# Transitioning from Methadone to Buprenorphine / Naloxone (Suboxone) We offer telemedicine Suboxone treatment to overcome opioid dependence & addiction: Confidential phone & video calls with your medical provider Experienced clinicians who truly care Online support groups Pick up Suboxone same day (if prescribed) ## RX Only: See important safety information about Suboxone SUBOXONE is indicated for the treatment of opioid dependence in adults. SUBOXONE should not be taken by individuals who have been shown to be hypersensitive to buprenorphine or naloxone, as serious adverse reactions, including anaphylactic shock, have been reported. Taking SUBOXONE with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants can cause breathing problems that can lead to coma and death. Other side effects may include headaches, nausea, vomiting, constipation, insomnia, pain, increased sweating, sleepiness, dizziness, coordination problems, physical dependence or abuse, and liver problems. For more information about SUBOXONE, see [**Suboxone.com**](https://suboxone.com/), the full Prescribing Information, and Medication Guide or talk to your healthcare provider. You are encouraged to report negative side effects of drugs to the FDA. Visit www.fda.gov/medwatch or call [**1-800-FDA-1088**](tel:+18003321088). .webp) ## 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. ### 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 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 the 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](/content/we-are-here-to-help/index.html). ## Symptomatic Management of Opioid Withdrawal Withdrawal symptoms are uncomfortable, but there are [withdrawal treatments](/content/suboxone-faq/what-can-i-do-to-stop-experiencing-withdrawal-symptoms-from-opioids/index.html) 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? 1. **Talk with an enrollment coordinator** Meet confidentially with an experienced enrollment coordinator who will learn more about you, your experience with opioid dependence, and your health goals. 2. **Doctor visits via phone & video call** During your first online medical provider visit, your provider will learn more about you and collaboratively develop a personalized Suboxone treatment plan for your opioid use disorder. 3. **Prescription refills** Your Suboxone treatment prescription will be refilled during weekly, biweekly, or monthly telehealth visits with your Bicycle Health provider. ## 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. We are [physicians, nurse practitioners, and physician assistants](/content/leadership-team/index.html) who are invested in your recovery. Bicycle Health providers, staff, and leadership believe everyone deserves access to confidential, individualized, and non-judgmental care for the 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. ## This page has been medically reviewed by Rebekah L. Rollston, MD, MPH Rebekah L. Rollston, MD, MPH, is a board-certified Family Medicine Physician and Head of Research at Bicycle Health. She earned her Medical Degree from East Tennessee State University Quillen College of Medicine (in the Rural Primary Care Track) and her Master of Public Health (MPH) from The George Washington University Milken Institute School of Public Health. Her professional interests focus on social determinants of health & health equity, addiction medicine, gender-based violence, sexual & reproductive health, rural health, homelessness & supportive housing, and immigrant health. Dr. Rollston has published on these topics in various medical journals.