methadone to suboxone questions

[scaredtodeath877]

My husband as been on 280mg of methadone for the past three years.  He's been very successful and about 2 months ago began his tapering and is now on 265mg.  However, his clinic sent him for an EKG last week, as there has been evidence that large doses of methadone can cause QT prolongation, which is exactly what his EKG showed.  His physician discussed the results with a cardiologist and they feel that it is in fact the methadone causing it.  Their recommendation was to decrease his dose and retake the EKG in a month to see if the problem has improved.  The problem is that the nurse at his clinic has already discharged several patients with this same condition. He is scheduled to return Tuesday to receive his take homes, which they are unlikely to dispense. They have been dismissed without support, left to find other treatment options on their own.  I find this extremely irresponsible, but I suppose that is besides the point.  Anyway, we are both scared to death, we've read that suboxone isn't effective in patients receiving dosages as high as his.  The plan at this moment is to immediately take him to an emergency and have him moved to a detox program.  Once there will they treat with another opiate until the methadone currently in his system has had time to metabolize and then switch him to suboxone?  Or will he be forced to detox on his own?  Can suboxone be successful with his current tolerance to methadone?  I'm so brokenhearted for him he has turned his life around in the past few years and is a productive respected member of our community.  He hates the thought of losing all of that as much as he hates the thought of being sick for months and months.  I appreciate any insight any of you have.  TIA.

[scaredtodeath877]

Abritt and Weaver71, thank you both so much.  I know that he is in for a long tough ride, having been there myself many years ago. :(  But of course that means that I also know that he can get through this.  I wish I could do it for him though. :(  I also wish that I had found a community like this when I was going through it.  I plan on sharing this site with him and encouraging him to participate himself.  I know that he will be grateful for all the support.

Weaver71, I actually just had him read this thread, and he thinks that he would like to message you sometime.  He's still sort of hoping for the best come Tuesday, but expecting the worst.  I'm sure that one of us will PM with you questions, thank you for the offer, we both appreciate it!

[weaver71]

I was getting close to those dosages of methadone, maybe surpassed it, not exactly clear how much i took. I had to go on hydros for 4 days, then wait another two days, and I passed into suboxone failry easily. Mind you, I have been 3 wks in high dose methadone detox many times, so easily is subjective. I think that subs gave me a break from the methadone fog. I still had a long ride though subs and getting clean, but the subs sort of helped me step out of my cycles, for a support community, and fess up to some of my role in the whole addiction process. I agree that many doctors and clinics just up the dose and price to make many of us "happy." It reaches a point, we have to decide to do it, no matter the cost. Active addiction costs more than anything i can think off. Anyway, I would let him cold turkey methadone at such a high dose. Keep him focused on progress over perfection and keep striving for freedom, it will come. You can private message me about my methadone sub experience. Many here will support your efforts. keep us posted.

[weaver71]

Sorry, I meant I would not let him cold turkey at such a high dose.

[abritt121222]

I don't know what a doctor will or won't do. However to start suboxone he will have to be in withdrawal when he takes it the first time because if he is not he will be thrown into what is called precipitated withdrawal and it is 10x worse than just normal withdrawal which are also terrible. The reason is because the bupernorphine that's the active opiate in suboxone is so much stronger than just about any narcotic there is that it kicks the other opiate off the receptors but in the same sense the bupernorphine does not you could say "turn on" the receptors as much as a full opiate because the bupe is actually a semi synthetic opiate and does not get the person high when the person has a tolerance high enough to be on the suboxone as your husband does. My best advice is find the sub doctor while still on the methadone and go from there with this so he can tell your husband how to get down to whatever dose of methadone he needs to be at to switch. Suboxone in my opinion is a better recovery drug that methadone because it simply cannot be used to get high when given to an opiate tolerant patient because it has a ceiling effect and what I mean by that is at 4mg it hits its ceiling and will do nothing more no matter how much more one takes which is why I say its a better recovery drug than methadone because I have personally seen ppl using methadone and getting high and the suboxone will also block other opiates if taken while on suboxone so other opiates will have no effect which is a great deterrent because on will be a lot less likely to go spending money knowing even if they get the drug they will still not get high

[cari463]

I just read your post  and I am shocked at the dose. I am a recovering methadone addict. I was taking 140mg a day for 13 years for nerve damage. I have been off of it  for a year now. I pretty much had enough and went to the emergency room and told them I wanted off of it. My doc did nothing to help me. Please go to the emergency room and have them find you a rehab center, your husband will feel better and  he will get a whole new outlook on life. I am not trying to make this sound easy that is one thing it is not is EASY,  it will take a lot of work from everyone, but it might save his life and that is worth the hard work.

[scaredtodeath877]

Thank you so much and I will read the articles you suggested right away.  I too hope that they will chime in.  I have so many questions!!   I can tell already that this will be a wonderful community for both support and information!

[scaredtodeath877]

Thanks ABritt!  And your right it is a very high dose of methadone.  We had both questioned this several years ago when the clinic he attends continued to increase his dose.  They told him that he began to feel sleepy on his dose they would know that he had reached his tolerance and that in order to be successful he needed to be sure to fill his receptors or his risk of relapse was greater.  Take the above with a dash of salt, this is simply how I interrpreted  what he told me and I may be mistaken, but I've always felt that they were happily increasing his does during the first year.  I understand that there are risks to his heart in continuing, but to me, it would seem equally as risky to completely cut him off without  first detoxing him, as you say, to a safer does, and offering support.  Sadly though this appears not to have been the case for several others at this particular clinic who have been discharged on the spot with no attempt to wean them down.

We have dicussed this with his family doctor who in turn discussed it with a cardiologist and their recommendation would be to decrease his dose to a safer level and repeat the EKG in 30 days.  His physician is willing to contact the clinics physician tomorrow and discuss his options, he however as warned us that he has no authority and obviously can't dictate how the clinic runs and what their specific requirements are.

Do you, or does anyone else here know if it's possible for his family physician to prescribe him an opiate for the first few days, while the methadone leaves his body, and then make the switch to suboxone?  We've also considered asking his family doctor if he would be willing to prescribe him methadone and wean him off, but I've been told that doctors are legally only able to prescribe methadone for pain.  Does anyone know if this is true?

Thanks again!

[clean_in_ks]

Welcome~ after reading your post, I thought immediately of two former methadone users that have invaluable experience.  One of them used suboxone to assist.  I'm hoping they (Gnarly and Weaver) will read this ha!

Another thing that might help in the mean time is to read up and learn from some articles specifically addressing methadone/opiates/subs/detox/nutritiona/withdrawal.

Those articles can be found if you scroll down all the way to the bottom of this page you are reading right now......look for "most viewed health pages" and then at the bottom of that box is another place to click to "see more health pages".  It has really helped me to read all those articles and I'm sure it will equip you and your hubby to get thru this.
Blessiings to you~

[abritt121222]

I have never taken methadone but have a l one history with suboxone and have read ppl need to get to a lot lower dose for the suboxone to help. The reason is because the ceiling effect of suboxone works before it is I guess you could say strong enough to stop withdrawal from that dose of methadone and I believe ppl have said they had to goto 20-30mg of methadone before switching to suboxone is what their doctors told them but don't take my word on this because I am no doctor but from post I have read in the past that seems like an awful high amount of methadone in a day anyway but I would suggest going to suboxone.com and they have a doctor finder on there that can find a suboxone doctor in your area and they would be able to help you out with this.

Good Luck and Godspeed
ABritt