Switching from Methadone to Suboxone: How Long Do I Need to Wait?

January 25, 2023

Methadone has been around for many years to treat opioid-use disorder (OUD). However, it is slowly becoming less popular and is replaced by buprenorphine or Suboxone. This is mostly because Suboxone can safely be taken at home, without any significant risk of fatal overdoses, while methadone is significantly more dangerous and hence has to be administered in person by going to a methadone clinic generally at least 6 days a week (i.e. direct observed therapy, or DOT).

This leads to many people transitioning over from methadone to Suboxone. The most important consideration when switching over to Suboxone is the waiting period before taking the first dose of buprenorphine (Suboxone).

How long should patients wait after finishing methadone, before starting Suboxone? 

Because methadone takes a long time to leave the system, it is best to wait at least 72 hours (3 days) before starting Suboxone. 

This is to avoid the signs and symptoms of precipitated withdrawal. These may include:

  • Muscle pain
  • Cramps
  • Diarrhea
  • Fever
  • Sweating
  • Dilated pupils
  • Insomnia
  • Depression
  • Suicidal thoughts
  • Rapid heartbeat
  • High blood pressure
  • Pain, including headaches
  • Anxiety
  • Nausea and vomiting
  • Runny nose
  • Goosebumps
  • Chills

If waiting 3 days or more proves too difficult, microdosing can be an option: Suboxone can be given in smaller-than-usual doses at frequent intervals to avoid withdrawal symptoms. Doses as small as 0.5 mg are taken (instead of the usual 8 mg). However, the longer a person can wait, the more smoothly the transition will be.

How can I switch to Suboxone from methadone?

QuickMD is the largest medication-assisted treatment program in the United States. They can prescribe Suboxone to you via telemedicine and guide you through the transition. QuickMD providers can also prescribe adjunct medications to you, to help you with any withdrawal symptoms you may experience during the transition period.

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