Posted by Shay Sweet on October 16, 2006, at 8:52:52
"]B]You have to get down to 30-40 mgs of methadone a day before switching to sub. Then you would have to withdrawal off methadone for a couple days before starting the suboxone. So you have a little ways to go at this point since you are on 145 mgs of methadone.[B/]"I have heard this as a general rule; I have been working with mental health and substance abuse, as well as dually diagnosed, clients/patients for several years but have not actually obtained certification/licensure in that particular field because I myself am suffering terribly on Methadone. However, the Psychiatrists I have worked with over time have had little if any knowledge about the prescribing information/limitations when it comes to these medications. When I heard about Buprenorphine two years ago, after only being on Methadone for a year--pregnant, no less--I researched the partial agonist properties of the drug inside and out. The only thing I couldn't do was to try it myself, but if it would take away the extra sixty pounds Methadone has afforded me, give me back my regular menstrual cycle (never thought I'd say that, but who stops getting a period at age 25?), and/or put the whole constipation thing behind me, I would do almost anything to make the switch.After working in treatment facilities on various levels, including Intensive Outpatient, Residential and Partial Hospitalization (PHP), both directly with the patients and indirectly through insurance companies and on medical records compliance, I have witnessed the administration of Buprenorphine/Suboxone in patients detoxing from either short-acting opioids like Percoset or from the more intense Methadone, and any difference in reactions to the overall detox process utilizing Bup/Sub is to try it myself, but if it would take away the extra sixty pounds Methadone has afforded me, give me back my regular menstrual cycle (never thought I'd say that, but who stops getting a period at age 25?), and/or put the whole constipation thing behind me, I would do almost anything to make the switch.After working in treatment facilities on various levels, including Intensive Outpatient, Residential and Partial Hospitalization (PHP), both directly with the patients and indirectly through insurance companies and on medical records compliance, I have witnessed the administration of Buprenorphine/Suboxone in patients detoxing from either short-acting opioids like Percoset or from the more intense Methadone, and any difference in reactions to the overall detox process utilizing Bup/Sub is not as notably different as I would have expected.Then again, these patients were/are being treated residentially and probably don't have the knowledge of the scientific/pharmacological properties and therefore are no so "in their own heads," so to speak.Bottom line: I have cut down from 160 mg/daily of Methadone diskettes to 80 mg/daily. The 30 or 40mg rule for Methadone is not accurate from what I have heard of others' experiences with the switch over, since that amount is still enough for the Methadone to be "stuck" to the receptors in such a way as to through the patient into instant and unbearable, violent withdrawals.Which brings me to my final question/point. Am I incorrect in saying that one must go through the entire weaning process from Methadone before starting Bup/Sub if one wants to avoid this nasty side effect? Most importantly, the Suboxone minus Naltrexone, or Subutex/Buprenex do not give the drug antagonist properties, although they are still partial agonist in nature. Do Subutex and Buprenex have the same effect in terms of making you feel markedly WORSE?Thanks to everyone and anyone who can answer these questions for me! Sincerely,Shay Sweet, M.S., Pharm D
poster:Shay Sweet
thread:695244
URL: http://www.dr-bob.org/babble/subs/20060727/msgs/695244.html