Other - Suboxone & Methadone Detailed 1st Person Review

[laws0n]

SWIM sees ALOT of threads about the differences between Suboxone and Methadone, not just the effects but other stuff that comes along with these programs. SWIM would like to share his personal experiences combined with his opinions about these programs. If SWIY dosent agree or thinks has a different experience than SWIM please realize that. SWIM hopes that people that are deciding between Suboxone and Methadone will get a little more insight and it will help him decide which one will have the highest chance of them eventually tapering off and not needing to take anything. This is from a firsthand experience, and will be ALOT different than what google will bring up.


Suboxone (Bupe)- Will take anywhere from a couple of days to a month for an appointment. SWIM is on this program and managed to get an app for 3 days later. Doses cant be perscribed over 32mg. The time it takes for people to completely taper off is spread out from as short as 3 monthes to as long as 3 years. The average time it takes is 9-12 monthes going down 2-4mg a month after they are comfortable with their dose. At first tapering is easy, the last 8mg are extremely hard and alot of people have to taper alower than they did before at 8mg and below.

Pros: Once SWIM went to a few bi weekly appointments he goes once a month for a whole months script. A good quality about suboxone is that it contains naloxone which will block other opioids preventing SWIY from doing them, there are also ALOT of other safety measures in Suboxone that is not in Methadone. Suboxone can be taken 1-4 times a day, most patients like to take 1/2 the daily dose 2 times a day.

Cons: The first appointment and 1 week script cost SWIM around $500, definently not cheap if insurance dosent cover it. All doctors will do a urine test on the first appointment and if SWIY tests positive for other drugs SWIYs doctor could be less likely to perscribe suboxone. Random urine tests are also common and doctors will drop patients they find irresponsible. SWIMs doc has a 3 strike rule and a strike can be a failed test, or missed appt. SWIMs friends that used H and tried Suxobone went back to H, they said it dosent work probably because it dosent get you "high" after a while like Methadone.


Methadone- In the US there is a website where SWIY can type in their zipcode and it will give SWIY a number and an extention to call to get an appt. Clinics only take new patients on certian days of week and usually as early as 5AM, it will take a week max to get an appt there. Methadone is usually given in a low to normal dose at first to see how much they need, doses can only be upped every week at SWIM's friends clinic so people dont ask for more every single day. It usually starts with 30mg daily going up 10-20mg a week untill SWIY has reached a comfortable dose. They will stay at that dose for 3-6 monthes and then start to taper down 10-20mg a week untill they dont need it anymore. Unlike Suboxone Methadone is hard to taper at first, a common thing SWIM has seen is SWIMs friends keep lying about what dose is comfortable for them so their dose is rediculously high (250mg) and then dont ever come off that dose and stay at the clinic. 1 year is probably the shortest time SWIY could spend at the clinic, alot of people stay there for years though.

Pros: Methadone works better for really heavy users, people SWIM knows that were into H like methadone way better than suboxone. Doses as high as 300mg can be given, unlike Suboxone after 32mg it will no longer be more effective. Classes and meetings are offered at some clinics that can also help addicts recover and get support. Methadone is also easier on people that slip up, if a person fails a test or fakes one or who knows what they make them go to classes in order to continue on the program, they dont drop people like Suboxone doctors do because the whole building is just for methadone, suboxone is usually perscribed by doctors that are regular doctors but took an 8 hour class in order to also perscribe suboxone.

Cons: Also very expensive. SWIM called and the operator told SWIM it was $400 for the first month and $250 each month after that, cash only (since addicts would probably bounce checks haha) must pay before dose is given. SWIY would have to get up every single day and get to the clinic before 9AM, (think they close at 10AM? not sure). This will be a part of SWIY's daily routine instead of a monthly 30min appt with a doc for Suboxone. However Sunday doses are given with the saturday dose in a "take home" bottle, so everyday but sunday. Since all patients in the clinic need this for drug withdrawls it means they have drug problems and might still be using, there are alot of negative people around there that will try to meet up outside the clinic to sell SWIY drugs. SWIMs friend said at the clinic he can get basically anything he wants in the parking lot, if SWIY is there for the right reasons he wont have to worry about this however. Methadone is also only once a day, even though docs say it should last all day for SWIM methadone would last 8 hours max. SWIMs friend would get anxious when the dose wasnt hitting him as strong as it did at first and would go out and buy a bunch of H to feel relief. One last thing is that Methadone has no blocker like Suboxone has, so people can use methadone and any other opiates that they want, although methadone raises one's opiate tolorance it dosent chemically block other opiates causing alot of people to have double, even triple habbits. SWIM's friend went from just opiates to becoming just as addicted to Methamphetamine, Crack, and Benzos while still taking his methadone dose AND doing the same amount of H that he was doing before the clinic.


Opiate addiction is a very hard habbit to kick, SWIM has been struggling with it for a little bit over a year and is already so sick of it. Both Suboxone and Methadone are options to consider but keep in mind they arent the only ways. The whole point of these medications is to stop cravings and withdrawls so one is able to live a "Normal" life, not worry about drugs, taper their way down, and eventually not needing to take anything. If SWIY is getting these perscribed just to get high everyday(abusing their script), still planning on using other drugs, and dosent have any desire to quit SWIY should keep using untill they are sincere about quitting, using these for the wrong reasons will only cause SWIY to relapse and become even worse. To be honest getting a Sub script or in the Methadone clinic is very easy to do and they dont care much about how sincere SWIY is, SWIM thinks the screening process should be a bit more strict lowering abuse. Remember that although these are very helpful medications they are NOT the complete solution to SWIYs drug problem, additional steps like support groups, not being around drugs, doing something productive to help your motivation will dramatically increase your succuess.

[Picass035]

Good advice overall! However there are a few points SWIM would like to make.

First off, the Naloxone found in Suboxone has NO effect on the user. Its function isn't to block other opiates at all. Even though it is used by ITSELF in OD cases, when combined with buprenorphine it does nothing more than make someone "think" they will go into precipitated withdrawals if they ever attempt to inject the pill. How Suboxone "blocks" other opiates is not because of the Naloxone, but rather because of its agonist/antagonist properties and its high affinity (or binding power) to the opiate receptors. That and its LONG half-life (~36 hours on average). If a user takes buprenorphine while still under the influence of other opiates for example, he/she will go into precipitated withdrawals regardless if Subutex (bupe w/o Naloxone) or Suboxone (bupe w/ Naloxone) is taken. The opioid receptor affinity of buprenorphine is SO high, that if one ODs on the drug, not even Naloxone will bring that person back.

Another point SWIM would like to add, is that it is very difficult for users with moderate/severe physical pain to take bupe over methadone. Although bupe is great to keep withdrawals at bay, it does very little for people with a lot of pain.

From SWIM's experience, he tells me that whenever he goes into withdrawal (which he does deliberately every 1-2 weeks to keep his tolerance low), his heart rate increases drastically. Suboxone/Subutex doesn't seem to help with that either. It's only when he takes a full opiate agonist that his heart rate goes back to normal.

All in all, if bupe works for someone who isn't you, it definitely is the BEST drug out there for getting off of addiction. The number of relapse cases is significantly lower with people taking buprenorphine, than it is with those who are on methadone maintenance therapy (FACT!).

In the end though, the addict must really WANT to get off opiate addiction. It's something that must come from withing. It's only with willpower that someone will truly find success.

[laws0n]

Thanks for those points. Yes Suboxone blocks other opiates because it binds to the receptors making others not able to attach. The Naloxone dosent come into affect if someone tries to use another opiate, to SWIMs knolwdge it only becomes active when used IV (who the hell would IV suboxone??), but SWIM has no experience or dosent know anyone that has tried this method.

SWIM agrees that methadone helps more with pain and also with Suboxone has a higher succuess rate.

Ratings on this thread would be awesome if you have time, SWIM worked hard on this =).

[soma]

Hrm, SWIM is prescribed 4x 8mg a day (32mg) and he was never urine tested, went in once ever 3 months, and also given 2mg clonazepam 2x daily as well as 20mg zolpidem/night for sleep. Needless to this isn't helping his addiction, and he genuinely suspects that this doctor is a pill-mill.

He also has a pain doctor who gives him 180 Norco 10/325 Hydrocodones a month, along with 10mg Zolpidem, 1mg Ativan, and 30mg Temazepam/daily. He has medical records for his pain (pulmonary embolisms) but he is still very young and has never been asked about addiction, asked for a urine test, or anything of the kind. He has other doctors too, for his amphetamine, and another for tramadol, norco, and his blood thinners. Yes SWIM may be a doctor shopper, but he finds it more economical than the street corner. He's been Dr Shopping for 7 years now, and he has quite a skill. He actually feels bad because some of the doctors seem to show genuine sympathy for swim's condition (which does hurt like hell, but not THAT bad).

[laws0n]

Hrm, SWIM is prescribed 4x 8mg a day (32mg) and he was never urine tested, went in once ever 3 months, and also given 2mg clonazepam 2x daily as well as 20mg zolpidem/night for sleep. Needless to this isn't helping his addiction, and he genuinely suspects that this doctor is a pill-mill.
????: Drugs Forum http://www.drugs-forum.com/forum/showthread.php?t=79248

He also has a pain doctor who gives him 180 Norco 10/325 Hydrocodones a month, along with 10mg Zolpidem, 1mg Ativan, and 30mg Temazepam/daily. He has medical records for his pain (pulmonary embolisms) but he is still very young and has never been asked about addiction, asked for a urine test, or anything of the kind. He has other doctors too, for his amphetamine, and another for tramadol, norco, and his blood thinners. Yes SWIM may be a doctor shopper, but he finds it more economical than the street corner. He's been Dr Shopping for 7 years now, and he has quite a skill. He actually feels bad because some of the doctors seem to show genuine sympathy for swim's condition (which does hurt like hell, but not THAT bad).


SWIM did get tested the first time, his doctor trusts him and dosent test for now but if he admitted to any slip ups he would get tested. SWIM's doctor is a regular doctor that took the 8 hour class to script Subs and believes SWIM unlike some stories SWIMs heard about methadone clinic workers being rude and not taking patients completely serious if they have a problem.

Off topic but SWIM saw SWISoma's daily doses are:
32mg Suboxone, 4mg clonazepam, 1mg lorazepam, 30mg temeazepam, 30mg zolpedeim, 60+mg hydro, adderall, plus more scripts with dose not listed + anything recreational SWISoma might do..... Thats an opiate, a pill for opaite addiction, 3 different benzos and 1 basically benzo so 4, blood thinners, AND amphetamines AND what ever SWIM does on the side. Thats one of the biggest loads SWIM has ever heard of.