Methadone to Subutex

[quarks]

Hey everyone,

I've been reading posts here for awhile, but it's time I joined. I've been off heroin for 5 years but with help of methadone maintenance program. My highest methadone dose was about 100 mg, but in the past six months or so, I managed to lower it down to 10 mg. Currently, I don't have any problems with 10 mg dose, so hopefully within a week or so, I could drop it down to 5 mg. Is there a difference in withdrawal symptoms if you quit methadone at 5 mg, or say 30 mg? Should I switch to buprenorphine (my adviser keeps on mentioning it and it does sound attractive after some research done), when I'm on such low methadone dose. I don't have health insurance, so I have to pay about $400 a month for methadone. On the other hand, Subutex is almost twice as expensive. That might also be a slight problem. I'd love to switch to Subutex, but I first wanted to know if getting off methadone at this stage (low dose) is a big problem and if switching to subutex would be 'starting from the beginning'. Even now, I have days when I feel just awful mentally, so if I stopped methadone, that might be accentuated. What should I do?

[Peter]

Welcome to the forums.Someone with more experience with methadone/subutex will be along shortly to give you some feedback.

[exjunky]

A long time ago I kicked heroin with methadone, but last year I kicked with suboxone. I found that suboxone maintenance is different than methadone maintenance in a few key respects:

1. It's hard to make the transfer from your current opiate to suboxone, because you have to go through at least mild withdrawals, and the first few doses of suboxone might make you feel worse.

2. Suboxone controls cravings better. With methadone I was always thinking "I'm not on enough! Give me more!" With suboxone I just felt normal.

3. You won't get high on suboxone, at all. But I imagine you stopped getting high on your methadone long ago so that won't be a change for you.

4. In the end, it's always hard to let go of that last little bit. Maybe you would find it easier to let go of suboxone? I did.

(By the way, every time I type "suboxone" it should properly read: "buprenorphine" but that word's too hard to spell, LOL. Subutex, same thing.)

[quarks]

Thanks for the reply.

I want to get off methadone badly, and I have no cravings at all even with small doses. When I made up my mind 5 years ago to quit, that was it. I've been around, a few times, heroin users and never had a problem staying away. Haven't been tempted since getting on methadone. I guess methadone does that. Today, it's even more so. But, I'm not sure, if I stay on methadone, how low on dose I should go before stopping. 5 mg, 2mg? lower? Currently, I'm on 10. I'm a a bit wary of switching to buprenorphine when I'm so close. Then, I'd have to deal with dose readjustment, and all that. But, I'm tempted since I've heard it's easier to get off bupren. What was your lowest dose before you stopped using methadone? Did you take anything else to help you with withdrawal symptoms. Thanks again for the reply. It means alot.

[serenityqueen]

First of all, I want to make a few things clear before I comment. I am on Methadone, have been for nearly 3 years, and have no plans of risking going off of it.(Why try to fix something that isn't broke?) It also helps tremendously with my chronic medical conditions that can cause excruciating pain if I weren't on Methadone so you can see I'm a firm believer in that fact that for some people, it is a huge help in Recovery.

I have not attempted to lower my dose, however, we were just talking about this is group on Thursday. Several people are detoxing off and they stated that once down to a dose like 10 mg, a safe taper, for them, was 1 mg. every 3 weeks. They said they didn't even notice that slow, small drop when they were where you are now. So with this in mind, you may want to be careful and not risk going through any withdrawals now, you've come so far from 100 mg., why chance it now? Also, can't medical staff advise you on safe detoxing? Or aren't you going to a Clinic?

If it were me, I wouldn't switch over to Suboxone or any other med since you are almost off of the Methadone. But that's my opinion, and we all know, opinions are like a$$holes, everyone has one.

Finally, congratulations on a life in Recovery from heroin! Isn't life even greater than you ever could even imagine?

God Bless,
Judy

[Lbad]

I can only share my experience...
I was on methadone for a long time (many years) after a lengthy battle (many, many years) with the needle and heroin and it (methadone) worked... I got off methadone because I wanted to not have to take anything to be ok. I came down from 100 mg or so to 10 in a slow painless blind detox..... Then I stepped off completely at around 2 or 3 and it was rough... big time rough.
I am so grateful that I did though because I then saw what a drastic hold it had on me. I mean my whole body physically, emotionally and spiritually went on a major rampage for months after last dose. Methadone is some powerful "sh*t".. lol
I found out I didn't even know what I didn't know about being completely off opiates.... I never relapsed and I have 5 1/2 years clean from methadone and any other drugs/alcohol. Stay open to that possibility for you too. You are so close to off I wonder why you would switch????

This post is not meant to start a debate with anyone please.. I am sharing my experience and it is my truth...

I also went to lots of meetings.. They helped (still do) too.

Take care and I am always here for anyone trying to get off methadone or any other opiate.... or anything else for that matter.


Life beyond anything you ever even thought about is available to you.....
My life is brilliant today in a way it never was on methadone.......

"There is a principle which is a bar against all information, which is proof against all arguments and which can not fail to keep a man in everlasting ignorance-that principle is contempt prior to investigation."
--HERBERT SPENCER

[quarks]

Thanks for the replies. It gives me a better picture what I'll face soon. The only reason I thought of switching (buprenorphine) is because of shorter withdrawal length/lesser symptoms. At least that's what i was told. I have a job and it scares me to think that I won't be able to function during that phase. I'm going to the clinic, but I take home doses. And, I have to pay over 400 a month. So, that's another incentive to get off it. Another reason is that I'm stuck to this place while I'm on methadone. I can't travel longer than a week or two. Also, I don't want to be on it anymore. Just so there's no misunderstanding, methdaone helped me kick my heroin addiction, and it helped me straighten my life and establish normalcy, and that was great, but it's time to remove the last shackle that's holding me down. Anyway, taking doses home helps me with lowering my dose even faster without rough and tumble. I'll try to bring it down to about 2 mg or so and then stop. Lbad, how long did your physical symptoms last? Able to sleep? I stopped using heroin a few times (before I made up my mind, it was supply failure ) and it was very rough. Sleep is my biggest problem. Last time it happened, I didn't sleep for a whole week, then I managed to get some xanax. I'm also worried about depression. Even with methadone, sometimes, I have to make myself do things that were just a normal routine. Should I try to get some antidepressants, or should I just wait for chemical imbalance to sort itself? Any more details about all this is greatly appreciated.

[Lbad]

Good Morning

((Quarks)) You situation sounds pretty similar to how mine was... That is good. It is always helpful to talk to people who have been where you are going...

1. Physical symptoms lasted a year after last dose easily... but..... they were only really bad for 2 weeks or so... The longest lasting (months) most difficult symptom was sleep. I thought ( I mean really) that I was going insane. I started sobbing in the Dr.'s office and they gave me some Xanax finally and I didn't abuse it and it got me through the roughest spot.
2. Methadone was way harder than heroin physically to withdrawal from in my experience..
3. I would take a week off work if you can.....
A week in bed and then I was able to "function" kind of.. anyway I took care of my children, went to meetings etc etc...
4. Even with methadone I was depressed too. I decided to give life a try. I got off everything and I mean everything and it worked for me. It took some time but my body and mind are fine now very "balanced" and I don't take anything.

On that note I want to state clearly that not everyone's experience with methadone is the same. We all react a little different and detox a little different...

I was open to the possibility that I "could" be eligible for a life free from all of it... I gave it a whirl and voilà... I am and I am ok and my life is beautiful. I never used to believe that something like that was possible for poor me... lol

I know that in my experience I had to be ready for anything... That first year was a roller coaster.. I held on to my a$$ and didn't use no matter what.... I knew that it would eventually get better and that I would not always feel like garbage... I was right too. It did change and I do feel better.

I am grateful for methadone... It saved my life. I am more grateful that when it's job was done I let it go.....

Bad

[bvaljalo]

Welcome to SR.com Congrats on your 5 years clean off your drug of choice, that's quite an accomplishment!

Anyhowz, to your question ... getting off of bupe definitely *is* easier than getting off methadone ... BUT the problem with what you're suggesting is that it's really difficult to make the transition from methadone to bupe, due to the long half-life (and high receptor affinity) of methadone interfering with the efficacy of the bupe. It takes a *while* to effectively start feeling well on the bupe, a week or maybe even two. During this time, you're pretty much in full-blown methadone withdrawals anyways, so you might as well not even be taking the bupe.

The optimal solution to this problem (albeit risky) is to go back onto short-acting opioids for couple of weeks before switching to bupe. Vicodin or Percocet are good options for this. I recommend this approach *only* if you can find a *really* cool doctor who knows what he's doing (my bupe doctor was in fact this smart and cool, having run a treatment center for 10 years) and who won't let you pull any crap.

Once on bupe, since you're on such a low dose of methadone already, you would probably be able to get by on a very low dose of bupe. I'm talking like 1-2mg a day max (which would be pretty cheap, certainly < $400 a month). If you were to get on that amount, and taper down to like .5mg every other day (as XJ did) over the course of a couple months, then quit, I can guarantee what you'd go through would be significantly less severe than what you'll go through getting off pretty much any amount of methadone.

But again, given the difficulty of making the switch from one to the other, frankly, you'd probably be better off just trying to get your methadone dosage down as low as possible before stepping off, then toughing it out.

Good luck in any case, and keep posting ... lot of great support on this site!

[Lbad]

((quarks)) Hope you are doing ok.. Check in when you can...