My husband and I were on a very high level of Oxycontin and the doc believed that the Sub would throw us right into w/d for about 4 hours (that's his time, not mine). However, and much to our elation, it did not. It did amsolutely nothing until we had taken the entire 8mg that he gave in the office. I tell you that because I think it is the same with Methadone. Because it has a long half-life, you must be careful with how much you are taking and how long you wait before starting the sub. (You have to be in "mild-moderate" w/d before starting). I would talk to a doc in your area. You can look on Suboxone.com to find prescribing doctors close to where you live. They could give you more exact information on how much, but I think it is like 40mg. a day. Keep in mind that this is also the amount of Oxy he thought we should be on before starting and I was taking 500mg. on most days. So, Im not sure there is an exact science to it. HELLC@mst. knows quite a bit about the subject and Im sure will respond during his late night reads.... Right, hellc???? He is very intelligent and is also tapering off methadone. I hope this is helpful. I can tell you that Suboxone has been a miracle for me. I have been on it for about a month and can't believe how good/great I feel most days. I felt 100% better on day 1.
I hate to be typing and have someone thinking that no one is responding, hence my chapters.
Anyway, The Suboxone has been great for me but I haven't begun the lower tapers yet. Others around here have and could tell you more about what to expect when that happens. I have only tapered 3x and am currently taking 2 8mg. tablets. Just did my third taper today. I notice "0" effects from these, maybe due to the high dose I started on.
I understand that methadone w/d are horrible and have heard that Suboxone is not so bad when done quickly enough. That's my goal.
I feel like I also need to say that though sub treats the physical and the cravings, there is an aspect to the mental if your prone to that. It has helped me to have knowledgable friends to help me through this (here, email and at home). I also go to a counselor once a week, as directed by my doc, and it is also helping. KNOWLEDGE is POWER in my opinion - and I am learning a lot about the "why" I hope that it will help me not choose that option when faced again.
I wish you the best of luck and look forward to hearing from you as you beat this thing!!!!
have a great night.
thank you very much for info i also belive knowdgle is power,i sure need some. i am a long term addict many years of abuse. it has coast me everything in life worth haveing,but any way back to now. I have been on methdone now for 4 years i am at about80 ml a day sometime more some less. In the am i am going to local substance abuse and ask for help in detox, i am very scared
Tobbs, I just wanted to tell you that you are doing the right thing. Whatever it takes to get "your life back together" is what you need to do. I would love to hear how things go, if you are willing to share, after tomorrow. Please take care of yourself and stay strong!! You can do this - you've already completed the first step - pat yourself on the back and keep the end in sight! You'll be in my prayers.
Sincerest wishes - M
anchorman, Thank you so much for your post. I wish you would have been around before I started. I am currently about to begin my second month, and hopefullly my last. I started at 32mg of Sub and am now on 16. I ended my 7 year rein on addiction taking approx. 500mg of Oxycontin daily. Someitmes less - depending on supply. anyway, this is very interesting to me and I will take it to heart and continue with my original plan of a pretty fast taper.
To all that are considering Suboxone Please Read...
I Had a horrible addiction to Norco (hydrocodone)...at the height of my addiction I was at 40 (10/325) pills a day. I was a professional and had the money to support my habit. My addiction got so bad that event the hydros were no longer keeping me from the withdrawals...I had to do something immediately and went to a methadone clinic. I was on MMT for a few months then switched to Suboxone because it was much better for my lifestyle of constant travel. Suboxone is not regulated as much as Methadone...so I could go to the pharmacy and get a months supply each time. I got upto about 16mgs/day and then started to come down, with my goal to be abstainance. My point is this...
Because Suboxone has a half life even longer than methadone...the withdrawals from Suboxone can last over a month if you have been taking it long enough(several months). The withdrawals are lower in intensity than stopping Norco, Vicodin, Oxycontin etc, however the duration is much longer. In order to minimize long Suboxone withdrawals consider the following:
1. I wish I had went staight from the Norco addiction to a 4 week suboxone withdrawal program. Unless you plan on being on Suboxone for the rest of your life...I think a 4 week detox program using suboxone is a wise choice. If you choose to be on Suboxone for several months or longer...if and when you go off of the suboxone,if you dont taper correctly, expect withdrawals that may last much longer than what your orginal drug of choice may have caused.
2. If you are on Suboxone for several months or years...It is essential that when you taper you do not stop until you are below 1mg/day. Many Suboxone doctors dont understand this. Bupe (the narcotic in Suboxone) has been used for years in Europe and is available in doses less than .5mg.
Because in the U.S.A you can only get it in 2mg and 8mg tablets...you will need to break the 2mg tablets into quarters. Trust me...a long slow taper will allow you to stop, but be prepared to have withdrawals up to a month after you stop. They will be manageable only if you come down to about .5mg/day and then stop. I tried stopping at 4mg/day and unbeleivable fatigue and depression set in that basically disabled me. When I stopped at .5mg/day...I had no depression, minimized fatique and was able to treat cramps with immodium, burning skin with clonidine.
Remember...suboxone withdrawals are lower in intensity and longer in duration than any other opiate. It is also important that your Suboxone doctor prescribe clonidine to ease some of the withdrawals. During your withdrawal period, I cant express enough the importance of exercise to start training your brain to re-learn how to produce adequate endorphins.
Suboxone really is a wonder drug, however, it is best for a 4 week detox or long term maintenance. From my personal experience...I would only recommend several months of suboxone if detox timing is a major issue or if you are coming off of several years(10+) of constant use of opiates.
Suboxone has many benifits over methadone if your methadone dose is low enough. Here is the scoop....
Suboxone has a ceiling effect. It dosent do you any good to take any more than 24-30 mgs of suboxone per day. This is one of the main reasons it was quickly able to gain FDA approval. It is really hard to overdose on suboxone because of this ceiling effect. Methadone on the other hand...continues to gain strength with larger doses...hence the term, "one mans dose is another mans poison."
However, because of this ceiling effect with suboxone...you really should try to get down to about 30-50mg of methadone a day before starting the suboxone. I went from 70mg/day of methadone down to 30mg/day before I started the suboxone. If you were at 150+mg/day of methadone...suboxone may be a difficult switch...but it sounds like you are about at the same level I was. Once I got down to 30mg/day the switch to sub was a piece of cake. However...you really should be 2 days into withdrawal before starting the suboxone...thats the catch. The reason for this 2 day withdrawal is technical, debatable and not worth going into. Talk to your doctor about it..he or she may have some advice such as using subutex during the two days. Once you have comfortably made the switch you can start reaping the benifits. No more locked boxes...you get a pill bottle with 1 months supply...it also is an effective antidepressant...traveling is much easier(no guest dosing ect)...no methadone stigma...suboxone does not show up on drug tests so you can keep your privacy.
Are there any cons to suboxone? Sure!
1. It is more expensive than methadone (I paid about $300/month for MMT and about $500/month for suboxone treatment) I had insurance that paid for the suboxone but this is what you can expect to pay out of pocket if you dont have insurance. The suboxone treatment included:
a. $75.00 monthly doctor visits. In the U.S. suboxone is a shcedule 3 medication that actually carries more regulation than many schedule 2 medications (exception is methadone). Suboxone can not be called into a pharmacy and it can not be refilled, so you must visit your doctor each month. Also, only a doctor that is "suboxone certified" can prescibe it, most pharmacies dont carry it and many dont even know what it is (U.S.A), however it is rapidly becoming more known.
b. two mandatory monthly drug counciling appointments (Michigan) $75.00/each
c. Suboxone $50/month to $400/month depending on your dose
depending on where you live...you may be able to avoid the drug counciling appointments.
2. Many doctors are less educated on Suboxone than methadone so many do not know how to properly taper your dose (especially new suboxone doctors who are naive enough to get all of their information from the drug manufacturer). The general rule is that if you are going to be on suboxone for a long time then a slow taper is mandatory and never stop above 1 mg/day or less. Because you have been on methadone for 4 years...a 4 week suboxone detox may be rough. I would give an 8 week detox a try before deciding to go on sub indefinately simply because the longer you are on sub the longer your sub withdrawals could last when you do go of of it. If abstinance is your goal...you will eventually need to face the lion anyway. An 8 week detox means you may only need to face a small Simba instead of MuFASA!! Sorry...dont want to scare you...actually if you taper slow and stop low...your suboxone withdrawals will be manageable. They will be weak but may be long depending how many months (years) you are on the suboxone.
However, if you fear you will go back to drugs after you are off suboxone then maybe you should stay on it indefinatly. Tough choice for many addicts
3. Suboxone simply may not agree with your system. Some people can not handle it. I think this is not common.
I wish you the best of luck and I hope this information helps you with your tough choice...let me know if you need anymore info
Because your situation sounds very similar to mine...I thought I would mention a few things.
Always remember the difference between the half life of Oxycodone and Suboxone. Oxycodone only lasts for 8 hours or so but suboxone can last up to 3 days. This means that when you taper...you may not experience the withdrawals from the reduced dose until the 3rd day or longer since unlike oxycodone, suboxone builds up in your system which means full effects may not be felt for sometimes longer than 3 days. (more typically 2 or 3days)
If you havent experienced this already...I thought I would mention it so you are prepared in the event it happens to you.
When I quit suboxone at about 1mg to .5mg/day, I didnt get the full brunt of the withdrawals until the 5th day. The 2nd week I only had the burning skin and by the 3rd week I was doing well. I was on Sub for 8 months or so.
As I mentioned in my other post...the clonidine eased the burning skin but increased the fatigue (for me...it was a good trade off) and the immodium AD knocked out the cramps and runs. However, use the immodium only as necessary because it is a weak opiate and although it is not a scheduled drug...I have heard some stories of slight withdrawals from immodium if taken to much for to long. It doesnt cross the bood brain barrier so any withdrawals symptoms would most likely be issolated to the stomach or maybe chills or something.
However, the clonidine was a godsend.
I dont mean to scare you but I also expreienced the first month of suboxone as bliss, however it started to diminish in the months to follow. The doses would not last as long, they began to make my stomach more upset (countered with benydral) and seem to affect my short term memory. At that point...I wanted off. Others did not have any of these problems
Keep me posted on your progress. I would love to help anyway I can. I am through this thing and really want to share my extensive experience. Some may not agree with what I write...but that is a good thing, because it opens conversation and helps establish truth. We can all learn from each other and as long as we are honest with each other...I feel we can offer more to each other than many of our doctors can assist us simply because my bet is that over half of the doctors treating us have not gone through this hell.
God Bless you and I wish you success
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