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Methadone precipitates Suboxone withdrawal?
  1. #1
    piperlaurie is offline Member
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    Question Methadone precipitates Suboxone withdrawal?

    I'm baaaaack. Actually, it happens to BE my back right now that's causing me severe pain. As some of you "regulars" dont' know, I successfully detoxed off of a 4-year dependence on Vicodin (for chronic pain) using Suboxone. Now I'm trying to get off the Suboxone completely so I can start taking the Methadone my pain doctor prescribed.

    I learned the hard way that you have to taper VERY slowly off of Suboxone. I thought I had but instead of mild discomfort I was hit with awful withdrawal on the 4th day. I immediately took 1/2 of a 8 mg. Sub pill and the withdrawal stopped.

    Then the doc gave me a prescription for Methadone (very low dosage of for my chronic neck and back pain0 telliing me to wait 24 hours before I started the methadone-which I did; however, the methdone must have precipitated premature withdrawal from the Suboxone because once again, it started happening. I had to take 1/2 of a Sub and sure enough that stopped the Suboxone withdrawal process.

    I'm now taking 1/2 of a 8mg. Sub every other day. That seems to be provide moderate pain relief but not when I have a flare up of my pain like I do right now with my back. Bottom line is that I need to start taking the methadone but I'm afraid even if I wait 24 hours to do so, it will precipitate Suboxone withdrawal again.

    Any suggestions? I really do need some strong pain relief here and on that score, Suboxone does not make the grade. (I don't believe it was intended for pain relief anyway--it just happens to be an off label use for it for some people.) That's why I need to start taking the methadone without the fear of it triggering another withdrawal. Please help! --pl

  2. #2
    Dave87666 is offline Member
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    I'd wait longer then 24 hours due to the long half life of suboxone,you will be fine since you're ok just taking 4mgs every other day...So to answer your question yes taking methadone too soon after subs WILL put you into w/d,and also suboxone is not intened for pain relief,its strictly for opiate addiction...

  3. #3
    piperlaurie is offline Member
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    Default Subxone safer than Methadone

    Quote Originally Posted by Dave87666 View Post
    I'd wait longer then 24 hours due to the long half life of suboxone,you will be fine since you're ok just taking 4mgs every other day...So to answer your question yes taking methadone too soon after subs WILL put you into w/d,and also suboxone is not intened for pain relief,its strictly for opiate addiction...
    Thanks, though actually reading all the posts here http://www.naabt.org/forum/topic.asp?TOPIC_>>=4048 I've almost decided to stay on the Suboxone for chronic pain because even though it's probably not as effective as Methadone, it does give me some pain relief--not when I have the recurring sharp shooting pain from my herniated discs, but for the everyday pain it works okay. More important I feel normal--no side effects (except for some anxiety-ridden dreams). Other people report that too.

    Comparing the two, Methadone with Suboxone, Sub appears to be far less dangerous and has a ceiling effect.

    I especially liked what this person said:

    "The level of physical dependence from bupe alone is less than that of other opioids. The pain relief affects appear to remain constant and most importantly you don’t develop a tolerance, in fact you may even require less as time goes on, like with me."

    Also, apparently it is legal now to prescribe it "off label" for pain--as long as it's a doctor registered to do so.

    Anyway, I'm just going to try it for a couple of more weeks and see how I do with the pain control on it. As I said, it only works minimally for the really sharp pain, but good for the other.... Thanks again for all your help!

  4. #4
    Dave87666 is offline Member
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    Go with what you,and your Dr. feel as best...Oh yeah and while I know you liked what that one person said,and in your case it may hold true..One thing that I know and learn though is that dependance varies from addict to addict...Just keep that in mind..

  5. #5
    Supermaz is offline New Member
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    Hi. I just registered here so I could chime in. Sorry Dave, but you actually have it backwards. You can take Methadone after Suboxone and it will do it's thing, But taking Suboxone after methadone will send you into withdrawal. You must wait 3 to 5 days after a single dose of methadone (40mg) to resume taking Suboxone. If you have any opiate in your system, suboxone will make you VERY sick. It has a higher affinity for your receptors, and so will pull any other opioid from your receptors, replacing it, thus causing withdrawal. If you have Suboxone in your system, all other opiates will simply be blocked and have no effect. Methadone is the only opiate that will still have an effect after taking Suboxone. This is from my own personal experience. I have taken Suboxone, and then taken methadone within a few hours and the suboxone in my system seems to enhance the methadone. I have done this more than once. Another thing I would like to mention is that suboxone withdrawal lasts MUCH, MUCH longer than full opioid agonist withdrawal. Similar to the length of time it takes to withdraw from methadone. I had a five year habit and in the end I was taking 200 to 300 mgs per day of oxycodone (Oxycontin). I did inpatient detox and was free from withdrawal in 4 days, and back to normal in two weeks. I was completely clean for 9 months. For some stupid reason I began using Suboxone, buying it from friends, and on the street. I used it for just over a year but only at doses of 1 or 2 mgs per day and rarely up to 4 mgs per day. Towards the end of using it, I had tapered to only half a mg per day for several weeks, then stopped. That was 17 months ago and I am still dealing with withdrawal symptoms today. The withdrawal in the beginning is just barely tolerable, and not quite as bad as full agonists, but horrible none the less. It gets incrementally better day by day but you'd be lucky to notice. After 17 months the worst of the physical symptoms have passed, But I still am experiencing minor digestive problems, sweaty palms, and feet, heartburn, intense cravings, and unbearable depression. In my opinion, suboxone is good for lifetime maintenance, but while I was using it, it had caused me severe depression. This is what had prompted me to stop. Most people do not have a year and a half to suffer withdrawal, but my wife is unbelievably understanding, and has seen me go through horrible torment from suboxone, but has stuck with me. Hell, she takes care of me like I am an invalid. Thank God for her. Most spouses would not be able to deal with this. My advice is to stay as far away from suboxone as possible, and instead do inpatient detox where you will be uncomfortable for 2 or 3 days and have your life back in a week or two. Suboxone did more damage to me in one year than 5 years of abuse of oxycontin. You don't hear this very often I believe because very few have had the opportunity to quit suboxone. This is my personal experience, and would not wish it on my worst enemy. Others may have different experiences with Suboxone, but this is mine and I will never use Suboxone ever again.

  6. #6
    Sach Huscht is offline New Member
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    Default Suboxone Withdrawal

    I had a brief >>>>>> addiction 1-2 yrs. in my early 40's. Got on Methadone ("MMT") and did very well for 4-1/2 years. MMT is very inconconvenient and uncomfortable. you sweat profusely whenever the Temp gets above 75-80 and lots of other side effects. The body's tolerance for methadone is amazing triple digit daily dosages are very common. Getting off MMT is a few months of extreme weakness and moderate anxiety with profound sleep disturbances. Why anyone whould want to go from Suboxine to Methadone I cannot fathom unless there is some sort of terminal-mortality or SEVERE pain management issue. MMT sucks, plain and simple.
    My last dose of Methadone was Oct. 2, 2007. I went to Suboxone with very little difficulty. During the preceding 10 months I decreased my MMT dose from 120 to 40 mgs per day and stayed at 40 for 4 weeks before the Suboxone Induction. I skipped one day MMT immediately before Suboxone Induction and it went well. I really did not need the full complement of comfort drugs (Benzo's, Clonidine, Donnatol, etc.) that I had amassed for Induction.

    I did appreciate the Benzo's though. Contrary to the PDR literature about Benzo's and Bupe I cannot detect any additive affect when the two drugs are taken together. NOT like MMT where a little bit of methadone and one 2mg 'stick' of Xanax and you fly high for the whole day.

    Being in NY City I heard much 'street talk' about how "the suboxone will not hold you" and that the Induction would be a terrible day. NOT so. Yes I had to skip one (1) day of methadone before induction and going from 120 to 40 (at 40 for 1 month) was not easy (nor without some benzos) but it was do-able and I remained productive during that time.

    The second Street talk about Bupe is that you simply walk off it. NOT so. I started at 8 mgs for day 1-2; 12 mgs. day 3--4 and then down to 4 mgs per day for about a week or so then 2 mgs per day for little more than two weeks (that was one small Suboxone tab per day). I figured after a month on Bupe I could just stop. That is what I did. I took one week off to do it.

    I only lasted 10 days. At first, I went through a mini->>>>>> like detox with a sharp peak of symptoms on days 2-3 and then got better for a few days. ON day 5-6,7 it got much worse. Classic >>>>>>-like withdrawal but less intense. The lethargy of MMT was not present so much and it was much closer to a >>>>>> detox than sudden MMT cessation. I have been through them all many times and could "set a watch" to symptom onset for each type of detox (including Benzo's).

    I had to go back on Bupe and am now taking 1/2 a small tab per day (1mg). I also take 1 mg of Klonapin per day (AM) and a non-narcotic sleep aid often at HS. I remained productive (working, although self employed so it is very flexible, I also have a comfortable place to live privately so I could time-out whenever needed. No one wants to be near a detoxing opiate addict at 3:15 AM.

    Bupe is stronger than I ever thought it was and must taper down slowly. My goal is opiate free. BTW, I find no side effects from the SUboxone at dosages under 2 mgs per day. At 4 per day I had frequent headache. At 8-12 per day my vision was blurry (plus increased headaches)and provided a very good reason to self-taper my dose downward. The headaches were classic migraine type (sensitivity to light, specific location of pain, etc.) no pain killer or advil/tylenol would help. Imitrex was a godsend for anyone with true migraines. Pre-1992 imitrex was only available by injection (at least here in NY).
    I have written alot. it is current and I hope to read other folks experience. There is so little out there about Suboxone. Not going to the MMT clinic and dealing with their adversaraial nature is the rediscovery of freedom. On MMT, your entire day revolves around that daily dosage. Just try dressing for a day work in suit and tie before getting your daily MMT daily dose and you know what I mean. I hope to read more in the future on this blog-thread.

  7. #7
    Sach Huscht is offline New Member
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    Default Suboxone Withdrawal

    I had a brief >>>>>> addiction 1-2 yrs. in my early 40's. Got on Methadone ("MMT") and did very well for 4-1/2 years. MMT is very inconconvenient and uncomfortable. you sweat profusely whenever the Temp gets above 75-80 and lots of other side effects. The body's tolerance for methadone is amazing triple digit daily dosages are very common. Getting off MMT is a few months of extreme weakness and moderate anxiety with profound sleep disturbances. Why anyone whould want to go from Suboxine to Methadone I cannot fathom unless there is some sort of terminal-mortality or SEVERE pain management issue. MMT sucks, plain and simple.
    My last dose of Methadone was Oct. 2, 2007. I went to Suboxone with very little difficulty. During the preceding 10 months I decreased my MMT dose from 120 to 40 mgs per day and stayed at 40 for 4 weeks before the Suboxone Induction. I skipped one day MMT immediately before Suboxone Induction and it went well. I really did not need the full complement of comfort drugs (Benzo's, Clonidine, Donnatol, etc.) that I had amassed for Induction.

    I did appreciate the Benzo's though. Contrary to the PDR literature about Benzo's and Bupe I cannot detect any additive affect when the two drugs are taken together. NOT like MMT where a little bit of methadone and one 2mg 'stick' of Xanax and you fly high for the whole day.

    Being in NY City I heard much 'street talk' about how "the suboxone will not hold you" and that the Induction would be a terrible day. NOT so. Yes I had to skip one (1) day of methadone before induction and going from 120 to 40 (at 40 for 1 month) was not easy (nor without some benzos) but it was do-able and I remained productive during that time.

    The second Street talk about Bupe is that you simply walk off it. NOT so. I started at 8 mgs for day 1-2; 12 mgs. day 3--4 and then down to 4 mgs per day for about a week or so then 2 mgs per day for little more than two weeks (that was one small Suboxone tab per day). I figured after a month on Bupe I could just stop. That is what I did. I took one week off to do it.

    I only lasted 10 days. At first, I went through a mini->>>>>> like detox with a sharp peak of symptoms on days 2-3 and then got better for a few days. ON day 5-6,7 it got much worse. Classic >>>>>>-like withdrawal but less intense. The lethargy of MMT was not present so much and it was much closer to a >>>>>> detox than sudden MMT cessation. I have been through them all many times and could "set a watch" to symptom onset for each type of detox (including Benzo's).

    I had to go back on Bupe and am now taking 1/2 a small tab per day (1mg). I also take 1 mg of Klonapin per day (AM) and a non-narcotic sleep aid often at HS. I remained productive (working, although self employed so it is very flexible, I also have a comfortable place to live privately so I could time-out whenever needed. No one wants to be near a detoxing opiate addict at 3:15 AM.

    Bupe is stronger than I ever thought it was and must taper down slowly. My goal is opiate free. BTW, I find no side effects from the SUboxone at dosages under 2 mgs per day. At 4 per day I had frequent headache. At 8-12 per day my vision was blurry (plus increased headaches)and provided a very good reason to self-taper my dose downward. The headaches were classic migraine type (sensitivity to light, specific location of pain, etc.) no pain killer or advil/tylenol would help. Imitrex was a godsend for anyone with true migraines. Pre-1992 imitrex was only available by injection (at least here in NY).
    I have written alot. it is current and I hope to read other folks experience. There is so little out there about Suboxone. Not going to the MMT clinic and dealing with their adversaraial nature is the rediscovery of freedom. On MMT, your entire day revolves around that daily dosage. Just try dressing for a day work in suit and tie before getting your daily MMT daily dose and you know what I mean. I hope to read more in the future on this blog-thread.

  8. #8
    mpvt is offline Platinum Member
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    Here's a good and educational read,I enjoyed it...........Dave

    https://www.naabt.org/documents/NAABT_PrecipWD.pdf

  9. #9
    Mikehag is offline New Member
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    I was taking 30-60mg of methadone for 2 weeks, I took 50mg of methadone approx. 39 hours ago, took 4mg of suboxone a couple of hours ago, I thought to myself " don't think I feel ????ty enough to take this yet" but took anyway. Wow! Like getting hit with the withdrawal bus! Holy ???? went from feeling fine to feeling like ???? in 2 sec. Suffered for about an hour then took another 2 mg of suboxone , felt little better, just took 2 more mg of suboxone total=8 mg feeling ok now, definitely wait till you are in withdrawal to take subs.

  10. #10
    Anonymous Guest

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    Yeah what Supermaz said was right if you take another opiate while on suboxone it will not send you into precips! It just won't work! Precips only happen when your addicted to a full agonist and then take the sub which kicks the full agonist off. If you say that happened I promise you it was all in your head cuz I used to have to get methadone sometimes when I didn't have insurance and couldn't afford the doc till pay day. The only reason I would wait was so I wouldn't waste the methadone by taking it with subs on my receptors. That's like another thread a guy was scared to take his subs cuz he had taken methadone the day before but it was a one time dose and he had taken sub the day before anyway. I tried to explain to him you don't get physically addicted to something with a one time dose plus the sub prob blocked it anyway. Somebody else tried to tell him I was wrong and he would go into precips but his body is addicted to the subs now which he also said I was wrong. Bottom line is poor information makes for a bad placebo effect the mind is a powerful thing

  11. #11
    Benz0maTic is offline New Member
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    Default To Supermaz

    What you said about from methadone to sub is not 100% true You are incorrect about the 3 to 5 days. Lots of people say 3 to 5 days, my doctor put me on subs form methadone 24 hours after my last dose of methadone. It worked for
    Me. It works for everyone. Anyone that can wait 3 to 5 days can practically wait a few more days and come off completely drug free. You need to wait 24 hours but if you feel that your still okay and don't have any w/d you should wait a bit longer. As soon as you feel a little bit of w/d coming on you must take the sub. I was on oxy for 2 years methadone for 3 now I am on suboxone. I just wanted
    To clear that for others so that no one else suffers for days in w/d just because they think they have to wait 3 to 5 days. Also remember everyone is different, for example me I'm not sure I like the subs I seem to be experiencing some unusual side effects. I think I might switch back to methadone. If anyone who has had a longer experience with sub can tell me a little about how taking it longer can reduce the dependence factor I'd appreciate that since I dont really have much experience with suboxone it's only been 2 months and so far It makes me feel bad during night time. And risk factors as well. Is methadone less harmful or is suboxone (for long term use) ?

  12. #12
    Benz0maTic is offline New Member
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    Mikehag is correct. And I know how you feel man. My doc told me to take half every 2 to 4 hours until I feel what dose is right for me. For 3 days I tried to figure out my dose now Im on 12mg of sub (1 and a 1/2) pills. Been on that from day one it's been about 2 months, I can't go down I feel bad if I even try to drop 1mg.

  13. #13
    No2ndChances is offline New Member
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    Question Advice needed

    [ deleted ]
    Last edited by ddcmod; 11-02-2014 at 11:36 PM.

  14. #14
    Anonymous Guest

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    [ deleted ]
    Last edited by ddcmod; 11-02-2014 at 11:36 PM.

  15. #15
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    Quote Originally Posted by Benz0maTic View Post
    What you said about from methadone to sub is not 100% true You are incorrect about the 3 to 5 days. Lots of people say 3 to 5 days, my doctor put me on subs form methadone 24 hours after my last dose of methadone. It worked for
    Me. It works for everyone. Anyone that can wait 3 to 5 days can practically wait a few more days and come off completely drug free. You need to wait 24 hours but if you feel that your still okay and don't have any w/d you should wait a bit longer. As soon as you feel a little bit of w/d coming on you must take the sub. I was on oxy for 2 years methadone for 3 now I am on suboxone. I just wanted
    To clear that for others so that no one else suffers for days in w/d just because they think they have to wait 3 to 5 days. Also remember everyone is different, for example me I'm not sure I like the subs I seem to be experiencing some unusual side effects. I think I might switch back to methadone. If anyone who has had a longer experience with sub can tell me a little about how taking it longer can reduce the dependence factor I'd appreciate that since I dont really have much experience with suboxone it's only been 2 months and so far It makes me feel bad during night time. And risk factors as well. Is methadone less harmful or is suboxone (for long term use) ?
    it works for you, so it should work for everyone..? get a grip man, we are all different... i waited over 48 hours after methadone, and still went into prec wd....

    good for you not doing it, but dont go quotiing that its ok for everyone coz you are wrong on that one buddy....

  16. #16
    mel38 is offline New Member
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    Soooo true..everyone is different. .I waited 24hrs to take subs after my last dose of methodone. The w/d were unbearable..Dr told me 24hrs was fine. NOT TRUE. Ive been on subs now for 2wks & its definitely not for me. I know most will not agree..but methodone is definitely a better fit for me.I start back 6am tomm morning and cant wait. The last 2wks have been hell on subs..Best of luck to anyone who makes the switch

  17. #17
    iloerose is offline Platinum Member
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    Mel: Docs often don't know much about suboxone. That is horrible what he told you to do: methadone has up to a 72 hour half life. I know someone else who jumped the gun on that and really got sick. The rule for methadone to sub here is to be below 30mg. and to wait at least 72 hours. Sub is a heck of a lot easier to taper, if you want off the methadone than tapering the methadone. It's possible your doctor has given you a too high of a dose of methadone. We can help you taper if you're willing, heck even if you want to go back to the methadone we will be here for you.

    You may want to post this to Randy35, he has much more experience with this. Here is the taper plan from Rober_325.

    http://www.drugs.com/forum/featured-...apy-50887.html

    I wish everyone well on their journeys.

    Peace,

    Iloerose

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