Process of switching from methadone to suboxone programs is often requested by patients. For best outcome, patient would need to be on a dose of 30mg or less of methadone, and be off methadone at least 3 days. Patient would also need to be off short-acting opioids, like codeine or fentanyl for about 24 hours to be in withdrawal when the first dose of suboxone is given. Otherwise risk of precipitated withdrawal will be high. For the day of induction, it is best advised patient get a small initial dose and then come back in 2-3 hours to review symptoms to consider additional dosing. Patient should consider taking day of induction off work and avoid driving.
