Suboxone - starting troubles? or adverse reaction??

[aFamilyAffair]

So my husband was in a methadone program for around two years, he tapered down to a 30 eventually, then spoke to the doctor about switching to suboxone, since i've done it before and had enormous success with it. So the doctor tells him that he'll need to wait 4 days and to take the suboxone on the 5th day after stopping the methadone. This is a long period of time, so he decides to use (I know, I know, spare the comments on that idea) to get him through the first 3 days and then hack it the 4th day. This he does. He waits 25 hours from the last dose of heroin before taking the suboxone. When he does take it, he's feeling sick already - muscle aches, anxiety, sweats, etc. But when he takes it - the film - he doesn't feel better. He continues to get worse, he says he feels as if he hasn't taken anything at all.
The question - is it possible to have waited too long before taking the suboxone? (his thought, not mine) I think it more likely that he somehow didn't wait long enough, though this seems odd to me as I have taken suboxone as soon as 15 hours after my last dose of heroin and felt fine in transition.
Alternatively - is it possible he's having some kind of reaction to the films themselves? He's taken the pills previously with no problem. This is the first time we've had any experience with the films. He's now using and trying to work up the nerve to try the suboxones again. Thoughts?

Thanks in advance for any feedback!!

 

[Pjkt2501]

You say he's taken the pills before with no issue, was this in a similar scenario as to now (5 days off methadone, 1 day off dope)?

What was his initial dose of suboxone?

I'm not positive, but I'm thinking that there's residual methadone still left in him and that is what's causing his problems switching over. How long has he been feeling rough? More than 12 hours? Has an attempt been made to contact the prescribing doctor?

Good luck! Hope he feels better! (Don't use more heroin! Not going to help a thing now that he has bupe in him.)

 

[aFamilyAffair]

the last time he took them he wasn't on methadone, so it was a while ago (longer than i realized, now that you mention it). but it was similar with regards to the time off dope.
initial dose was one 8/2 mg film a day, which seems sufficient to switch from a 30, no?
he was feeling rough for a day - went to the ER, too. they said they couldn't do much for him and weren't much help with regards to info as to what had happened.
prescribing doc says it should be fine if he took as directed. but he did. that's why i thought i'd reach out.
perhaps, as you suggest, the meth was still there after all.

 

[nsauce]

>prescribing doc says it should be fine if he took as directed.
>This is a long period of time, so he decides to use (I know, I know, spare the comments on that idea) to get him through the first 3 days and then hack it the 4th day.

Not to be an ass, but I'm pretty sure these werent the directions he was given. I can't say if that is the problem here, since I don't know what or how much he used during what was supposed to be his opiate-free period before sub, but I think precipitated withdrawal is a possibility. Again, I don't know all the facts so I could be wrong.

 

[THECATINTHEHAT]

30mg is the absolute limit for switching over, its more sensible to come down to 20ish. You don't need to wait 5 days, that's shit. Everyone's different but you've practically done the cluck by then, why not just get clean? I'm on day 5 of a methadone withdrawal and I'm pretty much fine now. I also had some subutex on yesterday, day 4 and was fine.

If you are already in moderate to strong withdrawal its pretty safe to say its ok to take the bupe. I hate to say this as its not exactly politically correct, but if he is desperate and is taking the bupe unsupervised he might want to try snorting it, I can never get on with sublingual. Start small and work up obviously, maybe 4mg every 15 minutes. The difference between the two roa was light and day for me.

Seriously, if you've got to day 5 of a cluck just stick with it and get clean. I'm doing it from 20mls so i don't imagine 30mls will be that much worse.

 

[Pjkt2501]

8mg of bupe is also a bit more potent than 30mg methadone is, at least to me. I find it to be about 10:1, maybe 40:3, methadone : bupe by mg. Try taking 1/4 of the strip at a time. Doctors tend to over Rx bupe because it has a pretty wide dose-range and is safe to do so, within a margin.

Your husband's sickness will pass with time, as one opiate is displaced, and in turn replaced by buprenorphine.

 

[THECATINTHEHAT]

8mg of bupe is also a bit more potent than 30mg methadone is, at least to me. I find it to be about 10:1, maybe 40:3, methadone : bupe by mg. Try taking 1/4 of the strip at a time. Doctors tend to over Rx bupe because it has a pretty wide dose-range and is safe to do so, within a margin.

Your husband's sickness will pass with time, as one opiate is displaced, and in turn replaced by buprenorphine.

Personally I'm of the opinion that the choice of sublingual administration has led to a lot of confusion and misinformation regarding bupe's potency compared to methadone. It's so hard to make sure that you're not allowing yourself to swallow any and takes a long time under the tongue to be adsorbed. I didn't feel that bad when I took some, I just wanted to take the edge of so I could get out to an NA meeting. I took 16mg sublingual, starting with 2mg and building quickly as it became apparent it was having little effect. I then gave up and snorted 4mg and i was a ok within 90 seconds or so.

Just my two pence.

 

[opiatekrzy]

methadone has such a long half life you really gotta be careful when switching to suboxone, and honestly 5 days seems about right. of course u will feel WD within2 days, but ur not in full blown WD, u stilll have methadone floating around in ur system, so if u give in and take a sub, u will be in agonizing precip WD for up to 10-12hrs...u gotta tough the withdrawl out until its completely out of ur system. my girlfriend has been on 40mg of methadone for about 5 months now, and occasionallly she will miss her dose as she cant make it to the clinic, she always complained to me she was in withdrawl, i would ALWAYS refuse to give her a suboxone as i told her she would get sick (precip WD) so she always thought i was being stingy with subs..one day i said "fine fuck it, go ahead take half of my film since u missed ur methadone dose today and think ur sick," so she did. 20mins later she as sweating so bad her jeans were soaked, she was dry heaving, RLS, in agonizing pain, crying too, for about 12 hours, so i asked her "now am i being stingy with my subs or protecting ur health?"