* Methadone Maintenance Therapy (MMT) MEGATHREAD *

We have decided to merge a number of existing threads discussing Methadone Maintenance Therapy (MMT) so we now have all relevant MMT-related discussion in the one megathread. This thread is for providing advice and support for people currently undergoing MMT or thinking about starting MMT, and for answering any questions relating to MMT.
Please adhere to the usual TDS guidelines and the one golden rule of no triggering content allowed.
-n3ophy7e
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I live in the UK and am enrolled in one of the well-established methadone programmes. I have given three month's worth of clean saliva drug test samples, attended all appointments (except for one which I missed) and as of 15/04/09 (Wednesday the week after next) I will only have to attend the local pharmacy to collect my methadone on site three times per week; I will be provided with methadone to take home for the other four days unsupervised.

The other day my keyworker who I have been seeing every week up until now (I now will start seeing her twice per week) has been trying to put me under pressure to come off methadone. She keeps asking me to justify why I feel the need to stay on methadone and this is both worrying and angering me.

If things are going so well, why is it so important for me to come off? I enjoy the stability that methadone brings to my life. For me it completely banishes all cravings for opiates and keeps me 'clean' (i.e. free from illicit opiates). Now that I am using a fixed, controlled dose every day there are no more overdoses. When I was using PPT overdosing was becoming a relatively common occurance and I have damaged my body as a consequence.

Is it right for them to want to take me off methadone when I'm doing so well if I'm perfectly happy to continue taking it as I am at the moment? What should I do? Can anyone give their opiniona on the situation (good or bad ones welcome)? I have weighed the advantages of being on methadone permanently against the obvious disadvantages (which people blow right out of proportion IMHO) and have decided I would prefer to be on methadone permanently if I can help it.

i hate to state the obvious but, the point of methadone is to stop using other op's, and prevent w/d's, and then begin decreasing your methadone dose until you are clean and free from the addiction. from what you've said everything seems to be going as it should.

i had a friend whos doctor wanted to up his dose, that is ass backwards to me and a bit crooked sounding, keeping him addicted and profiting from it, just like any street dealer.

if you want to be opiate free you need to start lessening your dose until you are, and be grateful you had the chance to do so under supervision, and not in jail, or cold turkey at home. maybe you should try seeing a therapist if you havent or dont already to get to the root of the emotional craving you have for opiates.

i hope this works out for you, keep us posted.

^ Maybe this sounds stupid, but who says you have to begin decreasing your methadone dose until you are free of this drug? I was under the impression that it is an option or right for people to be able to stay on the methadone for as long as they feel is necessary (for however long that might be). I know people that have been on methadone for years (on the NHS where profiting from patients is not a priority like it is in the US) even though they haven't relapsed. How is this so?

I think it is justified in my circustances because without the methadone I am prone to suffering from PAWS, which I refuse to deal with.

Fuck fuck fuck why do they have to make me come off of it? I'm sure from past experience it's going to fuck things up just when I'm doing so well. If it aint broke don't fix it! I'll just get so depressed, lethargic etc. that I will start using again very quickly and it will be a disaster. I cannot financially afford to get addicted again (who can though?). The last time I got addicted I used a large amount of savings I had so I didn't have to break the law to obtain funds for my habit, but things could be different the next time round. I really am very worried about this.

Artificial Emotion said:

^ Maybe this sounds stupid, but who says you have to begin decreasing your methadone dose until you are free of this drug? I was under the impression that it is an option or right for people to be able to stay on the methadone for as long as they feel is necessary (for however long that might be). I know people that have been on methadone for years (on the NHS where profiting from patients is not a priority like it is in the US) even though they haven't relapsed. How is this so?

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It really depends on the philosophy of the clinic and the empathy of the physician.

The way the opioid maintenance programs were sold to governments of the world by the pharmaceutical companies was that their medication would give addicts some stability that would keep them from resorting to crime, and because the medication could be accurately measured, it would be used to taper patients off of opioids completely.

That is how it has always been. More recently though, studies and experienced doctors have seen the advantages of keeping certain patients in maintenance long-term (a life-time in some cases).

Despite that there is no evidence of any severe health hazards associated with long-term use of methadone or buprenorphine, the fact is that there is still a stigma attached to the idea of giving opioids to opioid addicts for rehabilitation. A lot of doctors try to push patients through the program as quickly as possible, not taking individual circumstances into consideration.

You have to take a stand for yourself and play the game. My Suboxone doctor, while being very sympathetic to my situation, would rather his patients get completely clean. He has however told me that he believes that he has patients who need to be on medication long-term. He is a doctor, and few doctors like to be told what is best to do by their patients, so when he suggests I start tapering down, I go ahead with it. I'll go down from 4mg to 2mg for a month, and at my next appointment I will tell him it isn't working on. Long story short, I'm back up to 4mg now.

Tell them how you feel, and try to find another clinic in the meantime, in case they do drop you.

Because methadone is supposed to be a way to taper off of drugs, and from your recent threads I really think you need a break. Perhaps a way to stand back and reflect can do you some good.

Lysis said:

I really think you need a break.

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I agree. After what Shambles said to me in a PM conversation and this thread I really have to evaluate what I am going to do in the future.

^ Well, take into account that we are outsiders evaluating your posts. Just because we think you need a break doesn't mean you should overthink our thoughts. I think it's telling (to you) that more than just me (who is a true cynic) thinks that you need a break. Your posts are disturbing and come across as someone who really needs help. It doesn't mean you are a bad person, but if your posts are anything indicative of how you really think, I truly think you should consider seeking help.

If you don't want to come off then keep your ground and just say NO. It's your decision and they can't take you off w/o your consent, right? Then fuck what they say and tell them you'll come off when you are ready, which might never happen. And tell them what you said here in your original post.

I'm in a similar situation but with subs. My husband stopped subs a few months ago and is always on my case to stop. I went down to 1mg per day but that's it. I just tell him I'm not stopping now, not gonna live in pain and I'll stop when I'm ready, which I don't know when that will be.

Lysis said:

^ Well, take into account that we are outsiders evaluating your posts. Just because we think you need a break doesn't mean you should overthink our thoughts. I think it's telling (to you) that more than just me (who is a true cynic) thinks that you need a break. Your posts are disturbing and come across as someone who really needs help. It doesn't mean you are a bad person, but if your posts are anything indicative of how you really think, I truly think you should consider seeking help.

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Thanks for your genuine concern - I'm touched by your compassion.

Is it right for them to want to take me off methadone when I'm doing so well if I'm perfectly happy to continue taking it as I am at the moment? What should I do? Can anyone give their opiniona on the situation (good or bad ones welcome)? I have weighed the advantages of being on methadone permanently against the obvious disadvantages (which people blow right out of proportion IMHO) and have decided I would prefer to be on methadone permanently if I can help it.

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Should be your choice. If it's not broken don't fix it type thing.

On the otherhand wouldn't it be nice to be free of 'chemical handcuffs' for good? I am also an addict who has so far managed to survive without having to go on Methadone.

That may change sooner than I'd like to admit but I'm not sure I can manage without some opiate of somekind in my system to make it run properly. I've had many attempts at sobriety without success but I'm going to give it another shot.

may be your counselor knows how quickly methadone is addicting, you should try and get off the stuff as soon as you are stable, it is a very strong drug and extremly hard to detox off of i was on the mmt program here in the states for 7 years and tried many times to detox off without success. I finally found a Dr who was willing to give me the way off the crap it was with nutrition~ he explained what methadone does to the brain and the body then told me what amino acids and vitamins and minerals to take and it worked, it was not easy by any means but i went from 130mgs to 0 in 2 months with just a small amount of withdrawal symtoms. Look up Dr david arenson and read what he posted he will also email you back if you have a question, he was an addict for 18 years so he knows what hes talking about.

A lot of the methadone program was never designed for people to be tappered off. They even give out little pamphlets at my clinic explaining this and how to explain it to other people.

Artificial Emotion said:

The other day my keyworker who I have been seeing every week up until now (I now will start seeing her twice per week) has been trying to put me under pressure to come off methadone. She keeps asking me to justify why I feel the need to stay on methadone and this is both worrying and angering me.

If things are going so well, why is it so important for me to come off? I enjoy the stability that methadone brings to my life. For me it completely banishes all cravings for opiates and keeps me 'clean' (i.e. free from illicit opiates). Now that I am using a fixed, controlled dose every day there are no more overdoses. When I was using PPT overdosing was becoming a relatively common occurance and I have damaged my body as a consequence.

Is it right for them to want to take me off methadone when I'm doing so well if I'm perfectly happy to continue taking it as I am at the moment? What should I do? Can anyone give their opinion on the situation (good or bad ones welcome)? I have weighed the advantages of being on methadone permanently against the obvious disadvantages (which people blow right out of proportion IMHO) and have decided I would prefer to be on methadone permanently if I can help it.

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AE: opiates never got me and I've told you why (extreme nausea). You have a right to appropriate treatment, and you also know how loose and open to interpretation that can be to a third party.

It may or may not be realistic to have absolute abstinence from opiates in a person who is addicted to opiates. Similar could be applied to any addict - keep them on the stuff the rest of their life if they promise to remain placid?! That'd be a bloody miracle, wouldn't it? It would solve much of crime and many emergency room calls.

I give only a layperson's opinion, as I am not a medical doctor nor is your care entrusted to me as any more than a friend and listening ear. I think the nastiness and pain of your addiction are outweighing the benefits of staying on MMT. Every time you take that dose to keep you 'normal' the good about true peace will elude you that much further.

I urge you very strongly to seek peace and happiness in your life. If you wanted peace and tranquility as much as you want opiates at present, you'd be on a very firm path that no addiction could possibly shake. Find your foundation, mate. If you want happiness, then strive for happiness outside of a clinic. Create and build your own structure. You'll no doubt be surprised and proud at your efforts once you make those efforts.

Does anyone travel a long distance to get methadone each day?

I have been unsuccessfully trying to kick heroin for far too long. I have tried Suboxone, with limited success. When I was in one particular detox, I was given methadone, and the withdrawals weren't that bad, much more manageable than when I used Suboxone in the same way (or Darvocet, ugh, even worse). So I want to get on methadone again. However, after doing some research, I found out that the methadone clinics in my area (county) only give methadone to individuals who have been in AT LEAST one year of documented treatment of some sort. Since my earliest treatment was about 9 months ago, I do not make the cut. This is an absurd rule for so many reasons (I ranted about it in another post), but unfortunately, I can't get around it.

So with that in mind, I found out that if I want methadone, the nearest hospital/clinic/etc. that will offer the drug to me (without that stupid rule), is about an hour and 15 minutes away by car (up to 2 hours in shitty traffic). So at the very least, I will be looking at a two hour round trip each morning to get the methadone. This is an incredible hassle, but I want to kick this addiction worse than you can possibly imagine. My addiction negatively impacts so many parts of my life, it is absurd. I have gotten to the point where I will do whatever it takes to recover. Two hours out of my day to possibly save my life seems worth it.

Does anyone else hear share my struggle and have to travel a long distance to obtain methadone each day? I read a few stories online about individuals who have to travel HUNDREDS of miles each day across state lines to get their methadone, because the state they live in doesn't allow methadone dispensaries. This makes my measly two hour round trip seem like nothing; I will suck it up and do what I need to do.

read tchort's thread on methadone laws. I think there is a law that says if you live in a rural area or a place where travel makes it almost impossible, a doctor can treat you.

I used to have a good 80-100mg Oxycodone habit. One day i decided i couldn't handle cold turkey so i shot over to the methadone clinic. They signed me up for a 21 day detox, but i only showed up for 10 days. So i was at about 20mg on day 10, on day 11 i felt great! I was pretty surprised, but i beat the hardest part of the withdrawals with methadone and then walked off it before i became hooked. Probably not yer story, but i don't think 9mg will be THAT bad of withdrawals. Not soooo sure tho
unfortunately i few month later i relapsed and boom! same story over and over and over.
Finally i sought help in NA and they helped me with real life strategies that helped me cope.
happy to be sober now!!!
See you on the sober side of the fence soon buddy!
If you have a really hard time kicking the methadone, try signing for a suboxone treatment!

Yep I have been on methadone at an MMT clinic and I discontinued that methadone (against my wishes). It was a bitch to do, to say the very least. Actually I stopped methadone twice, and both times I eventually went back to using heroin. This last time I quit, I got back into a clinic after about a months worth of doing H, buying methadone from the street, and being in w/d. It was a really bad, uncomfortable situation. Like I said I'm back on MMT here in Seattle at THS. Good luck!

thelung- try suboxone man, but drop it asap so as to not get addicted to it. You MUST establish a support system once its gone. Try NA!!! Sounds corny but its a life saver man, I'm only 23 and its helped me more than methadone or suboxone.

Best way is to use buprenorphine for a few days BEFORE you get addicted to that .

DXM can also help a million IMHO.
plus any other sedatives to stop the heebie jeebies,

if have a good doc ask for some valium or some xanax cause your gonna find it hard to sleep

or things like like loperamide, kava, valerian, diphenhydramine.


A good anti depressant to help you sleep like mirtazapine is good to. Coming off any dose of methadone no matter how small is gonna give you you restless legs and tosssing and turning in your sleep if you get any in the first few days .


PM Me if youn want any more info cause im doing the same thing right now for the second time.

^^^ word.
I went to GNC and got some sleeping pills called 'tranquil sleep' containing 5-htp, melatonin and something i else I've forgotten. they worked great tho, i was surprised.