Bupe Need to go from Methadone to Suboxone fast (experienced)

[socio]

There's a lot of Search Engine info relevant, but I wanted to post this request for advice since individual situations always vary in their details.

I've had a lot of experience with Suboxone, on & off for at least 6 or 7 years, almost since it came out. I've gone back and forth with heroin a lot of times, and taken many "vactions" of a few day - a few weeks on methadone and gone back.

The methadone ones are the hardest.
Here's my current situation:

this time I've been doing methadone for 4 months. 2 months of methadone, then back on suboxone for 2 weeks, back off suboxone and on methadone for 2 months. Throughout that time I'm guessing, realistically my average daily dose is 60-70mg of methadone. In a week I'm moving to a town where I can get back on suboxone, but not methadone. I do have a full suboxone script to get me thru until I see a doc.

I need 30-50mg of methadone to hold me without noticeable sickness, but lately I've taken a lot of doses as high as 80-100 (after which I can skip a day), and I only have about 100 mgs left, so 2 or 3 days worth after today (using least amount possible), though I suppose I'll stretch it.

I'm not going to be able to use any short-acting opioids or have any comfort meds besides, say loperamide. Any ideas about the best way to do this? Like maybe string out the methadone on 20 mg a day for 5 days, then 2 or 3 off, and onto the Suboxone?​

What about this? Also, in the past, I've tried "tapering up" Suboxone while simultaneously "tapering down" methadone or heroin, so the final switch isn't so severe and shocking to the system. (More successful with H.) In other words, take like 0.1mg SL of suboxone the first day with my dose (no noticable precip withdrawal). The next day try to take 0.1 - 0.2 mg SL, after a few days bump up to 0.5 SL, so it's not really putting me into precip withdrawal. Then when I do my cold turkey days (usually 48-72 hours), I'll have some bupe floating in my blood during that time and when I go back through do-it-yourself induction onto Suboxone... Anyone have experience with that/think it's worthwhile?

No matter what, I figure I'm in for 3-7 days of moderate misery, but I'll take that. I can CT from methadone for a few if I have to. Just wonder what you all think the smoothest way back onto Suboxone from a 60-70mg/day methadone habit will be?

 

[traybuck]

sounds pretty good man.. You got the right idea. That's pretty close 2 what I did not long ago. I was jumpin off at 160mg methadone so it wasn't pain free by anymeans but it coulda been a lot worse.. Just stick with your plan.. I'm sure that's why you didn't get many responses cuz it sounds like you know what your doin... Good luck

 

[hazejunk]

I would stretch out the methadone as far as posible. Like take 20mg for 4 days then 2 on 10mg. After your last dose wait atleast 48 hours then start the bupe. This is what i would do. So i would not get any precip withdrawal from the bupe. Because 70mg is a prettry hi dose to jump from meth to bupe.

Good luck

 

[OpiYum]

70 is fine to jump. i jumped from 80 with ZERO problems barely broke a sweat

 

[socio]

Ok, cool, thanks all for the responses!
trayb -- sumtimes ya just get no responses, figured it was just too specific to my situation, but hopefully your reasoning is right.
Seems to be hit or miss, but I get the feeling from most people-with-experience's responses that it won't be absolute hell if I can stand a few days of taper, few days of withdrawal first.
Btw -- this is day 1 of withdrawal. 24 hours -- now! Expect to try going back on bupe in another 72-96 if I can last til Sun/Mon, but it's always worse in reality than just internet-talking about it!


UPDATE: In the interests of adding a datapoint to collection of such experiences...After 6 days off methadone (the first 3 of which I took ~150mg/day of loperamide), I resumed suboxone, and went through about 48 hours of unusually intense withdrawal (before taking it I was in "normal" withdrawal, what you would expect jumping off 'done for a week). I was vomiting once an hour, or more, for more than a day. Considered going to a hospital for dehydration, but didn't think I would die, so chose not to. Not sure how long it's been now, since I still can't sleep, but I think it's been about 4-6 more days on bupe (~8mg/day), with ongoing moderately intense withdrawal. Surprisingly unpleasant. Unclear whether problem is that bupe doesn't activate receptors strongly enough to meet my level of dependence developed on methadone, and/or whether the loperamide contributed to precipitated withdrawal. Anyway, won't be taking a methadone vacation from suboxone again. F this