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My long taper Sub to Methadone to Sub

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  • My long taper Sub to Methadone to Sub

    Like many, I became addicted to prescription opiates and then onto street drugs. Dependence and then addiction snuck up slowly over many years. The pain relief and comfort of opiates were nice at first. The funny thing for me is that opiates didn't so much stop pain but made it so It didn't bother me much. Many have said that opiates make it possible to sit on the couch and be perfectly content doing nothing with or without pain. That was the trap for me. Even when I didn't need them, opiates made everything better. Sounds good until you realize that your normal drive to live, work and play can be gone as long as you have a steady supply.

    Once I realized that I could not function normally without opiates, that is when addiction took over. Only someone that has gone through this can understand how the drug becomes like food or air. Without it, the withdrawal and dysphoria made it impossible to function. As soon as you get your "fix", you can function again. That was my life for several years.

    The other insidious nature of opiates is that anytime you use more, your tolerance increases. You keep needing more and more to function. When you are using everyday and several times a day, your tolerance can build to a huge level. Many of us addicts take a dose that would kill several people that had no tolerance.

    I wanted my addiction to end 5 years ago. I went to a suboxone clinic and believed that I could get off the opiates in a few months or so. Unfortunately, that didn't work for me. I tried over and over to induct on suboxone. I just couldn't feel right even after a week or more. I had read the Robert325 posts and kept thinking I was doing something wrong. Maybe I was. When you use on top of subs, you just continue to force your tolerance higher. That's what happened. After a year of trying to feel normal on subs I gave up and went to a private methadone clinic. I ended up taking 100 mgs of methadone for awhile during my journey to get free of opiates.

    .....More to come - I am now down to 1.75 mgs suboxone and feeling good. I am writing my experience hoping it will help someone else. I am definitely over the hump and soon to be free of opiates forever. If you are worried about your use, my advice is to quit now before your tolerance becomes intolerable. And, expensive!

  • #2
    Before I go on with my experience, I want to make a comment about the huge risk of methadone for people that use it to try and get high. Methadone doesn't make most people feel high. That can lead someone to think that they should take more. I know of a person that took it one evening and thought it was weak. They took more later that evening. All it did was make them sleepy so they eventually went to bed. All opiates depress your breathing. The person was found the next morning unconscious and blue. They would have died if someone didn't find them.They survived but suffered brain damage from the lack of oxygen. Methadone is a waste to try and get high with and is easy to OD on. You can overdose on any opiate (apparently even suboxone). Methadone isn't worth it to try and get high.

    When I went to the methadone clinic, I once again thought I could get off opiates in a few months. I told the Dr that I wanted to take the least amount necessary and then taper. Ha. What a mistake. The first several months I never got a dose that worked. What happened? I again used other opiates. Tolerance went up. I found out the methadone clinics know that many people continue to use other opiates. If you want to get off methadone or suboxone, you have to get stable first. If you still are looking for and using other stuff, you are either not really ready to quit or not on a dose that works. Over the next couple of years, I went up and down on methadone. If you find yourself thinking how nice it would be to "use" to feel good, talk to the Dr or clinic. Once you have enough, these feelings go away.

    The reason I went up and down on methadone was because I wanted to get off of it from the start. When the dose was too low, I would crave and use other opiates. I realized that I needed to get enough methadone to stop that. This isn't always easy at clinics. They have to be careful that people don't overdose so I kept having to ask for a higher dose over a month or more. I finally stabilized on 100 mgs. A few months later I started going down.

    Methadone clinics have to follow state and federal laws. A big downside of methadone clinics is that you will have go everyday for months or more before you can get take home doses.You take the methadone at the counter daily. You also have to wait in line for your turn. I don't know much about the laws but this is required. You also have to be drug tested regularly. You won't get take home doses if the test shows other opiates. I'm not sure about what happens if you take other drugs. I saw some long time patients get a months worth at a time. Most get a few days or a week after many months or a year. That is one of the reasons some call methadone liquid handcuffs. It will limit your ability to travel or take vacations for a good while. I heard you could get a Dr order from a clinic in another city if you really had to go out of town. Then you have to find that clinic and take it there.

    My suboxone Dr was at a different clinic. When I first went to him, I mentioned I thought methadone might work better. He said I didn't want to do that for the reasons above. I agree that suboxone makes life a lot easier. You typically get a prescription for a month that you fill at a pharmacy like any drug.

    In hindsight, I wish I would have just stuck with the suboxone even though my tolerance was too high for it to work well. I also think that I had problems with it because I didn't wait until I was in deep enough withdrawal to induct. Going deeper and longer into withdrawal lowers your tolerance. That is what I did going from methadone to suboxone this time. I was surprised how much better I felt after only 20 minutes. That is what I expected and what the sub Dr said would happen years ago when I tried subs the first time(s).

    IMO an even better way for some would be to just go through the 5-7 days of withdrawal going cold turkey if you are only using short acting opiates. It does take a strong commitment. I know of many people that have done it. I just couldn't do it. I had to work and be able to function normally. I could barely even talk on the phone during withdrawal. If that is the case, methadone or subs will work. You are still dependent on opiates when you do this. You can get your life back to "mostly" normal on either of them.
    Last edited by metha-sub; 06-21-2020, 11:59 AM.

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    • #3
      Methadone is known as a bear to come off of. It's true. What I found was just like the Richard325 taper plan, it is a percentage game. While Roberts plan is 25% reductions every 4 days, it is more like 5% weekly or less for methadone. I went down 5 mgs a week from 100 mgs of methadone. It was easy until I got to around 60 mgs. At that point, 5 mgs was getting close to 10% drops. I slowed down and started dropping 1-3 mgs per week or two. Below 40 mgs, it got a lot tougher. I would go down slowly and even went back up 10% a few times. Eventually, I got down to 15 mgs. I thought I could just taper methadone all the way to zero. Some people can but I think it is rare. Most people at my clinic never wanted to come down at all. From what I read and saw, many just plan on staying on methadone forever.

      Most Drs recommend that you are at 30 mgs or lower before switching to suboxone. I saw a couple of people try at 30 mgs and they didn't feel right. I know it works for some from what I have read. It seems to be a lot easier the lower you go on methadone before switching.

      I was below 30 mgs for several months before trying subs again. I think that helped. This time I followed the Richard325 plan closely. I did change things up a bit but not the COWS part. I went 3 1/2 days with nothing before attempting the switch. I was at a 26 COWS score. I first put a 1 mg piece under my tonque. I waited 90 minutes. I couldn't tell how well it was working but I definitely was not falling into the dreaded precipitated withdrawal. I put another 1 mg piece in. 20 minutes later I felt a whole lot better. I still had that anxiousness and aches but way better than before. I ended up taking another 1 mg and then I got hungry. That felt great after barely eating or sleeping for the last 2 days. I got up and went to the store and bought a bunch of food I wanted and drinks. When I had tried subs before, I went days after induction without being able to leave the house. That night, I could tell there was no way I was going to sleep. I took a last 1 mg for a total of 4 mg that first day.

      I didn't sleep well at all that first night. It reminded me of when I first started using opiates regularly. I could fall asleep but never went into a deep sleep and woke up like what seemed 20 times. I think it may have been a mistake to take that extra 1 mg before bed. The next day I decided to take only what I needed to feel well. I took 2 mgs in the morning and 1 mg in the evening when I started feeling off. So, second day was down to 3 mgs. I wanted to get to the lowest stable dose.

      At that point. I made a schedule of 4 day drops of about 25%. I was on 3 mgs for two more days or 4 days since induction. Then 2.5 mgs for 4 days and so on. It has only been two weeks now but I am down to 1.75 mgs with no trouble. I am dosing twice a day with the largest part in the morning and a smaller amount around 3 pm. I have found that keeps me stable. I plan on going to once a day at around 1 mg. I drop again to 1.5 in two more days.

      Sleep was a problem for the first week. I could fall asleep but only get around 4-5 hours a night. I like 8 hours. I took some benadryl only twice when the lack of sleep was really grating on me. Luckily I hate the way benadryl makes me feel. I swear I get hangovers from it. That means I won't take it unless absolutely necessary. The sleep problems are past me. I tracked how I slept until I had a couple of good nights. I don't even worry about it now.

      It feels like I have been tapering forever. I have been at it a long time with the methadone and now the subs. After the methadone taper, subs are easy. I was not convinced that I could get by on only 3 mgs sub. It is true or even less. It is great that I stabilized on a low dose. Using the Richard325 plan is the way to go imo. If you want to get off, remember the direction is down. More is not better. I would have a lot longer to go if I would have started with 8 mgs or more.

      I actually look forward to the drops. Everyday I feel more like my old self again. The 4 days then drop works great for me. Any longer and the amount of subs in your system is actually still climbing.





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      • #4
        I regret having taken so long to get off opiates. I will say that a clinic can get your life back on track if addiction has you in a mess. It will eventually. The methadone clinic is a crutch that does work to get people back on track. Just not having to look for opiates all the time is a big relief. Not to mention what happens when you run out at the wrong time. A suboxone clinic basically works the same way but with a lot less life restrictions. Either way you have a system that will get you stable and stop the drug seeking. It becomes something like any medicine that you have to take daily. And, it gets you in a routine where you can work and live without all the hassle.

        The downside is that you are still dependent on opiates. If you want to get off them, you have to taper. Methadone is more powerful. It is a full opioid agonist. Suboxone or Subutex is a partial agonist. That is why some people do better on methadone from what I understand. It acts just like other powerful opiates that lead to addiction. But it is a lot harder to taper.

        Both methadone and Suboxone are long acting. That is good and bad. It is good that it can last for a day or more. It is bad because they are hard to hard to get off of and take a lot longer to get completely out of your system. I found some information online that shows both build up in your system over more than a week. For instance, taking either for more than 4 days and you will have double the dose amount in your system. That means that if you take 16 mgs of subs, you will have around 32 mgs in your system after 4 days. It continues to climb for about 10 days.

        I think this is the genius of the Robert325 plan. By dropping after 4 days, you stop your levels climbing and the lower dose levels you off after a couple of days and then you decline slowly. Rinse and repeat.

        Now, you should follow your Dr's directions. If you want to get off, let them know and maybe suggest the Robert325 schedule. I am really pleased I have made it this far. Only a about a month to go until zero.


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        • #5
          I am doing well down to 1.5mg suboxone. I drop to 1.25mg tomorrow. My body seems to be getting back to normal. I have been sneezing like I used to. On methadone, I never sneezed. I asked others about it in a support group meeting that the methadone clinics make you go to once a month or so. Several people laughed and said they hadn't thought about it but they hadn't sneezed in years. Opiates suppress some bodily functions. Everyone on opiates know that your digestive system slows to a crawl. It also affected my urinary system. Still worked but slower. All of this is getting back to normal now that I am on a low dose of subs.

          What can you expect as you drop? For me, some days I don't have as much energy as I would like. Staying busy, especially physically busy, keeps your mind occupied and not focused on the way you feel all day. I think that is really important. If I just sit around and don't do much, that is when I notice sluggishness. A lot of people recommend exercising. I agree but it is not my thing. I would rather do some yard work, house work, or build something. Works for me.The most important thing is to stay on the lower dose. I have only felt "off" on a couple of days. The next day is usually fine. I wouldn't recommend ever going back up unless you just can't function. Push through it. You will stabilize even if it takes an extra day or two longer than the 4 day drop schedule. I haven't had to do that with suboxone but I did with methadone several times. Methadone drops can take a long time to adjust to at lower doses.

          If you have to stay on a dose longer than 4 days, remember that your blood levels continue to rise from that dose. It could make the next drop take longer to adjust to as well. That isn't a big deal as long as you realize that you may need to stretch out the next drops as well. As long as your direction is down, you will make it to zero.

          The first day of the drop I don't notice any difference.The sluggishness I have experienced is usually the second day after the drop. It isn't anything I can't deal with. Just less motivation to get up and start the day. Once I get going, I forget about it. By day three my blood levels are leveling off and I feel great. Same with day 4. So, it is just a bit of push to keep going and not fall back into the old habit of more is better. It isn't.

          My sleep is also back to normal. I only had problems the first week after transitioning from methadone to subs. I continue to feel like I sleep better as I go down.



          Last edited by metha-sub; 06-21-2020, 12:02 PM.

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          • #6
            Cutting suboxone strips is a pain. I have mostly 8 mg strips. Cutting these into smaller pieces gets tougher the smaller you go. I start by folding the 8 mg piece in half and cutting it down the middle as close as I can. That makes two 4 mg pieces. Then I do the same for the 4 mg pieces. That makes 2 mg pieces. After that, It gets harder to cut them evenly. From a video I saw about cutting subs, I cut smaller pieces from corner to corner into little triangles and then from the top of the triangle straight down for the smaller pieces. I can get the pieces pretty even down to .25 mg.

            I always end up with some slightly larger and smaller pieces. What I do is to take the ones that look just a bit larger starting on day 1 of the drop. Then I take the next smaller looking ones on following days. That means I am always going down.

            There are 2 mg strips that are the same size as the 8 mg ones. I have a few and will use those when I get down under 1 mg. They will be much easier to cut into small doses.

            To keep the 1 mg, .5 mg and .25 mg pieces organized, I found a daily pill organizer box. It has a compartment for each day of the week. I don't use it that way but instead separate the pieces by size into the compartments from left to right. It makes keeping the pieces separate easy. It can be hard to tell a .5 piece from a .25 piece if you don't separate them. It also makes it easier to take the right dose without having to cut a piece every time.

            I take my morning dose first thing. I found that it is easiest for me to do this before I even get out of bed. I put my morning dose in the last compartment of the pill organizer. When it's about time to get up, I put that dose under my tongue and go back to sleep for a few minutes. Works great and I can get going like normal when I get out of bed.

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            • #7
              Methadone clinics and most Sub clinics want you (or insist) that you attend support groups. I found that this really helped at first. You can ask questions and find out what other people are going through. I went to a lot of them at the methadone clinic when I first started.

              There are all types of people and reasons for being there. Most people abused opiates. Some have chronic health problems or even psychological problems that they were self medicating with opiates. Whatever the reason, everyone is there to either get their life back together, get stable or get off opiates.

              Going to the groups with a good attitude (not because they make you) will help you focus on your goals. These are a great place to ask questions of the Dr or staff running the group. Just be aware that some clinics don't ever talk about tapering or getting off opiates. Just like any service you are paying for, remember you are the customer. If you are in a big city, there is probably more than one place you can go. If you aren't getting the care or services you think is best, see if you can find another clinic. Do it early if it is a methadone clinic or you may lose all take home privileges.

              I have heard that some people have found regular Dr offices that will prescribe subs or even methadone. That may be best for some. But, you would probably have to find your own support group. Most places have AA and NA meetings that you can attend. Just be aware that some AA or NA groups look down on people that are still on subs or methadone. You don't have to bring it up. Do what works for you.

              One thing I found with groups is that some are real downers. Focusing on problems all the time or the difficulties of tapering is not what I wanted. I stayed away from those. Having a positive attitude helps a lot. If you want to get off opiates or any drug you can. Stay positive and away from places or people that make you want to use or bring you down.
              Last edited by metha-sub; 06-21-2020, 12:03 PM.

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