Waiting period for switch from methadone to subs?

[Baldwin]

Title says it, how long do I need to wait between my last dose of methadone (80mg, 60mg normally holds me well enough) and taking subs? I ran out and took my last dose this morning, will 24 hours be enough or do I need to wait longer?

I have to work a full day tomorrow and would dearly like to avoid precipitated WDs. Being half sick would be bearable I guess, I can power through with some diazepam, but I'd like to spare myself the discomfort if possible.

So, any advice/experiences regarding similar situations? It would be much appreciated

Edit: I just read that the waiting thing only applies to suboxone because of the naloxone in it, however, I've been able to obtain subutex, which doesn't contain any of that stuff.
Does this mean I'm in the clear and can just take a subutex dose tomorrow morning, bypassing any sickness? I get paid on tuesday, so it really is just a problem tomorrow
Sorry about all this worrying, I hope I don't get on your nerves too much

 

[effie]

Firstly - the naloxone in suboxone does nothing at all. Honest

The active ingredient in subutuex and suboxone is the buprenorphine. The reason it throws you into precipitated withdrawal is because it has a much higher affinity for your mu receptors (the ones opiates like methadone attach to) than most other opiates, so it basically kicks the other opiates off the receptors and attaches to them itself, abruptly stopping the opiates from working and sending you into precipitated withdrawal.

It is known as a partial agonist/antagonist so it has some opiate activity ("agonist") itself but it is also an "antagonist" which means it blocks the receptors, stopping other opiates from attaching to them, without producing any opiate effects itself. This is why people can get high off it if they have a decent dose and a low tolerance, but most people on maintenance find it to be pretty clear-headed.

Naloxone has a lower affinity for the receptors than buprenorphine does so it doesn't get a look in when buprenorphine is around - it is for all intents and purposes a completely inactive and useless ingredient. This applies when using it IV as well as sublingual by the way, not that it sounds like you are using it in that way...

Secondly to answer your question - unfortunately you need to wait til you are in withdrawal before you can take suboxone/subutex otherwise the buprenorphine will rip the methadone from your receptors and send you into precipitated withdrawal nastiness. It's usually advised to wait at least 36-48 hours and make sure you are actually definitely withdrawaing when you start the suboxone/subutex. It's a pain I know, but that is how they work.. hopefully you can handle some mild sickness at work, will be far moe preferable to the full on precipitated withdrawal you will get if you don't wait for that long..

Tis kind of tricky to explain how buprenorphine works even though once you grasp it it's quite a straight forward concept - there is a megathread about it in OD found here which although I apreciate is pretty long (and on its 13th version hehe) has loads of good info on the first page and is definitely well worth a flick through.

Hope that made sense - OD (Other Drugs) is the place to go if you have any more in depth questions about suboxone/subutex/buprenorphine, especially the thread I linked you to (found here incase you missed it!!!)

ps sorry if that was a bit detailed - OD is the place to answer your more complicated q's - but I feel that a good understanding will help you to do the switch as well and painlessly as possible, and also understand how the subutex works

 

[Baldwin]

Thank you very much for the in-depth reply and explanations, much appreciated

So it seems I'm in for a very sucky day tomorrow
I guess I'll make it at work, a computer job is nearly ideal for WD lol, diazepam is my friend

If the worst comes to the worst, I'll just munch 100mg of loperamide, it works for me and keeps the WD at bay for a good day, which is all I need till tuesday.

Scoring some stuff shouldn't be a problem (once I have money hehe), so maybe I should save the subs for a really rainy day.

Again, thanks for the info, I'll be sure to check out the link you provided