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    Switching from Methadone to Subutex, not Suboxone, Subutex. 
    #1
    Bluelighter doppelganga196's Avatar
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    Alright, i began methadone maintainence on April 17th & am now on 55 mg, up from 25.

    However even after all this time I still dont feel the stuff for 24 hours. I'm waking up several times a night with my entire body aching like i have a terrible case of flu. fucking terrible nightmares too. In fact if it wasn't for the amitriptyline i have on hand i doubt i'd sleep at all & i cannot wait until i get my diazepam script on tuesday.

    So the nurses told me last week i'd need to get down to 30 mg a day until i could go onto subutex. I absolutely do not want to go on suboxone as i feel the naloxone content would send me fucking suicidal. After my script runs out at the pharmacy on the 14th of may i'm gonna reduce my dose by 1 mg per day, until i'm at 30 mg. I wanna nip this in the butt before i become even more dependant & methadone saturated & god forbid, want to raise my dose.

    I'm just bascially looking for responses from people who have switched from methadone onto subutex & a quick summary of what that was like etc.

    Thanks everybody.

    p.s what kind of painklling properties does subutex/buprenoprhine have?
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    Bluelighter Fire&Water's Avatar
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    Quote Originally Posted by doppelganga196 View Post
    Alright, i began methadone maintainence on April 17th & am now on 55 mg, up from 25.

    However even after all this time I still dont feel the stuff for 24 hours. I'm waking up several times a night with my entire body aching like i have a terrible case of flu. fucking terrible nightmares too. In fact if it wasn't for the amitriptyline i have on hand i doubt i'd sleep at all & i cannot wait until i get my diazepam script on tuesday.

    So the nurses told me last week i'd need to get down to 30 mg a day until i could go onto subutex. I absolutely do not want to go on suboxone as i feel the naloxone content would send me fucking suicidal. After my script runs out at the pharmacy on the 14th of may i'm gonna reduce my dose by 1 mg per day, until i'm at 30 mg. I wanna nip this in the butt before i become even more dependant & methadone saturated & god forbid, want to raise my dose.

    I'm just bascially looking for responses from people who have switched from methadone onto subutex & a quick summary of what that was like etc.

    Thanks everybody.

    p.s what kind of painklling properties does subutex/buprenoprhine have?
    Subutex (in small amounts) has the ability to reduce rebound effects of fast acting pain meds' also .50 -1 mg in a person w/ a small med' tolerance can receive pain relief for many different types of pain (for how long I am not sure) To be on the safe side I think you should try to get yer' methadone dose down to 20 mg for 2-3 days before switching to subutex
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    Bluelighter Znegative's Avatar
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    ^I agree. You can't just decrease your dose by one mg each day, and when your at the point where you should be taking 30, switch to buprenorphine. It doesn't work like that. Idea,ly one would taper to 30mg or below, and then stay at that dosage for 2 weeks so that they are stabalized, and then make the transition. The reason for this is that suboxone's peak opioid activity is equivalent to somewhere around 30mg of methadone, so if you switch at too high of a dosage, suboxone cannot provide adequate relief.

    Also, just so you know, there is really no difference between suboxone and subutex. A lot of doctors will lead you to believe that subutex is somehow more of a "real" opiate than suboxone is, or that it's the naloxone in suboxone that causes withdrawals, or limits the opiate effects of buprenorphine. However, this is all BS. The naloxone is the suboxone formula is basically an inactive ingredient for all intensive purposes, as buprenorphine has a much higher binding affinity to the mu opiate receptor than naloxone does (meaning that even when injected, the naloxone cannot attach to the brain, because the buprenorphine is plugged so tightly into the receptors).
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    Bluelighter Crankinit's Avatar
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    The naloxone is the suboxone formula is basically an inactive ingredient for all intensive purposes, as buprenorphine has a much higher binding affinity to the mu opiate receptor than naloxone does (meaning that even when injected, the naloxone cannot attach to the brain, because the buprenorphine is plugged so tightly into the receptors).
    When taken as intended (sublingually) the naloxone isn't even metabolized, so the relative binding affinities don't have as much to do with it as the fact that the naloxone can't absorb sublingually and is destroyed in first pass metabolism.

    And while you're right that even when IVing suboxone the bupe can overpower the naloxone, this is only true in lower doses. As you increase the dose of suboxone and start getting dimnished returns from the extra buprenorphine, you'll eventually hit the point where you have enough naloxone to overpower the bupe, potentially causing rather horrific precipitated withdrawals.

    I IV'd my dose of suboxone once because I'd read over and over about how safe it is to IV suboxone and how the naloxone is completely ineffective, and ended up with the most awful 3 hours or so of my life. Sitting on the toilet while throwing up every 10 minutes into a bowl, drenched in sweat, heart pounding away like a jackhammer and every muscle and joint on fire.
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    Bluelighter Znegative's Avatar
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    Please don't misunderstand me, shooting suboxone is NOT safe, and I, nor anyone else on Bluelight condone's injecting it.

    And though I don't wish to get into another IV suboxone debate, I don't really see how at any dosage the naloxone could precipitate withdrawals with buprenorphine, as it is always at a 4:1 ratio. I do believe that the naloxone interferes more at higher dosages, causing delayed onset, headaches etc, but not full blown precipitated withdrawals. Even in the suboxone pamphlet it admits that way more naloxone than normally used in the case of overdose has to be administered, usually alongside another more potent opioid antagonist.

    I've unfortunately IV'd rather large doses myself (above 8mg), and never had a problem with withdrawals. However I would like to make it very clear that injecting (or actually taking a dose that high through any ROA) is completely pointless if you're looking for a "buzz". Even for people that have subutex, shooting more than 1mg at a time is going to dimminish the euphoric properties of buprenorphine, if they are on maintenance.

    As for your experience, I do not want to imply that I think you're lying, I just think that what happened to you is either very rare, or was possibly something else, like cotton fever.
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    #6
    Bluelighter Crankinit's Avatar
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    , I don't really see how at any dosage the naloxone could precipitate withdrawals with buprenorphine, as it is always at a 4:1 ratio.
    Except, as I'm sure you know, buprenorphine suffers from diminished returns and eventually a ceiling dose. So while 8mg of bupe might overpower 2mg of naloxone, it doesn't necessarily mean 16mg of bupe will overpower 4mg of naloxone, as 16mg of bupe isn't twice as potent as 8mg, more like an extra 20%, potent, if that.
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    #7
    Bluelighter Znegative's Avatar
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    Yeah, I was thinking of that to, but still, to get to the point where your naloxone is overpowering your bupe, you'd be shooting such ungodly ammounts that it wouldn't even make sense in the first place.
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    Bluelighter doppelganga196's Avatar
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    Thanks for derailing my thread guys, wtf, i'm not talking about shooting subfuckingoxone.

    & why on earth cant i lower my methadone dosage by a mg a day? It seems a lot quicker & less painfull than dropping by 5 mg every 2 weeks or some bullshit like that. i'm sorry i'm in a really really bad mood right now, i probly shouldnt even be on here, but why cant i lower my dose by a mg a day then once i'm at 30 mg switch to subutex? & if there's " really no difference between subutex & suboxone" then why are they two seperate drugs???
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    #9
    Bluelighter Znegative's Avatar
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    You need to stabalize on a dosage. It generally takes one to two weeks to shed the half lives of your previous dose. For instance, you're on 55mg of methadone if I'm correct, and you take it every day. Methadone has a half life of about 24 hours so the previous dosages accumulated. Like when you first start on methadone, they usually give you a dose of 30mg the first day. By the next day you will have 15mg left in your system, and then you dose another 30mg, so you have 45mg total. The ammount of methadone in your system levels off after a week or two, but the point is that you have much more methadone accumulated in your system than what your daily dosage is. This is why you can just drop a mg every day till you reach 30, because though it would be better than just jumping right on to suboxone/subutex from 55mg, your body would not actually be used to taking 30mg of methadone a day. You need to give your system time to adapt to that level, so that you're comfortable on it, and then make the jump. If you don't, you might end up feeling very uncomfortable on suboxone/subutex, as the main ingredient in both drugs is buprenorphine-a partial opioid agonist.

    Buprenorphine has a cieling effect, meaning past a certain dosage, you will not recieve any further agonist effects from it. At its peak agonist activity, it is about equipotent to 30 mg of methadone (which is why clinics often want you to taper down to at least that level before switching). If you jump on to buprenorphine before adjusting to 30mg of methadone, you will possibly feel very uncomfortable until you fully adjust to the bupe which could take some time.

    Also, the reason their is suboxone and subutex, is because R&B just does not want to give up their patent on buprenorphine. Subutex already went generic (in fact, R&B discontinued subutex, so only generic buprenorphine is available). By adding naloxone, they can claim that suboxone is less abusable, and in a way it works, as most people don't really take the time to do research on it, but just take their doctors word for it. That's all I'm going to say about this subject since I dont want to derail your thread. But you will be much happier if you stabalize on the 30mg for at least a week before making the transition. You don't want to get precipitated withdrawal with methadone, and with bupe's high affinity, you'd just be stuck in a really hellish state.
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    #10
    Bluelighter Fire&Water's Avatar
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    I have also read/heard from more than a few people, methadone induced PW's (from Bupe') are much worse than say hydromorphone - oxycodone...
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    Bluelighter doppelganga196's Avatar
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    Cheers Znegative that was a decent bit of info in your post. Posts like the one above^ just seem like an unfinished thought, you took the time to actually write in reply to my thread.

    I didnt know about the drug company (i assume thats what it is) R&B. I know little about subutex or buprenorphine for that matter. Methadone i know about, & many other opiates for that matter. I've only been on methadone about 3 weeks but when it was offered me i accepted it over subutex/suboxone as i knew little of them only that it was a bit of an upper which at the time i didnt need.

    I have been on a diazepam tirtration for many months now, tommorow i pick up my script - 28, down from 42. You see the reduction of 14 every 2 weeks like you mention above with methadone another drug with a long half life. I'm at 6 of diazepam - three 2mg pills a day down from 30/40 mg a day.

    I do plan however to reduce down to at least 40 of methadone over the coming month & frankly i'm wondering if bupe is even the drug for me & i may just think about saving it for when i'm down to like 10 mg of methadone a day & switching to a low dose of subs.

    I doubt i could handle suddenly swapping over to a drug i'd never done before & tapering off that. With methadone at least it is something familiar.
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    #12
    Bluelighter Fire&Water's Avatar
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    It was life experience -
    I dont talk on the cell very long either...

    edit: I also neither bookface nor twatter
    Last edited by Fire&Water; 07-05-2012 at 22:50.
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    #13
    Bluelighter doppelganga196's Avatar
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    Well at least tell us what you were getting at in post number 10...
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    #14
    Bluelighter Fire&Water's Avatar
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    Quote Originally Posted by doppelganga196 View Post
    Well at least tell us what you were getting at in post number 10...
    Exactly what it says...besides reading/hearing I have personally experienced PW's induced from switching back from methadone to subutex too soon, compared to the other analgesics I mentioned, mg. for mg. Methadone is going to kick ya' in the face if you dont wait long enough (unless you are down to a steady 20-30 mg. regimen)
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    #15
    Hi I've been on 50ml of methadone for the past 8 years. A week ago I decided to stop my methadone and switch to heroin. How long must I take heroin before I can painlessly take subutex, is a week off methadone long enough or will it still be on my receptors, its costing me a fortune in heroin just to stop my methadone withdrawals. Also how long would I need to be on subutex before becoming physically dependent on it? Please help as I can't continue like this much longer and I'm so depressed I feel life is not worth it anymore. I've lost 3 stone in weight and hardly eat as I've no appetite. I'm at my wits end so any help will be much appreciated. Thank you in anticipation - Dowo.
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    #16
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    Quote Originally Posted by Dowo View Post
    Hi I've been on 50ml of methadone for the past 8 years. A week ago I decided to stop my methadone and switch to heroin. How long must I take heroin before I can painlessly take subutex, is a week off methadone long enough or will it still be on my receptors, its costing me a fortune in heroin just to stop my methadone withdrawals. Also how long would I need to be on subutex before becoming physically dependent on it? Please help as I can't continue like this much longer and I'm so depressed I feel life is not worth it anymore. I've lost 3 stone in weight and hardly eat as I've no appetite. I'm at my wits end so any help will be much appreciated. Thank you in anticipation - Dowo.
    I think that they recommend you get down to 30mg of methadone before switching to subutex, so try to get below the equivalent of 30mg of methadone in heroin before the switch. This will ensure that the subutex will 'hold' you, as in keep you from feeling withdrawals after making the switch since the ceiling dose of subutex makes it have limits in how big of a habit it can treat without having you withdraw for the first few days or so after the switch.

    1 week should be enough time after your last dose of methadone before starting the subutex. As for how long to wait after your last dose of heroin, well 24 hours is the amount of time to wait if you want to play it safe. I find the best way to do this is to keep the subutex at home and go out for the day and try not to think about the withdrawals. If you are just sitting at home with the subutex there then your mind will make you feel the withdrawals a lot sooner, making you give in and take the subutex sooner, which makes it less effective. Even after waiting the 24 hours it may still take a day or so before you stabilize on the subutex.

    As for how long before you become physically dependent on the subutex, well you are already physically dependent on an opioid so it doesn't matter much. The only time that this is really relevant is if someone is looking to do a short taper using the subutex, and doesn't want the milder more drawn out withdrawals that come with it, compared to the more intense but shorter withdrawals from heroin or other shorter acting opiates.
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    #17
    Bluelighter deidara's Avatar
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    Quote Originally Posted by Znegative View Post
    Please don't misunderstand me, shooting suboxone is NOT safe, and I, nor anyone else on Bluelight condone's injecting it.

    And though I don't wish to get into another IV suboxone debate, I don't really see how at any dosage the naloxone could precipitate withdrawals with buprenorphine, as it is always at a 4:1 ratio. I do believe that the naloxone interferes more at higher dosages, causing delayed onset, headaches etc, but not full blown precipitated withdrawals. Even in the suboxone pamphlet it admits that way more naloxone than normally used in the case of overdose has to be administered, usually alongside another more potent opioid antagonist.

    I've unfortunately IV'd rather large doses myself (above 8mg), and never had a problem with withdrawals. However I would like to make it very clear that injecting (or actually taking a dose that high through any ROA) is completely pointless if you're looking for a "buzz". Even for people that have subutex, shooting more than 1mg at a time is going to dimminish the euphoric properties of buprenorphine, if they are on maintenance.

    As for your experience, I do not want to imply that I think you're lying, I just think that what happened to you is either very rare, or was possibly something else, like cotton fever.
    I realize this is an old thread but I was wondering this exact question. With bupe, I've heard that less is more. Would someone on mainetence or with a opioid tolerance be able get "get high" off shooting 1mg?
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    #18
    Greenlighter jsquared's Avatar
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    Quote Originally Posted by deidara View Post
    I realize this is an old thread but I was wondering this exact question. With bupe, I've heard that less is more. Would someone on mainetence or with a opioid tolerance be able get "get high" off shooting 1mg?
    I firmly believe less is more, especially for IV roa. I have iv'd a whole 8mg film, in hopes of a buzz but I actually caught more of a mild buzz when only iv'ing a quarter (2mg) of one. I was taking 3 8mg strips per day sublingually for almost a year & now take only 1/4 to 1/2 a strip per day and feel juuuust fine I am not condoning it though..for obvious reasons.
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    #19
    Bluelight Crew BingeBoy's Avatar
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    That's what people here say in my subutex shooting days 16 mg + an anti-histamine was the way to go. Still regret that shit though.
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    #20
    Greenlighter jsquared's Avatar
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    My fiance said that when he was in the hospital as a kid, they gave him IV benadryl & he said it was one of the best highs he's ever gotten.. that's funny.
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