oldskoolraver
09-04-2005, 08:18
Hi,
I'm a 25 yr old male who got hooked on h back in chicago in '98.
I got on methadone 2 yrs ago since 3/25. I hate the stuff but I
would of never kicked it without it. I could stop but would end up
doing it again a month or so down the road. I have moved to ATL a year
ago and am living a great life, I used to have nothing to lose now I
have everything to lose. I have been in prison 2x on a year apiece, got
out the first time was out a couple of months and got hooked again and
busted shooting up on the aniversarry of my first prison term.
I tried to get into rehab in prison and they told me I
didn't have enough time! Nice rehabilitation huh! I got out again and
got high like the day after I got out. Several months later I saw
myself going back to prison or the morgue! I got on 'done, started on
170mgs and I am now @ 25mgs. Can I use bupe or subutex to get off it?
How much/how often should I decrease myself? I used to be
able to miss a day and a half, now if I dont take my dose when i wake
by mid afternoon I'm out of energy! Is bupe or subutex expensive cuz i
have no insurance! Also, my teeth are terrable from
dope and 'done and I take good care of them. Does anyone have the same
problem?
Thanks,
Chris
"I'm gonna kick tomarrow" Jane Says Janes Addiction The famous words of all junkies
This is an old thread but an important subject.. wanted to see if anyone had any input on tapering methadone and the use of buprenorphine/naloxone (suboxone) as part of this process.
One used to be prescribed suboxone, and was told by both her methadone and suboxone doctors that this way of tapering is sometimes utilized, although a patient can go all the way down to 0 mg simply tapering the methadone, slowly but steadily at whatever pace is comfortable. The latter may be worth a try, especially if the methadone is a financially viable option, and for stability/continuity of care, imo, as far as the staff (doctors, counselors) as well as the substance being tapered. But that is in no way a medical opinion, just a personal one. I will try to see if there are any studies on pros and cons of using solely methadone to taper vs. using methadone and then transitioning to suboxone.
As for dosage range at which this can be done, one was told that once one is decreased to 30mg of methadone or less, they are able to gauge an equivalent and effective dose of suboxone at that point and continue the taper downwards with suboxone instead of methadone.
Suboxone has the advantage of being a take-home/prescription medication and does work a bit differently than methadone, although it is the same concept. But it is expensive, with the 8mg/2mg pills (meaning 8 mg buprenorphine, and 2 mg naloxone in each pill) going for around $10-15 per pill in the US, so depending on the pace of the taper and the required dose, it could get pretty expensive, as the highest dose, likely around where they would want to make the transition, is generally around 32 mg (four of the 8mg/2mg pills). This is where the ceiling effect starts to show significantly, so they would not likely be able to make the switch from a methadone taper to a suboxone taper until this dosage equivalence is reached. Methadone, on the other hand, is an agonist and does not have the significant ceiling effect present with buprenorphine, so can usually be dosed as high or as low as needed, without change in effectiveness.
Depending on individual circumstances, one option or the other may be preferable, but treatment decisions are always best made with the input of one's medical providers and one's own preferences taken into account.
The use of suboxone as a substitute for methadone towards the latter part of a taper is definitely something that is offered and considered an option within MMT (methadone maintenance treatment) procedures and protocols as far as one understands it, but again I'll try to find some more specific information on when and how this switch would best be made, and the dosing equivalents- although they are not the same substance and act differently on receptors, so no dose is entirely equivalent, but they can make comparison for purposes of alleviating withdrawal symptoms and whatnot.
If anyone has experience with this particular way of tapering, please feel free to add your knowledge to this thread!
swim has done this in the past though is now back on methadone and waiting to go to detox and be placed on naltraxone befor they leave so they can't use like they could when on subutext before. the theeth normaly go because of using citric acid when injecting plus the large amount of suger in methadone they now use suger free.
when coming down from 150mg they did so at 5mg every two weeks or every month now and then if having a bad time of it untill they got to 40mg then there gp said 5mg was to high of the over all % so it would not be save to continue like this so the sugested 2mg every three weeks. when they got down to 20mg there gp said that they should start to prepair for subutext once they reached the 10mg level by leaving it as long as possible between doses of methadone so they would stretch it out every coupple of days or so till they could go 24 hrs with minimum of discofate between doeses
when they had done this the doc had a script of subutext waiting for swim at chemist a day after there last methadone dose they started on 8mg's and then whent up to 12mg to feel coftable over a week. swim does not no how much this costs as they have the nhs so treatment is freely avalible.
they where lso supported by a substance missuse team threw this process they then cut down on subutext to 4mg then realised they could swallow it during supervised consuption and then use so they did and are now back on methadone but down to 30mg.