Should I switch from Suboxone to Methadone for Chronic Pain?

[jcalderaio]

Hello,

I'm currently on 12 mg/day of Suboxone for tingling/burning all throughout my body (in addition to Amitriptyline and Lyrica). However, I still have LOTS of pain - I still get this tingling sensation on top of my head and other painful paresthesias. I heard from multiple people that Methadone is better for pain than Suboxone, and so I brought it up to my doctor. My Dr. agreed to switch me to Methadone, but not without a few caveats:

1) I will need to quit Amitriptyline because it interacts with Methadone.
2) He will only give me a maximum of 30 mg Methadone a day.

I tried quitting Amitriptyline, but I started tingling and burning all throughout my body so badly that I had to go back on it. My hope is that the Methadone will work so well that it does the job of both Suboxone AND Amitriptyline so I will be essentially cutting out a medication.

BUT, is 30 mg Methadone really going to provide me with more pain relief than 12 mg of Suboxone? 30 mg of Methadone seems like a very small amount, especially when compared with 12 mg Suboxone! (but if it really is THAT much more effective at controlling pain, maybe it doesn't matter)

[otterwatcher]

Good plan Batman!

[jcalderaio]

Yeah,

I've decided it's not a good idea to switch, especially given the fact I am an addict. I feel I am too susceptible to becoming addicted to the methadone. I haven't ONCE been tempted to abuse my Suboxone, but I think that once I get a taste of a REAL opioid then I'll want to get high. Thanks.

[fntn]

Thank you Dee!

[Dee1956]

This is not new information however it is more than just anecdotal information.  It appears that 8 mg of subxone is equivalent to 60mg.
Just my humble opinion, it doesn't sound like the best idea to go from 12 to 30.
http://www.ncbi.nlm.nih.gov/pubmed/9767199

[Dee1956]

Hi I just happened to see your post, it hasn't been answered.  I don't have a great answer but there is a conversion chart from Suboxone to Methadone, you can search it out.
At the same time, from everything I have read if you were going from 30 mg of Methadone to 12mg sub it would be ok, the opposite is not true.
Suboxone is much stronger than other opiates so you would want to do the conversion yourself before the doctor switches you.
Good luck, Dee