Bupe Can you take low doses of methadone and subutex together or alternate without PWs

[Gordon]

I have done this before, I take 2mgs of Subutex and a few times I have taken methadone, around 10mg to 25mg, then done metha for few days and back on subutex, have had no withdrawals to speak of, is this because I take low doses? that I do not get any PW? is it possible that if I took methadone for around a week at around 25mg to 30mg then I can swtich to subutex 24 hours later without any withdrawals? like I said I have alternated in the past and had no trouble to speak of, the longest I gone on methadone has been 5 days, and then subutex, so if I wanted to do a week on meth at low doses then would I still not have any withdrawal issue if I went back on sub 2mg the next day, or more then 2mgs of sub?

thanks!

 

[damonoxide]

Quick note: I advise not using "meth" as an abbreviation for methadone. Gets confusing what with the other meth.

To your question: those doses of methadone are definitely low, well below the blocking effect. Switching to bupe, especially a full 24 hours later, should pose no issue in my experience and to my knowledge.

 

[Gordon]

So am assuming I can alternate between subutex and methadone? speacially when they both are low doses. Methadone works for my knee pain more, but I use methadone ocassionally. The last 3 months I've been using 2mgs of subutex but I do not get any high or euphoric like I did in the past when I was on sub for few years What is the maximum methadone dose you have to take in order to wait few days to take sub?

Like I said my methadone doses have been max 30mgs. If I did take methadone for a week at 30mgs would I need to taper the meth to go back on subs? or can I switch straight from 30mgs methadone to 2mgs of subutex? or would I need more then 2mgs of sub coming off 30mgs of methadone?

thanks again folks!

 

[Gordon]

By the way is it possible to take low doses of both methadone and subutex together?

 

[damonoxide]

I don't know about taking them together but my guess is that it would be useless at best and would induce PW at worst.

2mg of sub would probably be enough after 30mg of methadone to prevent withdrawal but you might experience an increase in pain since for most, bupe isn't great as a PK, especially compared to methadone.

 

[Lorne???]

If you take 30mg of methadone for a week, you should wait 48 hours before dosing buprenorphine.

with methadone, the amount of time is nearly as important as the dose, as it's roughly twice as potent at steady state, and has a longer duration.

mixing them is completely pointless. Contrary to popular belief, low doses of buprenorphine can be mixed with other opioids, but we're talking very low doses(not 2mg) and again, it's just pointless(especially with methadone.)

 

[Gordon]

I figured since my receptors are not all covered by either subutex or methadone since they are low doses- then taking them together at their low doses may potentiate eachother? I was led to believe you only get PW if methadone is covering all your receptors and over 30mgs (when you take them together or switch to bup from methadone).

Do I still have to wait 48 hours to switch to bup if I tapered the methadone to something like 5mg? bearing in mind I would have only used the methadone for a week at no more then 30mg/20mg.

 

[Lorne???]

You can't fill all of your opioid receptors(well, I suppose you could, but you'd be OD'd.)
That's why opioids have no ceiling effect.

And the PW's have nothing to do with receptor occupancy, it's because buprenorphine is a partial agonist, with low intrinsic activity at Mu receptors, and a corresponding ceiling effect. In simpler terms, buprenorphine just doesn't activate receptors the same way the good 'ol classics do(morphine, methadone, etc.)

I'm confused with your question of tapering. The main point is if your taking even a moderate dose of methadone for a week(remember 30mg of done' at steady state is circa 100mg oxy, which although not large, is not puny either) you should wait until WD starts to kick in, which for a lower tolerance should be 48 hours. But if you take a very small dose of methadone the final day, maybe you can get away with 24-36h. YMMV.

And mixing then is pointless, I promise. Any above microgram dosing of buprenorphine I simply to competitive to mix with other opioids.

I was saying you could, if you were inclined, take 5mg of methadone with 400mcg bupe, though I've no clue why you would want too.

 

[Gordon]

Thanks for your responses.

I want to take bupe as it raised my endorphins levels particularly when am working out. (I usually take my dose when I wake up in the evening and then 20 mins later do some sports-this raised my endorphins levels and makes me feel good for rest of the night). With Methadone it keeps my knee osteoarthirtus pain at bay. I thought if I take 30mg of methadone and 0.5mg of bup then I can get the best from both works? would bup still have some affect if I took 30mg of methadone?

I mentioned taperng the methadone if I was on t for more then 6 days, but am thinking I wil be alright taking 25mg or 30mg or methadone on the last 7th day and switch to 2mg or 1mg of bup? please note I a not a regularly user of methadone. This is my third time using methadone and I've never used methadone for more then 4 days in the past. Before this week I used methadone back in November for 4 days, then switched to bup without any trouble at all.

P.S I have used bup 12-24 hours after taking dope and other opiates and never had any PW, I never been in withdrawals when I've taken bup, so maybe because it's such low doses and am not a regular opiate user that I do not get PW? who knows.

My main concern was if bup will still have an affect in terms of endorphin activity while taking the methadone to help with my knee pain. Again I take bup in the evening when I wake up and then work out straight after, this helps my endorphins and gives me euphoric feeling, I do not get thse feelings of I took my bup earlier and worked out later, infact I would feel the opposite-like am mentally withdrawing, for some reason bup has a good mental affect when I wake up and take it-then work out 20 mins latter, anybody know?

 

[purplehaze147]

I figured since my receptors are not all covered by either subutex or es- then taking them together at their low doses may potentiate eachother? I was led to believe you only get PW if methadone is covering all your receptors and over 30mgs (when you take them together or switch to bup from methadone).

Do I still have to wait 48 hours to switch to bup if I tapered the methadone to something like 5mg? bearing in mind I would have only used the methadone for a week at no more then 30mg/20mg.

No no no lol. First off wait AT LEAST 48 hours, a doctor made me wait 72 hrs when I switched over. Methadone lasts much longer than most opioids. It takes a couple days for the withdrawal to even start & around 7-10 days to peak. They're not gonna potenate each other you're just going to end up getting very sick, trust me.

I've felt PW from dosing buprenorphine 12 hours after a single 50mg tramadol. I was already very sick & it made me sicker.

 

[Gordon]

No no no lol. First off wait AT LEAST 48 hours, a doctor made me wait 72 hrs when I switched over. Methadone lasts much longer than most opioids. It takes a couple days for the withdrawal to even start & around 7-10 days to peak. They're not gonna potenate each other you're just going to end up getting very sick, trust me.

I've felt PW from dosing buprenorphine 12 hours after a single 50mg tramadol. I was already very sick & it made me sicker.

That's strange because I've taken tramadol a few times and then bup 4-12 hours later and never felt PWs. I've also in the past alternated between other opiates including methadone with bup and still never suffered any PW whatsoever, then again I've never taken opiated regularly for more then 4 days, that included methadone too. I've always been on bup since the start of the year then any other opiates, but 2mgs Subutex! I feel my tolerance to bup has built up.

One thng I do not understand is when I was on bup maintainence in the past for 8 years I always felt euphoric, even at 0.5mg, speacially when I worked out doing cardio and sports (took my bup dose and worked out straight over in the evening) then I went a year without any bup and opiates, but when I got back on bup I never felt a single high or euphoric, not even at 4mgs or 8mg, why is that? can you build tolerance even if u stay off bup for a year? for now bup only holds me, but no high or anything, just don't get it is all.

 

[purplehaze147]

^ I did inject it though. I got the suboxone right before I had to go to work thinking it'd kick in faster.

Lower dosages of buprenorphine (suboxone, subutex) feel better for some strange reason.

 

[ladianios]

Just a heads up, 2mg of sub is not a low dose, a low dose of sub would be measured in micrograms increments. 2 mg of sub is enough to basically ruin any "decent" effect of any other opiate be it therapeutic or recreational except maybe fentanyl which I believe has a higher binding affinity than bupe but I could be wrong on the fentanyl thing, good luck in your quest

 

[Gordon]

Thanks folks, do appreciate this info.

I figured 2mgs was a low dose compared to anyting higher, I think I have a fast metabolism hence feel the affects of 2mgs wear off so soon.

Can I ask how many ays will methadone be in my system if taken for 5 days at doses around 25mg-30mgs? I have a urine test coming up on Thursday evening and I figured if I took methadone 20mg on Saturday evening as my last dose then perhaps by Thursday it'll be all gone?

thanks again!

 

[siq]

I just would not be mixing methadone and subs, just a bad idea... stick to one.

 

[crzydiamond]

I don't think the not getting precip wd has anything to do with "low doses" (as 2 mg isn't really a low dose)

I think it has more to do with the fact that you don't have a habit (only take methadone occasionally)
Just like with narcan, if you don't have a habit you don't get that feeling like death/immediate wd when given it.

Basically what I'm saying is, you wouldn't be in wd if you just stopped the methadone after a few days. Bupe won't put you into precipitated wd either, unless you have a habit.

(Now if you did have a habit then what above posters are saying applies...and wait...)

(And as for how long it's in your system just do the half life math...)

 

[Gordon]

Well I've taken the sub 2mgs 4 hous ago and have had no symptoms so far, this was 24 hours after last methadone dose of 20/25mgs. I don't think I ever had PW in my life, even when I took heroin on top of bup and other opiates, I just never felt withdrawals. Maybe being on a low dose of sub and doing methadone occassionally to help with pain in low doses has something to do with it, but none the less no PW so far.

 

[crzydiamond]

You wouldn't get pw taking heroin on top of bupe and other opiates. Pw happens when you first go onto bupe from a full agonist too soon

I'm confused. Do you normally take bupe regularly? If so, you wouldn't get pw cause there would still be bupe in your system. I was under impression from your other thread that you were taking full agonist methadone then starting bupe. But if you take bupe, then take methadone then take more bupe, no you would not get precip wd.

 

[Gordon]

Yes I usually take bup, since January 2015. I took methadone for 5 days, by then I figured bup was out of my system as usually I feel the symptoms of bup the next day if I don't take my dose. I was feeling the affects of methadone too so am assuming meth broke throgh the bup, but now its been half a day and still no PW.

I use to take bup on top of opiates and vice-verse, but if your saying that if one normally takes bup and then opiates and then bup without PW then I gather it's that scenario.

 

[crzydiamond]

Yes exactly, if you normally take bupe and then take opiates and then go back to bupe you won't get any pw

Even though you don't feel the bupe it stays in body very long. The half life alone is like 24-36 hours I believe. So if you take bupe daily yes you can stop for a day or 2 to get high because the blocking effect is lessened but there is still some bupe on some receptors.

If you didn't take bupe (or had been off for a long time), and you had an opiate habit and then took bupe, that is when ppl go into precipitated wd.

But stopping for a few days then going back to bupe won't result in pw. Now if you took a few weeks off...different story

Edit: oh, and if pw was to hit its usually within the first 15-20 minutes. You would know almost immediately, you'd start feeling not quite right then boom! You said it's been a half day so you're definitely fine