trying to avoid precipitated withdrawal

[weaver71]

After reading many doctor mistakes I wanted to get some input. My doc told me to go from 3 years on 100mg of methadone to 150mg of Norco for 4 days then quit until I hit a 20+ on COWS(c. 3 days) then start with 8mg of subtext. Many friends have with higher dosages have stopped opiate use with this doc., but none of them on methadone. Does this sound reasonable or am I asking for trouble?

[quitinoxys]

You are correct its the Buprenorphrine that causes the precipitated w/d. In your other post you stated you have been on subs for 2 days so if you are not experiencing precipitated w/d then I wouldn't worry about it now. Good luck.

[weaver71]

Buprenorphrine is what actually causes precipitated withdrawal, nalaxone just keeps you from using it IV to get high. Subutex and Suboxone will create precipitated withdrawal.

[vicki595]

I can't help but believe you'll be okay. Subutex is different from Suboxone. It does not contain Naloxone which is the narcotic antagonist that will cause precipitated withdrawal.

Do your research and check the difference between the two...

[vicki595]

Are you sure about that?  He's going to Norco and then withdrawal and going by the COWS chart...why would his doctor suggest this?  He's not going directly to Sub from methadone and he's going to Subutex...Hmmm.

[gnarly_1]

about a week or 2...........Gnarly

[weaver71]

How long should I be at 20mg methadone before the sub?

[gnarly_1]

HI your going to need a lot more time off the methadone to avoid persipatated withdrawal normally they have you go down to 20 mg of methadone b/4 inducing sub......this is not enough time to get it all out of your system and pushing it from a high dose is going to make it worst .......take your time ween down to 20 then jump to sub we have had several people do it from 20 successfully good luck and God bless.........Gnarly  

[vicki595]

You're welcome. Yes, follow the COWS closely. That's what you need to do, bottom line, because that determines when you'll start the Subutex.

I'm glad you'll have someone with you, I think that's important. And on that day, you can always call the doctor, tell him how (awful) you're feeling and do a doublecheck with him. I think you're good and wish you well. Don't stay on the Sub for too long or you'll have a heck of a time getting off that, too.

[weaver71]

It will be 7 days no methadone and 4 days no norco, then subutex. My doc seems to think it will work and my friends say what you say. Trust him. I have never gone to doctors my entire life, so my trust level is compounded beyond being an addict. The last doctor I tried this with told me to go out in the streets and get more methadone to taper. I left angry and went and dosed high. So far I'm following this doctors advice and am willing to do or go through whatever it takes to get my life back. Thanks for the encouragement. I will do this, one way or another. Methadone stores itself in fat and even bone, but I think it's out of the brain within 7 days. I sure hope so. It seems nobody knows for sure with methadone. It's a strange chemical compared to other opiods. If my doc is right then I'll definitely let people know. It seems easy compared to the two weeks cold turkey I've tried in the past, at least for me. I will follow the COWS strictly and have someone to sit with me so I can confirm any decisions I make in this process. Thanks again.

[vicki595]

I don't think 7 days is short. Do you mean without Methadone or Norco? Or just the Methadone and then 4 days off the Norco?  It makes some sense to me. Methadone has a long half life as you know.  But, it's not longer than 7 days right? Did you find something that says different?

I'm sure you're nervous based on what you've read. Info from the internet is not science or always sound medical advice. Do your reading. You need to trust your doctor and if you have these questions, call him up. He works for you, Sweetie!  I see the problem with where you live. Will someone be there with you?

Also, remember the folks you've talked with who've done well with this doctor...and follow the COWS chart.

Post back-

[weaver71]

The methadone 100mg to Norco is 300mg+, which I can handle the discomfort as long as I don't end in precipitated withdrawal in the end.

[weaver71]

I'm supposed to follow his instruction and do this on my own. I'll look up the conversion, but every body is different and want to be safe. Seven days without methadone seems short to me. I'd rather be in the office, but options are limited in the mountains of Northern Cali. The stories I read have probably mad me paranoid.

[vicki595]

I don't remember the conversions off the top of my head. It sounds about right to me but I can't swear to it. I could check but so can you!

Just search conversions from Methadone to Norco and you'll see if this is proper. You need to be in moderate withdrawal to introduce Sub. Is the doctor going to induce you in the office?  That's the standard and I think it's important to be there under medical supervision for the first doses.