Methadone taper Month 8 from 150MG --end goal suboxone

[NIKKI83]

Hey there,
My wife has been detoxing/tapering off of Methadone (from a clinic) since August 2016. She started at 150MG which she was on for almost 8 years.
She is now entering her 8th month of taper. In January she reached 85 MG and today she is down to 42 MG. She has done an unbelievable job.
I am so proud of her and so happy this is happening. Her end goal is to reach 30MG and transfer to suboxone.
The issue is, since January and 85MG up until now 42MG she is basically living with non-stop migraine. We even had an MRI & CT done just to be
sure, both came back ok. What can I do to help her with these headaches? The last thing I want is for her to reach for something drastic
as she is closing in on her goal?
Is there a combo of anything she can take to alleviate the withdrawal? Is there something natural she can take? Is there a prescription she should have?
Be aware she is very sensitive to interactions with Methadone so a lot of what's out there to my knowledge would create a wobbly wife.
Thanks!

 

[bigjoey]

Many on meth have the same problem with headaches. I was on 90mgs in Aug 2015, went into treatment Nov 2015 and detoxed blind by Apr 2016. By the time I was in the 20's it felt like the headaches would never go away. She could try increasing her water intake as it helped me most days. For some reason it's pretty common amongst us "methadonians"...that and the horrid constipation.

 

[Erikmen]

I agree. It took me months to get off methadone which i had been using for almost 8 years. The migraine was gone, but it wasn't the worst side effect. I believe that when she totally gets off things will improve significantly. It's very difficult for sure, so everything else should be okay. Exercise, eat well, drink lots of fuids and find a great hobby to compensate all the sadness that may come. And yes, constipation shouldn't be a problem anymore. good luck!

 

[Jabberwocky]

I would honestly suggest her stabilizing on her current dose of methadone before continuing with her taper. That means staying at her current dose for 2-4 weeks.

How fast is she tapering, lowing her dose on a weekly or biweekly basis? And how much does she lower her dose each drop?

When she switches to buprenorphine, I'd also suggest her using a shorter acting opioid like codeine or tramadol for a week before starting the buprenorphine - it will make the transition MUCH easier.

 

[OverDone]

Switching from methadone to suboxone will be very uncomfortable to say the least. What she has accomplished so far is HUGE and it says a great deal about her character and determination.
I work at a methadone clinic that encourages a slow taper (tapering 3mg to 5mg every two weeks). Some patients prefer to not know what their dosage is as they begin their taper and sign what is called a Blind Dose Contract. This benefits some by removing the "numbers game" from their thought process
As she tapers, there will come a point where she will have to be completely abstinent of methadone (and other opiates)before suboxone can be administered. This will be mentally and physically difficult but extremely possible. I have heard that some make this transition easier by using buprenorphine (subutex) during the abstinence stage prior to introducing buprenorphine/naloxone (suboxone)

 

[Jabberwocky]

IME the amount of discomfort one can expect to experience when switching from methadone to buprenorphine, or using buprenorphine to come off methadone, totally depends on how one manages the taper/induction onto buprenorphine. It will be more difficult to go from 30mg of methadone to buprenorphine than it would be from a lower dose of methadone to buprenorphine, but that doesn't mean it will necessarily be very uncomfortable.

With the right medication, particularly using a short acting full agonist like codeine or pseudo opioid like tramadol for 3-7 days between getting off methadone and getting on buprenorphine, there doesn't need to be any serious suffering involved (especially if they have access to other medication like gabapentin, clonidine and diazepam to aid in the transition).