Getting off methadone can be difficult. When done properly, however, switching from methadone to Suboxone can make for a smart transition plan.
People have different reasons for making the switch from methadone to Suboxone. Some of the most common motivations include:
- A desire to avoid daily clinic visits and long wait times to dose
- Perceived stigma associated with methadone and/or methadone clinics
- A desire to break free of highly regulated methadone treatment programs
- Long distance travel is required in order to attend the methadone clinic
- Resolving adverse cardiac effects developed while taking methadone
- Continued abuse of opiates while in a methadone program
What to Expect in Transitioning From Methadone to Suboxone
When it comes to switching from methadone to Suboxone, there’s a lot of misinformation floating around. The most important thing to understand is that this process takes time. You can’t simply stop taking methadone one day and begin taking Suboxone the next. By working closely with your prescribing clinician and support team, you can develop a transition a plan and set realistic expectations that set you up for success.
Before you transition to Suboxone, you have to taper your dose of methadone. A study published in the Journal of Addiction Medicine found transfer is “…feasible in outpatient settings for those transferring from methadone doses below 50 mg.” However, most experts agree it’s best to taper down to around 30 mg of methadone per day. The taper process should always be individualized so it works best for you.
You’ll need to be in a moderate state of withdrawal before taking your very first dose of Suboxone. In truth, this is usually the most difficult part of the transition process. It’s where many people throw up their hands and abandon all hope of transitioning from methadone to Suboxone. But when it’s done correctly, waiting for signs of moderate withdrawal before starting Suboxone makes a huge difference in the transition and your overall treatment success.
Amanda’s Experience Transitioning to Suboxone
Transitioning from methadone to Suboxone is not only possible, it can be done with minimal discomfort. No one knows that better than Amanda, who was gracious enough to share her own personal experience with our readers.
I was addicted to OxyContin for five years – in and out of rehabs six different times. I never could get over the hump with 12-Step programs. I’d get sober, then find myself smoking Oxy again two hours after leaving rehab.
I finally decided to try something different; I entered a methadone program. I started out on 60 mg every day, but they eventually increased my dosage to 80 mg. I spent the next 14 months driving 147 miles round-trip – six days a week – just to take my medication.
Despite all the roadblocks, I busted my butt to follow the rules because I wanted an opportunity to get take-home methadone. After a year of proving myself, I earned “monthly” status – that’s 28 days of take-home methadone and one clinic visit a month. I was so proud of what I’d achieved.
But everything changed a year later.
One morning, just as I opened one of my sealed take-home bottles and was about to take my daily dose of methadone, I got distracted by my baby crying. I screwed the cap back on the bottle, returned it to my medication lock-box – which contained another 17 unopened bottles – and went to check on my daughter. After getting her settled, I randomly grabbed a different bottle from my lock-box and took my medication. Little did I know, this innocent scenario would destroy the year of hard work I’d done to earn some freedom in my treatment.
I was called in for a random pill count a few days later. During that visit, the medication nurse held each take-home bottle up to the light and counted the pills inside, as usual. Then she began unscrewing the caps of each bottle and checking the seals, which is something they’d never done before. I honestly didn’t think anything of it…until she came across the one bottle I’d already opened and broken the seal. At this point, I was told the broken seal violated a new clinic policy – one that I was totally unaware of – and all my take-homes were immediately revoked.
I didn’t know it was against the rules to open one of my own bottles without removing the medication, but I was panicked about the fact I’d been bumped back down to daily visits. The clinic had so many new patients that the wait time for morning dosing had grown to 90 minutes. And my car could no longer (safely) make the 147-mile trip six days a week. That meant I’d have to miss multiple days of dosing each week and suffer withdrawal symptoms because of it. I was scared to death.
On my drive home that day, I decided it was time to break free of the methadone clinic. I’d heard that Suboxone prevents opioid withdrawal symptoms, so I found a local Suboxone provider and made an appointment for three days later. Then the receptionist dropped a bomb on me; she said I’d need to be in withdrawal before starting Suboxone.
I thought to myself, “Wait…what? I’m trying to avoid withdrawal symptoms, not purposely put myself through them.”
Probably sensing my internal panic, the receptionist told me that we have to start Suboxone while I’m in moderate withdrawal or it will trigger very rapid and very painful withdrawal symptoms. I promised myself I’d wait it out.
[porto_content_box align=”left”]To minimize your discomfort, SaVida Health may prescribe non-controlled substances known as “comfort medications” to treat specific symptoms of withdrawal in the following circumstances:
- In the process of tapering your buprenorphine dose
- During the required period of detox prior to buprenorphine induction
- You’ve had an interruption in insurance and awaiting eligibility
I’m not going to lie; those three days without methadone were agonizing. Instead of properly tapering off methadone, I jumped off cold turkey. (Something I would never recommend to anyone.)
By day two I was drenched in sweat but felt like I was freezing. My bones ached. I had no desire to move, but the bouts of vomiting and diarrhea forced me from the bed to the bathroom more times than I can count.
And while the physical withdrawal symptoms were bad, I think the mental games being played inside my head were worse. Every minute of every day, my brain told me I could make all the sickness and pain go away by using. My disease tried to convince me that, no matter how much Suboxone they gave me, I’d never be able to get away from methadone.
When I showed up at my Suboxone provider’s office, I was a wreck. We talked and came up with a treatment plan. He assured me that, if the starting dose wasn’t high enough to eliminate my withdrawal symptoms, we’d gradually increase it. I quickly got the sense that these people were truly here to help me, and that made all the difference in my transition from methadone to Suboxone.
Despite the fear and anxiety I built up in my head, my starting dose of Suboxone WAS high enough. I didn’t feel “high” or overly medicated like I felt at times on methadone. Once I was able to stop worrying about the fear of returning withdrawal symptoms, it became a lot easier to focus on my recovery and continue working on the underlying causes of my addiction. Knowing I didn’t have to arrange my life around the methadone clinic’s schedule gave me a new sense of hope.
I am living proof that you can successfully transition from methadone to Suboxone. And if I can do it, so can you! Never give up on yourself or your recovery.
If you’re interested in switching from methadone to Suboxone, the caring professionals at SaVida Health are happy to answer your questions and work with you to develop a comfortable transition plan. Call us today!