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Thread: Conservatives question methadone maintenance (UK)

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    #26
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    I think you mighta confused OD's with deaths Dex. In all the statistics i have EVER read about the heroin maintenance programs, there has not been one single death reported. The overdose figure was like 11% i believe IIRC, and they were all dealt with quickly and safely becuz of the nurses and EMTs always near by while the users did their shots, and all the OD's was able to avoid death.

    I cant speak for users who died outside of the program while at home after usin EXTRA dope on top of their monitored doses, becuz Im sure some of them kicked the bucket but Im sayin as far as ppl that was stayin in line with the program, I dont remember hearin of any deaths of people who were followin the rules as prescribed. I could definately be wrong but that is the memory that I got from all the readin I done about the subject so far.

    Anyways, if any of yall want to discuss the use of methadone vs. suboxone come join our thread in Other Drugs
     

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    #27
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    Quote Originally Posted by DexterMeth View Post
    You see, the main problem (aside from this subject being from the dark ages) is that most people simply refuse to accept personal responsibility for anything. Fucking retards.
    I agree. Tax dollars shouldn't be put towards this. Get clean on your own and pay your own way. Should taxpayers really suffer because someone made some bad decisions?
     

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    #28
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    Dextermeth,

    I'm not doubting you but I found one thing you said strange. Is it really true that 10% or above overdose while on heroin maintenance? I mean if they are on this, they are using pure pharm grade heroin and injecting it in a 'clean' room so to speak, correct? In a safe environment? Or do these places just give the heroin to addicts and let them use wherever they want?

    I know in Norway for example, they have 'clean' rooms where addicts only need bring their heroin and have access to syringes,etc.. and inject in a safe room and there have been no overdoses in these rooms and such.
     

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    #29
    Quote Originally Posted by DexterMeth View Post
    You see, the main problem (aside from this subject being from the dark ages) is that most people simply refuse to accept personal responsibility for anything. Fucking retards.
    I'm doubtful of this. Personal responsibility is associated with free will - and addiction could be said to be the loss of free will. Besides there are many other illnesses, accidents etc that in some way people bring on themselves.
     

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    #30
    Quote Originally Posted by shpongled1234 View Post
    I would like to hear about using krantom to taper from Opiates! Please post it!
    what is that? i am a heavy methadone user and wouldlove to get offthe stuff,my tolerance just keeps on going up and upl i
     

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    #31
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    First of all , this aint the place to post that info anyways, but second of all, no heavy long term opiate user will be detoxing with kratom. Its a pretty weak plant compound that is a irregular kind of opiate , not a full agonist , it is somethin that ppl who dont got much of a habit might benefit from, but if you got any type of addiction to somethin like heroin or methadone, I dont think you should waste your time tryna mess with that shit. You would have to eat huuuuuuuuge amounts of powder, Im talkin like measuring cups full and i doubt even then it would do anything for you. I dont know give it a try if you want but u need to discuss that shit in the right forum, it dont belong in this article, Im just letting u know.
     

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    #32
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    Quote Originally Posted by semigenius View Post
    I agree. Tax dollars shouldn't be put towards this. Get clean on your own and pay your own way. Should taxpayers really suffer because someone made some bad decisions?
    Taxpayers pay more money when people with drug problems commit crimes and get locked up and put a strain on the system. Anyways, you could say the same arguement for welfare and all forms of public assistance, should they get rid of that too? No...its in the best interest of the government and the community to have programs like this that offers aid, you do realize that in the US at least, it aint like its some kind of government handout program....You can get methadone "from the government" thru Medicaid at clinics that take insurance and many clinics accepts medicaid. thats a government program but it aint like your taxes is directly gettin put aside specifically to buy methadone for people. Anyways you would be payin much more taxes to cover that junkie in jail. Is the cost of over $35,000 a year per inmate and thats only at the cheap prisons better than payin like $3,000 a year per client at the clinic (And thats assuming its one of them expensive 50 dollar a week clinics--the actual cost of methadone is mad cheap, my pills is about $17 every 2 weeks so its like $35 a month which would be under 500 a year. If you so worried about payin your money and taxes on somebody "who made a bad decision" and its a whole lot more complex than that, I think its only the logical thing to support care and treatment svc's for addicts to get to them before they get locked up than waste at least ten times that amount to keep em locked up. Its simple logic yo, u want to look at this emotionaly with all that "oh why should i have to pay for a bad decision" shit, or u want to look at it in the simple straight forward & logical way which clearly shows u which one is better for your wallet?
     

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    #33
    Quote Originally Posted by DexterMeth View Post
    Do you honestly think that heroin use is safer than methadone use, keeping in mind 100% of the people on heroin maintinance inject it? The few places there is heroin maintinance (or where it is being studied for possible normalcy I believe), the amount of people that die from overdoses in the program is somewhere around 10% or above I believe. 10% of people on methadone do not die from it. If they did, we'd all be on buprenorphine.

    I was thinking that the government would administer an oral opiate.....heroin isnt that bioavailable, but I assume that if you get the dosage right it could work.....I guess that would be problematic if you prescribe an oral dose that is high enough to match their IV dose...that is definitely not a good idea outside of clinical supervision.

    Do you have sources to support the claim that 10% of people who are on that maintenance program die? I am not calling you a liar, but I would like to confirm that. It seems high.....why would a higher % die from clinical IV use than from street IV use?...unless the clinic sucked and they didnt know what they were doing.


    I have heard from some users that the WDs can be harsher and longer lasting on Methadone than on heroin, and that it requires an even smaller reduction in dosage to get WD effects compared to heroin, and it still doesnt give you as much euphoria despite comparable if not worse addictive potential...I see that as a major drawback...but I have never been on a methadone program, so I could be way off base and not know it. I am parroting what others who I trust have told me.


    Are there any other opiods or opiates that stop the WDs?
     

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    #34
    Quote Originally Posted by lacey k View Post
    I think you mighta confused OD's with deaths Dex. In all the statistics i have EVER read about the heroin maintenance programs, there has not been one single death reported. The overdose figure was like 11% i believe IIRC, and they were all dealt with quickly and safely becuz of the nurses and EMTs always near by while the users did their shots, and all the OD's was able to avoid death.

    I cant speak for users who died outside of the program while at home after usin EXTRA dope on top of their monitored doses, becuz Im sure some of them kicked the bucket but Im sayin as far as ppl that was stayin in line with the program, I dont remember hearin of any deaths of people who were followin the rules as prescribed. I could definately be wrong but that is the memory that I got from all the readin I done about the subject so far.

    Anyways, if any of yall want to discuss the use of methadone vs. suboxone come join our thread in Other Drugs

    Yeah, this sounds about right. That is part of why I think that a heroin based program can be effective when administered in a closed clinical setting....though I can see the advantages of Methadone for outpatient recovery, if it has stronger affinity yet weaker effects.....Does Methadone help prevent overdose because of this or make it more likely?


    Sorry, I wont threadjack anymore.


    Anyway, I strongly support supporting these programs, even with Methadone...though I would support a heroin based program at least for those who are under close supervision as inpatient patients.
     

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    #35
    Quote Originally Posted by lacey k View Post
    First of all , this aint the place to post that info anyways, but second of all, no heavy long term opiate user will be detoxing with kratom. Its a pretty weak plant compound that is a irregular kind of opiate , not a full agonist , it is somethin that ppl who dont got much of a habit might benefit from, but if you got any type of addiction to somethin like heroin or methadone, I dont think you should waste your time tryna mess with that shit. You would have to eat huuuuuuuuge amounts of powder, Im talkin like measuring cups full and i doubt even then it would do anything for you. I dont know give it a try if you want but u need to discuss that shit in the right forum, it dont belong in this article, Im just letting u know.
    Kratom is actually more powerful than heroin "by weight", or at least the pure active chemicals are...You can get 96% Kratom (alkaloids?) from oversees pretty easily if you buy in bulk....I have no idea how well it would work at high doses for long term high dose addictions, but I do know that there is a much smaller amount of cross tolerance than you would expect.....it might be worth researching anyway.
     

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    #36
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    ^^way back a few years ago after I had quit dope for a lil while and was just startin to do it more again I was barely even havin a habit, I mean I would be able to make a bundle last 2 days. like some serious, baby habit shit, and I tried usin kratom to detox and it kinda helped at real high doses, Im talkin like 6 tablespoons of that shit at a time to dose anything that would do shit at all. It was barely somethin that was effective at a extremely low habit, so there aint no way that it would even begin to touch somebody with a actual habit. I aint sayin it aint worth lookin at but that you would be downing like measuring cups full of powder and most likely your tolerance would be too high for it to work. even if it aint got much of a cross tolerance I feel like the more subtle highs that ppl who aint regular users get alot out of, are usually completely useless to more experienced fulltime users so IDK. i would be interested to see somebody try tho but I was jus speakin frmo my experience which was that it wasnt too strong at all on a extremely barely-there habit so I got to be realistic and doubt that it would be worth tryin for a regular solid habit, but who knows like i said..It would be interestin to see somebody try .
     

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    #37
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    Lacey is very right.

    Methadone is supplied in a standardized by pharmaceutical companies. 70 mg will be 70 mg every time.

    Kratom is not at all standardized. Some vendors claim to sell "standardized" extract, but there are no regulations on it. So you're stuck with leaf powder which may or may not do something depending on the batch and whatnot.

    Sounds like a great detox idea.
     

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    #38
    One capsule of pure Kratom Alkaloid is probably like 10 measuring cups full of Kratom....I may be exaggerating a bit, but its actually some extremely potent stuff 'by weight'.

    Crude Kratom herb might not be good for anything beyond a mild pill addiction, but I think that a concentrated extract.....not like a x15 extract, but like pure alkaloids made in a lab....It might show promise. You would just have to dose pretty high, and using crude herbs wont cut it.


    This is not a 'definitive source' but Wikipedia says.

    Dry kratom leaf contains roughly 0.25% mitragynine. A typical dose ranges from 15 mg to 65 mg.
    So taking 4 1000mg capsules would be 268x a threshold dose in an opiate naive person.....probably would do SOMETHING in an heroin user, wouldnt you think?


    You would have to take 400x as much leaf to = what you would be getting in a capsule of pure alkaloids.....but I think we should be aiming for full spectrum rather than single chemical.
    Last edited by Sentience; 07-05-2010 at 12:14.
     

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    #39
    Bluelighter flacky's Avatar
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    Plants never have a consistent alkaloid content. That's why the typical dose ranges from 15 mg to 65 mg. That's a horrible margin.

    You also have no guarantee that what you're getting from any of these "ethnobotanical vendors" is what they say it is.

    Kratom's a joke. Might be good for when you're sick one day, but in terms of leading a functional life, forget it.
     

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    #40
    What about a pharmaceutical grade extract, or standardized full spectrum concentrate produced by a lab?

    You understand that I was NOT talking about using crude herb to treat patients, right?
     

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    #41
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    That's the problem. There is no pharma grade extract of kratom. Anyone telling you that they have some "standardized full spectrum concentrate" is only as good as their word that anyone can post on the internet.
     

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    #42
    I was talking about possibilities rather than encouraging people to buy random stuff off the internet and hope that it helps.

    I was suggesting that it would be a worth while field of study for chemists and medical researchers.

    However, I have seen chem labs selling 40% pure alkaloids, supposedly.....In my opinion that is no more or less credible than buying RCs from the same merchant sites.
     

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    #43
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    The difference between "possibilities" and "realities" is that only one is actually useful. Everyone knows that kratom has great possibilities. Until the actual research is done and it's actually available as a pharmaceutical product, it will remain useless. Your argument is that kratom is useful for opiate maintenance and detox. Therefore, your argument is wrong. QED

    Also, your argument about RC's, while valid, is irrelevant with regard to your argument.
     

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    #44
    Thats kind of a negative attitude. All I said was is "that it might be worth researching", and I was clearly talking about the pure or concentrated alkaloids. Talking about using the whole plant for high level IV heroin addition is a 'straw man' because it did not address my actual comment. Also, I didnt come out and say 'Hey everyone, our problems are solved, pharmaceutical grade Kratom alkaloids are available to everyone for cheap and the research is is completed!'. I didnt say anything of the sort. All I said is that its worth researching, and I mentioned that the alkaloids ARE more potent by weight and active orally if you extract them.

    First of all, your "worthless" claim rests on the assumptions that alkaloid concentrates are unavailable and that there is no data to support its use.....both claims are false. There is a rich history in east Asia of people using Kratom to fight off Opium WDs.....Its a lot cheaper there. Its a leaf that grows in large quantities on trees and anyone can afford tons of it. Also, the concentrates are in fact available right now.

    You make a semi-valid point in that there is little standardized testing for many of these products....though some claim third party testing which is probably possible to verify.

    If everyone had the attitude that possibilities are worthless we wouldnt have much progress. I was just saying its worth while to research....however, you CAN get potent concentrates right now if the levels found in bulk herb are not doing it for you....I would test the waters though, and I think research should be done before this become a treatment.

    Lighten up. I dont see why this should be an argument.
     

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    #45
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    Although you may have not explicitly stated that kratom is better than methadone treatment, the weight of the full body of your arguments is conducive to that conclusion, and that is thus what you are inherently standing by.

    Also, you clearly don't know what a straw man argument is and I suggest that you look it up. Actually, at this point, my eyes are darting to your second paragraph and I think that you know very well what I'm about to say and I'm going to cease repeating myself and wasting space on this board.

    This thread is about the position that methadone maintenance plays in improving social conditions. If you have something to add to that, feel free. I don't so I'm going to stop putting up the same arguments to your unfounded ideas. If you really want to keep it up, PM me and we can do this all day, but, once again, I'm not going to waste space.
     

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    #46
    I am sorry for going off topic, but I was certainly NOT suggesting that Kratom was superior to Methadone, especially bulk herb kratom for high dose IV addicts. I suggested nothing of the sort. The data just isnt in. We need a clinical trial before we can determine that, based on a pharmaceutical grade extract.

    When you attack a position that is not the position of the person you are responding to, that is a straw man. Perhaps you imagined that I held a position which I do not actually hold, so in your mind it was not a deliberate straw man. However, I did not suggest that Kratom was superior to Methadone in raw or extracted form. It was just a random thought in response to somebody stating how 'weak' kratom is....well, its actually quite potent, a lot stronger than heroin orally and certainly active in oral doses small enough to fit into a tiny white tablet.

    I feel like you are projecting and that maybe you are irritated because I prefer heroin based inpatient programs to Methadone based ones. I dont think that out patient heroin programs would work out so well, because it would just end up supplementing a habit rather than helping somebody tapper off, while the Methadone is actually effective for discouraging that....so maybe Methadone the superior outpatient drug for addicts who were seriously addicted to high doses, but the drawback is that its actually even harder to tapper a Methadone dosage than it is to tapper a heroin dosage, which is why I think that just using heroin for most of the inpatient portion of a rehab program might be preferable......then I had a completely random thought in response to the 'potency' of Kratom which is active at just 15mg, but I was certainly not saying that Kratom therapy makes methadone obsolete.....All I was saying is that its worth researching as the active chemicals are in fact effective at doses small enough to fit into a capsule...I think it deserves a clinical trial. Thats it.



    This was obviously a misunderstanding, so maybe we can move on.
     

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    #47
    However, I see your point above...if you are the kind of person who keeps going back to heroin after detox, then maybe a life long methadone prescription is the only thing that will keep you employable and well.

    If you actually want to kick your habit entirely and live a sober lifestyle, or a non opiate addicted lifestyle where you can still party on other drugs in moderation but not be a slave to chemical dependency....Methadone might not be the right choice. Detoxing on Methadone is a slow and painful process. Detoxing with heroin or buprenorphine us faster and potentially less painful.....but yeah, nothing is to stop you from relapsing once you are sober, so if you dont think you have the will power to stay clean then a lifetime supply of Methadone will leave you more functional than a heroin addiction will.
     

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    #48
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    ^ I've never detoxed or been on methadone because I've never had a habit bigger than once a week. You just said things which didn't make sense and I pointed that out. As I said, if you have a standing disagreement with me then you can PM me. I'm not going to respond to arguments here and waste space.
     

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    #49
    I think you had some faulty assumptions about my position and what I was suggesting. I dont have any serious disagreement with your position, I just dont think you addressed my actual positions.

    I think its fine if you dont want to respond, but choosing not to respond means not needing to have the last word and just walking away.....how often do you hear people trying to get one last jab in before saying 'Im done here'....but 10 posts later...



    Methadone is an important drug to a lot of users.
    Newer drugs have many advantages in that detox can happen faster.
    Heroin based detox and Sub are alternative options, with Sub probably being safer but not for everyone.
    Kratom isnt even a player right now, except for low level pill addictions, but its worth researching in its pure extracted form because it is potent enough to put in small pills.
    All forms of drug maintenance and detox programs should continue to get funding or have their funding increased.
    We also need more safe houses and needle exchange programs.
    Methadone is perhaps a preferred option for people who cant seem to stay clean past detox....however, it has major weaknesses in that detox is more difficult and time consuming.

    If you dont see anything above you disagree with then there really isnt an argument.
     

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    #50
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    I see no problem with someone who wants to be on a maintenance drug like methadone for the rest of their lives. Those who want to quit will and stick with the program. However, some simply don't like the way methadone or buprenorphine make them feel. I firmly believe that a doctor who specializes in addiction should be given every pharmacological tool available to help treat their patients. DHC, Codeine, Darvocet, hydromorphone depots under the skin, methadone, buprenorphine, etc. etc. I'm not talking about giving the patient an unlimited supply of their DOC, but methadone and suboxone shouldn't be the only drugs they can be offered.
     

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