Opioids A question about methadone.

[I_Hate_This_Place]

I'm a big fan of methadone maintenance and the clinic system in the US where you start with observed dosing at the clinic six days a week and after every 90 days of good behavior and clean UAs you move up the takehome schedule and after two years a goodie-two-shoes can be going in every four weeks to give a UA, see their counselor, and walk out of there with 27 bottles. AFTER TWO YEARS.

Because of the corona-mania and corona-phobia a few of the states have asked for and received permission from DEA to move anyone with a clean UA up to every going 2 weeks (13 bottles) or every 4 weeks (27 bottles) way ahead of the schedule and guess what's gonna happen. Plenty of methadone takehome bottles and Suboxone tablets will be hitting the local economy and even if a person wouldn't ordinarily be selling their doses, we're seeing the fastest economic collapse in world history with up to a third of the working population thrown out of work because of the fake-news corona hoax. But the suffering is real and this is only the beginning of the hard times. If you had a job and could buy your opiates on the black market maybe that'll become more difficult. Maybe you'll look into the opiate treatment programs and clinic system for methadone and buprenorphine. Well, they've made treatment more accessible, and for methadone it's a huge change.

DEA Diversion Control FAQ

COVID-19 FAQ

https://www.samhsa.gov/sites/default/files/faqs-for-oud-prescribing-and-dispensing.pdf

Under the old rules in place since 1970, after 90 days a person starting methadone maintenance can apply for one additional takehome (in addition to the Sunday and holiday takehomes for when the clinic is closed). Under the new rules a person with just 90 days of good behavior and clean UAs and a counselor backing them can apparently (leaving it up to the clinic) get as much as a 14-day supply and be going every 14 days. All you need now seems to be a minimum of 90 days and, theoretically, you could be getting the 13 takehome bottles every two weeks that it took me 15 months to earn, 90 days at a time, with clean UAs and a counselor who was backing me at the staff meeting when it came up for discussion. Now they're leaving it up to the individual clinics to divide their compliant patients (meaning clean UAs and following all the rules) into two categories, 14 doses and 28 doses. Wow.

Anyone interested ought to check out the Reddit /methadone https://www.reddit.com/r/Methadone/

Interesting & detailed explanation. Thanks for the posts. I use buprenorphine for my pain management but would like to be able to try methadone again. Until the whole opioid hysteria thing I was on methadone for quite a period of time for pain management. My Dr. mentioned trying the clinic system but due to the regulations & such regarding it; it just didn't fit for someone like myself with a multitude of health issues limiting my ability to visit said clinic on the schedule required. There's also the whole needing catherization for UA & some other happy horse shit that seriously prevents me from trying the clinic system but it was the only recommendation they had apparently. Other than the whole "I can write you suboxone for your pain management but honestly you're probably better off just getting on the street yourself like you already are & not have it on your record. Even if I write it for pain management not everyone will look that closely." schpeel.

I digress though. I'm just curious to see exactly what changes to the system have been made & whether or not they may end up being long term. If methadone became more available even on the street that would catch my interest. Besides availability there is of course the pricing issue. I know we don't discuss that here so I won't mention specifics but I saw a number of cents per mg mentioned earlier in this thread & will just say that the price mentioned is about a 5th of what I'm used to seeing on the low end! At that cost it might actually be an affordable alternative. As it is the price alone is a major impediment for me considering going back to methadone. The price for Suboxone is just so much cheaper than methadone regardless of availability where I'm currently located.

This thread has brought up some discussions that caught my interest. Thanks again for the posts. I find the information regarding the workings of the methadone system in the US to be of great interest.

Edit: To answer the recreational question I would say yes. Though I use opiods for pain management in terms of recreational properties I would say I find methadone to be high on the list. Like negrogesic I find methadone to be one of the more enjoyable opiods if going with the oral ROA. The duration is also a positive. (y)

 

[Wishdoctor79]

... with a multitude of health issues limiting my ability to visit said clinic on the schedule required. There's also the whole needing catherization for UA & some other happy horse shit that seriously prevents me from trying the clinic system but it was the only recommendation they had apparently. Other than the whole "I can write you suboxone for your pain management but honestly you're probably better off just getting on the street yourself like you already are & not have it on your record. Even if I write it for pain management not everyone will look that closely." schpeel. ... At that cost it might actually be an affordable alternative. As it is the price alone is a major impediment for me considering going back to methadone. The price for Suboxone is just so much cheaper than methadone regardless of availability where I'm currently located.

This thread has brought up some discussions that caught my interest. Thanks again for the posts. I find the information regarding the workings of the methadone system in the US to be of great interest.
... I find methadone to be one of the more enjoyable opiods if going with the oral ROA. The duration is also a positive. (y)

Hmm. Needing a catheter to give a UA could indeed be a very large barrier to overcome. We had a few clients who came in wheel chairs, some with amputated legs, one of them was walking on a prosthetic leg and I'm sure that there were some with ostomy bags. Like i said the only time staff would have to actually be in the toilet with you to guard against substitution was if you'd missed two days of doses, which in my case happened from a missed Saturday because i missed not just that day but also the Sunday takehome that was there waiting for me but i didn't show up. Speaking of behavior and UAs they tend to go by objective numbers in the records which are computerized and pretty foolproof so if the system says I missed clinic only that one time in the 90 days they'd not even mention it except in passing. But missing days of clinic all the time would be a different story.

The UAs are supposed to be random and their computer software supposedly has some kind of way to do that so nobody at the clinic could go in and see when your next UA is scheduled to give you a heads-up. And the federal regulation says that they need to have at least 8 UAs every year, so you could go over a month without a UA. When you enter the clinic there's a front desk where the first thing you say is your number and he punches it in and it tells him to get a UA, but there was one guy working the front desk who was getting chummy with the clients and he either quit or was fired because the software had an opt-out to skip the UA like if it was really busy or an emergency or something, the front desk guy could just whisper to the client that they had missed giving that UA and so on and so forth. Lots of stories like that made me want to make them into short stories for a book. Oh well. The gossip went that there were some people who somehow or other not given a UA for six whole months but that's hard to believe unless the person's counselor was also in on the game because the counselor is sposed to see you every month, but now i remember when my counselor quit they didn't even assign me a new counselor for ... six months, yeah. It was a crazy place. Lots of stories i could tell, and this thread is kind of like a public blog for those memories which i want to emphasize the stigma against methadone is mostly from dumb stories like the IVing toilet water and the boiling of "spit" which is a verb, and as a noun it sounds like children in grade school.

So your doctor sounds like malpractice suggesting you buy Suboxone on the street for pain management. Maybe you could recognize the one or two different pills and they're PROBABLY not counterfeit but anything's possible. And you buying your own pain meds on the black market is overall a very dangerous suggestion because if you're getting them legit they have a record of what they prescribe and how you fill them. So if that doctor is replaced by another doctor are you sposed to tell the new doctor your old doctor have you buying your pills on the street and how is that gonna be good for your future medical treatments?

And also BTW, Suboxone is NOT LABELED for use in pain. There was no data I could ever find on the presumed anti-analgesic effect of the naloxone. On a bang for the buck basis, generic Subutex which comes in 8 mg would probably rank close to methadone tablets for being the lowest cost per day to treat chronic pain. If a methadone clinic offers Suboxone they'd probably also offer Subutex. It's not relevant at all to this thread so i won't give any numbers but for a while there after being on methadone i went back there and got a scrip for Subutex and the doctor was fine with it as long as i went in to see him and pay him every two weeks for each 14-day scrip of Subutex. I found very roughly that Subutex was maybe four times stronger mg-for-mg than Suboxone. Yeah, if i had a choice between a 2 mg Subutex and and 8 mg Suboxone i'd choose the 2-mg Subutex.

We had A LOT of chronic pain patients at the clinic on MMT, but if they said they wanted to be in treatment because they were discharged from pain mgmt. they'd be told Sorry that's not what this is for. So they could say that they were in pain mgmt and they got discharged for a dirty UA and the counselor at intake would be Way to Go, that's what we're here for, we want you to stay clean here and that's what the program is all about, and if you stay clean you can be earning takehomes, blah blah.

If you take methadone every day the same dose every day you're probably not gonna feel more than a kind of warm euphoric glow that for me happened usually about 4 hours after my dose and lasting at most an hour. Very subtle. People on methadone might be obviously impaired if their dose is too high, meaning that it's be illegal to drive because they couldn't pass a field sobriety test, but they'd probably tell you that they don't feel high at all. And the highest dose there was 200 mg, where some states require blood titer peak & trough blood testing to justify a dose higher than like 150 mg usually. OK, so that was my actual highest ever dose, 150 mg. And they start you at 30 mg unless you think that's too much and would rather start with 20 mg. Then they can raise you 10 mg every two days. And the doctor at intake would write pretty much everyone to go up to 80 mg as they feel comfortable and to see him again for when you want to go higher than the 80 mg. If you wanted to take months and months before going over 80 mg that's fine but they pushed people to raise their dose if they have a dirty UA because having a higher dose I can testify removes any and all cravings to get high. So that's the other reason for me writing this is that so many people choose ignorant and prejudiced stereotypes about methadone clinics and clients.

The biggest problem for pain mgmt people was the daily dosing at the clinic because the analgesia wears off long before they'd be approaching anything like withdrawals. Methadone tablet scrips would usually say every 4 hours as needed, or they'd give 3 tabs a day and say to take them every 8 hours. Something like that is much more often than the once a day at the clinic. But if you're thinking long term like being on methadone for 10 years or more, then maybe it'd be worth it to have that daily attendance and earn the takehomes and then stay stable and don't be taking anything else without a scrip, etc. But if you're home with bottles the easiest way to divide the doses is to add water and pour it back and forth between the bottles so they're more or less equal, it's just for you anyway, a buying friend would insist on a sealed bottle with tamper seal.

Well, the problem with opening up the takehomes to 14 and 28 days for people with maybe just a very short time in the program and all of a sudden, wow, they have a box of 13 bottles and well, shit happens and then they test dirty on the UAs and that goes on their record. Every methadone clinic in the world is gonna have some former clients or maybe prospective new clients who hang out around the clinic at various times because we're social creatures, after all. They'd shy away from you if you look like a cop or DEA but it's just people and we're all just folks trying to get by and this new world of corona-phobia is gonna vary tremendously across locations. Like the state of Georgia is opening up this weekend, so they for sure haven't changed any rules there to give people more takehomes on account of a fake crisis.

 

[I_Hate_This_Place]

A lot of useful information.

Thanks for the detailed response! Apparently I'm not the only verbose member on BL! (y) I hadn't expected that detailed of a reply. Thanks for going so in depth regarding your experiences with Methadone & related topics. I'm very familiar with the medications themselves (pharmacology, experience, etc.); I've taken pretty much every opioid on the market in my country (& some not ) at some point in my life. My health kinda went to shit about a decade ago & since then I've found opiods to be a valuable tool in my getting through life as pleasantly as possible toolbox. I'll reply to each part individually. Readability & all that jazz.

Actually I'll have reply properly tomorrow or something. I started typing up a post responding to each section individually but just got an alert on my phone that it's time to go pick up my groceries. So I must go now. Pick up time windows & such. So I saved what I typed up to a text file & I'll come back to this with a proper reply when the time allows. I just figured I'd go ahead & let you know that I was replying since I liked your post but didn't reply. After you putting that much information in a post I'd like to respond to it. I just had to go unexpectedly. I look forward to speaking to you in the future.

 

[I_Hate_This_Place]

A lot that I'll reply to individually below.

Thanks for the detailed response! Apparently I'm not the only verbose member on BL! (y) I hadn't expected that detailed a reply. Thanks for detailing so much regarding your experiences with Methadone & related topics. I'm very familiar with the medications themselves (pharmacology, experience, etc.); I've taken pretty much every opioid on the market in my country (& some not ) at some point in my life. My health kinda went to shit about a decade ago & since then I've found opiods to be a valuable tool in my getting through life as pleasantly as possible toolbox. I'll reply to each part individually. Readability & all that jazz.

Hmm. Needing a catheter to give a UA could indeed be a very large barrier to overcome. We had a few clients who came in wheel chairs, some with amputated legs, one of them was walking on a prosthetic leg and I'm sure that there were some with ostomy bags. Like i said the only time staff would have to actually be in the toilet with you to guard against substitution was if you'd missed two days of doses, which in my case happened from a missed Saturday because i missed not just that day but also the Sunday takehome that was there waiting for me but i didn't show up. Speaking of behavior and UAs they tend to go by objective numbers in the records which are computerized and pretty foolproof so if the system says I missed clinic only that one time in the 90 days they'd not even mention it except in passing. But missing days of clinic all the time would be a different story.


The UAs are supposed to be random and their computer software supposedly has some kind of way to do that so nobody at the clinic could go in and see when your next UA is scheduled to give you a heads-up. And the federal regulation says that they need to have at least 8 UAs every year, so you could go over a month without a UA. When you enter the clinic there's a front desk where the first thing you say is your number and he punches it in and it tells him to get a UA, but there was one guy working the front desk who was getting chummy with the clients and he either quit or was fired because the software had an opt-out to skip the UA like if it was really busy or an emergency or something, the front desk guy could just whisper to the client that they had missed giving that UA and so on and so forth. Lots of stories like that made me want to make them into short stories for a book. Oh well. The gossip went that there were some people who somehow or other not given a UA for six whole months but that's hard to believe unless the person's counselor was also in on the game because the counselor is sposed to see you every month, but now i remember when my counselor quit they didn't even assign me a new counselor for ... six months, yeah. It was a crazy place. Lots of stories i could tell, and this thread is kind of like a public blog for those memories which i want to emphasize the stigma against methadone is mostly from dumb stories like the IVing toilet water and the boiling of "spit" which is a verb, and as a noun it sounds like children in grade school.

Indeed. The whole UA thing has been a hassle over the years. I've dealt with Urology enough by now though that everything is documented. Despite that I've run into various pain management practices that tried to insist on urine. I can understand with Methadone due to the federal regulations regarding it. However other opiods do not carry the same regulations & other forms of testing are perfectly acceptable. Usually I've been able to get them to accept either Oral or Blood analysis. I don't see why that's not acceptable period but that's besides the point. Also of note is that the Methadone regulations regarding testing only apply to clinics. Methadone prescribed for pain is not subject to the same regulations. As I well know as I was prescribed it for years. I'm glad I kept my bottle labels & records as a lot of Dr.'s do not believe Methadone can be prescribed just like any other opioid without special restrictions if used for PAIN.

So your doctor sounds like malpractice suggesting you buy Suboxone on the street for pain management. Maybe you could recognize the one or two different pills and they're PROBABLY not counterfeit but anything's possible. And you buying your own pain meds on the black market is overall a very dangerous suggestion because if you're getting them legit they have a record of what they prescribe and how you fill them. So if that doctor is replaced by another doctor are you sposed to tell the new doctor your old doctor have you buying your pills on the street and how is that gonna be good for your future medical treatments?


And also BTW, Suboxone is NOT LABELED for use in pain. There was no data I could ever find on the presumed anti-analgesic effect of the naloxone. On a bang for the buck basis, generic Subutex which comes in 8 mg would probably rank close to methadone tablets for being the lowest cost per day to treat chronic pain. If a methadone clinic offers Suboxone they'd probably also offer Subutex. It's not relevant at all to this thread so i won't give any numbers but for a while there after being on methadone i went back there and got a scrip for Subutex and the doctor was fine with it as long as i went in to see him and pay him every two weeks for each 14-day scrip of Subutex. I found very roughly that Subutex was maybe four times stronger mg-for-mg than Suboxone. Yeah, if i had a choice between a 2 mg Subutex and and 8 mg Suboxone i'd choose the 2-mg Subutex.


We had A LOT of chronic pain patients at the clinic on MMT, but if they said they wanted to be in treatment because they were discharged from pain mgmt. they'd be told Sorry that's not what this is for. So they could say that they were in pain mgmt and they got discharged for a dirty UA and the counselor at intake would be Way to Go, that's what we're here for, we want you to stay clean here and that's what the program is all about, and if you stay clean you can be earning takehomes, blah blah.


If you take methadone every day the same dose every day you're probably not gonna feel more than a kind of warm euphoric glow that for me happened usually about 4 hours after my dose and lasting at most an hour. Very subtle. People on methadone might be obviously impaired if their dose is too high, meaning that it's be illegal to drive because they couldn't pass a field sobriety test, but they'd probably tell you that they don't feel high at all. And the highest dose there was 200 mg, where some states require blood titer peak & trough blood testing to justify a dose higher than like 150 mg usually. OK, so that was my actual highest ever dose, 150 mg. And they start you at 30 mg unless you think that's too much and would rather start with 20 mg. Then they can raise you 10 mg every two days. And the doctor at intake would write pretty much everyone to go up to 80 mg as they feel comfortable and to see him again for when you want to go higher than the 80 mg. If you wanted to take months and months before going over 80 mg that's fine but they pushed people to raise their dose if they have a dirty UA because having a higher dose I can testify removes any and all cravings to get high. So that's the other reason for me writing this is that so many people choose ignorant and prejudiced stereotypes about methadone clinics and clients.


The biggest problem for pain mgmt people was the daily dosing at the clinic because the analgesia wears off long before they'd be approaching anything like withdrawals. Methadone tablet scrips would usually say every 4 hours as needed, or they'd give 3 tabs a day and say to take them every 8 hours. Something like that is much more often than the once a day at the clinic. But if you're thinking long term like being on methadone for 10 years or more, then maybe it'd be worth it to have that daily attendance and earn the takehomes and then stay stable and don't be taking anything else without a scrip, etc. But if you're home with bottles the easiest way to divide the doses is to add water and pour it back and forth between the bottles so they're more or less equal, it's just for you anyway, a buying friend would insist on a sealed bottle with tamper seal.


Well, the problem with opening up the takehomes to 14 and 28 days for people with maybe just a very short time in the program and all of a sudden, wow, they have a box of 13 bottles and well, shit happens and then they test dirty on the UAs and that goes on their record. Every methadone clinic in the world is gonna have some former clients or maybe prospective new clients who hang out around the clinic at various times because we're social creatures, after all. They'd shy away from you if you look like a cop or DEA but it's just people and we're all just folks trying to get by and this new world of corona-phobia is gonna vary tremendously across locations. Like the state of Georgia is opening up this weekend, so they for sure haven't changed any rules there to give people more takehomes on account of a fake crisis.

As I said the idea of having to go to a clinic isn't really appropriate for pain. Though I know many people that have done so due to the ridiculous state of affairs that exists in my country. As you stated there are quite a few pain patients forced to go that route. That was part of what people suggested to me regarding a clinic. Just lie & say you have an issue as chances are they won't do it for pain management type thing. I'm guessing that the pain patients that do go end up trying to do something similar to what I had though. Basically once one gets enough "take homes" one would be able to split up the doses of it as one does for pain management. From my experience Methadone works best with a 3-4 times per day dosing style in terms of pain management at least. Thanks for elucidating more on the clinic system. As I stated I'm not that familiar & am glad you are able to provide such in depth information.

I'm not sure I made it clear but the situation regarding my Dr. is along the lines of this. I was in pain management for years; "opioid crisis" happened; my Dr. dropped me like a pound of bricks without a reason & left the state. I had a referall & 3 months of scripts. Needless to say I was unable to find anyone willing to take a referral. As such I ended up acquiring the exact scripts I was taking on the street. This continued until I found a new Dr. (actually a resident which complicates things as you'll see) who I trusted. I explained the situation to him that I had continued taking my meds as prescribed just that I had no choice but to acquire them myself due to the circumstances. He agreed to resume the scripts if my DT was consistent with my story. Needless to say everything was completely consistent as I like I stated I'd been taking the same medications exactly as prescribed. Methadone in this case.

I was on 30-40 mg a day for reference. An appropriate amount with my health history though well over the 90MME that the "guidelines (that everyone forgets are fucking guidelines not rules but I digress)" that people are worrying about. Well the supervising Dr. disagreed with the resident that I've reffered to as my Dr. & instead suggested that I get on Suboxone which he conveniently able to prescribe... I said no thank you let me think it over & get back to you on that. In the meantime I lost my Methadone source & was forced to switch to bupeprenorphine after a wash out period of IR medications so as not to seriously precipitate off the Methadone when transitioning the bupeprenorphine. Financially buprenorphine was beginning to look like a more viable option due to the high price of Methadone in my area. Though as I stated the price is no longer an issue as I can't find it at all now.

For fucks sake most surgery guidelines call for discontinuing buperenorphine patients off of bupeprenorphine prior to surgery! Either stop entirely or switch to an alternative such as Methadone. With my health stopping isn't an option. As such the absolute stupidity of the situation is astounding. Not surprising but astounding none the less. In my case even though Suboxone is not for pain I'm using it for that. If you're familiar there are some buprenorphine pain formulations. Temgesic & Belbuca come to mind.

From personal experience & my knowledge of the substance I take Suboxone strips cut up into pieces on a similar regimen to that of Belbuca. Belbuca is bupreprenorphine strips at doses up to 900mcg every 12 hours. With the way I'm able to cut them I end up taking 1.5mg per day. 500mcg x 3 or 1mg + 500mcg at the appropriate intervals. It's not as effective as a full agonist such as Methadone but I'm the first to say that it's better than nothing! Though not at all it's intended usage it provides analgesia. So I continue to use it in the hope that something works out better in the future with the medical system or supply / financial issues.

My Dr. (the resident) is aware of all this & is more than willing to as I stated do the Suboxone thing. He'd love to help me more but feels his hands are tied. That may change in the future with him at a new practice but he still won't be on his own he'll be working for the same medical system sadly enough. Though he can write his own scripts & such by then. With the current situation I don't know that he will keep his current plans though. I'll have to wait & see if I ever end up even speaking to him again. We debated just writing me the Suboxone with a note that it's for pain but worry that having it on my record would be an issue. As many Dr.'s don't bother to read the notes. They'd see Suboxone & not even let me make a pain management appointment without even reading further is our guess. As such after discussing it he agreed it was likely best to just keep acquiring the bupeprenorphine myself & continuing as I have for the time being last I saw him before this situation started. He had left the practice to complete the residency prior to this & was planning on seeing me again at a new practice upon his return. As I said who knows if that will still happen.

Just so you're aware the Dr. did ask about my knowledge & the safety of acquiring the medication before suggesting that I continue to get it as I have been. If he didn't feel comfortable that I'm safe doing so he wouldn't have recommended it. I've considered trying to order things depending on the financial feasability but am not familiar with DNM's. I'm relatively computer savvy but not familiar with crypto. In terms of RC's I'm not aware of an opioid available at the moment that would fit my needs or be financially viable. With my health issues & tolerance Kratom doesn't quite work out as well. By comparison the analgesia from bupeprenorphine is higher in my case. Also though buprenorphine has a host of negative side effects the positive outweigh the negative. With Kratom the plant matter itself is just to much for my guts. I have enough GI issues without consuming that much plant matter. Extractions just don't seem to be economical, feasible or up to par in most cases.

I digress though & begin to ramble to much as I get into the specific details of my case. My apologies; I'll do my best to respond more directly to the information provided in your post. As opposed to what you mentioned in your post about this thread becoming sort of a blog for stories related to Methadone & or the MMT system & related issues.

So I don't blame my current Dr. (the resident) he's been trying his hardest. We'll see what happens in a month or 2 when he can practice but with the current situation that changes things as well. We where looking at the palliative care angle advocated for by Dr. Thomas Kline but sadly enough some fucking bitch with misdirected grief & anger issues ruined his life & the life of his 34 patients. Some bitch whose son died of an OD on non prescribed opioid (heroin, etc.) she decided it was up to her to report this Dr. & start what led to him losing his license.

Sorry for the rant! It's just gotten to be far to common an occurence that pain patients like myself are royally fucked because someone's child made used there free will to make a personal decision that resulted in injury or death. Fucking absurdity at it's finest. You don't stop everyone from driving cars because some people drive erratic & kill themselves or others for example. I'm digressing again though.

So before I turn this monstrous post into a full on novel I'll try & wrap it up. I really appreciate you providing the information you have regarding the clinic experience. As well as the changes that have occurred as a result of the current situation. Honestly this current situation has really scared me off of the idea of being dependent on anyone let alone the clinic system. Seeing as I tend to stockpile long term I can continue buprenorphine without the risk of interacting with others. If I was in the clinic system or obtaining the Suboxone through a Dr. I might actually have more hassles / contact. Though my Dr. agreed they'd be willing to do oral DT if I went on Suboxone legit it's still a major hassle. Considering the cost of Suboxone & the amount I need the benefits of not having to deal with the medical system outweigh the negatives in this case.

Hopefully this whole thing is relatively clear. I got interrupted partway through the post & though I re-read it I may have gone off-track or repeated myself. If so my apologies. Once again thanks for the informative post! Hopefully my reply helps to make you feel it was worth the time you took to post the information you did.

 

[F.U.B.A.R.]

What was the question again..??

 

[Nicocastillo7]

I'm sorry but what you describe is called a methadone-assisted detox if they have you on a very low dose with 5 mg tablets you said, and it lasts three months with the last month tapering down.

That's not methadone maintenance, which is a long-term thing where the patient can stay on it forever as long as they follow the rules of the clinic.

Your mom had 40 of the 5-mg tablets but you didn't say what your daily dose is. If you're feeling nausea then you're almost surely taking more than 5-mg a day.

What happens after they take you up to, what level?, and then down to zero in a few months? Most probably you'll be back to feeling the same lack of happiness that made you seek out opiates in the first place. There is essentially no scientific basis for using methadone for short-term detox. Searching the English internet for Argentina's laws or framework for methadone maintenance came up with nothing for me. Maybe you don't have a legal framework for MMT in Argentina and all they can do is this short-term medication assisted detox.

Certainly, it would not be a maintenance, it is a detoxification that uses methadone Here we have nothing like an MMT or anything like it

 

[Wishdoctor79]

Certainly, it would not be a maintenance, it is a detoxification that uses methadone Here we have nothing like an MMT or anything like it

Yes. In countries without MMT it's used as you describe. But you didn't say (in English) what led you to be getting these tablets doled out to you by your mother. How you'll feel after they taper you back to zero might have the detox make you feel even more of a craving for opiates than you had before you began this treatment because maybe like many others you might find methadone in those low doses to make you feel better than ever before. You said the methadone makes you feel good and you have energy and you're doing things. Well, what will you do in the way of drug use if you end up where you were before but the only significant change is that you greatly benefited from that low dose of methadone? If there's no MMT then it's gonna be hard to find on the street but maybe you have plenty of BTC to buy it on Darknet somehow. What you will do depends on what you want to do and how strong you are.

Drugs alone won't help you stop taking other drugs. Maybe only with intensive individual and group psychotherapy and a client motivated to be drug-free ... maybe only then.

There could be another factor relating to seeming to be of younger age and maybe a limited time of using opiates and that's the requirement in the MMT regulations that a prospective client must be opiate dependent (any opiate) and that physical exam and/or history shows such dependence has been present for at least 12 months.

Maybe you wouldn't qualify for MMT based on duration of opiate dependence and if so, in the US they could put you on Suboxone/Subutex after just 30 days of opiate dependence.

I'm just guessing now but it seems to me that MAYBE you're not even physically dependent on opiates, and certainly less than a year of physical dependence, and if that's the case, they've done the opposite of their intent and "primed" you to crave methadone.

In the low doses of up to 30-40 mg a day methadone can be a FANTASTIC benefit to people feeling the pains and sorrows of living in this fucked up world, much preferable to the dreck drugs for "depression" like Prozac or Cymbalta or Wellbutrin or whatever other crap they're pushing for anti-depression or anti-anxiety. At that clinic I went to I doubt there were more than a handful of clients taking those garbage drugs when they could have as much methadone every day as they wanted, and they could lower their dose if it was too much or raise it for a while as needed. Lots of people might be experimenting with opiates and find that they feel good, maybe for the first time ever. The stupid MDs call this addiction but i call it self-medication because the drugs the doctors give you don't hold a candle to the age-old balm for sorrows and pains, the juice of the papaver somniferum.

 

[Nicocastillo7]

Yes. In countries without MMT it's used as you describe. But you didn't say (in English) what led you to be getting these tablets doled out to you by your mother. How you'll feel after they taper you back to zero might make you feel even more of a craving for opiates than you had before you began this treatment. You said the methadone makes you feel good. Well, what will you do in the way of drug use if you end up where you were before but the only significant change is that you greatly benefited from the low dose of methadone?

Drugs alone won't help you stop taking other drugs. Maybe only with intensive individual and group psychotherapy and a client motivated to be drug-free ... maybe only then.

There could be another factor relating to seeming to be of a younger age and maybe a limited time of using opiates and that's the requirement in the MMT regulations that a prospective client must be opiate dependent (any opiate) and that physical exam and/or history shows that such dependence has been present for at least 12 months.

Maybe you wouldn't qualify for MMT based on duration of opiate dependence and if so, in the US they could put you on Suboxone/Subutex after just 30 days of opiate dependence.

What I wanted to say is that my mother gives me the pills every day at the time and dose indicated by the doctor.
Probably after using methadone for a while I will start taking kratom, what I plan to do with my drug use is not really stop taking drugs completely, I plan to continue using some drugs, but my goal is to stop abusing opiates, Maybe according to you I don't qualify for an MMT and I'm glad of that
My history of opiates use is 4 years in total, with times more intense in the use of some things like oral morphine and oxycodone, but the opiates that I have taken every day during the last years have been tramadol and codeine, together with many other drugs that I also use
You probably think that my drug use is not strong enough, but believe me yes, I am polytoxic, but my goal is to stop abusing painkillers, because I am also dependent on benzos,
I have been taking benzos for 4 years, never from recreationally, it is prescribed to me because I suffer from generalized anxiety disorder

I decided that my mother controlled my medications, because I know the risks of having all the pills at my fingertips, during these 4 years I have had all my medications myself and I have administered them myself, and it is a real disaster along with my consumption of other drugs

 

[Wishdoctor79]

I'm glad I kept my bottle labels & records as a lot of Dr.'s do not believe Methadone can be prescribed just like any other opioid without special restrictions if used for PAIN.

As I said the idea of having to go to a clinic isn't really appropriate for pain. Though I know many people that have done so due to the ridiculous state of affairs that exists in my country. As you stated there are quite a few pain patients forced to go that route. That was part of what people suggested to me regarding a clinic. Just lie & say you have an issue as chances are they won't do it for pain management type thing. I'm guessing that the pain patients that do go end up trying to do something similar to what I had though. Basically once one gets enough "take homes" one would be able to split up the doses of it as one does for pain management. From my experience Methadone works best with a 3-4 times per day dosing style in terms of pain management at least. Thanks for elucidating more on the clinic system. As I stated I'm not that familiar & am glad you are able to provide such in depth information.

I'm not sure I made it clear but the situation regarding my Dr. is along the lines of this. I was in pain management for years; "opioid crisis" happened; my Dr. dropped me like a pound of bricks without a reason & left the state. I had a referall & 3 months of scripts. Needless to say I was unable to find anyone willing to take a referral. As such I ended up acquiring the exact scripts I was taking on the street. This continued until I found a new Dr. (actually a resident which complicates things as you'll see) who I trusted. I explained the situation to him that I had continued taking my meds as prescribed just that I had no choice but to acquire them myself due to the circumstances. He agreed to resume the scripts if my DT was consistent with my story. Needless to say everything was completely consistent as I like I stated I'd been taking the same medications exactly as prescribed. Methadone in this case.

OK. I'll be brief. I feel you've been doing what William Burroughs or Lenny Bruce would call "making" a doctor. But what you're seeking is not a scrip but approval and validation for using opiates obtained illegally and self-medicating with a somewhat diseased body and risking some very serious complications. Your resident MD in training is learning a lot from talking to you but he's not authorized to write the scrips you need. And you have no assurance he'll ever play that role for you.

I don't care what DT means or why you think some kind of test can prove that you're takng exactly what you would be taking if there had been a MD RXing you what you want. I think this is BS and self deception that could hurt you in the long run because the longer you go without any real medical supervision the more likely something will happen that makes the house of cards collapse.

You don't want to have to give a UA sample because of urinary catheter seems to me is a very lame excuse.

99% of the MDs at pain management clinics would either reject you outright or put you on the lowest possible opiate dose and have the most intrusive monitoring they can think of.

Get on MMT and give them the UAs and have them all come back clean and after a year in the US under the 1970 rules you could be going in weekly to get 6 bottles and divvy them up as you please except on the one day a week you attend clinic. Every clinic has some back and forth of bottles changing hands, whether trading for money or sex or whatever, it's a fungible and valuable good and maybe during that first year you could become buddies with another client who gets sizeable takehomes and so when your daily observed dose wears off and you feek pain maybe you'll take some of those extras you got somehow or other. It happens at every clinic. Those with more somehow find a way of sharing them with others.

I think it's BS to be buying Suboxone strips on the street to treat your pain off the books because MDs will see it as just one more opiate addiction using street drugs. Their DT doesn't prove anything and your records of what you say you took don't mean anything.

 

[Wishdoctor79]

OK, so let's assume that the medication-assisted detox in Argentina is to succeed to stop using opiates and be happy and healthy without significant drug use and without cravings for the methadone which seemed so pleasurable. How could that be reached? Maybe there's a good reason for wanting to be drug-free, like a career in government service or a security clearance or maybe marrying that girl from the rich family would all be out of the question. (I'm actually at the other end of that where I'm looking at current events and the impending economic devastation and famine and looting and riots and lock-downs for real and saying why not have some happiness by going back on methadone.)

I said intensive group and individual psychotherapy, which many might well say it's all BS, but I'm thinking more along the lines of having some sort of guide or wise elder to help understand why they were using the opiates and find what else besides taking opiates could bring a strong and enduring feeling of well-being.

Religion can do it, theoretically at least. When I was a teenager I read the books of Thomas Merton about his conversion to Roman Catholicism and becoming a Trappist monk, probably assassinated by CIA after he became prominent as opposing the Viet Nam War.

Work can do it. Devoting yourself to some kind of physical work to strengthen the body can do it.

If you're young and don't have a strong physical dependence to opiates it might be a big mistake to become psychologically dependent on methadone because after anywhere from a few months to a year of daily doses over say 30-40 mg it can be extremely difficult to live without it.

 

[Wishdoctor79]

Maybe according to you I don't qualify for an MMT and I'm glad of that
My history of opiates use is 4 years in total, with times more intense in the use of some things like oral morphine and oxycodone, but the opiates that I have taken every day during the last years have been tramadol and codeine, together with many other drugs that I also use
You probably think that my drug use is not strong enough, but believe me yes, I am polytoxic, but my goal is to stop abusing painkillers,

In the US to go on MMT you'd need to be at least 18 and physically dependent on opiates for all the previous twelve months, meaning physical withdrawals on cessation and daily usage whenever you have them. Daily use of tramadol and codeine could be self-medicating for depression and anxiety. Tramadol can have strong SSRI effects. And I've always found codeine to relieve my "depression" and anxiety and obsessiveness.

What if you're self-medicating for mental health? It's only the past 100 years of human history that opiates have been demonized and prohibited by laws. Harrison Narcotics Act.

What if you find life miserable without opiates? My experience tapering down to zero from 100 mg of methadone in about 12 months was the worst of it being the lethargy and inability to do anything. So that led me to get some amphetamines in order to be able to have the energy to do what was needed. I'm not the only one who started using speed after quitting an opiate.

You distinguish between your daily usage of the tramadol and codeine and you seem fine with that presumable oral intake, but you don't like to "abuse" oxycodone and morphine, like take high doses getting blotto, or do you mean injection that you're injecting the pure mu agonists?

OK, hypothetically let's say you find an understanding doctor who prescribes you either tramadol or codeine for daily use, a long term scrip with refills.

What do you think you'd do if someone who supplied you in the past says, hey, I have some Opana IR or Dilaudid? Would you tell them to stay away and to not offer you stuff like that? I've heard this kind of story before and if you want to stop doing something you just have to decide that it's over and you won''t do it any more. Tell then you're probably just gonna keep on what you're doing. Methadone-assisted detox could be just what I said before, which is be a new drug for you to crave.

 

[Nicocastillo7]

In the US to go on MMT you'd need to be at least 18 and be physically dependent on opiates for all the previous twelve months, meaning physical withdrawals on cessation and daily usage whenever you can access opiates. Daily use of tramadol and codeine could be self-medicating for depression and anxiety. Tramadol can have strong SSRI effects. And I've always found codeine to relieve my "depression" and anxiety and obsessiveness.

What if you're self-medicating for mental health? It's only the past 100 years of human history that opiates have been demonized and prohibited by laws. Harrison Narcotics Act.

What if you find life miserable without opiates? My experience tapering down to zero from 100 mg of methadone in about 12 months was the worst of it being the lethargy and inability to do anything. So that led me to get some amphetamines in order to be able to have the energy to do what was needed. I'm not the only one who started using speed after quitting an opiate.

Ya le dije a mi médico que solo quiero tomar metadona por menos de 3 meses o hasta que pueda obtener kratom, tengo retiros físicos desagradables cada vez que he estado sin opiáceos, por lo que podría decir que hace un tiempo desarrollé una dependencia física. Ahora, la parte psicológica es algo muy importante que seguirán aplicando durante mucho tiempo. ¿Dijo que usa anfetaminas después de dejar los opiáceos? Bueno ... realmente dije que quiero dejar de abusar de los opiáceos, lo que no significa que deje de usar otras drogas.

I'll probably keep smoking a lot of weed, taking mdma once every 6 months, taking ketamine maybe once a month, idk


Drugs are already part of my life, I don't think I can live off all drugs, I just have to find a balance, and be more responsible, my mother now accepts me to smoke weed, we are in quarantine and I go out to smoke in the backyard, then I come back and we talk normally, I want to, I don't want that life of not being able to talk all day sedated
I have to find a balance between drug use and abuse

 

[Wishdoctor79]

Drugs are natural. Not just humans use drugs but also many animals. Maybe like if you were the son of the President and wanted to be running for office, stuff like that, there'd be a reason to stay away from all illegal drugs.

Humans have used drugs since before we were humans, most likely, because many animals use drugs. Ronald Siegel, author of Intoxication: Life in pursuit of the natural paradises, says that drug using is a natural urge along with thirst, hunger, and sex.

Finding balance between drug use and abuse is no different from finding balance between work and rest, or duty to parents versus duty to spouse or children, yada yada, or duty to family versus friends. Finding the right balance is about learning how to get the most benefit out of something while minimizing the cost or harm of it.

There's absolutely no way, no how that you'd benefit from methadone maintenance. But you've got yourself a good resource in that doctor who prescribed your methadone for this detox. All the drugs you like are prodrugs metabolized by the CYP2D6 enzyme, so that gradual creation of an active metabolite with codeine and tramadol gives it a more gradual onset so those could be less subject to abuse just by their inherent nature. See https://www.practicalpainmanagement...s/non-responsive-pain-patients-cyp-2d6-defect

Your Doctor was extremely liberal to give that to you and it's a pretty big risk he took in introducing you to methadone given your youth and relative inexperience with hard drugs.

So my best advice to you is to absolutely stop all those other opiates for the duration of this detox. And show your gratitude to that doctor!

 

[Nicocastillo7]

You distinguish between your daily usage of the tramadol and codeine and you seem fine with that presumable oral intake, but you don't like to "abuse" oxycodone and morphine, like take high doses getting blotto, or do you mean injection that you're injecting the pure mu agonists?

OK, hypothetically let's say you find an understanding doctor who prescribes you either tramadol or codeine for daily use, a long term scrip with refills.

What do you think you'd do if someone who supplied you in the past says, hey, I have some Opana IR or Dilaudid? Would you tell them to stay away and to not offer you stuff like that? I've heard this kind of story before and if you want to stop doing something you just have to decide that it's over and you won''t do it any more. Tell then you're probably just gonna keep on what you're doing. Methadone-assisted detox could be just what I said before, which is be a new drug for you to crave.

tramadol and codeine have been non-prescription drugs, let's say I get them differently, the doctor is assisting me with methadone, I never prescribe tramadol or codeine,
But I think what you say makes sense, I have stopped taking other opiates since I started with methadone, but ... do you think it would be better in that case to return to the more "weak" opioids? and try to reduce them gradually?
I'm not CYP-2D6 deficient, I get all the recreational effects of tramadol and codeine, I don't think they are drugs with less abuse potential

 

[Nicocastillo7]

but you don't like to "abuse" oxycodone and morphine

I could not understand everything you are trying to tell me, sorry, I have abused these two drugs in a row in the past, it is likely that if I had the same access to them as I have access to tramadol and codeine my consumption would probably be serious worse .. i love oxycodone
What is being relatively inexperienced with hard drugs? Is IV drug use the only thing that makes you a hard drug expert?

 

[Nicocastillo7]

If you're young and don't have a strong physical dependence to opiates it might be a big mistake to become psychologically dependent on methadone because after anywhere from a few months to a year of daily doses over say 30-40 mg it can be extremely difficult to live without it.

I don't want my dose to exceed that, and I will probably use kratom after that

 

[I_Hate_This_Place]

OK. I'll be brief. I feel you've been doing what William Burroughs or Lenny Bruce would call "making" a doctor. But what you're seeking is not a scrip but approval and validation for using opiates obtained illegally and self-medicating with a somewhat diseased body and risking some very serious complications. Your resident MD in training is learning a lot from talking to you but he's not authorized to write the scrips you need. And you have no assurance he'll ever play that role for you.

I don't care what DT means or why you think some kind of test can prove that you're takng exactly what you would be taking if there had been a MD RXing you what you want. I think this is BS and self deception that could hurt you in the long run because the longer you go without any real medical supervision the more likely something will happen that makes the house of cards collapse.

You don't want to have to give a UA sample because of urinary catheter seems to me is a very lame excuse.

99% of the MDs at pain management clinics would either reject you outright or put you on the lowest possible opiate dose and have the most intrusive monitoring they can think of.

Get on MMT and give them the UAs and have them all come back clean and after a year in the US under the 1970 rules you could be going in weekly to get 6 bottles and divvy them up as you please except on the one day a week you attend clinic. Every clinic has some back and forth of bottles changing hands, whether trading for money or sex or whatever, it's a fungible and valuable good and maybe during that first year you could become buddies with another client who gets sizeable takehomes and so when your daily observed dose wears off and you feek pain maybe you'll take some of those extras you got somehow or other. It happens at every clinic. Those with more somehow find a way of sharing them with others.

I think it's BS to be buying Suboxone strips on the street to treat your pain off the books because MDs will see it as just one more opiate addiction using street drugs. Their DT doesn't prove anything and your records of what you say you took don't mean anything.

I'm really confused? 8( I believe you entirely misinterpreted my post. I wasn't asking for any type of analysis on your part. I was just curious how the methadone system worked & since you responded in such detail that I figured I'd be courteous & respond in kind. I didn't ask to be psycho analyzed over the internet.

I don't have the time ATM to give a in depth reply (EDIT: I ended up being verbose as I usually am ). I made time for my last post explaining the situation. The Dr. (resident) in question just like every other Dr. I've been able to see since the one Dr. dropped all his patients & moved out of state isn't advocating for me buying buprenorphine or even getting it scripted as any kind of ideal situation. He would like to just write me the scripts that I need. That would be the ideal situation as he has stated to me.

Ideally Dr.'s would not have to worry about issues such as government, society, the "almighty $" or even the dubious moral crusades that people who's intentions being well or not so engage in that interfere with the practice of medicine. Sadly enough that isn't the case in reality. Clearly we don't live in an ideal world. At least in this particular context. Well in any context we don't live in an ideal world but I digress. In this case I'm referring to the fact that as I stated sadly enough outside factors interfere with the practice of medicine.

I'm quite confused by your statement of "I don't care what DT means or why". A DT is short hand for a "Drug Test". In many cases it is synonymous with UA or urinalysis. Quite often the terms are used interchangeably to the best of my knowledge.

Regardless of that fact; there are other forms of drug testing outside of urinalysis. There are oral & blood testing methods as well as hair for that matter. All are less invasive & painful in my situation. I'm not going to go into details regarding my anatomy but there is no reason I would voluntarily submit myself to something that causes my irritation, pain & to be blunt "piss red" for a few days. It's patently absurd that UA is somehow a superior method than other methods of drug testing. All of which can have a quite high degree of inaccuracy in case you were unaware of the literature regarding the topic.

Moving on my records do mean something. My records showed that the Dr. was incorrect in there assumption that prescribing methadone for pain was not allowed outside of a clinic structure. US federal law differs on methadone prescribing for pain as opposed to for addiction. My prescriptions where & always will be for pain management. As such the prescribing guidelines that applied to my case where that of pain management not of addiction treatment. As such there is a completely different prescribing protocol. In any case state law supersedes federal law & in this case again state law differs greatly in the prescribing of methadone for pain as opposed to addiction. Thus the reason for my records. The pill bottle labels showed the Dr. that they where wrong in there assumption. Which is often what's needed for someone to take the time & actually listen to you but I digress.

Upon seeing the relevant records they took the time to stop talking out there ass & go on the internet to the relevant section of prescribing law on the appropriate .gov address as well as to the relevant prescribing legalities for the state I'm located in & proceed accordingly. They realized they were in the wrong, apologized & we moved on. As I stated there is a lot of misconceptions regarding methadone usage in the USA. That would be why I was curious about the clinic system. There are a lot of misconceptions & was curious as to some information regarding said system which again I thank you for providing.

However there are also a ton of misconceptions regarding methadone & it's use in pain management. There are some Dr.'s who believe it is a great analgesic & use it almost exclusively. I saw some Dr.'s that felt that way for a period of my life until the attached hospital such down there pain clinic. No fault to either myself or the Dr. it was a business decision. Regardless as a result I was & am very aware of prescribing regulations regarding methadone & it's usage in pain management. I also feel that it is a useful tool in the opioid analgesic tool-belt & feel that it fits certain patients particularly well as do certain other analgesics. Every individidual is just that; an individual. Based on physiology, metabolism, liver enzymes, etc. as well as the problems causing each individual to feel pain each individuals circumstances are likely to be unique to that individual. As such each patient will respond differently to particular opioid (& non opioid for that matter) analgesics & as such each patient should have the analgesics used in there treatment also be individualized. In some cases methadone is the "extended" medication of choice (though in some cases it is closer to a mid duration but I digress) of choice. In other cases the physician & the patient as well; as a good Dr. will include the feelings & responses of the patient to the treatment in the treatment plan; will decide on say an extended release version of morphine, oxymorphone or hydromorphone. Perhaps even a fentanyl transdermal system. It really depends on the patient.

So basically what I was trying to say is that keeping records & in the example I had given previously (that perhaps was misinterpreted?) was for the purposes of clearing up a misconception regarding the prescribing requirements surrounding the usage of methadone in pain management as opposed it's usage in addiction treatment. Two very different usage case scenarios with widely divergent requirements & legalities surrounding there prescribing & dispensing practices. My apologies if there was a misconception somehow & I didn't clearly convey that my interest may have been related to a personal circumstance but is for all intents & purposes at this point academic.

As I stated if I was to go on buprenorphine for pain it would be in the form of Belbuca because as we both can agree Suboxone is not indicated for pain management. At this point everything with my Dr. has been discussed not put down on paper. Though I took an oral drug test with the intention of getting my methadone prescription restored test was not entered into my medical record. I had an agreement with the Dr. that if they where unable to prescribe me my medication as they wanted to do after being made aware of my situation vis a vis getting needlessly dropped when I'm a legitimate pain patient & them agreeing with my sentiment that "other people overdosing on street drugs such as fentanyl analogues does not have anything to do with pain patients & should not affect there treatment". In fact they agreed wholeheartedly & stated how they somewhat regretted there career path due to the government intrusion into medical care. They stated that with all the government & insurance BS as you say that they spend far less time helping people than they want to. Helping people is the reason they got into medicine & are disappointed by how hard that is to do. I feel for the Dr. & in no way blame him. I understand that they are put in a shit position.

I digress though & become extremely verbose. Again you have my apologies. However; I will state that regardless of any miscommunication that may have occurred there is no need to be hostile. Even if you erroneously believed that I was asking for a psycho analysis there is no need to refer to my physical issues as a "lame excuse". Maybe for you adding more pain & difficulty urinating when you already have pain & difficulty urinating to be a "lame excuse". I just find it to be a part of being me & getting through the day. As I stated I have no reason to inflict additional difficulties & pain upon myself when there are alternative forms of drug testing. Not that drug testing is particularly accurate or needed for that matter. I'm a chronic pain patient. If you feel that government intrusion on pain patients is something to be celebrated that's your opinion. My opinion is that drug testing of chronic pain patients is not something to be celebrated. I can understand the rationality behind testing people that have given a reason for the system to do so such as selling there prescription. Though I don't agree with drug testing in general. I'm more of a personal freedom; your body, your choice; kind of person. I say to each his own though. If your opinion differs that is your choice. It's your body it's your choice but don't force your choice on others. Also just because I understand the rationality behind something doesn't mean that I agree with the rationality.

Understanding something does not mean that one agrees with it. You may be right that 99% of pain management Dr.'s would try to do low dose intensive monitoring. However; you'd be wrong in thinking that's what they want to do. From my experience & that of others in the pain community the Dr.'s are acting out of fear. If they where allowed to practice medicine as they chose to it would be a different situation. Again every Dr. is different but anecdotally from personal experience & that of others in the pain community (I'm active in various pain groups & forums, etc.) many Dr.'s are just doing what they feel they are forced to do. If given the choice they to practice medicine un-beholden to any interests be they financial, governmental or societal they would practice medicine in a very different manner than the way it is currently practiced. Again this is from experience I can't speak for others outside of those I've spoken to.

As for the rest of your statement recommending I go to a clinic & get take homes & find a buddie, trading for sex or buying I don't know where to start. I didn't imply that I use substances in that manner. (Not that there's anything wrong with that & at times in my life have done so; as I would think most members here have)
If I somehow mistakenly gave off the impression that I was just looking to abuse methadone my apologies. I'm looking into all this in the context of pain management & the fact that the ideal world doesn't exist. I have to work with the options presented to me. Be that through societal or financial means or a combination of both & other factors.

You may think it's BS to be buying buprenorphine & dosing it the same as one would if prescribed Belbuca but that's your opinion. To me there is little difference between my usage of buprenorphine (or any other analgesic for that matter) & the usage of Belbuca. Since buprenorphine is the opioid in question I refer to Belbuca. If I'm taking the same substance I have a hard time seeing how the substance magically becomes different because it's prescribed? As I stated Dr.'s have no problem with this. The reason I mentioned methadone is because from past experience it works better. My Dr.'s are aware of this. Thus why they also where hoping I could find a way to get back on methadone or another full agonist. It would greatly simplify upcoming surgeries & procedures (though they are postponed ATM due to the Covid situation) as well as & more importantly give me a higher quality of life once again. My quality of life shouldn't be dictated by the whims of government or society when it's known what works to help improve said quality of life at a reasonable cost. The medications are not overly expensive it's just the BS as you called it; that's in between. It's just that I see a very different form of BS.

Hopefully this post has clarified for you what I was trying to say & you also see the difference. Again my apologies if I wasn't clear the first time. Feel free to let me know what I may have said that gave off such a wrong impression. I try to remain positive & see this miscommunication as an opportunity to see where I may have made a mistake in communicating what I was trying to express. I'm on the autism spectrum (Asperger's) & do my best to communicate as clearly as possible. Occasionally miscommunications do occur though & apparently that has happened here. Unless for some reason after this post you still have an issue with what I'm saying in which case I guess I just have to wait for your reply & see what reason that could possibly be? As by now with how verbose I was in my reply & reiterate my point I hope that I got said point across!

Edited: Double posted a sentence

 

[Nicocastillo7]

I'm really confused? 8( I believe you entirely misinterpreted my post. I wasn't asking for any type of analysis on your part. I was just curious how the methadone system worked & since you responded in such detail that I figured I'd be courteous & respond in kind. I didn't ask to be psycho analyzed over the internet.

SAME

I felt something similar for this person's comments about my consumption, and I even talk about my consumption as if I knew all about my drug history or even as if I knew a little bit about my life, I felt a bit attacked in a way

 

[Wishdoctor79]

I am on methadone maintenance at this time, a very low dose, they are supposed to increase it in a week, if I take it for 3 months (last month reducing)
would I abstinence when it reaches 0?

The reason for me asking the probing questions about your opiate usage was the above posted April 16, ten days ago. You wanted to know if you'd feel withdrawals at the end of a 3-month assisted detox by saying "would I abstinence when it reaches 0?" That question of yours was the original reason for days and days of repeated questions for ascertaining how much opiates do you take, like what doses and how frequently, and you didn't give any clear answers and maybe you didn't know why I was asking the same questions of you.

And then after you said it makes you feel good but it doesn't feel like a recreational drug and saying the clinic system sounded good to you, you seemed to be expressing at least a slight interest in the possibility of you joining such a clinic. So I was trying to give you intelligent feedback to both of these interests or issues or topics. It seemed that you were saying it might be something you'd like for yourself. And then you said you're a polytoxic drug user which you said is serious and then you seemed to be asking me what does it take to be considered to be a hard core drug user, like I was dismissing your drug usage as being less important.

I was trying to figure out what you meant by "abuse" when you take oxycodone or morphine versus your everyday codeine and tramadol, and especially important to me was learning if by abuse you meant injection because codeine and tramadol are generally NOT injected while an injecting drug user with oxycodone or morphine in an injectable form would at least be trying them by an injection route, either IV or IM. So today now I learn that "abuse" doesn't mean injection but it seems that you're referring to a state of sedation and lethargy in the aftermath of those doses where you're incapable of doing things. It seems that's what you meant today about the aftermath of a big dose but you didn't say what kinds of doses do that to you.

Only today did we learn that tramadol and codeine are not prescription drugs there, so you can just go into a pharmacy and buy them. Well, that's pretty important and relevant to understanding your legal environment. But I believe you haven't said what doses you take for any of those drugs and you haven't described your level of discomfort when you "abstinence" or told us what kind of doses of tramadol or codeine you'd take to relieve those withdrawals.

In the US tramadol from its very beginning was always a prescription drug from the late 90s requiring a doctor's prescription but it wasn't a controlled substance, so a doctor could write a scrip with 11 refills and the scrip is good for 12 months. And from 1998 I can remember many people on alt.drugs and alt.drugs.hard telling us about the addictiveness of tramadol and people having seizures from taking over 400 mg a day. Codeine was sold OTC for a long time from Spain and we'd get 30mg or 60mg tablets in the mail from online pharmacies and without any acetaminophen, but in the US the best you could get OTC was something like 10 mg codeine and 500 mg acetaminophen and you'd have to show ID and sign your name in a book at the pharmacy before that was totally eliminated and now in the US the stronger codeine tablets with 30 mg are in a higher schedule and if it were sold as pure codeine it would be a C-2 but it's not sold here as pure codeine, only if it's mixed with other ingredients like acetaminophen or another drug for cough or cold.

I've answered all of your questions as I understand them to the best of my ability and you posted today that you feel my questions were intrusive and you seemed to resent my characterization of your drug use as being less than hard core. Well, you're living with your mother and the opiate use started only four years ago. That's just getting started. Ten years isn't that hard to survive but if you can stay alive and out of hospitals and jails after 30, 40, 50 years then you can come out to answer questions in places like this and they ought to give you the respect you deserve.

You're posting in a second language so that's a big part of the misunderstanding and you seem to have forgotten or not realized why I kept trying to find out from you what doses of which drugs you take on a daily basis buying them OTC and then also what doses of morphine or oxycodone do you "abuse" and how frequently do you abuse them?

I won't ask you any more questions trying to learn your level of opiate usage. I kept trying for ten days to find that info but you didn't want to say.

 

[Nicocastillo7]

Only today did we learn that tramadol and codeine are not prescription drugs there, so you can just go into a pharmacy and buy them. Well, that's pretty important and relevant to understanding your legal environment. But I believe you haven't said what doses you take for any of those drugs and you haven't described your level of discomfort when you "abstinence" or told us what kind of doses of tramadol or codeine you'd take to relieve those withdrawals.

Hey if I have said the doses I used to take of those 4 drugs in some different threads, when I had to leave tramadol in a cold turkey, I had been taking it in doses greater than 400mg, in the last 5-6 months maybe I was using an average of 600 -750mg of tramadol, at that point 400mg only removed my withdrawal symptoms, codeine used up to 300mg and I always needed to supplement it with something else.
If you need to know the frequency, then tramadol every day since I started using it 4 years ago (only stopping using it when I had morph and oxy on hand)
Oral morphine use 80mg or 100mg and Oxi 60mg-80mg those were the doses I used (here there is only oxy EP) when I received the imported percocet pills I used to take only 30mg-50mg (removing the paracetamol)

You're posting in a second language so that's a big part of the misunderstanding and you seem to have forgotten or not realized why I kept trying to find out from you what doses of which drugs you take on a daily basis buying them OTC and then also what doses of morphine or oxycodone do you "abuse" and how frequently do you abuse them?

The frequency with which I have used morphine and oxycodone in the last 4 years has been inconsistent, but I can give an approximation of the frequency, there was a time in 2018 and the beginning of 2019 where I used oxy and morph 3 to 4 times a week , this for a few months, the last few months I have been taking morph and oxy less frequently, I took them for the last time in my relapse before starting methadone

In the US tramadol from its very beginning was always a prescription drug from the late 90s requiring a doctor's prescription but it wasn't a controlled substance, so a doctor could write a scrip with 11 refills and the scrip is good for 12 months. And from 1998 I can remember many people on alt.drugs and alt.drugs.hard telling us about the addictiveness of tramadol and people having seizures from taking over 400 mg a day. Codeine was sold OTC for a long time from Spain and we'd get 30mg or 60mg tablets in the mail from online pharmacies and without any acetaminophen, but in the US the best you could get OTC was something like 10 mg codeine and 500 mg acetaminophen and you'd have to show ID and sign your name in a book at the pharmacy before that was totally eliminated and now in the US the stronger codeine tablets with 30 mg are in a higher schedule and if it were sold as pure codeine it would be a C-2 but it's not sold here as pure codeine, only if it's mixed with other ingredients like acetaminophen or another drug for cough or cold.

I've answered all of your questions as I understand them to the best of my ability and you posted today that you feel my questions were intrusive and you seemed to resent my characterization of your drug use as being less than hard core. Well, you're living with your mother and the opiate use started only four years ago. That's just getting started. Ten years isn't that hard to survive but if you can stay alive and out of hospitals and jails after 30, 40, 50 years then you can come out to answer questions in places like this and they ought to give you the respect you deserve.

haha ok, I understand your point now, it's good to know that I don't plan to live like this for the rest of my life
"you live with your mother" yes, so what?
you're probably a man with a long history of drug abuse that you probably don't want to ever meet because I really don't care, don't worry, I don't want to be in this stinky world for long, I don't mention much of my personal life, but I have a son, and I have to take care of him, and although this is the beginning, it must be the end of these types of consumption, my money must go to my son, not to my drugs, my mother does not support me, nor my son or my drug use ... and if I feel attacked, maybe it's because of the different languages or not?


Okay, this is embarrassing, codeine and tramadol are prescription drugs here, but tramadol is available from veterinarians without a prescription, here we have veterinary pills of 75mg and 80mg, so can you understand the abuse of this for so long? Codeine is available in pharmacies a presentation with 30mg of codeine and 500mg of acetaminophen (I have always removed this) and this presentation of codeine is available without a prescription, now you understand?