Methadone quitting nightmare today, need advice

[SCARED SHITLESS]

I have to pose this question if not to convince my medical team, then for my own piece of mind. And please excuse any errors as my body feels as though its been to hell and back today and am still a little shaky.

So today was the day I?d be coming off Methadone by way of suboxone rapid detox. I had heard about it from some of the heroin users I know, and apparently it works a treat, although I should have been suspect, because there are still many users who won?t try it.

So I brought it up to my prescriber and told her what I had heard, that it went something like: skip a day of methadone, day after: 2mg of suboxone, then 8, 10, 8, 6, 4, 2, then none and voila, cured. Im not that naive, but thats what I heard the gist of it to be. And so thats exactly what she prescribed.

While my GP and pharmacist must treat many users, I don?t know whether they see much outside the norm. So Sunday I had my last dose in the morning which was 2.5 or 25 of methadone depending who you ask, and I had tapered down 2mg a fortnight prior as well. Yesterday, Monday I saw my doctor, got my new script, and was told to take the 2mg later in the day.

Well last night came and I wasn?t experiencing any withdrawal sx, and because I had heard precipitated withdrawal was a bitch I held off. This morning I still felt well, but thought if I left it any longer, I may get in trouble, so I took the 2 mg suboxone at 10.00 and by 11.00 I was sweating uncontrollably, I had stomach cramps that match my labour pains and I knew I was withdrawing.

I thought this method, using suboxone short term, was to save the pain of withdrawal. Home alone I rang the pharmacy to ask advice and after recounting my story she said to come in to have the 8mg. I could barely walk but made it there, was dosed and came home.

Well 30 mins later, if I had a gun I would have used it. I was in the most excruciating pain. My fingers were icy cold and felt as though a million needles were stuck on the end of them, and although I was sweating profusely I was freezing cold, and I couldn?t lie or sit still. Id go from lying in a ball to falling on the floor having to stretch my legs, then the pain would get so severe I screamed out crying for it all to end.

The only time I had experienced this before was over 2 years ago when I injected a targin not knowing what it was, and it kicked of 60 mg of methadone at once, I saw angels that day and remember that ice cold feeling over my body which made me think I was going to die. The ambulance was called but they didn?t believe me then either and being so agitated they thought I was on ice, well I won?t tell you the rest of the deplorable treatment I endured.

This felt exactly like that, I could barely call my hubby who was at work but couldn?t be home for another hour so I called the pharmacist who said this was highly unusual and he?d never heard of it before, but he?d check back with me later, and my GP had finished for the day. So the only thing I could do was take some valium, which I need 20mg of to settle down to a stable self, but still quite effected by everything else.

No-one knows what to do, but I for one am petrified to take suboxone again tmo. What happened to me? and what should I do?

 

[Jekyl Anhydride]

Induction to Subs from Methadone seems to have higher incidence of PWD vs some of the shorter acting opioids. The most accepted method is waiting till you've reached a 26 on the COWS scale. Clinical Opioid Withdrawal Scale. Basically making sure you're in heavy WD before inducting. For those that don't have that option inducting with very small doses of Subs seems to have a higher success rate. Once you're in full PWD it's rough to come out of quickly without drastic measures.

This article followed people inducting on to Subs from 100mg of methadone and while there's no guarantee, the people who used smaller split doses of subs fared better than those who took larger induction doses.
https://www.ncbi.nlm.nih.gov/pubmed/17517480?dopt=Abstract

At this point I think adding small doses of subs till you begin to feel at least a little bit better is your best option. So sorry you had to go through that.

 

[LopLover]

...So I brought it up to my prescriber and told her what I had heard, that it went something like: skip a day of methadone, day after: 2mg of suboxone, then 8, 10, 8, 6, 4, 2, then none and voila, cured. Im not that naive, but thats what I heard the gist of it to be. And so thats exactly what she prescribed.

While my GP and pharmacist must treat many users, I don?t know whether they see much outside the norm. So Sunday I had my last dose in the morning which was 2.5 or 25 of methadone depending who you ask, and I had tapered down 2mg a fortnight prior as well. Yesterday, Monday I saw my doctor, got my new script, and was told to take the 2mg later in the day...

...Well 30 mins later, if I had a gun I would have used it. I was in the most excruciating pain. My fingers were icy cold and felt as though a million needles were stuck on the end of them, and although I was sweating profusely I was freezing cold, and I couldn?t lie or sit still. Id go from lying in a ball to falling on the floor having to stretch my legs, then the pain would get so severe I screamed out crying for it all to end.

...This felt exactly like that, I could barely call my hubby who was at work but couldn?t be home for another hour so I called the pharmacist who said this was highly unusual and he?d never heard of it before, but he?d check back with me later, and my GP had finished for the day. So the only thing I could do was take some valium, which I need 20mg of to settle down to a stable self, but still quite effected by everything else.

No-one knows what to do, but I for one am petrified to take suboxone again tmo. What happened to me? and what should I do?

You took the Suboxone too soon. Methadone lasts so long in the body, even after all that tapering and so low a dose, that one day isn't long enough to clear your receptors enough to take Suboxone. I feel your pain, as I've experienced it as well. I was hospitalized for several weeks for an entirely different problem (respiratory failure due to pneumonia on top of severe COPD) I had been on about 4mg of Sub for a few years, tapered down from a starting point of 8 mg. My local hospital is cheap as hell and didn't want to pay for Suboxone, so they switched me to methadone while I was there. After I went home, I talked to my provider (he cussed out the hospital and said I should have called him, to which my reply was that, had I been conscious, I would have) %) and he said I could taper off the methadone and go back to Suboxone or just get off all of it, that it was up to me. He warned me, though, about the danger of precipitated withdrawal should I not wait long enough off the methadone. His advice was 3 days minimum--after only about 4 weeks on a dose of 15mg twice a day.

Since I don't follow directions, especially when it concerns drugs, I ate up the rest of the methadone, trying to get high and never making it, then got ready to go back to the Sub. I waited until, in MY opinion, I was sick as a dog. It was probably the second night when I took my regular Sub dose, 4 mg, and expected everything to be fine. HA! Half an hour later I felt just like you described. I was in withdrawals WAY worse than I had been before and didn't know what to do. I read everything I could find and didn't get much advice, so first I tried more methadone--zero effect. Then, since I figured it couldn't get any worse, I tried more Suboxone--zero results there, too.

I spent the entire night pacing the floor with horrible muscle cramps, runny nose, and eyes, the whole shebang, on top of being so weak from pneumonia that I almost couldn't breathe or do anything. I came out of the hospital permanently dependent upon supplemental oxygen, and while now I'm used to being attached by a hose to a machine or bottle, I wasn't then and was always tripping over the thing. I'd broken my finger the day before I came home, in fact, falling after getting my feet caught in the hose. So I already wasn't a happy camper, and then these mega-withdrawals that were horrific--aargh!

By halfway through the next day they had finally gotten better--I wished I had some valium! All I had were a bunch of inhalers of different kinds, all of which all made me edgy and anxious. When it got better, it did it really quick. The withdrawals just went away, although that anxiety didn't for a long time. I took my regular Sub dose the next afternoon, not long after the withdrawals went away--probably not smart--but it worked just fine. Then I went on from there and stayed on Sub for several more years. So it should be safe to try the Sub again once your precipitated withdrawals are gone, especially if it has been 3 days or more since your last methadone dose. One point, though--it's very rare but does happen that people can actually be allergic to one of the drugs in Suboxone, either the buprenorphine or the naloxone. If you keep getting sick from it and you really want to do Sub, you can ask your doctor for Subutex, which is just buprenorphine without naloxone. But if it's the bupe that you're allergic to, Suboxone's going to be a non-starter. Best wishes to you, and thank you for your story.

 

[tacodude]

You took Suboxone way too early... You said 2.5 or 25 of methadone, which is a huge difference. You need 2-3 days off methadone. The pharmacists telling you to come in and take 8 MG was completely inappropriate. They should have told you that you precipitated withdrawals. What they can't say or know is that you can use heroin, morphine, opium from poppy seed tea, or any other opiod to pull you out of withdrawals and then attempt to wait another few days before trying Suboxone again using 1 mg every hour to make sure one doesn't induce withdrawals, as if that happens it gets worse the more you take, and figure out the lowest dose needed as bupenorphine is a horrible opiod with an intensely severe withdrawal and extreme potential to make dependency more severe.


Wait for more people to give you better advice how to approach this

 

[mostly-human]

IMHO - switching to subs from either methadone or a strong habit, it's always going to make you feel awful..


Typically when I have switched from 'done to subs I have used smack/fent to pull me out of those horrific PWDs but I dont take more methadone - and I'll repeat each day until taking the sub (just 2mg) is manageable and then I will slowly keep taking more, 2mg every 2hrs or so, until eventually I feel "stabilized"

This method is much easier (maybe even only possible) if you can have a private supply of subs and not need to keep being dosed under supervision.