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Switching from methadone to suboxone

Ok... A quick run down:

She was on 40mg methadone for three weeks.
She ceased taking the methadone 18 days ago and went 72 hours without anything.
She started back on her 24mg subs (after those 72 hours) two weeks ago
She is feeling significantly better at the two week mark.
She is currently experiencing extreme lethargy, slight anxiety and scattered thoughts.

Anyone have a rough estimate as to how much longer until she is back to her usual self?
 
Could anything else in her life be contributing to the lethargy, anxiety and mental fog? Sometimes things which have nothing to do with the drug transition can be blamed on it. At the end of the day, you don't really know how much of this is directly related to the opiates and how much could be from other stuff. Especially when it's not primary WD (where it's pretty clear when things are caused by lack-of drugs). I would just say to make sure that she eats, sleeps and does not take on too much real life stuff (but enough to stay distracted from the process). The WD being done won't ensure that she feels great, as again other stuff in life can affect us too, but in general it's not going to get worse over time.

How is she sleeping? I know that all of these symptoms can be brought on by insomnia, which can come into play in situations like these.
 
Just thought I would point out that bupe has a stronger affinity than naloxone. Even though one is an antagonist/agonist, the other is an antagonist, they BOTH bind with opioid receptors.


Naloxone will NEVER kick off bupe. You never have to worry about it. Whenever you take a bupe and naloxone pill you won't go into withdrawals like you were taking a naltrexone pill because even if the naloxone binds, the bupe will kick it off. If the bupe doesn't fill all your receptors, and the naloxone fills some then a) only has a 30 min half life, and b) the bupe will still be giving you a plus opiate charge, and you'll end up at neutral, or above.
 
MDONE MG - BUPE MG
20-30 = 8
40-60 = 16
70-90 = 24
90-120 = 32-36
Click to expand...

@@Tony WIlliams

I don't know where you got that conversion chart but it is way off. If you switch from 20mg methadone to 8mg bupe you are boosting your tolerance like crazy. I was on 80mg methadone for well over a year and switched to 12mg bupe.. and even that was more than I needed. Also bupe has nalaxone not naltrexone neither of which are to blame for your precipiated wtihdrawals. Also there is no 'double block' from the nalaxone in bupe. Also also there are plenty of people on here who IV suboxone contrary to what you may think..

@@OP

First I want to say that 24mg bupe is WAY WAY WAY more than 40mg methadone. Shame on the doctor that put you on that. You could probably get just as good pain releif with 5mg oxycodone 4x daily but with way less dependency. I am not surprised you did not like being on the methadone considering you came from a monsterous buprenorphine dose. If I were her I would have the doc up my methadone dose. I can't imagine 40mg coming close to holding me if I came from 24mg bupe.

As other mentioned, you can't switch from methadone to bupe without a waiting period, as you will go into precipitated wtihdrawals. That being said, you by no means have to go down to 30mg first. I went from 80mg meth to 12mg bupe and it was a sinch considering how hard/brutal people make it sound. What I did was used a full agonist short acting opiate for 4 days (in my case heroin), then waited as long as I possibly would which was about 26-30 hours after my last shot of dope, and dosed the bupe. I did not have precipitated withdrawals..or anything near it. I actually got relief. Not 100% releif but the runny nose sneezing tearing sweating bullets subsided quite a bit

it took me about 10 days to fully transition for the chills and stuff to go away. It was like being in bad PAWS for a few days which tapered off and by day 10 I was feeling 100%. The transition went off withotu a hitch though.. I was expecting to be sick like throwing up and stuff.. but really only the 1st few days were anything noteable which was mostly bad chills.

Now you do not have to switch to a full agonist short acting opiate for the 4 day period between your last dose of meth and 1st dose of bupe. You can do it drug free, and simply just wait the 3-4 days. Methadone withdrawals will not peak until day 3-4 anyway.

Update:

SEems like you made the jump already. Congratulations. At the 2 week mark you should be fully adjusted or very near it. I am surpsied you/.the doc chooses bupe over methadone. IME the pain killing capabilities simply do not compare (that is assuming you are on an adequet dose relative to your tolerance. I do not advise being on such a high buprenorphine dose.. as there will come a day when you want/have to detox for whatever reason and thats a very very high dose resulting in extreme dependency. 24mg bupe is like being on 160mg methadone IMO.
 
OverDone said:
Ok... A quick run down:

She was on 40mg methadone for three weeks.
She ceased taking the methadone 18 days ago and went 72 hours without anything.
She started back on her 24mg subs (after those 72 hours) two weeks ago
She is feeling significantly better at the two week mark.
She is currently experiencing extreme lethargy, slight anxiety and scattered thoughts.

Anyone have a rough estimate as to how much longer until she is back to her usual self?
Click to expand...

Dont know about (only) 3 weeks on 40 mg...It shouldnt be that hard to transition, but 40-60 mg. for a few months can cause long drawn out PAW's, even on a 8-12 mg. Sub' maintanence.
In these cases the easiest way to go (if at all possible) is to get on a 30-60 day full agonist pain med'

If hydrocodone is enough to chase away w/d's use it, if not, use oxycodone or hydromorphone, just enough to cover the w/d's & PAW''s, you're not trying to stay high, you are just making yourself comforatable.
Most will say this is way-overkill but methadone is a totally different beast & the only drug I would suggest this
long, easy taper for. Many people are aware of how long methadone PAW's can live on your back.
 
Swain said:
@@Tony WIlliams

I don't know where you got that conversion chart but it is way off. If you switch from 20mg methadone to 8mg bupe you are boosting your tolerance like crazy. I was on 80mg methadone for well over a year and switched to 12mg bupe.. and even that was more than I needed. Also bupe has nalaxone not naltrexone neither of which are to blame for your precipiated wtihdrawals. Also there is no 'double block' from the nalaxone in bupe. Also also there are plenty of people on here who IV suboxone contrary to what you may think..
Click to expand...

OK. Here that's the chart and how MY DDU do things. if you're on 70mg and wanna move to bupe it's 18-24mg. Myself was on methadone 40mg but I used alot and shot upto 120mg meth or drank more at night as my 40mg wasn't enough I'd say 8-mg would of suited me anyway - in the end I went down and dropped off done and onto subs 2mg, 4mg then upto 16mg which never held me so I went ot 24mg for 2-3 week and went down.

We are ALL different I guess.

The "double block" shit I mentioned was if you IV'ed it or it was bioabailable you'd get pre-wds from bupe but the suboxe too, ovbiously I aint 100% but my mate stopped sub used for a few days and then shot suboxone and did get pre-wd even though he was stabled before, I guess all diff.

I get a generic brand of bupe. 100mg pill with 8mg bupe by arrow gen
 
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