Opioids Methadone/Buprenorphine Equivalency

[Azulon]

Can anyone tell me the equivalency between these two drugs?

What would 30mg of methadone equal in terms of buprenorphine?

 

[HeadphonesandLSD]

Clinics consider 30mg of methadone to be equivalent to the ceiling of bupe. Which would be 8-16mg. In my experience clinics are very liberal with subs and have no problems giving a patient with almost no tolerance 16-24mg daily. They also refuse to switch you from methadone over to bupe until you've gotten down to 30-40mg or so and claim bupe can not cover the withdrawals above that.

If I were looking to make the jump I would start with 8mg of bupe after I'd gone into withdrawal from methadone. Since methadone lingers around so long it might take 2 days or more before you're safe to dose the bupe. Although I've managed to jump from long acting opioids to bupe within 24 hours this isn't the way it works for everyone. If you're one of the unlucky ones you can feel really shitty until precipitated withdrawals end.

Once you've switched experiment with lower doses of bupe. With bupe less is always more. Lots of people find they can get by with doses far lower than what clinics prescribe. I can personally get by on 0.5-1mg of bupe daily. I usually take 1mg split into two doses 12 hours apart. One when I get up and another in the afternoon.

 

[HeadphonesandLSD]

Oh another thing you should be aware of with bupe from the clinic. They can not prescribe you anything less than 8mg daily from what I've seen. Every patient is on 8mg, 16mg, or 24mg. They prescribe you based on the strips and not the milligram dosage. In my experience the best way to deal with them is to take whatever they give you during induction if they want you to dose at the clinic itself. Since you'll get take homes upfront unlike the methadone clinic you can just take whatever you want at home without telling them and stockpile whatever is left over. At the clinic I went to they do not check the amount of bupe in your system when you're drug tested they just look to make sure you're taking bupe and not other drugs like thc, benzos, or whatever else.

Most people I know are given a prescription for 2 weeks worth of whatever dose the clinic gives them. In my case that was 14 8mg strips of bupe. Since I only took 2-4mg daily (I took higher doses back then) this 2 week supply ended up becoming a 4 week supply. This is why bupe is so common on the street now. The majority of people prescribed it are not taking the full dose they're given.

I've gotten my daily dose so low now that one 8mg strip lasts me an entire week. So for every 7 I get from the clinic I get 6 left over.

You'll have to experiment yourself and figure out your own level with bupe. It isn't like methadone. They aren't making you take it in front of them and line up for the tin man. I did not make it with the clinic long. I didn't see the point in spending $400+ a month, pissing in front of people, attending group with junkies, and making the trip into the city every two weeks when I could simply purchase some bupe off the street for cheaper and not have to deal with all the BS they make you go through.

 

[Azulon]

Thanks for your reply. I appreciate it. I just went to one of those online clinics via telemedicine and got an entire months supply of 8mg strips BID. Crazy to me!

Anyway I get a month of methadone at a time, 30mg qd. 22 and 1/4 brand name Methadose pills. I have ended up double dosing about 7 times out of the month so that's why I got the bupre.

 

[CfZrx]

I have never heard

I just went to one of those online clinics via telemedicine and got an entire months supply of 8mg strips BID.

Online clinics?! Interesting! I wonder if those are helping reduce harm, or amplifying the problems?

 

[Dr. John Thackery]

i’ve been alternating between methadone and bupe (subutex) for months. The longest i’ll be on pure methadone is 2 weeks. but it’s usually 3 or 4 days on each in and alternate.

anyhow i’m just starting to wonder about the equivalency in terms of staying well.

seems to me that 1 mg of bupe has clearly more wellness power than 20 mg methadone. I’d put it at 1:30 mayb? i havnt experimented that much in terms of minimal dose to get well because the switches were always only for the purpose of medicating breakthroughs pain with high methadone doses - so i havnt done much experimenting with minimal methadone doses


no issues at all with bupe causing predicted withdrawal even one day after methadone - almost feels like the reverse is happening now tho - methadone after bupe and not getting well

 

[lolis my thesis]

I'm tapering methadone and stuck at 20mg(actually 15). Been on it 30 years since started at 60mg at pain clinic for literally. Half my life. Pain doc is retiring and methadone would only be an option if I say I need it for addiction at addiction clinic; careful not to say anything about pain. WTF? doesn't seem fair unfortunately same pain doc put me on benzos too so that's a problem.
Bupe is way more convenient route but methadone makes me comfy enough at 15mgs; I am actually scared of precips.

I can either go to the clinic for addiction; stay at pain clinic which would mean switching to bupre. or get off. Does anyone think a complete taper of methadone is even possible. Like I know people miserable for months after tapering their methadone down to 1 mg.
At the crossroads I spose.

 

[Dr. John Thackery]

I'm tapering methadone and stuck at 20mg(actually 15). Been on it 30 years since started at 60mg at pain clinic for literally. Half my life. Pain doc is retiring and methadone would only be an option if I say I need it for addiction at addiction clinic; careful not to say anything about pain. WTF? doesn't seem fair unfortunately same pain doc put me on benzos too so that's a problem.
Bupe is way more convenient route but methadone makes me comfy enough at 15mgs; I am actually scared of precips.

I can either go to the clinic for addiction; stay at pain clinic which would mean switching to bupre. or get off. Does anyone think a complete taper of methadone is even possible. Like I know people miserable for months after tapering their methadone down to 1 mg.
At the crossroads I spose.

i’m in a similar boat.

very old doctor and i’m totally fucked when he retires i’ll never get pain treated again. but fentanyl and crack addicts pissingdirty get take homes of a two week supply for me, per day.

subs are easy to get and cheap but they do basically nothing for pain.


he scripts me benzos also but ive made sure not to become dependent on those

 

[HeadphonesandLSD]

I jumped off at 10mg of methadone a day. Went cold turkey on a whim. It wasn't a fun time but I got through it by locking myself in a room with a case of water and little food. You'll hurt all the way down to your bones and have a really hard time sleeping. But after about 7-10 days you'll be through the acute phase of withdrawal. I felt well enough a week later to go hiking with a friend.

Of all the opioids I've went cold turkey off of it was by far the longest and worse acute withdrawal I've had. But it isn't as bad as I imagined it was going to be. You can do it if you try.

I don't understand why the pharma industry is the way it is now. There are many people I know that have gone through the GP prescribing opioids -> pain clinic -> "addiction" clinic pipeline. They all have the same stories about being scripted opioids while naive about them then ending up hooked and eventually the doctors cutting them off with no warning. It's cruel and unusual punishment. I know a lot of people that should have never been placed on methadone in the first place. They all only had a mild dependence on stuff like hydrocodone and would have been far better off being put on an ER version of it. I know time release/ER tablets for hydrocodone exist but I've never ever seen one in person. I've only seen pictures of them in books. The modern ER medications are all garbage too. I know plenty of people that had prescriptions for stuff like OCs who get nothing from the "abuse proof" modern versions that are hard lumps of plastic that refuse to dissolve in the stomach. Several people have told me they've taken one of those orally, felt nothing and then saw it come out of the other end intact. The pharma companies and doctors must know they're useless and do not work.

What bothers me the most is the fact that a lot of these GPs don't seem to know anything about the drugs they're prescribing. It isn't hard to find information about them. All you have to do is spend a half hour doing research on your own instead of having faith in the literature the pharma reps give you.

Anyway, 10-20mg of methadone isn't that hard to kick. It's going to suck and the acute phase of withdrawal is 7-10 days. A long time to feel bad but doable. I suppose it is harder if you're forced to dose it at the clinic. But if you've saved up enough take homes you could try skipping a dose. Take it every other day for awhile then jump off. It'll make it more bearable when you decide to stop taking it.

What I did was sit in a room with a bottle of the liquid for a week then on the 7th day I took it outside and poured it on the ground. Then I knew I was going to make it.

 

[Syntherize]

To everyone still on these maintenance drugs: if you want to stay on them fine for whatever your reasons are, but if you decide to taper off them completely, whether it is Bupe or Done, you must slow down your taper as much as possible when you begin to approach the point of full opioid receptor saturation (~2mg for Buprenorphine/~40-50mg for Methadone), and it can vary from person to person. Try to do the slowest micro taper that you can and you’ll be free of dependency—even just a quarter milligram at a time. Also, getting a gym membership helps tons if you can because of the neurogenesis that comes with anabolism, but you need to be on a smart program, still nourish yourself well, stay hydrated, sleeping at least eight hours a day, and take smart supplements such as quality multivitamins, refined fish oil, creatine, etc. You can all do this if you want and I used to have a gram per day real H habit for over a decade, but I’ve also restarted and been on and off (currently off just Kratom powder) from time to time. Godspeed

 

[qazw]

sleeping at least eight hours a day

How the fuck is anyone supposed to sleep that much while tapering off opioids? I sleep about half of that currently on 20mg of bupe because even that doesn't keep me well long enough to sleep through the night.

 

[Syntherize]

How the fuck is anyone supposed to sleep that much while tapering off opioids? I sleep about half of that currently on 20mg of bupe because even that doesn't keep me well long enough to sleep through the night.

If you can’t eat or sleep while tapering from such a high dose of buprenorphine then you are clearly doing something wrong and you must evaluate yourself in order to find the true culprit. I’ve come off gram per day multi-year IV heroin habits and even fentanyl too (citrate) without any lasting problems. Like I said in the other post: stay active since even light exercise like walking at a slow pace for an hour will help you recover faster and exercise also helps rewire your brain, but exercise is just one little important ingredient in the whole pie, so don’t forget to eat well, hydrate, sleep, and supplement your nutrition too.

 

[qazw]

If you can’t eat or sleep while tapering from such a high dose of buprenorphine then you are clearly doing something wrong and you must evaluate yourself in order to find the true culprit. I’ve come off gram per day multi-year IV heroin habits and even fentanyl too (citrate) without any lasting problems. Like I said in the other post: stay active since even light exercise like walking at a slow pace for an hour will help you recover faster and exercise also helps rewire your brain, but exercise is just one little important ingredient in the whole pie, so don’t forget to eat well, hydrate, sleep, and supplement your nutrition too.

I'm not even tapering. It just doesn't last anywhere near long enough. I have tapered off from 32mg once in the past (When coming off 2g a day smoked heroin habit) and that was pure torture the entire way down. Right now the problem is that the 20mg just doesn't cover anywhere near 24 hours. No amount of exercise will help someone sleep if that someone is in acute opioid withdrawal... The "true culprit" of why I can't sleep is that I feel too hot and too cold at the same time while having gigantic pupils -- which is to say, I'm sick. I can eat just fine though. But sleeping is 100% impossible when I'm sick.

 

[Syntherize]

I'm not even tapering. It just doesn't last anywhere near long enough. I have tapered off from 32mg once in the past (When coming off 2g a day smoked heroin habit) and that was pure torture the entire way down. Right now the problem is that the 20mg just doesn't cover anywhere near 24 hours. No amount of exercise will help someone sleep if that someone is in acute opioid withdrawal... The "true culprit" of why I can't sleep is that I feel too hot and too cold at the same time while having gigantic pupils -- which is to say, I'm sick. I can eat just fine though. But sleeping is 100% impossible when I'm sick.

If the bupe isn’t lasting you enough time it might be because your body metabolizes it faster. You can try to take the 20mg in two or three evenly spaced doses instead, or you might need to get back up to a higher dosage of bupe while trying to evenly split the dose over the same amount of hours daily. The point is to taper off slowly even by as little as .5-1mg/day (from each daily dose 1,2,3x/day) even if you’re taking two or three doses. You can do it if you do it right and there won’t even be any PAWS after for the most part. Once you get down off the subs you can try some whole ground red kratom powder in order to make the experience even more tolerable, but avoid any kratom extracts or pills. Stick to the whole leaf powders as I do and you’ll be fine. The funny thing tho is in order to taper off Kratom I’ve used low doses of bupe in the past as well but only for like two weeks at around .5mg-1mg at a time. Letting your body and mind heal should be your first priority in a venture like this, and you must believe in yourself too. Godspeed