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 Post subject: MMT -> suboxone
PostPosted: Sat Nov 12, 2011 4:35 pm 
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I am currently switching from methadone to suboxone and my dr said that I will only have to go 24 hours from 30mg then i can switch over, but I was wondering if I should just go 2 days even but I feel like I'm cuttin' too close together and I'm really trying to avoid a trip to hell, anyone else think that this might be a little close? or should I just give it a shot and if it's bad then I'll call it a learning experience haha


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PostPosted: Sat Nov 12, 2011 4:37 pm 
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I forgot to say that I've been on 85mg for about 9 months all together


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PostPosted: Sun Nov 13, 2011 1:22 am 
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Your doctor likely has experience in switching people from MMT to Suboxone. I have switched a couple of times, and can tell you some of the things I experienced. Mind you, it was a chaotic time in my life and I may not remember everything. If you are concerned about the 24 hour wait (I haven't heard of this before), then tell your doctor, and I don't see why he won't give you the extra 24 hours flush time.

The first time I switched from a dose I remember as being closer to 50mg than 30mg. I had reservations about the high dose, but the doc I had at the time was very experienced. He's one of my city's biggest prescribers of MMT and Suboxone. He said I should have my first dose of buprenorphine at least 48 hours. That meant having my last dose of methadone in the morning, having the next day dry of all opiates, and inducing on my first dose of bupe the next morning.

Secondly, my doctor put me on Subutex for the first two days then switched me to Suboxone. He said that the naloxone in the mix may have potential for it to make the transition a little bit harder. He also said that technically everyone prescribed Sub should be put on Subutex for the first few days, then switch to Suboxone, but no doctors actually do it!

First day I was prescribed 4mg, and told to have another 4mg later in the day when I felt I needed it. When I switched from 50mg, I was prescribed Subutex first 2 days. When I switched from 30, that doctor put me straight on Suboxone. Also 4mg morning / extra 4mg evening if needed that time too.

Now I just gotta say, your transition will likely have a small degree of precipitated withdrawal. This is unavoidable. But you gotta understand that because we're already withdrawing when we have our first dose of Suboxone, things are uncomfortable anyway. In my experience, the first dose of Suboxone just alters the withdrawal symptoms and makes them a bit speedier, and a bit weirder. Precipitated withdrawal feels a bit different to standard withdrawal. It wasn't any more uncomfortable than the WD's from the methadone, but it was different, no worse. Fortunately, the precipitated withdrawal slowly faded away over that first day, and by evening I felt confident enough to have the next 4mg. Make sure you clear your schedule on that day.

From the 2nd day onwards, things really start to look up. Over the next few days, I ended up stabilising on 16mg both times. The great thing is, when you switch from MMT to Suboxone, you'll feel heaps more human. I felt like my emotions came back, and I realised how much the methadone had saturated my body. While the transition can seem scary at times, it's incredibly worth it, and a lot of life's colour returns once you stabilise.

Interested to know how it goes for you. Keep posting.


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PostPosted: Sun Nov 13, 2011 12:19 pm 
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I was thinking that my Dr. might do the subutex for the first few days, most of my friends had that deal when they first started, I was a little surprised when he only said 24 hrs' without any methadone, which kind of scared me but, he seemed surprised when I suggested waiting 2-3 days but I guess I'll find more about this once I get my dose lower (I just started from 75-70 today without any difference really, just sweats n an extra serving of goosebumps). I am pretty sure I'll survive and just troop through any precipitated withdrawal. I just hope that all these ticks I'm finding on me won't get me any sicker : / (nothing bad yet) haha, thanks though for the info


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PostPosted: Sun Nov 13, 2011 12:28 pm 
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It's generally recommended to be at or below 30 mg of methadone before inducing onto suboxone. It's long lasting so a methadone transition to suboxone is a bit more challenging at times. Often, doctors will discontinue methadone a couple weeks beforehand and switch the person to short-acting opiates immediately preceding the induction. If done carefully, it is possible to avoid precipitated withdrawals. That said, keep in mind this is not based on my personal experience - I've never been on methadone. This is just what I've learned about methadone from other people and research. So take this for what it's worth.

Good luck with your induction and keep us posted.

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