Methadone to Subutex

Question

I am new to this site so bare with me. I have been on Methadone for 2 years next month and this past week I was going to be starting Subutex. Well my friendly methadone doc who will be my bupe doc too tole me to take my 190mgs of methadone on Thursday and come in on Friday to start the bupe. Well little did I know it threw me into a massive medical withdrawl and really screwed me up. As I am sitting there freaking out my doc then lets me know that sometimes this happens and that we probably should have tapered me down first. this literally distroyed me. I was looking forward to getting off the methadone and having a halfway normal life. I was so excited and ready to be me again and then my world came crashing down around me again. The whole time I was in withdrawl all I could think about was my kids and if it wasn't for them I wanted to kill myself at that moment. I didn't want to feel the pain anymore. Iam so sick of being a slave to any drug and now that I finally realize that I truly am a slave it makes me more depressed and I jsut have a feeling of helplessness. anyway my question is has anyone gone on bupenorphrine from methadone, how low was your dose. should I go off methadone completely go on like oxy's or norcos to be able to go on bupenorphrine or what should I do. My doctor is hopeless and he is the only one in my city that I can go to. What should I do? Please Help Me.

wait2long · Answer

Hello...i successfully transitioned from methadone to suboxone. with MY experience you really need to be down to 20-30 mgs of methadone for a month before starting the suboxone.  i am not positive if it makes a difference that you took subutex, but gathering from what you said, i am assuming it doesnt matter.  it was a HUGE mistake of your doctor to have you start the sub that soon and from that high of a dose, which IS why you were put into precipitated withdrawals.  i knew i was going to be starting my suboxone on thursday or friday, so knowing this i "did it up" on saturday night, i took 70 mgs, every other time my dose was 20 -30 mgs daily. so on sunday which was my last dose of methadone, i took my regular dose of 20 mgs. i went to my sub doctor on monday, got my prescription, and waited for the withdrawals to start. (you HAVE to be in withdrawals before you start the sub) i waited almost 5 full days before i even felt the withdrawals, methadone has such a long half life (meaning it stays in your system for a real long time after your last dose) it takes a while to even be sick enough to start the sub, well i thought i was sick enough also, i wasnt and was put into immediate precipitated withdrawals (because of the saturday i took 70 mgs, it was still there in my body more than my body was used to) i felt just awful for 2-3 days, then i started to feel better finally.  but it was hell getting here.
i just wanted to let you know how it was for me. now that i have told you this, my sub doctor wished she had put me on percocets or vicoden for the month previous to my suboxone induction, it is a much easier transition from a shorter acting opiod (even heroin) then from methadone...do you think your doctor would be willing to do this for you?  or you can do a taper down to 20-30 mgs of methadone, stay there for a month, then do the sub induction.  from MY experience i would have to recommend going on a shorter acting opiod for a month before your induction to suboxone or subutex...only because your methadone dose is so high and your length of time on it. it would be a much smoother transition with NO precipitated withdrawals, you would only have to wait 12-24 hours from your last dose of percs/vikes to your first dose of sub...
if you have anymore questions...please feel free to contact me anytime, i am so sorry you went through this, but i did too, and it was awful.  let me know if you have any more questions i can hopefully answer for you...

GoingToMakeIt · Answer

IBKleen, you are great!

gnarly_1 · Answer

Hi....well the physician desk reference suggests tapering to 30mg or less then waiting 3 days b/4 taking the sub...as addicts we ''want it now'' you just have to take your time participated withdrawals are the worst...we have several members who have successfully did the switch and they should post back to you....keep posting for support where here for you
>>>>>>>>>>>>>>>>>>>Gnarly<<<<<<<<<<<<<<<<<<<<<<

wait2long · Answer

I FOUND IT!!!   its in my profile...its called SUBJECTIVE OPIATE WITHDRAWAL SCALE...  IT IS A LINK, YOU WILL HAVE TO COPY AND PAST IT PROBABLY...BUT THIS IS WHAT MY SUBOXONE DOCTOR GAVE ME TO GO BY TO MAKE SURE I WAS SICK ENOUGH TO START THE SUBOXONE INDUCTION...

wait2long · Answer

just so you know...i am having a brain cramp...it is not a cows chart..DUH!  it is a sows chart...and i still cannot find it. but i will, ok?
self-administered opiate withdrawal symptom chart...i'll be in touch...

HelpMyself · Answer

thank you and I will stay in touch.

wait2long · Answer

Well i cant seem to find a COWS chart right now...but i will keep looking for you...also i am so glad to hear your going to do long term maintenance, especially after being on methadone...it really IS necessary after methadone, it takes such a long time to rid your body of methadone...i would have NEVER been able to get away from it if not for the suboxone...keep in touch...and i will get that cows chart for you somehow...also..another thing to remember...i was also on the full 32 mg dose of suboxone for 5 weeks (because again, the methadone) i had NO PROBLEMS at all tapering down fromm 32 mgs to 12 mgs where i am now...so dont be afraid to take more then 4 mgs or 8 mgs...take what you need to feel "WELL", you should have no cravings, no withdrawals, a little bit depressed, but my doc called it dysphoria-the opposite of euphoria-but manageable...you should be FULLY functional by the second maybe 3rd day.  please stay in touch!!   i will get info for you ok? and continue to look for cows chart...

HelpMyself · Answer

I am definitely going to talk to my doc about the shorter opiates. I am just tired of feeling like I do on this methadone and destroying my body. Thank you so much for all of your help. You don't know how much it is appreciated. I am a nurse and mother of 2. I can't afford to check out of life with w/d  and I know it sounds like I am trying to take an easy way out and I am not making excuses but I need to be there for my family and I have screwed my life up I don't want to screw up their's. I need to be clean for them and I want to be so badly. I know that sub isn't be drug free but in my mind right now it's the next best thing. I know that opiates completely change your brains make up so I am prepared for long term maint. I just want to be good for my kids you know what I mean.

wait2long · Answer

either way would work..but i would definately drop the methadone as soon as you can and start the shorter acting opiod as soon as you can, stay on them for a month, then do your induction to sub...it will be easier and quicker for you this way.
also there is a chart he should have used, its called the COWS chart, it rates your withdrawal symptoms, and once you hit a certain score, then you know you are safe to start...i will see if i can find a COWS chart for you, obviously your doctor doesnt have one, or he just didnt bother with it, i will look for one...ok?
and just stop the methadone and start the short acting opiods...you cant get sick from that...you just wont feel much for a few days until the methadone starts to leave your system, but better than going cold turkey...ok?

wait2long · Answer

I also just wanted to add, that i am so happy now that i followed through with it, and you will be too.  and your right, methadone is just horrid..going cold turkey you could be looking at up to 6 weeks of withdrawals, and 1-3 years of PAWS...so another reason i recommend the shorter acting opiod for you...then do your transition to sub...if there is anything else i can do to help, let me know. i also have a lot of info in my journal on suboxone.
 and i also hope you plan on staying on the sub for at least 6 weeks, to make sure your withdrawals from the methadone are over with, i am on for the long term maintenance...do you know what you will  be doing yet?

HelpMyself · Answer

so what you are saying is I should get on a shorter opiate before I transition. See the thing that makes me so mad is I specifically asked my doctor before I started the sub how long I should be in withdrawl. He said 24 hours. so I was then he examined me and I told him that I really did not feel bad and so he knew my w/d wasn't bad and he sent me to the pharm to get the sub came back he gave me a 4mg tab waited 20 mintes and it put me into w/d. HE KNEW THAT I WAS NOT IN W/D and I trusted he knew what he was doing. He knew how high my dose was. grrrrr anyway OK so should I taper down to the 20-30mgs then start the short acting opiate or should I go ct and then get the short acting when I start to feel bad then wait then do the sub. i want to talk to my physician but right now I really don't trust a word he says you know what I mean.

HelpMyself · Answer

I was in shear agony. I once was given Nubain in the ER whole on Methadone and had a lot of fear from that and then it happened all over again Friday so I just have had it. I was so looking forward to the bupe and then my doc screwed me up. I have been on meth for 2 years i dont abuse it I don't take or do anything else I wish I would have never started the done and just stayed on my hydros and oxys. Done is the worst thing you could ever be on. I appreciate all of your support. I have needed to talk to someone about this for a while with no one there. I have been trying to get a lot of info online but I wanted to talk to real people who have been threw what I have. It is so encouraging to know others have kicked it's butt and are doing so well. It gives me hope and I thank you all.

nogie1717 · Answer

I went from Methadone to Suboxone and my addiction doctor said that you HAVE to be down to 30mgs AND THEN wait 2 to 3 days before you take your Suboxone for the first time.

Your w/d's were due to the high affinity of Buprenorphine, meaning the Bup kicked all of the methadone off of the mu receptors in your brain, making you VERY uncomfortable.  

I can't imagine the pain you went through.

Stay on your methadone until you can make that decrease.  You might feel like a slave to the drugs, but by no means should you feel the horrible agony that you did.

I take Sub on a daily basis and it has been wonders.  I was abusing the methadone and then the w/d's would hit and I would be a wreck.

HelpMyself · Answer

the night that my doc sent me into withdrawls he put me directly back on methadone so I am now on 150 mgs of methadone and he wants to taper me down.  I just don't know what to do.l am so scared to death of w/d. I have to work I have two young children to deal with I just wish I could poof this away. I thought about checking myself into somewhere and start the w/d process then go to the subutex. My doctor isn't a good communicator he just wants me to fill his pocketbook. I am just a lost soul right now.

dogneedshelp · Answer

Yes that drug has helped a lot of people but seems to be a bugger to get right especially when it is time to quit. Here is a link to an article that discusses Tramadol as an alternative to your problem:
http://www.informaworld.com/smpp/content?content=10.1080/10550490500528712

It seems that the Tramadol is as efficient and in some cases slightly more so as far as withdrawals. Unfortunateley you probably have 18 hours of withdrawals ahead of you because the Dr. may have given you the Sub too early and it will take a while for the Sub to let go of your brain so another drug can step in and give you some relief. I feel for you as I know wd's are hellish as I am right in the middle right now. Keep you mind busy so you can't stare at the clock and dwell on how bad you feel. I put on headphones and cranked up the volume then I sit here and type all day long to try and keep my mind off how bad I feel. It has been the best thing I could do.The first day I suffered but then someone said try headphones and man did that help. So between typing constantly and drowning my brain in music, it doesn't have time to think ""WOW I really feel like ****"  

Hang tough and know that A LOT of people are very interested in your recovery and want to help you through it. Keep posting and let us know how you are doing.