Opioids Question about Subs ceiling and Methadone

[Screaming_Skull]

Just wondering, I know they say the ceiling dose for angelsic effects is 4mg of Suboxone which is suppose to equal 30mg of Methadone, I've always heard a 8mg strip was like a wafer(40mg of done). But anyway when a person is on Suboxone no matter what they are only going up to 30-40mg of Done' or say if they are taking 16mg is that like 60-80mg of Methadone,or does it stay at saaay 40. Asking because I'm thinking about switching and was always kinda confused by this...

 

[SAMCRO]

They aren't exactly comparable at all but the info generally says that the ceiling of bupe is ~ = 30 mg done. Ceiling of bupe is higher than 4mg though I would say more like 8-12. The best thing to do for switching done ---> bupe is to get down to as low a dose as possible which means under 30 is recommended. Then also wait 72 hrs after last done dose or until you are in moderate physical withdrawal.

Getting as low as possible is important because it seems done causes precipitated withdrawals more than other opies prob due to long half life + lipid solubility.

 

[Kid Amine]

I thought the ceiling effect on subs was 32mg/day, 180-200mg for methadone. I looked up PWD, found this as it pertains here:

"Methadone;
Patients transitioning from methadone to Buprenorphine require a slow taper to 30mg./day of methadone, for at least one week. Last dose must be no less than 36 hours prior to induction. A minimal score of at least 5 to 6 on COWS [(Clinical Opiate Withdrawal Scale)] is recommended."

here's that scale if you want to assess yourself, tho personally the 'sweating' question doesnt not have a scale for 'literally melting' or 'patient brought extra clothes for him/her' (10+ in my book). Im at a 24 right now, accurately counting the sweat thing.

http://www.naabt.org/documents/COWS_Induction_flow_sheet.pdf