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PostPosted: Thu Sep 22, 2011 5:12 pm 
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I’m hoping someone will help me out. Here’s the scoop. Right now I’m on seven milligrams of methadone a day. I’ve been trying to taper off, but once I got to five it got really ugly, and that was going down a milligram a month or even every two months. I want off everything. Desperately. Ten years ago I had testicular cancer and ended up addicted to oxycontin for about six months, then I got on methadone. Never once used again. Never. Don’t think about it now, don’t want to think about it now, nada.

The methadone costs me $91.00 a week and I have monthly takehomes. I want to get off it, but tapering is just kicking my butt. My uncle who’s a cardiologist, claims suboxone is the way to go, but my methadone clinic charges $178.00 a week for suboxone. There is a local doctor who will prescribe it for a monthly fee of $200.00, but you have to buy your own medication.

My question is: how much suboxone would I need coming from seven milligrams of methadone? I don’t want to be high or anything. I just want to function, let the receptors repair for six months or so, then taper off the subox. But suboxone can’t cost me more than what I’m paying for methadone, so it’s going to depend on how many milligrams I need.
I’m about to finish my dissertation for my Ph.D. and I won’t be able to go through the defense if I’m not functioning well. Help!


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PostPosted: Thu Sep 22, 2011 6:12 pm 
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Man sorry to say no matter how you look at or what you do, Suboxone is going to cost you more than methadone and what you are paying now. The only way you might be able to go this route is if you got on generic subutext somehow which is hard to get on even for people who have been clean and with the same suboxone DR for years. Honestly this is my opinion, I just don’t see why you would want to go onto another drug when you are so close to being clean with methadone I mean you are at 7mg just a couple more tapers and you are free of all this shit period, so why add six more months of opiate replacement meds when you don’t have too? I mean just try to fight it man just give it one true shot with detoxing off methadone before using another med to do so which in turn you will then have to detox off that to so you are now detoxing of 2 meds instead of 1 is all I am trying to say.

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PostPosted: Thu Sep 22, 2011 8:22 pm 
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Well, based on my personal experience and according to my cardiologist uncle, who claims he actually did several hours' worth of research, methadone is much, much, much more difficult to come off of, even at a slow taper. Once I got to five, I was in full withdrawal and went back to six, then to seven, at my counselor's insistence. (I'm hypertensive. Go figure. I run marathons, but I'm hypertensive.) Even if I was able to go all the way down, once I hit zero the withdrawals would most likely last months and months, while coming off suboxone would be easier. zThese facts are documented in JAMA. As I said, my plan is to get on the suboxone, stay there until the receptors had healed, maybe three to six months, then begin a taper. I've been on methadone for eleven, maybe twelve years with no issues, no failed urine tests, nothing, and that doesn't count for anything with a doctor prescribing suboxone? I mean, why would I stop methadone to get on suboxone to screw it up? Surely the prescribing physician would review my records. My question is will two milligrams daily be sufficient if I'm on seven milligrams of methadone?


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PostPosted: Thu Sep 22, 2011 10:51 pm 
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Hi and welcome, I know absolutely nothing about methadone but it sounds like 7mg is a super low dose. I think you my find you wont even need 2mg of sub. Have you tried searching the internet for a conversion chart? Another idea is you could call the Dr.s office you found and ask them what they think you would have to start at or even your methadone clinic. They should no if they provide both. Just because you ask them doesn't mean you don't have to stay there. My meds cost me about $450 cash for 60 8mg films so you should be on a low enough dose that I think the sub will be cheaper than nearly $400 a month for methadone.


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PostPosted: Fri Sep 23, 2011 6:56 am 
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It is possible, maybe even probable, that your sub treatment could cost more than what you're paying now. Suboxone treatment is known to be pretty expensive. But, like Breezy_ann said, you can probably get away with a very low dose of sub and that should save you some money. You could probably start with a really low dose - the minimum that will stifle your withdrawals from the methadone. That could be 1 or 2 mg only. It's hard to say.

I've never taken or had to quit methadone, so I don't know what the withdrawals are like, but I've heard they are bad, so your plan is legitimate and you're not the first to go that route. Transitioning from methadone to suboxone can sometimes be tricky, but you're on such a very low dose that it hopefully shouldn't be a problem. They usually suggest a minimum dose of 30 mg before switching to sub.

Also, there won't be any receptor "healing" going on while you're on suboxone. It's still an opiate and still stimulating those opiate receptors.

I hope this helps. Ask more questions if you need to and we'll do our best to help.

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PostPosted: Fri Sep 23, 2011 11:05 am 
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Hi again, I think being on that low dose of methadone you will not require much sub, like I said the 8mg tabs cost about $8 a pill, if you were started at 2mg a day, you would only need 8 per month. You could cut them in fours and without insurance would cost around $65. Even if you required 4mg it would cost you about $120. So you said the Dr. Was $200 a month so with either of these doses it is cheaper than $365 you are spending monthly at the clinic. Of course I can not say for sure how much sub you will require but I am pretty confident it would be 4mg or most likely lower. If you switch I would suggest asking for the Suboxone Strips, they are much easier to cut into 4 equal pieces than the tabs. Keep us posted.


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PostPosted: Fri Sep 23, 2011 11:44 am 
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I'm very grateful to you guys. Thank you for your input. And the stuff about the "receptors healing" I actually questioned too, but I got it from my (possible) doctor's website. It may just be propaganda:

We now understand that the opiate receptor in the brain has been damaged by long term use of short acting opiates. This is why tolerance develops and withdrawal occurs if the drug is suddenly stopped. Suboxone actually allows the opiate receptor to heal while it is being taken. There is recent new evidence that indicates that the opiate receptor takes about 100 days to heal and that it will actually heal while the Suboxone is being used.

A common treatment model I use in my practice is to put the opiate addicted patient on a stable dose of Suboxone for about three (3) months, while they are engaging in a recovery process and developing a relapse prevention plan. After about 100 days on Suboxone, with the opiate receptor now healed, tapers off the Suboxone are typically tolerated very well.


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PostPosted: Fri Sep 23, 2011 12:49 pm 
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Well, the way I understand it, nothing "heals" (and I don't even know if "heal" is the right word because they just return to normal), until we remove all the opiates and start producing our own endorphins again. Again - that's the way I understand it.

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PostPosted: Fri Sep 23, 2011 4:38 pm 
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I wouldn't discourage you from switching to sub but...since you are on such a low dose of methadone, I bet you could keep tapering down from methadone just as easily....We aren't supposed to debate which is better sub or methadone (and in any case I am no expert and not a medical professional of any kind), but since you are thinking about switching I think it's ok to share some opinions. It's true that methadone is known to be very difficult to discontinue--however i think that is really in the case of going cold turkey or tapering rapidly. With slow tapers I've heard that it can be totally painless. Now, 7 mgs a day is already a low dose. Then consider, a big problem after getting off opiates is the (very common) post-acute withdrawal syndrome--and believe me many people getting off sub experience PAWS! Either way, with methadone or sub, many people think the best way to avoid a bad withdrawal is to taper SLOWLY. I'm just saying, if switching to sub is too expensive or too much of a hassle, i think you should focus on your methadone taper and you'll be ok. It sounds like methadone treatment has really worked well for you so far and you sound like you are very stable, and I suspect that switching to sub at this point is unnecessary and it won't necessarily be any easier to discontinue taking sub than to stop methadone, and also, there is definitely no guarantee of avoiding PAWS! About that quote from the doctor regarding receptors healing--it doesn't sound like anything I've ever heard about sub anywhere else...I'm not sure it's "just propaganda" but...it seems that it could just be that doctor's way of describing it? Honestly, I just think you should consider how well you are doing now and that sometimes it's better not to mess with something that's working. That being said, I agree with what the others have said to you, that if you do go on sub you can probably start at a low dose like 2 mgs or less and then go down from there. I'm just not sure that once you get down to such low doses of sub and methadone like you are on now, that one is going to prove easier than the other to get off of, or that one will have less PAWS than the other. But whatever you end up deciding, I wish you well...it sounds to me like you have a great chance of doing well whichever way you go.


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PostPosted: Fri Sep 23, 2011 7:06 pm 
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It's my understanding that Sub maintenence is roughly equal to 60mg oxycodone a day. I looked at one of those opiate conversion charts and it said the methadone and oxycodone have a 1 to 1 equivalence. So you will increase from 7 mg to 60mg methadone on Sub. The may not be exactly accurate. I seem to remember Dr. J saying that Sub is equal to 30 to 40 mg of methadone. You will definitely increase your tolerance.


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PostPosted: Fri Sep 23, 2011 9:00 pm 
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That is awesome and congrats that you have done so well at your methadone clinic I mean that is real impressive. But sorry to say you could have 50 years clean at your methadone clinic it won’t play any role into how a suboxone DR will treat you. Patients that have been model patients with the same SUB Doc for year have been told no, they will not switch you over to generic subutext. But at the same time not every Sub DR is like these so don’t think it is impossible it is just hard.

But hear me out whether you detox of methadone or suboxone it is going to be hell no matter which drug you are on. But if you switch to suboxone you are going to have to go through that hell not once but twice. Because you will have to detox for a day or two off the methadone to start the suboxone and with how long it’s half life is who knows how long it might take for you to get sick enough to start Suboxone. I just think with all your clean time no matter how bad things get you would be able to beat the methadone WDs and again 7mg man is so low. Over all what i am saying i guess is i wouldnt want to think you should have to go through a extra 6 months of this shit when you are so dam close to being done with it all. And I mean man how do you know suboxone WDs are going to be any better? Either drug you are going to be sick for a few months right? I guess that is the main point as to why i would switch to Sub if i was in your shoes. At the end of the day i will support you choice either way just wanted to share my thoughts with you.

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PostPosted: Sat Sep 24, 2011 1:40 pm 
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CompLitDoc,

I have successfully tapered off of both Methadone & Subs. In my experience the Sub was much,much harder to come off of. It seems like from what I read you are looking to find an easier detox but subs are not the anwser. If your looking for another maintence program then that's another story. I honestly don't hear of to many people taking subs for just a few months. You said "my plan is to get on the suboxone, stay there until the receptors had healed, maybe three to six months, then begin a taper" I don't know about your receptors actually 'healing' while on subs. I have never heard that :?


I was on methadone for a couple years and on subs not even one year. The methadone maintenence program worked for me. I tapered down to one mg before jumping off methadone for good. Look, I know it's hell to taper right now but your so very close. I would just hate for you to have to go though the withdrawl from methadone just to get on subs and them not work for you. You've worked hard to get where you are. Any taper will kick your butt so you might as well keep at this one!

I have to strongly disagree with your uncle about methadone being much more difficult to come of of. Not even close.
Once I tapered and jumped from 1mg methadone I had a 'couple' nights of insomnia.I was able to function fine during the day. Go to work, etc.. I took natural OTC meds for sleep & anxiety. Calms forte and sleepy time tea. Within two or three days I was feeling normal again. I had seven years clean after that.

I just tapered off subs over six weeks ago after eleven months. (I tapered from 6mg down to .125mcg) I knew pretty quickly after starting subs I wanted to taper off of them.The taper took longer then I wanted. Many times during my taper off subs I was actually thinking of switching to methadone. I wished I was on a methadone taper. Ok, I don't want to deter anyone from subs so i'm not going to get specific but the sub taper was much harsher. I was not able to function like I had when I tapered from methadone. The subs also left me with some lingering w/d symptoms. I'm still having trouble with sleep and it's been six weeks. It also took a bit of time for my stomach issues to subside. I underestimated how strong this drug really was until it came time to taper.

Besides the taper are you having any other side effects? You wrote that you've been on methadone for eleven/twelve yrs with no issues. That should tell you something. If it's not broke don't fix it! Your so close at this point I would stick with it man! You might end up spending more $ if your on subs longer then you want to be.

If you do decide to try suboxone I would recommend taking a very, very small dose! 2mg maybe even try 1mg to start. It might be enough seeing as you are on such a low dose of methadone.

Keep us posted :)


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PostPosted: Sat Sep 24, 2011 2:29 pm 
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Bboy42287 wrote:
But hear me out whether you detox of methadone or suboxone it is going to be hell no matter which drug you are on. But if you switch to suboxone you are going to have to go through that hell not once but twice. Because you will have to detox for a day or two off the methadone to start the suboxone and with how long it’s half life is who knows how long it might take for you to get sick enough to start Suboxone.


This is totally not true. Quite a few of us have detoxed off Suboxone without going through "hell." And at the OP's low methadone dose, I doubt that he will have to wait that long between his last methadone dose and induction onto Suboxone.

CompLitDoc - I think you will find many different opinions about switching from methadone to Suboxone. I encourage you to read through some of the stories in the Stopping Suboxone section of the forum. We have had several members successfully quit Suboxone by tapering down to a really low (microgram) dose over a long period of time. We have also had members do a quicker taper as a way to detox off of full-agonist opiates.

Some of us had an easier time of it than others, but all of us experienced at least some withdrawal. I think the people who reported the least amount of withdrawal and PAWS were the ones who tapered really slowly and exercised a LOT at the same time. But in all my time as a member and moderator here, I don't recall anyone who got on Suboxone for 100 days and then just easily stopped because their receptors were somehow healed.

I think some healing can occur during the tapering process, as you force your body to start producing it's own endorphins again. And some healing must occur because you are not constantly reinforcing the response-reward circuit in the brain by being triggered, getting high and going through withdrawals constantly.

Nevertheless, you are the best judge of your own situation. You've been on methadone for a long time and if you really think that you're unable to continue tapering then maybe it is time for something new. I do wonder though how drastically you were reducing your dose as you got down around 5mgs? I ask because the inspiration for my Suboxone taper came from information about tapering from methadone - mainly that once you get to really low doses, the recommened drop would be like 10% of your dose every 2-4 weeks. So if you're on 7mgs you would drop to 6.3mgs and that should be tolerable. Then you repeat when you've adjusted to the new dose, dropping to 5.7mgs, etc.

I guess what I'm trying to say is that maybe you could just finish your methadone taper if you take it slower. I know it is tedious as hell, but that's how a lot of us have gotten off of Suboxone. It took me over 4 months just to go from 1mg of Suboxone to 0.2mgs, which is where I quit. Whatever you decide to do please feel free to use us for support along the way. Good luck!

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