“Short-term Buprenorphine for Methadone withdrawal?”
Male | 36 years old
Medications: Albuterol
Conditions: Asthma
2 Answers
AddictionMedicineSpecialist|AddictionMedicineAddictionMedicineSpecialistBecause of persistent withdrawal lasting weeks or months, methadone is notoriously difficult to taper and stop, although surprisingly many people do manage to get off it without too much trouble. The hardest part is coming off the last, lowest dose, i.e., 5-15 mg/day. Buprenorphine has similar issues but in general is somewhat easier to stop than methadone. If you worked with a skilled addiction specialist, you could certainly taper and stop buprenorphine. But assume it will take weeks or months. One potential issue is that buprenorphine is usually a pretty good antidepressant, so you may have some depression or anxiety coming off it. People just feel better on buprenorphine.
Why in the world do you want to stop methadone?The risk of relapse is extremely high when people stop maintenance therapy with either drug. Both drugs are safe and effective for many years. Often, people decide to stop when they're tired of being sober, or if a friend or relative convinces them maintenance therapy is just another "addiction" and they need to stop (not true!).
I've come to regard opioid replacement treatment as something you're on forever, certainly 5-10 years or more. How do you know it's safe to stop taking it? When you've achieved full adult function: stable relationships (ideally including marriage or other long-term committed relationship). You have a career, not just a job. You've bought a house or have a similar stable living arrangement. There's just not a lot of drama in your life. Life is good!