Bit late to this thread but I feel there is some iffy at best advice given here I'd like to add to. PWs (precipitated withdrawls) are NO JOKE and can not only be literally traumatic, and in some cases bad enough to require an ER visit, once experienced they can often scare people off from ever trying again, which is doing them no favors.
Long acting opioids like Methadone and Fentanyl (which is lipophiliac like THC) can be very unpredictable and personally dependent on many factors for when it is "safe" to induct on suboxone. For some 24-72 hrs in fine and they can take a 4 or 8mg strip and be fine, no PW, and then can just increase from there until comfortable. But that's a dangerous game cuz for others even 72 hrs+ isn't long enough and a high dose of Bupe will send them to HELL.
The good news is you don't have to choose between suffering for a week before inducing sub, or risking PW!
When in doubt DO NOT, I repeat DO not take "normal" sub doses like 4 or 8mg to start. No, start with the tiniest amount you can, like 0.25mg, 0.5mg TOPS. Wait an hour+ if it didn't make you feel worse (but probably not better either at such a low dose) then take another 0.25mg. Wait another hr+ to see if that makes you feel worse or still about same. If worse...stop adding bupe for awhile longer. If not, we'll rinse and repeat above steps over the next couple days.
If you start in the morning 0.25mg every 1.25 hrs = 4mg over 20hrs (or 3mg over 15hrs if they are lucky enough to be getting some sleep haha. If no negative effects (which will be minor if they occur at all) you can then feel comfortable upping the schedule to 0.5mg every 1.25hrs the next day, watching for the same signs. By now, however, since the bupe is building up in your system you should actually start to finally feel BETTER (albeit prob only a little) about an hour after each 0.5mg dose. If not and it makes you feel any worse then pause for a bit, or go back to 0.25mg each dose. So now we have 0.5mg every 1.25 hrs = 6mg in 15hrs/8mg in 20hrs (plus leftovers from day before due to crazy long bupe half life).
If you've made it this far, congrats, you're almost out of the woods and without any fear of traumatic PWs or having to suffer days and days of intense WDs without hope or comfort. Now you can up it again to a full 1mg. every 1.25 hrs, which will get you to 12mg over 15 hrs. By now the bupe has replaced pretty much any remaining full agonists in your receptors and you're safe to just start taking 2mg at a time ea. 1.25hrs and repeat until your WD symptoms are largely or completely alleviated. For some that might have been by the 12mg mark for others (mostly heavy fent users) you may have to keep going to 16mg, or even as high as 24, or rarely even 32 (seemingly a ceiling beyond which no more bupe will have any more effect).
There you go, an all but risk free and far less painless way than playing it safe and waiting 3-5+ days to take and 8mg strip, all to be thrown into PW anyway cuz you're one of the unlucky ones.
It works and it needs to become standard practice in clinics and treatment centers in these days of crazy fentologues out there for people using street drugs. Or even just people wanting or needing to switch from methadone to subs. Or to quit entirely for that matter as a rapid bupe taper after this process is not as difficult as jumping off long teem Done OR Bupe maintenance, even with reasonable tapers.
This is a tired and true method that has worked for everybody I've ever introduced it to. Worked in the sense of not a single instance of PW, and a much painless process than just "waiting it out" the "safe" 72+ hrs, which sometimes STILL isn't safe and has caused terrible PWs for some long term street fetty users!
Hope this helps some people as it helped me and so many others. Yet so few Docs, clinic, treatment centers and users are aware of this method smh.
