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Opioids Subutex to Methadone

day 14 and still cant take sub? man, everyone reacts different. I waited a day or two and was on sub in no time; so not all is the same but it does seem many take a week + to be able to make the switch.

even when using sub I'd sometimes shoot dope and then take a sub 8 hours later and be fine.
 
Sorry your PM appt was so rushed, as you mention, most of us pay quite a large sum to these doctors so we should expect adequate time & some positive outcome from each meeting.

I've had trigger point injections, as a last ditch effort. I'd been an inpatient under my PM dr receiving my zillionth ketamine infusion, which was largely ineffective, when he had a feel of my back & felt I may benefit from TPIs.

He explained it may hurt as nerves would be entrapped in the spasmed muscles, & that the fine needles would be going in approx three inches.

I remember saying "how do you know when you get the right spot"? To which he replied "you'll let me know". OMG, holy hell I did! By screaming & leaping off the bed! I had seven performed, which unfortunately did zero IME.

Also, I've had so many shots, blocks, interventions..I think ultimately you've got to figure out if any of it is helpful or just a waste of your resources.

Similarly, I take subutex currently after an allergic reaction to suboxone. I'm on the max dose & also wondering now about changing to methadone.

I went through a living hell self medicating with oxy, & like yourself, really wanted to try a less abusable avenue.

Funnily enough, not so long ago my PM really pushed for methadone as it apparently works great for neuropathic pain, which is the pain I can't just push through or stretch out or rest & ease up.

If you feel nerve pain, or sciatica is a primary source of your pain then ask him for his thoughts on trialling it.

If your family are dispensing your scripts strictly as instructed, do you honestly think that (if your dr was to script another opiate/opioid), you'd again fall into the grips of addiction?

At least if nothing changes in regard to your PMs stance, & adjunct pain meds don't help, you do have another avenue open. A mmt clinic.

Best of luck,

Rtp
 
Okay so only s hand full of you know that I had to go to the hospital this week because of severe pain I just could not deal with. SO tmrow I am not only having my Dad (who is a physician and colleague of my doc and explaining that I need to get on methadone ASAP. If he agrees will he put me one an equivalent dosage of methadone? Because that would make life easiest for me. If he has to titrate up, I could be screwed because of having ti leave to Cali next week so I hope he tapers up quickly. Also what would 16 mg of subutex a day equal to in methadone?

The second option after that will be simple just going to a methadone clinic because I can't stand this pain any more. How long does this usually take and ~ how much does it cost monthly? Gotta be cheaper than PM...? Right?
 
...Also what would 16 mg of subutex a day equal to in methadone?

The second option after that will be simple just going to a methadone clinic because I can't stand this pain any more. How long does this usually take and ~ how much does it cost monthly? Gotta be cheaper than PM...? Right?

I can't speak to the dosage as I was on it for maintenance not pain, but if you get your doc to write it, it almost certainly won't be more than 40mg/day to start.

In regards to the clinic, that depends on your location/local services, I went to a private clinic that charged $14/daily(~400/mo), for the juice + testing + counseling and while it was cheaper than the drugs I was doing, it's a lot of money. Insurance will typically never cover a done clinic unlike Sub/PM unfortunately. It's usually pretty easy to get started, they'll have an induction day once or twice a week, you have to talk to the admin, tell your tale & drop some piss then pay the fee and they'll dose you. They usually start people around 30MG and different clinics have different rules on how fast you can raise, I was able to go up 10mg a day for until 100mg, then 5mg a day.

Since you're using it for pain, you'd almost certainly want to do a peak and valley(trough?) test to allow for split-dosing as a single daily dose will not take your pain away all day. Going to the clinic everyday was a huge pain in the ass, there's usually not many in an area and they close fairly early, at mine I could never get take homes as I smoked weed at the time so I had to go Sundays & Holidays as well. The side effects from done were worse than those from Suboxone (namely constipation) and reduced libido, but I was almost certainly taking too high of a dose.
 
are you guys from the same area? because here in Boston methadone is easily free and many do split dosing so they are open rather late depending where you go. also, you will eventually have take homes if you keep clean and show they you are doing well.

what I am not understanding is.. well.. if you are truly in pain, why are you going to methadone? why not take actual pain killers? or are you thinking you will not be able to get the same type dosage you would with methadone?
 
Okay guys, so I only told one other member so far. Last weekend the pain got so severe I could not move, like literally the disk was pushing on the nerve so hard that it felt like someone inserted a sword very slowly through the middle of my spine and down through the bottom of it and then spread out into my right leg. So they took me to the ER, I couldn't stand up properly so they had to take me in a wheel chair. When I got in there they immediately were going to start giving me IV dilaudid but I told them I was on subutex, so that quickly became IV fent. I stayed for the weekend and they gave me some other meds, did some spinal manipulation and were able to somehow get the disk from pushing on the nerve too much.

When my parents saw this they finally stopped treating me like a junkie and realized the pain I was in was not a lie or a trick to get on stronger pain meds, especially since I WASN NOT ASKING FOR THEM. So we set up an appointment with my PM and this time my dad (who is a physician) is going to be coming with me. I want to be prepared for this. I take 8 mg subutex AM and 8 mg subutex PM. So we have agreed that we are going to look into Methadone. Now I wanted to ask those of you what the equivalent dose is (on the high side) I do not want to risk walking out of that office and not feeling anything less than 100% pain relief.

Also, I wanted to know the tips and tricks for Methadone because of my years of reading these forums I have read all sorts of things including the fact about 30% of the dose gets wasted by using it normally because of the acidity in the stomach. I never paid too much attention to how much of it was true or what not because I never thought I would ever be on it. But if you could post some tips to getting as much out of my dose as possible it would be greatly appreciated. I already have benzos so that is going to be a huge help I am sure, but I imagine antiacids could help with the other issue? Is it like tums that would be the best help? Just whatever you guys know that will increase the pain effectiveness of the methadone would be amazing. I just have this fear that I am not going to get RXd a high enough dosage.

Also, The last time I took subutex was last night at around 7:00 or 8:00 PM. So how effective should my first dose be assuming I get it filled around 7:00 or 8:00 PM and take it around then. That should be ~24 hours since last dose of subutex so I should be getting about how much of the total amount of drug? I did some looking around online and the best I could come up with is 1 mg bupe = ~10 mg methadone? Is this accurate at all?
 
:X FUCK, FUCK...FUCK!! I just lost my fucking post because of my lap top (long story). My pain is screaming "end this shit!" after my PM appointment yesterday. It was, as always, an exercise in futility. I digress.

I don't have the mental faculties to re-type everything I was trying to say to you, MD. Basically, as always, major props to you as you seek answers for your pain. Our story/history is different, but PAIN is pain when un-managed. I feel your angst and struggle. I wish I could reach through cyberspace and comfort you, my brotha. You offer so much of yourself to others on this site. I respect you for your service in the military. I grieve for the damage it caused your body and mind. I admire your strength to fight through this so-called life, helping others to do the same.

Methadone for pain? It seems if you ask 50 people, you'll get 50 opposing views, ranging from "best solution ever" to "devil drug". I have nothing to offer. My PM started me on it day one, because he believes it's excellent (and cheap) for CP. I was opiate naïve, so I remember little beyond excessive sedation and drool. I stopped within a month.

I've not dealt with addiction, personally. I have little to offer there. My fear of addiction has kept me IN PAIN for decades, as I refused opiate therapy until 2014. It's not gone well, because opiates cause more problems (GI) than they solve for me. Right now I'm prescribed Oxycodone, but it doesn't touch my pain.

I'm less than amused when a previous poster said "If you're in pain, why not take opiates (pain killers)". Duh...read the fucking thread...focus on the subject matter. Do you not find it astounding that folks who don't have pain have a potpourri of meds available at all times? Yet, CPPs contemplating life in pain vs. stretching a good piece of rope, can't even PAY a fucking "PM Specialist" to make eye contact? Forget about OIC meds costing upwards of $300 per month. :!

My rant won't help you, MD. Your description of your PM doctor took me back to my appointment just 28 hours ago. I'm just so frustrated I want to rip his head off and shit down his throat, except...er...the throat ripping I can do, and enjoy. But...my bowels won't move even with daily consumption of enough softeners, laxatives, stimulants for a colon cleanse and bowel prep for scope.

(((HUGS))) and heartfelt empathy to you, MD. I'm sorry I don't have answers for you (or me). I am glad that you have your parents. I lost my dad just days before 9/11. My mom is now 89 and I placed her in a nursing facility in 2005. I have been in the "parent roll" for longer than I can remember. It doesn't help that my mom is the spawn of Satan. (yep) I need riot gear just to visit!
 
LOL and it is okay, and really my PM is not bad, he really had done everything in his power to help me. I just happened to catch him on a REALLY shitty day that NEVER happens. He has never turned me down for anything. But he had a brand new front desk clerk and she somehow managed to schedule like a million different appts and fill 30 min slots with 1hr long intake appointments.

So when he got to me (a patient he knows very well and we never change anything [I cant blame him for thinking this time would be different even though it wasn't]) he asked a few questions and I started to mention the pain he said okay I will just give you 30 more! I was thinking "I could take 100 mg right now and it wouldn't be any different" just because of how bupe works if you have been on it long term.

But to show you how great of a guy he really is when my dad called him (my dad sends ALL his PM patients to him) he said no problem lets fix this as best we can and I will see you after work. So he is seeing me at 6:00 PM an hour after he stops seeing patients. So I am hoping we can get this worked out, because I have to make it to California next week stay for 5 days and then travel for another day back to Florida. So to say the least I am going to be in severe pain. And the worst / beautiful part is the wedding is going to be in Sonoma and is wine themed so I need badly to be on stuff that keeps me from drinking.
 
Good to hear. I hope you get this sorted out. Your trip sounds wonderful sans the pain. It helps the mind and the body to have something to look forward to.

It's a blessing that your dad's a doctor, and you feel "heard". I must say I wish I had a good doctor. Wishes are a waste of time in my world, though. Take care, MD!
 
Mad Dash, despite all this I have faith that things will get better for you. You have been through a LOT of shit and have overcome so much and to suffer like that so you can stay on track with your recovery is very commendable.

I'm proud of you man, you'll be in my prayers and I wish you a safe trip. Peace :)
 
Thanks Peach you have always been a posted I cared about a lot. Keep up the good work!
 
Yo guys I need an answer I always help everyone I can please help me! What is the equivalent methadone dosage for 8 mg of freaking bupe?!?!?!
 
I'm looking, but cannot find specifics once past the "ceiling" dose of 4 mg in conversion to Methadone. Chemistry isn't my strong suite. Sorry, MD! :|

Surely your PM doctor knows the answer. Weren't you meeting him this evening?
 
Sorry....tried to edit/add info...technical glitch...gr-r-r-r

Source: NCBI says 8 mg (sublingual) Bupe is approximately 60 mg (oral) Methadone, but FFS don't hold me to it...

Let wiser med minds prevail. :\
 
I'm less than amused when a previous poster said "If you're in pain, why not take opiates (pain killers)". Duh...read the fucking thread...focus on the subject matter. Do you not find it astounding that folks who don't have pain have a potpourri of meds available at all times? Yet, CPPs contemplating life in pain vs. stretching a good piece of rope, can't even PAY a fucking "PM Specialist" to make eye contact? Forget about OIC meds costing upwards of $300 per month. !

want to know, you moron!? because we are talking about someone who is calling himself an ex addict but is suffering from an excruciating amount of pain, so why not go the route that would take care of the pain rather than other routes!? and yorue right, I've never had pain, I've only had a brain tumor and had half of my fucking head removed; but again, youre absolutely right w/ what was said.

and to Dash: there is no equivalency when it comes to Methadone and bupe; we are talking two drugs that work very differently; yes, they are both considered opiate blockers but I've known people who have come from 200+ of methadone to 16MG of bupe; then you have the people who left bupe (8-16MG) and have maxed out at 70MG methadone. the drugs work differently; maybe ask the person who is not an addict, she may know.
 
No this was a BULLSHIT situation MY father is a PIECE OF SHIT. HE FUCKED ME VERY GOOD. He refused to allow me to take ANYTHING. The doctor had convinced him the let me take 60 mg twice a day. So this asshole says no more than 10 a day. The doctor looked at him like he was a fucking moron which says a lot and said that is nowhere near the dose he needs to be on. So the doctor said minimum I will go is 40 mg or he would fear malpractice. My piece of shit father wasn't happy with that but couldn't fight him anymore. So THAT is what I am stuck with. I don't even know if it is equivalent, I might find myself in WD thanks to my cock sucker of a father. I swear to god, you should have heard the names "junkie, I am going to disown you, I wish I could watch you sleeping under a bridge you loser and all because you didn't listen to me and joined the fucking army!" he called me worthless and swore he had already cut me from the will which I didn't care about. I did everything in my power not to kill him. MY OWN FATHER, he is literally WORSE THAN MY EX-WIFE.
 
MD...That's the PAIN and frustration talking. I'm sorry for your father's hurtful words.

BBT...I apologize if I offended you. I misunderstood when you said "I'm not in pain. I just like the feeling." My bad, so please accept my apology. There's no need for name-calling, either. You called yourself a "junkie". I didn't. I don't know you, nor you, me. I don't judge, because I don't like to be judged. I have been dogged for "not" taking prescribed Oxycodone, though I too am in crippling pain. I am truly sorry if I misspoke.

Let's not bottleneck MD's thread. PM me if you need to further rant. If not, peace out. :| I'm not looking to make enemies here. I've got family to feel that niche.
 
BTW guys you are actually both friends of mine I would hate for y'all to get into a fight over me for no reason.
 
MD so sorry to hear that your father interfered in such a negative & hurtful manner.

Thank god your PM is starting you at a minimum of 40mgs bid.

I'm sure I posted a response ystrdy re converted doseage. Can't see it though..

As another poster pointed out, converting a partial to a full agonist is tricky, but have faith in your PM dr. He's the expert.

Unfortunately, a long time ago I came to the conclusion that it's not helpful to have even the best of intentioned relatives involved in my medical r'ships. But not before my mother "disposed" of my morphine deceptively. When I confronted her she told me I didn't need it & that "that stuffs addictive you know". Uh duh.

You & I both would've thought that your father being a doctor would have more empathy, & been more of a help than a hindrance.

I read a while back that 16-20 bupe is roughly 40-60 methadone. So fingers crossed you don't go into withdrawl.

Let us know how you go with it.

Wishing you luck & a whole lotta relief from your pain so you have an enjoyable trip away ❤️

Rtp
 
Last night I slept like a baby for the first time in years... I can't even begin to describe how good waking up felt. But as far as the pain goes, I would say it has dropped it by another 5% but this would not have been a problem if we had just started out on a proper dosage. Thank you everyone for your positivitey. I am keeping in their until nezt week when it is supposed to raise to 60 mg
 
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