YOU HAVE A CHOICE: DECIDING BETWEEN OTP MEDICATIONS
If you’re thinking about starting on an OTP program, or changing your medication or dose, it seems like there’s a lot of competing information about what to do and what’s available.
Should you try a private clinic, a public clinic, or just dose at a pharmacy? What’s the difference between Suboxone, Subutex, Methadone syrup or Biodone liquid?
Many people end up trying more than one because different treatments work for different people at different times in their lives.
Here is some info alongside peer opinion and advice.
Methadone v C: Which way should you go?
If you have decided that OTP might be for you, you need to choose which medication you want to be on. Be guided by the info below, your own experience, your prescriber’s opinion and what your peers tell you.
Danny: I’m on methadone right now – I’ve also been on bupe. I found that on bupe, it was difficult to continue holding it, the taste was really bad so I wanted to swallow it, but if I did it wouldn’t work and then I’d be hanging out heaps. I find that methadone kicks in quicker and holds you quicker. Bupe is much slower and takes a while to start holding you. I like that quicker come up.
Marly: I swapped over to methadone because when I was on the bupe, if someone offered me gear, I couldn’t stop myself – even when if I did it, it made me sick. But being on methadone, I know gear is just wasted on me, so I don’t bother with it.
Pat: I was on methadone then moved to Subutex when my son was born. When I was on bupe, I decided that I didn’t want to use anymore. I was confident I could stay abstinent and deal with my issues without using. I went back to methadone when my son was much older because I didn’t have any reason to not use. I’m on a small dose of methadone so I can still get a result from having a shot. Things may change again.
Alex: I’ve been on methadone and bupe. I found that when I was on bupe, it was easier to control my substance intake. You can skip a dose if you want to use, but you have to plan it. If you're on methadone you can use whenever you want, although you need a lot more gear and it’s not really worth it.
Jane: I didn’t realise how stoned I was on methadone until I moved onto bupe. On bupe, my head seemed a lot clearer and I had a lot more energy. It was a lot more like being straight. I liked being able to think and I ended up doing more – getting out and participating in life more.
Bill: I went on methadone because I’d been buying it on the street for years, so I kind of knew what I was getting. Bupe was a bit of an unknown and I was nervous about things, like what if I had an accident and they needed to give me opioids – would I go into precipitated withdrawal? There were too many things I didn’t understand, so I stayed with what I know.
Kath: I knew all these people who had been on methadone for years and years, but it didn’t seem like that for people on bupe. My doctor told me bupe was easier to come off. I didn’t want the program to be a dead end for me, so I decided on bupe. It’s worked well for me. I’m coming down now and it’s going ok.
Lorenzo: I found it really hard to sleep on Suboxone, and it made me get really sweaty and hyperactive which is why I wanted to switch back to methadone. But when I raised it with my doctor, he acted like I was just doing it so I could start using again.
Justin: I reckon switching from methadone to Suboxone was the best choice I made in my treatment – it gave me my energy back and cleared my head, which is what I needed for my daughter.
Stephanie: I swapped over to methadone because Suboxone straight up doesn’t work for me, I was hanging out every morning before I got my dose.
Tanya: I have ADHD, and I found that Suboxone made it worse – I was a lot more hyperactive when I was on it.
Milly: Bupe gave me way too much energy. But when I’m on methadone, I have to be around people I trust in the afternoons, because it hits me like a tonne of bricks and I often go on the nod.
Karen: When I switched from methadone to bupe, it cleared my head and killed my urge to drink alcohol. I started feeling a lot of emotions and memories I had been blocking out for so long, with gear and then with ‘done and alcohol. Being on Suboxone made me feel all this shit again – my mental health wasn’t ready for that, and I felt like I had no release at all.
What’s the difference between methadone syrup and Biodone?
Both these products are methadone, but the simple answer is that Biodone has the additives removed from it. “Methadone” is the general name for the drug and “Biodone” is a brand name. You usually can only get one or the other, and it’s not your choice. At pharmacies, it has a lot to do with the company they have an account with - One mob sells methadone syrup and the other sells Biodone. It’s really rare to get to choose between the two. A lot of clinics use Biodone because it’s healthier. Some stay with the syrup because a lot of people on the OTP prefer it.
Garth: I’ve used both and didn’t notice much difference to be honest. Except with methadone, the taste stays in your mouth longer. Biodone tastes worse but once you’ve swallowed it, the taste goes.
Gina: Biodone just doesn’t seem to hold me as long as methadone. I know they say they’re the same, but I know what I feel. I had to go up on my dose when my clinic moved to Biodone and it still didn’t hold me the full 24 hours. I prefer methadone every time.
What’s the difference between buprenorphine products Subutex and Suboxone?
Joel: Suboxone doesn’t agree with me. It makes me feel ill. When my clinic changed from Subutex to Suboxone, I went looking for a doctor who would listen to me and prescribe Subutex for me. Luckily, I found one, or else I would have been using again. I couldn’t have stayed on Suboxone.
Nina: I’ve only ever known Suboxone. It works fine and I don’t have a problem with it. I’ve never tried to inject it, so the naloxone is no problem for me. It does the job and keeps me away from using the needle every day.
Ezy: I was on Subutex years ago, and then was made to swap when Suboxone first came out. I found bupe alright, the only trouble was that every time I put the Suboxone films it in my mouth I wanted to chuck up. The taste was BAD. When I was on bupe, being on the tablet was alright, but as soon as I hit the film it was no good. I’m on methadone now, but if they brought back Subutex at my clinic I would go on that for sure. It’s too easy to use on top of methadone. When you have bupe in you, it doesn’t matter how much you use, you’re not going to feel it.