Methadone 'blip' while on Suboxone - a question?
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Methadone 'blip' while on Suboxone - a question?
Hello all - I have been on Suboxone/Subutex in some form since March 2008. I recently went rapidly down from 20 mg/daily to 8-10mg/daily. Feeling not too bad - just sleepy w/lack of energy. So I was wondering if anyone could share some ESH w/me on this subject. Pretty much maintained at 8 mgs right now and hoping to stay that way until I go down to 4 mgs.
For reasons I won't get into now (but nothing shady), I will be w/o the subs for 2 days here (took my 8 mgs today and am out of town, like a dumbo cannot get my hands on my rx until Sunday.) I do however have access (per my dr) to methadone. I plan on maintaining w/as little as possible (30 mg max) for the next 2 days, and then going back to my subutex, 8 mg/daily. I was wondering if anyone has done an intermediate dose of methadone during subutex/suboxone maintenance tx?
Basically, my concern is whether i will have to wait the requisite 48-56 hrs (or longer!!!) you would normally have to after stopping the methadone (on Sunday -- after taking it only Friday & Saturday) before transitioning back to the subutex? I've heard if you are stabilized on the Subutex beforehand, then you shouldn't have to wait as a long as if this were a typical 'sub induction' when only taking a couple days worth of methadone between - but I'm not sure?
I've tried to contact my sub doctor but have not yet heard back. I really do NOT want to jeaporadize my recovery w/a drawn out w/d and possible relapse (which is the reason I got on the subs in the first place - always relapse w/cold turkey) - so I do feel this is a matter not only my recovery, but of life and death here. No medical advice, I know I need to speak to my doctor - but has anyone been through the same thing? I wonder if I'd be better waiting it out cold turkey until Sunday? I just know how awful I feel when I miss my usual sub dose - and going through the emotional roller coaster I've been on, I feel like my recovery will be at risk. Feel free to PM me if you are more comfortable, as I realize this might be a touchy subject here. Thank you!
For reasons I won't get into now (but nothing shady), I will be w/o the subs for 2 days here (took my 8 mgs today and am out of town, like a dumbo cannot get my hands on my rx until Sunday.) I do however have access (per my dr) to methadone. I plan on maintaining w/as little as possible (30 mg max) for the next 2 days, and then going back to my subutex, 8 mg/daily. I was wondering if anyone has done an intermediate dose of methadone during subutex/suboxone maintenance tx?
Basically, my concern is whether i will have to wait the requisite 48-56 hrs (or longer!!!) you would normally have to after stopping the methadone (on Sunday -- after taking it only Friday & Saturday) before transitioning back to the subutex? I've heard if you are stabilized on the Subutex beforehand, then you shouldn't have to wait as a long as if this were a typical 'sub induction' when only taking a couple days worth of methadone between - but I'm not sure?
I've tried to contact my sub doctor but have not yet heard back. I really do NOT want to jeaporadize my recovery w/a drawn out w/d and possible relapse (which is the reason I got on the subs in the first place - always relapse w/cold turkey) - so I do feel this is a matter not only my recovery, but of life and death here. No medical advice, I know I need to speak to my doctor - but has anyone been through the same thing? I wonder if I'd be better waiting it out cold turkey until Sunday? I just know how awful I feel when I miss my usual sub dose - and going through the emotional roller coaster I've been on, I feel like my recovery will be at risk. Feel free to PM me if you are more comfortable, as I realize this might be a touchy subject here. Thank you!
Last edited by Shellslove; 02-26-2009 at 07:47 AM.
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One time I had to go w/o subs and was forced to substitute oxy's instead in order to get through 3 days until my doctor got back into town. I *really* did NOT want to have to do it, but felt like I had no choice. I ended up only needing about 80mg/day (my habit, months earlier, was more like 240+mg/day) for each of the three days. When I got my subs again, I took them pretty close to immediately. The side effects of having done this were very minimal.
Now, I can't say for certain it would work out this way for everyone, nor can I personally attest to whether or not methadone would work the same as OC's did for me in terms of holding me over w/o causing ill effects when I re-started the subs.
If you're gonna do this, I highly recommend keeping your methadone dose WAY WAY down. And I also think that you are totally imagining 'how awful you feel when you miss your sub dose'. I believe that effect is more psychological than it is 'real'.
I say that because I've had to miss a lot of sub doses in my day for various reasons, and I've found that you really don't honestly even START to feel legitimately 'bad' for at LEAST 24 hours w/o subs. And that it actually takes a good 2-3 days before you get into full-blown withdrawals.
My bottom-line opinion is this: you'll want to do a serious assessment of how bad you're *actually* feeling, before starting on this course you're describing, and absolutely do as LITTLE of the methadone as possible. MY plan would be something like ... wait 24 hrs at least, then *IF* I start to feel really bad (which you honestly might not), take 20-30mg of methadone, ONE TIME, and then tough it out until you get your script. If you keep it really really mellow on the 'dones, I would guess you could go straight back to the subs w/o waiting.
Now, I can't say for certain it would work out this way for everyone, nor can I personally attest to whether or not methadone would work the same as OC's did for me in terms of holding me over w/o causing ill effects when I re-started the subs.
If you're gonna do this, I highly recommend keeping your methadone dose WAY WAY down. And I also think that you are totally imagining 'how awful you feel when you miss your sub dose'. I believe that effect is more psychological than it is 'real'.
I say that because I've had to miss a lot of sub doses in my day for various reasons, and I've found that you really don't honestly even START to feel legitimately 'bad' for at LEAST 24 hours w/o subs. And that it actually takes a good 2-3 days before you get into full-blown withdrawals.
My bottom-line opinion is this: you'll want to do a serious assessment of how bad you're *actually* feeling, before starting on this course you're describing, and absolutely do as LITTLE of the methadone as possible. MY plan would be something like ... wait 24 hrs at least, then *IF* I start to feel really bad (which you honestly might not), take 20-30mg of methadone, ONE TIME, and then tough it out until you get your script. If you keep it really really mellow on the 'dones, I would guess you could go straight back to the subs w/o waiting.
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Thanks B =) I was secretly hoping you especially would have some wisdom to impart! You seem to really know your stuff ....I guess knowledge comes with the journey through addiction and the strive toward a life of recovery. Thank you for your thoughts. This was basically the answer I was looking for (crossing my fingers to get, that is.)
By the way, you are 100% (+ a bagillion) correct about the panic I feel when I don’t have access to subs. I know a lot of the w/d ‘pain’ I feel is more self-inflicted anxiety, which stems from a lifetime of self-medicating. This is actually the biggest problem I had when I started suboxone treatment. I would take ‘bits’ throughout the day, which inevitably led me to take too high a dose. This is the exact behavior suboxone is meant to eradicate, hence the longer half-life. I will say however, I have been able to get it so that I take my 8 mgs in the late AM and try to forget about pills for the rest of the day. If I have ‘pangs’ of w/d or kicky legs - I’ve learned to give myself the 15 mins, and it usually passes – I know it’s in my head a lot of the time. However, when I wake up the next day — I can feel that I am ready for my next dose – and I mean physically! It’s more the lack of energy and the ‘verge of panic’ I get until I take my dose. I’ve tried to get past this — still trying to break the habit. – but I do see some validity to the physical symptoms starting - this is why I’m scared.
I don’t want to be paralyzed with that awful fear – I did it to myself this time and like you said, I feel like I don’t have much of an option here. I have to spend the evening with my family Friday and have a work deadline Tuesday - will be working out here all weekend. I don’t have the option of being useless— and I don’t want to put myself in a weak position where my fears overcome me, I say eff it, and relapse.
Unfortunately, I have no access to short term opiates (hydro, oxy) – only the methadone my dr was able to call in. My insurance won’t allow early sub and being in a rural area pretty much scr^ws me. So I plan on taking, like you spoke of, as small as possible a dose of methadone to get by. I have about 50 mgs worth (in the form of 5 mg pills) – to last me until Sunday afternoon. My biggest fear is a) feeling like shi%* all wknd, the methadone not working, panicking and looking for rx I’m not supposed to and b) throwing myself into precipitated w/d when I go back on the sub. I know you said your transition was nothin’ – I’m worried because the methadone has such a long ½ life. I guess I’ll wait until I feel moderately crappy Sunday night and go from there ---- if P w/d happens, then it does and I guess I’ll have to deal until I stabilize? Made my bed, I’ll lie in it. I just always feel like great– there’s another roadblock – and I can’t slip up again...I’m terrified. :praying
By the way, you are 100% (+ a bagillion) correct about the panic I feel when I don’t have access to subs. I know a lot of the w/d ‘pain’ I feel is more self-inflicted anxiety, which stems from a lifetime of self-medicating. This is actually the biggest problem I had when I started suboxone treatment. I would take ‘bits’ throughout the day, which inevitably led me to take too high a dose. This is the exact behavior suboxone is meant to eradicate, hence the longer half-life. I will say however, I have been able to get it so that I take my 8 mgs in the late AM and try to forget about pills for the rest of the day. If I have ‘pangs’ of w/d or kicky legs - I’ve learned to give myself the 15 mins, and it usually passes – I know it’s in my head a lot of the time. However, when I wake up the next day — I can feel that I am ready for my next dose – and I mean physically! It’s more the lack of energy and the ‘verge of panic’ I get until I take my dose. I’ve tried to get past this — still trying to break the habit. – but I do see some validity to the physical symptoms starting - this is why I’m scared.
I don’t want to be paralyzed with that awful fear – I did it to myself this time and like you said, I feel like I don’t have much of an option here. I have to spend the evening with my family Friday and have a work deadline Tuesday - will be working out here all weekend. I don’t have the option of being useless— and I don’t want to put myself in a weak position where my fears overcome me, I say eff it, and relapse.
Unfortunately, I have no access to short term opiates (hydro, oxy) – only the methadone my dr was able to call in. My insurance won’t allow early sub and being in a rural area pretty much scr^ws me. So I plan on taking, like you spoke of, as small as possible a dose of methadone to get by. I have about 50 mgs worth (in the form of 5 mg pills) – to last me until Sunday afternoon. My biggest fear is a) feeling like shi%* all wknd, the methadone not working, panicking and looking for rx I’m not supposed to and b) throwing myself into precipitated w/d when I go back on the sub. I know you said your transition was nothin’ – I’m worried because the methadone has such a long ½ life. I guess I’ll wait until I feel moderately crappy Sunday night and go from there ---- if P w/d happens, then it does and I guess I’ll have to deal until I stabilize? Made my bed, I’ll lie in it. I just always feel like great– there’s another roadblock – and I can’t slip up again...I’m terrified. :praying
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Also - my dr has rx'ed neurontin for me - though I'm still not sure about it. I know (well, I think =) ) it's technically an anti-seizure (or anti-spasmodic?) that is sometimes used for nerve pain and off-label for several ailments. I've had problems w/RLS forever -- dx'ed yrs before abuse of opiates. This was one of the main reasons I started w/the unfortunate 'self-medication' - RLS can get pretty unbearable -- and many drs don't always get that. I guess the subs are supposed to help the RLS symptoms, and do help a bit -- but my dr has included the neurontin.
I've used Lyrica in the past and it seemed to help ALOT --- but alas, it's a more abusable drug and my dr doesn't think it's a good idea. (though he rx'ed ambien - so go figure. I don't really use the Ambien tho - it scares the wack outta me.) Anyway, I've tried using the neurontin, but it doesn't seem to really do much? I know it's sometimes used as a medication to ease symptoms of opiate w/d -- so I guess I could ask my dr about just upping the dose and skipping the methadone-- but as I said, neurontin doesn't seem to have much effect. Honestly, I DON"T want to treat this like w/d--- darn it, I wish wasn't in the position b/c I was doing really good and I'm scared.
Oh also, B, I think the reason I am having physical w/d symptoms is b/c I literally went down from 20mgs/daily+ of subs daily to 8mg/daily overnight I was determined to get off such a high dose and I have....it hasn't been unbearable but I'm still trying to stabilize and now this!!!!!!!! grr what next?
MAN, I am a whiny grump today, sorry =( The road to recovery seems to have a whole lotta bumps lately!
I've used Lyrica in the past and it seemed to help ALOT --- but alas, it's a more abusable drug and my dr doesn't think it's a good idea. (though he rx'ed ambien - so go figure. I don't really use the Ambien tho - it scares the wack outta me.) Anyway, I've tried using the neurontin, but it doesn't seem to really do much? I know it's sometimes used as a medication to ease symptoms of opiate w/d -- so I guess I could ask my dr about just upping the dose and skipping the methadone-- but as I said, neurontin doesn't seem to have much effect. Honestly, I DON"T want to treat this like w/d--- darn it, I wish wasn't in the position b/c I was doing really good and I'm scared.
Oh also, B, I think the reason I am having physical w/d symptoms is b/c I literally went down from 20mgs/daily+ of subs daily to 8mg/daily overnight I was determined to get off such a high dose and I have....it hasn't been unbearable but I'm still trying to stabilize and now this!!!!!!!! grr what next?
MAN, I am a whiny grump today, sorry =( The road to recovery seems to have a whole lotta bumps lately!
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I give up - I'm so frustrated....been looking on the internet all day to find out...can I just switch from suboxone to methadone and be okay? do I need to wait for the suboxone to leave my system first? I know it may 'block' some of the methadone's effect - but will I go into w/d? Everyone and there mom talks about going down to 30 mg of methadone waiting it out blah blah before going to suboxone...but no one mentions the reverse! is this such a hard thing, jeesh!
Has anyone had the experience, did the methadone (or other opiate) cover you until you were able to get your subs? I can't believe I'm dealing with this mess again - I just want to throw my hands up right now and give up
and I feel like I'm a thread ender or an SR leper....like whenever I jump onto a thread I end it in it's tracks. I mean, I know this particular post is about meds and some people feel any medication in recovery is like crack or cryptonite, but I just would like to hear some other experiences and just be able to talk things out...I just feel like I don't belong here. Everyone is so friendly and full of knowledge to each other -- but me, I feel like an 'outsider' here -- and I already feel like that in life, and it doesn't feel good. pity party.
Has anyone had the experience, did the methadone (or other opiate) cover you until you were able to get your subs? I can't believe I'm dealing with this mess again - I just want to throw my hands up right now and give up
and I feel like I'm a thread ender or an SR leper....like whenever I jump onto a thread I end it in it's tracks. I mean, I know this particular post is about meds and some people feel any medication in recovery is like crack or cryptonite, but I just would like to hear some other experiences and just be able to talk things out...I just feel like I don't belong here. Everyone is so friendly and full of knowledge to each other -- but me, I feel like an 'outsider' here -- and I already feel like that in life, and it doesn't feel good. pity party.
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First of all, suboxone has a loooong half-life, you won't go into withdrawal for over 24 hours, and it won't be bad for about 48, if it is bad. Also, if you are going to buy methadone on the street, suboxone is even easier and cheaper to score...at least most places it is. And why not call around to some clinics, tell them the situation, and see if you can get a couple of subs prescribed in the interim? I think some docs would do it if you are honest and submit to a urine test to show no other drugs.
If you could explain why you are out of subs early, it might help us understand the nature of what's going on here. Even if it's just that you used too many, tell us the truth and we can help you more. Just about all of us have done stuff like this..so no need to be embarrassed.
KJ
If you could explain why you are out of subs early, it might help us understand the nature of what's going on here. Even if it's just that you used too many, tell us the truth and we can help you more. Just about all of us have done stuff like this..so no need to be embarrassed.
KJ
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Sorry I thought I made it clear this wasn't shady. As I said I was taking more than rx'ed when I first started, but have stabilized at 8mg suboxone (w/some symptoms such as loss of energy, fatigue, and restlessness) I am out of town and don't have the end of my script w/me (my fault) -- my dr would just rx some more subs, but a)my insurance won't cover them early - I still have 3 days left - sitting at home and b) the pharmacy refuses to just fill a 3 day supply so I can pay out of pocket - which actually outraged my dr.
Dr was reluctant to give any short acting opiates for craving fears so rx'ed about 60 mg of methadone to last me the 2 days until I can get my sub refill -and this was all like a rush job and a favor from him on vacation. I can't get a hold of him so I cannot talk to him about is it okay to to just start the methadone over the subs? --- and do I needed to be in w/d to start the subs after 2 days of methadone? I'm scared and anxious and shaking and fed up and I'm ready to give up. My friends invited me to a happy hour here and I'm just gonna go to forget everything -- this isn't worth it right now.
Dr was reluctant to give any short acting opiates for craving fears so rx'ed about 60 mg of methadone to last me the 2 days until I can get my sub refill -and this was all like a rush job and a favor from him on vacation. I can't get a hold of him so I cannot talk to him about is it okay to to just start the methadone over the subs? --- and do I needed to be in w/d to start the subs after 2 days of methadone? I'm scared and anxious and shaking and fed up and I'm ready to give up. My friends invited me to a happy hour here and I'm just gonna go to forget everything -- this isn't worth it right now.
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Shellslove,
I have no advice to offer, just wanted to express some encouragement for you during a frustrating time. Sometimes it seems that the harder we try to do the right thing, the harder it becomes. All I can do is pray for you that things will start coming together quickly. You're too far away for me to share
).
I have no advice to offer, just wanted to express some encouragement for you during a frustrating time. Sometimes it seems that the harder we try to do the right thing, the harder it becomes. All I can do is pray for you that things will start coming together quickly. You're too far away for me to share
).
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Join Date: Dec 2008
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Hey friend.......sorry to read you are having problems. I have no knowledge on the subject, but hope you get through it problem free! Sounds like you are getting good advice. Thanks again for taking the time to send me that nice PM. You are very sweet, and I hope and pray you get through this little "bump" in the road....and get back to your regular program. xoxoxo
Hang in there....you have lots of love and support here! xoxo
Hang in there....you have lots of love and support here! xoxo
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yikes - sorry about the Biotchy McBiotcherson Attitude yesterday -
-- I was having 'a day' if you know what I mean =) I thank you guys for the kind words of support and adivce....and NO i didn't go to happy hour, nor have i 'slipped up' -- it's only 2 days right? I'll deal - I was being a big cry baby! I know I'm lucky to have the subs in the first place - it's just, things get frustrating and I get overwhelmed, you know. Sorry and thanks again :ghug3 tryin a wee dose of the methdone today whilst working...lets see how that goes :praying
-- I was having 'a day' if you know what I mean =) I thank you guys for the kind words of support and adivce....and NO i didn't go to happy hour, nor have i 'slipped up' -- it's only 2 days right? I'll deal - I was being a big cry baby! I know I'm lucky to have the subs in the first place - it's just, things get frustrating and I get overwhelmed, you know. Sorry and thanks again :ghug3 tryin a wee dose of the methdone today whilst working...lets see how that goes :praying
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When my husband went off of suboxone - it took until day 4 that he went into withdrawals.
I read a lot about it and most seem to complain about withdrawals on day 3 or 4. Hope this releaves some of your anxiety.
I read a lot about it and most seem to complain about withdrawals on day 3 or 4. Hope this releaves some of your anxiety.
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