help.


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PostPosted: Sun Dec 25, 2016 11:49 am 
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Hi Jim,

To the best of my understanding, the issue is degree of sickness as opposed to time, which is wildly variable among individuals. The idea is to get to 15 or 16 on the COWS...maybe lower with short acting opiates is enough.... but with methadone especially I'm pretty sure it's safer to wait till you're sicker than that.

As to going to work Tuesday, if you don't wait long enough before jumping you'll likely be too sick to make it anyway. If you're going to do it, you want to do it right. I hope others weigh in as I'm far from an expert..


Good luck,
G.


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PostPosted: Sun Dec 25, 2016 12:46 pm 
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I'm in agreement with Godfrey regarding how much discomfort you're feeling vs time away. You may not know what a COWS scale is so either ask or I'll assume you found the answer.

Here is our section regarding Methadone and what others have done in your shoes.

http://www.suboxforum.com/methadone-maintenance.html


If you still cannot find enough information, just ask and I'll dig around. Mostly this is a Suboxone site but we've had plenty of members come off of Methadone and onto Suboxone but it wasn't an easy task. Expect some serious withdrawal effects before you can successfully make the switch. It can be done, but it is harder than with pain pills or other weaker opiates.

Please let me know what you need and we'll do our best to help.

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PostPosted: Sun Dec 25, 2016 12:49 pm 
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Hello Jim,
You are entering a steep process. One of the hardest. The switch to bupe after methadone is more difficult than any other because of half life and tolerance.
Not getting to 30 mgs of methadone, (loweri g tolerance ), and your timeline back to work, (two days) tells me that short acting opiate s may be the way to go for an extended period. The switch takes time if your trying to do this without sickness. But it is a slippery slope.
Many have come here with your very same question s.
I highly recommend this morning going to the Search tab at the top of the page or Dr Junigs Talkzone and look for Switch to Buprenorphine from Methadone. There you will find the facts.

My other questions are, do you have a Dr? A Sub Dr? Or are you doing this on your own?? Im guessing the later. Just my guess.

72 hours is a start, good work. But this process takes time till stablized on Buprenorphine Jim. Please do more research.
These are my opinion s after watching others here and in person at clinic in 6 years. You can do this, but not over a weekend painlessly. We want everyone to succeed here. You can do it too.

Razor


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PostPosted: Sun Dec 25, 2016 12:55 pm 
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Hello thanks for all the feed back as I know it's the holidays and who wants to be bothered with this. I'm v not sure how to gauge my withdraw at this point as I've taken 25 mg of hydrocodone and surprisingly I don't feel too bad so I'm guessing that's because of the hydrocodone. I was going to try to make the jump tonite as that will be 4 days into my last dose but now I'm not so sure. If precipitated wd does happen is there anyway to relieve that. Thanks for all the help as I know this isn't a methadone forum. Yes I am doing it on my own with no doctor I have 30 suboxone 5.6 the new generic type. At 7am tomorrow it will be 96 hours into my last dose.


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PostPosted: Sun Dec 25, 2016 3:14 pm 
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Jim, the best way to deal with PW is to make sure it doesn't happen. The idea is to feel sick, so that you've likely set yourself back some by taking the Vicodin ( I think it was)

Here's a link to Dr. Jung's post on PW. Right below it I think there's an post on methadone.

http://suboxonetalkzone.com/precipitate ... -now-what/

If you're still feeling pretty good, or not too bad, you're not ready to jump. PW especially in Methadone people can be brutal. If it happens there's really nothing to be done but to dose yourself according to your doctor's instructions. I had some PW...about 2 hours worth...but it can go on for 24 hours I believe, then no cake walk from there for a couple of days.

Do you have a doctor?

If it were me I'd give up the idea of going to work Tuesday and do this right. If you can't do that, then perhaps consider waiting for a more opportune time...

Here's a link to COWS...tally your score honestly as it's easy to exaggerate symptoms in order to be done with it...

http://www.naabt.org/documents/cows_ind ... _sheet.pdf


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PostPosted: Sun Dec 25, 2016 4:31 pm 
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Ok thanks again. So tomorrow at 7am will be 92 hours I figured with the Vicodin it would help me get through some of the crappy feeling im going through and I figured since I took the Vicodin at 7am and it normally runs its course in 12 hours I might be good to go tomorrow. Thanks for the link's. I'm a programmer so normally if need be I can work from home not sure if it's gonna be easy working with these conditions. Thank you for the help.


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PostPosted: Sun Dec 25, 2016 5:38 pm 
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Good luck Jim.

The thing to really hold onto if you read Dr. Junig's article is to stick with it no matter how sick you
get. Once you've jumped you've jumped. PW doesn't last forever. Don't try to overcome the block by taking
huge amounts of opiate. Dangerous, and won't work very likely, and all would be for nought.

I'd feel better if you were more tuned into degree of sickness than time. I was told 24 hours minimum. I went 31 and told myself that had to be enough, but looking back I wasn't that sick. And I had a very large habit. Within a couple minutes of my first half strip my heart rate shot up from 120 to about 160 (normal for me is in the high 50's), almost crapped myself, and amazing powerful restless limbs. Thanks be, it only last just those few hours. I got 50 percent better all of a sudden, then gradually improved from there. BY day 4 i really felt well, just beat to hell, but I knew I was gonna be all right. It's a nice feeling. And worth the short term pain.

Hope you'll keep us posted.
G.


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PostPosted: Sun Dec 25, 2016 11:55 pm 
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Four days is plenty. The problem is, buprenorphine is a partial agonist only, and does not have the ability to cover such a big tolerance. Trust me, I did it from the same dose. Even if you skip precipitated withdrawal, sub will not cover you, no matter what dose you take. It took me a week to convert, as in the buprenorphine lowered my tolerance and it was no fun. What does your doctor recommend?

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PostPosted: Mon Dec 26, 2016 8:58 am 
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Hey thanks again for the feed back 92 hours in and I'm in mild withdraw I know I'm not that sick yet but this being in between sucks. I feel like I should just take the sub and go through the pw it sucks I won't feel much better. I don't know what to do.. Ok here is one more question if I take it now and go into pw how long normally to be stable on suboxone also should I start with a small dose. Also im not doing this with a doctor's care unfortunately im doing it on my own.


Last edited by jimMethadone on Mon Dec 26, 2016 3:59 pm, edited 1 time in total.

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PostPosted: Mon Dec 26, 2016 3:57 pm 
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Ok so here is an update for anyone still reading I still didn't try the suboxone. I actually received an order of kratom and surprisingly it's helping some what it didn't take it all away but most of it. So tomorrow will be day 5 I might try the induction tomorrow.


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PostPosted: Mon Dec 26, 2016 4:59 pm 
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Hey Jim,

Seems like you want things both ways....to get sicker but to do whatever possible
to alleviate what WD symptoms you do have.

Not that I don't understand that. :D Are you in an area in which it's hard to find a doctor
to over see all of this? Be better if you did. How much to take isn't an exact science. I'd take at least 16 mg the first day, better yet 24. Best to go gradually. Maybe 4 mg every 45 minutes or so. Once you get over 24 mg you're bumping into the ceiling effect, which mean you're not going to be getting much if any therapeutic value

The second day, you can take all your dose...say 24 mg...at once.

Bear in mind, I'm not a doctor. I'm not even very bright. So much better if others weigh in.


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PostPosted: Mon Dec 26, 2016 9:17 pm 
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Hey Godfrey thanks for the input I really appreciate it tomorrow at 7am will officially be my fifth day with no methadone my plan was to be in work tomorrow but I left a message saying I'm really sick which isn't actually a lie. So I think tomorrow I'm going to try the induction I'm really hoping I'm ready it's really hard to gauge my withdraw because I have been taking things to help nothing long acting. So I'll post tomorrow and let every know how it goes. Thanks again.


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PostPosted: Mon Dec 26, 2016 10:25 pm 
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Best of luck Jim. Please don't rely on my dosage advice alone. For one thing I'm new around here. If I were you I'd start a new thread and ask that question...how much to take....after last dose of methadone.

The issue as I understand it is twofold, the first being how much of the methadone is currently
occupying your opiate receptors. If there's too much...which can partly be predicted on the basis
of how sick you are...the bupe can cause precipitated withdrawal. You don't want that.

The other problem is tolerance. If your tolerance is too high, you won't get sufficient coverage from
the bupe. This will leave you feeling sick for a couple days, if it happens. It's a separate issue from PW, but perhaps it's distinction without much or a difference. The longer you wait, the lower the chances of PW
and also the lower your tolerance. Lower on both counts is better.

At a certain point, adding more bupe won't help. That's the ceiling effect. There's really not
much difference therapeutically speaking between 16 mg and 24 or even 32. As I understand it,
the bupe even turns into a pure antagonist if you take too high a dosage. So that wouldn't
be good either.

I write all this as if I know what I'm talking about, but I only have a very surface and very incomplete understanding. Which is why I'm urging you to get more opinions.

Calling in sick was smart. if it were me, I'd wait until I really couldn't bear any more WD. To be as safe as possible you really want to get as sick as you can. Methadone is a notoriously difficult jump.


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PostPosted: Mon Dec 26, 2016 10:33 pm 
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Yea unfortunately I didn't do enough research so I'm hoping things go good tomorrow i was fairly sick this morning before I got the kratom in me which I would recommend to anyone detoxing it actually does help. So I'll wait a few hours after I wake up to see how I feel I just find it so hard to believe I would still have methadone in my system after five days. I'll keep everyone posted thanks for all the help it's been really uplifting. I have 30 subs no doc I have 8 years clean well methadone clean so I think I'm ready.


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PostPosted: Tue Dec 27, 2016 10:26 am 
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Ok so its day five and I took kratom early this morning and it i guess took away my withdraw i should deff be in withdraw by now but I actually think the kratom is helping alot, because i think I am going to wait another day to take the suboxone.

Since I can't find much research on taking suboxone after kratom and if it could cause pw. I also spoke with my boss and told him I was incredibly ill and he said please don't come in till you fell better. I am a programmer so working from home isn't a problem.

The fact that I am actually working rite now either means the methadone has not left my system all the way or the kratom is helping. If anyone has any information on taking suboxone after kratom please let me know.

Thanks again for all the help.

-Jim


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PostPosted: Tue Dec 27, 2016 10:42 am 
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Jim,

YOu've got to cut out the kratom and Vicodin and any other opiate or near opiate. You can't get out of this
without suffering. There's no get out of jail free card. You can't possibly assess your WD symptoms as to their intensity when you keep taking substances that reduce them.

Kratom I believe interacts with receptors in a different way than full on opiates. I doubt anyone can tell
you much about how they will interact with the Sub, or if they can it would be an individual experience, anecdotal kind of thing.


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PostPosted: Tue Dec 27, 2016 10:47 am 
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godfrey wrote:
Jim,

I know I know but i have read so many success stories about taking kratom to get through tell they could take suboxone I can do 12 hours standing on my head but this five day thing sucks LOL. Also the amount of fast acting opiates ive taken are no where close to where my tolerance is. I think I am gonna take my last dose of kratom today around 5pm and not take anything and see how i feel in the morning.
Thanks for your reply.

YOu've got to cut out the kratom and Vicodin and any other opiate or near opiate. You can't get out of this
without suffering. There's no get out of jail free card. You can't possibly assess your WD symptoms as to their intensity when you keep taking substances that reduce them.

Kratom I believe interacts with receptors in a different way than full on opiates. I doubt anyone can tell
you much about how they will interact with the Sub, or if they can it would be an individual experience, anecdotal kind of thing.


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PostPosted: Tue Dec 27, 2016 12:09 pm 
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I cannot tell u a lot about kratom & never really heard of it until this forum. There's been ppl heavily addicted to kratom. Ur trying to relieve urself of symptoms with something very addictive. Also, ur gonna have to stop everything to see where ur withdrawal stands or ur just going around in circles wasting precious time. That's just my opinion. None of us wanted to experience withdrawal, I was scared to death when I did it. But I got through it and was sooooo glad I did. I totally understand why ur doing it, but if u want to induct on suboxone, ur gonna have to just stop everything and see where ur at....and when ur COWS score is high enough then induct on ur suboxone. Kratom isn't anything I'd mess around with personally. If you've gone 4 days without methadone, then stop and see where ur at because right now, u have no idea.

There's a search bar here, go to it and type in kratom. There's been ppl post about it. Ppl who were addicted to it, ppl who were pretty sick in withdrawal coming off of it and ppl used it to stop suboxone (which I personally wouldn't recommend). So there are some things on this forum u can read about it. Also, go to the methadone maintenance section on this forum, u may read some great information there.

I wish u tons of luck, I can absolutely understand ur worry cause I would have been too. But sometimes we get to worried about the withdrawal and it keeps us from moving forward when we need to.

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PostPosted: Tue Dec 27, 2016 12:33 pm 
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Thank you for your reply. I have actually detoxed many times in the 32 years I have been alive. It's just that I finally got the programming job i've been working so hard to get and was trying to do this so i could function at my desk without falling asleep. I have also been givin the idea of taking fast acting opiates till the methadone is out of my system. Tomorrow at 7am will officially be 6 days I will be astonished if there is still methadone in my system by then. So what i am going to do is take my last dose of kratom at around 7pm and try to get through the night then in the morning I wont take anything and gauge my withdraw. I will keep everyone posted. I hope that this thread can help someone else in my shoes.

jennjenn wrote:
I cannot tell u a lot about kratom & never really heard of it until this forum. There's been ppl heavily addicted to kratom. Ur trying to relieve urself of symptoms with something very addictive. Also, ur gonna have to stop everything to see where ur withdrawal stands or ur just going around in circles wasting precious time. That's just my opinion. None of us wanted to experience withdrawal, I was scared to death when I did it. But I got through it and was sooooo glad I did. I totally understand why ur doing it, but if u want to induct on suboxone, ur gonna have to just stop everything and see where ur at....and when ur COWS score is high enough then induct on ur suboxone. Kratom isn't anything I'd mess around with personally. If you've gone 4 days without methadone, then stop and see where ur at because right now, u have no idea.

There's a search bar here, go to it and type in kratom. There's been ppl post about it. Ppl who were addicted to it, ppl who were pretty sick in withdrawal coming off of it and ppl used it to stop suboxone (which I personally wouldn't recommend). So there are some things on this forum u can read about it. Also, go to the methadone maintenance section on this forum, u may read some great information there.

I wish u tons of luck, I can absolutely understand ur worry cause I would have been too. But sometimes we get to worried about the withdrawal and it keeps us from moving forward when we need to.


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