Transitioning from Methadone to Buprenorphine / Naloxone (Suboxone)
RX Only: See important safety information about Suboxone
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Why transition from methadone to buprenorphine / naloxone (Suboxone)?
Patients may desire to transition from methadone to buprenorphine/naloxone (Suboxone) for various reasons, some of which include the following:
We recommend patients work with their healthcare providers to develop an ideal treatment plan.
Online Suboxone treatment at Bicycle Health provides:
Our online clinic
- Confidential phone & video calls with your medical provider via our mobile app
- Online support groups from the privacy of your own home
- Experienced, addiction-medicine trained online Suboxone doctors who truly care
- Suboxone home delivered
In person
Patients often wait days-to-weeks for an in-person clinic visit- Lots of time lost in transportation to and from the clinic visit
- Unpredictable wait times during in-person visits
- High and often unpredictable costs
What’s the transition from methadone to buprenorphine / naloxone (Suboxone) like?
Transitioning from methadone to buprenorphine/naloxone (Suboxone) can be physically uncomfortable for many patients, as well as increase risk for relapse. It is important that you work closely with your healthcare provider to develop an appropriate transition plan.
If you currently get methadone from an OTP, your Bicycle Health provider will coordinate with your methadone clinic staff to slowly taper your methadone dose. To minimize the risk of precipitated withdrawal, it’s recommended that methadone be tapered to 20-30mg daily before beginning treatment with buprenorphine/naloxone (Suboxone).
The dose of methadone should be reduced by no more than 5-10% weekly. The lower methadone dose you’re on at the time methadone is stopped, the less discomfort you’ll experience throughout the transition process.
After your methadone has been tapered to 20-30mg daily, which you’ll stay on for approximately 1-2 weeks, you’ll need to be abstinent from methadone (and all opioids) for 36-72 hours, or until you’re experiencing moderate withdrawal symptoms. Once in moderate withdrawal, you can take your first dose of buprenorphine/naloxone (Suboxone). Your provider will work with you to achieve an effective dose of buprenorphine to relieve your withdrawal usually within 1 day of starting.
Transitioning from methadone to buprenorphine/naloxone (Suboxone) takes time, and the taper may differ from patient to patient. It’s vital that you work with your medical provider to determine what’s best for you.
Lastly, if the transition to buprenorphine/naloxone (Suboxone) is unsuccessful, then patients can return to methadone treatment immediately.
To speak with a member of our team about transitioning from methadone to buprenorphine/naloxone (Suboxone), schedule a call here.
Symptomatic Management of Opioid Withdrawal
Withdrawal symptoms are uncomfortable, but there are withdrawal treatments your Bicycle Health provider can prescribe to help relieve these symptoms:
- Clonidine helps reduce anxiety, irritability, muscle aches, sweating, and runny nose;
- Hydroxyzine (Atarax) helps relieve anxiety and insomnia;
- Tizanidine (Zanaflex) helps reduce muscle spasms;
- Ondansetron (Zofran) relieves symptoms of nausea and vomiting;
- Loperamide (Imodium) helps relieve diarrhea; and
- Bentyl helps relieve gastrointestinal (GI) symptoms, especially abdominal cramping.
And lastly, once you start induction with buprenorphine/naloxone (Suboxone), you’ll begin to experience relief from opioid withdrawal symptoms.
We recommend arranging for childcare and time off work throughout the methadone-to-buprenorphine transition period, as many patients may experience discomfort for up to 1-2 weeks.
How does Bicycle Health work?
Your Journey to Recovery with Bicycle Health
Here at Bicycle Health, we combine buprenorphine/naloxone (Suboxone) treatment with behavioral health supports, like online support groups and health coaches.
Learn more about how our process works here.
We are physicians, nurse practitioners, and physician assistants who are invested in your recovery.
Bicycle Health providers, staff, and leadership believe everyone deserves access to confidential, individualized, and non-judgmental care for transition from methadone to buprenorphine/naloxone (Suboxone).
Schedule a call with an enrollment coordinator to learn how buprenorphine/naloxone (Suboxone) treatment can improve quality of life.
My life has improved 100% on this medication. I can deal with the ups and downs, am rarely depressed, don't have a lot of anxiety and have my energy back. I feel like a normal person again.