Suboxone or Methadone?

You’re not alone, I’ve been where you are. Here, we discuss the differences, pros and cons of Suboxone and Methadone. I’m not a doctor, but through experience, I can a different outlook than a doctor does.

Let’s start with Methadone.

Methadone is a synthetic opioid, a full agonist. It is prescribed for pain and opiate dependency. It has a cross-tolerance with other drugs of it’s class like heroin, oxycodone and hyrdocodone, but a much more longer duration of effect. It can stay active for up to 20 hours, not including it’s half life. For pain patients, it is usually dispensed in tablet form, these tablets are what makes it to the streets. In heavily regulated clinics, liquid Methadone is used.

Some people use Methadone as a recreational drug, but many agree that it does not hold much recreational value. It does indeed relieve pain and withdrawal symptoms, but many say it does not produce the same euphoria as heroin and Oxycodone. On the street, Methadone is a very dangerous drug, it goes to blame for 1/3 or painkiller deaths.

Methadone is a very potent drug. It is used only for patients with severe, chronic pain who have tolerance to opioid medications and those addicted to heroin and other painkillers who also have very high tolerances with the same class of drugs. People trying to use the drug recreationally are put in danger of overdose because of the drugs’ potency. Someone who has used Vicodin a few times could have adverse effects from just 1mg of Methadone.

Other dangers are drug interactions. Many medications can have adverse and even fatal effects when mixed with Methadone. These are reasons why Methadone should never be touched without a prescription. Because of it’s dangerous features, Methadone has cause much concern, giving it a very bad name. The reality is: taking the drug as it is prescribed by your doctor, and notifying them anytime you need to take other medications (over the counter or prescription); it can be a safe and effective drug which has helped many good people.

Methadone is ideal for addiction recovery because of it’s long duration, it allows patients to experience relief all day long with one dose. It has a sort of sticky effect in the brain’s opiate receptors, making other opiates less effective and less desirable. It does the same thing by raising the patient’s tolerance, making other opiates much less effective.

Now, let’s check out Suboxone

Suboxone or it’s generic name Buperenorphine is a semi-synthetic derivative of thebaine. It is mixed agonist-antagonist which is used for treating patients with opiate withdrawal as well as acute pain. Suboxone comes in tablet and strip forms, tablets no longer as popular for their potential for abuse. Suboxone tabs and strips are sublingual, meaning they aren’t swallowed, but placed under the tongue and let dissolve. Most of the medications are orange flavored.

Suboxone is not as chemically alike to other drugs than Methadone. Though some street users do still abuse it, it is much less desirable. It was created to relieve withdrawal symptoms, but at the same time, block all other opiates from being effective. It does this in a couple different ways. Suboxone is not just oe drug, it is a mix of Buprenorphine and Naloxone. Buprenorphine attaches to opiate receptors in the brain and acts sticky, making it hard for any other opiates to cause an effect. Naloxone is a pure opioid antagonist that is used for opiate overdoes. In this case, it is used to deter abuse. When injected, it can cause immediate withdrawal by eliminating all other opiates a person is using from the body.

Naloxone is used to deter abuse of the drug itself as well as deter patients using the drug from using heroin and other opiates. It is said that if a person who is taking Suboxone also takes another opiate, the other opiate will not be effective or the person will go into withdrawal depending on the order of drugs taken.

Okay, so what’s the conclusion?

Both drugs have their similarities and differences, not all people require the same drugs or same treatment. I want to point out first that you should always try to kick an opiate habit cold turkey and get a support system like NA or AA before jumping straight to Methadone or Suboxone, turning to opioid replacement. Both drugs can help you out, but depending on the level of dependance, may make things worse, you will become dependent on either.

Both drugs can be used as a maintenance program, meaning that your doctor can keep you on the drug for a long period of time to stay away from using other drugs. Suboxone was designed as a shorter program, which may be the case for some people.

Methadone is used more for a maintenance program than Suboxone, many people try Suboxone and switch to Methadone if treatment fails. Some patients end up taking Methadone for many years, essentially trapping themselves with the drug. It has helped many people, but just worsened opiate addiction for others. If used for maintenance, both drugs can be very dangerous to stop using without doctors orders, both requiring tapering plans.

Every person has different needs, hopefully by outlining some things that some doctors are not up front about, you can make an educated decision about your treatment. Best of luck!

Hit the wall @ 28mg during taper

No_U_TURNUp until a couple weeks after the last update, my taper seemed to be going great. I could tell that the lack of sleep was starting to get to me, and my stomach was really starting to act up. My taper is 2mg/week. Once I hit 30, I was in rough shape. I noticed that I didn’t want to get out of bed, and when I did, it took forever to get moving. For about a week, I kept convincing myself that I had some type of bug, I live in the Northeast, so it would make sense.

At the end of the week, I couldn’t sleep, 4 hours after dosing, I would get these splitting headaches that turned into migraines until I ingested my next dose. Once I added up all the symptoms, I realized that this is no flu here. On my next visit to the clinic, I had an assessment done. Turned out that the COWS (clinical opiate withdrawal scale) also said I was undergoing withdrawal. This was on a Friday, I stuck it out through the weekend, I actually bought some Cimetidine (Tagamet) to help my dose out a bit. For those of you that don’t know about Tagamet, it’s an antacid which share the same metabolic pathway (CYP-450) as Methadone. So by taking 200-1000mg about 40 minutes before your dose, it helps by making your body metabolize it much slower, but it can also cause very high serum levels. So if you are on a high dose, I really wouldn’t recommend potentiating with the shit.

Anyway, I felt a bit better taking the Cimetidine throughout the weekend, on Monday, I stopped taking it. If you use it for prolonged periods of time, you can increase your tolerance to Methadone and other opiates requiring you to up your dose. On Monday I got the increase, I was hoping for maybe 2mg, but the doc gave me 5mg, probably because of the score on the COWS. Once the dose metabolized, I immediately started to feel better. It’s amazing how much 5mg of Methadone really is.

As of that Friday, my taper is halted at 35mg. My plan is to hang around on this dose for maybe a week or so, then continue to taper, but at 1mg/week this time. I read heaps of information, especially from the folks at Opiophile about Methadone and tapering. I though that I had set a realistic goal of tapering at 2mg/week up until about 10 or 15mg, then going at 1mg/week.

Many people have tapered at that rate, but hey, everyone is different. I haven’t been smoking much, here and there when I was feeling like shit, but I have to watch it with the clinic, especially because with my taper plan changing, it pretty much doubled the amount of time until I am done with Methadone, and I really don’t want to go the clinic every day until then. The clinic I go to does not allow us to smoke weed, though I have heard some do allow it. It obviously isn’t a major issue like benzo use, but they will rescind privileges for doing it. At one point, I was showing up twice a week, tested positive for THC and they bumped my privileges back to 5 days a week (Monday-Friday) this clinic is open 7 days a week, so it is a big deal not having to go in on the weekends.

That’s about it for this time guys, I’ll post another update once I have begun the taper again. Until then, I’m going to keep doing what I’m doing.