What is better when you have a prolonged Que-T? Methadone or Suboxone for pain management?

Dear Amberrosey, I am not a doctor, but am a former suboxone patient and have been here on drugs.com for about 3 years. I can tell you the switch to suboxone from methadone is tricky and many medical professionals even don't properly know how to do the switch. Both methadone and suboxone are long acting opiate replacements, therefore they leave the body and brain receptors slowly. There is a sister medication to suboxone called subutex and it does NOT contain the naloxone that the suboxone does, but will quell withdrawal and cravings exactly the same as suboxone. I am guessing here, but can almost guarantee you that although you had NO methadone prior to your suboxone induction, you still had it resting on the brain receptor sites. The proper way to switch from methadone to subutex is to taper down at least to 30 mgs or less of methadone, wait 72 hours with NO methadone or other opiates ( in withdrawal) and then start on subutex.

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I think what happened here is a particularly awful form of withdrawal called Precipitated Withdrawal. The 2 meds, ( the methadone and the suboxone, which both require the whole receptor site, not a partial seat) literally were fighting each other off the receptor sites, thereby causing both to "precipitate" or "drop" off the site and then they fought to keep each other off of those receptor sites. It throws a patient into horrible withdrawal, and all that can be done is to wait for the methadone to leave those sites before subutex can work. Suboxone had both meds, the bupenorphine and the naloxone in it, so, it really did fight that residual methadone. Suboxone and subutex are both complex meds and the switch from methadone to subutex really is the trickiest switch. Normally someone on short acting opiates like loratab or vicodin would only have to wait 24 hours in withdrawal with NO opiates before being started on suboxone or subutex and within 20 minutes to 45 minutes, there will be significant relief of withdrawal and cravings, at the 1 hour late mark, the patient feels really good and at 2 hours later, amazing. I can also tell you that with your other condition, the subutex will be the better medication and the lower the dose, the easier it will be on your heart, liver, pancreas, all your organs. I know you may think... hmmm... Patti is not a doctor, and I am not, but I do know subs pretty well and can almost guarantee you this precip is what happened. Many drs and clinics have done the same thing to other patients and once that methadone is completely gone off the receptor sites, you should be safe to take subutex. Best of Luck, you are in my Prayers, Pattishan61

This is just my opinion, now. You did ask for opinions, right? You didn't even mention the word addiction, so I'm going to assume addiction isn't an issue with you. There is a difference between becoming dependent on a physically dependent drug and becoming addicted. You already became dependent on Methadone, and you'll become dependent on Sub too. Methadone is a good pain killer, but only at very high doses. Sub is not that good of a pain killer at any dose.

Based on your injuries, and what you have said, I would get away from Sub and Methadone, if that's still possible. Sub will cause you to have an incredibly high resistance to pain meds so the less you take the better.

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It seems what most people in your situation do is to get on a fast acting, short term pain killer, such as Oxycodone, or Vicodin. But then the drug I hear great things about is the Fentanyl patch. I've read where people with injuries like yours say Fentanyl gave them their life back. You put 1 patch on and you're good for 3 days. If you get Breakthrough pain, and it does happen, then you take 1 Oxycodone pill, usually a Percocet, or a Vicodin. Docs usually allow you 3 or 4 pills a day for breakthrough pain. For people with no addiction issues, this is the best way to go. Yes you will become physically dependent on these drugs, but it's easier to quit the short acting narcotics than Methadone and Sub. And inbetween these meds you can use Celebrex and other non narcotic pain killers.

The irony of your situation is you said you didn't want strong narcotics like Oxy, but you were taking a narcotic even stronger than Oxy, Methadone. You need to educate yourself on pain meds. Don't count on docs to teach you.

In 1997 I trusted a pain doc, and didn't do my home work. That doc made me so dependent on narcotics I may never get off them. The point is, don't trust docs to teach you what you need to know. There was no Internet in 1997. Today in 2011 you have all the info you need at your finger tips. And people like me will share our experiences.

In fact, maybe I can start to teach you something. There are drug names, which break down into Brand Names, Generic Names, and then names of certain pills. I know this is confusing, but I'll try and make it simple. There is a drug called Oxycodone. This is it's generic name too. And watch the spelling of all this, because a misspelled word can change things. Oxycodone is a medium to very strong opiate, or narcotic pain killer. It's heavily abused and so recently the pharmaceutical companies are looking to make it in ways that are harder to abuse it. This is because it's a very good pain killer. It works fast, and it wears off in 4 - 6 hours. It's also called Roxicodone. When it's called OxyContin, it's still Oxycodone, but it's in a time released formula. The one pill dissolves so slowly that the pain relief can last up to 10 hours. It's also sold as Percocet. Percocet is Oxycodone mixed with Tylenol. Percs come in 3 strengths with the Oxy in it going from 5 mg to 7.5 mg and finally 10 mg. And there are 2 new time released Oxycodone pills I don't know the names of off the top of my head. But all these are the drug Oxycodone.

Vicodin, Lortab, or Norco all have the narcotic Hydrocodone in them. They also all have Tylenol. Hydrocodone is slightly weaker than Oxycodone. Different people respond better to different pills. The only way to know is to try.

Then comes Morphine which is considered more powerful. It also comes in many forms.

The strongest Narcotic is considered Fentanyl. It doesn't come as a pill. It's used as a patch, and many people with round the clock chronic pain swear by it. This is what I think you need. Look into it.

Both Sub and Methadone will give you a very high resistance to these drugs, and you shouldn't take them. Unless you know you're the type to get addicted to pain pills, stay away from Sub and Methadone. And btw, Sub is now used as the Butrans patch. Beware. It's still Sub. Not good for you.

If I've been unclear ask me questions and I'll respond.

Good Luck. Thor