... been on the methadone maintnance program since october 2009. So basically ive been on it about 1 year, 4 months. I started at 40mg and worked up to 70mgs in 5mg increments. So within a week i was on 70mgs basically and have never went higher than 70. I am currently in the process of switching to Suboxone. Im tired of being a slave to the clinic everyday and i dont care for what the methdone makes me feel like. Im constantly tired and its just interferring in my life. I have a 2 year old son and i feel like a dunce because half the time i get home from work, im so beat i just wanna sleep and it feels like im neglecting him some. Ok so heres my ? My last dose of methadone was on Sunday morning at 7am and today is the followin wednesday. How long should i wait before i take my first dose of suboxone?my dr said the worse i feel before i take my dose, the more effective my dose will be. Is this relative to anyone else who has made the switch? i scared to death of takin it to early cause ive heard that it will put your body into severe withdrawls almost instantly. Any insight into this topic would be greatly appreciatted... Thank you all!!!
Do NOT take Suboxone unless you are at 26 or higher on the Clinical Opiate Withdrawal Symptom Sheet (google COWS) take the test first!!! Be perfectly honest. You do not want to go into precipitated withdrawals. It is a horrid way to start subs indeed.
Keep us posted on how you are doing. I am no expert on Subs nor methadone, but I do know all about opiate WD, so I can help with that.
Best wishes to you,
Can't really add much to what Sweetlemon said other than to be encouraging. Methadone is a long acting opiate so you need to be 72 hours past your last dose and scoring fairly high on the COWS. Different opinions as to how high, but the scale you have sounds pretty accurate.
Do keep us informed as to how you are doing and congratulations on your decision to be opiate free,
Hi ricky, The methadone needed to be tapered down to at least 30mg before jumping off. But since you are already going cold turkey, stick to the COWS and wait it out. Please trust me on this. Each person is different. It also depends very much on the drug that someone is quitting. Oxycodone will get you to the 26 much sooner than quitting methadone. This is exactly why the clinics rely on the COWS and not the number of hours or days to determine when one should begin sub induction. That's a very important step too. The least mg of sub you take to get relief the better. It will be that much easier to taper from lower doses when the time comes. I helped a member just last week who was using massive doses of morphine (up to 900mg per day) and high doses of oxycodone. A 3 year addiction. He finally reached the 26 after about 75 hours. He stared with half an 8mg sub. Waited 2 hours and took the other half.
Waited a few more hours and took another 4mg, bottom line, it took him a day and a half to stabilize at 12mg. That's not bad considering the amount of meds he had been taking. Do NOT start out taking 8mg or 16mg as your first doses. That is much too high. Remember, you can always take more if you haven't reached the comfort zone yet, but you can not take less. Too many docs start people on 12, 16, even 24 mg doses!! I will send you a link regarding subs. Take special note on the induction section. Although it recommends 2mg increments, with methadone (in my opinion) 4mg would be ok as the first dose. You may want to do the 2mg increases after the initial 4mg. It's important to wait at least 90 mins to 2 hours between doses during induction.
Hang in there, you can do this!! :-)
Ricky, you are supposed to be at 35 mgs ( actually 30) or less of methadone in order to make a smooth safe switch to suboxone. I know most people don't want to wait, but it is best. I am NOT judging you here at all, I am putting this in here for others who read these responses and may be thinking of making the switch. Methadone is also a long acting opiate replacements, so that is why a person must wait 72 hours before starting subs. If a person does not wait, the risk precipitated withdrawal setting in, this means that there was residual opiate taking up residence on the receptor sites that the suboxone needs to sit on, the 2 meds fight for space on the site and then both medications precipitate( drop off) the site and major major withdrawal sets in. Methadone can take days to recede off the site and it does slow the metabolism down, which can make it take longer for one person than another.
Subutex, the sister med to suboxone ( it does NOT have the naloxone the suboxone does) is actually what you should be switched with, but you should also wait until you are down low enough on the methadone to make the switch safely. Not only would I recommend anyone thinking of making the switch get an actual suboxone/subutex doctor, but do the require counseling, it truly will help you heal, I PROMISE it.
you should have been told by your doc or clinic that you should at least tapper down to 30 mg of methadone,and the day you yake your last dose wait 24 hours then an additional 72 hours before taking first dose of th subs. if your last dose was 70 mg and you have been on it for roughly 16 mos.i would wait at least 4-5 days.hang in there.also if you are in a medical marijuana state.this may help with the wait. good luck
Hi rickyricky I personally dont know about this subject but wish to offer you support also some advice that may be helpful ! the name of a fantastic site called theroadback.org these people have trained counsellors on site & if you want help just find the link on the home page & send them your questions they will certainly reply to you ASP with answers also while on the site look around its interesting. take care thinking of you & proud you are taking hold of the addiction you were on & trying to get better ! good one, so bye for now Candypq
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