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Opioids Methadone Mega Thread and FAQ v 2.0

^^

It's not recommended to switch to suboxone unless you are on 30mg's and below of methadone. Anything higher than that, you have to wait many days and still end up with a rough transition a lot of the time. It's definitely doable, but it most likely wont be a cake walk. Just like anything else, you will have to wait until you are in moderate-severe withdrawal, which after 5 days of 50mg's of methadone, probably wont be for at least 3 days.
 
"I decided to make this FAQ to be a companion to the buprenorphine FAQ phrozen created. With these two FAQ's, anyone considering some for of opioid maintenance will have two resources to use to compare and contrast the differences of the two drugs, helping them come to a decision of which drug would be better for them."

Thanks Cap'n! [:
 
Mr.Scagnattie said:
^^

It's not recommended to switch to suboxone unless you are on 30mg's and below of methadone. Anything higher than that, you have to wait many days and still end up with a rough transition a lot of the time. It's definitely doable, but it most likely wont be a cake walk. Just like anything else, you will have to wait until you are in moderate-severe withdrawal, which after 5 days of 50mg's of methadone, probably wont be for at least 3 days.
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That said, i have a friend of mine who used to take suboxone and methadone. They were dependent on heroin but not dependent on methadone or subutex/bupe. They took the methadone in low doses (less than 30mg) and found that they could take suboxone 12-24 hours after their last dose of methadone. This led me to believe that the waiting five day rule after taking methadone is only applicable if you are dependent on methadone. But Im not a doctor and i have no background in pharmacology.
 
cyborgeous said:
That said, i have a friend of mine who used to take suboxone and methadone. They were dependent on heroin but not dependent on methadone or subutex/bupe. .
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That's not how it works, man. You don't get dependent on specific opiates... you get dependent on opiates in general, the whole class of drugs and how they effect your brain. Your receptors don't differentiate. That is why if you're dependent on heroin, methadone and sub will make you feel better, and vice versa. If you're addicted to heroin, that means you are dependent on opiates, and any opiate at the right dose for your tolerance level will take your withdrawals away. There is no such thing as, "oh I'm dependent on heroin not methadone, so i can take that and not get addicted." Does not work that way.
 
Is it possible to get methadone prescribed for addiction in the USA? (by prescribed I obviously mean picked up at a pharmacy). I remember negrogesic talking about getting it way through some high class detox place or something, but I dunno.
 
cyborgeous said:
That said, i have a friend of mine who used to take suboxone and methadone. They were dependent on heroin but not dependent on methadone or subutex/bupe. They took the methadone in low doses (less than 30mg) and found that they could take suboxone 12-24 hours after their last dose of methadone. This led me to believe that the waiting five day rule after taking methadone is only applicable if you are dependent on methadone. But Im not a doctor and i have no background in pharmacology.
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Agonism
Methadone - Full Agonist
Bupe - Partial

Equianalgesic
Wiki says bupe is 5.3 stronger than methadone .25mg of bupe = 1.35mg of CHRONIC methadone

Half life in hours
Bupe 20–70, mean 37
Methadone 15–60 mean 24

What else do you want?

You'll need to ask personal experience as to whether methadone or buprenorphine is easier to discontinue.
 
lolwhatzdrugs said:
Is it possible to get methadone prescribed for addiction in the USA? (by prescribed I obviously mean picked up at a pharmacy). I remember negrogesic talking about getting it way through some high class detox place or something, but I dunno.
Click to expand...

Yes it's possible, but it's only allowed to be scripted in a private doctor setting for pain management, not opiate withdrawals. And even then, methadone is rarely scripted to people even for pain.
 
Mr.Scagnattie said:
Yes it's possible, but it's only allowed to be scripted in a private doctor setting for pain management, not opiate withdrawals. And even then, methadone is rarely scripted to people even for pain.
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Where I am in the US, I know several people who have or have had methadone prescriptions for pain.

Are you sure it can't be scripted for an opioid taper/maintenance? Posts I've read in the past seem to be contradictory on the subject.
 
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^^

Yes it's a law. It's under The Harrison Act. It is illegal for a doctor to prescribe methadone for the use of opiate dependency/detox, outside of a clinic setting. They can script it for people with chronic pain, and do, though just not as often as they give other drugs. But I know a lot of people who are scripted methadone for pain, and it's requested a lot because it's much cheaper than other opiates.
 
Mr.Scagnattie said:
That's not how it works, man. You don't get dependent on specific opiates... you get dependent on opiates in general, the whole class of drugs and how they effect your brain. Your receptors don't differentiate. That is why if you're dependent on heroin, methadone and sub will make you feel better, and vice versa. If you're addicted to heroin, that means you are dependent on opiates, and any opiate at the right dose for your tolerance level will take your withdrawals away. There is no such thing as, "oh I'm dependent on heroin not methadone, so i can take that and not get addicted." Does not work that way.
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Hmmmm, i would say its not as simple as that. I am no expert but methadone, bupe and heroin, yes, they are all opiates and you are right in that you are either dependent on opiates or not, but each of those drugs do work on different receptors. Subutex for example doesnt quite ill all of the receptors that heroin does. For example, people who are chronic pain patients are often scripted high doses of bupe as pain relief and then they are given endone for breakthrough pain. While the endone inhibits breakthrough pain it has no euphoric effect. So i would say its not as simple as simply being dependent on opiates or not.
 
lolwhatzdrugs said:
Later in 1925 https://en.wikipedia.org/wiki/Linder_v._United_States ruled that doctors could not be prosecuted for prescribing drugs to addicts, saving Dr. Linder.

Hell, all this opioid withdrawal does cause chronic pain ;)
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Yeah I mean, if we want to start delving into case law applicable to The Harrison Act, on both sides of the argument, we could be here all day.. hah, as in the case of any law really. There is a lot of gray area surrounding The Harrison Act, for example.. scripting opioids to chronic pain patients, who also happen to be dependent and seeking detox.. There have been some pretty landmark cases on both sides, but I digress. As much as I'd love to have a legal and philosophical debate on The Harrison Act and it's case law doctrine, this isn't the time nor place. PM me though if you wanna talk more about it.
 
Mr.Scagnattie said:
Yeah I mean, if we want to start delving into case law applicable to The Harrison Act, on both sides of the argument, we could be here all day.. hah, as in the case of any law really. There is a lot of gray area surrounding The Harrison Act, for example.. scripting opioids to chronic pain patients, who also happen to be dependent and seeking detox.. There have been some pretty landmark cases on both sides, but I digress. As much as I'd love to have a legal and philosophical debate on The Harrison Act and it's case law doctrine, this isn't the time nor place. PM me though if you wanna talk more about it.
Click to expand...

Nah that's a plenty good summing up. You're a good sport.

And wouldn't you just mean not the place since it would be ok if I Pmed you? ;)
 
lolwhatzdrugs said:
Is it possible to get methadone prescribed for addiction in the USA? (by prescribed I obviously mean picked up at a pharmacy). I remember negrogesic talking about getting it way through some high class detox place or something, but I dunno.
Click to expand...

I think Americans have to get it at the methadone clinic. Except if they're for pain, then those 1mg, 5mg, 10mg, 25mg pills are something else but available at pharmacies, same as here. Only in Canada do we have to bring our script from our monthly (or more) appointments to the clinic to a pharmacy which will dispense it for you.
The first 90 days of showing up good time bad time is hell without a car, I was lucky to have somebody care for me and bring me there every morning. I got my 6 takehomes (max, I hear americans can have 7 takehomes, which is the only thing I envy from their system). It's the same with suboxone in fact in every province but Ontario, where apparently any regular GP can script it, but I'm sure the ORT clinics make their best to keep their patients in the dark about that.
 
got into an accident at 8:15 AM on the way to the clinic this morning (I wasn't driving). Luckily the cops/ambulance/firetruck were cool and did what they needed quickly, My driver told them he needed to drop me off for my first day of work at 9am so they rushed us out and I made it to the clinic at 8:55. But I messed up my knee pretty badly and Im wondering if it would even be worth going to the ER after taking 35mg of 'done
 
I used to agree with this statement but after two years of subutex I can tell you that my three years on methadone were more productive and I was in less pain.
 
Still hanging on methadone detox....

Ok,it's day 12 without anything but Clonidine,and xanax. Tryed some excercise yesterday.I get out of breath too fast since I started this taper/detox.
But I will give it another shot.Ate some solid food last night and been drinking green tea and water. I'm tryin to flush this shit out quickly as possible . I really hope it aint another month or year of feeling like this as I read somewhere. Anyway,In case anyones interested,I'm going to win this frigging' battle!!!What the hell is 25 years of daily done.I'm kickin' this dones ass!! I'll bet many have said that and failed. Got to hold on!!And be strong!! My dog dont understand.I always played with her before....thanks fer listnin' to my belly-aken....Andy
 
Do you have any specific HR questions? If so ask away, otherwise this will be closed, as OD is not a place to just make threads about what's going on in your life.. when you get 50 posts and become a Bluelighter, you'll get access to your blog feature, and then if you want to write things like this.. that is the place to do it.
 
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