Switching From Methadone To Subutex New Thread
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My husband was on 32 mg of methadone and has waited 96 hours to start his Subutex. During these 96 hours he has taken a total of ten 30 mg Oxycodone's. He took 4 mg of subutex this morning and was withdrawing about an hour after this dose. he took about three more milligrams of Subutex and he is sweating & saying he doesn't feel right. He has waited for about 14 hours in between the last dose of oxycodone and Subutex. Should he take two more milligrams to ease symptoms or should he wait it out?

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Re: Verwon (# 2)

You are absolutely correct Verwon! Buprenorphine itself, even without the naloxone added, is such a powerful receptor-filler that it can cause the precipitated withdrawals you mentioned. It happened to me. I was on Subutex for over a decade when I needed to have a hip replacement, so my doctor's strategy was to switch me over to Dilaudid for a while until the buprenorphine was completely out of my system, thereby restoring my receptors so traditional opioid painkillers would work. Well, it was—and is—a decent strategy but as you said, one must be patient (no pun intended) and wait until one is totally
opioid-free. I also didn't wait long enough (suffering already), so it was one of the most difficult challenges I have ever faced. Precipitated withdrawal is hellish to put it mildly. Normal withdrawal is to PW as a mild cold is to pancreatic cancer.

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Re: Keikee (# 3)

Please see above post. It's not the Naloxone that causes the PW, it's the Buprenorphine. Very common misconception, but frustrating none the less.

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Are you positive your husband is taking Subutex? I think he's taking Suboxone. You need to be sure.....

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The Subutex itself can actually cause precipitated withdrawals and should not be taken, until someone is already in full withdrawal. The NIH explains that the active ingredient, which is Buprenorphine, takes a stronger hold on the opiate receptors in the brain and causes other opiates to be kicked out, however, it is also a much milder opiate, so it's not as potent as the others and withdrawals can occur.

The FDA warns that this medication carries the risk of being habit forming and may cause side effects, such as nausea, dizziness, headache, dry mouth, and constipation.

Thus, it seems he took his Subutex too soon, since he was still taking Oxycodone. It is always best to follow your doctor's prescribing instructions.

How is he doing, now?

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Stacsanny

Well subutex contains no NALOXONE so the presence of this would not cause pws. No doubt he is stil withdrawing from the methadone. By administrating other powerful opiates are only prolonging this syndrome .If he intends on using subutex as an oa protocol it should be under the care of a PHYSCIAN .Was his primary dependence on methadone for pain control or opiate dependence? That will make a big difference in going forward.

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