Hello all, I am seeking advice about Suboxone microdosing as a technique to covert MMT clients to BMT. I have used microdosing to initiate Suboxone in OUD clients who are not in withdrawal due to recent opiate use. This process has gone relatively smoothly, I used the schedule as per Vancouver Costal Health. When I tried to do similar with clients who were on Methadone, I had trouble at a dose higher than 4 mg. One of my clients was stable on MMT and the dose at 65 mg. He was having some constitutional symptoms that I hoped would improve with the switch. The second client was harm reduction and at a methadone dose of 90 mg, was still using FTY, Coc, and sometimes other opiates. He had previously been up to 115 mg, still harm red’n. My hope for him was to get him to a plateau and stop the euphoria from opiate use. They both developed withdrawal described as coming on within a few hrs of the Suboxone and Methadone, dosed at the same time. The withdrawal was more severe with increasing the dose of Suboxone to 8 mg. The withdrawal was described as significant and lasting 4-6 hrs. My harm red’n client abandoned the effort and now continues in harm red’n on MTD. The first client stabilized after stopping the MTD cold Turkey from 40 mg ( I had tried weaning the MTD). Since then he has continued the BMT, though there has been a relapse for unrelated reasons. I wonder if I am more missing a consideration for my MMT clients. Thx in advance.