So i'll make this post quick, im 32 been on methadone/biodone for about 2 years and subby bout 1yr prior. (My drugs of choice was Heroin, originallly from injured back at the gym, oxycontin etc)
I have worked my way down from 120mg to 32.5mg a day ( I just dropped again today) im keeping my magnesium up and taking the odd clonazapam but keep it to an absolute minimum as I already suffer from anxiety.
So to the question.
I hear people switching to subby and coming off easier. Which Im not sure about.
I hear of people trying a shorter acting opiate for a week then going into detox, which methadone taking so long to get out of your system scares the shit out of me and ive experienced 6 days without methadone before.
Then I read of a methode inwhich they put you under and inject you with naltrexone, thus getting the drug off your receptors and out of your system while in hospital.
I am currently reading about detox treatment centers on the east coast as we will be moving there, also I have private or will be getting it very soon for this purpose as the waiting period is only 2 months for drugs treatment.
So anyone if they can recommend a center, or share their experience it would be much appreciated.
Thank you again I just feel confused on the next step
thank you
The detox method you alluded to is known as a rapid taper. They are generally incredibly ineffective and highly dangerous. They're all incredibly costly. Best avoided.
Buprenorphine will absolutely be helpful in your transitioning off methadone. If you're afraid of using it for an extended detox of six months following cessation of methadone, which is actually what most knowledgeable doctors are recommending following long term methadone use (I'm not sure two years on methadone is quite long term though, as it's that is pretty standard), using it for a week or two to aid in the acute detox is absolutely recommended. You won't have to taper or detox from the buprenophine, as two weeks on it isn't nearly long enough to become dependent. All it would do is allow you to detox from the methadone more comfortable.
The most comfortable and efficacious method of detoxing from methadone I'm aware of involves:
- Taper, taper, taper! Taper as long and as low as you can. Some people say that jumping off 20mg isn't any different than jumping off 10mg or less of methadone, but there is very good reason to taper as low as you comfortably can. Don't taper by more than 1mg/week dose reductions once you get to 40-30mg, and take breaks from your taper whenever you want. I was able to jump off around 15mg of methadone by using the following medication...
- While you're tapering get yourself organized with a medical professional who is willing to provide you with the following medications to manage your acute withdrawal (you may have to source your own short acting opioids though, as most doctors are unwilling to provide something like that to transition to buprenorphine even though it makes a big difference and have very little potential to cause more problems than its worth).
- After you jump off methadone, take an opioid like codeine, tramadol or even hydrocodone for about three days. This will allow your body to get rid of any methadone hanging around in your system so you can safely transition to buprenorphine to avoid precipitated withdrawal upon induction on that.
- On day four of no methadone start taking buprenorphine. You shouldn't need more than 2mg twice a day, but you should take whatever you need to feel comfortable. Less tends to truly be more with buprenorphine, particularly in this context, and I'd recommend not taking more than 4mg twice a day. Use buprenorphine for one to two weeks. If you use it for two weeks it's a good idea to halve your dose for the second week.
- Use the following medication for one to two weeks along with buprenorphine: diazepam (or another moderate to long acting benzo like clonazepam - what you want to avoid are the short acting benzos; diazepam is ideal because it has the best muscle relaxant properties of other benzos, so it will help as an anxiolytic and muscle relaxer, whereas clonazepam will be more the former than the later) 10mg twice a day; gabapentin 400-800mg three to four times a day as needed; IBU 600-800mg two to three times a day as needed; clonidine 0.2mg once to twice a day as needed (definitely at night, although not taking it during the day is okay is the RLS/hot and cold flashes aren't too bad); and a sleep aid like trazodone or Seroquel (I prefer trazodone for a variety of reasons).
- Discontinue the buprenorphine after one or two weeks. Continue taking the gabapentin and clonidine for up to a month if needed. Continue taking your non-habit forming sleep aid for up to a year or more following your detox (three to six months is enough for most people to avoid issue with detox related insomnia, although it's good to have around for the first year). Consider getting on an antidepressant like bupropion (whatever works well for you) prior to detoxing, and continue this for a year or more following your detox. It probably won't make a huge help, but anything that helps helps.
- Get exercise! Hiking during methadone withdrawal totally saved my life. Also, learn to meditate, do yoga, or whatever kind of structured contemplative practices you're drawn to. Certain types of meditation (vipassana, self compassion, tonglen, etc) go a hell of a long way to helping you learn to self regulate in healthier ways without having to just rely on drug use. Also, work on ensuring a healthy diet, as nutrician and hydration are really helpful.
- Also find yourself a therapist you give with and work with them. You'll have more than enough of stuff that you're best off having one-on-one support with.
Two things to consider is finding an inpatient detox place (one that uses ALL the above mentioned meds, namely buprenorphine, diazepam, clonidine and gabapentin) in order to help you kick in. Also consider some kind of 90 day IOP program to help get yourself the support you'll need following cessation. Inpatient rehab can cause more problems than it solves, and generally speaking a good IOP program (assuming your living environment isn't too unhealthy) goes farther to helping you transition to a healthier lifestyle. Keep in mind that with any kind of treatment it will be up to YOU and you alone to advocate for yourself. Most "profressionals" in the recovery industry have no business working in a health care field (horribly undertrained, not knowledgable about opioid use disorder, generally fucked up individuals, etc).
Mafioso's post is a little misleading though. For all practical purposes the naloxone doesn't actually do anything. Buprenorphine has both a higher binding affinity to opioid receptors than naloxone and doesn't even get into your system in significant amounts unless you were to inject the Suboxone (possible if you plug or snort it might). But even if it got in your system it wouldn't do much compared to buprenoprhine.
The blocking properties of buprenorphine are entirely the result of buprenorphine. Naloxone was added more as a marketing ploy than anything else. It allows the company to claim that is prevents misused via injection or something, but this doesn't really happen as advertised given buprenorphine's higher affinity to opioid receptors.
More at anyone's request. Someday I'm going to make a sticky about this stuff so I can just link people to it instead of having to write this out each time

No worries OP, happy to do it. It would just save me some time.