Getting off methadone can be extremely difficult. Luckily, there is an alternative to tapering all the way off. Switching from methadone to Suboxone can be the perfect transition plan if done properly. When I worked as a counselor at an opiate treatment program, many of the patients asked me, “can you switch from methadone to Suboxone?”
The answer is yes. However, there are certain criteria that must be met in order for one to do so. In this article I’m going to explain to you what these criteria are. I’m also going to teach you step-by-step how to switch from methadone to Suboxone.
Methadone and Suboxone
Some people are confused about the differences between methadone and Suboxone. These differences must be understood before you make the transition. Methadone is a full opioid-agonist. This means that it completely mimics the effects of heroin, morphine, Vicodin, and other opioids. It’s the most powerful medication available to treat opioid dependence.
This can be a double-edged sword. Since it’s so powerful, it can work wonders at eliminating opiate withdrawal symptoms and cravings. On the flip side, coming off methadone can be hard due to it’s strength. This is where switching from methadone to Suboxone can help.
Suboxone is composed of buprenorphine and naloxone. Buprenorphine is only a partial opioid-agonist. This means that it still mimics the effects of opioids, but it’s not as strong as the full-agonist methadone. Naloxone is a partial opioid-antagonist. This means that it blocks the effects of other any other opiates.
Often I had patients ask me, “is Suboxone better than methadone?” Neither medication is better or worse. Furthermore, they’re used to treat different levels of opioid addiction severity.
Here’s a brief description of their pros and cons:
Methadone
- Strongest medication
- Least expensive
- Can be difficult to come off
- Horrible stigma associated to it
- Often have to attend a clinic daily for the first several months until you start earning take-home privileges
Suboxone
- Not as strong of a medication as methadone
- Very expensive
- Can still be difficult to come off
- Not as much stigma associated to it as methadone
- You can get a prescription from a doctor
Note: Only people with the most severe cases of opioid dependence should be placed on methadone.
Reasons for Switching from Methadone to Suboxone
There are a few reasons one might consider switching from methadone to Suboxone:
- To feel less medicated
- To experience less side-effects
- To not have to come all the way off methadone
- Family pressure
- Wanting to avoid the stigma associated with methadone
Everyone is biochemically unique. Some patients feel better on Suboxone than they do on methadone. Conversely, many patients feel better on methadone than they do on Suboxone. I had two patients that switched from methadone to Suboxone and didn’t like the transition. They both ended up getting back on methadone, and feeling much better as a result.
How to Switch from Methadone to Suboxone
Step 1:
Switching from methadone to Suboxone needs to be done correctly. If you’re thinking about switching from methadone to Suboxone, you must first talk to the doctor who is prescribing the medication to you.
At the opiate treatment program where I worked, we offered both of these medications. This made switching from methadone to Suboxone very convenient.
If you attend a methadone clinic that doesn’t offer Suboxone treatment, you can have your counselor help you find a treatment center or private doctor that can prescribe it to you.
If you’re taking methadone prescribed by your doctor or pain management clinic, they too can help you make arrangements for transitioning to Suboxone at another location.
Step 2:
After meeting with the doctor, you’ll be put on a methadone taper schedule. This means that you’ll be decreasing the amount of methadone medication over a period of time. It’s best to taper slow, or at least moderately slow, to avoid shocking your system. This could lead to severe physical and psychological symptoms, opioid cravings, and a possible relapse.
The taper will end at about 30-40 mg of methadone. This is where you will begin switching from methadone to Suboxone. The transition point is entirely up to the doctor prescribing your Suboxone. The doctor where I worked had patients taper down to 30 mg before switching from methadone to Suboxone. This is pretty standard, although some doctors might have you stop at 35-40 mg.
Doctors have you get down on these low doses because anything higher makes switching from methadone to Suboxone much more difficult. This is because Suboxone is a weaker medication. So 30-40 mg of methadone is considered equal to a regular dose of Suboxone.
Step 3:
Once you’ve successfully tapered down to the amount of methadone your doctor has established, you’re now ready for the hard part! Unfortunately, you’re probably going to have to wait approximately 72 hours after your last dose of methadone before switching from methadone to Suboxone.
If you’re not in at least partial opioid withdrawal, the agonist buprenorphine could send you into precipitated withdrawal. I’ve heard some serious horror stories of opioid abusers taking street Suboxone too early and ending up in the hospital. Don’t let this happen to you!
Note: Subutex can also put you into precipitated withdrawal. This is because buprenorphine has a high affinity but low intrinsic activity at the mu receptor, the partial antagonist displaces agonist opioids from the mu receptors, without activating the receptor to an equivalent degree, resulting in a net decrease in agonist effect, thus precipitating a withdrawal syndrome.
*It is a common misconception that the Naloxone in Suboxone initiates the precipitated withdrawal. This is false. The naloxone can only initiate precipitated withdrawal if injected into a person tolerant to opioids. Taken sublingually the naloxone has virtually no effect.
As long as you do everything your doctor asks you should be fine. On the day of your switch, your doctor will do some tests to see if you’re in enough withdrawal to give you Suboxone. If the doctor thinks you’re ready, you’ll most likely be given a small dose of Suboxone to see how you respond. If that goes well then CONGRATULATIONS! You’ve successfully switched from methadone to Suboxone.
My Clinical Observations of Patients Switching from Methadone to Suboxone
I observed many patients switching from methadone to Suboxone. As I explained earlier, only twice did I witness patients getting back on methadone. All the other patients I saw switching from methadone to Suboxone reported that they felt good. Many stated that they enjoyed more energy and less sweating after the transition. Furthermore, they often reported being happy to not feel so medicated anymore, as the methadone can have this effect.
The two patients who ended up switching back to methadone told me they liked the feeling of being medicated. Everyone is different. If you’re thinking about switching from methadone to Suboxone I suggest you set up an appointment to talk to your doctor about it.
Conclusion
Based on my clinical observations, switching from methadone to Suboxone can be an awesome transition plan. I should warn you, however, that coming off Suboxone is still not easy. Don’t underestimate the power of buprenorphine. Yes, it’s only a partial-agonist. But it’s still a powerful medication that exacerbates imbalances in biochemistry.
While tapering methadone or tapering Suboxone, you should work on natural ways of increasing your endorphins to promote physical and mental well-being. If you do this, you’ll be well on your way to being medication and opiate free.
If you have any questions on switching from Methadone to Suboxone, please don’t hesitate to leave it in the comment box below.
Iâve been on methadone for over 15 years at a fairly high dose average 150 over the years. Iâve wanted off for so long but every medical official has told me it canât be done, my âbrain is wired this way for to long.â I feels so discouraged. Iâm down to 67 mg (steady for months) and I thought about detoxing for 2/3 days and go on suboxone 8 -16mg, whichever, just to put it to the test, see if I can hack it. I want off desperately but so afraid itâs paralyzing. Is my plan crazy?
Been on methadone for 6 days, went from 25 up to 55 mg, stopped cold turkey and waited 3 days, will it be safe to transfer over to suboxane without pwdâs?
Hi Matt my name is Renee I’ve been on methadone for 21years and for the past three years been on a125mgs. I am tired of going to the clinic every day and dealing with all the bull…. that goes on there so I walked off and wanted to know to get on Suboxone an try something different. Today is my 12th day without no methadone I’ve gotten my script of Suboxone 2.5mg 3x’s a day . On my seventh day I took two of them one first I was good then the second put me into pwd it was horrible I am so scared to take it again but I feel like crap do you think tomorrow will be my thrirtheen day without methadone will I be ok? Please help !!!
Renee, I know what you went through with pwdbsince I went through it as well switching from methadone (90mg daily) to suboxone. I took my first suboxone dose around noon and went into pwd that lasted 6 hours for me then dosed suboxone again the next morning around 8 am and all was good. We are all different so no one can say for sure but based on my experience you should be ok to dose. I am not an expert but I do believe the suffering of pwd is because the buprenorphine is removing the methadone from opiate receptors so I believe the methadone is no longer attached at this point. I understand your hesitation though, i am trying to remember how long ago it was when I went through this, maybe 6 years ago or so but I will never forget it for sure. I hope I have helped you a little here. Also another idea is to dose just a small amount and wait a couple hours to see how you do them up the dose. Suboxone for me take up to two hours to fully kick in so wait at least this long before upping your dose. Please post back tomorrow and share how it went as this could help others going through this as well.
once you taper, go 72 hours without any methadone, you may go into PWD once from what I’ve heard, (basicially the sub is kicking the remaining methadone off your receptors) and if you most likely won’t experience PWD the 2nd or 3rd dose.
They now do micro transfer from methadone to suboxone. No more need to go cold turkey for 72 hrs ( varies from one person to another) usually must be no higher than 30mg methadone/day. You stay on methadone while they start you on .5 mg of sub. And double the dose daily (12 hrs split). Depending on your methadone dose, after about 10 -12 days of constantly building up the amount of suboxone they under supervision stop your methadone and adjust the suboxone if needed. Just did it. I felt a bit tired during 10 days. 7 out of 10 or no different then a day if you had a really bad sleep. But no withdrawal at all. Better for me on Suboxone. Was already at 20 mg of methadone after 22 yrs above 110mg in average. Why so long. Honestly I was always to busy with a business to run, a family to take care of, etc. Regardless I am now reducing the suboxone. Should be done in 6 months. Important ! I kept a clean productive life since the beginning (only my wife and doctor know about my meds) my first child was born 6 month after I quite street drugs to me it has no part in her life, same with my other kids. Obviously where I live in Canada, if you work and behave well, the system is there to support so doctor every 3 months and pharmacy every 2 weeks.
What? Who? where! Is this done in an inpatient setting? This is music to my ears!
Does the suboxone they micro dose you with still contain Naloxone?
Can you take anything to help you with the withdrawals while you’re waiting the 72 hours or so to make the switch from Methadone to Suboxone. Such as benzos or clonidine or Valium
Michael, yes absolutely you can take the meds you mentioned during this 72 hour period just donât take any opioids during this time. Donât jump the gun either, I did several years ago when making this switch and paid the BIG price of precipitated withdrawals which is FAR FAR worse than standard withdrawals. For me it lasted 6 house and was horrendous then faded away. I only waited about 50 hours and started feeling bad so thought I was ok to begin suboxone. How wrong I was. The next day I was good to go on with taking the suboxone as normal but would never want to go through that again and wouldnt wish it on my worst enemy. Anyway, your question was about comfort meds and you are fine there. They can make it easier to get through this period which is a good thing. I also wanted to share that the first time I made this switch I was very disappointed with suboxone and went back to methadone after a few weeks. It as wintertime and I was accustomed to the warm feeling that came with each methadone dose and suboxone didnât have that. I know it seems simple and petty but you should be mentally prepared that suboxone is only a partial agonist and not a full which will have differences. This isnât to say suboxone isnât strong because it definitely is very strong but also very different. This difference is a good thing imo especially is using suboxone to get off methadone since it is a smoother transition to reality imho. Hope this helps my friend. Take care.
Hi Matt,
Iâm coming off of Methadone, my last dose was 10 mg., I take it in tablet form . The highest amount Iâve ever taken is 40 mg, I have been on this drug for a year for pain.
My question is my last dose was Monday morning and itâs now Friday but Iâm also taking clonidine and bentyl to help with the withdrawal, Iâm starting to feel the cramps thru the bentyl and my eyes are moist would it be safe to start taking subutex and if so how much should I start with?
I will also disclose that while I was in a detox 4 years ago accidentally they gave me someone elseâs naloxone pill and for 2 days I thought I was going to die, as I was there detoxing from heroine! So I know all to well what pwd feels like, and Iâm scared to death of any sort of a repeat! Please advice, as full sobriety is my goal!
Yes u can absolutely take benzos to ease the withdrawal until the conversion over to Suboxone just be careful got to take too much benzo
Can you take kratom while waiting the 72 hours for the switch from Methadone to Suboxone?
Shayne, while I havenât done this personally I know a few people who have done this and say they didnât have issues with kratom and sUboxone causing precipitated withdrawals. With that said if it were me I would still make sure I was in full blown withdrawals before taking suboxone just to be sure. I have been through precipitated withdrawals and it is no fun at all, much worse than any other opioid withdrawal by far. Hope this helps. Take care.
I am on 110 mg of methadone daily. If I go cold turkey, how many days would I need before taking Subutex?
Generally 3 days but a better scale would be to use cows (clinical opiate withdrawal scale). That can help ensure you do not go into precipitated withdrawals. Google this to find more info (donât think it allows me to post a link). Hope this helps.
I have been off herion for 2 yrs recently relapsed for a weekend and got scared and went to a methodon clinic i been on it for 2 days now and want off becuz its giving me a high feeling i have only done 40 mg within these 2 days its now been 24 hrs since my last 20 mg dose and i have a suboxone but is it still necessary to wait 3 days ???? I have no insurance and they say i make to much for a clinic and i cant afford doctors co pay really looking for advice
Be VERY careful. If you take the Suboxone too early you’ll go into the worst withdrawal of your life. I’m going to post an article that will help you gain clarity to this situation more:
How To Use Suboxone For Opiate Withdrawal>>
I have been off 80 my of methadone, tried a sub after 2 weeks,still got sick….(felt like crawling out of my skin,bile thrown up,etc.)I think it’s because I was on the juice for over a year,but terrible feeling because it’s straight medication compared to dope
Hi Matt,
I have been on Methadone for 11yrs now but am planning on switching to Suboxone. Im at 36 mgs now & am working on tapering down to 30 mgs before I switch. Ive heard you need to wait 72 hrs 1st before taking your 1st dose of suboxone. My ? is, during that time would it be ok to take a xanax or 2 to help me a tab with the withdrawls & hopefully sleep? Or do I have to strictly not take ANYTHING at all during that time? And is there anything else you think I could do or take to help me get through that dreaded 72 hrs, like kratom, or possibly any vitamins or supplements or anything like that? Any suggestions would be much appreciated. Ive been wanting to do this for a long time now but still im quite nervous about it because im terrified of w/d’s & being sick. Thats why ive stayed at the clinic for so long. But im done living my life in fear & my health is also greatly suffering as a result of opioid-induced endocrinology that I have suffered greatly from for years & years not knowing that was why & now I have severe osteoporosis from it (im only 36) & severe adrenal insufficiency that im hoping to correct once I make the switch.
Need to ask you some I am on methdone I ran out yesterday is it ok to take a peace of sub to get me threw the day
Probably not. Its too soon. It would send u into the WORST withdrawals. I took suboxin too soon one time and I almost called 911 it was so severe. It made regular withdrawals seem like a cake walk.
NO!! I am an addict who switched from Suboxone to Methadone because the Suboxone wasnât strong enough for me. I had problems driving on the Methadone so I cold turkeyed the Methadone at 120 mg. I waited 48 hours and only took 2 my of Suboxone to try and go back on it as I had only been on Methadone 1 month. HUGE, HUGE (I CANNOT SAY THIS MORE CLEARLY) MISTAKE!! I went into full blown precipitated withdrawal and I though that I was going to DIE!! I have a very long history of opiate abuse and I have been through many withdrawals. This was ALL them combined. If you want to know what Hell feels like, then do what I did. After 4 hours of this gut wrenching agony I took 2 more milligrams of Suboxone hoping to make it stop. NOPE, it got WORSE!! This went on for around 10 hours until I finally passed out. When I woke up the PWâs were gone. I am on day 6 with no Methadone and I am still not in full blown withdrawal from it. I ABSOLUTELY DO NOT want a repeat experience so I am riding these withdrawals out until they get to a 26 on the COWS sheet, which is the advise that I have been given. I will take regular Methadone withdrawals over Percipitated Withdrawals ANY day!!! At this point I think that I may just be immune to the regular withdrawals of opiates due to the HELL I went through the other day. Please take my advise and DO NOT DO WHAT I DID!! IT WILL SCAR YOU IF YOU LIVE THROUGH IT!!!!!
Thanks for sharing your experience Marie. My precipitated withdrawals lasted 6 hours coming off 90 mg methadone and only waiting just over two days since last methadone dose. I dosed suboxone around 11am (just a small corner of the strip) and after 30 min started to feel better so took about 2mg more and pwd started about an hour or so later then subsided about 6 pm. I was so scared to dose again that day so waited until the next morning to dose any more suboxone but when I did everything was fine. Just wanted to pass that along for anyone else reading this. I believe the suboxone remeoves the remaining methadone from receptors causing the pwdâs so (At lest my theory is) you should be good to dose again once it subsides. To anyone who does experience this you will likely be to scared to dose soon after so dose again when you feel comfortable doing so should be what I would do (and this is what I did). Anyway, hope you are still doing well.
No. No. No youâll be instantly dope sick.
Hi, Laura, to your question in regards to the 72 hour waiting period between your last dose of methadone and your first dose of suboxone. 72 hours is an educated guess by doctors to honest with you. Time actually has nothing to do with it. It all depends on the person and their metabolism. I know people who has made the switch and watched the clock and calendar for 72 hours to arrive. Once it Did, they took their first dose of suboxone and within 10 minutes dropped to ground and crawled to the toilet. Yep precipitated withdrawal got them! Then there’s some who only waits 24 hours and they’re perfectly fine. My doctor is the smartest and most intelligent man I’ve ever met. And, He also saved my life! But, he told me when I made the switch from methadone to drop down (slowly) to 30mg. Then wait 72 hours but in reality at least 6 or 7 days. Bless his heart he tries. He’s only advising that because he wants to make 100% sure me or no one else goes into precipitated withdrawal. But the fact is, like most doctors they’ve never actually done or experienced the drugs. I went from 3 years at 95 mg. To 4 mg of suboxone every 12 to 24 hours for the first week than 2 mg per day for the next 2 months. Then eventually weened myself off. 72 hours or 7 days, it doesn’t matter. As soon as you start feeling yourself go into at least moderate withdrawal from methadone, you are clear to tale the subs. Start with 2 mg or less. Just to see how your body reacts. You may feel the suboxone knock the remaining methadone off your receptors but don’t let your nerves convince you that it’s precipitated withdrawal. Trust, you’ll know if it is within 10 to 20 minutes max! But after an hour see how you feel. If no PW then take a little bit more. And so on. Doctors will prescribed people 3 8mg strips per day, which is why 98% of people are selling half of their script each month. 3 8mg strips per day is too much for a darn elephant let alone a person. If you start taking a lot of the suboxone you will only become addicted to it like you have everything else. It’s very easy to. But never forget, subs are just as hard as methadone to get off of. So take only what you need and only as long as you need. If not, you’re defeating the purpose. Good luck buddy, I know you can do it. It’s not easy, but that’s why God made you strong!
Did you quit cold turkey at 95. I am on 75 and I stopped going on Monday and this is now Wednesday im hoping that I make this transition ok. Im very scared at what’s to come. Can some one plz help me im only im some withdraws not partial yet or full. And I don’t know how long this is gonna last
I just made the switch to suboxone after17 years of methadone. Was on 200 mg, weaned down to under 30, I’m on my 4th day of suboxone, feel that its the best thing i could have done. You will be fine
That sounds like best info I’ve read on the switch, thanks. Been in the game way way too long & can tell the real from the BS. Good luck in your jouney
Hello Mr. Finch,
I have been in MMT for about 5 years on 175 mg. I am working on dropping about 10mg every 2 weeks. I have a treatment center and a doctor lined up to make the switch to Subutex (generic). My question is: Is there a high success rate for people who switch to Bupe that have been maintained on this type of Methadone dose for 5 years? I know you said only 2 people you know of switched back, but I didn’t know what their dose was like. I have not had a dirty UA during my time in treatment and I am tired of the clinic setting. After switching, should I return to feeling normal?
Thanks!
Matt
Hi Matt,
In my experience working there nearly everyone loved the switch. Typically it takes a few days to a week to feel your best though for some people. I think you’ll like it a lot. Nowhere near as many side effects as methadone.
Mr. Finch, I’m hoping to can help explain why my pain specialist did the following to me.
I was involved in a serious car collision 18 years ago, have had three back surgeries with the most being January 2013. I suffered from chronic pain and a few other issues ever since the collision. I’ve been on numerous opiate meds of the years and most recently, methadone. A few months back my specialist told me about this new drug (to me), Suboxone and that he may try changing to this as time goes on. That time came this month as he hadtampered me down to 30mg of methadone and out of the blue said it was time. So he had me finish the last of my methadone which occurred on January 19th and then start a 25mcg fentanyl patch the same day. After 3 days then I put on a second patch which he had me take off in the am two days later. That same day I started Suboxone one 2mg then 6mg more a hour later. He then had me taper off the Suboxone by reducing dosage by 2mg a day then go to 1mg (half a pill) for two days then nothing. He prescribed no other pain meds of any kind, schedule me to see him in three weeks and told me to contact him if I have any problems. I followed his directions to a “T”.
Referencing conversations that I had with him regarding the Suboxone, I believe he was simply going to change my pain medication and not go entirely off of medication. I my mind this was straight forward and during my last appointment he made no mention of actually going off of all medications and given my situation I would never of agreed with that.
I have made attempts to contact him via different means with no success. Now on to the effects of such action.
– Slept less then 6 hours out of 120.
– Significant pain increase related to issues associated to collision and surgeries
– Massive headache
– Numerous withdrawal type symptoms
I saw my GP who has agreement with specialist that only specialist will prescribe pain medication which I’m aware of and wasn’t asking for at that time. I hadn’t slept for over two days and was looking for some sleep medication which he did prescribe. I had tried natural sedatives with no success.
After no to little sleep for 119 hours I went to emerge in the hope of getting some pain relief. I wasn’t looking for nor wanted more methadone and know that one can’t just take a different opiate because of the Suboxone. Dr. gave me an injection of toradol then later some T3s. This helped, but I was still in a lot of pain and discomfort. The Dr then prescribed Naproxen and more T3s. I’m feeling a little better, but 48hrs after emergency visit I’m still suffering.
My question(s) to you if you would is does this make any sense to do things this way and why would a trained specialist do such a thing? I was referred to him because of the special licence required here in British Columbia, Canada to prescribe methadone. Now that I don’t have the need for the methadone I will not be returning to see him, but am considering putting in a complaint or giving him a piece of my mind.
I apologize for the extreme length, but wanted you to know as much as possible.
A huge thank you for reading and providing any feedback.
Scot
i have been taken 15mgs of methadone for 4 years, recently started sob-oxen film at 24mgs per day.
i feel better, but the first few days were rough. I think my methadone days are over,,
i HAVE GREAT INSURANCE, I pay $20 for the doctor visit and $1.92 for 60 strips. Even the pharmacist mentioned that was the least expensive he’s ever witnessed..i have medicare part A, B,and D
Thanks for sharing Joe. I’m glad you got through the rough few days and are feeling better now. And that is CHEAP Suboxone! Good for you!
Thank you Matt for the reply. I do have a question. The transition was relatively painless, due to the fact I was only on 15 mg of methadone (pill form) the doctor who has me on saboxen/ naloxen films 3 packs a day which is 24 mg. Is kind of high? Or is that a typical starting dose ? I’ve been going on 2 weeks clean of methdone, with no problems except I don’t get that little euphoria it gives you in the morning. Also coming off methdone now I notice and my wife notices I’ve lost some water weight especially in the face. I know for a fact Opioids makes you bloated. My doctor will be writing 90 films tomorrow to last for the month. I’ve heard of some nightmares on the cost of 90. My prescription says your insurance saved you $324.00 last week, and that’s only for 21. No matter what the amount I pay $1.92. What a blessing this is. I have Medicare Part A, B and D and that’s were WellCare picks up the cost for one year..thanks
Dr i just have been taking methadone for three days 20mg do i still have to wait 72 hours to start the suboxon
It’s really about seeing what you rate on the Clinical Opiate Withdrawal Scale (COWS).That is a low amount of methadone and since only a short dosing period, if you have a fast methadone metabolism you may be able to take it earlier than the 72 hours.
I also recommend reading the following article which should help you gain a lot more clarity on when you can safely take Suboxone:
How To Use Suboxone For Opiate Withdrawal>>
I am getting ready to switch. I’ve seen several people asking g about the question I getting ready present, yet you nor anyone else has addressed it.
ONE DR AS ALMOST ALL THE OTHERS SAY TO GO WITHOUT METHADONE FOR 3 TO 4 DAYS, MY HUSBAND FOUND A DOCTOR AND HE SAID THAT’S NOT NECCESARY THAT THE SUBOXENE CAN BE INTRODUCED IN SMALL DOSES OVER A FEW DAYS, MYSELF LI,E OTHERS ON THIS THREAD ARE CONFUSE AS YO HOW THIS IS POSSIBLE WITHOUT SEVERE WITNDRAWL. WHAT IS YOUR PROFESSIONAL OPINION AND/OR EXPERIENCE WITH THIS METHOD? THANK YOU IN ADVANCE.
I am a chronic pain sufferer with neuropathic pain after knee surgery.
I’ve been on methadone for 3 years and am convinced it is making me sick .
I have tapered down from 100 mg a day to 5 mg a day by myself and am having trouble going the last bit . My Dr is switching me to suboxone .
My unusual situation is that I ended up taking methadone 5 times a day ..so I must metabolize it very fast. My question is how that might effect my transition …..my Dr and I are going to use a withdrawal,score card to measure my withdrawal symptoms and then the suboxone dose will be triggered when I get to a certain score . The dr is guessing that because of my fast metabolism , I will go,into withdrawal more quickly and might be ready for the suboxone at around 48 hrs .
What are your thoughts on this unusual situation ? Low dose and odd dosing interval? Also I have been using short acting hydromorphine for break through pain…I presume I can continue to do,this while on suboxone ? My plan is to taper off suboxone and then find a different pain med to be on ..opioid probably as nothing else works but in low dose.
Thanks
Alan
Hi Matt,
I stummled across your page looking for any literature about what my Primary Care NP had said she feelsm the most comfortable that I do along with the Medical Director of where I got form Primary Care amd have simce been referred and just begun 2 weeks ago one of the newwer Hep C meds that is for 12 weeks and zero side efects so far. So she is awesome for making this happen. Also she had me referred to Vascular Surgery and the wound climic for a few wounds, one the has been trying to heal a year and then managed to habve a varicose vein burst on the bottom side of my R foot that was very painful and I had surgery, Ablation of the greater Sapheous vein due ti valve damage and por perfusion back up to my heart, i know ha two small ones forming on the leeft ankel but the right one due to me living alone and haveing to get to my methadibe clinic daily , and make all tyoes of appts my wounds hurt at 8/10 when no pains meds due to my doctors wrong that the 155mg of methadone should take care of it. I had to basically beg for a few percocet which helped very little, and after months or crippling pain and not being able ti stand or walk Ive convinced he my pain in huge.
So my point is this, My legs, feet, mental health and all around every day chores I can no longer do without streamer pain and feeling like I don’t want to be on this planet. NO I”M NOT SUICIDAL AND DON’T HAVE A PLAN. i just miserably and depressed because i wouldn’t be healing even after and I cant continue to to all my appointments and the clinic daily via on a bike or on foot.
So I came up with a plan and asked the supervisor if the state allows medical take homes so I could go stay with my parents for a month or so and heal. A lady had same thing went to Respite care and said her inner ankle venous ulcer healed in a month. I got so excited to finally gt off my feet and made a appt and go the supervisor at my clinic who was on board and said all he needs is documentation for primary care and he would send it to the state for approval but he thought it was a sounded like a great plan. So I told my PC and had her talk to my mother who doesn’t drink or smoke and is very responsible,
WEll Yesterday Friday around noon I get a call from my PC saying her and the Medical Director don’t feel comfortable with the plan for fear of overdose and my higher than some dose of 155mg. SHE PRESENTED TO ME A PLAN AS i WAS JUST WAKING UP THE THEY WANT ME TO TRANSITION TO SUBOXONE IN A WEEKS TIME WITH SOME NEW TRANSITION DRUG BUT I WOULD STILL FEEL SOME WITHDRAWALS JUST NOT FULL BLOWN. FIRST OF EVERYONE FULL BLOWN IS DIFFERENT AND i HAVE DONE THIS SUCCESSFULLY TAPERING TO 30-40mg about 8 yrs ago, and when I was 20 years on I did 90mgs in 90 days with 2 weeks of darvacet too help ease off and was successful. But after I fully woke up and said yes because suboxones is my goal anyways its just been on hold for my venous ulcer issues, I realized what the heck was happening. I was going to my parents to heal, at better , not be in pain an now my doctor who doesn’t even prescribe suboxone wants me to sw=itch over in a week???????? CRAZY RIGHT? Well Im scared because when I did the 9o in 9o days I was miserable for 3 months,
what are your thoughts of going from 255mg to suboxone with out dropping my dose over a weeks period? I was on Suboxone for 4 years ans will also call my old doctor but any help is needed now. I know this was long , but I want to give you a point of reference, I don’t want do this with ll my other health issues, suggestions> Thanks for reading if you made it this far! Take care and keep up your awesome service.
Warm Regards,
Angela Lyman
I’m currently transitiotioning from methadone to subs. My sub doc doesn’t seem like he knows anything about the switch. He said to wait 36-48 hours. He gave me 16mg a day which I now will be too high already. Yesterday was my last dose of methadone. I’m on 28mg. Took about 25mg in the morning and the rest around 4pm last night. So depending on the cows test I’ll start tomorrow morning by only taking less than 2mg to see if I go into pwd. Obviously I’m terrified of that. I have a three year old and I have to pick him up tomorrow so I’m worried I’ll be sick but I also start work Monday so I have to take my dose tomorrow. I’m feeling ok right now….just a little anxious, heart racing, and a bit achey…but it’s doable. Do most people go into pwds? I know people say to wait 48-72 but my doc said I’d be fine at 36-48 as long as I am in moderate withdrawals.
Hi I’m from valdosta ga. . I’ve been on methadone for about a year and a half now . For the last two months I’ve been wanting to get off of the methadone and start the suboxone treatment because I’m just tired of having to go to the clinic here . They don’t want to let you decrease as you should and the money . I’ve been on suboxone before and I had no problem getting off one for the other but this time I’ve started goin less to the clinic and its been almost six days since I last went to the clinic snd I was on 70 mgs do you think I’ve had enuf time and won’t have a problem switching over . About a month ago I tried after about three days andcit put into severe withdrawal. I had a very bad expeirience . What do you think . Should I wait or try a very small dose .
Roger,
Switching from methadone to suboxone can be very tricky, if your methadone dose isn’t 30 mgs or below. At 30 MG methadone, the recommended wait time is 72 hours. It’s best to see your Suboxone Dr. and discuss this and he/she will check your COWS score which can guide them in dosing you with suboxone. If you are using short acting opiates to keep you out of methadone withdrawal, you must stop taking these for close to 24 hours before the Dr. can determine an accurate COWS score.
~Mary
OAS RECOVERY SPECIALIST
I am currently on 100 MG of methadone. I’m looking to make the switch to suboxone. If I continue to take the 100 mg dose until Saturday and take a 40 mg dose on Sunday would I be able to switch to suboxone on Thursday? Thanks.
Raul L,
Honestly, that is a tricky one. The recommendations for switching are to be at a dose of about 30mg methadone and even then to wait approximately 72 hours. Since you are only taking 40mg for one day, you still have a buildup of methadone in your system from the previous high doses, so I think that it is a risk that I’m not sure that Id take.
~Mary
OAS RECOVERY SPECIALIST
I am currently on a 100 mg of methadone. I’m looking to make the switch to suboxone. My suboxone Dr wanted me to be at a dose of 40 mg first. If I take my usual dose of 100 MG until Saturday and than take a dose of 40 mg on Sunday. No methadone on Monday, Tuesday, and Wednesday. Would I be able to switch to suboxone on Thursday successfully?
Raul L,
That’s pretty risky. Ideally tapering to 30mg and being off for approximately 72 hours is the recommendation. If you had done a normal taper then you would probably be fine.
~Mary
OAS RECOVERY SPECIALIST
I’m looking to make the switch to suboxone from methadone. I’ve been on methadone for almost 7 weeks. I took a last dose of 100 MG of methadone on Sunday at 12 noon. Will I be able to switch to suboxone on Thursday 4 days later? I will not be taking any methadone Monday, Tuesday or Wednesday. Thanks
Carlos,
In my opinion that is risky to try. The recommendation of approximately 72 hours (3 days) wait between this switch is based on a dose of 30mg and below. Sure, some have switched and had no precipitated withdrawal but others have not.
~Mary
OAS RECOVERY SPECIALIST
If I take a detox drink will it flush the methadone out faster for me to get on suboxone and finally get away from methadone?
Carlos,
Many of the “detox drinks” are simply ways to disguise the opioid metabolites and not so much as ridding the body of the medicine. There is a scale that Drs will use to determine if the withdrawal is advanced enough for buprenorphine induction called: Clinical Opiate Withdrawal Scale (COWS). Here is the link to the pdf: http://www.naabt.org/documents/cows_induction_flow_sheet.pdf
Methadone
It is recommended that patients transitioning
from methadone to Buprenorphine slowly
taper to 30 mg./day of methadone, for at
least one week. Last dose must be no less
than 36 hours prior to induction, and may
be 96 hours or more. A minimal score of
at least 5 on the COWS is recommended,
although some physicians prefer scores
of 15 or higher.
Patients transferring from methadone or
another long-acting opioid to Buprenorphine
may experience discomfort for several days
and dysphoria for up to 2 weeks.
~I hope this helps!!
~Mary
OAS SPECIALIST
I’m commenting here cause I’ve just hit the 24 hour mark of my last dose at 40mg which ive been on for 6months a that dose. I’m getting worried after reading these stories I might get precipated WD. I start the suboxone at 10am Wednesday morning. Thats what the doctors suggested. Now they actually only wanted 36 hours but being I’m 5mg above the dose they wanted I figured 55 hours would be ok. I know you cant possibly know my body. But does it sound suitable as long as I’m in withdrawal
John, I just wanted to check in and see how you did. Were you able to make the switch without getting sick? I’m also switching to suboxone, but my doctor wants me at 20 mgs. I’m currently at 26. It’s getting tougher. Can you please let us know how you did? Thanks!
i want to only take suboxone for 2 weeks to get through the methadone withdrawl and then stop before i become dependant on suboxone….how do i start my dose and how do i cut my strips to taper in 2 weeks time…someone please help me?
I take 95 milligrams of methadone everyday but would like to switch to Suboxone. All of the research I’ve done online shows people tapering down to 30 or 40 milligrams before the switch. However, my clinic wants me to stop cold turkey, come in three days later in withdrawal for the first dose of Suboxone, likely just 8 mg. This sounds brutal and it’s making me consider whether or not to switch to Suboxone.
My clinic has a new director who I really don’t like. Nowhere in our patient handbook did it say that we couldn’t drink while on methadone maintenance. Obviously I shouldn’t but it didn’t state that it was a matter of compliance so I dropped from Phase 5 to 3 just like that! (I had 2 hot U/A’s for alcohol and was told about them simultaneously.) When I brought this up to the clinic director she thrust a print out (that she had just printed) at me and said, “Here read this because it says you can’t drink!” I said “Yes but it wasn’t in the handbook” and I started to get a little testy and she threatened to throw me out of the program. I pointed out to my somewhat sheepish counselor that I never made any attempt to hide my drinking so obviously I didn’t think I would lose phases over it. Based on this new “less caring” environment, I’m considering quitting methadone cold turkey and using marijuana to get through the withdrawals – – fortunately I live in Colorado where pot is legal and there are any number of edibles available if I don’t want to smoke.
I would be grateful for any HELPFUL input or advice anyone here might have for me. I don’t need sanctimonious or holier-than-thou comments however.
Do not stop methadone cold turkey. There isn’t enough pot in Colorado to stop withdraws. I’m in methadone withdraw now have been for 14 days my Dr gave me ms cotin 60 mgs an they are barely helping i go tomorrow an am Probaly still not going to get my script of subutex he is wanting me to have the methadone completely out of my system which seems to be bullshit to me. Anyway don’t go cold turkey unless u want to get back in dope!!
Lee here is my best article on getting off methadone that I encourage you to read:
How To Get Off Methadone Without Withdrawal
And here is an article on marijuana for opiate withdrawal:
Marijuana Eases Opiate Withdrawal Symptoms
Just weed is not going to cut it with methadone withdrawal. I experienced this personally and it was the worst I have ever felt in my life for about 6 months. I wasn’t on a program either so I was only taking about 5 mgs a day n it was still horrible. You’re going to need some kind of benzo and weed at least to deal with the withdrawal.
I have been going to a MMT for 3 years now, was on 80mg for the first year and then have been tapering fast, then stopping and “stabilizing”, then 3 mg every other week, then 2 mg every other week, then jumped up 10 mg from 34-44 because my counselor said a few mgs woudldn’t make me feel any better since I was feeling emotional and craving xanax to help me sleep. BIGGEST regret I gained all the weight I lost of on Methadone. So now I’m on 30mg and am seeing a DR. for subtext in El Dorado Hills for $300 a month with it all reimbursed due to my insurance. Receptionist and doctor were very helpful. They said the LOWER the methadone mg the better because the easiER the transition will be. He will even prescribe volume or xanax and some vitamins based on what he thinks is best during our consultation next Wednesday July 13th. Then a couple days later the brutal 72 hours off methadone… I’m a baby 1 full day I am sluggish and not very friendly at all. I really hope this works for me, I’ve asked my clinic multiple times over the last 2 years with 3 different counselors and nobody knows anything, and continue to tell me they will ask for me. But blessing in disguise instead of 30-40 minutes now just 5 minutes.
I too think I need to request off work or at least the last couple days when it gets brutal.
Moral of the story I am no professional, but I think the lower the easier the transition can be but it will never be easy. The most important thing is to wait those 72 hours and see your doctor and they can dose you appropriately every few hours until you feel better (if it works for you since I know it’s not for everyone.)
Can’t weight for these methadone side effects to go away!
KELLY
Kelly,
I know the transition from methadone to suboxone (subutex) can be difficult but the longer wait is necessary. I remember a patient from my group who switched too early and the withdrawal was horrendous. My friend who went from methadone to suboxone said that she took short acting opiates (oxys) during the waiting period and stopped those close to 24 hours before suboxone induction. She didnt have any problems. Good Luck!!
~Mary
My last dose was March 21st, the director of the clinic I was going to printed out a consent form that I never saw and it didn’t have my signature, and it was for her to discuss my business with another patient. I called the headquarters and he said “she runs a good clinic!” I asked him, so she is in control of my health and doses, he said “YES!” my husband couldn’t believe it, And my husband said “do we need to get an attorney?” well I saw the nurse practitioner and she dropped me 5 mgs for no reason, and she said I will see you in a month, the next day the director found out I called the headquarters and said it will be my last dose and I can’t go to any BHG clinics, they put me through hell and i only missed 5 days in 3 years, my sister passed away and they made me dose. Just go in their cause it sucks even with some good smoke and my benzo script but thanks to the director, I know where to get a wafer…..but pay 40 for one. There should be a law against shady directors to have control of our well being, cause people are scared to say anything cause they know you gotta have your dose to get by, and they use that for their gain….I think they are worse than the dealers I got my h from cause at least they never handed it to me for 3 years and all the sudden think they have an doctorates in MMT physician, and involentary discharge me from the whole state cause only BHG here in my state. I’ve tried to get some answers, and even my medical records and the director refused to give them to me
TL;DR “What’s the fastest you’ve heard that someone can safely taper without experiencing debilitating withdrawals?” or “What’s the fastest doctors recommend for a taper?”
Hello!
I’ve been on Methadone for about 6 years now. I was planning on tapering in 2014, I had it all worked out with my counselor & doc & I was very ready. The day I was supposed to start my taper they did a routine pregnancy test & were surprised to find that I was pregnant! Lol
I had no idea that I was pregnant & I had never been pregnant before, so that was an adventure. đ
And of course I couldn’t taper because it could cause miscarriage. So i had to wait. My son was born in Jan 2015 & I finally started my taper about 6 months later. I started out at 110mgs & have been tapering 2mgs every 2 weeks. Now I’m at 75mgs & I’m getting really impatient. I have terrible side effects from the methadone. Extremely excessive sweating, fatigue & weight gain. My son will be walking soon & spring is here. I don’t want to spend another summer feeling sweaty & tired. I want to be able to run around & play with my son.
So my question is. How fast do you think I could taper down to 30mgs so I can make the switch to Suboxone? I’m going to be talking to my doctor at my next appointment but that’s 3 weeks away. I just want to know what to expect so I can plot it out on a calendar & see when the earliest & latest dates for switching might be. I know you can’t give specific dosage info for people on here, so what’s the fastest you’ve heard that someone can safely taper without having too bad of withdrawals? I have to be able to take care of my son, but I can tolerate some discomfort. I’m not worried about cravings causing relapse. I’m a different person now & I have my son. I would never risk his safety & wellbeing. Even if I didn’t have my son though, I still wouldn’t relapse. That’s what Methadone did for me, it gave me stability so I could distance myself from that lifestyle & learn to live a normal healthy life. If I have cravings I’ll probably just binge on ice cream. I have my husband who can help while I’m waiting the 72 hours between my last dose of Methadone & first dose of Suboxone. And of course I’m not looking forward to feeling crappy for a few days, but I’ve been on Suboxone before so I know it’s worth it to wait.
I just want to switch to Suboxone before summer is over so I can at least enjoy some of it with my son.
Sorry for the long post. And if you made it this far, thanks for reading it all. lol
You’ve probably already figured out a plan, but as we have similar situations, I thought I would let you know what I just did.
I was on 120/day of Methadone for 5-6 years. I tried stopping cold turkey to switch, and that was horrendous. It scared me so bad, that I didn’t work up the courage to switch again until a year later. The fastest my doctor said I could go down was 10 mg per week.
However, Due to my take homes, the nurse let me go down 15mg the first week, and then I went down 10 every week from there, until I got to 45mg. I then dropped another 15 down to 30mg, and stayed at that for 4 days.
I took my last dose of 30mg on Sunday at 3am, and dosed with Subutex at 10am on Tuesday (about 48-55 hours from my last methadone dose). I did not have any precipitated withdraws, however, the first few days were very tough. I don’t know if it was the methadone still coming out of me, or just because my subutex dose wasn’t high enough yet.
I started to worry that subutex would no longer work for me, but as I got to 24mg, and let it build up a few days, I started to feel amazing again.
I will say that the methadone detox was not nearly as bad as I thought it would be, but I did have some tough days. I did stop the detox once, around 75mg, to let my body adjust for an additional week though. Don’t forget that, if you ever want to stop the detox, detox at a slower pace, or even go back up, you can. Although I was scared, I was very impatient, but knowing I could stop it or go back up at any time gave me peace of mind.
I don’t have children, so I’m not sure that once you got lower, if going down 10mg per week would be too much. Try different things out, and see what works for you.
Hope this was helpful.
(Sorry for the long Read. Lol)
Good Luck!
I’ve been on Methadone for almost ten years. In 2011, I dosed all the way down to 2mgs and went through the withdrawl process. I was starting to feel somewhat better after about 2 weeks. I ended up being on the back of a motorcycle and we were hit head on by a car. I then relapsed from taking pain killers for my back pain. I eventually went back to methadone spring 2012. Recently, I had been tapering down off Methadone at approx. 2 Mgs a week. I got down to 28 Mgs and at that point I felt I was ready to make the switch to Suboxone. I want to be free drug free once and for all so I’m hoping the suboxone will be a good way to adjust, taper off and be completely drug free.. I took my last dose of methadone on Tuesday morning. I went Wednesday and Thursday with nothing. It was difficult but I was determined to make the switch a good one. I was terrified to be thrown into precicated withdrawl. I waited approx. 50 hours, by that point I was in substantial withdrawl. I was still scared to take my first dose of suboxone, fearing that I might be thrown into precicated withdrawl or that I wouldn’t feel right on suboxone. I started slow with only 2mgs of suboxone. I started feeling better within mins. I waited a few hours and took 2 more Mgs. Then a few hours after that I took 2 mgs for a total of 6mgs all day. I felt pretty good considering my body and mind was trying to adjust from being in withdrawl for two days, lack of sleep and the change in medication. I slept well last night for the first time in 3 days. This morning I woke up and took 2 Mgs and I’m feeling really good. I feel like I’ve made a good switch towards sobriety.
I have a question.I am on methdone and have thought about switching to suboxone.I am also on pain meds(percs).Can I be on pain meds while on suboxone?
No u can’t take any opiates while on them or it’ll actually backfire n throw u into withdrawal.
I am on 70 milligrams of methadone right now I’m trying to go into a program because I have continued to use heroin I am having a problem getting into a program because I am on the methadone I need to go into a detox but I don’t want to tell them I am on the methadone I haven’t taken my dose in four days and the detox that I’m able to get into only gives suboxone now I have been using heroin in place of my methadone obviously for the withdrawal reasons am I going to have to be worried about any of this crazy s*** that I’m reading
I don’t know how your body is going to respond Christopher, but I’m happy to hear that you’re trying methods to conquer your addiction. I wish you the very best.
Maybe not!!! If I couldn’t get my opiate 1 day I would take suboxone 2 keep from getting sick. It had only been overnight since I’d had opiates. However, my sister mixed them w speed n it threw her into horrible DTs.
Hey. So, I was just switched from methadone(27ml) to suboxone (2m) three days ago. I have it split into 2 and take only one a day as I am trying to taper off it all. I feel lousy all the time but really want to be done with it all. How long should it take to get off completely.? Am I feeling so badly because I’m wd from the methadone, I don’t want to take a higher dose because I’m so low right now and don’t want to take even longer. How long should each taper dose go for? Thanks
I come from Scotland, I am a 59 year old female. Following major surgery 15 years ago I was on morphine followed by dihydrocodene for a number of years and became addicted. My doctor put me on methadone which I have been on for 10 years. I have a drug worker with whom I discussed coming off methadone. I was offered Suboxone. I was painted a picture of this wonder drug that I would feel better than I had in years and they had 100 percent success rate. I thought the answer to my prayers. I was given a 30 hour methadone free window , I was on 30mls. Started Suboxone and within an hour I took a bad reaction but put this down to just starting it. I was to be on it for 4 weeks gradually tapering down, I was never on the maximum dose. I was never well during this period, couldn’t work, couldn’t function. When it came to an end I crashed. I had no support from the drug worker, he accused me of taking something else. He did urine test me and of course everything was negative. I couldn’t bear another day and took an overdose. It was serious as I had to be ressussitated. I was put into psychiatric hospital of which I walked out. Went to a pharmacy and bought codeine based meds. The pure relief to my body and mind was immense. My doctor has now prescribed a small dose of dihydrocodene to taper off gradually. The whole experience was a nightmare. Had I known I would have stayed on methadone. This is 6 weeks later and I just want to get better. This has been my story.
I think the reason you had such a bad reaction was that they started you on the Suboxone way too early & put you in precipitated withdrawal.
They should have had you wait at least 72 hours. In my opinion it really is a miracle drug if used properly. I was on it before, they had me wait 72 hours & take a test to gauge the severity of my withdrawal symptoms to make sure I was fully in withdrawal & then they gave me 2mg. I felt better immediately & it was AMAZING. I felt like I wasn’t even an addict for the first time in 8 years. I had energy, I wasn’t sweaty & I didn’t nod out. I highly recommend it if it’s done properly. If you take it too early you WILL feel like crap for a long time.
I hope everything goes well for you, whatever you do. đ
i have been on methadone for 11 years after years of addiction to percocet and oxycontin. Methadone worked well at a dose of 87 mg. i finally thought i would try to taper and be done with it, mostly because of how others perceive me and because $90/wk makes it difficult to survive on my own. the taper was ok, i did 5mg per week till 30mg then 2mg per week to now i just went 3 mg last week and to 1mg today. i have been so sick for the past week, i cant even function. i made an appt with dr for suboxone for monday but i dont know if i should switch. i thought i could handle it, but i cant-i can’t function and it will be just as much or more money. i feel like i have made another stupid decision that is destroying my life. i don’t know if i shld just go back up and be resigned to beibg on methadone forever. any words of wisdom would be great….
Son just switched this morning from 80mg methadone to 16 of suboxone. He took methadone for 7 months. It was abruptly stopped with no tapering. His last methadone dose was 2 days ago. He took first dose of suboxone this morning. 30-40 minutes after dosing he felt like he was in full blown withdrawal. Is it possible that he is? We want to know how long these symptoms will last and if the transition can still be successful especially since he was not tapered off the methadone before starting suboxone. I fear his recovery could fail. Pulse and respirations are normal but diarrhea, vomiting, flushing, agitation, muscle aches, cramps, runny nose, mild tearing were present 3 hours after first dose. It’s now 7 hours post dose and he still feels awful psychologically but physical symptoms appear better although he still denies improvement. How long will this last? Is the new medication blocking any residual methadone that was present in his system? Is that why he still feels so bad?
-worried mother!
What you are describing sounds like buprenorphine-precipitated withdrawal. At the clinic I worked at, as well as nearly all others, patients need to taper down to 30-35 mg and be on that dose for about a week, then wait 3 days then transition to Suboxone. 80 mg of methadone without a taper, then waiting only 2 days to use Suboxone would almost certainly cause precipitated withdrawal. Please read the following article to help you understand this better:
What is Precipitated Withdrawal?
Disclaimer: I am not a doctor. This comment is for informational use only. Itâs not intended to treat, diagnose, or prevent any disease. Always check with your doctor before changing your diet, trying any new supplements, medications, exercise or opiate tapering programs.
So in your opinion do you think his symptoms will improve while using suboxone? I thought suboxone treated withdrawal symptoms but I’m learning that it can cause them. Its so confusing. My biggest question is will it work since the induction was not done properly? Will his next dose be just as hard on his body? He’s due to dose again in the early morning. Thank you so much for the information.
I really don’t know. That was a lot of methadone he was taking, and not a lot of time off it. I don’t know how his body will respond if he takes the medication again in the morning. He might feel good, or might feel bad, I just don’t know and it’s best to have a doctor oversee this transition to avoid these complications. However, just because the induction caused precipitated withdrawal, this doesn’t mean future doses will do that. Although I’ve never seen anyone go from using 80 mg of methadone to Suboxone, as methadone is much more powerful in comparison.
Disclaimer: I am not a doctor. This comment is for informational use only. Itâs not intended to treat, diagnose, or prevent any disease. Always check with your doctor before changing your diet, trying any new supplements, medications, exercise or opiate tapering programs.
He is physically doing a lot better from my observations. He has admitted feeling a little better this morning since the induction on Saturday morning. The transition was prescribed by a doctor but of course he could not be reached over the weekend. I’ve found your blog to be very helpful and enlightening. I’m doing my best to encourage him with factual information so he’ll know more of what to expect from day to day. I read a lot about transitioning to suboxone on the link you provided. It even mentioned a study about patients in his situation, although their dose was 10mg lower than his when they transitioned. For those of you reading this and either considering switching or have found yourself in precipitated withdrawals you should really use the link provided.
I’m so happy to hear about his progress, and I’m also glad you have found helpful and enlightening information on this blog. The more research you do, the more tips you’ll have to help him do better with his life.
I stopped taking 125mg meth 6 days ago can I start taking suboxone now?
Eddo,
Probably not. It is usually recommended to wait 3-4 days but that’s at a dose of methadone of about 30mg. Yours is simply too high to expect the methadone to be out of your system sufficiently so that you don’t suffer precipitated withdrawal. I know many who have switched to short acting opiates long enough for the done to leave their system, and then stop them between 12-24 hours . Are you doing anything in the meantime to keep yourself comfortable?
~Mary
OAS RECOVERY SPECIALIST
yes unfortunately The horrible alternative H!!! When can I go in for the subs?
Heyy I made the switch waited 6 days dropped 10mg’s every 3 days from 160 until i made it to 30 the dr then perscribed me 4 30mgs roxi’s for for dayys and then xanax for the the 6 day and then inducted me on 3 8 mgs a day I only take 6 mg’s I never started that high no way i feel awesome sometimes I only take 2mgs in the morning then 2mg’s at night got my life back thank god I am sso happy i did this Im getting off in two weeks going to start a 21 day taper from 6 mgs i’ve been on for almost 3 months woot getting it back on track thank the good Lord
So I put myself in a program and got on methadone treatment for an opioid addiction after breaking my arm and being put on diludid. I was on 100 mg lost my insurance and couldn’t afford it seeing I’m a single mom of 2 teenage boys and rent and bills. So i detoxed cold turkey
Today makes 7 days off methadone but now the with draws seem the worst. So i too alil less than half a sub strip a friend gave me to help me. I feel alil better still body aches tho. I don’t want to be on subs either but I couldn’t take how sick I felt coming off 100mg of methadone. Should I just use a piece of sub when I’m feeling really bad? How long does this last?
I’m in the middle of full blown withdrawls I took my suboxen too soon and now I’m to scared to take it again in so scared so tired I’ve had five hip surgeries and the kicking of the legs is killing me idk what to do please help I’m so tired I’m so lost and scared idk how much more I can take I’m was on 155mg methodone and stopped all at once cuz the clinic lied to me about me heart I got pissed hot headed said F you and left found a suboxen Dr she gave me a scrip she warned me to wait and I tried but it hurt so bad biggest mistake ever I wanted to just die I begged for help from my husband he felt so helpless idk what to do or she to try the suboxen again in almost on day 4 just 8 more hrs and it will be day four.
c. curzio
I have left my question 2 times and it disappeared both times?
Hey Lizzy. I just looked into this, and it appears that only some comments are coming through. Please email me at the following address and I can answer your questions. Sorry for the inconvenience, and I will fix this issue as soon as possible.
finchy444@yahoo.com
Sent an email, thanks!
Just sent your email back Lizzy! Have a wonderful night!
I’m on 15mg of methadone which I haven’t had for 2 1/2 days, what damage of suboxone should I start off at? Thank u.
Ask your doctor what the right dosage is for you Elaine. Best of luck to you.
take 2 mg first then another 2 mg in 2 hours and repeat till u take 8 mg
Hi, my sister is currently an impatient and a mental health facility and trying to wean down off of the methadone, she’s a 260 miligrams they took her down to 140 2 days ago and today they put her down to 120. Her ultimate goal is to try to get off of it and onto suboxone. I feel like this is not going to happen. After reading most of these replies and your article I am so discouraged.
She is inpatient due to a suicide attempt after our mom died. She is also bipolar, is on Depakote and seraquil and klonopin? And that high dose methadone. I feel like these drs are helping her feel numb, that how she looks…in slow mode, freezes, her head drops. Any advice? She begged them today to help her get off and they said it will take a year or more.
That sounds like a lot of medication she is on. Very powerful combination, with many co-occurring disorders. I wish the best for her, and it must be hard to lose a mom. If they said it will take a year, you could always get a second opinion. I would never let someone tell me my fate. At the clinic I worked at, they would do rapid tapers if the patient desired one. If she is that depressed on all those meds, and her doctor said it will take a year to switch to Suboxone, you always have the option of switching treatment centers.
Matt i made the switch to suboxone. Im not sleeping much i tapped down to 30mg of done. But my doctor only wants me to take 4mgs. A day, i don’t feel right im very tired man. On an other reply someone was talking about kratom. How does that work. After subs or b4 subs. And i don’t know what else to do. To get my life together. I’ve looked and looked. You know what you are talking about.
Here is a link to the kratom article:
How To Use Kratom For Opiate Withdrawal
Id like to know something, I here different answers on how the naloxone works in Suboxone. I hear the naloxone is not gonna do anything as far as throwing you into withdrawl unless it is injected. I tried to switch from the meth to sub and was thrown into the worse withdrawl within 15 min of taking the suboxone tab under my tongue. I hear that Subutex will not do that if you wait the proper time to get most of the meth out. I have 5 (8mg) tabs of Subutex and about a months supply of suboxone(8mg tabs) which I got from the Doc the last time I tried to switch and it didnt work out. The Subutex I acquired on my own. I just wanted to find out about the Bupenorphine, I also read that alone will knock any meth out of your system immediatly out of your system. Why cant I get a solid answer on this. It varies from site to site or person to person. I would really like to know so I can mentally put my self at ease if the Subutex wil work better for the first few days. I dont want to mess this up because I went through alot to locate some subutex. Once I switch Ill go back to a new doc and get the strips I guess. The doc that gave me the suboxone a year ago is just a piece of crap. Hes probably not practicing anymore due to his behavior. Ok, ANYWAYS can somebody tell me that has EXPERIENCED taking the SUBUTEX and switched from meth. I need to get off of the meth, makes my life miserable, sweating, tired, feel like im 90 and going to the clinic every week when I can get the sub by the month with 1 visit. Ive been clean for 6 years and Im on 45 mgs of meth now. I just really need to find out if the Bup will clean you out or is it the Naloxone? HELP ME OUT PLEASE
Hi Jake,
Buprenorphine has a high affinity but low intrinsic activity at the mu receptor, the partial antagonist displaces agonist opioids from the mu receptors, without activating the receptor to an equivalent degree, resulting in a net decrease in agonist effect, thus precipitating a withdrawal syndrome.
It is a common misconception that the Naloxone in Suboxone initiates precipitated withdrawal. This is false. The Naloxone can only initiate precipitated withdrawal if injected into a person tolerant to opioids. Taken sublingually the Naloxone has virtually no effect.
Hi Matt, I have successfully been on Suboxone in the past, but had to go onto the methadone when I was pregnant. Now my daughter is 3 and I just recently got down to 30mg methadone, then last Wednesday I had my last dose of methadone and my dr changed me to Suboxone which I wanted, but she gave me my first dose of Suboxone only 12 Hours after I’d had my last dose of methadone, and I haven’t been feeling good. First day, which was last Thursday, I had 4mg Suboxone in morning n had bad tummy pains and chills etc. went back for 4mg more 4 hours later and only felt abit better. I am now on 12mg and still aren’t feeling the best. Mostly cold, cold chills. So what I plz want to know is will I feel better soon? And did the dr do the wrong thing by not making me wait and if so will I get better soon?? Thankyou.
Hi Melony,
I’m sorry you’re feeling so bad. The doctor where I work makes people on methadone wait 48-72 hours after their last methadone dose before switching them to Suboxone. Otherwise, doing it while they are not in mild withdrawal can cause buprenorphine-precipitated withdrawal.
I hope you feel better! My prayers go out to you!!! Congrats for all that you’ve achieved. Take care.
No idea if this is still active or answered or not – but here goes. My first post/reaching out. So I have been on the LOVELY MMT for about 6 weeks (at 80mg). I had a couple dirties, which were completely my fault, but started to do better – when my counselor dropped a bombshell on me. Out of the blue she said I could either start going to a Celebrate Recovery Program (9 monthes lon, that costs $100 a week on top of MMT fees) 3x a week, with a 45 min drive each way (and I have a 6 month old daughter…so this means my fiance gets to totally take care of her while im gone 3x aweek) – or she would push to discharge.
Anyways, that was not an option, so I called a really kind doctor and got an appointment for Sub. Time taking it, I know it was too quick, but about 33 hours after methadone dose. I definitely had some bad withdrawal first evening/night, second day just was so tired and weak I couldn’t get out of bed ALL day, I didn’t feel quite as bad but was bedridden. Now this is the 3rd day and I am feeling better, but still not 100%. Lack of motivation/energy seems to be the most common effect, although ive managed to at least be up and about and eat since about 6AM. The withdrawal type of effects seem mostly gone, other than feeling really cold and low energy. My induction Sub dose is around 10mg, it was 8mg/day but that wasn’t holding me due to my methadone tolerance and inability to step down.
My question is, to anyone who has experience anything similar – things ARE getting better, but I am self employed and need to work, and do not want to go back to the clinic! How long is a reasonable amount of time to expect to start feeling better/stabilize/normalize? I will say I am a fast metabolizer of methadone, within 24 hours I am always feeling withdrawal. Thanks in advance for any responses!
Hey Matt,
I have a few questions. I moved to a new state and the methadone is SO EXPENSIVE here I can just not afford it anymore. The highest dose I got up to was 50mgs and I was only going to the clinic for 2 months. I tapered down to 38 mgs. I decided to go cold turkey and switch to suboxone. I’m on day 4 with no methadone. Other than goose flesh and a little restlessness at night and lower energy I don’t really have much of any withdrawals symptoms. I’m wanting to switch to sub but I’m not going into withdrawal enough according to COWS assessment worksheet to introduce it. I’m just really confused as to what is going on. Is it because I was on it for a short time? Will it get much worse. I have researched so much and am not finding much of anything. Any knowledge or advice you have would be great! Thanks!
Hey Karli,
Thanks for reaching out to me. When coming off a dosage of 38 mg methadone cold-turkey, the symptoms can least anywhere from a few weeks to a few months…or even several months or longer, depending on the individual.
The Suboxone will help, obviously, though they cannot put you on until they are sure you are not at risk of going into buprenorphine-precipitated withdrawal. But that arises another dilemma: Now you’ll be on Suboxone and will have to get off that medication, which can also be quite difficult.
Karli, this website has everything you need to know to get off opiates, and get off medications as well. I’m going to post a few articles I believe you would greatly benefit from reading:
Methadone Withdrawal 101: How To Beat Withdrawal
DLPA: A Miracle Supplement For Opiate Addiction Recovery
How To Get Off Suboxone Without Withdrawal
Study this website as much as you can and the answers you seek, you shall find. Please keep in touch with me and I would be honored to help you along your journey. You’re not alone in this. Take care.
Hi Matt,
I have been on methodone for the past ten years for chronic pain. I have suffered through the sweating, runny nose, and such anxiety I can’t leave the house most times and only now that I am tapering have I discovered that these were caused by the methodone! The prescribing doctor is a pain specialist and when I complained of these things he said the sweating is “dose-related” and prescribed benzodiazepines for anxiety. I took that to mean that I was taking too high a dose of methodone (40 mg per day) and that I am a,crazy, weak, lazy person. Thanks in great measure to your site, I see things differently.
I have been tapering down for the past few months and am now finding my “threshold” at 4mg per day (2mg every 12h). I will be seeing the pain specialist again in about 10 days and his plan is to put me on the butrans patch (no naloxone). I am really not in much pain and would rather not take anything at all for awhile. My question is this: given your experience with clients who have discontinued their methodone, which is the safer, healthier, gentler path â kratom or buprenorphine? I have ordered Calm Support and DLPA and plan to follow,as much of your methodone-without-withdrawals protocol as I can. So far, with only extra vitamins and minerals and a bit of meat protein I am experiencing mild withdrawal symptoms.
Thanks for your amazing information and guidance!
Hi Barbara,
Congrats on tapering down to such a low methadone dosage! That’s simply amazing, and I commend you. Also check with your doctor before trying any new supplements of course, but in my experience people generally have better experience using kratom for short-term transition off methadone then buprenorphine,
Glad you are trying to follow the protocol as much as possible. It’s a pretty awesome plan! I’m really glad to read about you experiencing only mild symptoms from the strategies you’ve been implementing. Good for you!
If there is anything else I can do to help you along the way feel free to ask me anything. I am sincerely here to help and I would love to be updated on your progress. Take care and hope to hear from you soon.
Thanks Matt. I am lucky to be only dependent, not addicted, to the methodone, so that is huge. I am prone to distrust anything that comes from a drug company now so I will be trying kratom when the time comes (if I can build up the courage). I suspect the withdrawals will make courage a non-issue, though.
Your generosity is a blessing. Thank you.
Hi
my daily dosage of metadone is about 10 mg.
I have two questions.
How many days I need before switch?
What dosage of sublingual buperonorphin is good for me.
thanks for your time.
Hi Lee,
Depending on the doctor that is prescribing you the medications, he might make you wait between 48-72 hours, closer to the 72 side. Also, everyone is biochemically unique, so there is no way for me to know what dosage would be good for you. Your doctor will know this.
Take care.
I’ve been on a 100mg of methadone for 3 years. I am wanting to switch to suboxone to get off methadone because of the nasty clinic I have to attend and to eventually come off everything all together. I’m scared. I just started a nice paying job in law enforcement and I feel if anyone finds out about the m’done I will be fired and my dreams will be flushed down a shit stained toilet!!! Please let me know if the switch is worth the risk of withdrawel? Thank you.
Hi Sunny,
95% of my patients enjoyed the switch from methadone to Suboxone. Most found it to be a very easy and smooth transition. The doctor will have you get to a low enough dosage where the switch won’t cause withdrawal symptoms.
The only issue is the doctor will have you wait a couple of days after your last dosage of methadone before taking the Suboxone to avoid the chance of going into buprenorphine-precipitated withdrawal. Some people freak out over this, though I noticed it was usually just fear, and the many that did found it to be much easier than they thought it would be. Hope this info helps you. Take care.
in very SCARED now Down to 40mg of methdone i must wait til detox begins as i took to much an put me in full detox,i wait 72hrs?Will i be very sick?DR says il take subutex in 3days,does that sound correct
Hi Ruby,
You can do it! Just listen to your doctors orders and you’ll get through this.
I am on 65mg a day of methadone. I have been on this same does for four years and I’m so ready to make the switch. I’m scared though. I have done so much better and got my life on track within these 4 years. But I’m at the point of feeling sloppy everyday and I want to stop feeling like this. Do yoy think it will be easy ? I took suboxone before and liked it but I never stopped doing other things. When I got on methadone I stopped doing other things. So I believe I have that mindset of controlling myself if I do take suboxone. What do you think ?
Hi Joseph,
I’m so happy to hear you have put your life back on track while being on methadone. Many of my patients on methadone made very easy and successful transitions to Suboxone. There was only 2 patients out of everyone that decided to get back on methadone after switching to Suboxone. They told me they liked the effect of methadone better, and were nowhere near sober, nor were they ready to get off medication.
If you have the right mindset the switch is easy, and most patients tell me they like being on a weaker medication with less side-effects after they switch.
Listen to your heart. Don’t be afraid. Do right, fear not! Study the articles on this blog as there are many natural and healthy ways to help you get off opiates and medications for good.
I made the switch yesterday. I got down to 30mg for a week like the dr told me too. He didn’t ask me to stop completely tho. he put me on two 8mg strip a day witch might be to high. I go back in a week for a follow up. The only issue I’m having as far as withdrawals is just muscle cramps and aches. I’m still eating and sleeping like normal. He told me that within 72 hours the suboxen will have won the fight and it will take over.. I hope so. It’s best to go to a dr. So you can get a months supply. Especially if you have insureance. The dr visit is expensive but we’ll worth it.
Hi Victor,
Congratulations on making the switch from methadone to Suboxone. Having a month supply to take at home sounds like it will really benefit you. Thanks for sharing your experience. I believe it will help others who read it.
Hi victor, so can u plz tell me are u saying ur dr didn’t make u wait anymore than 12 hours after ur last dose of methadone to start the Suboxone?
I wish someone would answer this and how this could even be possible.
So I have a question after reading your post,I know it’s old but I’m doing the switch on Monday, I have been on a 65 mlg methadone a day and in the last week dropped it to 30 so Friday will be my last dose then Monday at 10am I have an appointment to see the suboxen dr. From what I understood you had to be clean from methadone for 48-72 hrs before you take the suboxen but in your post it said your doctor didn’t make you do that,and you didn’t get severely ill with withdrawals? I’m a mother of a five year old and a wife and I have a large house to run and I can’t be ill for days before taking the suboxen so I pray that is true and I can switch like that. We will see what the Dr says I guess. Thanks for the info đ
I’m on methadone and want to switch to suboxone asap my clinic isn’t working with me to taper down its like they don’t want me to switch. My methadone dose is 160 witch is high but getting on the clinic I was told otherwise is there any suggestions you can make ?
Hi Anthony, my name is heather. I am from Bronx Ny however I have just moved here from Manhattan ‘I’ve been on 3 PG’s since I’ve been here,unfortunatly I keep getting throw ou. Susspision of selling pilla fights,ect. its not it easy being a white agrio in the S. Bronx/. So now I just got throw off my 3rd pg for azul, witch was not trie,but because I didnt go to my fair hearing they sent me to a program associated with Montifore but only for 2 weeks, untill I found a new PG on my own. I have sent my paper work out to 13 PG’s from Phelam Bay to Spring St. in Soho,mostly programs I’ve been on before thinking they would know me and know im not a violent person, however that didnt matter because none of them want to touch me because of my negative discharge. So my only option left pretty much is to get on Suboxone, I went from cope to Suboxone when I lived in Phili 3 years ago anf after 18 hours, I took a half a strip and after 20 minutes I got up,started cleaning and had no craving for cope,That lasted for about 3 months untill I got lockrd up for coping and by the time I got out of the bookings, I said,excuse my language but Fuck that ,I’m gin to get 4 bags to pop and I bnever went back to Suboxone,so yesterday I bought 10 estrĂas on the street and my usual dos of Methadone is 170 but they put me on administrativo detox and have been takin me down 10 mg’s every 3 days. Now is my first day on 90 mg’s. I can say I feel sick,or enen uncofortable,however when I wake up in the morning I feel it,chile,sweating and when I get to my PG the first thing I do is sin a bag to take the edge off. Sorry, I’ve been ramblyn on. But the real question I wanted to ask is I dont want to go back to the PG tommorow. I want to begin my detox now,by my self. Just get comportable on my couch ,have plenty of sticks by my side and just deal with it .And after the 3 days go to a Dr. who I know will suscribe them to be cause I can aforo to buy them on the street everyday,being I have no job, they say at the3rd day I can go to my Dr. and he can take blood work to make sure all the Suboxone is out of my system, but I’m sayin,”I’ll be so nick by that 3rd day how am I gong get on that train and even get to him? So I guess what my real question is,how will I know Im deffinatly ready to take take the strip ,I know its master when your on cope but IU’m comĂșn of Meth and escarde to death about the reverse reaction witch has happened to me before ,so when you gro this message if you can just get back to me I would really appreachiate it. hvhernet30@gmail.com or you can even call me,Heather (917) 564-5917,thanks hope to here fromyou.
sticks?
yes ive been going to the clinic for 14 yrs n im @130MG which ive been for a long time. At one period my dose was 260mg n my dose feels exactly same as dose is right now. Anyways i dont know what to do as far as needing to switch to suboxone im unable to afford my clinic. Honestly i dnt want to leave the methadone but i have no choive. Ive Medicare which actually covets both suboxone n methadone but good luck to me course no doctors who i guess just dnt wanna prescription its such bu. s.. So guess i need to find out how i am goin to do as far as why do ppl hav to go down on my dose?
Find another clinic, they are ment to support your recovery process not hinder your recovery process. To me methodne was the worst decision I ever made, as I still used oppiots anyway, it just became more expensive and harder on myself and my children. I’m down to 25 on my dose and am making the swap to suboxone next Monday, my last dose will be Sat pm, then Monday at 1pm the swap begins. I can’t wait. Methadone has been like an invisible chain around my throat.