Opioids Methadone Mega Thread and FAQ

[messedupgirl]

will someome let me know if 10 mgs of methadone is enough to stop witdrawls in an EXTREMLY TOLERANT opiate user

 

[Tommyboy]

You seem to be pretty bad position. You may need 20mgs of methadone to keep the sick away the first day. You can try to cut the dose lower and lower after the initial dose.

 

[epiks]

Question for you MMT patients..or anyone really.

Have any of you tried suboxone and eventually switched to methadone? I hear all the time about people quitting methadone and going on subs but not really the other way around. I have been a heroin user for around 5 years now almost 6. For the last 2yrs I've been on and off subutex. I'll use it for 6 months with a few relapses with dope. Then think "I don't need this anymore!" or I'll be in the middle of a fat binge and miss my appointment. Whatever the case, at the beginning it worked great. I felt awesome, like I could conquer the world! But now that feeling is totally gone. I'm on 24mg and have been testing different does between 2-24mg and nothing seems to hold me like it used to.

My second question is should I try methadone? Honestly the main reason I want on 'done is because I'm expecting a "good feeling" from it. Even if thats not the case. I keep thinking to myself "if I just get on methadone, I will be feeling good all day. Obviously not like heroin high, but a decent buzz at least for a couple hours. Even tho all my research has concluded that most people feel no euphoria at all, maybe a "glow" for the first couple days but thats it. The main reason I haven't made the switch is because I get my subs free, I would have to pay the 300/mo for methadone and also I don't want to be forced to drive to a clinic 5x a week. I would never be able to go on vacation or anything, right?

Sorry if this is all jibber jabber, I've just been going back and forth with whether or not I should switch to methadone or stay on my subs.

So; Methadone users that switched from subs. Are you happier? Are you glad you made the switch?

 

[SubDude]

I was in the similar position but as you said on MMT first. I get sub s free too but don't like it near as much as methadone. However, not enough to pay $13 a day and go back to square one with regards to takehomes and count checks later and observed urines when ever they choose. It's not worht the cost and hoops to jump thru for me.

 

[RunRunRun]

epiks,

I am at the moment on mmt. I go there with one person who did a free subutex research program for 6 weeks then he switched to methadone. But I don't really talk to him. Six weeks was just probably not long enough for him to get his life in order before he tried to detox. I used to be on subutex and suboxone as well. It did wonders at first as you described. But being a junky, I relapsed and every time I did, I got worse and worse it seemed. I got to the point to where I was using and in between using mostly IV hydromorphone, oxymorphone, and H, I would inject small amounts of subutex because I quit seeing the doctor but had a stock pile left and wanted them to last. Plus doing small amounts of IV bupe, it gets out of your system quick. I could use again within a few hours if it was a small enough amount.

I don't advise anyone to try and do that and yeah I know IV use of bupe is not the smartest thing. IMO, especially if they are serious about wanting to quit or even want to quit one day. After doing that, bupe had no effect on me but barely kept the w/d symptoms at bay. And it just made me sleep and lazy. Even at any dose and any ROA. I kept telling myself I wish I would have never started to IV it.

So that is why, down the road I started mmt. Methadone didn't even do what it use to either. Back before I would IV, I loved methadone. It was probably my DOC. Lasted long and with enough, I could get a good nod. But not long before I started the mmt, I was taking a lot of methadone in between using other, stronger and short acting opiates. I even started injecting methadone and at pretty high doses.

Not too many months after that, I finally started the mmt. And methadone does not do what it used to, at all for me. I was even able to start at a high dose my third day because I ended up in the ER from injecting 120mgs of OM er in one 3ml rig my second night of mmt because I was not at near of a high enough dose to have me the least bit stable. And I know the first bit of mmt is going to be hard for everyone, but I had some pretty big problems besides my drug one at that time.

Even when I was brought to a high dose, like I said before(and I was real quick after my incident), it didn't do anything for me as far as a buzz. Some people it does give them more of a buzz and does for a while. Honestly, I kinda wish it did for me. But I think I either had such a high tolerance when I started or fucked it up back when I was banging methadone.

As far as driving up there everyday, I had to drive 30mins six times a week at first. But you phase up and eventually can get to the point of going once a month. And our clinic has a sliding scale based on income you can apply for. It is just something you have to take a bit more serious which I am trying to do. I mean some people just do it for the dose to not be sick and not do anything else as far as recovery. And also after a certain amount of time, on a higher dose, you won't be able to use and feel anything/rush/high from it. Methadone just builds up and has such a high affinity for your receptors so after a while it is near impossible to break through. I've heard it takes up to ten days off to feel about the full effects of something.

Hope this helps. I know, I'm scattered.

 

[epiks]

@SubDue Yeah, I don't think I can handle all that bullshit. Especially random drug tests because I still plan on using every once and awhile. I do it with the bupe but since I always have to wait for WD and feel like shit for 1-2 days I binge for a week then stop for three. I figured with MMT I could just do it every once and awhile and not feel forced to binge because I'll feel like shit. I will probably eventually fail a drug test tho and screw it up.

@RRR Thanks for that post. You really made me think...To be completely honest I always just kind of thought of it like "got my subs, im clean, im good" but its like you said..WHAT ELSE are you doing to help the recovery, because that alone will not work. I guess I've always known that, but never actually took it to heart. A magic pill a day won't keep the addiction away. I need to work at it constantly and actually better my life. I'm sorry to hear about the ER trip, thats got to be so frustrating..The MMT had the ability to help but they wouldn't raise your dose. I would have the done the same thing. And I know exactly what you're talking about with the subs. They don't do shit just barely keep the sickness at bay. I think I will keep on with the subs and actually try making changes in my life and be more serious about recovery. And if I keep failing, THEN I will consider MMT again.

Thank you both for your posts!

 

[Fire&Water]

@SubDue Yeah, I don't think I can handle all that bullshit. Especially random drug tests because I still plan on using every once and awhile. I do it with the bupe but since I always have to wait for WD and feel like shit for 1-2 days I binge for a week then stop for three. I figured with MMT I could just do it every once and awhile and not feel forced to binge because I'll feel like shit. I will probably eventually fail a drug test tho and screw it up.

@RRR Thanks for that post. You really made me think...To be completely honest I always just kind of thought of it like "got my subs, im clean, im good" but its like you said..WHAT ELSE are you doing to help the recovery, because that alone will not work. I guess I've always known that, but never actually took it to heart. A magic pill a day won't keep the addiction away. I need to work at it constantly and actually better my life. I'm sorry to hear about the ER trip, thats got to be so frustrating..The MMT had the ability to help but they wouldn't raise your dose. I would have the done the same thing. And I know exactly what you're talking about with the subs. They don't do shit just barely keep the sickness at bay. I think I will keep on with the subs and actually try making changes in my life and be more serious about recovery. And if I keep failing, THEN I will consider MMT again.

Thank you both for your posts!

Right choice...The Dones' will eventially put you in an unhealthy fog (compared to Bupe') & you will eventually come to "spite" the (un)glow

 

[Tchort]

Have any of you tried suboxone and eventually switched to methadone? I hear all the time about people quitting methadone and going on subs but not really the other way around.

Yes, I was on Buprenorphine for 3 months, then back to heroin, then to MMT. I found Buprenorphine did nothing for cravings. The stimulating side effect was unnerving at times, and one of the side effects listed on the prescriber's information insert is nightmares; and I can say from experience that I had awful nightmares the whole time I was on BMT.

Methadone has a lot of unpleasant side effects as well (much worse constipation than any opioid I've ever used, profuse sweating, feeling hot, decreased sexual potency/interest, etc) but I find it worked better for me. Though I am considering switching back to Buprenorphine, I haven't made up my mind totally yet (only for reasons of convenience rather than because it's superior).

Studies done indicate Methadone and Buprenorphine are basically the same when it comes to 'success rates'- they are equally good at what they are supposed to do. Though they both have specific advantages and disadvantages over the other, and Methadone has decades more experience, testing, etc under its belt (important when it comes to co-occuring mental health problems, diseases like HIV/AIDS, pregnancy, etc).

 

[adder]

Have any of you tried suboxone and eventually switched to methadone?

I can tell you how it was in my case. I've never been a maintenance treatment patient (turned down many times due to overpopulation...) but I've tried methadone, buprenorphine, 18,19-didehydrobuprenorphine, and even semorphone as maintenance drugs.

Most of the time I was on methadone, the first time it was in 2007. Then I got back to shooting up and would jump back on methadone numerous times when the situation was hard. It wasn't until October 2011 when I started taking buprenorphine after a hard binge on morphine and levorphanol. The feeling was alright at high doses, my mind wasn't so cloudy as in case of methadone, my mood was a little brightened, and most importantly buprenorphine lasted at least 30 hours for me while I have to dose methadone twice a day. But the doses of buprenorphine that really helped me were very high like 24mg.

I wanted to save more buprenorphine so I started taking 18,19-didehydrobuprenorphine, it's 2 times as strong as regular bupe. But eventually after trying semorphone I decided that it's impossible to taper down buprenorphine because when I lowered the dose I started getting chills, sweating, and things like that.

If you need to know how it is done on detox wards/clinics/whatever it is called in the US that puts you on the program, then in my country I haven't seen people switching from bupe to methadone. It's the way you described - psychiatrists encourage people new in detox wards to go on bupe instead of methadone and they also encourage methadone patients to think about switching to bupe. The reason why it's the same way in other countries is probably different but here Suboxone is relatively new.

When I was in a detox ward on my way onto the program (Feb '09 but I couldn't hold on and discharged myself on demand; I never really was with junkies who live on the streets and steal to buy their heroin so it was quite a shock for me, besides the idiot that is the chief there cut my clonazepam by 1/3, I don't know who does that! and I wasn't even on heroin then, I was addicted to morphine...), Suboxone was then like a novelty, a new option on some maintenance programs. Earlier, there had been only one "program" where the doctor prescribed Polish brand buprenorphine (bupe-only pills but they're only 0.2mg and 0.4mg, they're used for pain and eventually this is prohibited by now from what I know).

My second question is should I try methadone?

Well, this is the next step usually when buprenorphine fails. Usually if someone's put on the BMT at the beginning and it works for him/her, the person is kept on bupe, otherwise the person is switched to the MMT. It's your choice but if I were you and didn't get into methadone, I would think it over because it's much harder to get off it than getting off bupe. I don't know what's the limit in the clinic you go to, I know people are given more than 24mg in the US (the maximum dosage is 24-32mg) but honestly increasing the dose from 24mg doesn't give as much as increasing e.g. from 8mg to 16mg IME. There's just some ceiling and while you still can overdose on bupe, it doesn't give you anymore over some point because it's just a partial agonist so it does stimulate opioid receptors but not as strong as full agonist. Hence people with tolerance don't get euphoria as opioid-naive people do at very low doses (e.g. one 8mg pill dissolved and prepared for injection is enough even for 8 opioid-naive people to get high, this is practiced in Ukraine and such a pill costs a lot on the black market because smugglers from France or Italy know how strong bupe is for opioid-naive people and it's not sold as a maintenance drug but rather as a drug for abuse).

 

[DeLee]

I got a question, how long does it take for methadone withdrawal to hit?
Take me for an example, 110mg per day and have been on it for 7 months.

 

[adder]

I guess you would feel fine for more than 48 hours, anywhere from 2 to 3 days from dosing, taking such a high dose for a long enough time for the drug to attain stable levels in body fluids and to cumulate in fat.

The thing is methadone withdrawal doesn't really take long to hit (in my case it holds me for 16 hrs at best, I need split-dosing) but it unfolds slower than withdrawal after abrupt stop of taking opioids like heroin. So e.g. before you really get diarrhea, you feel a terrible pain in your gut and your stool is hard. Everything is less intensified but it lasts longer and that's why it's considered by most people to be much worse than withdrawal after stopping heroin.

 

[BananasAndOranges]

I got a question, how long does it take for methadone withdrawal to hit?
Take me for an example, 110mg per day and have been on it for 7 months.

at the end of day one youll for Sure feel sick im guessing if you dont have backup. Taper down dont just quit. Day 3 is the day you usually start getting violently sick. With a dose like that you are going to need to go to er if youre really going to cold turkey.

 

[TheLostBoys]

I got a question, how long does it take for methadone withdrawal to hit?
Take me for an example, 110mg per day and have been on it for 7 months.

Wowzers.............that is a humongous dose. You can not just quit with a dose 110mg per day. You gotta taper down or you will suffer big time...............

 

[traybuck]

Wowzers.............that is a humongous dose. You can not just quit with a dose 110mg per day. You gotta taper down or you will suffer big time...............

^^This however It's not that big of a dose at least were I'm from.. But I would not try and go cold turkey off of a dose of that size that's forsure.Im at 120 right now myself. If I skip a day or two I really start feeling like shit big time. My stomic starts cramping soo bad I can barly stand up I sweat like I'm in a shower It's just not a good idea. Plus it's vary hard to tollarate other peaple when coming off a dose that size imo.

 

[adder]

at the end of day one youll for Sure

This is nonsense. How could he feel sick at the end of the day if this is his daily dose 1) supposed to be taken by him every 24 hrs / 2) he takes whatever the source is.

If this is pure methadone syrup or it's in a pill form, there's no way such a huge dose won't hold a person who needs dosing once a day for over 48 hrs.

Concerning tapering down / cold turkey dilemma (but DeLee didn't really say he'd stop taking methadone, I treated it as a strictly theoretical question), I agree with all posters above me. You won't survive quitting it just like that, you must taper it down and the bad news is it's a long way ahead of you from 110mg to 0mg if you want to stop taking methadone.

 

[BananasAndOranges]

This is nonsense. How could he feel sick at the end of the day if this is his daily dose 1) supposed to be taken by him every 24 hrs / 2) he takes whatever the source is.

If this is pure methadone syrup or it's in a pill form, there's no way such a huge dose won't hold a person who needs dosing once a day for over 48 hrs.

Concerning tapering down / cold turkey dilemma (but DeLee didn't really say he'd stop taking methadone, I treated it as a strictly theoretical question), I agree with all posters above me. You won't survive quitting it just like that, you must taper it down and the bad news is it's a long way ahead of you from 110mg to 0mg if you want to stop taking methadone.

Not nonesense at all. By the end of day one I Meant after a whole day if you get any sleep, that next day basically i should have said day two, you Will feel like shit. If you asked anyone at a clinic how long till they feel methadone sick I dont think anyone would say they could last two days. Day 1 will be rage sorry for typing like a wad. Also You have to think about everyones metabolism. Anything that speeds the metabolism up will affect how long methadone is in ones system. If you can really say you could go 2 days without a dose that high your fucking crazy. Unless your one of those kids who uses on the side dont underestimate that shit. Everyones body is different. How long have you been at a clinic person above me? Just because hes taking 110 mgs doesnt mean a thing tolerance builds quickly.

 

[ms4104]

I was on 80mg MMT and when I hit the 24 hour mark I was already feeling 'off.' Not sick per-say but just off. Any opiate user knows what I mean. If I had to go another 12 hours or worse 24 I would def feel more and more sick.. I wouldn't wanna do it.

When I switched from MMt back to bupe afte rbing on 80mg meth for a year, I took a 4 day heroin vacation, got this really good stamp and got high for 4 days.. then after my last heroin dose, I waited 36 hours (with the help of some ketamine) to dose my bupe. No precitated withdrawal here!! It took me about 6 daYS TO adjust and feel like 90% and 2 weeks to feel 100%. I feel so much better now than when I was on methadone.. and I leveled out at only 12mg bupe from 80mg methadone (prob could have done even less).

 

[adder]

I'm feeling "off" after at most 16 hrs after the last dose of methadone and by "off" I mean serious start of methadone withdrawal (means I need to go poo and it doesn't matter the crap is hard as concrete, I just have a terrible pain in my gut). Thus I split my dose. Anyway, I've been on a detox ward (here "detox ward" means all junkies are taken in - these for detox, these to enter MMT after stabilizing dose etc.) and I've seen a guy on an even higher dose (145mg to be precise), he got kicked out because a benzodiazepine derivative was found in his urine and clonazepam he had taken wasn't in his card. He had been there for a few weeks, enough for methadone to get at stationary concentration in body. It was evening so it'd already been some hours after he took his dose. He was fine for the whole following day (he did manage to go back to the city he lived), just long enough to buy heroin and just kill the withdrawal with 1/2 gram of heroin...

I also have my adventures from that ward. I lied about the dose I had taken before I was taken in. And so I was given 50mg on the 1st day (split: 40 + 10 in the evening; there's a regulation a patient can't be given more than 40mg at admission no matter his condition), 60mg on the 2nd day, 70mg on the 3rd day and I signed out on the 3rd day too. It was Wednesday, I somehow survived till Friday to buy methadone from my regular source (= I could wait to get clean syrup so it wasn't that bad and I had experienced methadone withdrawal for 4 days and it was just hell).

Well, this is just my opinion, somebody asked, I was one of the people who answered.

 

[supersmoker27]

So I want an increase and I could use some advice

Ive been on MMT for a year now and have been steady at 52mg. Started at 30mg, stable at 42mg for 8 months, and one 10mg increase about 3 months ago for a total of 52mg.

When I got my 10mg increase 3 months ago it really helped to bring out the positive effects of the methadone, and made me realize that im not reaping the full benifits of it. I had more of that great motivation I first had when I started MMT, and I was able to taper from 6mg xanax to 1mg and go from using cocaine every day to now only once a week. It just basically increased my will to change for the better.

Latley ive been testing dirty for coke and benzos. My doctor wants to see results with no coke.
So ive asked to get tested twice a month instead of once a month. That way I will have more pressure to stay clean and I can show the doctor consistent results. I want to have at least one UA with only benzos to show him before I ask for another increase.

The last time I asked my doctor for an increase I felt like I was almost drug seeking. And after talking to people and reading around I hear that it should not feel like this.

I really feel like I can benefit from another increase, but do not want to feel like scum looking for more drugs. Just wondering if anyone has been in a similar situation, or has any words of wisdom.

My plan is to just explain to my doctor everything I just typed out. He is very honest, nice, and I can tell he really just wants to help. So im sure when I explain how im feeling he will put my worries to rest. just wanted to hear from others.

 

[adder]

10mg of an increase is generally nothing and it's accepted right away but Texas law is definitely a lot different from Polish law.

Anyway, how is that possible you were let to stay on the MMT program if you take cocaine? Taking every day would certainly give a positive on some unscheduled test. I don't get this policy at maintenance programs... This is bullshit for me. The only difference between the US and the UK for example and Poland is how much methadone is available so if I had a British citizenship, I would begin taking methadone from the program starting next week. But I'm fucking Polish. --whatever--