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Opinions on Methadone and Suboxone?

DownerSensation

Greenlighter
Joined
Mar 31, 2018
Messages
37
So i recently just started taking suboxone, started at 8mg and am now at 12mg. Hopefully dont plan on going any higher than 12mg and can eventually work my way down.

But as of right now (as i've just started treatment this week) i find myself having a lot of cravings even at 12mg of suboxone. I was wondering if anybody who has tried both Methadone and Suboxone if methadone would be better for my cravings? And if so is it essentially worth it when taking into consideration the withdrawals and other side effects methadone causes? Or am i too early into the process that cravings are basically inevitable at this particular moment and should probably just stick with the suboxone?

Ive been doing a lot of research but could definitely use some more insight/opinions on this matter.
 
Hey there Downer! I see that you're relatively new to the community, so if I may, I'd like to give you a warm welcome. We will all try to be here for you throughout this process as much as we can. Firstly, I need to give you the same spiel that everyone else gets. We are a Harm Reduction forum. We are here with the sole objective of, well, reducing the harm associated with both recreational drug use and self-medication. There is a certain level of subjectivity involved with what is and is not allowed.

Technically speaking, this isn't our forte, as this is more of a question regarding how to proceed with your life and your medical care. However, I'd like to twist this into a Harm Reduction-oriented deal, as we all know, recreational Opioid usage is typically detrimental to the health of the individual, so we will try to help you with that.

Basically, Methadone and Buprenorphine are not comparable in a linear way. Buprenorphine has much more complicated pharmacokinetics than Methadone, but, as an addict speaking from a mostly anecdotal point of view, Buprenorphine does not control cravings to the extent that Methadone does. I was a Heroin user for about 10 years. My average was typically 2g per day of Brown Heroin when I'm in the states or .5g pure Morphine base when I can get it. Buprenorphine does not control my cravings for Opioids and actually, it kind of fucked with my head.

I don't need to describe what cravings are like, but for me, Buprenorphine was like being in the desert and being extremely thirsty, dying of the heat; someone brings a glass of cold water. I want to drink it down, but I can only have sips. I don't want sips, I'm dying of thirst. I'm not saying you're as insane or detached from physical reality as I am, but this act of half-way mitigating my cravings actually affected me in a very negative way. The "taste" I got everyday was nothing but a continuous reminder that I couldn't fully satiate myself.

This, what some would call a "mind fuck", actually led to an increase in dangerous and self-destructive behavior. This topic is not something that is going to be brought up in the Lancet or anything, but I know I'm not the only one to be affected in such a manner by the partial-agonist properties of Buprenorphine.

In short, Buprenorphine will not mitigate cravings to the same extent as Methadone. Essentially, folks typically choose Buprenorphine as it is more easily accessible and you can get a script for it much more easily than Methadone. People choose Methadone for a reason. It's more difficult to deal with, it requires every day presence at the clinic, as opposed to a monthly prescription, yet, people still choose it. Think about it and I think you will understand. Buprenorphine is probably not right for you. Cravings are often treated as an insignificant side-bar to Opioid addiction, but cravings can hijack the mind entirely and produce a state or cycle of constant anxiety, longing and depression.
 
Thank you for the warm welcome and quick reply! I have done a lot of research on Suboxone as well as Methadone but still find myself stuck on the matter.

I have just took my daily dose of 12mg Suboxone, so withdrawals are completely suppressed and feel a lot better in that regard. As for cravings, you certainly described it well, but yea cravings is the hardest thing for me to overcome at this time. I would prefer to stay on suboxone as from my research suboxone seems like the safer way to go compared to Methadone. But overall my main objective is to get clean so if Methadone were the only thing to do so than so be it. I cant see my doctor untill sometime next week so i figured i would ask the BL community and see what people recommend and state their opinions.

So essentially i just want to know if Methadone withdrawals and side effects are worth taking away my cravings, and as well as my withdrawals?
 
Downer, I'm trying to figure out what, in your opinion, the primary issues are here. Being that Methadone is highly regulated in most parts of the Western world, I can only assume that you are in that position. As I said, again, going on this assumption of your situation, Buprenorphine is typically more accessible, as it is much safer in an overdose situation by comparison. The issue here is that you're trying to rebuild your life. Basically, when I first started my Methadone program, it took away all cravings, all need to call my dealer, all need to sit around waiting all day. It took all of the issues that are associated with clandestine Opioid use out of the picture. With all of this gone, I was able to stop and really consider some things in my life that I, frankly never "had the time" to do.

If you're in a program but you're still dealing with cravings that are disruptive to your life, then I think it's probably a good idea to at least consider Methadone as an alternative. Most folks tend to interpret Buprenorphine withdrawal as less intense than Methadone, but for our purposes, there isn't a big need to differentiate, as both drugs produce severe, high-dosage dependence, with an accompanyingly severe withdrawal syndrome. Both are long-acting drugs with long-lasting (weeks) withdrawal syndromes. In short, it is difficult to get off of both drugs. The important thing is choosing what works for you.

What is the point if you're still dealing with cravings? I don't know about you, but my occupation requires a lot of creative thought and strategy to do it properly. Every situation is different from day to day and as silly as it may sound, cravings for Opioids are definitely powerful enough to completely disrupt my mental process. I am just not as effective as an instructor if I'm dealing with cravings.

What are your biggest worries or questions?
 
First off, i appreciate the information you provided me so far and has definitely helped me with determining which one may work better for my particular situation.

I suppose ny biggest concern is that if i which over to Methadone (from Suboxone) i wont be able to get myself back to the Suboxone once i make the switch, but would like to eventually come back to Sub for the finally stretch of getting off everyrhing. Also when pricing comes into play, Methadone is certainly the better option for me (and most others from what i've read). As for me, Suboxone costs 2x as much as Methadone does. But for me thats the last factor i take into consideration as its very difficult to put a price on getting your life together.

Oh and as for accessability within my clinic, both Methadone and Suboxone are held to about the same restrictions and "protocalls" as either way i will have to go to the clinic everyday to recieve my dose, untill i can build trust with the clinic and eventually take home carries i think they're called.
 
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Yeah once you take methadone it will be extremely hard to switch back to Suboxone. Maybe I'm biased because methadone scares the shit out of me in that regard and I take Suboxone but personally imo I would give it another week or two before you make your final decision. It took about two weeks for my cravings to go away completely. And honestly I've tapered and quit Suboxone in the past and it was relatively easy if you do it right. But ya it's still early. I would give it some time.
 
Just realized this thread is older than I thought. How did things pan out for you?
Blue.
 
I have had a lot of people tell me the same thing, that it is difficult to switch from Methadone to Suboxone.

I am still on Suboxone as of right now, taking 16mg a day. I have been trying to give the Sub some time to "do its job" per se, but still find myself having cravings to want to get high again.

I am going to stay on the Sub for another week or two and if by that time i havent noticed an improvement in my cravings than i am more than likely going to switch over to Methadone, and hope that the Methadone works better in this regard.
 
Well, not all Methadone users have to go to a clinic. Many pain specialists prescribe Methadone as the long acting med and use oxy or hydros for breakthrough pain. I get my Methadone from the pharmacy every month.
I guess the only good part of being on Methadone is that should my doctor quit I can go to a Methadone clinic. NOT something I want to do and I'm not happy about being on Methadone but my doctor basically said Take it or Leave it.
 
Okay yeah sounds good. Whatever works for you. I hope the Suboxone ends up working better for you but if not I'm sure being on methadone will help. Anything's better than the alternative. I'm definitely not having cravings anymore on suboxone. In fact even when I was doing Heroin everyday towards the end I started almost hating doing it. It felt like such a chore but I did it out of necessity so that I wouldn't withdrawal so in a way I stopped craving it before I even switched. It was only when I started getting sick that I craved it out of necessity. But ya right now being on suboxone I definitely don't have cravings but most of the time I don't feel 100% if you know what I mean. Mostly towards the end of the day and the first few hours after I wake up. At work for some reason I feel better most of the time, not all the time though but that's probably cause my mind is kept busy and preoccupied. On suboxone, I just don't have a lot of energy and I'm constantly bored, depressed, and lonely. I don't know what to do about it. Like when I was doing heroin this was definitely not a problem. Probably because I was always busy with everything that came along with the habit and plus it just dulled and numbed my senses. And I never had time to think about a lot of the stuff I think about now. Or maybe I just didn't care because Heroin was my #1 and she was all I needed. But now I think about things like how magical and amazing it would be to fall in love with a girl and have someone I could be close to all the time or having a badass reliable friend or group of friends to go on exhilaratingly fun adventures with. It literally brings tears to my eyes sometimes because I want so badly to have good people in my life to experience the world with me. And yet I am so utterly alone and stuck. It makes me so sad and depressed. I hate it. Im sorry for venting to y'all on this thread but I really want to figure this out. Thanks for listening. Sincerely Blue.
 
Blue, how is everything going so far with your Suboxone maint.? I hope all is going well.

As an update for me, today was my first day switching to 30mg of Methadone from 16mg of Suboxone. I do feel like i need to be at a higher dose, but even at this smaller dose (Note that this is a small dose for me, NOT for a naive user) i feel i have less cravings towards the need to get high/relapse.

So in conclusion i am glad i made the switch, even though it is the first day. Thank you Keif for all the info you provided, it certainly helped a lot!
 
If you ever want to get off, or switch back to buprenorphine, don't get on a very large dose; enough to satisfy , however I wouldn't keep going up just because they let you

80-90mg was fine for me, YME - Kief knows about ORT, and he's a knowledgeable guy in general. Hope things work out
 
Yes I've taken both in separate instances as a maintenance drug, mainly to keep me from needing to use heroin.
I'm currently at a methadone clinic where I get 100mgs a day and I feel good and I don't have intense urges to use heroin. I feel like it works so much better than Suboxone but everyone is different with what works for them.
I'd recommend switching to methadone if you can. It's not going to prevent you from using anything if you want to so you have to take it right or the combination could leave you not being able to enjoy or appreciate the methadone anymore.
Good luck
 
^ The 3rd eye is only to be open by those who have found a sense of sanity lest it drive you into a hole

( Glad MD works for you, for heroin use, or very high pills recommend it. I think taking over 100mg( or 120, just some number) should be less common - just from personal experience. Some peop may need 140, pretty much no halfway healthy person needs 250mg, and it prolongs theqt interval at those doses/ Doses that high are rare though AFAIK
 
Thanks guys!

I dont plan on going over 70mg of Methadone, and hopefully can maintain myself at lower dose like 50mg-60mg. I truely just want to beat this habit/addiction and i think now that im on Methadone i have a better chance of beating it than i did when i was using the Suboxone.

Definitely glad i made the switch, and again, thank you everybody for the info/help!
 
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