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switching from meth to sub
I need some advice please!! I have been on methadone for 3 years I badly want to get off it so I decided to switch to suboxine. I use to be on 210 mg daily and tapered down to 100 mg because all the crazy things the methadone had done to my mind and body. I gained 100 lbs always sweaty I had crazy cravings mainly sweets and was even getting up in the middle of the night and not even remember eating would and the crazy chronic constipation. I would feel considerably comfortable one minute and the next I would feel like I hadn't taken my dose. I recently decided to switch to suboxine because I want off the methadone and my life is way to up and down to be without anything. With all that said I got down to 64 mg and was on it for a week I was going to slowly taper down 30 mg and wait like 4 days and start the suboxine but the circumstances have changed when I got a call from a suboxine doctor telling me they have a spot for me and I had to take it because where I live there isn't many around. I saw the suboxine doctor on Friday. He told me to just stop taking the methadone and wait 24 hrs and then start the suboxine but after reading all these testimonials and others I'm confused and scared. I took my 64 mg on Saturday because I wasn't sure I'm ready to go through all this. Well Sunday I decided I want to do this I can't stay on the methadone any longer so I took 30 mg. Here it is Monday and I decided to just stop taking the methadone all together. I am having some withdrawal symptoms but can still manage to get my daily chores done and take care of my 2 and 3 years olds. My big question is when can I start the suboxine so I don't go into awful withdrawals. Please help thank you!!!!
So what happened, did you get the subs? It's likely hard to write, but let us know how you are and what your plan is. You'll get through this. Keep us posted.
However, if there are opiates present in your system, the naloxone (an active ingredient in Suboxone) will pull all opiates off of your receptors, causing you to go into immediate precipitated withdrawals, which is why it is recommended you wait 24-hours after last opiate use to take Suboxone.
Just a quick clarification. It's not actually the naloxone that causes either precipitated w/ds OR opiate blocking, it's the buprenorphine itself. That's a common misconception. The naloxone was added to bupe for two primary reasons...one, to minimize the risk of IV abuse, and as a psychological motivator to keep people from using while on Sub.
The reason other opiates don't cause a high while on Sub is because of the bupe and how it binds to the receptors. The naloxone does very little (if anything) in sublingual form. IV naloxone is a different story.
Just a quick clarification. It's not actually the naloxone that causes either precipitated w/ds OR opiate blocking, it's the buprenorphine itself. That's a common misconception. The naloxone was added to bupe for two primary reasons...one, to minimize the risk of IV abuse, and as a psychological motivator to keep people from using while on Sub.
The reason other opiates don't cause a high while on Sub is because of the bupe and how it binds to the receptors. The naloxone does very little (if anything) in sublingual form. IV naloxone is a different story.
mrswally,
From personal experience, as well as a medical standpoint, you should wait much longer than 24 hours after your last dose of methadone in order to take Suboxone. As I'm sure you know, methadone has an extremely long half-life (averaging from 38-72 hours) which means that even though you haven't consumed it, it is still in your system. Being that it's still in your system, the methadone will still be stuck to your brain opiate receptors.
The medication Suboxone is meant to bind with your opiate receptors, and block other opiates from binding with them, essentially blocking any high you may be trying to receive. However, if there are opiates present in your system, the naloxone (an active ingredient in Suboxone) will pull all opiates off of your receptors, causing you to go into immediate precipitated withdrawals, which is why it is recommended you wait 24-hours after last opiate use to take Suboxone.
Getting to the point here, if you take a Suboxone too early while on methadone, it could be a recipe for disaster. Even though you're on a low dose of methadone, the methadone still has the same half-life and can be present in your system even though you don't feel it. I urge you to wait longer than 24 hours if you can stick it out, otherwise you may take the Suboxone too early and find yourself sicker than you've ever felt before. It's no fun, and there is absolutely no way to counteract the sickness - since the Suboxone has bound with your receptors, even if you use drugs to remove the sickness, they won't penetrate the Sub. I'd wait about 2 or 3 days, honestly. You may feel sick during those days while you're waiting, but if you take the Suboxone correctly, it can be an amazing, life changing drug.
From personal experience, as well as a medical standpoint, you should wait much longer than 24 hours after your last dose of methadone in order to take Suboxone. As I'm sure you know, methadone has an extremely long half-life (averaging from 38-72 hours) which means that even though you haven't consumed it, it is still in your system. Being that it's still in your system, the methadone will still be stuck to your brain opiate receptors.
The medication Suboxone is meant to bind with your opiate receptors, and block other opiates from binding with them, essentially blocking any high you may be trying to receive. However, if there are opiates present in your system, the naloxone (an active ingredient in Suboxone) will pull all opiates off of your receptors, causing you to go into immediate precipitated withdrawals, which is why it is recommended you wait 24-hours after last opiate use to take Suboxone.
Getting to the point here, if you take a Suboxone too early while on methadone, it could be a recipe for disaster. Even though you're on a low dose of methadone, the methadone still has the same half-life and can be present in your system even though you don't feel it. I urge you to wait longer than 24 hours if you can stick it out, otherwise you may take the Suboxone too early and find yourself sicker than you've ever felt before. It's no fun, and there is absolutely no way to counteract the sickness - since the Suboxone has bound with your receptors, even if you use drugs to remove the sickness, they won't penetrate the Sub. I'd wait about 2 or 3 days, honestly. You may feel sick during those days while you're waiting, but if you take the Suboxone correctly, it can be an amazing, life changing drug.
Weaver's post is excellent! Very informative. The other posters gave you important info you need to take seriously also.
Switching from methadone to sub does have special considerations. For one, Methadone has a long half life, so it may take you a little longer before you're at the stage of w/ds per the COWS scale where Sub induction would be appropriate. Like weaver said, it isn't an amount of time that matters, it's the level of w/ds. A person should be in moderate w/ds at least before starting Sub.
Your doctor is the one who needs to guide you here, and you need to follow his directions. If he tells you to stop taking the Methadone at a certain time before your 1st Sub dose, then you need to comply...and NO, don't take any other meds..opiates, benzos (ie Ativan, Xanax, etc).
In order to safely transition over to Subs, you need to follow the directions so you can be induced properly, and so the doctor will better be able to assess an appropriate induction dose for you. With Sub, less is more, and coming from Methdone, there is already a prepensity for docs to start patients out on higher Sub doses than necessary.
We cannot give you dosing recommendations, but what I WILL say with the Sub is, it's always better to start lower. The dose can be adjusted UP easier than DOWN for the induction. Stay in close contact with your doctor. I hope you found a good sub clinic that requires therapy and regular tox screens?
Good luck to you!
Switching from methadone to sub does have special considerations. For one, Methadone has a long half life, so it may take you a little longer before you're at the stage of w/ds per the COWS scale where Sub induction would be appropriate. Like weaver said, it isn't an amount of time that matters, it's the level of w/ds. A person should be in moderate w/ds at least before starting Sub.
Your doctor is the one who needs to guide you here, and you need to follow his directions. If he tells you to stop taking the Methadone at a certain time before your 1st Sub dose, then you need to comply...and NO, don't take any other meds..opiates, benzos (ie Ativan, Xanax, etc).
In order to safely transition over to Subs, you need to follow the directions so you can be induced properly, and so the doctor will better be able to assess an appropriate induction dose for you. With Sub, less is more, and coming from Methdone, there is already a prepensity for docs to start patients out on higher Sub doses than necessary.
We cannot give you dosing recommendations, but what I WILL say with the Sub is, it's always better to start lower. The dose can be adjusted UP easier than DOWN for the induction. Stay in close contact with your doctor. I hope you found a good sub clinic that requires therapy and regular tox screens?
Good luck to you!
Don't take the percoxts if ou're going to take the sbs. I wish doctors didn't leave people to figure tis out themselves. As bad as it is caring for small children with withdrawals, if you take the sub too soon, ou'll be in precipitared withdrawals and then whatwill you do? Listen to Vicki and call your doctor. Weaver gives very god suggestions and the CowS table is helpful but you shouldn't be doing this by yourself.
Are you planning to begin the Suboxone? If so, no opiates or you'll get sick. I think you need to research this some more...
From what I've read, the subs is supposed to block those percs from working (or any other opiate for that matter). Have you connected with your Dr. on this? I think that would be the best way to guide you where needed.
I also wanted to ask I have some Percocet 20 I haven't taken ANYTHING besides methadone in the past three years but I need some help can I take them?
Hi there- Your doctor needs to be much more involved in this process. You should know exactly what to do here...Give the doctor a call and run these questions by him. Induction of Sub from methadone can be tricky so be safe.
It took me almost a year to get down to 100 mg and recently in the past 3 weeks to get to 64 mg when I decided 3 weeks ago to switch to suboxine sorry I should have mentioned that. I have been off 210 mg for a long time. Thank you for the advice. I just realized a couple hrs ago how sick I am. I'm so sweaty but cold then hot I have goosebumps that won't go away. I have been constipated forever and now I can't stop going and this was all changes within hrs. Everything hurts even my eyes. I would love to just get this all over with but I have two little ones who need me and my husband works fulltime in the military and my two older children will be here in a couple days. It just isn't my reality right now to go through withdrawals. I'm getting my script filled tonight he prescribed me 16 mg daily do you think I will be ok if I wait until late afternoon tomorrow and start slow like 4 mg. Omg I don't even know if I can get that far. Thank you again!!!
Google COWS scale. Clinical Opiate Withdrawal Scale. That is the tool that doctors are supposed to use for buprenorphine induction, not an amount of time. For most opiates 24 hrs is usually fine, but methadone requires special consideration. You are likely still detoxing from the 200 mg and your down to 64mg and sub manufacturers suggest one be down to 20 or 30mgs. You must be in moderate withdrawal for methadone to sub transfer. Runny eyes and nose. Sweats and displayed pupils. Your skin should have goose bumps and the hair on your arms will stand up. All this is described in the COWS check list. Do not induce based on time. It took me 7 days to reach full acute withdrawals from 200mgs of methadone. My doctor had me take 200mg of norco a day, for 4 days. I was in pretty bad withdrawals, but the norco took the edge off. I went another 24 hrs with nothing, and induced with 4 mgs of sub. I felt okay, so I took another 4 mg sub. I felt great. I'm glad I spaced the induction doses by 1/2 hr, It was pretty psychedelic feeling my mind change so drastically. Anyway, be careful, I have a friend who took her sub too early and couldn't even care for herself for 3 days. She waited 24 hrs and induced with16mgs. Send me message if you want, I've been in and out lately. We have a lot in common though, let me know if I can help.
You have to wait for at least 24hrs before taking suboxone otherwise it will send you into immediate withdrawals. I would wait longer than 24hrs if possible. I sent you a message explaining it in more detail, but I also would not get involved in Subs. I explained more in my message to you. You can do this! Others with more Methadone experience will be on here to help you as well.
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