Opioids Question about switching from methadone to bupe

[wavyregime]

Hello all I am currently on 140mg of methadone at a clinic. I am stable but due to excessive drowsiness and other personal reasons I would like to switch to Suboxone or preferably Subutex. How long after my last dose of 140mg of methadone can I take an 8mg pill/strip without experiencing percipitated withdrawal.

Other websites say 72hrs but some say 24-48hrs. I am also curious if I should lower my dose of methadone before making the switch.

THANK YOU IN ADVANCED BROS AND SISTASS

stay wavy bluh

 

[Keif' Richards]

Dude, you need to wait longer than 72 hours. Please take my advice on this. 140mg Methadone is nothing to sneeze at. I imagine precipitated withdrawal from such a large dosage of Methadone would be a trial by fire. Switching from Methadone to Buprenorphine is, sadly, well-known for being an extremely difficult and delicate process. It's not simple and it's going to vary widely from person to person in terms of severity. Typically, Methadone maintenance patients are weened down to a dosage of approximately 30mg and only then do they start talking about Buprenorphine.

I'm just saying, if you have the option and you're not being forced to do anything, do not cause unnecessary pain for yourself. Attempting to switch to Buprenorphine from that dosage of Methadone outright is guaranteed to be a very difficult process, even if you play all of your cards right. You should reduce your dosage to the above stated 30mg and then take a 72 hour break from Methadone before attempting to induce on Buprenorphine.

What you are describing is the exact wrong way to go about this man. I'm not being judgmental. This is a difficult process and I want you to succeed.

 

[Båtmannen]

Dude, you need to wait longer than 72 hours. Please take my advice on this. 140mg Methadone is nothing to sneeze at. I imagine precipitated withdrawal from such a large dosage of Methadone would be a trial by fire. Switching from Methadone to Buprenorphine is, sadly, well-known for being an extremely difficult and delicate process. It's not simple and it's going to vary widely from person to person in terms of severity. Typically, Methadone maintenance patients are weened down to a dosage of approximately 30mg and only then do they start talking about Buprenorphine.

I'm just saying, if you have the option and you're not being forced to do anything, do not cause unnecessary pain for yourself. Attempting to switch to Buprenorphine from that dosage of Methadone outright is guaranteed to be a very difficult process, even if you play all of your cards right. You should reduce your dosage to the above stated 30mg and then take a 72 hour break from Methadone before attempting to induce on Buprenorphine.

What you are describing is the exact wrong way to go about this man. I'm not being judgmental. This is a difficult process and I want you to succeed.

Shouldn't it work to just wait until the withdrawal feels significant/strong, and then add buprenorphine?

 

[Slow_Mobius]

Shouldn't it work to just wait until the withdrawal feels significant/strong, and then add buprenorphine?

Methadone has a really long half life, so you'll certainly have to wait longer than most other opioids to avoid precipitated WD. It's possible to go into PWD while you're already in WD

 

[Chunkybutt647]

Honestly, if you want to switch to suboxone or subutex, then you should taper down to 30 mg slowly and make the switch then. Talk to your prescribing methadone doctor and discuss it with him or her first and see what they have for guidelines but most will help you in the transition. Also, you should contact a Sub clinic to transition to that will allow you to switch from methadone to
Subs. But i do not advise you to try this on your own. Its a stupid decision to make. These doctors will help you get off if that is your desire or to switch to Subs for maintenance. And methadone withdrawl especially from a dose thats as high as 140mg is no joke. Trying to switch at home may not work and you may have to go back to methadone which depending on your clinic, you may lose your current place and have to wait for months before being let back in. This would be a grave mistake on your part as I had to withdraw from a high dose of methadone and let me tell you its FUCKING HELL. Dont do it. Im on suboxone maintenance now this last time for 2 and a half years and im happier on suboxone than methadone but there is a proper way to do things where you have a fighting chance to stay sober rather than relapse. Remember our way doesnt work, so try the right way to do things. Talk to your doctor and contact a sub clinic and talk to them before doing anything.

 

[Keif' Richards]

OP, you are definitely free to do whatever you feel, but I can tell you that the path you are choosing is probably the most difficult one. I don't understand what the rush is. If it's a matter of principle, like you're tired of the "clinic lifestyle", that is not a good enough reason to put yourself through a hellish acute withdrawal. The consequence of doing so could be an instant, immediate return to Opioid use. Please understand that, even when people titrate down to 30mg, there are still instances of precipitated withdrawal.

I would recommend taking a step back and figuring out a more reasonable course. It's just not worth it. Yes, you're going to begin to feel shitty when you withdraw from Methadone, but it's such a protracted process, that you're likely to say "I can't stand it anymore, I must be ready for the Bupe", when in reality, you have a long way to go.

I don't refer to this as a very difficult process just because I feel like it. It's an extremely delicate process.

 

[Lorne???]

^ That

Switching from 140mg of methadone straight to buprenorphine is, fucking insane.

You would literally be better off cold water extracting oxy

If excessive drowsiness is the problem, lower your dose slightly. Clinics seem to overdose patients. That isn't a blanket statement, just people who had a modest habit end up on a lot of md.

If you pass drug tests, you should only have to go once a week; some clinics will eventually allow once or twice monthly dosing, though that would be over a year.

It's your business, though without a valid reason, it just doesn't make sense; you would have to slowly taper down to 30-40mg per day, then switch to a
More standard opioid like Morphine or oxycodone for a couple of days while the methadone wears off, then 20-30 hours after your last dose, start with a small dose of buprenorphine, like 1-2mg sublingual(this can vary, as different dosage forms and potencies are around)

And then, if every thing's fine you tutorage your dose up gradually.

It isn't simple when done even halfway right, and takes time, unfortunately

Would try a small dose reduction or something first, before going into this

Just please don't cold turkey over 100mg chronic methadone; opioid wd isn't like benzo wd, however that dose(And especially rapid, precipitated withdrawal) could put you in the hospital.

 

[OntarioGuy]

I know at my clinic if you want to switch, the doctor likes to taper you down to 15-20 mg's, then make u go without it for 5-7 days before being dosed with subs.

If u take sub 48 hours after taking 140' ur in for some hell. Even 3-4 days I bet wouldn't be enough.