Expert: Jacqui - 10/28/2009

Question
QUESTION: my husband has been using methadone in liquid form for about 9 months. Now they tell him that he can get off of that liquid and go to pills and it has barely withdraw symtems.He wants to get off of everything and be clean again.I don't understand why they didn't tell him that in the beginning.My question is,"Is it true that he can break off from the pill?"

ANSWER: Hi Cheryl,

No ... that is not true.  I am not sure whether you have just been given some really dumb information or misunderstood what they told you.  Methadone is methadone no matter what form it is in.  There won't be any difference in withdrawals from liquid or tablet.  I am wondering whether they are thinking of putting him on a different KIND of drug in tablet form, however all opiates have withdrawals once someone is dependent, so I can't see that there would be any difference.

I would suggest that you go back to the medical practitioner and double check.  Then if you have any more questions, I would be happy to answer them.

Kind regards and stay safe,

Jacqui

---------- FOLLOW-UP ----------

QUESTION: my name is alfred im cheryl husband she made a mistake i switched to a pill called suboxone the reasone i changed cause i was sent out of town to work and the nearest methadome clinic was  70  miles so i couldnt be driving back and forth thats 140 round trip so the doctor mention about a pill that i can carry on myself a 30 day supply and it was only about 30 dollars more then what i pay now and i wouldnt have to go to the clinc every day and the consolor said it is easier to break from so did i do the right thing i just want to be off everything please help

ANSWER: Hi Alfred,

Firstly, I want you to take stock of your situation and realise that if you race to get off everything, there is more risk of you relapsing. I am really, really familiar with the phenomena that when people stop using then just want to get off their treatment (methadone or suboxone) asap.  I also know that the slower the better.

Suboxone does come in tablet form.  However, you cannot just stop.  It is still habit forming and if you stop suddenly there will be withdrawals.  When it first came on the market people were like "oh wow, this has no withdrawal effects", but the same was said about heroin when it was put on the market in the 1800s and valium in the 1960s and both of these are habit forming as well which we now know.  

I would suggest that you go down slowly each week.  I am not sure of your dose, but you might want to try half a milligram a week.  I know this will take a while, but you are much more likely to succeed.  If you feel that this is too fast, then slow up a bit.  Make sure you try to not get too stressed, and don't put yourself in positions where you will feel like using.

Alfred I wish you all the best.  I get lots of requests for info about coming off treatment and I always tell people one last thing.  Remember that if you do lapse, it isn't the end of the world.  It is quite common that people will lapse, and if people look at it as a small hurdle that they need to get over, then they usually come out okay.  If people think of it as a catastrophe and that all is lost, they often relapse fully.  Don't hate yourself if you slip up!

Take care, and whatever you do, do it safely,

Jacqui

---------- FOLLOW-UP ----------

QUESTION: thank you for your advice and concern. when you said that i should take half a mil. a week i don't understand you. because the dr. prescribed 8 mil. tab. for me. and told me to break it in half, so that means im taking 4 mil." A DAY".Today was my first day taking it and i felt dizzy and light headed. I felt sick at work and left home. I called the dr. and she said not to take no more because she thinks that i had a little bit of methadone in my system. She had told me that I have to be 8 to 10 days off the methadone before i start the Suboxone.well when they tested my U.A.there was a very slight trace of methadone in my system still.she still decided to put me on the Subox.so when i called her today complaining of my sickness,she said that it was probaly that small trace i had in my system.she said to stop taking it for 3 to 4 more days. so i asked her what do i do until then.she said do what you have to do until then.I suggested if i do herion and she said yes until i see her again. for sure there won't be no trace of methadone in my system and i can start the subox.I was on 80 mil. of methadone so now i'm taking 4 mil of subox a day, is that too much? thank you for your advice and i hope this long paragraph was not too bothering. Alfred

Answer
Hey and sorry for the confusion,

What I meant was that if you want to reduce, I would suggest that you only reduce a small amount a week, such as one milligram.  Bearing this in mind, you need to do what your doctor prescribes.  

If you take heroin and it is still in your system when you take the suboxone, you may go into withdrawal as well.  If you do decide to use heroin, then the next day, see if you can wait until the afternoon before you take the tablet.  

As far as your dose being 4 mil, I think that is pretty low actually.  80mg of Methadone is a lot, and 4mg of suboxone isn't much at all (a higher dose would be about 16mg), but if you are really keen to get off things altogether, then it will take longer to get off 16mg.

Again, sorry for the confusion.  If you are able to get 30 days worth of tablets, there may not be such a huge rush to come off.  Take your time to get stable and don't rush yourself.  If you need me to answer any more questions, please ask!

Best of luck Alfred!

Jacqui