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PostPosted: Wed Aug 30, 2017 5:45 am 
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I am on 110 mgs of methadone for 5 years. I saw a doctor a few days ago and he already gave me a prescription for Suboxone and told me to start taking it right away. He said to start it that evening by taking a small piece of the sublingual film (spelling might be wrong) and if I didn't feel worse it was OK to proceed. Because of everything I have heard about precipitated withdrawals I am scared to start taking this. I was going to try to stop taking my methadone and get into withdrawal before I do what doc says or I could start tapering down off the methadone before I take it. Obviously I am so terrified of any withdrawal so I want to do whatever is going to have me withdrawing the absolute least. I would appreciate any advise or if anyone has any positive transition stories similar to mine. Thanks!


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PostPosted: Wed Aug 30, 2017 9:31 am 
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Missdawn ur on 110mg of methadone and ur doctor told u to immediately take ur suboxone without tapering down ur methadone dose or be in withdrawal?? Am I reading that right, because I'm thinking surly this doctor knows better than that.

If I did read that right, it's recommended to get ur methadone dose down to somewhere around 30mg. Methadone and fentanyl are two opiates that makes the transition to buprenorphine a little different than other opiates. Those two medications stay in ur system longer. Most ppl that have done this transition and posted on this forum have tapered their methadone dose and stopped around 4 days before their induction to suboxone.

If u were to have went straight home from ur pharmacy and taken suboxone when up until that day u were taking 110mg of methadone and not waiting, u would have very likely experienced precipitated withdrawal.

I'm definitely no expert in the transition from methadone to suboxone so I don't want to tell u exactly how to go about it, I'd rather someone with more knowledge about it do that. I don't know if u should just stop the methadone now and wait for a few days before inducing onto buprenorphine or if u should taper ur methadone dose then stop for a few days...... I'm not sure what ur situation is and if u even have access to more methadone to do that type of taper. But I would at least be in withdrawal before I started bupe. Hopefully someone will be along shortly to help u better. I don't want to tell ya wrong because I've never done it personally.

If u do experience precipitated withdrawal, u just keep dosing ur regular prescribed dose of buprenorphine and it will eventually level out. I'm sorry ur doctor didn't explain anything to u about this transition. Plenty of ppl make this switch so please don't get discouraged. When I did my induction from oxycodone to buprenorphine, I waited 32 hours...... it wouldn't be a good idea to go from 110mg of methadone one day (for the past 5 years) and then the next day start ur induction to bupe. Definitely don't do that.

I'm so glad u came to this forum missdawn! Others will be along soon :)

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PostPosted: Wed Aug 30, 2017 5:36 pm 
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The most likely issue is that methadone for the treatment of opioid addiction must be prescribed in the setting of a certified opioid treatment program (OTP). In other words, your Suboxone doctor can not legally prescribe a methadone taper. If you are taking it as a pain patient from a pain doctor then that rule does not apply.

If treatment at an OTP is not an option then waiting 3-4 days off methadone and beginning with a minuscule amount of buprenorphine would probably be the best way to go.


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PostPosted: Wed Aug 30, 2017 9:11 pm 
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I go to a methadone clinic for heroin withdrawal. I can still go get my methadone everyday but I am not sure if I would be commiting a crime by attending both facilities. I already started tapering down, going to 100 mgs tmrw and I'm thinking of going down 10 every couple of days. I have detoxed from methadone before and I know I can get close to 30 pretty quick with little discomfort. I have not picked up the script of Suboxone yet. I asked the doctor as many questions as I could about the withdrawal and tapering down on my dose and he seemed so sure that I would be OK. He said many of the patients make the transition just fine and appeared not to be concerned at all. But I have heard so many things and after reading around on this forum it sounds like many ppl have had bad experiences so I am very leary and want to make sure I do this right with minimal withdrawal! Thank you for your posts!


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PostPosted: Thu Aug 31, 2017 8:36 am 
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Missdawn if u had went from 110mg of methadone and the next day started ur suboxone induction, u would have had precipitated withdrawal and I'm thinking it would have lasted for a bit. Now I'm not going on personal experience, but I've saw so many ppl come to the forum dealing with this transition. I was truly hoping someone with this experience would have responded to u by now. Hopefully Dr. Junig or docm2 will see this thread also.

Imo tapering seems like the smartest thing to do but I don't know what to tell ya about being at two different places and all that. Hang in there Missdawn, ur very brave!!

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PostPosted: Thu Aug 31, 2017 2:54 pm 
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Well, this is the plan I have come up with so far: today is Friday, I took 100 mgs of methadone this morning, which will be my last dose. I am gonna get into as much withdrawal as I can over the weekend and take the Suboxone Monday. I saw the COWS worksheet so I will have someone rate my symptoms Monday morning to determine if I am ready to take the Suboxone. I hope this works. I really don't have the time to wait to taper down to 30 mgs of methadone because I have some family court issues and I need to get started on this asap. Now, the doc did say that if I got real bad he would give me something to help. Not his exact words but it was a little comforting to know that. Also, I read on here that some ppl went to the emergency room. So, couldn't I just do that if it gets too bad? I would love to hear personal experiences similar to mine. Thank you everyone!


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PostPosted: Fri Sep 01, 2017 9:36 am 
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Usually there's all kinds of ppl sharing their transition from methadone to suboxone...... I don't know where they've disappeared to. One thing that we always tell ppl who may possibly experience precipitated withdrawal is to just keep dosing ur prescribed dose of suboxone. U will level out regardless. I really am pulling for ya and please let us know how ur doing through this. I'm still hoping for the other members here who have more experience to come along, so keep checking bk Missdawn and good luck!!

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PostPosted: Fri Sep 01, 2017 11:43 am 
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Hi all
I've been a lurker for a couple of years. On subs since 2007 and in the process of tapering. But that's all a story for another day.

The reason I'm posting is because the lack of input from methodone folks. It's a holiday weekend so i can u derstand :D

i quickly tapered from 80mg to 30mg in about 30 days and then waited 24 hours from my last dose to induct at 2mg. I had precipitated withdrawals that lasted 5 days and the i finally adjusted at a 12mg dose of subs. My doctor added an additional 2mgs each day until i felt better. My doctor was like yours and acted like PW was no big deal and to this day i think he thinks it was all in my mind.

So basically i had 5 days of hell and then life got good again.

I can answer any other questionx you have when i get home from work later todsy. I'm on a small tablet now and i can't communicate effectively lol . I just wanted to pipe in and let you know you another person's experience with the switch.


Syl

p.s, want to thank everyone on this forum. Your words have helped me go from 12mg to 2.75mg gave me strength


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PostPosted: Fri Sep 01, 2017 12:57 pm 
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Thank you for your replies. I am 30 hours with no methadone and I plan on starting the Suboxone Monday morning. If I can wait that long. I know how important scoring myself correctly on the COWS worksheet is so I have printed out a copy and have read on other forums to score at least a 26 before I start the induction. I'll post back later to let you know how I'm doing. I think getting through these four days will be the hardest.


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PostPosted: Fri Sep 01, 2017 1:00 pm 
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Did you not wait long enough and that's why you experienced PW?


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PostPosted: Fri Sep 01, 2017 1:24 pm 
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missdawn1786 wrote:
Did you not wait long enough and that's why you experienced PW?



I was told by my dr that 24 hours was enough as long as i was under 30mgs of methodone. The doctors just don't know enough about suboxone so they tell us what they are told during their brief training. I do think if he bumped me up to the 12g of subs on the first day i wouldn't have suffered so long, but he would only bump me u
2mg per day. But that is purely speculation on my part


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PostPosted: Fri Sep 01, 2017 1:34 pm 
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I do think you are wise to wait as long as possible before you induct, and then when you do jusf start with 2mg and add 2mg every hour or so if you go into PW. Even if you have to go up to 16mgs to feel better. You can easily taper down to 8 or 6mgs once you stabilize.

The good news is that once i was completely on subs my life improved exponentially, lost the 80 pounds i gained while on methadone and had energy again. So just keep you eye on the end prize and realize any discomfort is just temporary :D


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PostPosted: Fri Sep 01, 2017 3:11 pm 
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Thank you. It's so nice to be able to read about others who have experienced the same thing. I am going through a really tough time right now. Involved with Family Court and it is the hardest thing I have ever had to go through. Tougher than any withdrawal I will ever feel. That's why I know I can suffer for four days to reach my ultimate goal. Nothing is more important to me right now than getting of this methadone.


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PostPosted: Fri Sep 01, 2017 4:39 pm 
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I too at one time switched from Methadone to Suboxone . I was however buying mine in pill form 20mg. off the streets. So that was all i was taking when i made the switch. i was able to switch after waiting 48 hours. i never had any PW and I took 12mg of subs and that seemed to do the trick.

Since you are waiting several days, I am hoping the Methadone will leave your body so you will have not have any PW when transitioning.

Good luck to you. being on Subs was the best thing I ever did. I hope things will work just as well for you.


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PostPosted: Fri Sep 08, 2017 11:16 am 
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Mis Dawn, I am thinking of you, wondering how you are doing. I wish others who could have responded to you. For induction to suboxone to methadone it is suggested that one gets down to 30 mg before even trying. Then you need to be off the methadone for as long as possible or you can take a look at the COWS chart to see if you are in enough withdrawal to work. Either way I've learned it is very difficult to go from methadone to suboxone. I would appreciate hearing from you to see how you are doing
Take Care, D


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PostPosted: Fri Sep 08, 2017 2:05 pm 
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Missdawn

Been thinking about you and hope you are making out okay with your transition to subs. I know the first few days are rough but hoping you are starting to stabilize.

It does get better, I promise.


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