subutex or methadone

[steve99]

SWIM has a second addiction to resolve. After prolonged period of H abuse he was inpatient detoxed in 2001 with subsequent naltrexone implants. This was successful for him and he led fulfilling life for 6 years. Recently he had a chance meeting with old `friend` and now has a 2 month old habit. He wants to stop and wonders if he should taper down on methadone or use prescribed subutex 2mg.

Anyone have any thoughts or suggestions on how to help him?

[Orchid_Suspiria]

Swim has had little experience with subutex but he hears it is usually pretty successful and pain free,methadone.Well that can lead to a third and far nastier addiction.Methadone has some euphoria attached and a days of long blissful apathy,don't get caught up with it unless that is what swiy wants.

[steve99]

Thanx for reply Orchid. SWIM has packet of 2mg subutex on table in front of him but waiting for withdrawals before he takes them is a problem, especially when the H is easier to get than a pizza.

He knows that for the subs to work he must be showing symptoms otherwise they will bring on instant turkey. He reads on forum that they must be taken 24 - 48 hours after last opiate dose. Basically he is scared of pain and hates being sick. The methadone option is possible but needs to be taken early so that he doesnt want to top up with H later he cant trust himself not to do this.

In most other areas of his life he is relatively successful but this is a problem he cant fix easily. He wishes he had someone to talk to about it but cant risk trusting his partner because he worries that she may lose respect for him. As Oscar Wilde said he can resist everything but temptation.

[chukbzle]

Well i just started subutex today and i know how ya feel,im all alone with my prob its even hard not to abuse these .if you ever wanna chat or bs or talk about remedies ,helpful things or whatever i could use it too ,my girl loves me but doesnt quite grip the hell i go through. methadone is way to easy to abuse and hard to tell how much is too much.subs are way better and the main thing to remember is not to want that opiate high.it sucks but at least symptoms go away and tapering isnt bad even if its .5 mg at a time .makin it to .25 makes the w/ds nothing. good luck man .message me if ya wanna talk bout nething ,

[steve99]

Hi Chukbzle,
I sympathize with you and know what you are going through, good luck.

I posted that back in June when I was unsure of how to deal with my problem. Shortly after that I decided to check in to private hospital detox here in england. They manage the withdrawal symptoms with sleepers and cocktail of various other prescription drugs. After 4 days of this they introduce a `challenge` dose of naltrexone - the opiate blocker. The next day a full tablet is given to clear out any residual opiates still hanging around. Finally I had an australian double O`neil naltrexone implant that lasts between 4 and 6 months. That means I cannot feel effects of opiates during this time.

The whole process was reasonably painfree and it is the only way I know of getting clean. It remains to be seen what will happen in the long term. The last relapse happened after 6 years of being clean so I guess you always have to be on your guard. Still for now I`m clean and reasonably happy.

I recommend you treat your partner as well as you can, although she may not understand whats happening with you she will be a great asset to you when you start to feel the whole in your social life. Leave all the junkies behind you and get some new clean friends.

This stuff is the hardest thing I have had to do and I wish you all the best.

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[rocksmokinmachine]

If SWIY's level of use is low, and realy wants to quit, then Subutex is the way to go.

Back when SWIM was a heroin addict, he just used his methadone to fall back on when nothing else was available. However, if SWIY has a big habit, methadone may be the correct choice, gradually reduced over time. Once SWIY gets to 10mg/ml he may want to switch to Subutex.

[Solinari]

When detox for me was an option a few years ago now (man where does the time go), the only choice was, Lofexidine, oh man, even thinking about the name of that drug brings back the days of the cold yawning rattle waiting to get enough for a bag.

Subutex seems to have replaced that now, at least that's what i have gathered. I never got the choice, it was detox (with a cruelly low dose of valium and Lofexidine) or methadone maintenance. At first i opted for the detox, outpatient though, and did last the two weeks (barely) but i declined the famous 'naltrexone challenge", as if it's some contest that will change your life, at least that's how it was presented to me.

After a short period of being completely drug free, i was back to square one, with the daily hunt for ways to get a bag. I was out on methadone while waiting for an inpatient place which eventually came around, again with Lofexidine and 40mg of Valium, again a very low dose of valium especially when you're being supervised by doctor(s) and nurses (mostly). Anyway, that failed too.

So it was back on the methadone for me, and after being on relatively low doses, i was eventually put up to my current dose, 90mg. It has worked, although i do have "days of long blissful apathy" (Orchid_Suspiria, you have summed that up perfectly), i lost the gaunt ghostly junkie look and put on about 4 stone. I still use occasionally and admit as much to my doctor, but i don't have withdrawal, and i don't crave a bag, at least not very often.

For detox, Subutex seems the only option. Methadone doesn't work well in my experience for detoxing (i did try that as well by the way).

[Solinari]

Dam still no edit, 3rd paragraph, second sentence should be put on, not out on.

If someone could change that for me and delete this i would appreciate it. And, please tell me when i will be able to edit my own posts.

Thanks

[rocksmokinmachine]

Once you recieve enough reputation points to become a silver member

[Solinari]

By the way, the quote "long days of long blissful apathy" i can totally relate to, but i have to say, although it's usually apathetic, it's isn't always blissful, far from it actually.

[JaWill88]

has anyone here been on high doses of suboxone/subutex and methadone at different times? how do they compare? swim is on suboxone right now and was at the highest dose (32mg) but is tapering now. swim is very thankful for it and has turned swims life around. but swim still goes speedballin sometimes and wonders if methadone would be more effective at curing opiate cravings?

[rocksmokinmachine]

SWIM is currently on 16mg buprenorphine as he speaks

[singentsmythe]

dont touch meth. i went from 100ml to .5ml (no sxxt) took me two months to feel 'normal'. bad stuff...this was over two months!!!!!!

m

[Orchid_Suspiria]

At one time swim would have said subutex/suboxone would be the best option because of less addiction potential but now that swim is on suboxone.Well swim can tell you suboxone is not as perfect as some try to bill it.Infact methadone has some advantages.For one it has the opiate euphoria that makes one craves opiates.Suboxone takes away withdrawals but swim still craves euphoria and methadone would atleast give him this.

[JaWill88]

swim went to detox from halloween and got home yesterday. swim was detoxing from suboxone. for all you swiys thinking buprenorphine has mild withdrawals.... its all BS. dont buy into it. swim has known a couple people who have been on methadone and suboxone at different times but each for about a year. one said the withdrawals were about the same and the other actually said suboxone was way way worse. and the withdrawals from these long acting opioids make it soooo much worse. swim would rather suffer heroin withdrawals any day of the week. swim should have stayed at detox but lied said he was fine and went home. swim feels like SHIT. just a warning to you all. oh yeah btw i dont think my withdrawals have even peaked yet.

[Solinari]

For me at least, it isn't about the detox, it's about staying off the smack. I have detoxed a few times and it really isn't the hard part, unpleasant as hell yes, but you know you can get through it.

It's after you have detoxed, staying off the smack from day to day. So for someone wanting to detox and get off the drugs and put it behind them, then from what i can see, buprenorphine would be better for that. For someone who has been through the detox route (possibly many times) and just can't keep clean (for whatever reason), then maybe methadone would be better.

Personally i know i couldn't go drug free at this time, i have tried it and failed multiple times. Since i got put on a high-ish dose of methadone (took me months to get as high as 90ml unlike other stories i have heard), i have never done better, as i have said before i still use from time to time but there is no daily hunt or graft down at the local supermarket trying to get money for a bag.

If you have just got yourself a habit, then i think you should try and get off it with a detox and then get on with your life. If you are a long term user and have been down that road then you will know yourself if you can stay off it after any detox.

I must add though, that i know very little about Buprenorphine maintenance, i really don't know anyone who has been on Buprenorphine long term, unlike the many methadone users i know. I would also say that you have nothing to lose going for the detox first off, so if you are really unsure then just try the detox.

[smoothnmelo]

From what Swim has heard from a longtime friend on Subutex maintenance for about 2 years, the "Instant Withdrawal Symptoms" issue when switching from Methadone maintenance treatment is largely being confused due to the following: There are two forms of Buprenorphin treatment available, one with the opiate blocker Naltrexone mixed in, and one without. That is the one you want. It is called Subutex, and comes in 2mg and 8mg. The highest possible dosage for the Methadone/Subutex switch is 40 mg. Swim is considering to make the switch himself after years of agregious Methadone Program experiences largely due to the administration and their intrusive close introspection into every aspect of Swim's life, that he cannot take any longer. He is almost there at 43mg. The Bup with the Naltrexone mixed in will cause the nasty instant withdrawal symptoms everyone is talking about. Why anyone in their right mind would want to take anything containing Naltrexone, which Swim considers to be an instant recipy for agony, is incomprehensible to him anyway. Two weeks ago, all this was put to the test, when Swim missed his "Saturday program," which closes at 10.45 am sharp. This is a special punishment the program has in store for patients, who are in "non-compliance," even if they have obstained from heroin for over ten years like Swim. When Swim had to get through two days without his Meth dose, he got his first chance at putting the Subutex, his friend graciously let him use to cover his withdrawal symptoms to the test. Swim felt slightly uncomfortable due to the fact, that the available Subutex dose was not enough to cover his needs. He should have had around 24mg per day, and had to make due with around half that. Aside from that he was fine.

[rocksmokinmachine]

I agree, buprenorphine is an agonist/antagonist anyway. Personally I don't see the point of adding another antagonist, this will just make the user violently ill. Methadone is notorious for being one of the most unpleasant of all opioids to withdraw from.

Unless it is to prevent abuse someway.

[JaWill88]

Originally Posted by smoothnmelo

From what Swim has heard from a longtime friend on Subutex maintenance for about 2 years, the "Instant Withdrawal Symptoms" issue when switching from Methadone maintenance treatment is largely being confused due to the following: There are two forms of Buprenorphin treatment available, one with the opiate blocker Naltrexone mixed in, and one without. That is the one you want. It is called Subutex, and comes in 2mg and 8mg. The highest possible dosage for the Methadone/Subutex switch is 40 mg. Swim is considering to make the switch himself after years of agregious Methadone Program experiences largely due to the administration and their intrusive close introspection into every aspect of Swim's life, that he cannot take any longer. He is almost there at 43mg. The Bup with the Naltrexone mixed in will cause the nasty instant withdrawal symptoms everyone is talking about. Why anyone in their right mind would want to take anything containing Naltrexone, which Swim considers to be an instant recipy for agony, is incomprehensible to him anyway. Two weeks ago, all this was put to the test, when Swim missed his "Saturday program," which closes at 10.45 am sharp. This is a special punishment the program has in store for patients, who are in "non-compliance," even if they have obstained from heroin for over ten years like Swim. When Swim had to get through two days without his Meth dose, he got his first chance at putting the Subutex, his friend graciously let him use to cover his withdrawal symptoms to the test. Swim felt slightly uncomfortable due to the fact, that the available Subutex dose was not enough to cover his needs. He should have had around 24mg per day, and had to make due with around half that. Aside from that he was fine.

the instant withdrawal has absolutely nothing to do with the naloxone in it. if there is ANY opioids in swiys system wether its heroin, oxy, methadone, whatever, and swiy takes buprenorphine in any form wether its suboxone or subutex, swiy WILL go into withdrawal. buprenorphine has a very high affinity for the receptors and kicks other opioids out. the naloxone in suboxone never gets into ones system when they take it sublingually. it is only there to prevent intravenous abuse.

[Lisa J]

SWIM is on a low enough dose of methadone to switch to subutex (10 - 15 ml daily) but can't because she also has to have fentanyl, SWIM'S GP is going to try her with a different opioid to try and replace the methadone, it will be interesting to see what he comes up with. SWIM'S case is complicated because her GP has to deal with her heroin addiction and her need for pain control, if he gets it wrong she may be tempted to use heroin again to take the pain away.
SWIM has friends on subutex and they are getting on much better than they did on methadone because there's no incentive to use on top, unless you're on very high doses of methadone there's always a chance you'll use a little gear on top.

[BumpBump]

swim finds that df's or just codeine can get him through the worst of it, even co-codamol if swims only got a small habit for a short time, nurofen plus x4 = 50mg of codeine roughly? if thats not enough swiy can easily get away with 3 co-codamol ontop taking it upto a safe 70mg+ of codeine. Anything else look in the codeine thread for a cwe. Over the counter detox

[rocksmokinmachine]

I definately wouldn't recommend this. A longer acting opioid is needed for combatting withdrawal. It cannot be easily done, it really isn't that hard to get a methadone/subutex prescription in the UK.

SWIM remebers DF detox's in UK prisons, grim, grim days.

[chrisbx]

You have had 6 years drug free. Use your knowledge and past success of your decisions not to use. Use subutex as this will be much easier to get off than methadone. 2mg will not be a high enough dose to effect cravings or use on top. Depending on how much H you are using daily I would say 16mg will hold you and work best for the blocking effect and help with cravings. You can taper down quite quickly once you have got stable. good luck

[JaWill88]

swim has no cravings for heroin anymore, instead it's cocaine. but if swim at least feels the presence of an opioid in him, he doesn't feel the need for cocaine. should swim switch to methadone? will that give at least a hint of feelings of opioids in him unlike suboxone where he feels completely normal? btw swim is not worried about the withdrawal for either as for when he wants to kick, he will get back on a short acting opioid like codeine or hydrocodone. he will be phyically addicted to that and not bup or meth, and then will do a detox that only lasts like a week instead of months. anyone on methadone feel effects from it? does swiy feel somewhat high on it or at least feel it's presence?

[rocksmokinmachine]

To answer the question: Yes. Methadone definately causes opioid like feelings. It is very long lasting.

If SWIY has been on buprenorphine a long time, he best staying on it. Methadone causes some of the worst withdrawal symptoms of all opioids. Plus there is always the temptation to use on top.

SWIY will just have to be strong to fight the psychological cravings of cocaine. Some anti-depressants have been known to help. I think it is mitrazepine (sp?) that is prescribed in some clinics to heavy crack users. Other than that the only advice I can offer is to drink plenty of water, eat a good diet, and take B complex vitamins. B6 (niacin) converts to dopamine in the brain and will help replenish it.