15mg of methadone to suboxone. Nervous. Need advice please.

[Marie656]

Hello! I am hoping that someone can be of help to me and give me some advice. I am currently on 15mgs of Methadone. I have been on methadone for 9 years and I need to get my life back. I started on the methadone clinic due to a oxy addiction. I have no desire at all to use. I have a new Dr. That is going to help me through the transition from methadone to suboxone. He has prescribed me clonidine and Clonazepam ODT. I’m very nervous about this transition. He advised me to wait 48 hours before taking the first dose of suboxone and told me to take a half at first just Incase I take it too soon and go into precipitated withdrawals. And then if I’m okay with that to take the other half. I’m ready to do this but I am nervous. I am concerned about how bad the withdrawal may be, I know it’s different for everyone. I also apologize in advance because I’m sure this question has been asked. I’m new to this forum and wasn’t sure where to post this question. If anyone could give me some advice, I would greatly appreciate it.
Thank you

 

[Las Veghost grower]

You do not want to get sent into precipitated wd trust me, I would start out taking a quarter strip not a half and continue taking a quarter of a strip every hour till you feel right, make sure you are in withdrawal before you take the sub, and not just runny nose and watery eyes a little further then that

 

[Marie656]

Thank you, I was thinking about doing that as well. I appreciate you taking time to reply.

 

[Las Veghost grower]

Thank you, I was thinking about doing that as well. I appreciate you taking time to reply.

A lot of people with a lot of experience with sub here, I don’t have any experience with methadone tho, but more people will come along that have made the done to sub transfer, just remember most doctors never had to get on suboxone and if the patient gets thrown into wd it dosent really effect them. But it’s devastating for you, not saying don’t listen to your doctor but first hand experience is worth a lot, good luck buddy

 

[Señor Moreno]

Welcome Marie.
I have not experience doing the transition, but 48 hours and half a suboxone seems too risky to me.
Also, did your doctor told you to do it at home, on your own? Over here they do it at the clinic so they can keep an eye on you, and they advise to wait 72 hours at least, wich hurts, but not near as badly as a precipitated wd.
Don't know the induction dose, but I would bet it would be well under half a 8 mgs suboxone.
Be careful with doctors telling you everything is gonna be ok, I have read it ..

 

[Señor Moreno]

I am on 30 mgs and I know for a fact that taking half a suboxone 48 hours after my last methadone dose would send me to hell, no doubt to be had.
15 mgs is a low dose, indeed, but you have been on it for a long time.
Can you ask your doc for pregabalin/ Lyrica, or get it from other source? If you could it would be great, as it works wonders for opi wds, and since you also have clonidine and clonaz, you should be able to wait 4 or 5 days, just to be on the safe side of things

 

[Marie656]

I am on 30 mgs and I know for a fact that taking half a suboxone 48 hours after my last methadone dose would send me to hell, no doubt to be had.
15 mgs is a low dose, indeed, but you have been on it for a long time.
Can you ask your doc for pregabalin/ Lyrica, or get it from other source? If you could it would be great, as it works wonders for opi wds, and since you also have clonidine and clonaz, you should be able to wait 4 or 5 days, just to be on the safe side of things

Thank you. I am going to wait as long as possible. It’s just my mind that starts to mess with me. I need my life back and it’s becoming harder and harder for me to stay on the clinic. I hope this is the right thing for me to do. Obviously I won’t know until I do it. I’m prepared to not feel to great, although I’m scared of feeling really bad. So I am going to do the quarter vs the half. Can always take more, but can’t take less. Better safe then sorry. I appreciate your advice. Thank you again

 

[Harmredux]

I just went through something similar. I know it's not what you want to hear, but I waited about 30 hours after last use of a very short acting opiate, and a 8mg strip of subutex broken into 4 pieces sent me immediately into precipitated WD.
I have been around the block, and I know exactly how it feels to be honest with everyone, looking for help, and still not getting the treatment you DESERVE.
Do NOT TAKE ANYTHING WITH NALOXONE for a long time. You should be transitioned to JUST bupenorphine with NO NALOXONE. This is a completely reasonable request on your part considering your honesty and compliance.

What I was not told is that even though precipitated wd sucks, it only lasts a couple hours. The difference between precipitated and regular is that I had rapid heart beat and literally felt like I couldn't move. I was on the verge of consciousness, and worst of all the legit area I take pain meds for in the first place hurt like hell. Horrible. But being an idiot, 3 hours later I took another 1/4 of the subutex and it repeated all over for a couple hours.

Please try to get something without naltrexone for a month, THEN switch.

I hope it works out, please keep us posted. I got my scripts refilled today and seems like they are working at about 1/2 what I need for the horrible pain I have, but the ONLY GOOD THING was that even through the horrible night last night I got at least 1-2 hours sleep which is amazing for me. I went 22 days without a wink CT off oxy a few years ago and have ptsd from it. Sometimes what doesn't kill you also DOESN'T MAKE YOU STRONGER, just leaves mental scars, lol.

 

[Las Veghost grower]

I just went through something similar. I know it's not what you want to hear, but I waited about 30 hours after last use of a very short acting opiate, and a 8mg strip of subutex broken into 4 pieces sent me immediately into precipitated WD.
I have been around the block, and I know exactly how it feels to be honest with everyone, looking for help, and still not getting the treatment you DESERVE.
Do NOT TAKE ANYTHING WITH NALOXONE for a long time. You should be transitioned to JUST bupenorphine with NO NALOXONE. This is a completely reasonable request on your part considering your honesty and compliance.

What I was not told is that even though precipitated wd sucks, it only lasts a couple hours. The difference between precipitated and regular is that I had rapid heart beat and literally felt like I couldn't move. I was on the verge of consciousness, and worst of all the legit area I take pain meds for in the first place hurt like hell. Horrible. But being an idiot, 3 hours later I took another 1/4 of the subutex and it repeated all over for a couple hours.

Please try to get something without naltrexone for a month, THEN switch.

I hope it works out, please keep us posted. I got my scripts refilled today and seems like they are working at about 1/2 what I need for the horrible pain I have, but the ONLY GOOD THING was that even through the horrible night last night I got at least 1-2 hours sleep which is amazing for me. I went 22 days without a wink CT off oxy a few years ago and have ptsd from it. Sometimes what doesn't kill you also DOESN'T MAKE YOU STRONGER, just leaves mental scars, lol.

Odd reaction, what short acting opiate were you taking

 

[negrogesic]

The doctor gave you bad advice. Taking 4mg of buprenorphine 48 hours after taking methadone will almost surely result in precipitated withdrawal. 15mg of methadone is a small dose as far as methadone maintenance goes, but it definitely enough to produce a severe withdrawal syndrome.

I would recommend the following method for induction:

Microdose induction of buprenorphine-naloxone in a patient using high dose methadone: A case report

Buprenorphine is a partial mu-opioid receptor agonist approved for the treatment of opioid dependence. The risk of withdrawal symptoms and wait time required to safely initiate buprenorphine provides challenges to both patients and providers. Microdose ...

www.ncbi.nlm.nih.gov

Essentially you take tiny doses and gradually increase. I recommend you share that link with your doctor and ask to approach it in that fashion. The problem is you might need a different prescription for the 2mg suboxone, because .2mg of an 8mg suboxone strip is 1/40th of a strip (a tiny little sliver).

Also note that naloxone isn't what causes the precipitated withdrawal, it is the buprenorphine itself, so the inclusion of naloxone doesn't really matter.

 

[Las Veghost grower]

The doctor gave you bad advice. Taking 4mg of buprenorphine 48 hours after taking methadone will almost surely result in precipitated withdrawal. 15mg of methadone is a small dose as far as methadone maintenance goes, but it definitely enough to produce a severe withdrawal syndrome.

I would recommend the following method for induction:

Microdose induction of buprenorphine-naloxone in a patient using high dose methadone: A case report

Buprenorphine is a partial mu-opioid receptor agonist approved for the treatment of opioid dependence. The risk of withdrawal symptoms and wait time required to safely initiate buprenorphine provides challenges to both patients and providers. Microdose ...

www.ncbi.nlm.nih.gov

Essentially you take tiny doses and gradually increase. I recommend you share that link with your doctor and ask to approach it in that fashion. The problem is you might need a different prescription for the 2mg suboxone, because .2mg of an 8mg suboxone strip is 1/40th of a strip (a tiny little sliver).

Also note that naloxone isn't what causes the precipitated withdrawal, it is the buprenorphine itself, so the inclusion of naloxone doesn't really matter.

^ this is definitely what you should do

 

[Marie656]

I just went through something similar. I know it's not what you want to hear, but I waited about 30 hours after last use of a very short acting opiate, and a 8mg strip of subutex broken into 4 pieces sent me immediately into precipitated WD.
I have been around the block, and I know exactly how it feels to be honest with everyone, looking for help, and still not getting the treatment you DESERVE.
Do NOT TAKE ANYTHING WITH NALOXONE for a long time. You should be transitioned to JUST bupenorphine with NO NALOXONE. This is a completely reasonable request on your part considering your honesty and compliance.

What I was not told is that even though precipitated wd sucks, it only lasts a couple hours. The difference between precipitated and regular is that I had rapid heart beat and literally felt like I couldn't move. I was on the verge of consciousness, and worst of all the legit area I take pain meds for in the first place hurt like hell. Horrible. But being an idiot, 3 hours later I took another 1/4 of the subutex and it repeated all over for a couple hours.

Please try to get something without naltrexone for a month, THEN switch.

I hope it works out, please keep us posted. I got my scripts refilled today and seems like they are working at about 1/2 what I need for the horrible pain I have, but the ONLY GOOD THING was that even through the horrible night last night I got at least 1-2 hours sleep which is amazing for me. I went 22 days without a wink CT off oxy a few years ago and have ptsd from it. Sometimes what doesn't kill you also DOESN'T MAKE YOU STRONGER, just leaves mental scars, lol.

Thank you!!!! I just spoke with my Dr. And I explained that I was concerned with pw. And that I would feel a lot better at least starting on the subutexs since they don’t have Naltrexone. And after the first month I will have no problem going to the suboxone. I want to thank you for your comment because that was something I was very worried about.

 

[Las Veghost grower]

The naloxone dosent do anything I’m pretty sure it put in the sub ad a scare tactic to reduce abuse

 

[Marie656]

^ this is definitely what you should do

The doctor gave you bad advice. Taking 4mg of buprenorphine 48 hours after taking methadone will almost surely result in precipitated withdrawal. 15mg of methadone is a small dose as far as methadone maintenance goes, but it definitely enough to produce a severe withdrawal syndrome.

I would recommend the following method for induction:

Microdose induction of buprenorphine-naloxone in a patient using high dose methadone: A case report

Buprenorphine is a partial mu-opioid receptor agonist approved for the treatment of opioid dependence. The risk of withdrawal symptoms and wait time required to safely initiate buprenorphine provides challenges to both patients and providers. Microdose ...

www.ncbi.nlm.nih.gov

Essentially you take tiny doses and gradually increase. I recommend you share that link with your doctor and ask to approach it in that fashion. The problem is you might need a different prescription for the 2mg suboxone, because .2mg of an 8mg suboxone strip is 1/40th of a strip (a tiny little sliver).

Also note that naloxone isn't what causes the precipitated withdrawal, it is the buprenorphine itself, so the inclusion of naloxone doesn't really matter.

Thank you. I’m going to try to not take anything as long as I can. And when I do I will start with a quarter of the subutex. I appreciate your comment. Thank you again

 

[Señor Moreno]

There were those little 0,2 mgs bupe pills, brands like Temgesic, Buprex, Prephin...
Don't know how avaliable are they nowadays, if at all, but it worths asking your doctor about it. If you were able to get them, you could do your transition much more easier.

 

[Las Veghost grower]

If you can’t get the smaller dose pills or strips you can use water to dissolve the sub in then dose by volume, 8mg sub in 80ml water = 1mg per 10ml of water , and just put the water under your tongue like you would the strip

 

[Marie656]

Hello! I am hoping that someone can be of help to me and give me some advice. I am currently on 15mgs of Methadone. I have been on methadone for 9 years and I need to get my life back. I started on the methadone clinic due to a oxy addiction. I have no desire at all to use. I have a new Dr. That is going to help me through the transition from methadone to suboxone. He has prescribed me clonidine and Clonazepam ODT. I’m very nervous about this transition. He advised me to wait 48 hours before taking the first dose of suboxone and told me to take a half at first just Incase I take it too soon and go into precipitated withdrawals. And then if I’m okay with that to take the other half. I’m ready to do this but I am nervous. I am concerned about how bad the withdrawal may be, I know it’s different for everyone. I also apologize in advance because I’m sure this question has been asked. I’m new to this forum and wasn’t sure where to post this question. If anyone could give me some advice, I would greatly appreciate it.
Thank you.

I have started today. I had planned for a start date of August 1st. But I decided to start since I’m only delaying it and making myself more anxious by doing so. And this is something I really need to do. I have felt chained for many years. And I see other woman who in the late 60s that have been there for many years. Most need wheelchairs just to get in. I do not want to be that person god bless them. Anyway sorry about that little rant. I took my last dose of methadone Friday morning at 5:30 a.m. I went down 1 more mg and am now at 14. I feel okay. As long I don’t let my mind play me. I am ready and praying this will go a smooth as it can. I really would like to thank each one of you that took their time to give me their advice. Nobody besides another addict really knows what it’s like. You can read about it, but living it is a lot different in my opinion. I appreciate you all, and I will keep everyone updated on my progress. Thank you again

 

[Marie656]

Good morning everyone. So as I stated above I took my last dose of 14 mg of methadone Friday at 5:30 am. By Saturday evening/ early Sunday morning around 2:30a.m I stated to feel pretty bad. Goose bumps hot and cold and about a hour later the stomach issues started. I fought it till about 7:30 a.m Sunday. 50 hrs and only the last five were really bad and those were nothing compared to what I was expecting. I took a 1/4 of the subutex felt a little better about 40 mins later, no PW’s thank you lord!! Then about a hour later took another 2 mg. Today i plan to just take 4 mgs at once. I did also get some 1:1 CBD tincture ( Ringos gift ) at the dispensary and I really feel like that helped me a lot. So far this has been a very positive experience and I was really nervous about it. Every one that took time to leave advice me for me made this all so much easier for me just knowing that you were all out there. Thank you all for helping me through this.

 

[Nurse Ratched]

Good morning everyone. So as I stated above I took my last dose of 14 mg of methadone Friday at 5:30 am. By Saturday evening/ early Sunday morning around 2:30a.m I stated to feel pretty bad. Goose bumps hot and cold and about a hour later the stomach issues started. I fought it till about 7:30 a.m Sunday. 50 hrs and only the last five were really bad and those were nothing compared to what I was expecting. I took a 1/4 of the subutex felt a little better about 40 mins later, no PW’s thank you lord!! Then about a hour later took another 2 mg. Today i plan to just take 4 mgs at once. I did also get some 1:1 CBD tincture ( Ringos gift ) at the dispensary and I really feel like that helped me a lot. So far this has been a very positive experience and I was really nervous about it. Every one that took time to leave advice me for me made this all so much easier for me just knowing that you were all out there. Thank you all for helping me through this.

Really happy it worked out well for you.

 

[Marie656]

Thank you. So much. Take care-