Opioids Need help transitioning away from methadone

[negrogesic]

Whoops i forgot to share the link after i said "this describes some success switching from methadone to buprenorphine " :

Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method

Buprenorphine is a partial µ-opioid receptor agonist used for maintenance treatment of opioid dependence. Because of the partial agonism and high receptor affinity, it may precipitate withdrawal symptoms during induction in persons on full µ-opioid ...

www.ncbi.nlm.nih.gov

 

[SummerTaylour]

First of all, don’t panic. You’ve got time. I think I read you’ve been on methadone for 2 months. At any rate, like negrogesic said, taper down when you are ready and get set up with a sub doctor. They will help you with what you need to do.

Like I said earlier, if you’re going to chase highs using subs or methadone, it’s probably better to do it on subs.

I’m gonna start tapering down this week then, starting at 2mg. I won’t tolerate weight gain, I just won’t. That’s my biggest thing. I’ve been making myself throw up my food after I go on these sugar binges that I feel like I have zero control over, and I haven’t done that shit since high school, so I need to taper down as quickly as possible.

 

[Dr_Rolls_MD[MA]]

Whoops i forgot to share the link after i said "this describes some success switching from methadone to buprenorphine " :

Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method

Buprenorphine is a partial µ-opioid receptor agonist used for maintenance treatment of opioid dependence. Because of the partial agonism and high receptor affinity, it may precipitate withdrawal symptoms during induction in persons on full µ-opioid ...

www.ncbi.nlm.nih.gov

Thanks for sharing that. I’ve been away from here for a long time now. I never even heard of the Bernese method. Interesting!

 

[Nurse Ratched]

You are going to be fine. I just know it. The one thing you have in your favor is that it has been less than 2 months. Of course you are dependent at this point but I know you have to be very happy that it hasn't been 2 years.

The other thing you have in your favor is that buprenorphine is so much better for ones lifestyle. You get to take it in the privacy of your home and can get a months worth instead of going daily.

Plus the subs will be MUCH more safe as you won't need the fake oxys you were on. Fent is just so damn unpredictable.

You go girl.

 

[SummerTaylour]

What is the tapering process like? Does a 2 mg decrease feel like a lot, like do you have withdrawal symptoms?

 

[negrogesic]

What is the tapering process like? Does a 2 mg decrease feel like a lot, like do you have withdrawal symptoms?

The tapering process is relatively smooth, I can't remember exactly how i did it but 2mg shouldn't feel like too much.

 

[Dr_Rolls_MD[MA]]

Typically, up to 10% dose reduction shouldn’t be too noticeable. I always found going by percentage and not by milligrams is a lot more stable. So if you’re at 85mgs, then 10% is 8.5mg. I think if you went 5mgs that would be reasonable and you won’t notice much if anything. You could do that all the way to 50mgs. Then at 50mgs go to 3-4mgs at a time. That’s a decent, conservative taper.

What the clinic will probably tell you is to taper and then when you’ve gone 3-4-5 days without any withdrawal symptoms, then you can do another step of tapering. Just don’t rush it. You’ll be fine.

 

[Las Veghost grower]

The idea is to raise your tolerance to a point where it makes the use of other opioids unattractive, which reduces the desire to relapse because it's more difficult to get high. They sometimes call this the "blocking" effect of methadone but its not so much a blocking effect rather than a tolerance effect.

I personally think people should be allowed to higher doses of methadone so they don't feel the need to use something else. I mean I was on 380mg of methadone but that really isnt that much harder to get off of than say 180mg.

What don't you like about the methadone? Sure it comes on slow but I thought it was pretty enjoyable. Of course the enjoyability goes away over time but thats true of anything.

Stick with the methadone and maybe even increase the dose if 85mg isnt doing it for you. Last thing you want is to be on that street fentanyl (ie pressed pills).

Just curious is this “blocking” effect the same with bupe ? They say it blocks but isn’t it more potent then heroin mg4mg? So it’s a tolerance thing with bupe too ?

 

[negrogesic]

Just curious is this “blocking” effect the same with bupe ? They say it blocks but isn’t it more potent then heroin mg4mg? So it’s a tolerance thing with bupe too ?

Sort of, but its a bit different. Buprenorphine is very high potency and binds strongly but is a poor fit for the receptor which results in only partial activation (whereas methadone is the reverse, though still high potency technically). The result is similar, buprenorphine has a stronger grip on the receptor however.

 

[LivingOnValium]

Just curious is this “blocking” effect the same with bupe ? They say it blocks but isn’t it more potent then heroin mg4mg? So it’s a tolerance thing with bupe too ?

No it's a completely different mechanism. Buphernorphine has got a really high affinity for binding to the opioid receptors. So if you take other opioids while on bupe they just float around your bloodstream without being able to attach to the receptors because bupe already sits in there very tightly. That's the reason why there's no point in taking any opioids on top of bupe. I guess you could still take high doses of fentanyl to overpower buprenorphine (I believe this is what they do in clinical settings at hospitals etc. if one needs an emergency surgery or something similar) but that's a very dangerous thing to do. The amount needed is near to impossible to estimate and can easily lead to an overdose.

 

[Dextro .45]

When I started Methadone….it started to “block” the euphoric effects from Oxycodone at about 40-50mg after taking daily for weeks (started at 30mg at clinic)

I was on Methadone 80mg daily for years (still am) and once I banged four OC 80’s and didn’t feel sh!t ….complete waste of $160.

 

[negrogesic]

What is the tapering process like? Does a 2 mg decrease feel like a lot, like do you have withdrawal symptoms?

So what happened

 

[Addict39!]

Whoops i forgot to share the link after i said "this describes some success switching from methadone to buprenorphine " :

Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method

Buprenorphine is a partial µ-opioid receptor agonist used for maintenance treatment of opioid dependence. Because of the partial agonism and high receptor affinity, it may precipitate withdrawal symptoms during induction in persons on full µ-opioid ...

www.ncbi.nlm.nih.gov

How low of a dose of methadone do you have to be on to start the Burmese method, I have tons of subs 8mg at home but I got on a nasty fentanyl kick and had to start methadone to be able to work and get my life back on track, and help will do?

 

[negrogesic]

How low of a dose of methadone do you have to be on to start the Burmese method, I have tons of subs 8mg at home but I got on a nasty fentanyl kick and had to start methadone to be able to work and get my life back on track, and help will do?

I've never been on buprenorphine maintenance, only methadone, so I have no personal experience myself.

However it looks like 30-40mg of methadone is the optimal place to start the process.

 

[December Flower]

Why is methadone so potent though? I feel like my tolerance wasn’t even that high beforehand. Why would they want you to have such a sky high tolerance?? That freaks me out

I'm pretty sure It's so you don't feel opioids anymore. Just so you don't get any pleasure from say oxys or heroin and stay away.
Nobody is expecting any smart decisions from people in the fangs of opioids, so they rather drown you in methadone, so you can't make those decisions. There are still enough people that will shoot heroin on top of their methadone, won't feel anything from the heroin(or if anything just a little tickle maybe), and still do it over and over

That's just my theory though. I only work with addicts, I'm not one myself

 

[SummerTaylour]

I want to start tapering down, I really can’t stand being on methadone any longer. It’s making me fucking fat.

 

[Fiori di Bella]

Don’t use street Oxys. There is no quality control and Fentanyl is a probable additive. My friend gave me a 20mg Oxymorphone a few months ago and it did fuck all for me. I’m happy to stick with my 80mg of Oxy daily than to try to get street opiates.

 

[Las Veghost grower]

How low of a dose of methadone do you have to be on to start the Burmese method, I have tons of subs 8mg at home but I got on a nasty fentanyl kick and had to start methadone to be able to work and get my life back on track, and help will do?

Man I use to have a bunch of subs, what I wouldn’t give for a strip right now…

 

[StickyStyrofomeCup]

Really hope someone can help me with this ASAP

Alright I’ll try make it short

I have an opioid and benzodiazepine addiction. I was on, 2-8mg Clonazepam or Xanax, 25-100mg Promethezine and 30-80mg OxyCodone. Or about 250mg DHC if I couldn’t find OxyCodone.

I started getting sick if I couldn’t find any opioids. So I started buying bottles Methadone and taking 20-30 mg Methadone when I had no Oxy or DHC.

The methadone would give me a similar feeling but a lot more mild and I’ve never enjoyed it.

Now when I get my Targin and OxyNorm each fortnight

It doesn’t work the same anymore and I can’t figure out why?

Could you the 20-30mg Methadone I’ve been using when I run out really be causing my tolerance to shoot up?

Why won’t the Targin and OxyNorm work like it used to? Even at doses of 80mg OxyCodone it’s just not the same

 

[Sprice0524]

You'll need a lot of oxycodone to cover 85mg of methadone. Hundreds of milligrams.

Its never advisable to just stop taking methadone. Why the rush to stop?

One should always taper down first when stopping or switching from methadone to another opioid.

Perhaps its possible if you've only been on 85mg/day but you'll potentially need an amount of oxycodone that you probably don't have access to.

You are talking about real pharmaceutical grade oxycodone, not those pressed blue/green street M30 pills, correct?

Yeah, big difference between the pressed small blue pills which are fentanyl. But if she was stabilizing on methadone, she would be doing way worse and wanting more done, since since fentanyl is hard to target the Delta receptor I found out today from my doc, who also works in internal medicine at the hospital while seeing patients part time at my bupe clinic. Just a small anecdote on long-term use of those blue pills known as blues here in Portland Oregon: at the hospital where she works they admitted a couple in their twenties who came into the emergency room not even able to walk and the boy had paralysis on the left side of his body due to neurological damage from 8 months or so of daily smoking of the blues. They were not in withdrawal she said although subsequently to being admitted to the hospital for 30 days they stabilize them on methadone but the symptoms that they exhibited upon triage were that of a stroke and we're talking about 20-year-olds here guys. So have your fun on the weekends if you choose because building up tolerance to fentanyl takes habitual use and that in excess she told me because I was afraid I was going through fentanyl withdrawal having dabbled a couple times a week using the foil and a tooter. But the more I talked about it whether it was withdrawals from the green and blue knockoff flu alprazolam and whatever else they put in the mix bars sold down town. I ordered some diazepam from my guy in the US that are amongst the best from Galeinka 10 mg Bensedin to stave off the impending severe withdrawal symptoms even after a few days of use of the Street bars which it turns out from the vendor to be for the green ones 3 and 1/2 mg flu and a half milligram clon, which as anyone who has a clue are research chemicals easily purchased off the internet and just need the binders and the press to crank out your product and sell them on the street to kids as Xanax bars which are actually 2 mg of alprazolam and a person with low to little tolerance can get a good experience off of a half of one of those.

As to your methadone quandary, talk to the doctor and people who know what they're talking about and research the half-life of methadone versus the half life of oxycodone if you are actually getting it from a source that is in blister packs or the pharmacy from a doctor. I think oxycodone is pretty short and is between I want to say 9 and 15 hours, but it's been a while since I've been down that rabbit hole since oxycodone doesn't do it for me. Methadone on the other hand if you're taking it for pain management since you're talking about switching back to oxycodone and I'm imagining is isn't a recreational thing since you're at the methadone clinic, is the granddaddy Big Papa of opioid medication and in my opinion it is the number one choice if you want to stay comfortable once you dial in your dose. You're the one paying the clinic remember that. They can't dictate to you unless you give them a dirty test and it's part of their policy to up your dose which I've seen happen in clinics I've been to. I would suggest going down 5 to 10 mg a week. As the half-life is so long you are barely going to notice it if at all. And you can always ask your primary care or the methadone doctor for clonidine and depending on the doctor or if you have an outside doctor like I did ask for diazepam or even better clonazepam as it will help with the titration. Remember you allowed them to take you up to 85 mg which is a real nasty kick that will last you 60 days Plus and take you a good 6 months depending on how long you've been on it to get back to semi-normal energy levels even with vitamins and amino acids and exercise. But I am more concerned about the part where you say you want to switch back to oxycodone. Why? pain management, or is that just your drug of choice in your addiction?