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PostPosted: Thu Feb 16, 2012 5:22 pm 
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Hello, I'll just start right into my story. I've been taking Methadone , Vicadin, and at times Soma and Temazapam for the last 4+ yrs. My max dosage was 50mg Methadone, 40mg Vicadin, and just occasional Somas and Temaz. I got to the point recently of taking 40mg Meth., 10mg Vic., and I stopped taking the Somas and Tamaz. So at the start of this mo. I started cutting back on my own. Today is Feb.16 and I'm taking only 10mg of Methadone. I cut back at the beginning of the mo. pretty fast but did not feel that bad so I kept cutting back. I got down to 15mg of Methadone and nothing else and stayed on that for about 5 or 6 days then I cut down to 10mg Meth., 1/2 a pill in the AM and then 1/2 a pill in tAbout the 2nd day of this I started feeling uncomfortable but not real bad. So now I'm going to a pain management Dr. that can use Suboxone. After everything that I have read I'm scared, I've heard both Horror stories and Very Easy Detox stories. Can someone please tell me what I should expect from Suboxone treatment? I've heard you have to be in acute withdrawal before even taking the Sub. Considering my dosage is there another way to get off Meth. easier. With that said I want to let you know that I will not be seeing the pain Dr. until the first week of next mo. and also I never got "High" from the Meth. it was never a problem of wanting more and the mental and psyc. addiction is really pretty non-existent for me. I have no desire to keep taking pills or to get high. One more thing It was very easy for me to completely stop drinking Alcohol and I stopped smoking ciggies after 30+yrs. cold turkey without ant problems. So I do believe I have alot of will power. I'm looking to get off Meth. without any withdrawal. When my Dr prescribed it to me for severe Back and leg pain after 2 failed surgeries he said when time came to get off it it would be easy to just taper it back, with no withdrawls. If I would have know how powerfully addicting Meth is I would have never started it. The Dr. who I'm talking about has since taken another job and moved. I would appreciate any replies.


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PostPosted: Thu Mar 01, 2012 9:09 am 
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Hi BWG707 - First of all I want to apologize that your post hasn't been responded to yet. Sometimes that happens and a thread gets bumped down by a newer thread (by a few seconds) and gets lost in the process. It doesn't happen too often - please don't think this is representative of the forum overall.

I've read your story and I have one initial question for you: Are you on methadone for pain only? Or are/were you ever an opiate addict as well? It matters in that if you are not an addict, tapering alone will be easier for you that it is for us opiate addicts, because we always crave more and more and more. Non-addicts don't have that issue to deal with.

You have been tapering down significantly on the methadone in preparation to go onto suboxone. Is this because you and your doctor decided it would be best to use the sub to taper off the methadone? Methadone withdrawals are known to be wicked (although I've never experienced them), however, you're already at a really low dose. How manageable have your withdrawals been thus far? You know, you have the choice of continuing with your taper on the methadone and be done with it; or go forward with your current plan and switch over to sub and then taper off that. Sub withdrawals are generally accepted to be less severe than other opiate withdrawals, including methadone, but it is said to be more drawn out and last longer. And as you know, you'll have to be in withdrawals from the methadone before you can start the sub. However being that you're on such a low dose of the methadone, that shouldn't be a big issue in making that transition.

I honestly don't know how low you can get (dose-wise) when tapering off methadone, but I know with suboxone you can do a really low, slow taper and have next to no withdrawals, if done right. If you do decide to go forward with switching over to suboxone, please remember that you're only on 10 mg of methadone, so don't start too high on sub. If I recall correctly (someone can correct me if I'm wrong), 4mg of sub is roughly equivalent to 30 mg of methadone. You therefore won't need to start out very high on sub at all. At least that's my opinion, assuming my equivalency is correct.

Whatever you decide to do, we're here to help and support you.

Again, my apologies that this thread went unanswered for so long. I hope you're still around.

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PostPosted: Thu Mar 01, 2012 10:09 am 
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Hey BWG, welcome to the forum. Hat pretty much asked all the right questions, but I thought I'd throw my opinion in. I also jumped from methadone to subs my first time around. I was on 40mg when I left because I could no longer afford MMT and was just tired if going to a clinic daily. The fact that you dropped to 10mg without too much trouble is a good sign. I would feel a 2 mg decrease like it was its own detox. You say that you have a lot of willpower, and if you are not an "addict" I would definitley try and just finish your taper. Subs are great and can be an amazing tool, but its all about the induction. Unfortunately, methadone has an extremely long half life, so most dr.'s want the patient to wait at least 72 hours before doing a sub induction because of risk of precipitated withdrawl. You know your body best and wether or not you are an addict should be concidered before you decide what to do next. I personally was switched to a low half life opiate (dilaudid 4mg) for a full 7 days before my induction to eliminate any risk of methadone in my system. I'm sure others will chime in, maybe someone with a little more firsthand knowledge, and give you a better idea what your looking at. Either way good luck and again, welcome.

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PostPosted: Thu Mar 01, 2012 10:10 am 
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I honestly don't know how low you can get (dose-wise) when tapering off methadone, but I know with suboxone you can do a really low, slow taper and have next to no withdrawals, if done right. If you do decide to go forward with switching over to suboxone, please remember that you're only on 10 mg of methadone, so don't start too high on sub. If I recall correctly (someone can correct me if I'm wrong), 4mg of sub is roughly equivalent to 30 mg of methadone. You therefore won't need to start out very high on sub at all. At least that's my opinion, assuming my equivalency is correct.

The only reason I know the answer to this is because I just asked about mg comparisons the other day, and someone sent me this link which was very helpful: http://www.medcalc.com/narcotics.html

It says that 50mg methadone are equivalent to 1mg sub.

I also found this on wikepedia:
"Healthy users of methadone who commit to a slow taper, however, frequently find success in tapering to 30 mg in order to switch to buprenorphine, as well as in tapering off of methadone completely without the use of buprenorphine"

So I guess that being on only 10mg of methadone should make it easier to switch over to sub.


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PostPosted: Thu Mar 01, 2012 10:12 am 
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That first paragraph from my post above was a quote from hatmaker's post...I tried to use the little "quote" button, but I guess I didn't do it right because it didn't show up in white??


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PostPosted: Thu Mar 01, 2012 10:17 am 
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Correct me if i'm wrong but it sounds like your prescribed at home methadone (you mention pills) not going to a clinic right? Reason I ask is that at a clinic its usually liquid mehadone, which can be dosed down to as little as 1mg or even .5 mg. That allows for a slower more drawn out taper

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PostPosted: Thu Mar 01, 2012 11:13 am 
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StillProdigy, you bring up an excellent point. It might be just what is needed here, too - switching over to a short-acting opiate and using that to finish the methadone taper. (Again, this is assuming you're not an addict.) It will be a much easier taper and w/d process due to the short half-life. Do you think your doctor would switch you? You could talk to her/him about it.

and yes, I was wrong about the conversion. This is from Dr. Junig:

Quote:
...the problem is the non-linear kinetics of buprenorphine. You can't just extrapolate out with bupe, like you can with agonists that don't have a 'ceiling effect'.

In other words, one mg of buprenorphine is as potent as about 20 mg of methadone, 2 mg of buprenorphine is as potent as 30-40 mg of methadone, and 4 mg, 8 mg, or 24 mg of buprenorphine are all as potent as 30-40 mg of methadone! The calculator works fine as long as you use doses for buprenorphine below the 'ceiling' effect-- say down in the microgram ranges. But you cannot use those numbers to project out in a straight line-- because the potency of buprenorphine, being a 'partial agonist', doesn't follow a straight line.


I took this off another thread here on the forum wherein he posted.

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PostPosted: Thu Mar 01, 2012 1:13 pm 
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Oh yeah, I read about the mg's not being equal at higher dosages, but since such a low dosage was being refered to here, I thought the calculator could help give some kind of ball park comparison.


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PostPosted: Thu Mar 01, 2012 1:51 pm 
The dosing curve for Sub is linear up to a certain mg, I think it's 12. Once you get there is when it stops being linear. That's what my doctor told me.


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PostPosted: Thu Mar 01, 2012 2:10 pm 
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I just decided to check this forum (hadn't got ant replies for a while) and was pleasantly surprised to see replies, Thanks. Well first of all to answer a couple questions- yes I'm presrcibed 10mg pills for severe back and leg pain from an injury. At my peak I was on 50mg Meth. a day, 5-5/500 Vic. a day, Soma 3x a day, 30mg Temazepam a day, and 10-15mg Valium a day. Also I am physically dependant not addicted, I never really got a "high" and never craved more. Over time I got down to just 40mg M. a day and 2-5/500 Vic. a day. I started my taper at the beginning of Feb. I stopped the Vic. immediately but later during my taper I take them when I really need them also I' take Tem. when really needed. As of today I'm down to 5mg M. a day, still using the Vic. and Tem. for WD symptom relief. Yesterday was my worse day yet. I went from about 7mg to 5mg just a day before. Although it was bearable with some help from the Vics and Tem. Today I feel pretty good. Tommorrow I see my Dr. he doesn't know I decided to do this taper I wonder how he will react. Since doing more research I decided tapering would probably be best. So far it hasn't been too bad, I realized I probably haven't seen the worst. I set a goal to be at 10mg at the end of this mo. but I pushed some because I was able to bear it. I've decided to stay at 5mg for a little while to even out and let my body get used to this dose. I need to get some liquid M. to be able to break it down to single mg and less. I've been wondering once I quick all the M. and long will it take before I feel normal? I plan on tapering down to 1mg or 1/2mg before I jump. I see a Pain Management Dr. this coming Monday he's got a great rep. around this area. I'm curious to hear what his ideas are. One good thing, I have stockpiled M., Vic., Soma, and Tem. so if need be I can do what I want. You know alot of Docs are idiots they are so arrogant and cocky they think they know everything and try to order people around as if patients are second class citizens. It's so hard to find a good DR that will actually listen to you. That's one of the reasons that I'm getting off this stuff, I can't stand my new DR. I'm on a County Health Program that has a very limited number of Dr to choose from and the Dr turnover rate is very high. Everytime I find a good DR he ends up leaveing. All the good ones end up going elsewhere. After my next two Dr. visits I'll post what I find out. I want to thank everyone that replied to this post I really appreciate it and plaese don't stop if you have anything to say or ask. Bye for now.


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