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Dextox from Methadone to Vicodin to Suboxone
  1. #1
    piperlaurie is offline Member
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    Jul 2007
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    88

    Default Dextox from Methadone to Vicodin to Suboxone

    See my previous posts.

    Okay, I am about to enter an FDA study that will use suboxone to get me off of a 9-month dependence on methadone (25-30 mgs p/day). Overall, I've been on paid meds for over 5 years for chronic pain. Now I want to be off of opiates (don't like the side effects) and find other, non-narcotic, means of pain control. ( I have herniated discs, arthritis, bone spurs, stenosis and a reversed cervical curve of my neck.)

    Anyway, I tried going "cold turkey" before off of methadone and it was a nightmare. Never again. This time I believe I'll be doing it the right way. I came up with the idea of switching from methadone to vicodin then to suboxone which will help with the withdrawal symptoms tremendously. As you know, it is also a lot easier to transition from vicodin to Sub then methadone to Sub.

    The FDA doctor agrees this will probably ease my transition to Suboxone since it's much easier to go from Vicodin to Suboxone, them methadone to Suboxone since Sub stays in your system a lot longer than Vicodin (8-18 days vs. 2-3 days.)

    My question is, does anyone who has been through this know how long I should be on the Vicodin once I start taking the methadone? I was planning on staying on the Vicodin for about 7 days as I feel by then MOST of the methadone will be out of my system--at least enough where the Suboxone won't precipitate a worse withdrawal. Also, I know methadone is 10 times stronger than Vicodin--what then would be the equivalent dosage of Vicodin I should take that would match the strength of the Methadone I'm taking?

    My regular doctor (a pain specialist) has been informed and will be prescribing the Vicodin but I'd like to get someone elses take--specifically anyone who has gone through the Methadone withdrawal process themselves.

    I should add that one pain doctor on one of these boards said it took her/him 18 days to go through the worse part of the withdrawal from methadone. I don't think I need to be on Vicodin that long however.

    Thanks anyone and everyone who can help with this.

    piper

  2. #2
    Blessed365 is offline New Member
    Join Date
    May 2008
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    Piper,
    You can go from the methadone to the suboxone, especially with the dose you are taking. A lot of people have a hard time going from the methadone to the sub because they are on a higher dose than you. You will have to start the subs while in mild to moderate withdrawals. I had been without the methadone for 24 hours. What they won't tell you is if you still have stuff in your system, and with the methadone...you will, they will dose you with subutex first. This doesn't have the naloxone in it so it won't put you into immediate, horrible withdrawals. What I would do is lower the dose you are on now if it worries you, not swap over to something else and be in misery until you start the subs. Hope everything works out for you!

  3. #3
    piperlaurie is offline Member
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    Jul 2007
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    88

    Default Methadone to Vicodin to Suboxone

    Hi Blessed,

    Thanks for your post. One thing you said however doesn't make sense. Why would I be in misery if I'm swapping over to "something else" (in this case Vicodin) ? The whole point of switching to Vicodin is to help with the pain of withdrawal from methadone plus make it easier to switch over to suboxone.
    There is no guarantee the will put me on subutex, plus they are asking for 36 hours of withdrawal time if I go straight from methadone to suboxone (which I can't too physically) and 24 hours if I switch from vicodin.

    pip-er


    Quote Originally Posted by Blessed365 View Post
    Piper,
    You can go from the methadone to the suboxone, especially with the dose you are taking. A lot of people have a hard time going from the methadone to the sub because they are on a higher dose than you. You will have to start the subs while in mild to moderate withdrawals. I had been without the methadone for 24 hours. What they won't tell you is if you still have stuff in your system, and with the methadone...you will, they will dose you with subutex first. This doesn't have the naloxone in it so it won't put you into immediate, horrible withdrawals. What I would do is lower the dose you are on now if it worries you, not swap over to something else and be in misery until you start the subs. Hope everything works out for you!

  4. #4
    clinilab is offline Junior Member
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    Apr 2008
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    Quote Originally Posted by Blessed365 View Post
    Piper,
    I had been without the methadone for 24 hours. What they won't tell you is if you still have stuff in your system, and with the methadone...you will, they will dose you with subutex first. This doesn't have the naloxone in it so it won't put you into immediate, horrible withdrawals. What I would do is lower the dose you are on now if it worries you, not swap over to something else and be in misery until you start the subs. Hope everything works out for you!
    Actually, this isn't really true. The naloxone in Suboxone is so minimal it has NO EFFECTS ORALLY OR SUBLING. It CAN (not always) have an effect if used IV only.

    People think that its the Nal that cause withdrawal when switching to subs from other opiates or methadone. It's actually just the nature of Buprenorphine which is the ingrediant in both subutex and suboxone. Buprenorphine has a much stronger affinity for the opiate receptors on the brain than other opioids. What this means is, if there is any opioid left on those receptors BUPRENORPHINE will RIP them off and take it's place. It's this process that causes the severe withdrawal people talk about when switching too soon after taking other opioids.

    IOW, using subutex or suboxone will make no difference. Even your doctor might not understand this as its more of a pharmacist knowledge.

    EITHER WAY on that small of a dose, give yourself about 36-48 hours off everything and you should be ready for your subs. If your really worried about it, your FDA doc can order a serum methadone level the day of induction and see if it's low enough to proceed.

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