RE-Intro

Will methadone and buprenorphine together cause withdrawal? How do I stop precipitated withdrawal? What dose of buprenorphine is best? Do I have to be in withdrawal to start Suboxone?
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Pompeii222
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RE-Intro

Post by Pompeii222 »

So I spent a fair amount of time here back in the day "as they say" (2011-2014). I was originally on buprenorphine for 6-7 years and then I relapsed and ended up on methadone. This was around 2013 and I've been stable since then (only THC) showing up on my drug screens occassionally. No "licit" or illicit opioid use :) I've gotten really fed up finally with all the rules at the clinic mainly the mandatory groups and 1v1 sessions. I don't even mind the 1v1s so much but because I recently moved to a different city and clinic I've been having to do groups and 1v1s each week! So I started tapering from 170mg and I'm currently at 99mgs. I've been going slow 1mgs per 1 to 2 weeks depending totally on how I feel. So far I haven't noticed any withdrawal symptoms. There have been times my mind has, i think, tried to mess with me. After distracting myself for a little while I always end up realizing it's just in my head (for the most part) . I am having some back pain problems but I had a spinal Fusion in 2006 so its not a change for my back to hurt....unfortunately. my pcp has me taking gabapentin and it does help some. I intend on eventually getting down to 30 or 35mgs so I can transition back to buprenorphine and hopefully never have to go back to the insanely overcrowded tx center I'm at, located in Indianapolis. Then i look forward to going back to a drs office every couple-few months. This mandatory counseling. daily attendance for medication is very much... "for the birds" .
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suboxdoc
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Re: RE-Intro

Post by suboxdoc »

Thank you for sharing, and for coming back. I worked in methadone-assisted treatment for 6 years (actually, the six years I was gone from this forum. I was busy then!). I need to write a blog post about those experiences one of these days... there were good things and bad things, as you have pointed out. My main issue is that it is HARD to ever leave methadone treatment(!) Stopping buprenorphine is similar to getting off 35 mg of methadone/day... but most methadone programs allow dosing up to ridiculous levels. I kept our doses at about 100 mg/day (the average was 93 mg when I was there), but the company that eventually bought out the clinic had programs where people took 500 mg/day. Ridiculous. My impression, just my impression, was that they didn't like that I kept doses low. The CEO, when I first met him, said that there was no reason to keep doses low and that 95% of people on methadone should be on it for life. That job didn't work for me after that! It is one thing to be on buprenorphine for life, with no counseling requirement and the ability to leave town when you want or need to. But in methadone treatment in Wisconsin, testing positive for THC means daily dosing. No weekend trips, no moving to a smaller town that doesn't have a program, etc.

Good luck my friend. It will take a year or so to get down to 35 mg, but keep at it. If your program is anything like the one I left, they do not make it easy to taper. I really believe that many of those programs use methadone to keep patients as long as possible. After we were bought out (I had no ownership interest) the emphasis was always about numbers. Every week, how many were lost? How many patients were gained? NOT how treatment should work.
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