Transitioning from Methadone to Buprenorphine / Naloxone (Suboxone)

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:

Difficulty presenting to an opioid treatment program (OTP) daily

Living a long distance from an OTP

Desire or need to travel for work or vacation

Perceived stigma from taking methadone

Desire to take daily medication from home

No longer requiring the structure of an OTP

Body not tolerating methadone well

We recommend patients work with their healthcare providers to develop an ideal treatment plan.

Online Suboxone treatment at Bicycle Health provides:

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.
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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.

The convenience of getting help around my needs and schedule. I believe that if more people that need help knew about Bicycle Health, it would dramatically change the opioid abuse statistics.

Asst Store Manager, Alabama

December 2020

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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.
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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.

I appreciate the ability to connect with my patients when they need me the most. Online treatment allows my patients the opportunity to place their recovery first and keep on track!

Kathryn Rutland, MD

Bicycle Health Provider

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