Opioids Fentanyl Withdrawal: Suboxone vs Methadone

[JustferFun]

Long story short, I have a history of opiate/ opioid use and abuse. The last major issue I had was with heroin, but that was years ago. Nowadays, I don't even have a dealer or easy access to drugs......Recently, someone I know who really likes being opiated told me that some Oxy was available. Before that, he'd mostly just get vikes and he'd ask me if I wanted any and I'd just say no because I take kratom and vikes are useless to me. I can take four of the 10 mg and it doesn't touch me (not to mention the amount of acetaminophen in that). Occasionally, he would get percs, and I was down for that. I could actually still feel oxycodone as opposed to hydrocodone.

Anyways, he tells me about the oxies and so, naturally, I gave him money to get me some. They were supposedly 30 mg pills for $25 each (at first). I was so out of the drug scene at the time that I didn't know about the fake, blue 30's.

So, I go on a binge for maybe a couple months before I decide to stop. I can usually take some suboxone and be fine......but that was with heroin. Fentanyl is a completely different animal, at least for me. This has been discussed on Bluelight already, but fent causes precipitated withdrawal a lot with Suboxone. People have waited 72 hours and still had it happen. I was used to heroin so this was a complete surprise to me. It felt completely different.

The first attempt, I just did what I did with heroin. Just to be safe, I started out very small, like half of a half of an 8 mg. Obviously, that did nothing, so I just kept taking more. I didn't feel better but I didn't think I felt worse. The more I took, the worse it got, but not by so much that I thought that it was precipitated withdrawal. I just thought that I hadn't taken enough and that the withdrawal was getting worse with time. But by the time I got to 16 mg, it was pretty obvious that it wasn't working. It worked eventually, but it took a couple days to feel good enough to be able to work. I actually repeated this process about a week later after relapsing.

This is a terrible drug. It's significantly harder to come off of than heroin, IMO. People are going to be less likely to want to go through that. And none I've what I've said so far even considers the overdoses and deaths.

From what I can tell with a bit of research, it's not just me. This is a real problem. By all accounts, methadone seems to be a far superior option. I'm not necessarily suggesting long-term methadone treatment, but I'd at least try it for the first week. I'm just wondering what this community thinks about this subject because there's not really a ton of information out there.

Fentanyl versus Methadone in Management of Withdrawal Syndrome in Opioid Addicted Patients; a Pilot Clinical Trial - PMC

The most effective treatment for withdrawal syndrome in Opioid-dependent patients admitted to intensive care units (ICUs) remains unknown. This study aimed to compare fentanyl and methadone in this regard. This prospective, single-blinded, ...

www.ncbi.nlm.nih.gov

“Everything is not right anymore”Buprenorphine experiences in an era of illicit fentanyl - PMC

Conducted in the Dayton Metropolitan area of Southwestern Ohio, this qualitative study explores the self-treatment practices of people who use illicit opioids (PWUIO) amidst the new risk environment produced by illicit, non-pharmaceutical fentanyl ...

www.ncbi.nlm.nih.gov

 

[RUC4]

Precipitated withdrawal is expected when you've been given naloxone, but it can happen unintentionally with other meds also like naltrexone, buprenorphine/naloxone (Suboxone), and buprenorphine (Subutex). From what I understand, the medications I just mentioned are preferred over methadone because of the risk of overdose and dependency.

The first article you linked is about fentanyl vs methadone for treatment, which is different from subs vs methadone.

Is your question is methadone a better treatment for withdrawals than subs? It seems they both have their pros and cons. I've found a bunch of articles comparing the 2 on google.
Here is one article that's pretty straightforward

 

[JustferFun]

Precipitated withdrawal is expected when you've been given naloxone, but it can happen unintentionally with other meds also like naltrexone, buprenorphine/naloxone (Suboxone), and buprenorphine (Subutex). From what I understand, the medications I just mentioned are preferred over methadone because of the risk of overdose and dependency.

The first article you linked is about fentanyl vs methadone for treatment, which is different from subs vs methadone.

Is your question is methadone a better treatment for withdrawals than subs? It seems they both have their pros and cons. I've found a bunch of articles comparing the 2 on google.
Here is one article that's pretty straightforward

In terms of precipitated withdrawal, it's not necessarily expected just because you've been given naloxone. It depends on the opiate/ opioid, dose, length of use, the amount of time since last use, etc. I never had any issues with Suboxone induction when I was coming off of heroin. It was easy. With fentanyl, it's a pain in the ass. While length and severity of abuse will most likely vary from person to person and situation to situation, a lot of people end up suffering when taking Suboxone for a fentanyl dependence. In my case, it wasn't that bad, but this will prevent some people from seeking Suboxone treatment.

 

[Looking8ball]

In terms of precipitated withdrawal, it's not necessarily expected just because you've been given naloxone. It depends on the opiate/ opioid, dose, length of use, the amount of time since last use, etc. I never had any issues with Suboxone induction when I was coming off of heroin. It was easy. With fentanyl, it's a pain in the ass. While length and severity of abuse will most likely vary from person to person and situation to situation, a lot of people end up suffering when taking Suboxone for a fentanyl dependence. In my case, it wasn't that bad, but this will prevent some people from seeking Suboxone treatment.

Hey there, I really appreciate your candor in telling your story. I’m about to try and get clean from abusing fake blues, aka m30’s, that contain fent. I’m snorting anywhere from 6-10 a day, unfortunately. Seeing what I’ve written just now blows my mind, I can’t believe how out of hand my habit has became. In the past, I’ve used suboxone to fairly effectively get myself off of H, but this will be the first time I try using them for blues/fent, and I only have about 6 to do so with. Can you offer any further advice or tips on things that might aid me? Thank you in advance for any and all help, I really appreciate it.

 

[GeorgeWashington]

A few years ago I got on fentanyl. Started out using a half gram a week, and about 2 months later was up to 2.5 grams a week all snorting never banging it. When I quit, I had 3 Suboxone. I waited about 16 hours from my last use of fentanyl before taking half of an 8mg then an hour later I didn’t feel anything so I took the other half. Took half a sub the next two days. When the sub ran out I waited a day and got a big bag of kratom pills (like 250). I had to take 35 of these to feel anything. Over the next two weeks I tapered down to fifteen pills and have used kratom on and off since. I didn’t get withdrawal from the sub but my friend who had been doing more fent and much longer (couple years on and off) told me he went into PW after waiting 12 hours. I would wait a full 24 you should be ok by then of course it’s gonna suck. Might be better off going straight to kratom but it’s easy to get dependent on it but then again so is suboxone and it doesn’t even get you high after fentanyl

 

[GeorgeWashington]

Plus if you aren’t getting a script for the sub it’s stupid expensive

 

[JustferFun]

Hey there, I really appreciate your candor in telling your story. I’m about to try and get clean from abusing fake blues, aka m30’s, that contain fent. I’m snorting anywhere from 6-10 a day, unfortunately. Seeing what I’ve written just now blows my mind, I can’t believe how out of hand my habit has became. In the past, I’ve used suboxone to fairly effectively get myself off of H, but this will be the first time I try using them for blues/fent, and I only have about 6 to do so with. Can you offer any further advice or tips on things that might aid me? Thank you in advance for any and all help, I really appreciate it.

Ok, since posting this thread, I've learned some things. I think I might be able to help, but no guarantees as of now. Btw, I learned that if doctors (in the US) could prescribe morphine alongside of suboxone, premeditated withdrawal could be easily avoided for people who are addicted to/ dependent on fentanyl. They're legally not allowed to do that. Anyways, you hopefully won't have to go through 24 or 36+ hours of intense withdrawal before you can safely start taking suboxone......

I started using the Bernese Method - and it was working - but then one thing led to another and I have to start the process over. I have NOT successfully completed it yet, so I'm not here declaring victory (but I'm very confident it will work).

I don't know how much you know, but the Bernese Method is just a slow induction process where you gradually start taking small amounts of subs while still taking the blues. I think the Bernese Method has been around for a few years now but I'm not sure if it's in mainstream practice yet. They may still be researching/ perfecting it.

Thank god it exists though. My dumb ass has already gone through 3 different withdrawals where I had to be miserable for at least 24 hours each time. Even though that's nothing compared to a full withdrawal, it still sucked hard (and it could have been avoided). I think withdrawals also get harder with age, btw. Sorry for going off onto a tangent, but I'm deeply embarrassed that I allowed that to happen to myself that many times. I take responsibility for my own actions but it didn't help that my coworker kept waving it around my face. The first time I stopped, when I went through that hellish premeditated withdrawal, he texted me literally the next day after I finally felt better, telling me about a "special" his dealer was having. I just couldn't get away from it. Quitting my job was not feasible at the time.

There's no one-size-fits-all plan that I know of, which makes sense. There are obviously different degrees of dependence and withdrawal, depending on how much you take and how long you've been taking it - and probably other variables that I don't know about or that are unknown. In general, the idea with the Bernese Method is that you completely stop taking all opioids by the 7th or 10th day. But from what I've experienced so far, I think it can even be done a little faster. You may decide to adjust your schedule after you start it.

I'm going to post 3 different sample schedules below. I think they are a good baseline for figuring out your own schedule. You can choose one or mix and match from all 3 - that's what I'm doing. Sorry about the format of the first two. You just have to read them slowly.

Example Schedule 1
Day 1 and 2 0.5mg SL once daily, Day 3 1mg SL once daily, Day 4 1.5mg SL once daily, Day 5 2mg SL once daily, Day 6 2.5mg SL once daily, Day 7 3mg SL once daily, Day 8 4mg SL once daily, Day 9 5mg SL once daily, Day 10 6 mg SL once daily

Example Schedule 2
Day 1 0.5mg SL bid, Day 2 1mg SL bid, Day 3 2mg SL bid, Day 4 3mg SL bid, Day 5, 4mg SL bid, Day 6 12mg SL once daily, Day 7 16mg SL once daily

Example Schedule 3
Day 1: 0.5 mg once a day
Day 2: 0.5 mg twice a day
Day 3: 1 mg twice a day
Day 4: 2 mg twice a day
Day 5: 3 mg twice a day
Day 6: 4 mg twice a day
Day 7: 12 mg (stop other opioids)

NOTE: The third example might be too aggressive. I tried it and thought it might be too much, too fast. It started to block everything I took before I was ready to jump off.

 

[JustferFun]

Plus if you aren’t getting a script for the sub it’s stupid expensive

Well, the good thing is that because of the opioid epidemic, the government has made it easier to get subs. For example, it's mandated to be free if you're on Medicaid. I think it's required from any insurance company. Also, they've relaxed the requirements for doctors to be able to prescribe Bup. There are many more doctors now who can prescribe it.

 

[GeorgeWashington]

Well, the good thing is that because of the opioid epidemic, the government has made it easier to get subs. For example, it's mandated to be free if you're on Medicaid. I think it's required from any insurance company. Also, they've relaxed the requirements for doctors to be able to prescribe Bup. There are many more doctors now who can prescribe it.

I have heard it’s easy to get a script, I don’t like being on any list that says I’m a drug addiction or something of that nature but yea probably the way to go. I know people around here pay 20 bucks or so for an 8mg

 

[JustferFun]

I have heard it’s easy to get a script, I don’t like being on any list that says I’m a drug addiction or something of that nature but yea probably the way to go. I know people around here pay 20 bucks or so for an 8mg

I don't think you're on any list. It's just medical information like anything else, which means your privacy is protected by HIPAA.

 

[Looking8ball]

A few years ago I got on fentanyl. Started out using a half gram a week, and about 2 months later was up to 2.5 grams a week all snorting never banging it. When I quit, I had 3 Suboxone. I waited about 16 hours from my last use of fentanyl before taking half of an 8mg then an hour later I didn’t feel anything so I took the other half. Took half a sub the next two days. When the sub ran out I waited a day and got a big bag of kratom pills (like 250). I had to take 35 of these to feel anything. Over the next two weeks I tapered down to fifteen pills and have used kratom on and off since. I didn’t get withdrawal from the sub but my friend who had been doing more fent and much longer (couple years on and off) told me he went into PW after waiting 12 hours. I would wait a full 24 you should be ok by then of course it’s gonna suck. Might be better off going straight to kratom but it’s easy to get dependent on it but then again so is suboxone and it doesn’t even get you high after fentanyl

Really appreciate your story and advice man. I only have about 6 subs to work with myself. I'm not quite sure how to equate how much fent I've been using since what I'm hooked on are the blues from the darknet. Congrats are getting through it, I can't wait to be where you are.

 

[GeorgeWashington]

Really appreciate your story and advice man. I only have about 6 subs to work with myself. I'm not quite sure how to equate how much fent I've been using since what I'm hooked on are the blues from the darknet. Congrats are getting through it, I can't wait to be where you are.

No problem. You can do it. I recommend losing the number of your source, cus it is going to be tempting even later once you’re past withdrawal . Just remember how you feel right now cus you don’t want to redo this. Fent is such a useless drug. For me as soon as I had a tolerance, I couldn’t get the high I wanted even if I did enough to be nodding. Would go straight to falling asleep with none of the euphoria it had in the beginning. Wish I knew where to get good H anymore

 

[JustferFun]

A few years ago I got on fentanyl. Started out using a half gram a week, and about 2 months later was up to 2.5 grams a week all snorting never banging it. When I quit, I had 3 Suboxone. I waited about 16 hours from my last use of fentanyl before taking half of an 8mg then an hour later I didn’t feel anything so I took the other half. Took half a sub the next two days. When the sub ran out I waited a day and got a big bag of kratom pills (like 250). I had to take 35 of these to feel anything. Over the next two weeks I tapered down to fifteen pills and have used kratom on and off since. I didn’t get withdrawal from the sub but my friend who had been doing more fent and much longer (couple years on and off) told me he went into PW after waiting 12 hours. I would wait a full 24 you should be ok by then of course it’s gonna suck. Might be better off going straight to kratom but it’s easy to get dependent on it but then again so is suboxone and it doesn’t even get you high after fentanyl

Yes, I would definitely wait at least 24 hours after your last fent dose. The precipitated withdrawal on my first attempt was no fun at all. I've heard some people have to wait even longer, up to 48 hours and sometimes even longer (up to 72 hours, apparently). I'd say that's more for people with serious dependence, like people who smoke 20 blues a day (yes, that is a real thing) for a long time. I doubt someone like @Looking8ball will have any issues waiting 24 hours. I can't remember if I mentioned this before, but you and I are in the same range of 6-10 a day.

Fentanyl withdrawal can come on fast and it can be pretty intense because of the short half-life. On one of my withdrawals, I started feeling withdrawal symptoms like 8 hours after my last dose, but that's probably rare. As long as you don't have any obligations, that 24 hours is doable but it still obviously sucks.

 

[jurbs95]

You guys are lucky you do blues and aren't on cartel fent like out here in SoCal. Nasty stuff. I've lost almost all my friends in the past couple years who switched from H to Fent (H has almost dried up here, you really gotta know someone because fent has taken over) and for me I developed a habit of smoking half a gram to a gram of fent daily. I've had a blue before they have them out here, but I didn't feel a thing after smoking it. Anyways though I mainly dropped in to say that for me, I waited 5 days and went into withdrawal and had to pick up to calm things down. I've been trying to get clean since Decembwr 27th of last month. I'm now 6 days sober using gabapentin + clonidine in extreme doses. So much that I've had 3 seizures in the past few days. I got both suboxone and subutex. So scared to touch it. Idk whether to keep at it with the pills I'm running short. But from people I've heard of that were on fent powder and tried to quit. That it can take 2 weeks to a month of withdrawal. Because fent is lipophilic and also because of the other chems added. Bless you all, I hope we all get clean!

 

[JustferFun]

You guys are lucky you do blues and aren't on cartel fent like out here in SoCal. Nasty stuff. I've lost almost all my friends in the past couple years who switched from H to Fent (H has almost dried up here, you really gotta know someone because fent has taken over) and for me I developed a habit of smoking half a gram to a gram of fent daily. I've had a blue before they have them out here, but I didn't feel a thing after smoking it. Anyways though I mainly dropped in to say that for me, I waited 5 days and went into withdrawal and had to pick up to calm things down. I've been trying to get clean since Decembwr 27th of last month. I'm now 6 days sober using gabapentin + clonidine in extreme doses. So much that I've had 3 seizures in the past few days. I got both suboxone and subutex. So scared to touch it. Idk whether to keep at it with the pills I'm running short. But from people I've heard of that were on fent powder and tried to quit. That it can take 2 weeks to a month of withdrawal. Because fent is lipophilic and also because of the other chems added. Bless you all, I hope we all get clean!

Hey man, sorry about your situation but you're staying a lot stronger than a lot of people would be. Btw, the blues can be highly variable in strength......You should be ok to use subs 5 days out. But why are you having seizures taking an anti-seizure medication like gabapentin. Is it because you're taking so much that you're dependent on it and then you don't take it for a while? Hope you're doing ok.

 

[JustferFun]

You guys are lucky you do blues and aren't on cartel fent like out here in SoCal. Nasty stuff. I've lost almost all my friends in the past couple years who switched from H to Fent (H has almost dried up here, you really gotta know someone because fent has taken over) and for me I developed a habit of smoking half a gram to a gram of fent daily. I've had a blue before they have them out here, but I didn't feel a thing after smoking it. Anyways though I mainly dropped in to say that for me, I waited 5 days and went into withdrawal and had to pick up to calm things down. I've been trying to get clean since Decembwr 27th of last month. I'm now 6 days sober using gabapentin + clonidine in extreme doses. So much that I've had 3 seizures in the past few days. I got both suboxone and subutex. So scared to touch it. Idk whether to keep at it with the pills I'm running short. But from people I've heard of that were on fent powder and tried to quit. That it can take 2 weeks to a month of withdrawal. Because fent is lipophilic and also because of the other chems added. Bless you all, I hope we all get clean!

Smoking fent has to be one of the most addictive things in existence. It's like cocaine in that it's short-acting but it also has that intense opioid dependence/ withdrawal that's more difficult than heroin withdrawal. Fent is an absolutely terrible drug. If all else fails, methadone will help. I know that comes with a bunch of other issues but it's better than dying.

 

[Bobby Bats]

Yes, I would definitely wait at least 24 hours after your last fent dose. The precipitated withdrawal on my first attempt was no fun at all. I've heard some people have to wait even longer, up to 48 hours and sometimes even longer (up to 72 hours, apparently). I'd say that's more for people with serious dependence, like people who smoke 20 blues a day (yes, that is a real thing) for a long time. I doubt someone like @Looking8ball will have any issues waiting 24 hours. I can't remember if I mentioned this before, but you and I are in the same range of 6-10 a day.

Fentanyl withdrawal can come on fast and it can be pretty intense because of the short half-life. On one of my withdrawals, I started feeling withdrawal symptoms like 8 hours after my last dose, but that's probably rare. As long as you don't have any obligations, that 24 hours is doable but it still obviously sucks.

Not necessarily. I only been using a flap a day and I went in precips after seeking a Dr to try and quit after I went thru a detox, then cold turkey. So the 3rd time I went to Dr and tried suboxone. I waited 24 hrs and went to Dr office. He gave me a 4mg subox and sent me home. Said if no better in 1 hour take another 4 mg. I did just that and guess what? I went immediwtely into precip wd.

 

[Bobby Bats]

You guys are lucky you do blues and aren't on cartel fent like out here in SoCal. Nasty stuff. I've lost almost all my friends in the past couple years who switched from H to Fent (H has almost dried up here, you really gotta know someone because fent has taken over) and for me I developed a habit of smoking half a gram to a gram of fent daily. I've had a blue before they have them out here, but I didn't feel a thing after smoking it. Anyways though I mainly dropped in to say that for me, I waited 5 days and went into withdrawal and had to pick up to calm things down. I've been trying to get clean since Decembwr 27th of last month. I'm now 6 days sober using gabapentin + clonidine in extreme doses. So much that I've had 3 seizures in the past few days. I got both suboxone and subutex. So scared to touch it. Idk whether to keep at it with the pills I'm running short. But from people I've heard of that were on fent powder and tried to quit. That it can take 2 weeks to a month of withdrawal. Because fent is lipophilic and also because of the other chems added. Bless you all, I hope we all get clean!

how much clonidine and gaba you using? i have clonidine and lyrica. and am micro-dosing subxone now. any advice?
Im on day 7 of bernese methd, aka micro-dosing, but im still using fent. sniffing it, when i feel my skin crawling. i try and use very very little just to get over that hump.
im dragging out the bernese to like 10 days because my wife is going away saturday to sunday. so today is friday and ill do a 4 mg subox, a 2mg, and tonight a 4mg.
tomorrow she goes away so ill probably do 4 mg 3x a day.
then sunday shes coing back and ill do an 8 and an 8...
so monday ill wake and do a 12 mg and stop all other stuff and see .... but then monday ill be taking the lyrica and other stuff so any help there is appreciated.

 

[JustferFun]

Not necessarily. I only been using a flap a day and I went in precips after seeking a Dr to try and quit after I went thru a detox, then cold turkey. So the 3rd time I went to Dr and tried suboxone. I waited 24 hrs and went to Dr office. He gave me a 4mg subox and sent me home. Said if no better in 1 hour take another 4 mg. I did just that and guess what? I went immediwtely into precip wd.

Yeah, it can be tricky. Sorry you had to go through that. I've heard some people need 48 or more hours. This thing is still relatively new, even though fent has been on the streets for years. I think they're still figuring it out.

 

[JustferFun]

how much clonidine and gaba you using? i have clonidine and lyrica. and am micro-dosing subxone now. any advice?
Im on day 7 of bernese methd, aka micro-dosing, but im still using fent. sniffing it, when i feel my skin crawling. i try and use very very little just to get over that hump.
im dragging out the bernese to like 10 days because my wife is going away saturday to sunday. so today is friday and ill do a 4 mg subox, a 2mg, and tonight a 4mg.
tomorrow she goes away so ill probably do 4 mg 3x a day.
then sunday shes coing back and ill do an 8 and an 8...
so monday ill wake and do a 12 mg and stop all other stuff and see .... but then monday ill be taking the lyrica and other stuff so any help there is appreciated.

Are you still taking fent? The subs started to block everything for me when I was around your current dose, but everyone's different.

Btw, if you have any lingering mild withdrawal, kratom might help.