I have been on methadone for 6 months at 25 mgs. My doctor convinced me to switch to bupe because it is easier to come off of in the end so today, after 24 hours since my last dose of methadone, I took 4 mg of subutex. I am experiencing horrrible precipitated withdrawals and I can't see the doctor until tomorrow. Will I feel better if I go back to my normal dose of methadone tomorrow?
Switching from methadone to bupe
- Thread starter Hvnly101
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How are you feeling now? Did you take methadone eventually?
The time interval between the last dose of full agonist opioid and first dose of buprenorphine is generally given as 24 hours, but with methadone you should have waited at least 48 hours before taking the first dose of buprenorphine even though your methadone dose was quite low. Also, it's best to start with 2 mg of bupe and if after 2 hours, you don't feel all right, take another 2 mg, and so on. If I were you, I would just wait it out and then adjust my buprenorphine dose.
I'm not sure if it's easier to quit buprenorphine than methadone, but in my personal opinion and experience buprenorphine is a much better maintenance drug. I myself quit methadone after 2.5 years spent on it, the withdrawals were hellish, actually not very far from benzodiazepine withdrawal with some crazy symptoms on top of regular opioid withdrawal, and 2-3 months after quitting methadone I started buprenorphine maintenance as I couldn't pull myself together and probably was suffering from PAWS at that point. It's hard to say now if it was a good decision. Anyway, as a maintenance opioid that I have to take every day, I'd choose buprenorphine over methadone any day as it's a drug you don't really feel much and can live a more or less normal life without feeling drugged and without feeling withdrawals. With methadone though after some time on it I was emotionless and cognitively impaired. The first few months on buprenorphine are great after years of being drugged with opioids, feeling hopeless and depressed, sadly, this initial kick doesn't last forever, but then it's still way better than methadone, I've been on it now for almost 5 years and thanks to it I went back to the university, started working in a lab, all that certainly wouldn't have been possible if I was still on methadone.
The time interval between the last dose of full agonist opioid and first dose of buprenorphine is generally given as 24 hours, but with methadone you should have waited at least 48 hours before taking the first dose of buprenorphine even though your methadone dose was quite low. Also, it's best to start with 2 mg of bupe and if after 2 hours, you don't feel all right, take another 2 mg, and so on. If I were you, I would just wait it out and then adjust my buprenorphine dose.
I'm not sure if it's easier to quit buprenorphine than methadone, but in my personal opinion and experience buprenorphine is a much better maintenance drug. I myself quit methadone after 2.5 years spent on it, the withdrawals were hellish, actually not very far from benzodiazepine withdrawal with some crazy symptoms on top of regular opioid withdrawal, and 2-3 months after quitting methadone I started buprenorphine maintenance as I couldn't pull myself together and probably was suffering from PAWS at that point. It's hard to say now if it was a good decision. Anyway, as a maintenance opioid that I have to take every day, I'd choose buprenorphine over methadone any day as it's a drug you don't really feel much and can live a more or less normal life without feeling drugged and without feeling withdrawals. With methadone though after some time on it I was emotionless and cognitively impaired. The first few months on buprenorphine are great after years of being drugged with opioids, feeling hopeless and depressed, sadly, this initial kick doesn't last forever, but then it's still way better than methadone, I've been on it now for almost 5 years and thanks to it I went back to the university, started working in a lab, all that certainly wouldn't have been possible if I was still on methadone.
Yes a full agonist will reverse it. If you wait 24 hours though you might as well continue trying to transition to bupe.... Didn't your prescribing doctor warn you about pwd and to wait 3 days at least when switching from methadone due to its long half life. 24 hours for a stable habit even at a low dose is nowhere near enough.
Speed King
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OP, it is what it is for you, at the moment. It may be a bitch for a few days. You are making a pretty major transition.
The good news is, you will get over it.
Suck it up while transitioning. Some benzos or gabapentin will help during the shit period. Once you are stable on the bupe, your doctor will raise the bupe dose if you need it.
Check out some threads on bupe and methadone.
Whatever you do, take your bupe correctly. Withdrawal will be much easier. Also, keep your doctor in the loop. He knows what's up. He can help you get where you need to be!
The good news is, you will get over it.
Suck it up while transitioning. Some benzos or gabapentin will help during the shit period. Once you are stable on the bupe, your doctor will raise the bupe dose if you need it.
Check out some threads on bupe and methadone.
Whatever you do, take your bupe correctly. Withdrawal will be much easier. Also, keep your doctor in the loop. He knows what's up. He can help you get where you need to be!
opiatekrzy
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When I did this transition, even at 24mgs of suboxone daily, I still felt withdrawl from the methadone for about a month give or take. I was amazed at how powerful Methadone can be as well as Bupe is.
Speed King
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opiatekrzy, what was your methadone dose?
This is where the comfort meds like gabapentin come in.
OP, there is really no way to get around a sucky part.
If you can get Lyrica.and or a long acting benzodiazepine, that will at least take the edge off.
Is there any way you can titrate your methadone dose down using methadone?
This is where the comfort meds like gabapentin come in.
OP, there is really no way to get around a sucky part.
If you can get Lyrica.and or a long acting benzodiazepine, that will at least take the edge off.
Is there any way you can titrate your methadone dose down using methadone?
opiatekrzy
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Was on 120mg, dropped down to 20 and converted over to subs after 48hrs as directed by doctor
losangeles1993
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plz plz plz wait like 4 to 5 days .i hear soo many horror stories of people who dose too early
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4 - 5 days? where on earth did you get that from? 48 hours is generally regarded as the max waiting time to transition (assuming you dropped down to 20mgs as is recommended). after 5 days you'd basically be kicking lol
opiatekrzy
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How weird, I dropped to 20mg, literally waited 48hrs and went into PWD...then again my taper was a 10mg decrease every 3days...can this be why?
Not for people on high doses of methadone.... Even fentanyl patch people should wait 4-5 as the fentanyl could be soaked into the skin so it's still slowly releasing even after the patch is removed. Maybe washing the area scrubbing with soap, isopropyl, or and then soap while running water over it might make it better.
Bupe is extremely difficult to induce on unless it's for a lite tolerance that shouldn't use for more than just a rapid detox. I honestly think that unless a full agonist is provided to overcome pwd or to schedule taking the last dose of the full agonist on q schedule that's personalized in a location that is easy to rest in, get to the bathroom, has entertainment and activities to keep the mind occupied, and if possible someone to clean up the sweat and vomit that ends up in the environment.