thanks Loulou. Actually, I'm a lawyer and I'm investigating the death of a person who was using 380mg of methadone daily. She had been given 4mg of Ativan the day she died, after dosing with the methadone. Her drug history is not entirely known, but she had been getting the methadone legally for about five years. At the hospital, she went into respiratory depression and her heart failed. This is a sad loss for a family. I promised them that I would investigate, but I need to understand more from methadone users. Thank you, folks. Any info will be used to help prevent future losses of this kind.
This is very sad. My condolences to her family. I have something to say on the matter that may or may not help you out.
I've been on methadone now for close to 16 months and for about 6 months now I've been taking 250mg daily along with 0.5mg of Xanax 3x daily (I've been on the Xanax for close to 6 years).
You'd think that by now I'd be tolerant to both the benzo and the methadone but I still catch myself falling asleep at times. Also, I've been told that for the past year or so, I now snore (sometimes loudly) when I sleep. I find this disturbing because ever since I've had my tonsils and nasal polyps surgically removed, I was told I don't snore anymore.
My point being is that I totally agree with what others have said in this thread (because I seem to be experiencing it first hand) that methadone and benzos don't mix well at all. Even if you're tolerant to both, when you mix them, they seem to potentiate each other in terms of sedation and respiratory depression in a way possibly not usually seen with other opiates/opioids.
As a result of what I've experienced, I've begun to taper (lower) my methadone dosage by a small amount each week or bi-weekly. That's how scared I am of this.
In my opinion
(I'm not a doctor), this poor girl died because of the extremely high dosage of both medications combined. I believe she was at a dosage range where the therapeutic index is so narrow (the therapeutic dose is very close to the toxic dose - due in part to the extremely high dosages of both (adverse side effects are more pronounced), but also due to the synergistic effect I spoke of) that chances are that a large majority of
tolerant patients would not survive that combination at those dosages.
Methadone is also known to affect the heart directly (it causes lengthened QT intervals which for some patients can be dangerous). This is why (clinics here anyways) require that patients have an ECG done at the start of treatment with methadone and also every additional 100mg of methadone prescribed to that patient (i.e. 2nd ECG if patient begins to take more than 100mg daily; 3rd ECG if that patient is now on 200mg daily; 4th ECG at 300mg, etc.).
Again, it's always sad around here (since we focus on harm reduction when using drugs at BlueLight) when someone dies from drug use and therefore I'd like to extend my sympathies to the departed's family. May she rest in peace.