Suboxone for Methadone withdrawal and time off work

[KristenV]

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?

[arjunaji24]

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.
.

[arjunaji24]

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.

[arjunaji24]

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...

[arjunaji24]

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...

[kmack831]

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

[wait2long]

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.