methadone clinics how do they decide dosing?

If I go into a methadone clinic (canadian) and say I've been using various opiates., how do they decide what dose of methadone to give me? Do they make me take enough to see some bevahioral sign? Do they use a chart based on say how mych heroin I've used daily? What if I'm not sure wha amount I've been using

The only thing I know they look for is clear signs of use.. tracks and clear withdraw symptoms.. allot of them start you a little low to be safe.. good luck and enjoy the beginning of your new life.. welcome to BL and recovery!!!

I never did IV. What happens if they don't give you enough? You just have to also use your drug of choice until they give you enough methadone? Or you just go severely sick until they ramp it up?

What would be a normal starting does at a methadone clinic?

http://international.drugabuse.gov/...e-research-web-guide/part-d/question-3-what-a
from^
Canada
Patients are given a specific first dose of methadone, based on assessment outcomes, and observed for a period of time to determine reaction and toxicity. Guidelines require initial low doses (10-30 mg for first 3 days) for those at normal risk, and lower doses (10-20 mg) for those who have a higher risk for methadone toxicity, including those who use depressants, are alcohol dependent, are 60 years or older, or have respiratory problems.

How much are you using now and what do you need before you are sick?

From my personal experience, which is substantial, I could roll on 10mgs of methadone for six hours still being fully functional, even with a HUGE habit. I don't think you have much to worry about and everything to gain... allot of people really have no idea how strong methadone is if they haven't taken it before and I've seen a few junkies turn green thinking they needed all that.. i think some others can give you a hand here as well and they will

chch said:

If I go into a methadone clinic (canadian) and say I've been using various opiates., how do they decide what dose of methadone to give me? Do they make me take enough to see some bevahioral sign? Do they use a chart based on say how mych heroin I've used daily? What if I'm not sure wha amount I've been using

Click to expand...

They will take a urine sample to make sure you have actually been using opiates, they will ask you how much heroin or whatever opiate(s) you take you normally use per day, and they will start you on a relatively low dose and gradually increase it if you need more. If you're not sure how much you've been using just tell them you're not sure and are just estimating. Most people starting on methadone don't need a very high dose of methadone to alleviate withdrawals, so I wouldn't worry too much that you're going to be "severely sick" while waiting for your first dose increase. Hopefully the clinic you go to will have it so you see the doctor again the next day. You can (and should) also talk to the clinic about all your concerns and questions.

I don't know what province you live in, but in most provinces you will have to go to the pharmacy to pick up your methadone. It might vary depending on the province, but in most you go to the doctor at the clinic, get a prescription, take it to the pharmacy and drink your liquid methadone in front of the pharmacist. Although some methadone clinics do have a pharmacy in or near the clinic, so in that situation you should be able to get your first dose and presumably see the doctor again soon after to see how it has affected you. It really depends on the clinic and how they do things, there isn't really a standard country-wide protocol for starting someone on methadone aside from the things neversickanymore and I mentioned like assessing the person and starting them on a dose that is low enough to be unlikely to kill them.

Once you have started on methadone, your dose may be gradually increased every few days if you find it is not fully alleviating withdrawal symptoms, or some clinics might encourage you to increase it until you are at a typical "blocking" dose that would make it hard to feel much from a normal dose of heroin. Or some will just keep increasing it until you no longer use other opiates or complain of having cravings. But again, it really depends on the clinic and doctor. Some like to keep people on as low a dose as possible, and some like to encourage higher doses and staying on methadone for life. I think it's important that your methadone doctor considers what you want to do and what your goals are.

I think it's really important that you work on your mental addiction. Methadone is not a cure, once stabilized it merely alleviates your withdrawals, giving you a break from having to use heroin/whatever simply to not be sick, so you can work on changing your life - you still have to put in the time and effort. I strongly encourage you to take this chance work on the reasons why you use opiates in the first place, try to stay on a low dose of methadone and don't stay on it too long - it becomes harder and harder to get off it the longer you're on methadone. Of course you don't want to be forced to taper off it when you're not ready and just go straight back to using heroin, but you really don't want to end up like me and spend a decade on methadone telling yourself you'll get off it "later" and then find out how incredibly difficult methadone withdrawal is after 10 years of use. I absolutely wish I'd gotten off it a long time ago, it's had some major adverse impacts to my health from being on it for so long. I've been off it for around 5 months now and getting off it was the hardest thing I've ever done. Not trying to scare you, I just think it's important to tell people that they may want to have a plan to actively work on their addiction and the goal of getting off methadone sooner rather than later. It's so easy for people to end up on it for the rest of their lives and it's so limiting to your freedom.

Best of luck to you and sorry this was so long

^ very nice post swimmingdancer

Swimmingdancer said:

drink your liquid methadone in front of the pharmacist.

Click to expand...

Is that always true? because I've heard of people selling their methadone on the street.

I've just heard that in the shithole province that I'm in, it takes months on a waiting list to get into a methadone clinic. Maybe it my next life :/

chch.. most of the methadone sold on the street come from pain patients prescriptions which come in pill form. Do you know which clinic you want to go to or which one is near you.. call them up chch, they don't track you and are there to help.. see if they have a website.. call them up and find out the deal, if there is a waiting list, if you need a referral, get the ball rolling.. Good luck and please let us know what you find

chch said:

Is that always true? because I've heard of people selling their methadone on the street.

Click to expand...

Yes, when you first start on methadone you have to drink it at the pharmacy every day. Once you have gone a good chunk of time without using other drugs (according to your tests) your doctor may decide to allow you to get take-home privileges. It starts with 1 day a week you get to take it home, for example on Sat you might drink Sat's dose at the pharmacy and take home your dose for Sun. Eventually after years of testing clean from other drugs you might get a week's supply at a time. The most I ever got was a week's supply at a time except when I needed carries for travelling. Eventual take-homes may vary from clinic to clinic, doctor to doctor, and province to province (I'm in BC) but you definitely have to go every day for "daily witnessed ingestion" when you first begin methadone maintenance.

chch said:

I've just heard that in the shithole province that I'm in, it takes months on a waiting list to get into a methadone clinic. Maybe it my next life :/

Click to expand...

What province are you in if you don't mind sharing? Did you hear that from a reliable source (for example directly from the clinic)? Are there no options for paid clinics? They can normally get you in much faster (and their fee is not very expensive, much cheaper than being on heroin).

alberta at the moment
it has just about the worst health care system in canada besides maybe PEI
cheap I mean, and waiting lists
I hadn't thought of a paid clinic

I don't think there are as many methadone clinics in Alberta as there are in BC, and I'm not sure where in Alberta you live, but I'd look into a paid clinic as they tend to be able to get you in way faster (feel free to PM me if you need help finding one locally). Also have you considered Suboxone?

Are you doing any work on the mental side of your addiction?