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Switch from Methadone to Suboxone
  1. #1
    Gentlemansyd is offline New Member
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    Default Switch from Methadone to Suboxone

    So I have been on 25mg of Methadone for over a year after tapering down from 90mg. I am switching to Suboxone next weekend. Have taken days off so I have Friday through Monday to induct properly.

    Any personal experiences would be great. I have solid understanding of the differences and interactions between Methadone and Suboxone so I have a bit of a plan together.
    Any feedback would be great.

    New to forums so I apologize if this thread is redundant or in the wrong area.
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  2. #2
    Catrina is offline Diamond Member
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    Quote Originally Posted by Gentlemansyd View Post
    So I have been on 25mg of Methadone for over a year after tapering down from 90mg. I am switching to Suboxone next weekend. Have taken days off so I have Friday through Monday to induct properly.

    Any personal experiences would be great. I have solid understanding of the differences and interactions between Methadone and Suboxone so I have a bit of a plan together.
    Any feedback would be great.

    New to forums so I apologize if this thread is redundant or in the wrong area.
    Welcome!!

    Congrats to be getting off the methadone. Liquid handcuffs. It's awful stuff. You know already that the half life of methadone is very long. Because you've been on it for quite some time it might take a bit before you're ready to take your first dose of sub. The first few days shouldn't be too bad but once the withdrawal symptoms begin to arrive you're going to have to hang on tight until you score high enough on the COWS to safely induct. Something to think about now with only a few days left before the weekend.

    Have you seen and studied the COWS? It's important to score your symptoms before you induct the sub. The sicker you allow yourself to get, the better the transition. I know it stinks to think about having to go through these uncomfortable days but it will be so worth it in the long run. Be careful you don't take the sub too soon to avoid the danger of putting yourself into precipitated withdrawal. Not intended to scare you but you just don't want that to happen,

    Do you mind sharing what your plan for the sub is? Have you seen and read Robert's Sub Taper Plan that has been used here for many years quite successfully?. It outlines how to dose correctly and make your reductions. Consistency will be very important taking the same sized dose everyday (unless you are in the process of a reduction) and to dose at the same time(s) everyday. Induct with very small amounts of the sub beginning with 1 or 2mg (usually less but it's safe to say you'll need every bit of that coming from methadone). Allow a full hour for that to get into your system and then begin to add 1/4mg pieces once an hour until you are stable. Please do find the Plan and review it. It works!!

    Welcome again and keep posting. Ask questions if you have any. Plenty of awesome folks around here that are eager to help and support you.

    Peace,

    Cat

  3. #3
    Gentlemansyd is offline New Member
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    Thanks for the quick reply!
    Yes Roberts plan was my original guideline. I have my COWS scale printes off and pinned to the wall.
    Need to clarify that I will start the process the weekend following this one. I am mildly anxious about the process. My sub doctor was almost clueless on how I should induct. My only real glimpse was from my counselor. He went into PWD from only waiting 36 hours.
    Is there anything I should have to prepare? l have next Th, Fr, Sa, Su, & Mo off. My plan is to dose wednesday and ride from there. I have an important family event Sunday evening and am hopind to be stable enough to attend.

    I did taper to 25mg with relative ease but being on MMT for 5 years has me forgetting the beast that full W/D can be.
    So I am nervous...

  4. #4
    Gentlemansyd is offline New Member
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    One more point. I am on Wellbutrin (Buproprion XL) daily. Will this affect me?
    It has a notice with alcohol not to suddenly stop or seizures could occur. Wellbutrin lowers the threshold for seizures in general so it is worrying.

  5. #5
    Catrina is offline Diamond Member
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    Try not to be too nervous. We've all experienced withdrawal symptoms and no doubt about it, they aren't fun. Best advice is to not take any comfort meds at all as they will just slow down your scoring on the COWS. I wouldn't interrupt your Wellbutrin though. There are plenty of folks who have taken an antidepressant through this process. I know you've got to be dreading the lead up to inducting but it's necessary for the best results. Try to keep telling yourself that you are on the last leg of getting off the meth and onto the road to recovery. Once this switch is complete and you are stable it will allow the remainder of the methadone to dissipate and then subs will be easier to taper so long as you follow the plan carefully.

    Not at all surprised that your sub doctor was clueless. They usually are. Glad you got a head's up from someone else. Keep posting and please do read as many threads around here as you have time to do. This all helps. It passes the time and there's just something about coming onto this site and knowing that there are others who aren't judging you and know what you're going through. Fellowship. Online but still incredibly helpful. Do you go to meetings? If not, at some point please consider them.

    You're going to do great! If you keep posting, give us updates while you wait to induct, and let us know the day you are planning to make the switch, someone can try to be around to help out.

    You'll do great. Scary, but entirely possible and one of the best decisions you have made.

    Peace,

    Cat
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  6. #6
    Gentlemansyd is offline New Member
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    Will do. I meet once more with the Sub doctor and then once more the same day with my psych doc. Will provide updates afterwards.
    Thanks again.

  7. #7
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    So I have been on 25mg of Methadone for over a year after tapering down from 90mg. I am switching to Suboxone next weekend. Have taken days off so I have Friday through Monday to induct properly.

    Any personal experiences would be great. I have solid understanding of the differences and interactions between Methadone and Suboxone so I have a bit of a plan together.
    Any feedback would be great.

    New to forums so I apologize if this thread is redundant or in the wrong area.


    Welcome to you!

    Cat has given you excellent advice as she always does. If you follow what she has suggested you will do fine. I do have a couple things to add.

    Will you be inducting in the doctor's office or do you think they will allow you to induct at home? Reason I ask is that almost every sub doctor places patients on huge doses of sub at induction and plans to keep them on it for years, and in some cases the rest of the patients life. We see so many come here in that situation. Following Robert's plan is the way to go as evidenced by the thousands of success stories it has produced, and I'm one of them.

    In the event the doctor puts you on a very high dose in the office try not to fight it. Just get a script for as many subs as you can and come right back here. We can get you on the right track quickly.

    Glad you're aware of the Cows as it makes all the difference in a safe induction. I also switched from Methadone to Suboxone. The first two times I attempted to induct I got in a big hurry, didn't use the Cows and went into precipitated withdrawals not once, but twice. Never been so sick in my life. I finally got it right by using the Cows and waiting until I was at the necessary 26 score. Actually I was at a 28-30 when I inducted. And it took me nearly 90 hours or almost 4 days from the time I completely stopped the Methadone until I was ok to induct. The time varies for everyone and that's why the Cows is so important. Methadone is a beast because of it's long half life. The greater the amount of time you can wait in wd's to induct the better. You only have to do this once if you do it right the first time.

    Randy

  8. #8
    Gentlemansyd is offline New Member
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    Quote Originally Posted by Randy35 View Post
    Welcome to you!

    Cat has given you excellent advice as she always does. If you follow what she has suggested you will do fine. I do have a couple things to add.

    Will you be inducting in the doctor's office or do you think they will allow you to induct at home? Reason I ask is that almost every sub doctor places patients on huge doses of sub at induction and plans to keep them on it for years, and in some cases the rest of the patients life. We see so many come here in that situation. Following Robert's plan is the way to go as evidenced by the thousands of success stories it has produced, and I'm one of them.

    In the event the doctor puts you on a very high dose in the office try not to fight it. Just get a script for as many subs as you can and come right back here. We can get you on the right track quickly.

    Glad you're aware of the Cows as it makes all the difference in a safe induction. I also switched from Methadone to Suboxone. The first two times I attempted to induct I got in a big hurry, didn't use the Cows and went into precipitated withdrawals not once, but twice. Never been so sick in my life. I finally got it right by using the Cows and waiting until I was at the necessary 26 score. Actually I was at a 28-30 when I inducted. And it took me nearly 90 hours or almost 4 days from the time I completely stopped the Methadone until I was ok to induct. The time varies for everyone and that's why the Cows is so important. Methadone is a beast because of it's long half life. The greater the amount of time you can wait in wd's to induct the better. You only have to do this once if you do it right the first time.

    Randy
    In my search through forums your name and your advice has popped up quite a bit. I am excited you are here to help.

    I am lucky enough that the doctor has written me a prescription. This means the dosing is up to me and can be done on my own time when I feel comfortable doing so. My plan is to do as you say and try to induct with the smallest amount possible. I have no desire to be on Subs long term

    I have been on the 25mg methadone for close to 16 months so I have had time to become acclimated. The low dose has made it a bit difficult to comfortably go through a day without dosing. I am hoping that I will be around a 24-26 on COWS by 60 hours. I understand that there is no way to gauge how long it will take ahead of time. It is all just wishful thinking.

    Not sure if I need to start getting my daily vitamin intake started or if there is anything I can do ahead of time to make it easier.
    Any suggestions?
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  9. #9
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    In my search through forums your name and your advice has popped up quite a bit. I am excited you are here to help.

    I am lucky enough that the doctor has written me a prescription. This means the dosing is up to me and can be done on my own time when I feel comfortable doing so. My plan is to do as you say and try to induct with the smallest amount possible. I have no desire to be on Subs long term

    I have been on the 25mg methadone for close to 16 months so I have had time to become acclimated. The low dose has made it a bit difficult to comfortably go through a day without dosing. I am hoping that I will be around a 24-26 on COWS by 60 hours. I understand that there is no way to gauge how long it will take ahead of time. It is all just wishful thinking.

    Not sure if I need to start getting my daily vitamin intake started or if there is anything I can do ahead of time to make it easier.
    Any suggestions?

    Happy to help all that I can.

    That's great news hearing the doctor has written you a script and leaving the induction up to you. I wish all sub doctors would do that. That will make things so much easier. Definitely a winning situation.

    Vitamins and supplements are very important to our well being. There are many that can really help our bodies to perform at it's best. But in my opinion you should wait until after the induction to start a regiment of vitamins and/or supplements because I'm fearful they COULD interfere with the Cows score. As Cat mentioned to you earlier, you don't want to take any kind of "comfort meds" or supplements that would make you feel better during your planned wd's because it could slow down the Cows score. I would consider vitamins to be in that category, but others may disagree. If you have been taking them already that would be ok, but if it were me I would wait until after the induction to start taking them. Up to you of course.

    What else can you do to get ready: A couple of things come to mind. Do you have the Suboxone film strips? If you do I would cut up some small pieces in advance of your induction to have ready. While you're in wd's waiting to induct you'll be feeling miserable and probably have shaky hands and body. Might be difficult to cut the does up at that time. I used some small scissors to cut with and a pair of tweezers to hold the film strips. I just eyeballed it and kept cutting the film in halves until I got the doses I needed. Place the pieces back in the foil wrapper for safe keeping and make certain to label what it is because it's very easy to forget later. The film's come in 2mg, 4mg, 8mg and 12mg doses. Let me know which you have if you have the films. If you do cut up some pieces of 2mg, 1mg, .5mg and .25mg to have for the induction.

    And be prepared for a mental fight while you're waiting in wd's to induct. The time usually goes slow and you'll most likely become impatient. Don't rush the process. Keep in mind the Methadone's half life is long and it will take while for your score to rise on the Cows. If you take an Aspirin, Tylenol, Ibuprofen, etc it will slow down the Cows so avoid those kinds of meds. Unfortunately you have to suffer a while, but just know everyone goes through it. Its without a doubt the worst part of this process. Again, you only need to do it once so keep that in mind.

    Can't think of anything else at the moment, but if I do I'll let you know.

    Randy

  10. #10
    Gentlemansyd is offline New Member
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    Quote Originally Posted by Randy35 View Post
    Happy to help all that I can.

    That's great news hearing the doctor has written you a script and leaving the induction up to you. I wish all sub doctors would do that. That will make things so much easier. Definitely a winning situation.

    Vitamins and supplements are very important to our well being. There are many that can really help our bodies to perform at it's best. But in my opinion you should wait until after the induction to start a regiment of vitamins and/or supplements because I'm fearful they COULD interfere with the Cows score. As Cat mentioned to you earlier, you don't want to take any kind of "comfort meds" or supplements that would make you feel better during your planned wd's because it could slow down the Cows score. I would consider vitamins to be in that category, but others may disagree. If you have been taking them already that would be ok, but if it were me I would wait until after the induction to start taking them. Up to you of course.

    What else can you do to get ready: A couple of things come to mind. Do you have the Suboxone film strips? If you do I would cut up some small pieces in advance of your induction to have ready. While you're in wd's waiting to induct you'll be feeling miserable and probably have shaky hands and body. Might be difficult to cut the does up at that time. I used some small scissors to cut with and a pair of tweezers to hold the film strips. I just eyeballed it and kept cutting the film in halves until I got the doses I needed. Place the pieces back in the foil wrapper for safe keeping and make certain to label what it is because it's very easy to forget later. The film's come in 2mg, 4mg, 8mg and 12mg doses. Let me know which you have if you have the films. If you do cut up some pieces of 2mg, 1mg, .5mg and .25mg to have for the induction.

    And be prepared for a mental fight while you're waiting in wd's to induct. The time usually goes slow and you'll most likely become impatient. Don't rush the process. Keep in mind the Methadone's half life is long and it will take while for your score to rise on the Cows. If you take an Aspirin, Tylenol, Ibuprofen, etc it will slow down the Cows so avoid those kinds of meds. Unfortunately you have to suffer a while, but just know everyone goes through it. Its without a doubt the worst part of this process. Again, you only need to do it once so keep that in mind.

    Can't think of anything else at the moment, but if I do I'll let you know.

    Randy

    It is the 8mg film. I will be sure to go ahead and cut some up.
    So you would recommend starting at .25 and waiting an hour then up from there?

  11. #11
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    It is the 8mg film. I will be sure to go ahead and cut some up.
    So you would recommend starting at .25 and waiting an hour then up from there?

    When switching to Suboxone from Methadone it almost always takes a bit more sub to get someone stable. I would expect it take take you somewhere between 4mg and 8mg to completely stabilize. So like Cat mentioned earlier, I would start your induction with either a 1mg or 2mg dose. After the initial dose, depending on how you're feeling, I would take 1mg more. After that it will depend on your symptoms as to what dose would be best. If you're still in rough wd's I would continue to take another 1mg dose, but if you notice improvement I would take either .25mg or .5mg doses until you're completely stable. We'll know more when you're in the induction process.

    And it's very important to wait that hour between doses. Suboxone works fast for some, but slower for others. Giving it plenty of time to work is always the way to go.

    Randy
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  12. #12
    Gentlemansyd is offline New Member
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    Quote Originally Posted by Randy35 View Post
    When switching to Suboxone from Methadone it almost always takes a bit more sub to get someone stable. I would expect it take take you somewhere between 4mg and 8mg to completely stabilize. So like Cat mentioned earlier, I would start your induction with either a 1mg or 2mg dose. After the initial dose, depending on how you're feeling, I would take 1mg more. After that it will depend on your symptoms as to what dose would be best. If you're still in rough wd's I would continue to take another 1mg dose, but if you notice improvement I would take either .25mg or .5mg doses until you're completely stable. We'll know more when you're in the induction process.

    And it's very important to wait that hour between doses. Suboxone works fast for some, but slower for others. Giving it plenty of time to work is always the way to go.

    Randy
    I meet again with the Sub doctor tomorrow and my Psych doctor on Wednesday. Is there anything I should ask at either?
    Everything is on schedule so far. Last dose is Wednesday morning. All of my time off work has been approved as well so I guess it's just the wait until Wednesday. My anxiety has been slowly rising.
    I have already been having miniature panic attacks when thinking about it as well as two nightmares.

    I know this won't be easy, but I have a feeling it won't be half as bad as I have been thinking.

  13. #13
    Gentlemansyd is offline New Member
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    Default Last dose at 7:30am this morning

    Today was the day. I signed my discharge papers at my MMT clinic. I originally was just going to stop showing up. But out of fear of me having a moment of weakness and showing back up, I made it official so I cannot just return and dose without a bunch of red tape and a Doc visit.
    I have to admit I am anxious as all hell. I work today but then I have Thursday (tomorrow) through Monday off. If all is well, at 72 hours, I hope to be able to take my first dose of buprenorphine on Saturday morning.

    In 5 years the most I have done is go 48 hours without a dose. I am freaked out to say the least. In the past two nights I have had the feeling of withdrawals come up, even waking me out of a deep sleep at 3am the other night. I know it has to be psychosomatic because I was still dosing at that point.
    I hope I can be honest with myself in scoring on the COWS sheet. I am not myself when the anticipation of upcoming withdrawals sets in.
    Thoughts?
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  14. #14
    Lvg nghtmare is offline Platinum Member
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    Congratulations on your way to a new life my friend. You got this...
    We are all here to support you.. keep posting...
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  15. #15
    Catrina is offline Diamond Member
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    Quote Originally Posted by Gentlemansyd View Post
    Today was the day. I signed my discharge papers at my MMT clinic. I originally was just going to stop showing up. But out of fear of me having a moment of weakness and showing back up, I made it official so I cannot just return and dose without a bunch of red tape and a Doc visit.
    I have to admit I am anxious as all hell. I work today but then I have Thursday (tomorrow) through Monday off. If all is well, at 72 hours, I hope to be able to take my first dose of buprenorphine on Saturday morning.

    In 5 years the most I have done is go 48 hours without a dose. I am freaked out to say the least. In the past two nights I have had the feeling of withdrawals come up, even waking me out of a deep sleep at 3am the other night. I know it has to be psychosomatic because I was still dosing at that point.
    I hope I can be honest with myself in scoring on the COWS sheet. I am not myself when the anticipation of upcoming withdrawals sets in.
    Thoughts?
    Here you go. Congratulations!! Absolutely your head will mess with you when you are scoring yourself. Do you have anyone in the house who can help you with that? Sometimes someone else can look at things more clearly. In any event, just be conservative when you are scoring yourself. The score of each symptom may increase as another decreases and this can become confusing. Just do your best. Usually once the symptoms begin they will begin to escalate more quickly so hang on tight and just be kind to yourself. Believe it or not, waiting to induct and the induction itself is the toughest part but if you do it right, you'll feel much better once you have inducted and will finally be able to visualize the end of the nightmare.

    As far as the anxiety goes, here's what I did. When I began to feel anxious, I would slow myself down and take a minute or two to evaluate how I REALLY felt. Was my anxiety a craving? Did I have real honest to goodness withdrawal symptoms or was I considering caving because in my head I knew it would calm everything down. Almost always, I was able to separate the two and when I did I found that I could manage the physical discomfort and I was responding to my habit. Does this make sense?

    Keep posting and keep in touch. There are plenty of folks here who will continue to check in on you and answer your questions or to leave a word or two of support that is often enough to get us through the next hour.

    Peace,

    Cat

  16. #16
    Gentlemansyd is offline New Member
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    It means a lot thanks Cat!

    I live alone so I do not have anybody to give do a COWS evaluation for me. My best bet is to just bury myself in TV or play a video game or something so I can try to take my mind off of it. Day 1 without, (if you count today being day 0) will be fairly easy. I usually just get hot flashes and anxiety. My guess is that I'll be extra restless by Friday and I will have to have serious self control in order to not try to score myself too liberally and induct too early.
    I'll be on here a LOT with updates. In my search through forums leading up to now, I have found tons of posts of people at my methadone dose starting the process towards Sub induction but they never update at the end and say how it went.
    This thread is my only source of knowledge and advice so I appreciate anybody who spares the time to chip in and advise me.

    Thanks so much you guys! I will be updating very soon.
    Nice to feel the sense of community instead of feeling I am going through this alone.

  17. #17
    Gentlemansyd is offline New Member
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    Default 31 Hours Update

    Just a check in for posterity. Not crawling out of my skin just yet.

    So My last dose was just after 7am yesterday morning. When I woke up I felt 80% normal. My back is starting to hurt quite a bit and a thin layer of sweat has begun to appear on my back. Other than anxiety that comes and goes if I can distract myself, I am okay.
    Heart rate is 90bpm while resting.
    COWS score is at 6.

  18. #18
    Gentlemansyd is offline New Member
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    Default 48 hours

    So it is two days since my last 25mg dose of methadone. I am feeling more than mildly uncomfortable but able to put it out of mind for about 15 minutes at a time. The worst problem so far is staying in one place for more than a few minutes.
    As I believe Cat and/or Randy mentioned earlier, my COWS score, although increasing slightly (currently a 9 or 10), has had many of the symptoms go down while others go up.
    Heart rate is normal (b/w 78 and 81). Chills and aches are slowly setting in. Skin feels dry and and irritated.

    I think I may have gotten the last bit of sleep I will get until induction as well. Last night I woke up three times to find my legs shifting. I was doing it so much that my cat was attacking me in my sleep from shifting about so much. I regret not turning my daily work alarms off on my phone. Once it went off at 6am, I was uncomfortable to the point that sleeping through the RLS and aches was not possible.

    Going out for cigarettes to get out of the house. Maybe in another 12 to 18 hours I can induct.
    Would a safe 60 hour induction be unheard of?
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  19. #19
    Catrina is offline Diamond Member
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    Quote Originally Posted by Gentlemansyd View Post
    So it is two days since my last 25mg dose of methadone. I am feeling more than mildly uncomfortable but able to put it out of mind for about 15 minutes at a time. The worst problem so far is staying in one place for more than a few minutes.
    As I believe Cat and/or Randy mentioned earlier, my COWS score, although increasing slightly (currently a 9 or 10), has had many of the symptoms go down while others go up.
    Heart rate is normal (b/w 78 and 81). Chills and aches are slowly setting in. Skin feels dry and and irritated.

    I think I may have gotten the last bit of sleep I will get until induction as well. Last night I woke up three times to find my legs shifting. I was doing it so much that my cat was attacking me in my sleep from shifting about so much. I regret not turning my daily work alarms off on my phone. Once it went off at 6am, I was uncomfortable to the point that sleeping through the RLS and aches was not possible.

    Going out for cigarettes to get out of the house. Maybe in another 12 to 18 hours I can induct.
    Would a safe 60 hour induction be unheard of?
    Good Morning,

    Hang in there. Your symptoms are beginning so that's good. Please try not to think about how many hours and rely upon the COWS. This is very important. Having said that, it is possible that you'll reach that 26 score in the next day or so but the true test is the COWS.

    Yes. It's going to get worse before it gets better but it's the only path to a safe and successful induction. You won't be sorry for waiting out the storm until you are good and sick. The fact is that the sicker you get, the better the induction. Good news though that once you do induct, you will get much needed relief so you're not looking at weeks of this.

    You're doing fantastic. This isn't easy but necessary and you're doing it!! Hunker down, take plenty of hot baths, use heating pads for the aches and RLS (the worst!!!), and set up camp by getting some movies ready, Netflix or anything else to help you while away the hours and to help to take your mind off things. Don't fight the sleep thing because it only makes it worse. Face the fact that until you've inducted you probably won't get much sleep. I just stopped trying and it actually made things easier. Acceptance. With practice you can learn to accept what's going on knowing that you're on the road to a much better place.

    Keep checking in.

    Peace,

    Cat

  20. #20
    Gentlemansyd is offline New Member
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    Just a quick update. I finally hit 26 on COWS at 6:30am today. The wait time for me from my last dose of methadone was just under 72 hours. I inducted and am stable at 3.25 mg of Suboxone.

    Thank you all so much. This was much much easier than I had thought it would be.
    Cat and Randy, I owe you two so much.

    I was worried that I would never hit close to 26. I had gone up and down on the COWS chart multiple times. Im also not one to get nauseous easy so I was a zero on GI symptoms the whole time. What got my score up the most was the restlessness, sweating, aches, and my saucer sized pupils.

    One thing I'd like to mention. Once I got stable on the sub, my sense of smell has gotten weird. Hypersensitive to odd smells. For example, making coffee this morning, the fresh grounds smelt overpoweringly like nuts and fruit. I have 4 different coffee brands here and they ALL smelled like that. Weird, huh?

    Once I get acclimated, I will get the taper plan together following Roberts plan. Help from you two would be welcomed.

    Again, thank you. It means a lot. Wish I could give y'all a hug.

    - Rob
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  21. #21
    Thersagirl is offline New Member
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    Not sure if I'm in the right place but wanted to say I just came out of precipitated withdrawal! What holy hell! I have been on methadone for 6 years 115 mlg daily got myself down to 50 mlg for 2 weeks waited more than 72 hours then took 2mlg sub was fine not better just not worse following my doc orders took another 2mlg 90 mins later ok then took another 2mlg after 90 min and o my god. Almost instantly threw me into precipitated withdrawal! This was to say the least horrible ×1000. Don't want this to happen again but determined to switch to subs. It has been another 48 hrs since PW stopped. When can I try again without goin threw hell! Please help!
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  22. #22
    Gentlemansyd is offline New Member
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    Use the COWS chart and be patient. You were a little high of a dose at 50mg for the transition. You probably needed closer to 96 hours or more.
    Wait until you hit 26 again then try. I know it sucks but Im proof that it works. If I had listened to my doctor I would have dosed at 36 hours. That would have put me in the same position.
    Be patient. Good luck.
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  23. #23
    Catrina is offline Diamond Member
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    Quote Originally Posted by Thersagirl View Post
    Not sure if I'm in the right place but wanted to say I just came out of precipitated withdrawal! What holy hell! I have been on methadone for 6 years 115 mlg daily got myself down to 50 mlg for 2 weeks waited more than 72 hours then took 2mlg sub was fine not better just not worse following my doc orders took another 2mlg 90 mins later ok then took another 2mlg after 90 min and o my god. Almost instantly threw me into precipitated withdrawal! This was to say the least horrible ×1000. Don't want this to happen again but determined to switch to subs. It has been another 48 hrs since PW stopped. When can I try again without goin threw hell! Please help!
    Welcome!

    I'm so sorry that you've had to go thru this. It's awful to say but sub doctors are generally not well informed on the best way to induct subs or how to do a proper taper giving you the best shot at success. You are most definitely not alone. I sure wish you had found us and posted sooner but at least you've found us now.

    Unfortunately, there's not a whole lot you can do at this point except to wait it out and try to induct again. This is a good time to ask that you create your own thread. Title it however you wish. That way all of your posts and any replies you get will be in one place and easy for you to find. In addition, it'll be far easier for us to find you! Just copy and paste your post on your new thread so that anyone who comes by will have some background.

    What to do now? Wait. I'm sorry but that's all you can do. Your cows may be off a little by having taken 6mg of sub but the important thing is to allow more of the methadone to dissipate so that you don't have a repeat performance of the precipitated withdrawals.
    You will probably have to wait a couple of days and then reinduct. When you are ready, don't introduce multiple 2mg pieces. Instead, because you are transitioning from methadone we already can predict that your initial dose will probably be between 4-6mg/day. It's important to add very small doses until you are stable (little to no withdrawal symptoms). Take a first dose of 2mg and wait a good hour and then if you aren't stable, take another .5mg. Wait another hour and if you're still not stable, take another .5mg. After that if you still need more, begin to take .25mg pieces. That way you'll land at the lowest effective dose. With subs, less is more and you will feel best at the lowest effective dose. Keep careful track of how much it took you to get stable and that's your beginning dose. You're going to stay at that dose for around a week and if you're stable, you can begin your 25% reductions. Until you are down to 1mg/day, you can either dose once a day or split your dose into two and dose twice. Once in the morning and once 8-10 hours later being sure your second dose isn't too close to bedtime. Not everyone, but there are those who find that dosing too close to bedtime interferes with their sleep. If you do decide to dose twice, make sure you split your daily dose in half so that each dose will be the same. It's important to do whatever you can to maintain as consistent a level of the sub in your system as possible.

    Start that new thread and keep posting and asking questions. This is the hardest part but once you get past your induction, follow the plan used here carefully and you're going to do great. Be patient for now even though I know it's hard. The sicker you get before you induct, the better your induction will go and be sure to go slow so that you land at the lowest dose possible.

    Good luck and Welcome again.

    Peace,

    Cat
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  24. #24
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    Just a quick update. I finally hit 26 on COWS at 6:30am today. The wait time for me from my last dose of methadone was just under 72 hours. I inducted and am stable at 3.25 mg of Suboxone.

    Thank you all so much. This was much much easier than I had thought it would be.
    Cat and Randy, I owe you two so much.

    I was worried that I would never hit close to 26. I had gone up and down on the COWS chart multiple times. Im also not one to get nauseous easy so I was a zero on GI symptoms the whole time. What got my score up the most was the restlessness, sweating, aches, and my saucer sized pupils.

    One thing I'd like to mention. Once I got stable on the sub, my sense of smell has gotten weird. Hypersensitive to odd smells. For example, making coffee this morning, the fresh grounds smelt overpoweringly like nuts and fruit. I have 4 different coffee brands here and they ALL smelled like that. Weird, huh?

    Once I get acclimated, I will get the taper plan together following Roberts plan. Help from you two would be welcomed.

    Again, thank you. It means a lot. Wish I could give y'all a hug.

    - Rob


    Hello Rob -

    Outstanding job and so happy to hear you made it through the induction process. And 3.25mg is an awesome dose to be stable on!

    Not sure about the smelling issue. Have to think on that one.

    Just as you are planning, spend about a week on your stable 3.25mg dose then begin the taper process of reducing your dose by 25% every 4-7 days, or when stable. Keep in mind as you reduce that it may take your body a day or two to accept the new lower dose. Most people feel a few symptoms the first, and sometimes the second day after reducing, but by the third day things begin to level out. That doesn't happen all the time either.

    Just don't reduce any dose if you aren't stable on the current dose. You may be ready to reduce after 4 days on one dose, but may not be ready for 5-6 days on other doses. This is a process and not an event.

    Doing Awesome and I'm very proud of you! Be proud of yourself!

    Randy
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  25. #25
    Gentlemansyd is offline New Member
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    Quote Originally Posted by Randy35 View Post
    Hello Rob -

    Outstanding job and so happy to hear you made it through the induction process. And 3.25mg is an awesome dose to be stable on!

    Not sure about the smelling issue. Have to think on that one.

    Just as you are planning, spend about a week on your stable 3.25mg dose then begin the taper process of reducing your dose by 25% every 4-7 days, or when stable. Keep in mind as you reduce that it may take your body a day or two to accept the new lower dose. Most people feel a few symptoms the first, and sometimes the second day after reducing, but by the third day things begin to level out. That doesn't happen all the time either.

    Just don't reduce any dose if you aren't stable on the current dose. You may be ready to reduce after 4 days on one dose, but may not be ready for 5-6 days on other doses. This is a process and not an event.

    Doing Awesome and I'm very proud of you! Be proud of yourself!

    Randy
    I owe a lot to you and Cat. I surprised myself by how patient I was going through withdrawals. I had experienced PWDs in my using days so I was not looking for a repeat of that.
    I'm sure I'll want more advice over the course of my taper. I hope to speak with you again soon!
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  26. #26
    Gentlemansyd is offline New Member
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    Default Day 4 - Some Issues

    I am currently between 2-3 mgs once daily. I found that taking 4mg or more gives me a extremely weird feeling that I cannot quite describe. On my current dose, my mind feels scattered and I find it hard to concentrate and feel a little dizzy/lightheaded and anxious as all hell.

    I have a follow-up with the sub doc tomorrow but I don't put a lot of faith in her. Any advice? Is this just an adjustment period?

  27. #27
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    I am currently between 2-3 mgs once daily. I found that taking 4mg or more gives me a extremely weird feeling that I cannot quite describe. On my current dose, my mind feels scattered and I find it hard to concentrate and feel a little dizzy/lightheaded and anxious as all hell.

    I have a follow-up with the sub doc tomorrow but I don't put a lot of faith in her. Any advice? Is this just an adjustment period?


    Good Morning, Rob -

    Hope you see this before you go to your doctor appointment. If not that's ok too.

    What caught my eye first is you saying you were "between" 2-3mg of Suboxone daily. Definitely a red flag my friend. Your dose needs to be consistent at all times. Theres a HUGE difference between 2mg and 3mg. So whatever the dose is that stabilizes you, stick with that dose. And make certain to take your sub at the same time(s) everyday. That's very important to feel your best.

    You also said you found that 4mg gave you problems? I'm only asking, but if you were stable on 3.25mg at induction why did you try taking 4mg? Just curious. To be perfectly honest, coming from Methadone I was surprised you said you were stable on 3.25mg. It almost always takes more sub for those switching from Methadone. Saying that, it takes what it takes. Suboxone is STRONG, and the more you take the worse you'll usually feel. That's why we call it a "less is more" drug, because the LESS you take the better you'll feel. It works the exact opposite of other opiates.

    If you tell the doctor at your appointment you aren't feeling well I have little doubt that she'll instruct you it's because you need more sub, and maybe you do? But these sub doctors (most of them) think you need to be on 8mg to 16mg in most cases, and lots of them put patients on doses much higher than that, which is ridiculous. Let's see what your doctor says and go from there.

    It's important you let us know how you're feeling during the day and night. Adjustments can certainly be made. Talk to you again soon.

    Randy
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  28. #28
    Randy35 is offline Platinum Member
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    Quote Originally Posted by Gentlemansyd View Post
    I am currently between 2-3 mgs once daily. I found that taking 4mg or more gives me a extremely weird feeling that I cannot quite describe. On my current dose, my mind feels scattered and I find it hard to concentrate and feel a little dizzy/lightheaded and anxious as all hell.

    I have a follow-up with the sub doc tomorrow but I don't put a lot of faith in her. Any advice? Is this just an adjustment period?

    Hi Rob -

    How did your doctor appointment go? Hope you can update soon. Take care.

    Randy

  29. #29
    Gentlemansyd is offline New Member
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    Hey Randy,

    I am not sure why, but my reply to your post yesterday morning got caught up with being checked by a moderator and never got posted. Not sure why. There were no curse words or anything. Anyway...

    Doc appointment went well. She is of the belief that less is more and said to continue taking the 2mg daily and add .5mg if needed during the day.
    Today is much better than yesterday and I was able to sleep last night without much trouble.
    Hopefully I am slowly becoming acclimated to the Suboxone.

    I appreciate you checking back.

  30. #30
    Gentlemansyd is offline New Member
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    Default Night #6 on Suboxone (from Methadone)

    So I could not sleep AGAIN last night. Went to bed around 11p only to wake up at 2:30a tossing and turning. Had slight anxiety that comes on before physical w/d symptoms. I ended up taking 1mg of sub around 3:30a and was able to fall back asleep comfortably by 4a.
    Maybe I need to take a little bit in the evening after all.

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