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switch from methadone to buprenorphine, motivation back?

B

bullet_and_the_gun

Greenlighter
Joined
Jan 27, 2012
Messages
27
Location
France
Hi, my boyfriend just got off methadone. He'd been using it for a few years and has found it kind of numbed him and made him lose the motivation he used to have to work and do the things he used to find exciting. As I experienced the same thing after using methadone for just a few days, we realized the methadone may be to blame. I got my motivation back after using codeine instead of methadone, but I'm not as heavy a dope user as he has been. He is hoping that switching to the bupe will help. Has any of you experienced that ? I've read posts here where people advised to go on bupe when the methadone "zombie effect" was too hard to take. Do you think switching to the bupe can have a positive effect and help get rid of that numbness and lack of motivation ? Thanks for reading :)
 
Hi there, welcome to BDD!

I am going to move your thread to Other Drugs as they have more expertise in methadone and buprenorphine over there, hope that is okay. I would also recommend checking out The Dark Side forum (link in my signature) if you or your boyfriend would like some support and help as well :)

BDD > OD
 
I think you are on the right track, but....be very careful it can sometime take weeks for your methadone soaked receptors to receive the most/best benefits of buprenorphine. As many forum threads I have read similar to yours, most of the recipiants were alarmed how bad a precipitated w/d can be weeks after tapering down to just 15-20 mg's of methadone. The conversion from heroin to Bupe' is much easier for most people than done' to bupe.
If possible try to get a months worth of a full agonist like oxycodone, hydromorphone, if possible hydrocodone, (if you can get by w/ it) for a month, and this is after a tapering of your methadone to 30-40 mg's. Some might think this is way to cautious, but the next person will think Bupe' is shit because their receptors are NOT READY for the switch. Methadone is the only full agonist that will cause this (so far, as from what I have read) This is one to be cautious/prepared for.
 
Thanks for your response. I think you are right to advise cautiousness. My boyfriend was on 40mg of methadone and had been off it for 6 days before he started the bupe. He'd been using dope in the meantime. His doctor told him not to use for 9 hours before he started the bupe, but he did a small line a few hours before starting it (he started the sub in the presence of his doctor). My bf didn't really know about bupe precipitated withdrawals, well, now he does. He's been sick for about 36 hours now. I first thought that line of dope was entirely the cause of it, but from what you're saying, I'm starting to think maybe it can also be due to the methadone. Maybe it was too early to start the sub, or the 40mg were too much. Obviously we should've looked all that up before, but I'm still quite pissed at that doctor (specialized in drug addiction) who gave him such incomplete info.
Once that storm is over, do you think that in terms of motivation etc, the bupe can be better than the methadone? I read that the bupe didn't have that negatively numbing effect the methadone has. What do you think?
 
bullet_and_the_gun said:
Thanks for your response. I think you are right to advise cautiousness. My boyfriend was on 40mg of methadone and had been off it for 6 days before he started the bupe. He'd been using dope in the meantime. His doctor told him not to use for 9 hours before he started the bupe, but he did a small line a few hours before starting it (he started the sub in the presence of his doctor). My bf didn't really know about bupe precipitated withdrawals, well, now he does. He's been sick for about 36 hours now. I first thought that line of dope was entirely the cause of it, but from what you're saying, I'm starting to think maybe it can also be due to the methadone. Maybe it was too early to start the sub, or the 40mg were too much. Obviously we should've looked all that up before, but I'm still quite pissed at that doctor (specialized in drug addiction) who gave him such incomplete info.
Once that storm is over, do you think that in terms of motivation etc, the bupe can be better than the methadone? I read that the bupe didn't have that negatively numbing effect the methadone has. What do you think?
Click to expand...
Luckily, he was only on 40 mg's. Could you imagine the people on 150 mg's of methadone doing the switch !!! Yes Bupe' is way better in the long run, but you have to be commited to it, even if it's not giving you the slight energy/buzz - taper, taper, taper as comforatable as possible, behind every bupe' success story is a low mg. dose
 
He's been on bupe for a week and he's already starting to feel more motivated. A low mg dose? He's taking about 8mg a day. You're saying the lowest the dosage, the better it will be for the motivation? About two years ago he tapered the methadone and then stopped. Pretty soon he got really depressed, and that depression stopped when he got back on methadone (antidepressants didn't work). As he's a long time dope user, I was thinking maybe his brain was no longer able to produce enough dopamine for him to feel ok without taking anything. So I don't know how low a sub dosage he could handle. But I did tell him what you said.
Yeah, it must be really tough for someone taking a high dose of methadone to switch on to the sub. My bf was sick for three days !!
 
1-2mg's is more effective than 8mgs IMO. bup is a weird drug in that less is actually more, and most drugs aren't like that, i can go more in depth if you'd like :)
 
Yeah, please do give me more details, that would be great. Basically, the sooner you lower your dose the better? Do you have any advice on the way you should taper? Thanks!
 
Well, apparently the subutex doesn't bring much relief, compared to what the methadone used to do. It doesn't take the edge off at all. Maybe it takes time to feel the good effects of the sub... If any of you could provide any advice about that, it would be much appreciated.
 
Some people hypothesize that bupe's full agonist metabolite norbupe is responsible for the "less is more" effect. You take a small dose so there are still receptors for the norbupe to bind to. However, I have seen this logic disputed in ADD. Seems the real answer is still up in the air.
 
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