Opioids Methadone to help get off fentanyl

[N9ne]

I'm going to go to the clinic real soon. I'm not sure what mg they start you out at but what's a good dose for fentanyl wds? And how long should I stop for before going? 12 hours, a full 24, or does it really matter? Methadone is the only thing I've never done opioid wise. Does it give you energy or more if a downer?

 

[ghostandthedarknes]

There's no wait time for methadone like with Suboxone. Methadone would just make me nod the second I sat down and made me sweat like a pig. Around here they'll start you at 30mg and work you up to find the sweet spot. It's liquid handcuffs imo. Suboxone rapid taper is the best option for quitting

 

[N9ne]

There's no wait time for methadone like with Suboxone. Methadone would just make me nod the second I sat down and made me sweat like a pig. Around here they'll start you at 30mg and work you up to find the sweet spot. It's liquid handcuffs imo. Suboxone rapid taper is the best option for quitting

You have to wait so dam long on fent to take subs. I've seen a few people, including me, go into precipitated withdrawal trying to use subs to get off fent. I tried the Bernese Method but couldn't control the fent to do it. Ima try use Methadone for a few weeks and see how I feel quitting it. Might try to jump to subs then.

 

[ghostandthedarknes]

You have to wait so dam long on fent to take subs. I've seen a few people, including me, go into precipitated withdrawal trying to use subs to get off fent. I tried the Bernese Method but couldn't control the fent to do it. Ima try use Methadone for a few weeks and see how I feel quitting it. Might try to jump to subs then.

Do you have access to anything like oxycodone or hydrocodone? You can jump to them probably at higher doses, then taper a bit from them and then jump to the subs

 

[ghostandthedarknes]

For fent methadone is definitely better over bupe since you don't have to wait several days to start it and being a full agonist you'll probably get more effective relief compared to bupe, or at least that was my experience with it. Personally I think you could switch to methadone and after being stable on it for few weeks you can taper down slowly until you're completely off. Keep in mind that you need to address the reason you started using opioids in the first place or you risk falling back into addiction.

Ime methadone is liquid handcuffs. It is super hard to taper off. I felt every 1mg drop. If you go to a clinic you'll figure out quickly their goal is to keep you on methadone maintenance forever, not to get you off of drugs. Just another foot snare along the road imho

 

[space_invadaa]

How much and how long were you on the methadone? Curious as I just started going to get off fent.. wanting to make it short term as possible. Like I want to start tapering this week even lol

 

[Just a little pinprick]

I’d never use methadone to get off fent,I think it’s overkill,I just kicked a fent habit using just pregabalin,Valium and kratom and it wasn’t bad at all

If the day comes a few months from now and you’ve been on methadone during that time coming off of methadone will be nightmarish compared to coming off fentanyl,,only try methadone as a last resort and think of it as a long term commitment.

 

[Dextro .45]

Without chronic pain or a medical condition which required you to take opioid analgesic meds….Methadone could be an excellent choice.

You would be “stabilized” on a dose were you felt comfortable and free from withdrawal. Then your dose would be gradually reduced until opioid free.

Personally I’d have the doctor to the reduce your Methadone dose a single mg daily

Apparently when you’re low and about to “jump off” it becomes very uncomfortable, so you could ease up a little on the reduction, while adding Clonidine 0.1mg tablets (which are a GOD SEND) Amazingly Potent Anxiolytic and sedative (reducing Norepinephrine in the CNS/lowering blood pressure & HR)

Your doc should gradually reduce your Methadone daily dose with minimal discomfort which can be further aided with small therapeutic doses of:

Clonidine 0.1mg scored tablets (even half a tablet is effective enough 30min to bed)
Pregabalin 150mg X 2 daily or Gabapentin 300mg X 3 daily
Diazepam 5mg (near the end of cessation) 8am/2pm/10pm

That would probably be best to fully & safety be completely opioid free (physically)

Mentally is a different story man. Your brains pleasure & reward centre needs a significant amount of time to “heal” and return to responding to natural stimuli. Aerobic exercise, proper nutrition & positive social interaction with family & friends is hands down the best antidepressant and sure fire regiment to maintain proper mental health, emotional & mental well-being

Stay well

 

[NoPain91]

I just recently admitted myself to a methadone clinic in my city, two days ago to be exact, for the same thing as you. I've been struggling with a beast of a fentanyl addiction for six months & I decided I'm exhausted with the entire process of drug addiction. I was addicted to heroin for six years then found sobriety for three, then unfortunately relapsed after a bad breakup. I'm already on 40mg a day as today, my second day with the methadone clinic, is the day they began my first dose evaluation. They initially started me on 30mg a day, but upped my dose by 10mg since I was still experiencing mild withdrawal symptoms. You don't have to wait any specific amount of time, just schedule an appointment with a clinic & get your foot in the door. Methadone won't trigger a precipitated withdrawal like buprenorphine. The maximum dosage for a high opioid tolerance upon admittance is usually 30mg, then they'll dose eval you later, asking if you'd like to increase your dosage. Unlike buprenorphine, methadone will provide you withdrawal relief much sooner (within approximately 2-4 hours you will be feeling it). Now the initial effects of methadone, especially since you're coming off of fentanyl, won't get you high exactly, but you will possibly experience a light sedation on top of a relaxed sensation due to much of the fentanyl withdrawal being alleviated. For me personally, I felt so much better within a matter of three hours. Around hour four my eyelids were heavy from the sedation & I felt a mild body high that was free from any withdrawal pain. By the time I went to bed, I did feel a bit of withdrawal creeping in but I was able to sleep. When I woke up 5 hours later I was somewhat dopesick (it was much slower coming on than when in fentanyl WD), but I managed to make it to the clinic to receive my second dose (then the dose eval which bumped it up by another 10mg). As I type this, I'm having no withdrawal whatsoever & haven't used any fentanyl for 48 hours.

 

[Keif' Richards]

Hey there @N9ne

@NoPain91 gave a pretty good summary. I'll throw my hat in the ring to give you multiple viewpoints.

The clinic system is pretty standardized in the US and Canada. I can't speak for Europe and elsewhere. It's likely similar everywhere.

The clinic was designed to treat Heroin addicts. It worked just as well for the Pharma Opioid addicts decades later, as they were fairly similar to Heroin. Fentanyl is highly-variable in its potency compared to even Heroin. It's highly potent and this higher potency makes it more difficult for folks with a gas-station digital scale to make their drugs the proper strength.

I believe also that the shorter-acting nature of Fentanyl has led to a less-organized approach to self-administration. Heroin is taken 3 times per day typically which is easy for us to appropriate into our schedules as our days are often separated by our meals and the time in-between, generally eating three meals a day. When someone needs to take Fentanyl 5 or even 6 times a day to stay well, it's pretty easy to end up taking it 7 or 8 times in a given day. We also know that as far as medical science has shown, Opioid Dependence is practically infinite in how high it can go in a person.

Now the clinics have to deal with people coming in with dependencies several orders greater than they would've seen in previous generations. This makes the induction process difficult. I've talked with a few other people here on BL and in my personal life that have gone from Fentanyl to the clinic. Whereas a Heroin addict will feel the worst of withdrawal taken away by 30mg-40mg, these people are not feeling better until they get to 80mg or so. This is a combination of the higher dosage intersecting with time away from the Fentanyl. Many end up going to 120mg or higher.

If I were you I would prepare for a couple of weeks of discomfort while you have time away from the Fentanyl and are able to get to an effective dosage. The key here is that you need to stop using the Fentanyl. If you go to the clinic and start taking Methadone every day while continuing to take the Fentanyl, you're going to end up in a way worse and way more complex situation.

Most clinics will raise you by 10mg every 5 days, but they can make special dispensations if you're severely ill. When I say "severely ill" I mean really sell it to them. This is the gist. Let us know if you have any questions. You have a lot of proud veterans of the clinic system here.

 

[N9ne]

Hey there @N9ne

@NoPain91 gave a pretty good summary. I'll throw my hat in the ring to give you multiple viewpoints.

The clinic system is pretty standardized in the US and Canada. I can't speak for Europe and elsewhere. It's likely similar everywhere.

The clinic was designed to treat Heroin addicts. It worked just as well for the Pharma Opioid addicts decades later, as they were fairly similar to Heroin. Fentanyl is highly-variable in its potency compared to even Heroin. It's highly potent and this higher potency makes it more difficult for folks with a gas-station digital scale to make their drugs the proper strength.

I believe also that the shorter-acting nature of Fentanyl has led to a less-organized approach to self-administration. Heroin is taken 3 times per day typically which is easy for us to appropriate into our schedules as our days are often separated by our meals and the time in-between, generally eating three meals a day. When someone needs to take Fentanyl 5 or even 6 times a day to stay well, it's pretty easy to end up taking it 7 or 8 times in a given day. We also know that as far as medical science has shown, Opioid Dependence is practically infinite in how high it can go in a person.

Now the clinics have to deal with people coming in with dependencies several orders greater than they would've seen in previous generations. This makes the induction process difficult. I've talked with a few other people here on BL and in my personal life that have gone from Fentanyl to the clinic. Whereas a Heroin addict will feel the worst of withdrawal taken away by 30mg-40mg, these people are not feeling better until they get to 80mg or so. This is a combination of the higher dosage intersecting with time away from the Fentanyl. Many end up going to 120mg or higher.

If I were you I would prepare for a couple of weeks of discomfort while you have time away from the Fentanyl and are able to get to an effective dosage. The key here is that you need to stop using the Fentanyl. If you go to the clinic and start taking Methadone every day while continuing to take the Fentanyl, you're going to end up in a way worse and way more complex situation.

Most clinics will raise you by 10mg every 5 days, but they can make special dispensations if you're severely ill. When I say "severely ill" I mean really sell it to them. This is the gist. Let us know if you have any questions. You have a lot of proud veterans of the clinic system here.

I've been at the clinic for a month and a half now. I'm up to 95mgs. When I started I was taking about 25-30 blues a day. Now I'm still using but only 3-4 pills a day. I'm about to stop taking any blues and stay at 95mg. My clinic uses Methadose to. Not sure if that's any different.