Experienced Thoughts: Buprenorphine v Methadone?

[Optioidmistic182]

I relapsed after a good period of abstinence and was quickly more desperate and hopeless than ever about two years ago. I was never into the idea of ORT (opioid replacement therapy). This time it seemed I had no choice. To keep my life together and moving forward I surrendered to Suboxone treatment.

Now I’m in a weird place. The Subxone side effects have been pretty negligible until now, where I am sleeping way too much. That’s causing me some distress. I get out of bed frustrated and sad for having slept ~12-14 hours. I struggle with really knowing if I want to chance getting off of ORT.

I question whether or not I’d be happier going to Methadone. Suboxone rarely did much more than make me feel normal. The glee of that normalcy wore off fast. I can’t lie--I do still get something of a boost out of it. Part of my surrendering to ORT in the first place was a kind of conceding that I am happier to just take the opioids… but it doesn’t and isn’t a full agonist, so..

I’m not certain I want to give up the freedom that comes with Suboxone, and being much more like a normal patient that visits the doctor once a month, but I am thinking… does methadone--even after you stabilize over the months/years--provide you that satisfaction you need? Can you compare a length of time on Suboxone to Methadone?

I can’t really say I’m sure that the Suboxone is worth the idea that I am still shackled to a substance.

I feel like I need a change even if it’s something as stupid as shifting gears in my ORT. You don’t have to tell me how stupid that is. I’m aware this doesn’t exactly seem logical. I’m not sure I can or want to go abstinent again. If I were to muscle up to that idea I think I’d need to go away to a very luxurious treatment program. I’m not good at suffering in my own environment. I don’t know if I’d be able to commit to that though.

I started out so productive on Suboxone. I was chasing my passions and dreams vigorously. Something like a malaise has set in now. I have been trying to take less, but then I just feel depressed. Isn’t that great. I am beginning to feel the old familiar cycle in a way.

So yeah. I felt like I needed to start a sort of dialogue about my concerns. Thanks. Yes, I have a counselor, and he’s good, but I’ve yet to have a counselor that will actually have a conversation like this where it could put them at risk if they don’t say the right things that just keep you stable, y’know?

Side note… are there any unconventional treatment/detox centers I could consider that actually care to make you quasi-comfortable while you go through hell? I truly respect the 12 step program, but the culture doesn’t jive with me. I have the same repulsion to it that I do with church. Its a no-go for me. I’ve had several experiences while trying to force it that it served to bring me back down.

 

[VerbalTruist]

I think that you probably hit on it midway through your post. Maybe shifting gears in your current ORT is the way to go. I’m curious what your dose is and when you take it.

 

[Optioidmistic182]

I have been doing 16mg, half in morning, and half at the afternoon for a good while.

When I started out I found the transition to Suboxone rough, and would experience withdrawals in the afternoon. Chills, restlessness, runny nose. I somewhat gradually worked up to 16mg because at lesser doses I was very much capable of going into a dive and being able to feel the effects of full agonists. I wanted to stabilize on Suboxone and prevent any more of that.

Nowadays I am well aware that I can physically endure a day without if it were unavoidable for some reason, which it normally isn’t, but that doesn’t mean my mind forgets it usually. Some days I’ll go a few hours and say, “oh, I didn’t take my Suboxone?!”

 

[ChinaGroove]

I have tried both and I greatly prefer Methadone to Suboxone.
Methadone would hold off my withdrawl symptoms more effectively and for longer. Plus something about having to show up everyday to dose, perhaps the discipline required, seemed to provide that extra initiative not to mess around.
Suboxone, or technically Subutex in my case, just didn't click fir me. Perhaps I was still looking for a buzz and not disciplined enough. I know having a script that I could sell and keep enough so that I could use and not have to worry about being sick was really tempting. Perhaps I should have gave a more serious effort but it didn't work out that way. It could help you if you are ready to really turn it around. This is all just my experience, I don't want to discourage you from something that may help you.
Good luck.

 

[VerbalTruist]

My suggestion would be to taper down to like 4mg. Then decide what you want to do with your dose... That'll change it up for sure. Might give you the ability to appreciate what it is doing for you currently. Also, the fatigue could be from something else entirely.

 

[Optioidmistic182]

I am going to do that. I kind of have to doubt it would happen this fast, but I'd already started teetering downward 4-8mg's depending on how I felt for 3 days, and I'm starting to feel more awake. More clear. I hope that is the answer.

 

[VerbalTruist]

@Optioidmistic182 I think that's a great start. If you need any support during your taper or a pep talk you can always "@" me or shoot me a message. Tapering can be really goddamned hard. Take it slow. You should get to a point where you feel more clear and less... Fatigued and shitty. If you hit that spot, you might want to consider that your new dose, just as a thought.

 

[Optioidmistic182]

It’s so absolutely weird at about 4 days of taking only 8-12mg a day I’m feeling much happier, but simultaneously the addict in me really wants to take more. That’s the cross we bare.

 

[n3ophy7e]

It’s so absolutely weird at about 4 days of taking only 8-12mg a day I’m feeling much happier, but simultaneously the addict in me really wants to take more. That’s the cross we bare.

That is the painful part of tapering down, especially if you're doing it on your own. You have you be really strong and stick to your plan.