Opioids Methadone to Suboxone Switch Questions

[Inevective]

Hey guys! New to the forum. I'm currently undergoing the transfer from Methadone to Suboxone. I've been taking about 30mg daily (4 doses of 3/4 tsp out of each 120mg bottle) or every other day (as funds/avalability permitted) for around 5 years never exceeding 30mg. I finally have gotten fed up with it and want to switch.

My doctor told me to wait 72 Hrs and take a quarter of an 8mg tablet. They gave me at-home drug testing kit and said if I test negative after a few days then it was safe to induct. I'm doing an at home induction and they also prescribed Gabapentin for RLS? Not sure why, maybe to help with withdrawal somehow?

My girlfriend took about 20mg once a week for about 2 years and she was able to switch to Sub 4mg after 4 days from last dose without wds.

My main questions are: Is it as seemless as they say about the switch over after 72 hours? If I test negative for methadone is it true it's safe to dose? Will I still have methadone withdrawls even after induction?

Lastly, does anyone have any positive induction stories switching from Methadone to suboxone and not doing it too early?

Thanks for reading and hopefully replying. I'm completely new to Suboxone. Just want help and to be drug free!

-Inevective

 

[Trabbamab]

I switched from methadone to Suboxone. You are definitely in a good dose range to make the switch. However, the drug test part seems almost goofy to me. I don't think methadone even shows a positive for opioids in a take-home test. Methadone has to be tested for specifically and I don't think it can be done at home.

But basically, what you want to do is make sure you are feeling the WDs before you switch over. I waited about 72 hours and when I started on the Sub, I was shaky, sweating, etc. But how about looking at each question individually:

-Is it as seemless as they say about the switch over after 72 hours?
I am not really sure what you mean about "seemless". You have to wait for true WDs to set it so if you mean "painless" then no it is not. 72 hours begins to get a bit uncomfortable without a dose of methadone. But you will likely be mostly fine for the first 48 hours. The last stretch of 24 hours can start to get a little hairy, though, as that is when the true methadone WDs begin.

-If I test negative for methadone is it true it's safe to dose?
I really have some questions for the doctor who told you to do this. I won't tell you to not listen to your doctor's advice, so go ahead and use it at 72 hours. But you should be fine at 72 hours.

-Will I still have methadone withdrawls even after induction?
I did not and you should not either. I also took an initial, smaller dose when I was first trying the Suboxone. They only had the pills back then, so I cut a pill into quarters and tried one quarter. I didn't really understand that you are supposed to swallow the spit as it builds up in your mouth so part of my first quarter was likely ruined by running down my throat. But within about 15 minutes I started to notice I was beginning to feel better. I took another quarter at about the 30 minute mark (this was kind of stupid, as I probably should have waited longer) and after that one, I felt fine and all WDs were gone.

But yes, this was a very positive story for me and I think it is for most people. If you are worried about precipitated withdrawal, it is quite rare provided you wait until true WDs and start small and slowly. You should likely wait longer than 30 minutes like I did to take your next microdose. Once you are good taking the Suboxone, the methadone WDs will be behind you.

Best of luck!

 

[Inevective]

Hey thanks so much! That does give me a little comfort! Yea they gave me Methadone specific tests but I don't think it's gonna count for anything. My gf took one of the three tests total they gave me on day two of her sub and she still tested positive for methadone. Of course she was only taking once or twice a week though. I appreciate your story! I'm on Day 1 and only symptom is runny nose. So more time to go! Hopefully luck will be on my side!

-Inevective

 

[Keif' Richards]

Hey man, it sounds like you're going to make the transition in the best possible scenario. This is pretty much the protocol for switching. You're at a low dose of Methadone and you're getting ready to switch. You only have to endure a few days of relative discomfort. When serious withdrawal starts, I have to recommend taking extremely low doses of the Buprenorphine. That has worked for me. I'm talking about crumbs. Give it a few minutes between crumbs, if you start to experience withdrawal, you stop and wait a little longer.

I wouldn't recommend taking the full 2mg Buprenorphine on your first go-around. The Gabapentin (Neurontin) is your friend. I'm an Opioid addict (on Methadone now) and have been through withdrawal many times, on different continents. Gabapentin and/or Pregabalin (Lyrica) are the most effective, low-risk medications for Opioid withdrawal. I typically skip Benzodiazepines, but that is your call.

I hope this helps, but do keep us posted. Learn up on the pharmacokinetics of Gabapentin. She is a salty woman and requires a delicate touch. Here is a link to a guide that I would say is pretty effective in educating you on the subject. The Gabapentin is going to relieve a large portion of your symptoms.

https://www.reddit.com/r/Drugs/comments/3n5t6k/the_ultimate_guide_to_using_gabapentin/

 

[Inevective]

Hey thanks for the info. I actually took a Gab about an hour ago and just read that post. They're 600 mg each. I'm gonna try it out to see if I can feel a little better. Day 2 runny nose and goosebumps mainly only prominent sympt.will keep you updated!

 

[Still_Good]

I think you're on the right track. I switched from 30mg Methadone to Bupe some years back and it was pretty seamless.

You're wise to wait until you're sick before induction, but I don't know how necessary a drug test is. 72 hours before dosing should be fine.

My personal experience was that I needed 16mg/day of Bupe coming from 30mg methadone - and I still didn't feel quite right for the first couple of days. All in all the transition should be tolerable. Not painless, but totally tolerable. The last 24hrs before taking bupe you might want to have some benzos on hand, and they it wouldn't hurt to take some the first couple of days adjusting to bupe.

 

[Inevective]

Hey thanks! Yea I don't have access to Benzos. I pretty much and have accepted the fact I prob won't sleep for a day or two. The Gab seems to help a lil.

So I last dosed on Tue at 10mg do you think it would be safe to dose say Saturday morning with 2mg or less? Or should I wait till I'm withdrawing bad? The only thing about that though is the Gab is kinda hiding the symptoms so I'm not sure how/when to approach the induction. Any help or insight would be appreciated!

-Inevective

 

[Inevective]

Also Still_Good, what mg did you start the induction with?

 

[Inevective]

Day 3 (72 Hrs) - The Gab must really be hiding the symptoms. Normally at this length I've got GI Issues, insomnia, goosebumps like crazy, sneezing, runny nose (all the flu stuff), and lethargy. But today I only have light goosebumps, runny nose, and very light GI issues. I actually slept last night decently. I'm afraid to go ahead and take my first suboxone dose so I'm gonna stagger Gab today and try too make it to tomorrow night after I work. Any thoughts?

-Inevective

 

[Trabbamab]

Day 3 (72 Hrs) - The Gab must really be hiding the symptoms. Normally at this length I've got GI Issues, insomnia, goosebumps like crazy, sneezing, runny nose (all the flu stuff), and lethargy. But today I only have light goosebumps, runny nose, and very light GI issues. I actually slept last night decently. I'm afraid to go ahead and take my first suboxone dose so I'm gonna stagger Gab today and try too make it to tomorrow night after I work. Any thoughts?

-Inevective

Glad you are holding up well. The Gab may be helping with some of the symptoms but in reality you may not be that bad off. Methadone, like Suboxone, has a very long half-life. As an addict, we can work ourselves up and make ourselves physically sick when we begin to obsess about not having our drug. I remember when I was on methadone, I would feel sooooo sick if I went one day without a dose. But then when I had to detox CT off of it and also after I went back on methadone and then switched to Suboxone, I was amazed that the symptoms really don't start kicking in until the 3rd day. Really the 4th day is when s**t gets real. Once your mind is focused and you have a goal (you aren't just without drugs), it is amazing when the real WDs aren't as bad as your mind had made them before. That is my experience at least.

I actually did not know they had an at-home methadone test. I always thought it had to be a lab metabolite test. But I still kind of question the procedure because you could potentially be failing for methadone while being clear to switch to the bupe. It may be a way to ensure you wait long enough, though. But due to methadone's very long half-life, I imagine it could stay in your urine for maybe a week (yep, it does. Here is a link to some data).

As far as when you are clear, I would say you are likely good to go today but if you can hang on until tomorrow I think you are extending past the normal induction time of most people and would only be making yourself even more safe. Anything beyond tomorrow, in my non-medical professional opinion, is excessive and unwarranted. Just do like we have said here and do a very, very small microdose to start (perhaps 1/20th of your target dose if you can manage it). Wait a little while, and then take another. Wait a little while, and then take 2x microdoses. Keep going like this until you have taken a full dose and like Keif said, if you start to feel WDs increase, stop.

I will give you a tip though: I know it will be hard, but try to focus on something else after taking your microdoses and waiting to see if you feel anything. This is a point where it is really easy for your mind to start playing tricks on you. You will already be experiencing some WD due to the methadone, you will likely still be somewhat nervous and worried about precipitating withdrawal. It happened to me as well. For the first few minutes I swore I was making my WDs worse but it was just my mind playing tricks on me because I was nervous about the switch. If you can keep your mind on something else it will really cut down on any potential placebo effect you may experience. But do know if you wait 4 days, you should be clear. The naloxone in Suboxone isn't even really absorbed provided you take it correctly (AKA you aren't trying to shoot it up or snort it).

Best of luck and let us know how it goes!

 

[Inevective]

Hey man thanks! Yes I DON'T want ANY PW! So I'm a bit of a worry-wart. The only reason I want it so "seamless" is the day I induct is the day I work (tomorrow). I work at home which is great but I take calls at home back to back with no time left to use to get off. So that's why all the hesitation.

I totally agree about the placebo effect. The mind is a powerful tool. I really appreciate your feedback on the wait times.

Today was hard because I normally go get my two bottles of Methadone. But I pushed through that shit!

Tomorrow i figured Id work tomorrow (as best as possible) and as soon as I'm off induct. Just to be sure

Thanks guys for the help. Will post tomorrow with induction results!

Inevective

 

[Keif' Richards]

Hey man thanks! Yes I DON'T want ANY PW! So I'm a bit of a worry-wart. The only reason I want it so "seamless" is the day I induct is the day I work (tomorrow). I work at home which is great but I take calls at home back to back with no time left to use to get off. So that's why all the hesitation.

I totally agree about the placebo effect. The mind is a powerful tool. I really appreciate your feedback on the wait times.

Today was hard because I normally go get my two bottles of Methadone. But I pushed through that shit!

Tomorrow i figured Id work tomorrow (as best as possible) and as soon as I'm off induct. Just to be sure

Thanks guys for the help. Will post tomorrow with induction results!

Inevective

I don't like to make blanket statements because this only happens for a small(er) portion of the population, but Gabapentinoids in fact relieve all of my symptoms of withdrawal. Sweats, Hot Flashes, Insomnia, Restless Legs, Lack of energy/ambition, Depression, Anxiety. You're one of the lucky ones. I don't only get relief from Gabapentinoids, at the right dose they, in make me feel good. I could go for a run on day 3 of a withdrawal if I have Gabapentinoids.

This is kind of a PSA, but unfortunately, some people experience negative side-effects from Gabapentinoids. It's too bad, but given that most people are prescribed Gabapentin, which is the drug with a million variables (Urinary PH, Stomach Environment, Antacids, Timeframe), it's very hard for us to truly put our finger on what is going on with folks, whereas Pregabalin (Lyrica) in only effected really by the amount of food in your stomach, which only effects the time to peak plasma levels, not the actual potency or bioavailability of the drug.

Pregabalin is essentially linear in terms of its effects. It's easier to make a suggestion for this reason.

 

[Inevective]

I don't like to make blanket statements because this only happens for a small(er) portion of the population, but Gabapentinoids in fact relieve all of my symptoms of withdrawal. Sweats, Hot Flashes, Insomnia, Restless Legs, Lack of energy/ambition, Depression, Anxiety. You're one of the lucky ones. I don't only get relief from Gabapentinoids, at the right dose they, in make me feel good. I could go for a run on day 3 of a withdrawal if I have Gabapentinoids.

This is kind of a PSA, but unfortunately, some people experience negative side-effects from Gabapentinoids. It's too bad, but given that most people are prescribed Gabapentin, which is the drug with a million variables (Urinary PH, Stomach Environment, Antacids, Timeframe), it's very hard for us to truly put our finger on what is going on with folks, whereas Pregabalin (Lyrica) in only effected really by the amount of food in your stomach, which only effects the time to peak plasma levels, not the actual potency or bioavailability of the drug.

Pregabalin is essentially linear in terms of its effects. It's easier to make a suggestion for this reason.

Yea I do have to say I was utterly amazed that the Gabapentin took away almost all of my symptoms! It is a shame that it's still not clinically proven to at least assist in Opiod detoxes. But I guess that's why if only a small percent actually have the majority of their symptoms alleviated. I've heard bad reviews on Lyrica tho. Dunno much about it.

Day 4
So I broke down after waking up this morning from a tossing-turning rough sleep in the morning hours and just went ahead and inducted. I started with .5mg. Hour went by and didn't feel bad or good so I took another .5mg. Hour or so later felt a little better. So i took 2mg. So 3mg total. I feel fine but I feel almost the same as before. I'm afraid the Gaba is hiding so much that it's kinda interfering with my induction. Above they said 30mg of MDone = 16mg Sub (of course varying between indiviuals). I'm not anywhere even close to that. I guess I should just wait till tomorrow too let the Gaba wear off completely to be able to tell? Do you think I should take a little bit more today? The doctor told me to taper up to 16mg or until WDs have stopped. But like I said I'm going at it blind here. I just need to be at the dose of the Methadone equivalent.

Thank you all so much for the insight. Ultimately I'm SO glad I didn't have any PWs! Y'all are awesome!

-Inevective

 

[Inevective]

Glad you are holding up well. The Gab may be helping with some of the symptoms but in reality you may not be that bad off. Methadone, like Suboxone, has a very long half-life. As an addict, we can work ourselves up and make ourselves physically sick when we begin to obsess about not having our drug. I remember when I was on methadone, I would feel sooooo sick if I went one day without a dose. But then when I had to detox CT off of it and also after I went back on methadone and then switched to Suboxone, I was amazed that the symptoms really don't start kicking in until the 3rd day. Really the 4th day is when s**t gets real. Once your mind is focused and you have a goal (you aren't just without drugs), it is amazing when the real WDs aren't as bad as your mind had made them before. That is my experience at least.

I actually did not know they had an at-home methadone test. I always thought it had to be a lab metabolite test. But I still kind of question the procedure because you could potentially be failing for methadone while being clear to switch to the bupe. It may be a way to ensure you wait long enough, though. But due to methadone's very long half-life, I imagine it could stay in your urine for maybe a week (yep, it does. Here is a link to some data).

As far as when you are clear, I would say you are likely good to go today but if you can hang on until tomorrow I think you are extending past the normal induction time of most people and would only be making yourself even more safe. Anything beyond tomorrow, in my non-medical professional opinion, is excessive and unwarranted. Just do like we have said here and do a very, very small microdose to start (perhaps 1/20th of your target dose if you can manage it). Wait a little while, and then take another. Wait a little while, and then take 2x microdoses. Keep going like this until you have taken a full dose and like Keif said, if you start to feel WDs increase, stop.

I will give you a tip though: I know it will be hard, but try to focus on something else after taking your microdoses and waiting to see if you feel anything. This is a point where it is really easy for your mind to start playing tricks on you. You will already be experiencing some WD due to the methadone, you will likely still be somewhat nervous and worried about precipitating withdrawal. It happened to me as well. For the first few minutes I swore I was making my WDs worse but it was just my mind playing tricks on me because I was nervous about the switch. If you can keep your mind on something else it will really cut down on any potential placebo effect you may experience. But do know if you wait 4 days, you should be clear. The naloxone in Suboxone isn't even really absorbed provided you take it correctly (AKA you aren't trying to shoot it up or snort it).

Best of luck and let us know how it goes!

Hey bud any tips for Induction dose where the Gaba initially blocked the majority of my symptoms, I'm kinda flying blind. I took a total of 4mg yesterday and I had trouble sleeping. Slept about 3-4 hrs. I'm gonna try and take 6mg this morning andgo from there. I was considering doing 8mg but I'm a puss!

Any feedback would be nice. Thanks!

-Inevective

 

[tacodude]

I find Suboxone makes sleep hard even if it covers withdrawal symptoms

 

[Inevective]

I find Suboxone makes sleep hard even if it covers withdrawal symptoms

I ended up taking 8mg. Within 1 1/2 hr I got the opiate itch and eyes got heavy. Just woke up from a nap! LOL! I wonder if maybe 8mg is good since I diddnt sleep much last night or maybe I took too much? I'm gonna see how sleep goes tonight and how tomorrow feels. I am glad to finally sleep again.

-Inevective

 

[Inevective]

Day 6 Update
Took 10mg today. Lil trouble falling asleep last night. Woke up every hour starting at 7am this morning. I'm hoping with 10mg I'll sleep a lil better tonight. It seemed better today then yesterday.

Cheers!
-Inevective

 

[CfZrx]

Day 6 Update
Took 10mg today. Lil trouble falling asleep last night. Woke up every hour starting at 7am this morning. I'm hoping with 10mg I'll sleep a lil better tonight. It seemed better today then yesterday.

Cheers!
-Inevective

What happened man? Was your transition decent?