Bupe Suboxone vs Methadone

[slightly_paranoid]

Hi everyone,

I’ve been on Suboxone maintenance for about 2 years this time around. Recently I had a bad tooth issue that required me to stop Suboxone for 2–3 days so I could use full-agonist pain meds for the procedure and recovery. My doctor is compassionate and prescribed enough medication to keep me comfortable during the healing process.

Coming off 16mg Suboxone cold turkey was rough. I was waking up every morning in full-blown withdrawal — drenched in sweat — until the pain medication kicked in. I wasn’t trying to chase a high, just trying to stay functional and out of severe withdrawal, and the pain meds helped with that.

This situation made me think about my chronic pain more seriously. I have scoliosis with a noticeable curve (close to the threshold where a brace is usually recommended). I have x-rays, and I’ve dealt with constant tightness and discomfort most of my life. As I’m getting older, the pain is getting harder to just “push through.” Posture correctors help somewhat, but not enough to make life consistently manageable.

So now I’m considering whether methadone might be a better long-term maintenance option for me. My thinking is:

• Methadone may provide smoother, longer-lasting pain control.
• It may also help stabilize my emotional baseline and cravings more evenly.
• I wouldn’t have to deal with the “don’t talk / wait to dissolve” dosing routine Suboxone requires.
• I already have a good relationship with my addiction specialist doctor.

One of my concerns is the clinic requirement. I’d prefer not to have to go to a clinic every morning, so I’m wondering if methadone prescribed for chronic pain (instead of OUD) is a viable route. From what I understand, that can be done through a regular pharmacy if prescribed for pain, but I’m still learning the specifics.

I’m at the point where I’ve accepted that I’ll likely need opioid maintenance long-term. And if that’s the case, I’d prefer to be on something that supports both pain and stability. I know methadone can be harder to discontinue, but I don’t have plans to taper off. I just want to live a stable, functional life without constantly suppressing pain or withdrawal.

For those with experience switching from Suboxone to methadone — especially with chronic pain involved — what was your experience like? Anything I should know before discussing it with my doctor?

Thanks in advance.

 

[Stassi202]

Unfortunately, providing you with the accurate, informative information you’re seeking requires knowing your full medical an addiction history. Also why you started taking suboxone…what opioids were you abusing?

 

[slightly_paranoid]

I don't see how it'd constitute a full medical addiction history. Even my Doctor doesn't know it all but i'll share some. In my late 20s I was getting into things I shouldn't have: a couple valium here, a couple lortab there(albeit my back did need it as I have a curvature of the spine that others don't notice but I do the pain). That turned into getting prescriptions and not abiding by the dosing schedule everyday. Fast forward a couple of months and i'm snorting oxymorphone IR (moon tabs that broke easily). That time I got on Suboxone for years before weening and coming off of it fine. The latest that got me this time was good old 7-oh mitragynine.
After going through this tooth drama and being on a full agonist has made me realize I've been ignoring my spinal pain pretty damn good. There are streches and other adjustments I get to keep it in check but it's always in dull pain. It made that pain go away too and I've done my research that Methadone is a good Rx for someone with my profile: Has skelo - muskular back pain, opiod use disorder, and he's complaining the Suboxone isn't providing the full reflief. I think Suboxone is great for the physical symptoms but Methadone has an emotional pain aspect that it helps that I need. I think my Doctor would be on board, just have to get the insurance company to play ball. I plan on staying on Methadone or Suboxone long term for multiple reasons and want to know which would give the best quality of life, not how hard it's to kick. Plus taking subxone sucks, its a production to get away from your group of people to go wait 10 min for a medication to disolve. But Methadone is Schedule II while Suboxone is Schedule III which means it's not as big a pain in the butt to get. If my doctor writes it as a pain therepy medication, I think that will be the way to go.

 

[Slightly_Paranoid13]

Just to update this thread albeit I haven't received responses. I know many people lurk in these threads, so I want to update those that are interested in this same topic.

I took the plunge and quit Suboxone for 2 days and started on Methadone. So far......so good. It's working for my physical AND emotional pain. I knew that this would be the outcome. I am almost done titrating my dose and am at a medium dose that would be convenient for the diskettes, which I plan on asking for if I need to travel often for my work. They use the liquid formulation at my clinic to start you out with. I don't have the weird side effects that I got from Suboxone. It just wasn't a good fit for my body chemistry anymore. The Methadone seems to be much more forgiving and have less brain fog which is a huge plus.

I have felt extremely vulnerable during this process though and is awaking ancient feelings (weezer plug lol). Someone close to me recently said something to me that was just wrong and can now see why his offspring are struggling with alcohol and drugs themselves. I had a very rough childhood and college life. I got picked on a lot growing up and am in process of forgiving every last one of the assholes in my life. They don't deserve my forgiveness but they're getting it anyway because I want to be free. I processed it by acting like I was talking to him face to face and said all of the things I wanted to say to him in real life. It made me feel much better. I also reached out to a childhood friend who witnessed my Dad's abuse growing up and he helped talk me through it. So, I am feeling blessed. When it comes to friends, it's quality over quantity. One of the reasons I joined this site is to maybe meet some new people and help others by sharing my experience. I plan on sharing my testimony soon as it's a fire one.

 

[Ballu]

Glad to hear that it worked for you, and that you're happy. I personally hate Methadone, and will never try it again. I've been on Suboxone for almost 15 years, prescribed 8mg x 4 times a day, but only take usually 8mg x 2 times a day, or sometimes only 8mg x 1 time a day. I have questioned how difficult it will be to get off the suboxone when I do eventually decide to get off, especially considering how long I've been on it.. but just being honest, I may never get off it. Don't really see a need to. I've never had any side effects from Suboxone, and my teeth haven't been troubled by long term use of it, like some people experience.

I think you had it lucky, you went from Suboxone to Methadone. If you went from Methadone to Suboxone, I think your experience would of been completely different. I had a girlfriend that was on Methadone, and was tired of the drowsy, and droopy feeling that comes with taking Methadone, so transitioned to Suboxone. The experience was complete hell. If you don't allow enough time between your last Methadone dose, and your first Suboxone dose.. the Suboxone will dramatically pull all the Methadone out your body really rapidly, causing you to go into precipitated withdrawal. Really nasty situation.

Anyway, happy things worked out the way you anticipated and look forward to reading your testimony

 

[Halif2]

One of the reasons I joined this site is to maybe meet some new people and help others by sharing my experience.

That's a good reason to join. You never know how your experiences might help others to get through some tough experiences (or to avoid them).

I plan on sharing my testimony soon as it's a fire one.

A fiery testimony?! yes, give us the good word!

 

[Slightly_Paranoid13]

I think it is a good time to update this thread. I am about a month into Methadone treatment and it hasn't been an easy ride. I thought it would be a cake walk but the Suboxone really is a mother to quit, especially when you cold turkey at a high dose. I have the Methadone to help, true, but it has still been hard. So if you have a loved one that is on Suboxone and complaining that it's hard to quit - listen to them. Most aren't making it up and many are afraid to mention it because they don't want to be seen as "weak".

I am on a decent Methadone dose at this point, but still going into the clinic often. I still have minor withdrawal (but pain is managed), and that is ok as I want to be on the lowest dose to mitigate symptoms. I do not "feel" my Methadone dose and it just dulls my chronic pain, which I am thrilled to announce. I will be getting more take homes soon as time goes on. The only problem I have right now is that they are hesitant on giving me the pill formulation because they don't want me to "obsess" over the pills and dosage and should be a once a day dose that I take and forget. I get it, and am on board with that thinking. However, the main reason I am on Methadone now is for pain and the protocol for pain is to take smaller doses multiple times a day. I have been through the ringer enough to know that I WILL NEVER GO BACK to self-medication of opiates. Opiate addiction sucked - BAD. I am dependent on the Methadone, yes, but not addicted and there's a MAJOR difference between the two. I don't care if it's a dependence to caffeine or to heroin, it sucks being dependent on anything. But I have a legit medical pain condition that is being treated well with the Methadone but need smaller doses spread throughout the day (I'm only talking 2 or 3 doses a day) because I am a rapid metabolizer and that is the protocol for taking Methadone for pain. I am already on another medication that I take 3 times a day and would be convenient to just take my Methadone doses alongside that medication.

I didn't like was how nonchalant my Doctor was about liquid doses spilling during an airplane flight. They said if you put them in a ziplock bag, it won't spill out of the bag, but how the hell would you expect me to take proper doses while out of town if that happened? Flying is alreaady anxiety producing enough and that on top would be too much. I don't mind the liquid formulation if I am at home, but if I travel on a plane, I will demand the pills. If not, I will have to find another clinic or just go back on Suboxone (which will be painful again). I don't see what the big fuss is over the formulation but again, I will work with my case manager and Doctor but will be sure to advocate for my needs. I am serious about getting clean at this point in my life. Before, I was doing sobriety to make loved ones proud, but now I am actually doing it for myself because it's what's best for me. I've been in and out of sobriety and can tell you, I have been happier and more content when I don't have as many strongholds in my life. If you're being honest with yourself, you probably feel the same way.

Stay safe all and hope this report helps someone else in a similar position. I will continue to update as things progress. But overall, so far so good.