It is currently Tue Sep 26, 2017 12:05 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 10 posts ] 
Author Message
PostPosted: Wed Jul 13, 2016 5:21 pm 
Offline
New Poster
New Poster

Joined: Tue Jul 12, 2016 9:37 pm
Posts: 1
Hi guys. I'm wanting some advice from some people who have actually experienced this, or have first hand knowledge please. Not hear-say. I can't seem to find the answer to my specific question so I'm giving this a try. Please , no opinions,or stories people have heard. But actual knowledge.
Anyhow, I've got some severe back problems and began taking methadone here and there from someone I knew,because it greatly helped. (Wouldn't recommend that foolish decision to anyone). Anyhow, started to develop a bit of a dependency,so I said what the heck I'll just go to the clinic because it's helping my pain so much. Well obviously it got its hooks in me and I had no idea how physically addictive it would be. Again my fault for not having the sense to research. I would gladly just deal with the pain and find other non prescription ways of coping with the pain now, if I could go back. Anyhow, for numerous reasons, I want to switch to suboxone. And then about 6 months from now I'll have the opportunity,with work, finances, and other responsibilities, to detox from suboxone and get clean. But because I am a single dad and have a very demanding job as well as other circumstances, I am not in the position to take the time to do a full kick from methadone for the weeks /months that it takes to fully kick. But I am able to schedule time to go through withdrawals from methadone long enough to start suboxone. So my question is this, I am on 100 Mg's of methadone daily right now. If I stop the methadone cold turkey, how many days would I have to go before I could take my first dose of suboxone? I realize if I do the suboxone too early I will be in even more intense withdrawal. So I need to know how long I have to go before I can take the suboxone. And because of my priorities and schedule, I cannot take the time and go through the tapering down on methadone. It will be cold turkey from 100 Mg's. And please understand this is the plan that will work best for me, so this is what I need to do. So I am only interested in answers to that question. With absolutely all due respect, I'm not interested in opinions about what plan may be better etc... I know my circumstances and all the relevant details which make this the plan that I need to go with. I do not mean to sound like a butthead in anyway by saying that, Im just trying to be clear about what advice I m needing. And i ask that only people with first hand knowledge advise me. Thank you ahead of time for any info , help or guidance any of you can give. And if there are any of you with very in depth knowledge on this exact subject, I can't explain how much I'd appreciate it if you could correspond with me briefly by email about it. If so please let me know and I'll send my email address. Anyhow, thanks for at least reading this if anyone made it this far.
-FLORIDA


Top
 Profile  
 
PostPosted: Wed Jul 13, 2016 11:46 pm 
Offline
Long Time Member
Long Time Member

Joined: Thu Aug 08, 2013 5:40 pm
Posts: 441
Sorry DJT, I don't think you will get much traffic. Cold turkey from 100 mg a day of Methadone to go on Suboxone is just not done. I don't think you will find a Suboxone provider that will do it. The recommendation is to taper to 30 mg a day then be off for a week (of HELL) before inducing. I have done it, it isn't pretty, can't imagine what would happen at higher doses. My understanding is you would be sick for weeks as your tolerance has to drop to a level that the Suboxone can cover.
Maybe one of the other docs or someone that has made the transition will weigh in with more insight.


Top
 Profile  
 
PostPosted: Thu Jul 14, 2016 3:43 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1545
I know you don't want advice on different pathways, but understand that many other people will read this, perhaps after searching on Google and finding the title of your post. For THOSE people, I've often told people looking only to reduce their opioid tolerance to consider a methadone program. Methadone programs usually follow the course of stabilization (requiring a steady increase in methadone), maintenance for a year or more, and then tapering. But methadone clinics usually also offer straight detox, where the methadone is started, raised to meet tolerance, and then tapered. The nice thing about methadone is that a person can reduce slowly, by a mg per week for example-- a pace that is impossible to reproduce with buprenorphine.

As for going from 100 mg methadone to bupe, I agree with doc2m. I've taken patients through that path, or at least through pathways similar.... for example patients with very high tolerances, or people on methadone who wanted to start Suboxone but couldn't stay off the methadone for more than a couple days without using again. I honestly do not believe there is an answer to the question 'how long to wait', because everyone reacts differently. Methadone clearance varies dramatically from one person to another. When peak and trough levels of methadone are measured in methadone patients on 100 mg methadone, a petite woman may go from a peak of 500 ng/ml to a trough of zero, while a large man may go from a peak of 1000 ng/ml to a trough of 800 ng/ml. In other words, one person's dose will be around for 2 weeks, and another's will be gone overnight.

Beyond varied metabolism, many medications affect CYP3a4, the enzyme that breaks down methadone-- and protein binding varies as well.

Bottom line-- longer is better. When you stop methadone you need two things to happen: a drop in methadone levels and a drop in tolerance. Both things (methadone and high tolerance) cause precipitated withdrawal. A meaningful drop in tolerance will take a couple weeks... and the drop in methadone levels will take a day to a week.

The patients I've treated who went straight from methadone to buprenorphine got very sick... but precipitated withdrawal never lasts very long. That's the one positive. By the second day, the person feels 50% better, and by the third day probably 80-90% better, providing that the person does NOT use any more opioid agonist. I've read on the forum about people using tiny doses of buprenorphine and giving a bit more every 30 minutes for the induction-- and I've alsor read recommendations that once the person has PW, the best thing to do is to get to a therapeutic level of buprenorphine quickly, within one or two days. I tend to do the latter, thinking that at least being on 16 mg of buprenorphine will commit the person to treatment, and more-likely prevent the person from going back to agonists.


Top
 Profile  
 
Our Sponsors
PostPosted: Thu Jul 14, 2016 10:22 pm 
Offline
Average Poster
Average Poster

Joined: Wed Jun 22, 2016 11:52 pm
Posts: 19
When I made the switch from methadone to suboxone I was on 180 mgs of methadone a day. By this time I had take home doses. I was arrested in NJ and went cold Turkey about 10 days of excruciating agony. But I took this opportunity to get on buprenorphine..

I went to the Dr and this was 2008. The Dr gave me subtex because he said the naloxone in suboxone qould cause precipitated withdrawal.. Hahaha he actually said that. I was given a prescription for 90 sub pills and sent home.

Although I didn't have precipitated withdrawal, I was still very sick the first day. After day 3 I felt very normal.. Because your dose is so high it's going to take you many days of agony to transition. Looking back if I had a choice I woulda walked off the clinic and gotten on a short acting agonist for at least 2 weeks. Then I woulda jumped off them for about 30 hours before I induced.

I've done this every time I have transitioned back on bupe after methadone, I've done it 2x. Don't be like me! Drs want to help, let them.. Taper low before you walk off the clinic.


Top
 Profile  
 
PostPosted: Fri Dec 30, 2016 11:46 pm 
Offline
Average Poster
Average Poster

Joined: Fri Dec 30, 2016 7:54 pm
Posts: 8
Djt wrote:
Hi guys. I'm wanting some advice from some people who have actually experienced this, or have first hand knowledge please. Not hear-say. I can't seem to find the answer to my specific question so I'm giving this a try. Please , no opinions,or stories people have heard. But actual knowledge.
Anyhow, I've got some severe back problems and began taking methadone here and there from someone I knew,because it greatly helped. (Wouldn't recommend that foolish decision to anyone). Anyhow, started to develop a bit of a dependency,so I said what the heck I'll just go to the clinic because it's helping my pain so much. Well obviously it got its hooks in me and I had no idea how physically addictive it would be. Again my fault for not having the sense to research. I would gladly just deal with the pain and find other non prescription ways of coping with the pain now, if I could go back. Anyhow, for numerous reasons, I want to switch to suboxone. And then about 6 months from now I'll have the opportunity,with work, finances, and other responsibilities, to detox from suboxone and get clean. But because I am a single dad and have a very demanding job as well as other circumstances, I am not in the position to take the time to do a full kick from methadone for the weeks /months that it takes to fully kick. But I am able to schedule time to go through withdrawals from methadone long enough to start suboxone. So my question is this, I am on 100 Mg's of methadone daily right now. If I stop the methadone cold turkey, how many days would I have to go before I could take my first dose of suboxone? I realize if I do the suboxone too early I will be in even more intense withdrawal. So I need to know how long I have to go before I can take the suboxone. And because of my priorities and schedule, I cannot take the time and go through the tapering down on methadone. It will be cold turkey from 100 Mg's. And please understand this is the plan that will work best for me, so this is what I need to do. So I am only interested in answers to that question. With absolutely all due respect, I'm not interested in opinions about what plan may be better etc... I know my circumstances and all the relevant details which make this the plan that I need to go with. I do not mean to sound like a butthead in anyway by saying that, Im just trying to be clear about what advice I m needing. And i ask that only people with first hand knowledge advise me. Thank you ahead of time for any info , help or guidance any of you can give. And if there are any of you with very in depth knowledge on this exact subject, I can't explain how much I'd appreciate it if you could correspond with me briefly by email about it. If so please let me know and I'll send my email address. Anyhow, thanks for at least reading this if anyone made it this far.
-FLORIDA


I am getting here more than half a year late but for the sake of those researching this in the future I wanna tell about my switch from methadone to BUP. Withdrawal was almost 10 days, did not precipitate but the crazy thing was I was so close to being able to just kick from the methadone, wish I would've as this dupe or suboxone for those who use strips or are thinking of starting. Please know that for me Methadone was super hard, months of hell. This sub/bupe is way harder, at least for me.

15 years ago I fracture my back and a year later rupture four discs and re injure the tailbone area.
2 years later Im up to 240MG Oxycontins. Insurance dumps me and $32 a month bought me my only alternative.

Ultimately I have been tapering for 2 years from 160mg methadone to now .9-1.0 Bupe and next week I will jump off and use concentrated cannabis oil, similar to rick simpson oil for cancer.
Plan on taking daily video diaries for a possible you tube how to kick without loosing sleep and without benzos.

Hope I can help some other person one day avoid the pitfalls of opioids and how hard and unlikely you get off if your a chronic pain patient. just a lil on my history of opiod tolerance issues aka I'm sick of being a "junky"
Can be done with natural compounds.

God Bless Ya'll


Top
 Profile  
 
PostPosted: Sat Dec 31, 2016 3:06 am 
Online
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4220
I have to ask you. What kind of a forum do you think we are?

Amy

_________________
Done is better than perfect!


Top
 Profile  
 
PostPosted: Sat Dec 31, 2016 8:55 am 
Offline
Moderator
Moderator
User avatar

Joined: Mon Sep 15, 2014 7:15 pm
Posts: 2395
Location: Tennessee
I was wondering the same thing Amy.

$32 a month for methadone or suboxone.....,whichever ur talking about, is a lot less than most have to pay.

_________________
Jennifer


Top
 Profile  
 
PostPosted: Sat Dec 31, 2016 7:51 pm 
Offline
6 Months or More
6 Months or More
User avatar

Joined: Fri Nov 25, 2011 6:14 pm
Posts: 269
Location: Petoskey, MI
I have personally done this, but from 120 mgs. The problem I had, other than precipitated withdrawal because I didn't wait long enough, is that my tolerance was too large for suboxone to cover, which I didn't understand at the time because I didn't have this fantastic forum to go to yet. You see, buprenorphine is only a partial agonist, which does not have the power to cover large habits. So saying that, I did it anyways, once the precipitated withdrawal was over, it only took about four days, surprisingly, to finally feel normal and get on with my life. I'm in the same boat as you, can't go off to rehab or take a month off work. Every day was a little better, but I could not work for three days. The buprenorphine lowers your tolerance all on its own without naloxone, until you get low enough to be covered and comfortable.

_________________
PUGS NOT DRUGS


Top
 Profile  
 
PostPosted: Tue Sep 12, 2017 12:35 pm 
Offline
One Month or More
One Month or More

Joined: Sun Mar 13, 2016 8:50 pm
Posts: 31
I was switched from methadone to suboxone or subutex.
I was on 80mg per day and was inducted next day.
The first dose was 1-2mg to see how I reacted,then increases were 2mg for the first 24 hours.Then dosage got increased 8mg per day.
Within 2 full days I was in full withdrawal then by 4-5th day I was discharged feeling very good.When I reached 32mg per day withdrawal ended or at least the fetal position,spasms,sweats,etc....
The tablets were only available then and I was prescribed 32mg per day.
Sure induced withdrawal was severe and they wanted me much lower,but being younger and severe opiate addict they induced while I was dosing at 80mg per day.

If you have a choice I would highly suggest suboxone over methadone.


Top
 Profile  
 
   
PostPosted: Tue Sep 12, 2017 2:10 pm 
Offline
Moderator
Moderator
User avatar

Joined: Sun Jan 02, 2011 12:35 am
Posts: 2786
Location: Southwest
Thanks for the info Rob. The most important message I got out of your post was to tell others to use the COWS scale and be in medium withdrawal before inducing. It seems you walked through flames to get where you are today but it sure would have been easier if your doctor had told you to taper to 30 mg's and then wait the 3 days or whatever it is before inducing onto Suboxone.

From all the posts I've read here about switching over from Methadone to Suboxone, most addicts seem to really suffer getting to the goal. Obviously you did it so others can learn from your experience. I just hope they read what you wrote and take it to heart so they don't go through unnecessary withdrawal pains.

Glad it all worked out for you in the long term. Another life saved by Suboxone.

r

_________________
Don't take yourself so damn seriously


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 10 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
cron
 

 

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

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

Powered by phpBB® Forum Software © phpBB Group