Why am I not getting any PW after switch to bup from methadone?

[Jodias]

Hi guys,

I was on methadone for 4 years, no more then 40mils... I tapered down to 14mils and switched to Subutex earlier today. I was microdosing i.e starting at 2mg of bup and going up every few hours, now am on 6mgs of sub, I still have no withdrawals. I started 5 hours ago when I took my first dose of sub (2mg). I was off methadone for only 30 hours!

Now my question is if I was to get PW would I have got them by now? or will I get them later? I was expecting lots of PW as I only inducted 30 hours after last dose of methadone. Or could it be because I tapered down to 14mils that it made the transition of bup easier?

thanks.

 

[Keif' Richards]

Hey Jodias and welcome to Bluelight! It's not too far-fetched to expect this outcome. You took some precautions, you waited. I don't think there's anything truly anomalous about this situation considering everybody's different. You were never on a wicked high dose of Methadone either. I'd say with all of these variables at play, it makes sense to me.

If you were to get precipitated withdrawals from this experience, it's my firm belief that they definitely would have started by now and would be in full-force. I'm not trying to say that you couldn't potentially experience some discomfort somehow, by say, increasing the Buprenorphine dose too quickly, but for now, I'd say you're good to go. Keep doing what you're doing. The microdosing is smart, yet I have a chronically hard time convincing people to take less than 2mg when they're sick. They want relief fast, but they often pay the price and it's painful to watch.

 

[Jodias]

Hey Keif, thanks for your response.

Mind you I did use to take bup 4 years ago, I was on subutex for 9 years by that time, tapered slow to 0.4 and stopped, did H for 3 weeks, then used clonidine, clonopin and few DHS for further 1 week, and didnt suffer too badly, considering I was a long term bup user I thought I would suffer badly, but I think my slow taper and excercise helped me. I remember for the first 4 years of bup I was getting high of it, even 0.5 would get me high, but now I see it does not have that same high affect anymore, maybe because I had been on meth for 4 years that has something to do with it?

Anyhoos I hope I don't get any withdrawals from here on in.

 

[Keif' Richards]

It's pretty typical for these kind of "enjoyable" Opioid characteristics to fade rapidly when on maintenance. It sucks, I know, but that's pretty much it.

 

[Jodias]

But why is that? in the past when I was taking Buprenorphine/Subutex for 9 years it all gave me a high, lots of energy, feel good factor etc..Now it only keeps me off withdrawals and away from some depression that comes from missing a methadone dose or 2, well in my case anyway..Maybe because it's only the first day on bup after 4 years on meth?

P.S still no PW so to speak, can I get them tommorow? is it possible or am I in the clear now?

thanks guys!

 

[axe battler]

You should be fine tomorrow to take bupe again. I would try and stay as low as you can with the bupe. 6mg bupe is a higher dose than 14mg methadone, so you can probably take less tomorrow. Also with bupe, taking less is often more euphoric than taking more, as there is room on your opioid receptors for bupes metabolite, norbuprenorphine, which is a more euphoric drug as it's a full opioid agonist whereas bupe is only a partial agonist.

 

[HoldBack]

You are not getting precip withdrawal because you tapered low enough and did some microdosing to switch over.

I used to simultaneously increase bupe dose and decrease lope doses when I was making a switch off heroin.

Bupe tolerance as it relates to switching on or off is a funny thing though. It become much much more difficult the more times you do it. Be warned, too many switches and it becomes prohibitively difficult.

But you?re in the clear if you?re up to 6 mg

 

[Stargazer]

It seems tolerance gets really high from methadone. I noticed that when I was on it.

If you were going to go into pw (which, for the love of all that's holy, you don't want to), I'm pretty sure you would've already. You don't suddenly go into pw, when already having 8mg in your system. Microdosing was wise.

Holdback is right. Switching back and forth from a full-agonist opiate to a partial-agonist opiate gets more difficult. Im speaking from experience. Re-induction can be really shitty. It takes 4-5 days to get stable on Subutex fore. And it's brutal. Not a good idea to do too often.

 

[Keif' Richards]

Most folks I know at the clinic are not there to "do the right thing" with their life. The are there because they heard they could get Opioids given to them for free everyday.

To answer your question, we don't truly understand how many drugs and substances truly "work". Much of what is presented as scientific fact is actually not much more than a highly-educated guess on the subject. "It is believed that by influencing..." It's my belief that the experience of rapidly waning, subjectively positive aspects of maintenance drugs is actually a facet of the usage of all Opioids. The prime difference, again, in my opinion, is that maintenance is often the first time in many of our respective lives as addicts in which we are truly given pharmaceutically pure drugs, at the same time (more or less), every day, indefinitely.

The life of a street Opioid user, under the best of circumstances is going to consist of a rapidly changing purity and dosing schedule with intermittent breaks that occur spontaneously and can last for hours or days, further giving the user a lack of any true perspective. This tolerance is the body accommodating to the introduction of excess chemicals. Your body is saying, "this is how it is from now now on, gotta try and keep shit together".

This is just the advice of a friend. Pick a maintenance medication, commit and stick to the program. I would put any ideas of potentially switching to and fro between Buprenorphine and Methadone as the weather changes out of your head. It's extremely difficult and many of those who "pull it off" are often broken inside and suffering from extreme craving.

 

[axe battler]

So.what dose did you end up on day 2 of sub? You should aim for 2mg and under, which should be plenty to.cover 14mg meth. Then you may we'll find the positive effects to be more pronounced than on higher doses.