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PostPosted: Sun Mar 15, 2015 2:41 am 
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Hi everyone,

So, like most of the posts I read, I've been scouring the Internet on information regarding switching from Methadone to Suboxone.

I'm currently doing a Methadone detox from 45 mg. I've gone down 2 mg every day and am currently at 6 mg. I'll be at 4 mg tomorrow. I take my dose early in the morning. I've actually been doing extremely well with this detox, but today I'm having withdrawal symptoms. Their mild, for now, but I know they're going to get worse.

So here's my question: If I were to not get my Methadone dose tomorrow (24 hours since last dose) could I switch to Suboxone without going through nasty precipitated withdrawal? I have a bunch in my drawer, just sitting there, but I'm terrified because I've seen firsthand how horrible PWs can be.


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PostPosted: Sun Mar 15, 2015 10:54 am 
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Hi AshersMommy

First i would suggest putting this in introductions so more people see it. It doesn't seem like many people come down this far :shock:

I do not have first hand knowledge of making the switch from methadone to sub BUT i do have a close family friend who did the switch. He got down to about 30 mg and he had to wait several days to induct with sub. Since you are on 6 mg maybe you won't have to wait so long but IMO 24 hours is not enough time. There are many variables, how long you have been on methadone, how long you have been on 6 mg etc.

You could also PM Dr J to get his opinion. You could do a search here because i know there are at least 3 threads of people switching.

So consider posting in introductions .

Whatever you choose I wish you Good Luck. Sub has made me feel more "normal" and i wish the same for you


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PostPosted: Sun Mar 15, 2015 1:27 pm 
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Hi and welcome to the forum!

I did a little moderator housekeeping and deleted your post in introductions because no one had commented there yet. Then I moved your thread in methadone maintenance to Introductions, since that's where you seem to want it after Tiki's recommendation. We try to keep the forum free of duplicate posts.

We have several members who have made the switch from methadone to suboxone. I'm sure someone more knowledgeable than I am will answer your question soon. Until then you could search the forum for threads on changing from methadone to suboxone. This question comes up fairly often, so you should be able to find some helpful information.

Amy

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PostPosted: Sun Mar 15, 2015 3:37 pm 
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Thank you! I'm trying to do this on my iPhone while my 2 year old is trying to snatch the phone from me lol. So, I had to be quick!

Every post I've found regarding the switch to Suboxone from Methadone, is about people switching from 20-30mg. Since I'm at such a low dose (4 mg) and already experiencing pretty bad withdrawals, I'm wondering if taking the Suboxone will put me into further horrific withdrawals.


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PostPosted: Sun Mar 15, 2015 5:41 pm 
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I just wanted to give a little update for those who may read this.

I decided to go ahead and take 1/2 of a 8mg Suboxone sublingual strip. My last dose of Methadone was 6 mg (I had my schedule messed up in the first post) this morning at 8:35 am. I've been feeling like crap ever since last evening. I'm a giant wuss and couldn't bear through the withdrawal symptoms. Like I said, I took 4 mg of Suboxone at around 12:30 pm, totally expecting the horrendous precipitated withdrawal to come on at any moment. To my surprise, I started feeling better! I waited about 1 hour, then took the other half. I still have some mild cramping in my legs, but nothing I can't deal with.

If you're planning on switching from Methadone to Suboxone, I hope this post finds you. I was doing absolutely fantastic throughout my detox, up until last night. Yesterday morning, I dosed at 8 mg of Methadone. Switching for me was incredibly easy. I went from 48 mg Methadone, down 2 mg a day. Obviously everyone is different, but maybe I can give a little glimmer of hope to those who may need it.


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PostPosted: Sun Mar 15, 2015 5:59 pm 
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I'm glad you are doing well! I think that PW is a function of two things-- 1. your tolerance, and 2. the amount of agonist in the body. The two issues are inter-related, and seem to vary from one person to another.

It seems that PW becomes less and less likely as your tolerance goes down. The tolerances between methadone and buprenorphine match up at about 40 mg of methadone-- so at 6 mg, your tolerance was considerably lower than the effects of buprenorphine-- which was in your favor.

The main thing about PW is that while it can be severe, it never lasts very long. The best approach with PW is to take a dose of buprenorphine (or buprenorphine/naloxone) each day, and avoid taking agonists. If you do that, the PW will be mostly gone in 12 hours or so.


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PostPosted: Thu Aug 13, 2015 3:19 am 
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wow! congrats. ive come on here to ask some methadone to bupe questions and saw this post which is very interesting to me. are you saying you took 6mg of methadone at 8:35am and then took 4mg of suboxone at 12:30pm the SAME day? I am planning to switch soon I'm at 42mg and would probably drop 5mg and consider switching after that. if you did indeed take suboxone and methadone only 4 hours apart on the same day that gives me a bit of hope for my switch over because i crave my dose first thing in the morning since i got below 50mg and if i waited till 6-10pm that evening i would probably be DEATHLY ill.

so if being in withdrawal is more of a factor then waiting the suggested 2-3 days (or 4-5 depending on who you hear it from) days between methadone to suboxone, then i am going to rest a bit easier knowing the switch might not be as bad. I'm dreading the switch. ive been on suboxone 3 years ago but had to switch because of surgery and high tolerance. ive worked so hard to get down to the below 40mg mark but the park I'm so worried about is waiting for the methadone to leave my body. i know i will be in withdrawal by noon if i don't have my dose so if i have to even wait past that evening i will be in bad withdrawals and be tempted to take suboxone the same day. my initial plan was to try take small dose of oxycodone for 3-4 days then going the 18 hours in withdrawal before induction . but if being in withdrawal is all that matter this is hopeful. thoughts?


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PostPosted: Thu Aug 13, 2015 7:33 pm 
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As Dr. Junig pointed out, everyone is different. It's important to note that she was in withdrawal before her dose and after it, so she was in withdrawal for a lot longer than 4 hours. Also, we are assuming she stated the times correctly. If she didn't dose until 12:30 am that's a lot different. This post is from 6 months ago, so I don't know if Asher'smommy is still around, but perhaps she could clarify if she is. (We would love to hear how she's doing anyway!)

One difference I would suggest is that you start at taking 1 or 2 mg of sub. It may not be enough, but the PW might be less long or intense if you do get it. You will probably need to have a higher maintenance dose than 1 or 2 mg, especially since you're coming from methadone, but better to start smaller so the risk is lower.

I wish you success and no PWs!! If you need more details on how in withdrawal you will need to be before dosing with sub look up the COWS scale. Let us know how your taper goes and your induction!

Amy

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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