Methadone and Constipation

[MassachusettsNA]

Hey all

I have been on methadone 32mg/day for about four months now and have been having extreme constipation as a side effect. I have been trying to get my dose lowered but my program makes it almost impossible to lower the dose. I want to get off methadone treatment altogether but can?t afford to go into crazy withdrawals.

Im looking to find out the best solutions to the methadone constipation. I?ve tried almost everything but please if you?ve got any advice give it to me and others who are in need. I only post this question because the topic of this hasn?t been updated since two years ago on this forum.

Also, what?s the best way to come off methadone. How fast can I lower dose. What will help with withdrawals.

 

[Trabbamab]

I was on methadone for a couple of years and also experienced horrific constipation. Before finding something that worked for me, at the very worst I went 13 days without a bowel movement which is of course moving into very dangerous territory (actually years later, after doing some research, I was well past dangerous territory and should have gone to the hospital about a week before hand).

But I finally found something that works, pretty much no matter what. And that is Phillips Milk of Magnesia. Generally I would take, if I recall correctly (consult the instructions on the bottle) 3 - 3.5 tablespoons of it with a full glass of water. Then it is a waiting game. Usually you want to take it as you are going to sleep. It doesn't cause much stomach issues (avoid stimulant laxatives like the plague, of which Phillips is not one) but if you take it while awake, your stomach will probably start gurgling and making some embarrassing noises. And you will likely have some gas. But if you take it at night, when you wake up, you will go. If you aren't in dire straits right now, you can take a lower dose, possibly 2 tablespoons to just get the systems moving a bit better. If you are in a straight-up emergency state right now, take a full 4 tablespoons. But beware that it may cause diarrhea. If you find that you take the Phillips, go and then immediately settle right back into constipation, you can start taking a single tablespoon each day for a couple of days to try to get your system back on the right track. But you cannot take it every day for weeks on end I have heard.

 

[binny]

Methadone is used as a pain reliever and as part of drug addiction detoxification. So follow this steps:

• Drink plenty of water. ...
• Eat nine helpings of fruits and vegetables per day. ...
• Take magnesium tablets. ...
• Increase your daily fiber intake. ...
• If you decide to try a laxative to relieve constipation during methadone treatment, choose your brand carefully

 

[cj]

Miralax has helped me a ton

 

[Keif' Richards]

Seconded on the Miralax. I've found it to be the most consistently effective OTC laxative. It's a non-stimulant laxative, which is a gentler process. A stimulant laxative does pretty much what it implies, in that it will cause your GI tract to contract. Miralax should, in theory, cause more water to remain present in the digestive tract, making the stool easier to pass. As silly as it may sound, you can become dependent upon stimulant laxatives like you can anything else and they should be used sparingly for this reason.

As a seasoned Opioid addict, I recommend Miralax all the way.

 

[Pickledlemons]

Miralax is the answer. It was the only thing that consistently helped with my sub constipation. Sucks cause its pretty expensive. Theres no name brands but still costs $20 + a week for me to use. This is also what they gave me when I went to the ER for severe constipation. Turns out I just wasnt taking enough at the time. The doctor suggested that I use something crazy like 50x what is suggested by the OTC product. So don't be afraid to a bit more. The product he gave me also contained electrolytes so I'm guessing that means high doses can cause electrolyte imbalance.

 

[MassachusettsNA]

Thanks for the replies so far. I have actually tried the miralax already with limited results. Spoke to my gasterointerologist again today and he said that this is a very serious issue and he is extremely worried. He gave me samples of a medicine named Trulance. It’s a medicine for constipation of an unknown cause but he said it should without a doubt help me. I was able to get an appointment with the methadone doctor tomorrow morning also to discuss this with him and lower my dose again. My program makes it really hard to lower dose of methadone mainly the counselors tell me it’s a tactic to make more money. This doesn’t seem right to me but I suppose that’s why all of the counselors are so upset with their jobs and don’t seem to value the company one bit.

 

[Pickledlemons]

Thanks for the replies so far. I have actually tried the miralax already with limited results. Spoke to my gasterointerologist again today and he said that this is a very serious issue and he is extremely worried. He gave me samples of a medicine named Trulance. It’s a medicine for constipation of an unknown cause but he said it should without a doubt help me. I was able to get an appointment with the methadone doctor tomorrow morning also to discuss this with him and lower my dose again. My program makes it really hard to lower dose of methadone mainly the counselors tell me it’s a tactic to make more money. This doesn’t seem right to me but I suppose that’s why all of the counselors are so upset with their jobs and don’t seem to value the company one bit.

The miralax will work. Trust me. How much have you been taking? for how long? Even try tripling the standard dose. It said take one cap full twice a day? Take two, three times a day. By day 4 I promise it will work. The doc from the ER even said there is nothing better. You can even mix it with dulcolax for better results. wait until that magical day 4 before taking it though.

 

[MassachusettsNA]

Thank you I’ll try that. I have been spending insane amounts of money at the pharmacy. It’s killing me. My gasterointerologist gave me something called truelance yesterday so I’m going to try that.
Also my doctor is switching me to suboxone on Tuesday.

 

[Trabbamab]

I think you can take MiraLax daily, as I believe that is its use. It promotes healthy movements. But I would still suggest buying a bottle of Phillips Milk of Magnesia in case the MiraLax fails. You can't take Phillips daily. But if you drink a lot of water, increase your fiber intake and take MiraLax, you should be good. But Phillips is my "emergency release button" in case everything else fails. It works 100% of the time if you take enough.

Typically methadone or Suboxone constipation eventually evens out and only comes and goes in bouts that may last a few days to a week or two. This will be followed by one to several months of healthy bowel movements. This is tolerable and definitely where you want to get to. If you really adjust your diet, 100% healthy BMs are possible even while on opioid replacement therapy.

EDIT: I have also found that Suboxone tends to be much better with the constipation. For me, methadone tended to tie me up about 2x more often.

 

[TargetX]

Lactulose you can use everyday forever if you need. It won't slow down/paralyse the bowel like stimulant laxatives do. It works by drawing water into the colon so it softens and helps movement. It's pretty gentle but can relieve really extreme constipation if you up the dose