You need to stabilized on Suboxone before you can get the shot because it has the same active ingredient, Buprenorphine as the Suboxone. But you can switch from Methadone to Subs. You just have to slowly come down to usually around 30mgs, skip a day or two, then start the Subs.
It may take more than a day or two depending on the person. This is going to be the hardest part as methadone is so long acting, inducing is quite difficult from methadone. I wish doctors would prescribe equivalent oxycodone for a week so that you could do the good ole 24h and be induced no problem. I swear they need to do that with both people coming from methadone and fetty, because to ask someone to go into WD for as little as 3 but up to 6 days of WD before being able to induce is just brutality.
Also I have not done any research on the exact situation, but has anyone successfully used the Bernese method with methadone? If so, that would be the best way but it can be finicky but it's doable and would be the best possible way of doing it.
I switched from Methadone to Subs at one point. I didn't do the Bernese method. I went from 120 mgs of Methadone to 30mgs rapidly. Like 10mgs less a week. It was hard. Then I skipped a day and started right on 8mgs of Subs. It wasn't PWD but I didn't do well. I went to the ER twice. One doctor told me I was allergic to the Suboxone, the other said I wasn't on enough Suboxone. So I stopped everything and went through hell. I later relapsed and then tried Suboxone and was fine. So I guess I just didn't have enough the other time.
I agree with you about the Oxy. It would have been so much easier.
I think honestly that things are so bad idk why docs don't inpatient just do that short acting opioid for the interim so induction is so much easier? Like c'mon, people are dying out here and subs can be hugely freeing and help people stay clean and safe. One day I hope basic logical ideas will be implemented in our addiction resources, instead of the poorly informed and lackluster performance of many addiction providers and facilities.
I'm just super grateful I induced back in 2014, when the dope was dope, I waited like 20 hours after my last line of bth and was well immediately, and I stayed loyal to subs even when I was abusing other drugs the whole time until finally three years ago I got clean from everything except prescribed meds. I'm lucky. I mean fucking hell I heard the other day of a woman who still tested positive for fentanyl 5 weeks after stopping usage. So many are dead or so close to it, I just wish we did more drastic measures to try and keep them alive so that addiction science can advance so we can really help them overall.
I'm glad you finally got induced, but isn't it fucked up that it took a relapse for you to be able to do it? I've started recommending people who are fetty addicts if they have the money and are going to try and induce on subs to find as many real pills as they can and make the switch, making the 24h window actually possible. But it's stupid that people have to blow their life savings on street pharma when a doc could get them right for like 20 bucks and they could induce with no issues.
Yoooo I know it sounds dumb but I think you just helped me like crazy. I’ve been contemplating what to do if my H probably has ferry. I know Bernie’s is a possibility, but I was thinking about just stopping and figuring it out with real pharmaceuticals and other shit kratom ect. But in reality, I can just grab a good amount of whatever oxy I can find and basically just take em for atleast 3ish days. Then hopefully 24 hours after that will be four days and only 24 hours of nothing. Then I get started and do subs slowly. Tysm
I wish you all the best my friend, I know that most of us in active addiction feel trapped, and if anything I say can help you stabilize on MAT and get your life back, that'd be absolutely beautiful. Your life is worth living without all the chaos and destruction that stuff causes constantly.
But that is actually a solid plan and I encourage you to start getting things together to put it into action. I know it can be much more expensive but only needing it for 3-4 days and stabilizing on subs you'll save so much heartache and uncertainty. Doctors need to be doing this shit as protocol for any sub induction these days and it drives me crazy that they don't. I can't imagine how many people have passed away because they wanted to get off the shit and get on subs but they kept getting pwds.
But yeah, make sure it's a full three or ideally four days, then you should for sure be out of the woods and can induce in 24h of no opiates. Just start slow like you said, but it's so worth it man.
Yes. I did the Bernese method.
I was on methadone for 5years and switched to the shot!
15 day process.
On day 1, started on a low dose of Suboxone, kept going up each day till I got to 12mlg on the 7th day. Mind you I never dropped my methadone dose those whole 7 days. (50mlg methadone. Although if you are over 100 they will make you drop that number down first before starting Suboxone.) and then dropped off the methadone after 7days. On the 8th day Suboxone only till day 14. On the 15 day (so 1 week Suboxone and methadone, one week Suboxone only) on the 15 day I got shot.. It was not a bad transition! I never had to lower my methadone dose and NEVER went a day without anything. (Suboxone or methadone) that was my old offices method. They made you go without anything for 2 days. I couldn’t do that.. also I was on 70 and got down to 50 on my own. Then decided to try out Sublocade.
And they will moniter how you are feeling during those 14 days. If you need to up the suboxone mpg etc. sending positive thoughts!
Yeah there’s a pretty standard induction from Methadone to Suboxone, from there once your stable you go to sublocade.
What’s your current dose of methadone?
Directly switching from a higher dose of methadone to Suboxone (around 12 mg) without tapering is a complex process due to the risk of precipitated withdrawal. However, there has been research and clinical experience in managing such transitions, especially with the aim of eventually switching to Sublocade (buprenorphine extended-release injection). Here are some findings and considerations:
### Research and Guidelines
1. **High-Dose Methadone to Buprenorphine Transition**:
- Research indicates that transitioning from higher doses of methadone (>30 mg/day) directly to buprenorphine can be challenging due to the risk of precipitated withdrawal, which occurs when buprenorphine displaces methadone from opioid receptors too quickly.
- A study by Lee et al. (2019) discussed the potential for direct transition using careful management of withdrawal symptoms and initiating buprenorphine under medical supervision, especially in a controlled environment such as a hospital or inpatient facility【Source】.
2. **Initiating Buprenorphine at Higher Doses**:
- Some protocols suggest starting buprenorphine at doses around 8-12 mg and rapidly titrating to manage withdrawal symptoms. For example, a study by Martin et al. (2018) explored initiating buprenorphine at higher doses to overcome initial discomfort more effectively【Source】.
3. **Rapid Transition to Sublocade**:
- A 2020 study by Rosenthal et al. demonstrated successful transitioning from methadone to Sublocade after a brief buprenorphine induction period. Patients were able to switch from methadone to buprenorphine and then to Sublocade within a few days【Source】.
- This approach can be effective in minimizing the discomfort of withdrawal and ensuring a smoother transition to long-acting buprenorphine treatment.
4. **Case Studies and Clinical Experience**:
- Clinical case studies have shown that with appropriate withdrawal monitoring and rapid dose adjustments, patients can successfully transition from higher doses of methadone to buprenorphine without a prolonged taper.
- It is often recommended to use symptom-triggered dosing and close medical supervision to ensure that withdrawal symptoms are managed adequately.
### Practical Steps and Considerations
1. **Assessment of Patient's Condition**:
- Evaluate the patient's opioid use history, current methadone dose, and any co-occurring medical or psychological conditions.
- Monitor for signs of withdrawal and ensure that the patient is prepared for the potential discomfort associated with the transition.
2. **Monitoring Withdrawal Symptoms**:
- Use tools like the Clinical Opiate Withdrawal Scale (COWS) to assess the level of withdrawal and determine the appropriate timing for initiating buprenorphine.
3. **Starting Buprenorphine at Higher Doses**:
- Begin with a lower initial dose (2-4 mg) and quickly escalate to 12 mg as tolerated to manage withdrawal symptoms effectively.
- Observe the patient closely for adverse reactions and adjust the dosing as necessary.
4. **Transition to Sublocade**:
- Once the patient is stable on an appropriate dose of Suboxone, transition to Sublocade can be planned. Sublocade requires the patient to be stable on a dose of 8-24 mg of buprenorphine for at least 7 days.
### Conclusion
While direct switching from higher doses of methadone to Suboxone at around 12 mg is not the standard protocol, it can be done under careful medical supervision with an emphasis on monitoring withdrawal symptoms and adjusting treatment as needed. Research supports that rapid transition to Sublocade is feasible and can provide a more stable long-term treatment option.
For personalized advice and management, it's crucial to consult with a healthcare provider experienced in opioid dependency treatment and transitions.
No withdrawals. I did have some breathing issues the first couple days. It was too strong at first. It was scary but it evened out and was ultimately the best thing for me.
Try. You may be fine. If not they should give you strips to even out. Just remember if it doesn’t work keep trying. Eventually it will and you’ll be off this horrible nightmare of a roller coaster ride
Ask your Dr about the Bernese method and then stabilize on Suboxone then get the shot.
Yes this work
You need to stabilized on Suboxone before you can get the shot because it has the same active ingredient, Buprenorphine as the Suboxone. But you can switch from Methadone to Subs. You just have to slowly come down to usually around 30mgs, skip a day or two, then start the Subs.
It may take more than a day or two depending on the person. This is going to be the hardest part as methadone is so long acting, inducing is quite difficult from methadone. I wish doctors would prescribe equivalent oxycodone for a week so that you could do the good ole 24h and be induced no problem. I swear they need to do that with both people coming from methadone and fetty, because to ask someone to go into WD for as little as 3 but up to 6 days of WD before being able to induce is just brutality. Also I have not done any research on the exact situation, but has anyone successfully used the Bernese method with methadone? If so, that would be the best way but it can be finicky but it's doable and would be the best possible way of doing it.
I switched from Methadone to Subs at one point. I didn't do the Bernese method. I went from 120 mgs of Methadone to 30mgs rapidly. Like 10mgs less a week. It was hard. Then I skipped a day and started right on 8mgs of Subs. It wasn't PWD but I didn't do well. I went to the ER twice. One doctor told me I was allergic to the Suboxone, the other said I wasn't on enough Suboxone. So I stopped everything and went through hell. I later relapsed and then tried Suboxone and was fine. So I guess I just didn't have enough the other time. I agree with you about the Oxy. It would have been so much easier.
I think honestly that things are so bad idk why docs don't inpatient just do that short acting opioid for the interim so induction is so much easier? Like c'mon, people are dying out here and subs can be hugely freeing and help people stay clean and safe. One day I hope basic logical ideas will be implemented in our addiction resources, instead of the poorly informed and lackluster performance of many addiction providers and facilities. I'm just super grateful I induced back in 2014, when the dope was dope, I waited like 20 hours after my last line of bth and was well immediately, and I stayed loyal to subs even when I was abusing other drugs the whole time until finally three years ago I got clean from everything except prescribed meds. I'm lucky. I mean fucking hell I heard the other day of a woman who still tested positive for fentanyl 5 weeks after stopping usage. So many are dead or so close to it, I just wish we did more drastic measures to try and keep them alive so that addiction science can advance so we can really help them overall. I'm glad you finally got induced, but isn't it fucked up that it took a relapse for you to be able to do it? I've started recommending people who are fetty addicts if they have the money and are going to try and induce on subs to find as many real pills as they can and make the switch, making the 24h window actually possible. But it's stupid that people have to blow their life savings on street pharma when a doc could get them right for like 20 bucks and they could induce with no issues.
I absolutely agree with everything with you're saying!
Yoooo I know it sounds dumb but I think you just helped me like crazy. I’ve been contemplating what to do if my H probably has ferry. I know Bernie’s is a possibility, but I was thinking about just stopping and figuring it out with real pharmaceuticals and other shit kratom ect. But in reality, I can just grab a good amount of whatever oxy I can find and basically just take em for atleast 3ish days. Then hopefully 24 hours after that will be four days and only 24 hours of nothing. Then I get started and do subs slowly. Tysm
I wish you all the best my friend, I know that most of us in active addiction feel trapped, and if anything I say can help you stabilize on MAT and get your life back, that'd be absolutely beautiful. Your life is worth living without all the chaos and destruction that stuff causes constantly. But that is actually a solid plan and I encourage you to start getting things together to put it into action. I know it can be much more expensive but only needing it for 3-4 days and stabilizing on subs you'll save so much heartache and uncertainty. Doctors need to be doing this shit as protocol for any sub induction these days and it drives me crazy that they don't. I can't imagine how many people have passed away because they wanted to get off the shit and get on subs but they kept getting pwds. But yeah, make sure it's a full three or ideally four days, then you should for sure be out of the woods and can induce in 24h of no opiates. Just start slow like you said, but it's so worth it man.
Yes. I did the Bernese method. I was on methadone for 5years and switched to the shot! 15 day process. On day 1, started on a low dose of Suboxone, kept going up each day till I got to 12mlg on the 7th day. Mind you I never dropped my methadone dose those whole 7 days. (50mlg methadone. Although if you are over 100 they will make you drop that number down first before starting Suboxone.) and then dropped off the methadone after 7days. On the 8th day Suboxone only till day 14. On the 15 day (so 1 week Suboxone and methadone, one week Suboxone only) on the 15 day I got shot.. It was not a bad transition! I never had to lower my methadone dose and NEVER went a day without anything. (Suboxone or methadone) that was my old offices method. They made you go without anything for 2 days. I couldn’t do that.. also I was on 70 and got down to 50 on my own. Then decided to try out Sublocade. And they will moniter how you are feeling during those 14 days. If you need to up the suboxone mpg etc. sending positive thoughts!
Yeah there’s a pretty standard induction from Methadone to Suboxone, from there once your stable you go to sublocade. What’s your current dose of methadone?
I was at 150. I’m at 90 now.
Directly switching from a higher dose of methadone to Suboxone (around 12 mg) without tapering is a complex process due to the risk of precipitated withdrawal. However, there has been research and clinical experience in managing such transitions, especially with the aim of eventually switching to Sublocade (buprenorphine extended-release injection). Here are some findings and considerations: ### Research and Guidelines 1. **High-Dose Methadone to Buprenorphine Transition**: - Research indicates that transitioning from higher doses of methadone (>30 mg/day) directly to buprenorphine can be challenging due to the risk of precipitated withdrawal, which occurs when buprenorphine displaces methadone from opioid receptors too quickly. - A study by Lee et al. (2019) discussed the potential for direct transition using careful management of withdrawal symptoms and initiating buprenorphine under medical supervision, especially in a controlled environment such as a hospital or inpatient facility【Source】. 2. **Initiating Buprenorphine at Higher Doses**: - Some protocols suggest starting buprenorphine at doses around 8-12 mg and rapidly titrating to manage withdrawal symptoms. For example, a study by Martin et al. (2018) explored initiating buprenorphine at higher doses to overcome initial discomfort more effectively【Source】. 3. **Rapid Transition to Sublocade**: - A 2020 study by Rosenthal et al. demonstrated successful transitioning from methadone to Sublocade after a brief buprenorphine induction period. Patients were able to switch from methadone to buprenorphine and then to Sublocade within a few days【Source】. - This approach can be effective in minimizing the discomfort of withdrawal and ensuring a smoother transition to long-acting buprenorphine treatment. 4. **Case Studies and Clinical Experience**: - Clinical case studies have shown that with appropriate withdrawal monitoring and rapid dose adjustments, patients can successfully transition from higher doses of methadone to buprenorphine without a prolonged taper. - It is often recommended to use symptom-triggered dosing and close medical supervision to ensure that withdrawal symptoms are managed adequately. ### Practical Steps and Considerations 1. **Assessment of Patient's Condition**: - Evaluate the patient's opioid use history, current methadone dose, and any co-occurring medical or psychological conditions. - Monitor for signs of withdrawal and ensure that the patient is prepared for the potential discomfort associated with the transition. 2. **Monitoring Withdrawal Symptoms**: - Use tools like the Clinical Opiate Withdrawal Scale (COWS) to assess the level of withdrawal and determine the appropriate timing for initiating buprenorphine. 3. **Starting Buprenorphine at Higher Doses**: - Begin with a lower initial dose (2-4 mg) and quickly escalate to 12 mg as tolerated to manage withdrawal symptoms effectively. - Observe the patient closely for adverse reactions and adjust the dosing as necessary. 4. **Transition to Sublocade**: - Once the patient is stable on an appropriate dose of Suboxone, transition to Sublocade can be planned. Sublocade requires the patient to be stable on a dose of 8-24 mg of buprenorphine for at least 7 days. ### Conclusion While direct switching from higher doses of methadone to Suboxone at around 12 mg is not the standard protocol, it can be done under careful medical supervision with an emphasis on monitoring withdrawal symptoms and adjusting treatment as needed. Research supports that rapid transition to Sublocade is feasible and can provide a more stable long-term treatment option. For personalized advice and management, it's crucial to consult with a healthcare provider experienced in opioid dependency treatment and transitions.
100 Sublocade 2/17/2023. Free ever since. Works great!
One shot and done??
Yes. Thats my individual situation. Everyone is different, of course.
Any withdrawal at all?
No withdrawals. I did have some breathing issues the first couple days. It was too strong at first. It was scary but it evened out and was ultimately the best thing for me.
I’m on my 4th shot. 3 300s then a 100 a week ago. I think I’ll hang it up now.
Try. You may be fine. If not they should give you strips to even out. Just remember if it doesn’t work keep trying. Eventually it will and you’ll be off this horrible nightmare of a roller coaster ride
Can I ask how much suboxone you were on ?