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Methadone to Suboxone, please help!!
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    missdawn1786 is offline Junior Member
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    Default Methadone to Suboxone, please help!!

    I am on 100 mgs of methadone and I just recently went to a Suboxone doctor. He prescribed me Suboxone and told me to start taking it that evening, knowing I had just dosed at the methadone clinic that morning. He said to try a small piece of the sublingual film and if I didn't feel worse in a half hour then it was OK to proceed. And if I did feel worse to wait about 3 hours and try again. I am scared to do this after everything I've heard and read about p/w. I do not have the time to taper down to 30 mgs. I have to do this now so I need to know the best way for my situation. If I can wait until Sunday night or Monday morning, with my last dose of methadone being today, will that be long enough? And how much of the Suboxone should I start with. I am so scared of withdrawal but I do not want to experience p/w. Thank in advance for help/advice. Also, if anyone has had a positive or not awful experience and did it the way I am trying to do it, I would love to hear your story. Thanks!
    Last edited by Anonymous; 08-31-2017 at 11:32 PM.

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    I am on 100 mgs of methadone and I just recently went to a Suboxone doctor. He prescribed me Suboxone and told me to start taking it that evening, knowing I had just dosed at the methadone clinic that morning. He said to try a small piece of the sublingual film and if I didn't feel worse in a half hour then it was OK to proceed. And if I did feel worse to wait about 3 hours and try again. I am scared to do this after everything I've heard and read about p/w. I do not have the time to taper down to 30 mgs. I have to do this now so I need to know the best way for my situation. If I can wait until Sunday night or Monday morning, with my last dose of methadone being today, will that be long enough? And how much of the Suboxone should I start with. I am so scared of withdrawal but I do not want to experience p/w. Thank in advance for help/advice. Also, if anyone has had a positive or not awful experience and did it the way I am trying to do it, I would love to hear your story. Thanks!

    Welcome to the forum!

    I honestly can't believe some of these sub doctors. He gave you some of the WORST advice possible. Methadone is a very strong drug as the subs are. And methadone also has a very long half life just like the subs do. For those reasons it can take DAYS before you're ready to induct on the subs coming from METHADONE. I made the switch myself and it took me nearly 90 hours from the time I stopped the methadone until I was safely prepared to take the Suboxone.

    The very best way to know it's safe and you're ready for the sub induction is to use a Cows Chart. Here's the link below to a real good Cows....
    https://www.drugabuse.gov/sites/defa...rawalScale.pdf

    You do not necessarliy have to taper the methadone lower as many have switched to subs at higher doses than the 100mgs you're on now. It's best to taper lower, but not absolutely necessary. What's most important is to completely stop taking the methadone and allow moderate to severe wd's to begin. Use the Cows. The Cows assigns numbers to a variety of wd symptoms. You add up the score of the symptoms you're having and when you get to a score of 26 or higher you know it's ok to take that first dose of Suboxone. Take it any sooner and you risk having those precipitated wd's. I went through them twice getting in a hurry to induct and it's not something you want to experience I promise you. So use the Cows and score yourself honestly and accurately and you'll be fine.

    Below is the link to our sub plan...
    https://www.drugs.com/forum/suboxone...apy-66109.html

    Read through it entirely to become familiar with it as it's what we follow here. Its self explanatory, but aks all the questions you have. Myself or someone else can help you throguh the induction process and the subsequent taper process.

    The correct way to do this is once you're at the 26 on the Cows you begin the induction by taking small doses of sub every hour until stable with little or no wd symptoms. Coming from Methadone we suggest beginning with a 1mg dose and wait 60 minutes. For the following dose it's suggested you take a .5mg dose. After those doses the rest should all be .25mg doses until you're stable.

    The goal is to "build up" the sub gradually and not take a huge dose at once. You want to be on the LOWEST effective dose, not the highest.

    Read the info I've supplied. I'll check back.

    Randy
    Last edited by Anonymous; 12-13-2017 at 07:31 PM.
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    missdawn1786 is offline Junior Member
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    Thank you so very much for your advice. I will definitely try my hardest to wait the full 96 hours but will for sure wait til I score 26 on the COWS worksheet. I was so worried I could not do this coming off 100 mgs of methadone so it's good to know that there is hope for me. I will keep this thread updated as to my progress. I have not had methadone in about 30 hours but I am not feeling any withdrawal as of right now. I plan on taking the Suboxone Monday morning, if I can wait that long.

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    missdawn1786 is offline Junior Member
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    Also, I was prescribed 8/2 films. If I cut that into 8 pieces each piece would be 1mg, is that correct? And then cut each 1mg piece into four pieces to get .25mg pieces? I know, it's basic math but I want to be sure I'm doing it right.

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by missdawn1786 View Post
    Also, I was prescribed 8/2 films. If I cut that into 8 pieces each piece would be 1mg, is that correct? And then cut each 1mg piece into four pieces to get .25mg pieces? I know, it's basic math but I want to be sure I'm doing it right.
    Hello missdawn - the following video was made by a drugs.com member named HarrySmooth, the video will show you how to cut the suboxone strips accurately, here's a link - https://m.youtube.com/watch?v=ttZ5ATKb-LE

    Just remember that time is not the determining factor as to when you can start the sub induction, scoring a 26 or higher on the COWS worksheet is the only way to know that it is safe to start the induction process! Study Robert's sub therapy/taper plan until you understand it 100%! Listen to and follow Randy's advice, he will not steer you wrong! I wish you the best of luck... God bless us all!
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    missdawn1786 is offline Junior Member
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    Wow, that video was very helpful. Thank you. I am almost 36 hours with no methadone and no withdrawal. I hope I can get to 26 on cows by Monday morning. I figured this would be a good weekend to do this because of the holiday. I have never in my life WANTED to experience withdrawal but I am so ready to do this, lol. Thank you for your support!

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    Also, I was prescribed 8/2 films. If I cut that into 8 pieces each piece would be 1mg, is that correct? And then cut each 1mg piece into four pieces to get .25mg pieces? I know, it's basic math but I want to be sure I'm doing it right.

    Hi Dawn -

    Yes, your math is correct. The video that Ricky provided is a good one for sure. What I did to cut the films is to use some tweezers to hold the strips and small scissors to cut with. I cut the strips in halves by eyeballing them and I always got them really close to perfect. I would suggest cutting some strips up now in advance because once you're in wd's you'll be shaky and may have trouble getting them cut accurately. Put the pieces back in the foil wrapper and make certain to label what they are because it's easy to forget later.

    I really don't know at this point if you'll be ready on Monday or not for the induction. You should be, but everyone's different. I know people coming from methadone that only took 36 hours to hit the 26 score on the Cows so the time varies with each of us. Some need 48 hours, some like me longer. Mthadone's long half life is the reason for how long it takes. The most important thing is to be absolutely certain you don't take the sub too soon. You'll know when wd's are getting serious.

    If you do this right you'll only need to do it once.

    One other thing that's very important to mention. The goal is to be "sick enough" in wd's so you can safely take the sub. You don't want to be taking ANYTHING that will make you "feel better" during the time you're waiting to score the 26 on the Cows. Reason is things such as Tylenol. Motrin/Ibuprofin, or other such meds can delay your Cows score and make you suffer longer than necessary.

    Let the wd's happen naturally and once you begin to feel the brunt of them begin scoring yourself on the Cows. Once your score gets in the 10-15 range they usually start progressing faster. Keep checking in and let usk now how you're doing. I'll be around this weekend and will check back.

    Randy
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    missdawn1786 is offline Junior Member
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    That sucks, I took an ibuprofen about 3 hours ago cuz I was starting to get a headache. I'm sure it's lost its effect by now. Today has been pretty easy. I wasn't expecting much w/d today though. I know tmrw and Sunday is when it's gonna be hardest. I want my w/d to hurry up and start but nothing is really happening. I am really anxious to get this done but you are right, I need to just let it happen naturally and try to keep my mind busy. I have never gone longer than one day without my dose so I'm not even sure how I will feel tmrw. Guess I'll just have to wait and see! Thank you so very much for posting back, you have no idea how much I appreciate the support! I will get those films cut up now. Do you have any advice on things I can do to help pass the time?
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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    That sucks, I took an ibuprofen about 3 hours ago cuz I was starting to get a headache. I'm sure it's lost its effect by now. Today has been pretty easy. I wasn't expecting much w/d today though. I know tmrw and Sunday is when it's gonna be hardest. I want my w/d to hurry up and start but nothing is really happening. I am really anxious to get this done but you are right, I need to just let it happen naturally and try to keep my mind busy. I have never gone longer than one day without my dose so I'm not even sure how I will feel tmrw. Guess I'll just have to wait and see! Thank you so very much for posting back, you have no idea how much I appreciate the support! I will get those films cut up now. Do you have any advice on things I can do to help pass the time?

    Where people make the biggest mistake (I sure did) is getting in a hurry to induct and take the sub too soon. I did that twice and put myself into PWD's twice. I was so sick I really believed I was going to die. Ended up in the ER and of course they could do nothing to help. Precipitated wd's are HORRIBLE!!!

    I guess you can do just about anything to help pass the time except sit in the house watching the clock because minutes pass so slow. You'll be miserable waiting for wd's to get here. I would get out of the house as much as possible. Maybe go for a walk or jog if you're into that. Go to the store for groceries or to the mall and walk around. Go visit a friend. Anything but sit around waiting.

    Methadone's half life can be nearly 72 hours for some people so that's why the wd's take so long to happen. You're over 30 hours now off the methadone so I would expect you to be feeling some kind of wd's symptoms very soon now. Hang in there as best you can.

    Reading some threads and posts will also help pass the time.

    Randy
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    missdawn1786 is offline Junior Member
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    I at 55 hours with no methadone and I only feel slight withdrawal. Not even worth trying to score myself. This is pissing me off. Any other time I miss one day of my dose and am sick by that afternoon. I am starting to feel a little anxious and cold and sweaty but that's about it. And I haven't used or done anything! Anyway, hope everyone is having a good weekend! It's so nice here in STL!

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    I at 55 hours with no methadone and I only feel slight withdrawal. Not even worth trying to score myself. This is pissing me off. Any other time I miss one day of my dose and am sick by that afternoon. I am starting to feel a little anxious and cold and sweaty but that's about it. And I haven't used or done anything! Anyway, hope everyone is having a good weekend! It's so nice here in STL!


    Keep in mind you stopped from 100mgs of methadone and it could take longer than if you had tapered lower. You'll get there so hang tight.

    Randy
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    missdawn1786 is offline Junior Member
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    I want to continue to post so that people in the future that want to do this know what to expect. Coming off of 100 mgs of methadone, I am currently at 76 hours cold turkey. The first 2 days I experienced little to no withdrawal. Today, however, they are really starting to kick in. I scored a 12 on the COWS sheet and I believe I'll be ready to take my Suboxone tonight or tmrw morning which is what I hoped for. This is not nearly as bad as I thought it was going to be and I am so excited to start my new life, free of the liquid shackles that have been methadone for the past 5 years. I am overwhelmed with emotion at this point. Mostly excitement. But sometimes sadness and bouts of crying. Mostly I am just looking forward to taking my first dose of Suboxone and getting on with my life. This forum has been the most help of all. I got more useful information here and am thankful to the people that replied with their encouraging words. I may not have been able to this otherwise. I'll post back tmrw to inform you of how my first Suboxone dose goes. Thanks again!
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    Catrina is offline Diamond Member
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    You're doing great! Be conservative when you're scoring yourself and pay close attention to that magic 26. Follow Randy's instructions carefully taking those small doses until you become stable. Check in here often and share how you're doing in case you have questions or just want to be sure you're doing this correctly.

    You are almost done with the hardest part. Congratulations! You'll be there soon.

    Peace,

    Cat
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    missdawn1786 is offline Junior Member
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    Well I screwed up and thought I was "sick enough" and took the sub. It made me only a little sicker. I was able to get some sleep after several hours of hot and cold sweats and tossing and turning. This morning I woke up feeling a lot better but my question is what do I do now? Start all over? I can't keep doing this. I need this to work. I seriously thought about going and getting my methadone this morning but my mom talked me out of it.

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    Well I screwed up and thought I was "sick enough" and took the sub. It made me only a little sicker. I was able to get some sleep after several hours of hot and cold sweats and tossing and turning. This morning I woke up feeling a lot better but my question is what do I do now? Start all over? I can't keep doing this. I need this to work. I seriously thought about going and getting my methadone this morning but my mom talked me out of it.

    What was your Cows score when you took the sub?

    How much sub did you take?

    This would have worked perfectly if you followed the plan on the induction. If you took the sub too soon you're lucky you aren't deathly ill.

    Depending on the amount of sub you took will depend on whether you start over or not.

    Randy
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    missdawn1786 is offline Junior Member
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    I scored a 20 on the cows. I know I should have waited but I thought that I'd be fine. Which I was, it just sucked. I took about 4mg of sub.

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    Randy35 is offline Platinum Member
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    Quote Originally Posted by missdawn1786 View Post
    I scored a 20 on the cows. I know I should have waited but I thought that I'd be fine. Which I was, it just sucked. I took about 4mg of sub.

    Ok, IF you're feeling ok now and NOT having horrible symptoms (basically stable) you should call 4mg your daily dose. I suggest you split that dose and take 2mg in the morning and 2mg later in the day about 8-10 hours after the first dose. Take your sub at the same time everyday. Plan on spending around 4-7 days on the 4mg before reducing per the plan by 25%.

    Now If you ARE having some rough symptoms and just not feeling well then you should STOP taking any sub for at least today and probably tomorrow too. This will allow your system to adjust and you can basically start over without having to rely on the Cows. After a day or two without sub you would begin taking it again in .25mg increments until you're stable.

    If you've already taken a dose of sub today lets see how you feel later in the day and go from there.

    Sound ok?

    Randy
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    missdawn1786 is offline Junior Member
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    OK. I feel pretty much OK right now. A little sweaty and weak and shaky but not much withdrawal. I took 2mg this morning at 7am. So about 7pm tonight I'll take 2mg more. I think I can handle that.

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by missdawn1786 View Post
    OK. I feel pretty much OK right now. A little sweaty and weak and shaky but not much withdrawal. I took 2mg this morning at 7am. So about 7pm tonight I'll take 2mg more. I think I can handle that.
    I'm curious as to why you didn't follow the induction protocol precisely as it was explained to you?

    If you dosed at 7am then why would you take your second dose at 7pm? Randy just explained that you need to take your sub dose at the same time everyday "8-10 hours apart", not 12 hours apart! But why would you follow that piece of advice if you didn't follow one of the most important pieces of advice which was waiting until you scored a 26 or higher on COWS worksheet before beginning the sub induction? You are very lucky that you didn't put yourself into precipitated withdrawals!

    Members like Randy and Cat spend a lot of time here in the forums helping others like yourself, it just continues to floor me to see people doing things there own way instead of the way they were advised to! I'm at a loss, I just don't get it?

    Please, from here on out, follow Robert's sub therapy/taper plan and Randy's advice, if you do you'll be very successful... Take care... God bless us all!
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    missdawn1786 is offline Junior Member
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    Yes you're right. I should have followed instructions. I guess I just figured that it had been long enough and I scored a 20 so I thought that was close enough. If you've gone through withdrawals then you know that it's hard to see far enough ahead to make rational decisions. I just wanted to feel better. It didn't make me feel better, only slightly worse.

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    missdawn1786 is offline Junior Member
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    I'm also not thinking very clearly right now but I realize now that I would take my next dose between 3pm and 5pm. Thank you for your reply.

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by missdawn1786 View Post
    Yes you're right. I should have followed instructions. I guess I just figured that it had been long enough and I scored a 20 so I thought that was close enough. If you've gone through withdrawals then you know that it's hard to see far enough ahead to make rational decisions. I just wanted to feel better. It didn't make me feel better, only slightly worse.
    Yes, I know first hand just how bad withdrawals can be and the urgency to feel better. With the subs it's just so extremely important to hit that 26 on the COWS, the induction is the most critical part of the sub therapy plan. Luckily you got through it without too much discomfort!

    I've seen quite a few members here that have had problems with the sub induction simply because they didn't follow Robert's plan EXACTLY as outlined, they inducted too soon, took too much sub, etc..., they all suffered unnecessarily! If you go back and read through your entire thread you'll see how adamant we were in telling you not to start the sub induction until you hit that magic #26! I apologize if I was a bit harsh earlier, I just want you to have success using Robert's sub plan with the least amount of problems! Good luck as always and keep us posted? God bless us all!
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    missdawn1786 is offline Junior Member
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    I understand what you're saying. And I know you were not trying to be harsh or rude, I didn't take it that way at all. I regret not following the plan closely because I could have saved myself an evening of uncomfort. Looking back I wish I would have waited just a little bit longer to hit 26. It prob wouldn't have taken much longer anyway. I took my second dose just now. Again, it didn't make me feel better but also not worse. So for tmrw, take 2mg in morning at 7am and another 2mg 8-10 hours after that, correct? And then every day for 4 more days? Let me know if I got that right. Hopefully, in the future when someone else want to do the same thing they can learn from my mistakes. You don't know how much I appreciate all of you help.
    Last edited by Anonymous; 09-04-2017 at 03:57 PM.
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    Catrina is offline Diamond Member
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    Quickly jumping in MissDawn. Congratulations on getting thru the induction (blips and all!)

    In order to consider yourself "stable" you should have little to no symptoms. It sounds like you aren't quite there but you're on the good side of tweaking. Better this way than having taken too much and working to get it down.

    You did good by sticking with the 4mg. Coming from the mdone, that's so good. So, just so that it's clear, please give us the symptoms that you're having and how severe they are. 1 being barely there and 5 being I can't stand it.

    Tiny bits of subs are powerful and it could be that if you still aren't stable you could add another .25 to see if that will make you feel better. Don't do anything yet. Please check in and tell us details about how you're feeling. Maybe a little tweak will make a huge difference.

    Peace.

    Cat

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    Ricky71 is offline Advanced Member
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    Quote Originally Posted by missdawn1786 View Post
    I understand what you're saying. And I know you were not trying to be harsh or rude, I didn't take it that way at all. I regret not following the plan closely because I could have saved myself an evening of uncomfort. Looking back I wish I would have waited just a little bit longer to hit 26. It prob wouldn't have taken much longer anyway. I took my second dose just now. Again, it didn't make me feel better but also not worse. So for tmrw, take 2mg in morning at 7am and another 2mg 8-10 hours after that, correct? And then every day for 4 more days? Let me know if I got that right. Hopefully, in the future when someone else want to do the same thing they can learn from my mistakes. You don't know how much I appreciate all of you help.
    Excellent, so now we move forward with you following Robert's sub therapy/taper plan...

    To answer your question, yes, your dosing schedule for tomorrow will be 2mg at 7am and then 2mg 8-10 hours later. Like Randy has already mentioned, take your doses at the same time everyday!

    Do not try to rush the taper process, slow and steady wins the race! You might not always be able to make a reduction every 4 days, sometimes it may take an extra day or two or three so keep that in mind! Like Cat just mentioned in her last post to you, DO NOT make a reduction if you are not completely stable on your current dose, stable means very little to no withdrawal! Keep us posted on everything and ask all the questions you need to? Take it slow, follow Robert's sub plan to the "T" and you'll do just fine. Good luck... God bless us all!
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    missdawn1786 is offline Junior Member
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    I just woke up. I got some meds from my doc and those helped a lot as far as letting me get some sleep for a good 7 hours. Before I fell asleep my symptoms were: hot cold sweats-3, leg cramping-3 (that could also be from dehydration), anxiety-3 and really just an inability to eat or sit still-3. Now that I am awake my symptoms are as follows: hot cold sweats-1, leg cramps-2, anxiety-1, ability to relax, sit still-1. Thank you Cat for helping me through this. The ppl on this forum are truly AMAZING!!!

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    missdawn1786 is offline Junior Member
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    Thank you! I feel much better now that I was able to sleep a little. My Dr called me in a script for Valium. I was even afraid to take that bit I did And I believe that is what helped me sleep so long. Waking up, I feel little to no withdrawal. But I am so afraid to take more Suboxone cuz I don't want to feel worse again.
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    Catrina is offline Diamond Member
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    Quote Originally Posted by missdawn1786 View Post
    Thank you! I feel much better now that I was able to sleep a little. My Dr called me in a script for Valium. I was even afraid to take that bit I did And I believe that is what helped me sleep so long. Waking up, I feel little to no withdrawal. But I am so afraid to take more Suboxone cuz I don't want to feel worse again.
    Be careful of the valium!

    It sounds like you're doing well now. Good! The way you describe your symptoms, I'd stick with it and don't take anymore. The danger of putting yourself into PW has passed now that you have successfully taken 4mg without getting really sick. Check in in the morning and let us know how you're feeling. Hopefully you'll still be doing well. If not, then we'll figure it out. You should not be having any bad symptoms because if you are, you need more sub but we'll worry about that only if we have to. So long as you stay the way you are and/or begin feeling better, then you're on the right track.

    Peace,

    Cat
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    missdawn1786 is offline Junior Member
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    Can you explain to me any danger of taking Valium while inducting? Or being on Suboxone? I really hope he wouldn't prescribe me something that is dangerous. Also, should I check in in the morning BEFORE I take my morning sub dose or after?
    Last edited by Anonymous; 09-04-2017 at 08:49 PM.

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    Catrina is offline Diamond Member
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    Quote Originally Posted by missdawn1786 View Post
    Can you explain to me any danger of taking Valium while inducting? Or being on Suboxone? I really hope he wouldn't prescribe me something that is dangerous. Also, should I check in in the morning BEFORE I take my morning sub dose or after?
    I warn you of the valium because they are soooooo addictive and I don't want you to pick up another nasty habit while beating the one you already have. Dependency on benzos comes rapidly. If you need to use them for the next couple/three days you should be OK. I'd try to use them at night and only if you're having trouble getting to sleep. After three days, get rid of them. They are an entirely different animal and they have to be very slowly tapered because it's dangerous to do otherwise. If this scares you, I'm glad because I don't want you to have a another problem.

    Peace,

    Cat
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