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Unread 06-28-2007, 03:26 PM   #1
tmTim
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Default Switching to Suboxone from 90mg Methadone

Hello Everyone,
Just so you know my history I was using heroin for maybe 5 years, well only 3 of those years I would say I had a big habit. I switched to Methadone maybe 8 months ago and gradually went up to 120mg then back down to 90mg which I stayed at for the last 6 months now. I have totally changed my environment and friends etc and think maybe it's time to get off the done before I become too used to it.

Now here is my problem, The doctor who I am seeing that prescribes Suboxone is telling me that I only had to wait 24 hours then dose my first 16mg. Now everything I have read on my own has said that I need to either taper lower or wait atleast 4 days with no done before I made the switch.

Well I decided that maybe my doctor knows best so I took the Suboxone at about 36 hours after my last dose and I didn't really feel bad at the time, only slight goosebumps and sweats starting before I took it. Maybe 2 hours later I was in like full on WD's and felt so bad that I took my remaining 90 mg methadone dose takehome that I had left over.

It's weird because I always thought that once I took the sub that it was too late and that the meth would do nothing but instead it made me feel alot better. I regret taking it because now I have to start over but this time I am waiting atleast 4 days, so far tuesday at noon was my last methadone dose(the one I took 2 1/2 hrs after taking the sub).

So now I guess you could call this day 2? maybe 3?. I don't feel bad yet other then sweats and goosebumps so think I can wait it out atleast another day or 2 until I feel like utter crap and then take the 16 mg's of suboxone? What I am wondering is if it's even possible at this 90mg dose to successfully switch to suboxone with out those ULTRA bad WD's.

I'm not even bothering with the docter because he seems to not know methadone or suboxone very well, he even had to check the lil chart that comes with the pills to determine how much to take.

Apparently alot of those that he put on suboxone were only coming from lighter pill habits that have that shorter WD time, or maybe regular pain patients at 20mg of methadone a day. He seemed surprised that there are still methadone clinics around, that should have been a good sign.

Anyway I have to put my faith in you guys since I have not been able to find a doctor that knows about this. What would be a good route for me to get on to my new suboxone from 90mg of methadone? I am no longer allowed to get methadone so I will have to do without that. Maybe my best bet is to wait as long as possible before taking the suboxone?

Thanks guys,
-Tim



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Unread 06-28-2007, 03:33 PM   #2
Brett
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I switched from 80mg methadone, it was a bitch, but Im glad I did, My advise is to put as much distance between you and the methadone as possible before you switch, I stoped 10 days before the switch, I had percs the first 3 days then nothing the last 7, withdraw was unbelievable I didnt feel good the first 2 weeks on sub, but it was worth it.

Brett
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Unread 06-28-2007, 03:39 PM   #3
NancyB
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Hi Tim and welcome. Here's a link to our precipitated withdrawal sheet that you may find helpful:

http://www.naabt.org/documents/NAABT_PrecipWD.pdf

Methadone
It is recommended that patients transitioning from methadone to Buprenorphine slowly taper to 30 mg./day of methadone, for at least one week. Last dose must be no less than 36 hours prior to induction, and may be 96 hours or more. A minimal score of at least 5 to 6 on the COWS is recommended, although some physicians prefer scores of 15 or higher. Patients transferring from methadone or another long-acting opioid to Buprenorphine may experience discomfort for several days and dysphoria for up to 2 weeks.

The goal of induction is to safely suppress opioid withdrawal as rapidly as possible with adequate doses of Buprenorphine. Failure to do so may cause patients to use opioids or other medications to alleviate opioid withdrawal symptoms or may lead to earlytreatment dropout. To achieve this, some physicians have found they may need to dose as high as 32 mgs. the first day with some methadone to Buprenorphine transfers.


While you're not able to follow the protocol, hopefully the rest of this information will be of help.
Let us know how you're doing.
Nancy
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Unread 06-28-2007, 04:33 PM   #4
Mike
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Tim, This is the most up-to-date info on meth-bupe transfers. It is written by the doctors who teach other docs about bupe. It says that the time may vary quite a bit and to go by the symptoms instead. You should print this out and give it to your doctor.

http://www.pcssmentor.org/pcss/docum...neTransfer.pdf

"....In addition, it was advised to wait as long as possible after the last dose of methadone to perform the buprenorphine induction. Because of the difficulties in tapering a stably maintained patient's methadone dose, several studies have tried to induce patients at higher doses, such as 60mg, or 70mg. The results suggest that although it is uncomfortable, it may be possible, and not completely contraindicated..."

Nancy's link is good too. Welcome to NAABT!!
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Unread 06-29-2007, 07:51 PM   #5
tmTim
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Wow this is so weird, Remember on tuesday how I took a suboxone too early and got realllly sick then took another 90mg dose of Methadone. Basicly only suffered WD's for 2 hours before the methadone took over or something and I felt better.

Anyway fast forward to now, I haven't taken any methadone in over 3 days and have waited until noon today to take a 8mg suboxone when I sorta felt a little bit of the WD symptoms starting. Now it's 4 hours later and I feel better instead of worse like before. I actually feel as though the slight WD's even went away, how is this possible that I didn't suffer more then 2 hours on a 90mg methadone to suboxone transfer. Strange, I just hope this is it.

Maybe that first time I took the suboxone which gave me the precip WD's was enough to make my body ready for the suboxone?

-Tim
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Unread 06-29-2007, 08:23 PM   #6
tmTim
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Now it's almost 5 hours and all of the minor WD symptoms i still had a hour ago are now gone(gooseflesh and chills). For some reason I have a killer headache though but I guess that goes away with time. I really hope this is it and that I am over the methadone, I feel fine almost.

-Tim
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Unread 06-29-2007, 08:45 PM   #7
Mike
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Wow sounds good. If you are not in withdrawal now I think you area all set. 8mgs would be enough to cause withdrawal if you took it too soon, so it looks like you took it at just the right time, before the withdrawal got bad but long enough for it to start. The first week is the hardest, some people get a host of weird symptoms but most clear up in a week or so. Glad to hear you are doing well. Keep us posted and congratulations.
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Unread 06-29-2007, 09:44 PM   #8
tmTim
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Thanks both of you, That chart and other information really helped me gauge when the time was right to take my Suboxone. I think the next time i see the doctor I will give him a printout of the chart and other information so that other methadone (MMT) patients he prescribes Suboxone to won't suffer as I did with that first dose.

I feel even better now and am pretty sure that the transfer was a success.

Thanks again,
-Tim
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Unread 06-29-2007, 10:47 PM   #9
gotoffmdone
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Keep the Sub dose as low as possible to stay wd free. Your body will tell you when you need more Sub as the methadone leaves. I went from 400mgs of methadone and took Sub without being in any wd. I cannot describe what I felt like those first 20 hours. I did not go into any wd when I was given 2mgs of Sub. It was after I got my script filled and then took some more per doctors orders that the wds hit.

Had I not taken anymore Sub that first day and then only taken 2mgs per day until I could feel more of the methadone wds, I am certain I could have avoided all that agony. But that is history. I do not regret getting off methadone the way I did. Tapering to 30mgs from 400mgs would have meant I would still be waiting to start sub. I had enough of methadone.

I think going ten days without methadone before starting Sub, like Brett did, is phenominal.

Wayne
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Unread 06-29-2007, 11:15 PM   #10
NancyB
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Hi TIm, that's great news! If you want, we can send you a couple of our resource kits for you and your doctor. You can sign up through this link:
http://www.naabt.org/resource_kit/

I'm glad you're feeling better.
Nancy
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Unread 06-30-2007, 04:22 AM   #11
steffaroni
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Hi I stopped methadone 30 days prior to my suboxone induction. Now mind you after 4 days off my 35 mg methadone JUMP(yea not the brightest idea eh? ) I went back to my drugs of choice till 30 days had passed and felt I could start sub. was scared to death of what might happen and glad the clinical trial I did required u be off methadone 30 days.So was off methadone 30 days. The day before my induction my addiction doc said I could take my last ms contin at 3 pm. I did and by the next morning was in big wd's. perfect for my induction cause wow was I hurtin. lol...
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Unread 06-30-2007, 04:24 AM   #12
steffaroni
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Quote:
quote:Originally posted by steffaroni

Hi I stopped methadone 30 days prior to my suboxone induction. Now mind you after 4 days off my 35 mg methadone JUMP(yea not the brightest idea eh? ) I went back to my drugs of choice till 30 days had passed and felt I could start sub. was scared to death of what might happen and glad the clinical trial I did required u be off methadone 30 days.So was off methadone 30 days. The day before my induction my addiction doc said I could take my last ms contin at 3 pm. I did and by the next morning was in big wd's.It took me 12 mg to feel okay then I got to take 4 mg more so started my first day @ 16 then worked up to 24 mg then tapered to nothing in a month.
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Unread 06-30-2007, 10:54 AM   #13
cscally
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Welcome Tim and good going. Sounds to me like your induction was a success. I switched from methadone to sub too and like you, couldn't believe how normal I felt after taking it. I was waiting for something bad to happen as I couldn't believe I could feel that normal. It has been everything I hoped it would be. Pretty amazing huh?! I started at 16 mgs and am now stable at 4 mgs and still FEELING good. I capitalized feelings because I got them back once off the methadone. I really had no idea just how numbed out I was until I got off.

Although methadone gave me back my life back, suboxone let's me live it. Keep us posted. c
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Unread 06-30-2007, 12:22 PM   #14
firmbiz94
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Hey i just switched from 50 mg's methadone to bupe about 10 days ago.. I weaned myself down to 5 mgs in about 4 days... then about 30 hours later i took my first dose of bupe.. 4 mg's felt a lil wierd but never went to pw's...my advise would be definitely cut down as much as you can then wait at least 30 or more hours...untill you are feeling pretty sick from wd's..those headaches ihad too..i started spitting the naxolone out and i havent got them since..good luck and yioull feel great in a week!@
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Unread 07-02-2007, 08:34 PM   #15
tmTim
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Hello all,
Thanks for the support and ensuring me that I did indeed succesfully tranfer to suboxone. Just giving a lil update and venting some as well. I have noticed now that without my daily 120mg dose of methadone that I have a few issues that I never realized before.

I know that I am now over the physical dependency of methadone but I don't feel full if that makes any since. I'm guessing that my brain isn't quite creating it's pain/feel good chemicals properly just yet, and I am just feeling that lack of those chemicals. Very dull emotionally and aching all over yet hyperactive and unable to sleep at the same time.

I also noticed that I have some sort of back problem now because of the pain I can now feel. Before I only noticed that a portion of my right leg and foot had no feeling, sort of like it's asleep there. There was no pain before but I always thought it was sort of strange indeed. Now there is some throbing pain in the lower back to follow that as well . oh well

See I had a bad habit of taking xanax with my morning dose and driving to work, well I had 2 car accidents from nodding at the wheel and one of those was pretty severe but I was on methadone treatment at the time so don't think I fully noticed the pains, well I sure did feel my eyelid being stitched back together in the ER but not the smaller daily pains.

Anyway I am wondering if any of you knew if the other small joint aches etc will go away soon, Would suck to not only mess my brain up but my body as well. Wouldn't be too surprising considering I wasn't taking care of either. It's only been maybe 5 days now so I know I got alot of improvement that can still happen. It's really weird to be 24 and feel like an old man.
Still am very glad that I am getting off of methadone and that whole clinic atmosphere.

Maybe these aches are just part of the healing process.

Thanks!
-Tim
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Unread 08-12-2016, 09:17 PM   #16
Luv2Shop
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Question Looking for advice

Ive been at a methadone clonic for 3 1/2 years and Its such a mess there and they are understaffed and so I cant get my dose of methadone lowered there im at 90mg and go once a week there, and Im wanting to switch to subs to get off of this Im miseravle on methadone. Its taken more of my life away from me than the pills I was taking for pain in the first plce not knowing methadone was not the right way for me to go in the first place. Im physically very limited and disabled from mainly XLH rickets it runs in my family and causes alot of health issues. Im also finacially limited this clinic is costing me $450 month because medicare dowsnt cover it and thats the only insurance I have so Im wanting to go to a sub dr here but I dont know what to do because I cant taper down, and I def. am not staying for sub treatment at the current facility. From what ive read it seems to be possible to switch but Im not really sure whwre to turn or what to do because ive been stuvk at this place all year ive been wanting to get off methadone ASAP.
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Unread 08-12-2016, 09:37 PM   #17
NancyB
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Luv2Shop, I made a new thread with your post - this one is 9 years old and I think it would be best to make a new one for you.

http://www.addictionsurvivors.org/vb...ad.php?t=30461

Nancy
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