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Suboxone for Methadone withdrawal and time off work

Can anyone tell me how long I'll have to miss work while detoxing off methadone with suboxone. I know I have to wait until I'm 3 days into withdrawals before starting the suboxone. Also, does the doctor prescribe anything else for RLS and sleeplessness along with the suboxone?
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12835718 tn?1427483297
I am going through the process of switching from methadone to subutex. I i was buying methadone from the streets for afew months and decided to get clean gradually lowering my dose from 40mg to around 15mg  but after getting really sick because i couldnt miss work i switched to subutex 24 hours into the WD's from meth. ITs been 48 hours i just took another 4mg this morning, to tell you honestly i still dont feel right i bet by tomorrow or the day after i will be better. Last time i had a easier time coming off of methadone i was sober for 6 months i dont know why i had to go back on it again its been years of struggling with one opiate or another. Good thing I think my work wont fire me because they really need people other wise i would be in a very bad situation again. I will post back tomorrow, on day 3 of being off of meth to let u know how i feel on 8mg. its refreshing to read how people made it happen for themselves, better sub then methadone i think but then again who knows its hard to come off subs too
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Avatar universal
I NEED YOUR HELP ASAP!  Many people in this community have recommended you as the go-to person with all the knowledge.  My situation is very different from the posts i've read so far.  I am currently on 252 mgs of Methadone per day (split dose of 127 mgs, every 12 hrs, which I take twice daily, totalling 252 mgs of methadone each day).  I've been on the same dose for 6.5 yrs now and I desperately want to get off but I don't want to waste another 2.5 yrs tapering down at my clinic's recommended schedule of going down 2 mgs/wk (which equals 126 wks).  My desired timeline to get off the methadone completely would be 6 months, ideally.  Please tell me there's some possibility that I could do it that quickly.....

I'm desperate and need your help.  

I hope you get this message.  Thank-you!
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Avatar universal
Hello, Where did you get your information on the strength of the suboxone to methadone ratio? I am on 40mg of methadone daily and unable to find a doctor after trying for months and spending thousands of dollars on it. I finally found a doctor to prescribe me suboxone and was told to take 8mg per day to start. After reading your post...WOW. I never realized it was that strong in the ratio as you noted. I didn't fill the prescription yet as its 400 dollars for 60 of them. I was put on methadone for chronic pain but no longer getting it perscribled to me. If your calculations are correct...Im guessing that 60 suboxone will last me for
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Avatar universal
Hello, Where did you get your information on the strength of the suboxone to methadone ratio? I am on 40mg of methadone daily and unable to find a doctor after trying for months and spending thousands of dollars on it. I finally found a doctor to prescribe me suboxone and was told to take 8mg per day to start. After reading your post...WOW. I never realized it was that strong in the ratio as you noted. I didn't fill the prescription yet as its 400 dollars for 60 of them. I was put on methadone for chronic pain but no longer getting it perscribled to me. If your calculations are correct...Im guessing that 60 suboxone will last me for 4 months or longer! If this is correct, I know what I need to do. Thanks so much for posting this, you might be saving my life!
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Avatar universal
Hello, Where did you get your information on the strength of the suboxone to methadone ratio? I am on 40mg of methadone daily and unable to find a doctor after trying for months and spending thousands of dollars on it. I finally found a doctor to prescribe me suboxone and was told to take 8mg per day to start. After reading your post...WOW. I never realized it was that strong in the ratio as you noted. I didn't fill the prescription yet as its 400 dollars for 60 of them. I was put on methadone for chronic pain but no longer getting it perscribled to me. If your calculations are correct...Im guessing that 60 suboxone will last me for 4 months or longer! If this is correct, I know what I need to do. Thanks so much for posting this, you might be saving my life!
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Avatar universal
I been on methadone for 7 years now..my highest dose was 155 but I managed to get back down to 100.I recently had to go outta town an long story short I ran out of my methadone.I'm going on day 28 today now cold turkey and ya it's been hard but my biggest thing is sleep an zero energy..how long will this last.also I had a suboxone around day 10.it seemed to help for around 4 days I felt  better but since then kinda went back to the way it was..I have an opportunity to get another one question is will thAt one get me thru this.I've heard 30 days and meth will be out ur system so since I'm approaching thAt Mark I wonder if the sub will cover me thru the next few days..I gotta sleep..
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Avatar universal

As other people have said, longer is safer. Methadone withdrawals might not peak until day 5, but you should be well into by 36 hours and so you might be fine. Wait longer if you can though.  As for the suboxone, yeah start with 4 mg, and then 4 hours later if your still quite sick you take 4mg more. You can keep doing that on the first day until your symptoms are under control, but obviously if you can stop at 8mg or even 4 then stay there. Then the next day you take the same thing, and then you start going down by 2 mg a day, and then 1 mg a day near the end.  So for people that take 12 mgs the first two days, day 3 is 10mg, day 4 8mg, and so on.  That is for shorter acting opiates like H though, for methadone maybe just go down 1mg a day, or stay at the peak dosage for a few days longer, so that the entire wean takes maybe 2-3 weeks. I would play it safer on the 2 week side to reduce any rebound wdrawal from the suboxone (which happens when taken for H w'drawal (but it's super mild; almost nothing), but taking for up to 3 weeks is starting to get into dangerous territory.  Good luck.
.

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Avatar universal
As other people have said, longer is safer. Methadone withdrawals might not peak until day 5, but you should be well into by 36 hours and so you might be fine. Wait longer if you can though.  As for the suboxone, yeah start with 4 mg, and then 4 hours later if your still quite sick you take 4mg more. You can keep doing that on the first day until your symptoms are under control, but obviously if you can stop at 8mg or even 4 then stay there. Then the next day you take the same thing, and then you start going down by 2 mg a day, and then 1 mg a day near the end.  So for people that take 12 mgs the first two days, day 3 is 10mg, day 4 8mg, and so on.  That is for shorter acting opiates like H though, for methadone maybe just go down 1mg a day, or stay at the peak dosage for a few days longer, so that the entire wean takes maybe 2-3 weeks. I would play it safer on the 2 week side to reduce any rebound wdrawal from the suboxone (which happens when taken for H w'drawal (but it's super mild; almost nothing), but taking for up to 3 weeks is starting to get into dangerous territory.  Good luck.
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Avatar universal
Your possibly right about the dose being too low, but I know a couple people who were on suboxone, taking 12 mg's a day, and sometimes weekend binging on H.  What happened was the H didn't have nearly as much of an impact, but there was no precipitated withdrawal either during using or on Monday morning doses of sub.  I guess maybe because there was already so much suboxone in the system that nothing happened.  Definitely if your on H or methadone alone and then start taking suboxone all of a sudden it should send into withdrawal.  Interesting stuff...
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Avatar universal
Your possibly right about the dose being too low, but I know a couple people who were on suboxone, taking 12 mg's a day, and sometimes weekend binging on H.  What happened was the H didn't have nearly as much of an impact, but there was no precipitated withdrawal either during using or on Monday morning doses of sub.  I guess maybe because there was already so much suboxone in the system that nothing happened.  Definitely if your on H or methadone alone and then start taking suboxone all of a sudden it should send into withdrawal.  Interesting stuff...
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Avatar universal
hello, I find your knowledge and obvious compassion very helpful. I have a question. If I am on 25 mg of methadone (2.5 10mg pills) a day, and am switching to suboxone on my own because I have no insurance and the town I live in only has one doctor who prescribes it and he charges 1700.00 intake. how long will I need to wait since last dose, I believe a safe amount would be 36 hours.. secondly I believe 4mg max would suffice to alleviate the withdrawal symptoms? please correct me or tell me your opinion on my thoughts..I saw in one of your posts about a 21 day taper? if you could please tell me about this I would be so grateful seeing I want off everything and I have cold turkey, oxy first 400mg a day, than normal pk's about 25-30 perc, norc etc a day, and then heroin twice, methadone once. WOW just writing that made me feel so shameful, anyway I can do it again but life is "good" on the exterior so I cant miss work, or other things, I aprreciate your help in this matter. sincerely, Kmack
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Avatar universal
well i was on 30 mgs of methadone...waited 5 days before starting my sub, and the 32 mgs was barely enough to stop my withdrawals...so i really dont think i'm making this up, and i was far from high and to imply i was just tells me you really dont know how suboxone REALLY works, i was one sick lady from the withdrawals as i was put into precipitated withdrawals as the buprenorphine ripped any remaining methadone out of my receptors to empty them, until the buprenorphine was able to enter my receptors to stop the withdrawals...buprenorphine cannot enter a full pain receptor or a partially full receptor...thats why it is a totally different type of narcotic that cannot be compared to any other type of narcotics...i have taken them all, unfortunately and there is a HUGE difference.
it is not a full agonist like methadone, heroin, percocets, vicoden, or oxies...no comparison at all.  suboxone also has a ceiling effect....others dont.
thats why physical withdrawals from heroin, percocets, vicodens, oxies are 5-10 days and up to 6 weeks of withdrawals for methadone...that chart is meaningless.  
you should read the TIP 40 sheet...it explains ALL of this in detail that is very easy to understand the way it is explained how it works.

there is a lot your not taking into consideration when speaking about suboxone.

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Avatar universal
i DO understand what your saying, i KNOW naloxone/narcan is used to reverse the effects of an overdose...but the naloxone is NOT effective when taken sublingually...none is absorbed when taken sublingually like i copy and pasted above, which is why they made suboxone the way they did....if you shoot it up, then yes, the naloxone IS activated and absorbed into the system...
it is the buprenorphine that rips the opiates out of receptors and causes the precipitated withdrawals if your not in withdrawals  when you start suboxone...not the naloxone. if this isnt the case of naloxone not being absorbed sublingually, then how can it even be mixed in a tablet together with a narcotic like buprenorphione...?
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Avatar universal
Just for information purposes, Id been using methadone for over 3 years everyday. In the beginning I started with just one pill, but soon progressed to where I was on a constant dose of atleast 40mgs a day. Along came my cocaine addiction, it was very bad, I had gotten a settlement so I had alot of cash to blow at exactly the wrong point in my life. When the money ran out(over $50,000) I had to figure a way to get thru the cocaine withdrawls without going to a rehab. My use was all under the radar to my family, and alot of my friends, I was very depressed and thats when my methadone abuse basicly tripled to where I was having to take upwards of 100mgs a day, just to be able to deal with the coke w/d's. By the time I finally got benefits and got into an addiction specialist I was taking 140mgs of methadone, and as many other opiates as I could.  He helped me tremendously and tapered me down over 7months down to 40mgs. When I went to see the doctor that he worked for he recommended Suboxone, I really didnt hesitate cause Ive gone through bad methadone withdrawls and wasnt exactly confindent that I would be able to do it. So, I was started on 8mgs a day of suboxone, never went up, didnt need to I was able to deal with just the 8mgs. No some doctors(idiots) allow patients to switch over to suboxone too soon, before the proper tapering has been done. Its not smart to take someone whos taking 70mgs of meth, and start them on 24-32mgs of suboxone, Ive heard too many awful stories of people getting and staying on too high of a dose, and suboxone being used as a maintenance drug. It was designed to be used for easier detoxes for opiod addicts purely because its only a partial agonist, not as a maintenance drug like methadone. Now of course there must be certain circumstances where people need high doses of suboxone, but as stated above buprenorphine is very very powerful, much more than oxycodone, methadone or any opiate for that matter, so it needs to be properly used and tapered off. Now everyone is different, so there is no all purpose taper schedule that works for everyone, you need to see a Good sub doctor and get a full evaluation of all the particular issues at hand, and then come up with a realistic schedule of use and taper. You must be aware of the sad fact the many doctors do care about you, but they really care more about the money gained by someones addiction. That is why I love this site, we get so many different experiences and stories that we can all be better informed about the use of suboxone. Doctors are only required to attend a 8hr class in order to be a valid Sub doc, so they may not know all the extended issues the factor in the proper use of the drug. One thing we can all count on, is that this site is here to help us all with whatever struggles and obstacles life may throw at us, and in the end it is us that have to face facts and move on, in a more positive, productive life. I wish you all the best...and for anyone who agrees or disagrees with my opinion Id be happy to hear from all...Im here to learn, so if Im mistaken please let me know because its the only way that I and we can all grow with more knowledge.
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Avatar universal
Kristen- Depend on Wait2long's advice. She is amazing and she walked me and my son down this road! My son tapered down to 20 mgs of methadone after two years of use and a high dose of 95mgs. They tapered him about 2 mgs a week over a long time to get to 20mgs. He took a 10mg dose on a Friday morning and was in WDs by Monday am. They gave him 8mgs of subatex to start and over a few days took him up to16mgs and changed him over to subatex. His WDs /sleeplessness/ RLS were relieved within a day and he was back to work by Thursday.Once he was stablized at 16 he chose to begin an immediate slow taper. He started this process at the very end of March. It took about 4 months but by the end of July he was off of everything. He never missed work, had some low level WDs. He has had several challenges to his sobriety  during this time- a car accident and a pretty horrible wisdom teeth extraction. The ER gave him dilaudid after the accident and a day later he went back to his sub taper. The Dentist gave him lortab 10s for the dental pain- he took them as perscribed, tapered off over a few days and now only takes Ibuprophen. He gets the stitches out tomorrow! So. IF you are determined to do this YOU CAN! Make a plan and stick to it. I will send you his taper schedule if you like. Take care- take heart! lovepat
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401095 tn?1351391770
again..i want to emphasize the strength of suboxone/subutex...1 mg of sub = 15 mg of methadone....in comparison to other narctocis methadone is really not stronger...about equal to oxy...15 mg of methadone is about the same as 15 mg of oxy in strength..it is the long half life/which sub also has/ that makes it so hard to wd from..it can even store up in ur bones after long term use..another example when dealing with oxycontin verses oxycodone, there is a more difficult wd from oxycontin due to it is time released and longer half life...30 mg of methadone is equal in strength to 2 mg of suboxone...if someone is taking 32 mgs of sub they are strength wise taking over 500 mgs of methadone...so i am sure they would be sitting pretty good as far as no wds as they are using way more narcotics than they were at 30 mgs of methadone...and sadly doctors will start people at these extraordinary doses..educating urself to know better is the key as people get stuck on sub and i can see why...they r taking more narcotics than they were in the first place....30 mg of methadone would be taken care of with 2-4...6 mg max a day of sub...anymore than that could possibly be making the person high...and it is true...sub is possible to get a high from at a dose like 32 mg a day...unless u were a heavy heroin user etc...a hydro user at 80-100 mg a day can safely wd at 1-2 mg of sub and have no wds..i just worked with a 160 mg oxy user and 4 mg stopped his wd..and he did his 21 day taper and is drug free....32 mg of sub for a 30 mg methadone habit is just not realistic...for a 300+ oxy user or a heroin addict...perhaps but this is still on the very high side of the spectrum
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401095 tn?1351391770
no but when people are looking for help and needing to know info about work...they need to know their options....naloxone reverses narcotics...totally...someone can be unconscious from an overdose and not breathing and u shoot some narcan in their veins and they are wide awake...it totally reverses the effects of narcotics anf throws them instantly into wds as all the narcotics are gone from their receptor...u had mentioned naloxone/narcan has no effect on the drug and it very much so has an effect on the drug...subutex does not have narcan so u do not have this reversal of the narcotics...narcan is a code drug on every code cart in every hospital...for this purpose...if u do not see how containing narcan/naloxone would make these 2 drugs different then i would understand that as u have no medical background...my intention was not to show people how to abuse subutex...if someone wants to abuse drugs they can do it on either suboxone or subutex if they want to figure it out and believe me they will if they want to use bad enough...if there is a will there is a way...iwork closely with a pain mgt doctor who prescribes both ofthese daily and participate in studies concerning these 2 drugs...my intention was to set her mind at ease about missing work as there are ways around it..and anyone who knows me on her knows i would never try and teach someone how to abuse drugs..but i will state facts that i am sure of and that i haveseen with my own work background...it is a bit better than having opinions that have no clinical nor educational background and when u r trying to help people u need to know what u r talking about
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Avatar universal
yes...a transition from methadone to suboxone really is a totally different ummm, "experience"(lack of a better word) than switching from short acting opiods,  avis is right...
i was only taking 20-30 mgs of methadone, but it took the full 32 mgs of suboxone to over ride the withdrawals from the methadone...methadone has a LLOOON NNGG half life also...i started at 8 mgs and worked my way up to 32 mgs, 2-4 mgs at a time in 1 day...it took about 6-7 hours to feel better and that was about 5 days after my last dose of methadone-20 mgs....it was a very difficult process, but it CAN be done...
i stayed at 32 mgs for almost 6 weeks then tapered quite rapidly without a problem down to 24 mgs, then another rapid taper down to 16 mgs..i am now down to 6 mgs...
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199177 tn?1490498534
need,
What were you coming off ? Methadone is very strong she may have to start higher that doesnt mean she has to stay there but she may have to start high
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Avatar universal
I should have noted that I was on Sub for 4 years.  As far as I know, not too many folks on here were kept on it that long.
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Avatar universal
I really don't have any legitimate pain issues other than migranes. Please bear with me on the private messages- I've been trying to read them but my old computer keeps doing strange things- says its virtual memory is low, I'm new to this- sorry lol
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Avatar universal
Please, Please take this advice from me..

Even if it takes you some time to adjust to going from anything to suboxone, whatever you do, don't let the doctors talk you into taking a high dose.   Sub is a lot stronger or has a much longer half life then anything.  Doctors who have had any kind of extended experience with their patients will be responsible about this, but there are still doc's out there who think you can take 16mg or even more and then taper down to 2mg and stop and they will tell you "Don't worry about it, you won't get sick"!   If your doc has experience with this medication and has actually listened to the feedback of their patients who have succeded with this medication, they will start you on a lower dose, and won't cut you off a taper until a very small amount.  Say, 0.25mg  So if you already know you won't be able to stop taking this medication until your at that low a dose, don't start taking this at a high dose.

I would consider anything over 8mg way too high.

It took me over 2 years to go from 16mg, to 0.25 and I have no idea how I wasn't divorced because it will make you misrable to be around.  I would not wish it on my worst enemy!

PM me if you have any questions.
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Avatar universal
i did the same thing hun...i thought i was doing myself  FAVOR by buying methadone illegally to get off oxies...found out way too late that its not the case if you dont have a lifelong supply...its not what i thought or expected either...never even researched it much, i just read it help you get off drugs and started getting it illegally...very stupid of me...but you will be fine hun...just get your appointment ASAP!  so you can start making your plan..ok?  you HAVE to have a plan, and you have to it.

do you have any legitimate pain issues?  just one warning, suboxone doesnt do much for severe chronic pain...just so you know ahead of time...some say it does help them, but advil works better..LOL!
did you get my private messages?
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Avatar universal
most likely because an 8 mg subutex OR suboxone isnt strong enough to pull 100 mgs of methadone out of anyones receptors...thus no reaction.

tell them to try 32 mgs of sub along with their 100 mgs of methadone, guaranteed they wont mess with it again...lol.

i guess i really wouldnt know..i have never done it and thats not my goal, nor is sharing how to abuse it...sorry,not meant to offend.
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