Looking to switch from methadone to suboxone

[RedHat]

I have a decent amount of experience with both mathadone and suboxone. I was on suboxone for a while years ago, but didn't like it because even though it blocked my ability to get high, it didn't do anything about the cravings. I tried methadone, and initially, I liked it. It did take care of my urges and I was able to get clean for some time. But then the side effects of methadone started to get to me. Lazy, eating a lot, lowered testosterone levels, sweating like a fucking pig, very low sex drive and the worst damn constipation ever.

I'm contemplating talking to someone at my clinic about switching to Suboxone (I see some people pick it up there, so I know they provide it). And I did some research on the subject, and it looks like its best if I lower my dose below 30mg, then I have to wait at least 72 hours before I take suboxone to avoid the dreaded effects of precipitated withdrawal.
So I have a couple questions about this process.

There were a couple rehabs I went to that they would give me some stuff to help alleviate the symptoms of withdrawal. I would get them both before I started taking suboxone, then again when I was weaning off of it. I believe what they gave me was: Ropinirole (Requip) to take care of the restless leg syndrome, then Clonidine (blood pressure medication) to help with some of the other withdrawal symptoms. The first time I ever used Clonidine, I thought it was a damn miracle drug. I was on heroin so I only really needed to wait like 24 hours before taking Suboxone, but the Clonidine and Requip helped so much that I was able to wait much much longer.

Has anyone tried taking these two (or similar drugs) to help with the symptoms when switching from Methadone to Suboxone? If so, did it help a lot?

Also, I see a bunch of threads about switching from Methadone to Suboxone, but not much detail on how sick one would get in the interim? Waiting 72 hours seems like it would be a nightmare, which is whats got me worried.

Thanks!

 

[Keif' Richards]

Hey Redhat! I don't think we've interacted yet, so I just want to give you a belated welcome man. I'm actually really intrigued to hear that you were provided with Ropinirole (Requip) for your Restless Legs Syndrome. I have been curious about the usage of these dedicated RLS drugs in detoxification protocols, but this is the first time I've actually heard of it being done. I don't want to get side-tracked, but I'd like to know more about how the Ropinirole effected you. This could be really useful information to the community so please write back!

You are right in that there is a plethora of threads regarding this exact situation. It's complicated and the experience is inevitably fraught with anxiety. Nobody wants to experience Opioid withdrawal, so it's no wonder there are a ton of threads regarding this issue. I would encourage you to seek out some of these other threads, because both myself and others have been discussing this ad nauseum for years.

The protocol typically is to reduce your dosage to 30mg Methadone and then wait 72 hours before introducing the Buprenorphine. This doesn't work for everybody, so it's pretty much just a point of reference. Everyone is different and this process is not so much measured by time, but by how you feel. You need to be in withdrawal prior to induction with the Buprenorphine. If you don't wait long enough, there are serious consequences.

Are you implying that you're going to an in-patient detox? If so you probably have a lot of options. Clonidine (Catapres), Gabapentin (Neurontin) and Melatonin are just a few of the medications that they can give you to help you out. Are you familiar with Gabapentin?

You ask how sick you will get in the interim. As I said, it's not about time, it's about how sick you are. Your provider will typically have a few benchmarks to evaluate your level of withdrawal, but it's mostly dependent upon self-reporting. Some spots actually will not medicate until they see you vomit, but every place is different. Part of this process, unfortunately, involves getting pretty sick. You are not going to be in full-blown withdrawal, but you will come close. Luckily, with comfort medications you can make it through the process without too much misery.

Let me know if there's anything I missed!