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Day two on subutex....desperate for advice..any help would be greatly appreciated
  1. #1
    Mrcardoc is offline Junior Member
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    Default Day two on subutex....desperate for advice..any help would be greatly appreciated

    Give you the rundown on my story. 36 year old male On methadone for approx 5 embarrassing years. Started at 120mg and tapered to 26mg. Stabilized on 26 mg for over a year and got tired of the clinic politics. Found a sub doc that has little knowledge about methadone. Anyways I completed the induction correctly. They made me do this inpatient. 72 hours methadone free and the induction of sub at 4 mg four times per day total 16mg. I thought it was high and yesterday took only 3 times per day at a total of 12 mg. Today I discharged with a 30 day supply of 8mg subs. I am in need of guidance as I do not want to go to high on the sub dose as I do not plan on maintenance. I've been lurking and have seen most are way less than 12mg. I purchased a pill cutter so I can follow some advice. My doc wants me on a half of tab 3 times per day.....morning ,noon, and night. He has little experience with methadone so any help would be greatly appreciated.............
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  2. #2
    Ming23 is offline Platinum Member
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    Hey Mrcardic
    Welcome! Did u read Robert325's taper plan? It's the first post on this forum. It addresses many of the concerns arising during taper.
    Btw, you're right about being on a way too high dose! I also inducted in hospital but was on 60 mg methadone. You were down to 26 mg. I guarantee you don't require 12mg sub daily. And three times a day is overkill. The body levels out at about 8 mg.
    Randy will probably post soon. He's a wizard! But if you feel high, i would drop the dose. You could easily go down to 3 mg twice a day or even less. The point is to get off the methadone, true, but sub is best used at the lowest effective dose. It's a weird drug but I promise u that less is more! We feel better at lower doses. Plus, u have to taper the sub eventually, so don't go up too much in dose.
    Hope that helps clarify a lil better. Again, read the top forum post
    You've made the best decision! I jumped from the sub about 15 months ago after a 4-month taper. I was just thinking that regardless of life's challenges, at least I don't have to worry about having a habit. It's a great relief!
    Hang in there! You can do this!
    Lvg nghtmare and Iluv2smile like this.

  3. #3
    Mrcardoc is offline Junior Member
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    Thank you so much for the response. This is a great resource. As I was reading yesterday after being discharged from the hospital I did not take the 3rd dose which would have been 12mg. I remained at 8 mg total yesterday. I slept fine for the most part but woke up with zero motivation feeling pretty >>>>>>. I took 4 mg of my sub and within 20 minutes magic...... ready to take the day on. From this point I am not going to go over 8 mg daily but any advice on times of day an length between dosing would be very helpful. I know everybody is different but the support helps out so much. It feels so much better to be away from the methadone clinic even though I was on step 27 with a months worth of take homes. I have good discipline and I know I can do this with a little bit of guidance.

  4. #4
    Mrcardoc is offline Junior Member
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    I forgot to mention this is day 6 methadone free and day 3 on sub. Day one was in the hospital at 16mg induction ,day two in the hospital 12 mg as I refused the fourth dose. Yesterday I was discharged in the afternoon I had taken 8 mg there and did not take any more yesterday. Today I halfed one sub at 7am at a total of 4mg and planned on the other half at about 4pm totaling 8mg. My question is should I do my 4 day stabilzation at 8 mg , 6mg or 4mg. To get me out of the woods from the long term methadone use. I have not been on a consistent sub dose yet. I was at 26mg of methadone for a long period of time. It is 12:00 now and I feel good. I would greatly appreciate anybody's honest opinion so I can start some consistency before I start my regiment to low or to high. I know Ming recommended 6 mg but like I said this is only day 6 methadone free. I am greatfull for any advice.

  5. #5
    dsh12345 is offline Senior Member
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    It is hard to guess what your dose of sub should be. The only way to find out is to go into WD, and then take a bit at a time until you feel normal. That is the only way to figure out your dose of sub. However, if you go like 5 days at 4mg and freeze yourself there, your brain will get used to that dose, and 4mg will be YOUR DOSE no matter what the past was before that, get what I am saying?

    So, if you didn't titrate up for a proper induction that is OK. We can guess for you, but who knows. All I know is 4-6mg is usually enough for most ppl. 8mg is usually not needed. So, maybe pick a number 4 or 6 and start there?
    Iluv2smile likes this.

  6. #6
    Mrcardoc is offline Junior Member
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    Thank you for your advice it helps ease my thoughts knowing I have others. I have not titrated up at all. I've only gone down since my impatient induction. I am going to be very disciplined on this titration. I have 12 years clean off other substances so I know I can do this. The length of time I was on methadone was pitiful. Today I went ahead and stayed with the consistent dose of 8 mg 4 mg at 7:00 am and 4 mg at 3:00 pm. It made sense in my brain to level out for three days and start my taper to 6 mg on Sunday. If I feel ok from there I will well on my way to 4 mg by Thursday. I thank everyone for their knowledge helping me through this.

  7. #7
    dsh12345 is offline Senior Member
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    Excellent plan. Love it.

    Keep in mind a couple things. Subs act weird. They can last 24-72hr half life instead of 6hr half life of normal opioids. Methadone is 24-72 hours however too like subs, which is why it is also used for medication management for opioid addiction. But, subs are different than even methadone in that they are partial-agonist opioids, not full agonists.

    All of that means in summary: Keep in mind you won't feel the subs instantly. It might take a day or two for the effects of a new dose it kick in. It is nothing like full short acting opiates like oxycodone where you feel it within minutes, and it hits you hard and fast and you feel it. You have to be patient and slow with subs. When the subs are working properly, you will feel normal, it won't be an instant high like oxycodone where you know right away 'oh yea, this is a good dose to get me high". It is very hard to tell what "normal" is anymore when you have been on full opiates for so long, so when you are feeling "normal" from a correct dose of sub, you might not know right away. "Normal" might be alot less energy than you had when you were taking full opiates, thus you might mistake feeling "normal" for feeling tired and think there's something wrong with your dosing, where in reality there's nothign wrong and this is what normal feels like, because you forgot what it feels like to not be superman anymore where you had a bottle of artificial brain happiness sitting there ready to go whenever you got into problems.

    Thus, it might be rocky as your body gets used to it. Once you figure it out though, and your body figures it out, and you are confident you are on a good and correct dose, the rest should be cruise control for the taper down.
    Last edited by Anonymous; 03-24-2017 at 06:23 PM.

  8. #8
    Iluv2smile is offline Platinum Member
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    I too went from methadone 150+ methadone to sub 24 mg
    Been off methadone 3 years in May
    Off sub2+ years.

    I used the taper on here
    And worked through it everyday..

    The getting stable
    And
    Dropping 25% when stable is the most important part..

    Remember to drink lots of water while on sub
    Because it can dehydrate you ..

    It is very important to take the sub at the same time every day.

    Most people split their dose 2 times a day
    8-10 hours apart
    And then go to 1 time a day when you get to 1 mg

    I was on methadone 10+ years
    So I stayed on sub 9+ months by choice
    Because I needed to make some lifestyle changes..

    For me I felt normal on subs
    Not much different than I do now..

    It is different than methadone which is a full agonist opiate..
    just keep that in mind..

    It feels so great just to be off methadone !
    Right ?
    The only issue I had is why I did not do it sooner?

    I was in a detox and it really was not bad!

    You can do this
    And take your life back!
    Welcome to a great place to do that!
    Take care
    Bette
    Ming23 likes this.

  9. #9
    Mrcardoc is offline Junior Member
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    Thank you for everyone's support and suggestions. It gives me so much more hope. I am so glad to be away from the demon clinics. I know I can do this with the correct guidance I am finding here. I started a new thread for my daily journal methadone to subutex progress. Please continue to guide me into sobriety. I have a strong support group and good discipline. I am so greatfull for the support I am finding here.

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