Heroin, Suboxone, Methadone O My!

[MarkyMayhem]

Hello all! SWIM has a situation, and needs a bit of advice. First some background info. SWIM has been opiate addicted off and on for about 10 years[mostly on]. In 2004, SWIM completed 2 years of methadone treatment, at 60 mgs the entire time. Tapered to 10 mgs, relapsed after months of low level withdrawls and cravings out the ass. Went to rehab for 10 days got 3 weeks clean, relapsed, went on suboxone for 6 months and tapered off suboxone. The last 10 8 mg pills lasted 4 months or so. Clean for over a year. SWIM even had a massive accident breaking hip and ball end off of femur, plates and screws etc. needed to fix it. SWIM got LOADED on dilualid in the hospital, yet left with nothing more than a tylenol 3 script that got thrown out.
Fast forward 18 months. SWIM is having bad pain in hip and back, plus a not-so-good relationship. SWIM begins to use, get immediatly back on Suboxone. SWIM uses suboxone properly for almost a year. Then for some stupid reason, SWIM tracks down old dope dealer. SWIM begins to chip, first over subxone, then skipping days of suboxone. This continues for 10 months to a year. By this time, SWIM has spent untold $$$$ overriding suboxone, and has been not taking it as much as taking it. SWIM also has a 1-2 gram [mucho $$$] a day habit when using, and a HUGE tolerance. SWIM tried and tried and tried to not do dope and just take subs, even up to 3 8 mg subs/day. At the end, SWIM would seem to get withdrawls under the subs after 3 days or so and would do dope. SWIM runs a business whose assets are almost nil from dope. Also becuase of the economy and not handling business preperly for the last year, SWIM is barely making ends meet. SWIM realized that what he was doing was not working, and went back to the methadone clinic he used to attend. SWIM has been going for about 5 weeks. SWIM is at 60 mgs currently, and doing well. It took SWIM 3 weeks to get from the 15mgs initial dose to his current dose. During that period SWIM used daily until he hit 45 mgs, and then fairly regularly until currently. SWIM has used 3 times in the last 2 weeks and is ready to stop using altogether. SWIM's current dose holds SWIM 24 hours easy, and cravings are pretty minimal.
Here's the situation[s]. 1) SWIM cannot afford the almost $400 a month it costs to go to the clinic for much longer the way business is going. SWIM IS on the list at the state funded clinic, however it takes months to get on and is a pretty bad clinic compared to SWIM's current clinic 2) SWIM cannot handle being tied down to going to the clinic 7 days a week. SWIM cannot phase up without quitting smoking pot. SWIM is not likely to phase up 3) SWIM is having some side effects from methadone this time around that are pretty bad. Sweating, sugar craving, lethargy, falling alseep 2 hours after dosing, inability to write music or play instrument[s] creativly etc. 4) SWIM is FREAKING out and totally future tripping of getting off methadone, also what if I cant afford to dose, my car breaks down, it snows really bad, I get arrested for something etc. to the point that it is effecting his life in a MAJOR negative fashion.

SWIM is considering getting off methadone and trying to stay 100% clean [no subs no methadone etc] in the following manner and is looking for opinions..

SWIM is thinking taper his methadone down to 30 mgs or so over the course of 6 weeks. SWIM will hold at 30 mgs for a week. If at any time SWIM uses he will re-evaluate his plan. Once at 30 mgs for a week, SWIM will stop until he gets significant withdrawls, and then re-induce on suboxone [SWIM has 60 8 mg pills] SWIM will start with 2 mgs and continue to take suboxone every 2 hours until WD is gone. Then SWIM will taper from that ammount for no more than 2 weeks to nothing.
SWIM should then have plenty of extra suboxone pills. SWIM feels that if he can go several weeks totally straight with little to no withdrawals he will be OK and can use the suboxone as a sort of safty net, if SWIM feels like using and can't stand it SWIM can take a suboxone and know he will not be able to get high.

Is this a good idea? honest. What kind of WD might SWIM go through? Any suggestions or ideas would be appreciated. SWIM knows it is totally individual, he is just scared, really...

thanks, I'll pass your info on to SWIM

[dyingtomorrow]

There are a lot of good threads about this you should check out on the forum, but to answer your question directly ...

(I am using "you" hypothetically in this post.)

Suboxone is meant to be used for a fast taper, and it works great. For some reason doctors are putting people on suboxone for months and years, and they can't even taper like 2mgs from 32 mgs without going thru horrible pain, let alone quitting even at tiny doses. Fast taper is the way to go - meaning a month at the most.

SWIM REALLY REALLY does not recommend switching from methadone to suboxone, but going back on H (and doing the lowest amount possible not to get sick) for at least 2 days before hopping on suboxone, to save yourself 36-48 hours of hell (and to save yourself from the risk of acute withdrawals). If you want that pain, go for it, but why go thru excruciating pain and anxiety you don't have to go thru, and which risks you just giving up from the agony. Hopping from methadone to H for a couple days, then to suboxone is the way to go.

The best way to do it is do your last "good" holding shot of H in the morning. Then at night you should be a little sick. Do some cottons (not actual bags) so that you will be able sleep, and take some sleeping aids (xanax, etc.), the more the better. Try and sleep and stay knocked out as long as possible. Next morning after at least 12 hours has passed and you are feeling shitty, take the suboxone. Don't take more than 8mgs. This is the most painless way to switch to suboxone. Methadone is going to be 10x shittier to switch from.

SWIM has gone from 8 mgs (and shot 4 mgs on top of the 8 mgs on the first day) to 1 mg with zero withdrawal symptoms in 2 weeks. The first day was shitty of course, and SWIM wasn't lucky enough to have xanax, so he wasn't able to sleep until the 3rd day. But by day 3 he was feeling 100% normal, and has not had even the slightest discomfort tapering.

Do this: starting at 8 mgs (or less if you can), every 2 or 3 days you go down. Go 8, 6, 4, 2, 1, (and then fractions of 1 mg until you are comfortable jumping off). SWIM watched his friend do it in 2 weeks without any problems, and SWIM went from 8 mg to 1 mg in 2 weeks, and feels physically normal.

The only drawback is suboxone doesn't help cravings. SWIM's cravings are fucking intense, and that is something you just have to deal with. If you can get yourself some xanax or valium, you are actually going to be feeling good (and doubly good watching how fast you progress without the slightest pain), not just normal.

Make sure to do the suboxone taper fast. Once SWIYour body gets used to suboxone, even a small taper is going to fuck you up, and you might as well just hop back on the H and try again.

Oh, and one more thing. If you are really really hurting on the first day, wait 2 hours after you take the suboxone. If you can't take the pain, you can shoot a SMALL amount of H (preferably just cotton dregs - try and make sure you don't have any powder left by the time you switch to suboxone, but maybe just a cotton or two with some residue in it). This won't get you high, but it will take the physical pain away and let you sleep. You can only do this if you are dosing once every 24 hours, and not multiple times a day. It will be okay because the heroin will be gone 24 hours later when you are ready for the next dose, and you may end up feeling a little bad the next day (since you just put off your bodies adjustment), but actually it won't be as bad as the pain from the first day and will be managable.

Hope that helped.

[chillinwill]

preferably just cotton dregs - try and make sure you don't have any powder left by the time you switch to suboxone, but maybe just a cotton or two with some residue in it).

Well in desperate times, most of us have probably resorted to using old cotton and get whatever remains in them to keep from getting sick. However, this has a high risk for catching cotton fever and SWIM definitely wouldn't recommend this part at all unless one wants the possibility to be feeling even worse plus the withdrawals on top of that. Just my 2 cents though

[dyingtomorrow]

Originally Posted by chillinwill

Well in desperate times, most of us have probably resorted to using old cotton and get whatever remains in them to keep from getting sick. However, this has a high risk for catching cotton fever and SWIM definitely wouldn't recommend this part at all unless one wants the possibility to be feeling even worse plus the withdrawals on top of that. Just my 2 cents though

I started a thread about cotton fever issues in the heroin forum if he's worried about that. If you let your cottons dry out immediately after shooting up and always cook the water up to a simmer it's not going to be a problem. Plus in the scenario we're talking about, Person X is only going to do H for 2 days before switching to suboxone, so the cottons are going to be pretty fresh.

[MarkyMayhem]

SWIM does/did cottons all the time, almost daily really and has never had cotton fever, and isn't to worried about it, really..
SWIM had a habit in Chi-town around 2000-2002, BTW.. SWIM has the dealers names and the intersections & train stops still burned in to his head and to this day has dreams of scoring near 35/Bronzeville even though the projects there are gone...
Anyway... SWIM thinks Dyingtomarrow has a pretty good plan.. When SWIM was on suboxone before he used it for 6 months and tapered off with zero problems, actually.. See, SWIM has crazy cravings and shit as well... This disease is fucked up that way, the cravings are 10 times worse when SWIM/Y is clean aren't they?

So what about SWIM's plan/idea of doing a 2 week sub taper, toughing out the cravings for a few weeks to get the residual subs out of SWIM's system and then pretty much carrying the extra subs around in case of cravings. Could SWIM hypothetically take 4mgs occasionally in case of cravings and not cop a suboxone habit, assuming no more then 2 days use in a row?

[Dickon]

I am a lier, and the following might be one of my any lies....it is for entertainment purposes only....

HHHHHHmmmmmmmm [pulls face] Despite what younger and wiser people might say I don't like your plan one bit. I don't know why, it just smells all wrong. Can someone show me please the scientific evidence for switching to suboxone from methadone to end a taper. It seems that everybody's doing it these days apart from me and some SWI-German bloke [SWI-he jumped at 60mg methadone and is 6 days away. I offer up my respect and best wishes]. I have no experience of this, but surely you have to pay the withdrawal-piper when you switch. You can't just use heroin. I suppose because the half-life of heroin is so much shorter than that of methadone, if you are going to make the switch it might mean you don't have nearly so long to w.d. before you can. I assume dyingtommorow knows what he's talking about, either from personal experience or scientific research.

I'd recommend a thread in this section called "How to come off 150mg methadone a day cold turkey: the easy way" or something very much like that. I used a good few of the pieces of advice in that thread. I'm a week clean after having a 225mg a day methadone habit. I cut down roughly 5mg a day over 36 days and when I got to 5mg jumped. It's been a rough ride sure, but you're in exactly the same boat I am. I cut down to 60mg, even 50 effortlessly before the pain and heartaches began. Cutting down 5mg / day especially at the low end is a recipy for ropiness, but it's just about bearable if you can get yourself some clonidine, this is an absolutely marvelous anti w.d. medicine.

You can fuck about all you like with tweaking this and that, but until you've actually decided to quit, it doesn't matter what you do. When you have decided to quit, just accept it ain't going to be Christmas day, and reduce somehow, but for god's sake do it quickly. I've read on here countless posts about bupe being great for quick tapers and just as bad as M for long ones. Maybe do some visualizations (of you conquering the beast of addiction however you see it) or repeat affirmations "I can quit" "I can do it", "I will do it", etc. There is one thing that will guarantee your success, and that is taking control of your will, and fighting. Prepare yourself for a brief purgatory before a new heaven.

D (not talking about this in an abstract sense but just begining his 8th day off the methadone after first night of any kind of real sleep, w.d.s vanishing by the hour)

Dickon added 26 Minutes and 1 Seconds later...

P.S. I forgot one really obvious piece of advice. Go to an N.A. meeting!!!