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  • BDD Moderators: Keif’ Richards | negrogesic

Methadone to Subutex transition

R

recovery123

Greenlighter
Joined
Aug 14, 2024
Messages
5
I was told by my mtd clinic that I would be safe to transition from Methadone to Subutex once I reached 40mg. I have been working on tapering down for years, trying to maintain a work schedule so once I hit 40mg a couple weeks ago I was ready to go. My clinic referred me back to my health plan provider to go through them since they offer Subutex.

The provider made it sound like it would be a seamless transition and I could continue to work during the process and acted like I was silly for taking the week off. Good thing I insisted though. The taper schedule follows:


Day one: take 1/4 2mg bup every 3 hours for a total of 4mgs. Continue full opioid agonist (40mg methadone.)

Day two: take 1/2mg bup every 3 hours for a total of 8mgs. Continue full opioid agonist

Day three: take 3 2mg bup once in the morning and 3 2mg bup once in the evening. Stop taking full opioid agonist.

I went into p wd on day one. Have been feeling terrible ever since with some breakthrough moments of feeling tolerable, partly due to clonidine and gabapentin that were prescribed.

I am currently at 16mg daily as of today, technically day 3 without methadone. When will I feel better? I feel like I was mislead into thinking this would be a seamless transition, I was not at all prepared for this and need to return to work in 4 days. I cannot sleep.

Any advice on when I will start to feel better?
 
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kongoman said:
What a cunts of providers!! What a ridiculous schedule!!
Im sorry for you. But I think in 4 days youll be ok to work. Lets see if anybody says what you can do to feel better and sleep. Stay well
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Thank you! I'm definitely not happy with the provider. I appreciate your response, that is encouraging.
 
You’ll be fine before you know it. That is actually such a smart move! Methadone is meant to keep people stuck IMO. At least you have a chance with sub. I’m currently on subblocade which is a bupe depot that lasts 30-60 days with no withdrawals. Best decision I’ve ever made when it comes to my opiate dependency. I’ve come down a ton even since starting this and it’s still early. Haven’t felt any withdrawals at all on this stuff it’s great
 
Nice! That's really cool that you mentioned sublocade, that is my next goal. I'm happy that it is working out so well for you, that gives me hope. Any thoughts on the other bupe injectable, Brixadi? Sounds promising but have not spoken with anyone that's had experience with it.
 
recovery123 said:
Nice! That's really cool that you mentioned sublocade, that is my next goal. I'm happy that it is working out so well for you, that gives me hope. Any thoughts on the other bupe injectable, Brixadi? Sounds promising but have not spoken with anyone that's had experience with it.
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Never heard of that one but if it’s similar to subblocade; you’re probably good. I’m very happy I got on the shot now because not only have I been stable with no withdrawals for over 6 months, tapering the whole time. But there hasn’t been one craving for down or pills , not even once. I fucked up a couple times with stims but that is a whole different beast I’ve dealt with. It’s truly incredible how different subblocade has been compared to methadone or even suboxone. Proud of you for getting to that point. And yes you will feel better before you know it like I said! Everything’s already in your system working now. You’ll wake up in the next couple days feeling normal. I promise !
 
Methadone can be a good opioid substitute as subs. Levomethadone its better though. Every medication has his pros and cons. Lots of people have used methadone to get clean and others have used subs. Its easy to taper methadone if you know how. Lots of people think that you get hooked to methadone and you cant come off. Thats not true. I know people who stay like 10 or more years with subs. I dont think thats a problem if can stay away from street opioids and stop robbing and things like that. Thats why substitutes work for. There are tons of people who need meds to live, why do we worry to use methadone or subs for many years if needed?
Even diacetil morphine aka Heroine would be better for substitution. Less side effects. I wish live in Switzerland where they give it to heavy opioids IV users.

Thats my 2 cents of what I think about opioids substitutes.
 
I just have to say I agree with @kongoman that I also personal think that was a "kak" schedule or way to switch meds. But just my personal opinion. But yeah at the way things are going you should be good in 2-3 days. Sorry that you went through that
 
I've always heard and read that you should be down to 30mg methadone minimum before switching to buprenorphine, as buprenorphine apparently at the highest dose (32mg a day) will not cover a higher methadone habit.

Also they should not have been having you use a full mu opioid receptor agonist (Methadone) and buprenorphine (A mixed opioid receptor agonist-antagonist.) together, as it obviously leads to precipitated withdrawal, which is exactly what you got.

Please, please, please put in a complaint about them to themselves and also to your local health authority, it's dangerous what they are doing and could easily cause relapse or someone to lose their job or death at worst (If they are in poor health or have a certain condition, such as one that needs corticosteroid use around the clock and the person is corticosteroid dependent.).
Please do it anonymously if you have to.

@kongoman

You typed "diacetil morphine aka Heroine", I'm not being pedantic but it's diacetylmorphine / diamorphine (INN) and Heroin.
Heroine means female hero. 👍
 
Gaz_hmmmm said:
I've always heard and read that you should be down to 30mg methadone minimum before switching to buprenorphine, as buprenorphine apparently at the highest dose (32mg a day) will not cover a higher methadone habit.

Also they should not have been having you use a full mu opioid receptor agonist (Methadone) and buprenorphine (A mixed opioid receptor agonist-antagonist.) together, as it obviously leads to precipitated withdrawal, which is exactly what you got.

Please, please, please put in a complaint about them to themselves and also to your local health authority, it's dangerous what they are doing and could easily cause relapse or someone to lose their job or death at worst (If they are in poor health or have a certain condition, such as one that needs corticosteroid use around the clock and the person is corticosteroid dependent.).
Please do it anonymously if you have to.

@kongoman

You typed "diacetil morphine aka Heroine", I'm not being pedantic but it's diacetylmorphine / diamorphine (INN) and Heroin.
Heroine means female hero. 👍
Click to expand...
Im Spanish and I always doubt and mistake with cocaine and heroin. in Spanish heroin its heroina a female word. Thats why sometimes I write heroine.And for diacetil its in Spanish.

Your totally right. Here the minimum dose of methadone to transition to subs is 30mg. And you have to wait 24h at least before taking 2mg of subs. The best is to wait until you feel sick then take 2mg of subs.
 
Just to give an update, I do have moments of feeling ok but those moments are fleeting and between moments of really bad anxiety. I've noticed the anxiety sets in shortly after taking a dose. I am up to 8mg twice daily. Has anyone ever experienced anxiety with this or have any ideas why the bupe does not seem to help it one week into the transition from Methadone?
 
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