Bupe vs, Methadone - need advice on which is better for me

[mickeyaye6989 (OP)]

So I've decided to start a maintenance treatment, likely for a long term relationship, and am seeking advice on which one would work better for me. I'll give a ltitle background on my habit and experience with the two drugs, and describe my day of "Suboxone Day 1 - Induction" which was yesterday, and currently has me questioning if Subs are the right thing to go with.

My habit is .3-.5g/day of some nice #4, IV, going for the past 6-8 months. I know it's pretty good quality, and doesn't have any fent or bullshit because I've been drug tested and only had H metabolites in my weewee. Also, my connect is a guy who used to be a top level dealer in the area before getting popped a while back and slowing down, so his connects are dudes who move large amounts, but still work with him even tho he isn't flipping keys anymore since they knew him back in the day. Not sure on purity, but it's high and I can say that I don't really even feel a 16mg shot of Dilaudid.

I tried beginning Suboxone today, but am now questioning if it's the right choice for me. I waited 31 hours before dosing and didn't go into Precip WD's but still don't feel the amount of relief that I need to, or feel totally 'right' for that matter. I've taken Sub in the past and when I didn't have a regular habit, or much of one at all and while I did get a high from it, I almost always got really nauseated and had a terrible migraine with it. Today I started with 12mg, slowly dosed over the course of 5-6 hours, but by the time I reached the first day limit that the doc has, of 12mg, I still didn't feel nearly well enough and had crazy bad RLS and everything. Ended up having to go score some H and do a bunch more than usual to get well, but it did eventually straighten me out.

Basically, I know that for heavy users (which my doc said I fall into the large habit end of the scale) Subs often can't give enough relief to properly alleviate WD symptoms so methadone is often the first choice. I don't mind going to the clinic every day if that's what I'll have to do, as I'd have to for Subs for the first bit as well. I just want proper relief and Suboxone didn't get close to touching that today. I know that people often take 24-36mg (my doc here in Ontario, Canada has a 24mg max dose that he will prescribe) but I hate the weirdness that I feel from it, and because it's not making me feel normal, I have horrible cravings and am going crazy.

Sorry for the long post, tldr: I have a large habit and Subs don't seem to cut it. I inducted today and took 12mg but still feel really shitty and had to score because it didn't cut the WD's enough. IS methadone a better option? Anyone with experience trying Subs but finding they don't feel like the right fit for a maintenance drug long term? Any and all experiences appreciated

[Chip]

Never used Subs but if it is an option then try Subutex as it may get rid of the headaches, I have heard.

I'd still wait a few days (and take less as it has a low ceiling) before judging it but that's just my instincts.

I was a Methadone guy before detoxing and I always wondered if Subs were easier to detox from.

[Snout]

Chipper is right in my opinion, it's pretty common for both bupe and methadone for it to take a few days to feel full relief. If you already inducted ( induced?) , the worst is over, that's is for sure. You should ride it out, you will be ok soon.

[MoeMentim]

I remember taking 16-24mg the first day coming off a solid habit & it would take a few days for it to start working like it will from then on.  As soon as the lingering wd symptoms were gone I'd taper down pretty quick & would try to get to 2-4mg/day.  I found, like many have, that less is more long term.   Never been on mdone maintenance.

[bignasty]

less is definitely more with bupe. u should've started with 2-4 mg's in the morning then a fix of h at night for the first few days until it gets in your system good and you're somewhat used to it.

However, since you started with 12 mg's, you should at least give it a week before getting on methadone. Subs are a lot better for having freedom and not having to go to the clinic once a day and easier to detox from and taper down on. But if you're a CPP or you're just not ready to get totally sober(as sub will make you feel), methadone might be a better fit for you.

Lowering your dose might help with the headaches. If I were you, I would take 2 mg's every few hours until you feel better then STOP or you'll get a headache from taking too much IME.

Also, once you get stable on subs, try not to take any "breaks or weekends" without sub while using your DOC because it really does get harder and harder to get back on it every time you take a break from it. I kept taking dope breaks from sub and now I HAVE TO take methadone because sub simply quit working right for me.

If you still wanna use every now and then, I suggest at least taking .5 mg's early in the morning then do your DOC at night. Sub strongly blocks everything though so it would actually be best to take .5 mg's every morning for a few days before any scheduled "breaks" for using your DOC.

[mickeyaye6989 (OP)]

Thanks for the advice guys, looking back I do wish I would have just ridden it out, but I only got 12 the first day, and now since it's day 2, I've got 16 that I didn't take, and by tomorrow I'll have 32mg saved up to do another induction myself in a couple days. Will wait another 32 hours and then take a small dose to test for precip WD's, and once I'm in the clear will dose up until I feel better and/or hit 24mg. Honestly if they had let me have another 4-6mg I may have been ok, but I was still going crazy even after the 12mg.

I realize that I won't feel perfect, but I do feel that I needed more than 12mg to start out. What have you guys taken for your first day's dose, and how did you break up the dosing? The docs here at the clinic seem to prefer titrating your dose up slowly in 2-4mg increments by the 1.5-2 period, so the first day is horrible until the afternoon once you've got a third dose and had it kick in.

I plan on doing a self induction by waiting the same amount of time (30-32 hours), and then taking 2-4mg. If I feel like there's no chance of PWD's then I'll dose 12mg and then 2 hours later 6mg more if I need it. After that I'll take 2-4more until I'm at 24mg, which is the most they'll give you here at the clinic. They said that occasionally they'll make exceptions and prescribe 32mg but it's quite uncommon.

I feel like if my dose is that high then why not just do methadone? I really don't mind going to the pharmacy everyday, and it's half the price. Out of all the times I've taken bupe, I've never fully enjoyed it so I honestly feel like even if my WD's go away, I won't feel "normal" like I want to, as that might require a full agonist. I may be wrong, and I hope I'm not biasing my own opinion by pre-judging the drug's efficacy, but I have read that some patients who are on a high dose of opiates may not feel full relief from Subs even at a full dose. I just want to feel normal and then once I'm stable I can taper down slowly. My goal is to eventually get myself down to about 20mg, and then stay around there until I decide to come off, or who knows, maybe I'll stay on for a long time. If I can still have a holiday every once in a while, then it sounds like a pretty sweet deal, as it takes any worry away from avoiding WD's, and still allows me to dabble here and there. I'll be saving enough money everyday to allow for a nice big breakthrough blast when I do take a holiday, so no worries there

Lots of people take SSRI's or tricyclics and no one gives them shit, so why should it be any different if my antidepressant is methadone? None of us are getting high, and we would both have withdrawls, so the only difference would be the type and severity of those WD's. If they make you take it there in front of them, then why bother making it so restricted? That's enough restriction to make it have almost no chance of being used illicitly, as we are just taking our "daily vitamins".

[Chip]

The problem with Methadone is that I started feeling dopesick in the last 6 hours before 24 was up and it was really distracting and uncomfortable.

Then there's the sweating and constipation ... i couldn't wait to be off it, truth be told.

I only enjoyed the first 6 hours.

[bignasty]

based on your attitude towards and experience with sub/bupe and the fact that you don't mind going to the clinic once a day and that it's half the price, I would say go for the 'done if sub is not helping after 3-4 days. Especially since you're still wanting to use every now and then. Done blocks in a way but not like sub does.

IMO sub is a lot safer and easier to taper off of and less of a hassle. However, I think it should only be used if you're serious about getting clean and/or staying on it long term without taking "breaks" with your DOC. U gotta be really wanting to be clean because you're not going to feel ANYTHING from bupe like you will with 'done.

IMO 'done is better for folks with bigger habits and/or chronic pain issues. It's also better if you still wanna use as it doesn't block good opi's in the same way that sub does. Depending on your dose and how long you wait after you dose, it can actually add to the buzz from your DOC. Done isn't going to give much, if any, euphoria after you get to your stable dose but it'll help with pain/sleep a lot better than sub and you can add benzos to get a buzz. If you do use benzo's, please be careful while on 'done because that combo kills a lot of folks including a few friends of mine IRL.

[Snout]

Only a few lucky people feel anything at all from their methadone dose after a few weeks

[bonedust]

Only a few lucky people feel anything at all from their methadone dose after a few weeks

Yep yep. I got high for a couple years back when I was addicted to it then I was good and fucked. I think it was partly due to my super fast metabolism. Everything flies right through my body. It's good in some ways and bad in others.