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 MAT’S CLINIC 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.
