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Opioids Methadone Mega Thread and FAQ v 2.0

I wouldn't take bupe until as close to 72 hours after dosing methadone to be on the safe side. But if you have on a transdermal patch, the medicine is still going to be absorbing into your skin for hours after you take it off. I would probably wait until I was in full blown withdrawals if I was you. Precipitated withdrawals from methadone is horrible.
 
Thanks for the quick replies. I'm going to take the patch off, as I think it's definitely not doing me any good. Also, yes, sorry I meant 20 micrograms.

I had been on the bupe patches for a while, with tramadol for break through, but now we're going to use methadone with oxycodone for breakthrough. I just don't understand why she didn't just switch me instantly instead of all this tapering down crap for the bupe. Don't you think I'll be alright if I just take the patch off tonight and start with just methadone tomorrow on?
 
nordkraft said:
Don't you think I'll be alright if I just take the patch off tonight and start with just methadone tomorrow on?
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It's possible b/c the dose you're taking is a lot lower than say someone who is on bupe maintenance, but I would be very cautious. I've never experienced precipitated w/d but from what I hear, it's definitely something you want to avoid. I would take off the patch and wait as long as you can before dosing methadone. Ideally 3 days. But if you're going through w/d or you're in too much pain, I would take half the dose prescribed to you...wait 3 hours...then redose if necessary
 
Does anyone came across or has used methadone 40, manufacturer Mehr Darou, Please comment on this? We came across some but dont know if its genuine or good whatever? Thanks.
 
GABAking said:
It's possible b/c the dose you're taking is a lot lower than say someone who is on bupe maintenance, but I would be very cautious. I've never experienced precipitated w/d but from what I hear, it's definitely something you want to avoid. I would take off the patch and wait as long as you can before dosing methadone. Ideally 3 days. But if you're going through w/d or you're in too much pain, I would take half the dose prescribed to you...wait 3 hours...then redose if necessary
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I would take off the patch as well, though I feel that waiting three days is a bt much. I would wait until you withdrawals begin as this would most likely be a sign that there is no longer any additional buprenorphine being transmitted. Take the 5mg of methadone and I imagine that you will be relieved of the withdrawals and not have to fear precipitated withdrawal. Luckily the Transdermal BA of Buprenorphine is low (15% approximately), and as the dosages are in the microgram range anyway, I don't think that a possible 10-15 micrograms which might still be absorbing, will be enough buprenorphine to send you into precipitated withdrawal. It certainly will not be enough to block other opioids, that's for sure.

IMO, your doctor should have switched you to a super low dose of subutex weeks before deciding to transfer you onto methadone. That way you could still get an equal dose of buprenorphine/day (though it would hit longer die to the fact that it would be absorbed all at once, though that's not a problem with bupe as it is long acting as hell anyway), and not have to worry about possible complications arising from continual hourly bupe absorption while taking methadone...

I feel that some doctors just don't know what they are doing when it comes to buprenorphine, and when it's prescribed in the form of BuTrans (which is a formula intended for pain, not for the treatment of opiate addiction), they assume it's just another run of the mill opioid, just a little more potent and a little longer acting..

Addist,
We don't do pill ID's here. You should type the pills shape and score into any search engine and be able to find out if it's legitimate or not. If you can't find any information, well, it's likely not worth the risk. I've never heard of Mehr Darou but that doesn't mean shit as I am not a chronic pain patient. However, if it's some online pharmacy, I would NOT bother. Sure you may get real methadone, but you can also get ripped off completely, or sold some type of super potent designer opioid as methadone and overdose.. Really, not a smart idea if that's the case.
 
http://www.painphysicianjournal.com/2008/april/2008;11;S133-S153.pdf

"Accelerates methadone elimination (Moolchan et al. 2001)."

Wait, wait, wait... Someone clear this up.... Is this article stating cocaine aids in helping the body in expelling methadone? Is this obscure info or is this well known? I am guessing the repercussions and risks of using cocaine are not worth it. Just thought this was interesting information that I am interested in having cleared up. It may also be a good reason why not to use cocaine while on MMT or just when using methadone. Anyways like I said someone clear this quote up for me as I am really intrigued.

Edit: I actually had experience with useing 5 mcg/hr butrans as well as experiences with using roxicodone afterwords as it was not helping at all with levorphanol/tramadol withdrawals while waiting to see my doctor to get it changed to opana/vicodin. In my experience I did use the roxi even with the bupe patch on, but it was not as effective as it should have been so I took it off. It took about 24 hours for it to get to the point that my oxycodone was having a regular effect again, but I did use it for only 2 days after not having used it for a month or two.

If you do take it off I would use the oxycodone at a low dose (like 5 mg or even less as needed to subside W/D symptoms) instead of the methadone when you feel withdrawal symptoms setting in. In my opinion it would be safer to use that over methadone, but it does also have risks. Although like I said in my case I was withdrawing on the patch and I did use the oxy to deal with those symptoms and the only thing I noticed is it just was not as effective, but it did subside all W/D symptoms. Although I am not really educated or a doctor so just make sure you research into what you are taking (I am sure you have done some) and make sure you are making responsible educated choices as well as just subsiding w/d symptoms until the other medication is out of your system, which at that point you should than work to a pain management dose and not a recreation dose as methadone is VERY dangerous in the latter respect. Although it is supposed to be great for pain management due to its long duration.

Hope my experience with butrans--> oxycodone helped! Be responsible and stay safe!
 
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nordkraft said:
I have a quick question about my new methadone script. I'm a pain patient and I've been on a bupe patch (20mgs) for about a month and now we're going to taper up to 30mgs of methadone. However she's going up by 5mgs a week, while going down 5mgs a week on the patch. My question is, I've read different places that bupe potentiates methadone and other places that it would completely block it. Should I just rip the patch off and just take the 5mgs methadone or is the bupe actually doing me any good?
I tried to ask her about this but she seemed kind of clueless when I mentioned the whole ceiling effect idea.

Anyone know about this combo?
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Methadone actually potentiates buprenorphine in small amounts, I dont know if it is chemically the same way it potentiates tramadol But it is something that would be very foolish and harmful to pursue...
I would never condone this, and I experienced it (a) one and only time. The only reason I posted this thread was I thought maybe Seiko or another moderator might know the the reasoning behind it.
Edit: If you try this with methadone built up in your system, you will forever regret it...
I also noticed Seiko is no longer moderating "Other Drugs"
 
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As bayhead stated, Butrans (the bupe patch) isn't nearly as strong as the tablets...I was on it for a while and would have perks for BT pain....in my honest opinion I think you could just take off the patch and take the methadone and you'd be fine, but that is not HR whatsoever. So for the sake of being safe, take the patch off and wait till w/d start.
 
Don't ever take suboxone with any other opiate/ opioid as the nalaxone in the suboxone will cause you to go into acute withdrawal and make u feel horrible....only start taking suboxone when u are already in withdrawal....some doctors are nuts these days...

Edit: this post was meant to quote nordkraft about 5 posts up....sorry mods.
 
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Started Methadone maintenance on jul 18....on 110mg/day now and it's really helping me. Completely stopped all street drug use....prescription only now :)
 
ml42o said:
Don't ever take suboxone with any other opiate/ opioid as the suboxone will cause you to go into acute withdrawal and make u feel horrible....only start taking suboxone when u are already in withdrawal....some doctors are nuts these days...

Edit: this post was meant to quote nordkraft about 5 posts up....sorry mods.
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fixed
 
I started MMT on September 14th, so its only been 2 weeks, I started 120mgs this Tuesday, its seems to be working better.
 
On it for chronic pain due to multiple problems. Been 5-6 years now at a steady dose and in many ways it has given me my life back. I can get some restorative sleep, be productive but man, I do not like feeling tied to it and the rules that go w/ it. I hate the fucking sweating when it's 40 degrees or less to say nothing of the joys of summer. I live at the beach so I laid in the ocean all summer. I hate feeling dependent on anything/anybody and I get aggravated sometimes and think "oh fuck this, I'll be fine,i don't need this no more..."
Then I look at the surgery scars and remember the years of thinking The End had to be better and if I could hold on until my kid was grown then I could do whatever...
I'm really glad things never got that far.
I wish there was an alternative but at least there is something that works that I can access and afford.
Best of luck to all
-izzy
 
^Im glad you've accepted your situation. I think in some ways being on methadone carries just as much stigma as heroin, but in a different way. I've now been on methadone maintenance for over six months, and raised my dose twice from 30mg (now I'm on 50mg). I'm not too pleased about raising my dose, but each time I did so (I didn't even go up from 30mg until I had been on the program for over 2 months), I really felt as though it would be beneficial. I'm really hesitant to go up more, in fact I'm almost determined not to, but like a dimwit, I've been using heroin every single day on top of my dose. I made if 2 days without this week due to the aid of benzo's and amphetamines, but then gave in after that. I used to think that it was actually impossible to increase your tolerance enough by using additional opiates that one could get withdrawals unless these added, short acting opiates were taken as well. However, I've learned the hard way that its true, and come eight o'clock pm, I start to feel the rattle.

I imagine that all it would take would be to force myself to not use for a couple days, it's just so much easier said than done. I think my main problem is the psychological addiction of sticking a needle in my vein and getting that one minute rush, because I'm honestly not so crazy about the actual buzz from heroin any longer (I prefer the way methadone makes me feel). Anyway, I'm really trying hard to stay away from the H, if I can get over it and not use in the next few days Ill report back how it went.
 
Fire&Water said:
Any idea's "Captain" ?
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As per why a doctor would prescribe methadone and butrans? Probably because they think the dosage of buprenorphine in butrans is so low that it isn't going to interfere with methadone.

In this case methadone would be much more effective than a very low dosage of buprenorphine (transdermal BA of buprenorphine is very low).

All in all, as stated earlier, take off the patch before using the methadone.

If this isn't what you were referring to, just refresh my memory.
 
Im curious about the effect opioids (in particular Methadone) have on the endocrine system and the male hormone testosterone.
Ive read that opioids down regulate testosterone and I am interested in if anybody on this forum has any experience with this
or have any knowledge ?

Do DR's put either pain patients or maintenance patients on any medications if the levels are low?

And have anybody discovered or felt like their levels are lower than before, like not as much bodyhair or any other symptoms.
 
Full agonists, especially methadone, repress endogenous testosterone production.

Nicotine does the same thing for the record.

If you are concerned, ask your doctor to run a test, see where your levels are, and you and your doctor can make an informed decision from there. :)
 
Captain.Heroin said:
As per why a doctor would prescribe methadone and butrans? Probably because they think the dosage of buprenorphine in butrans is so low that it isn't going to interfere with methadone.

In this case methadone would be much more effective than a very low dosage of buprenorphine (transdermal BA of buprenorphine is very low).

All in all, as stated earlier, take off the patch before using the methadone.

If this isn't what you were referring to, just refresh my memory.
Click to expand...

If you take a look back to post #187 my question is a little different...
 
Hey all... Just a quick question for those who have come out of the methadone cuffs:

How bad can one expect withdrawals to be if stopping at 5-10 mg /day, having taken mostly 5 mg daily doses for the past two months and a half?

I once stopped cold turkey from a 60-80mg/day methadone habit, with 6-8mg clonazepam or 40mg diazepam on top of that also on a daily basis. That was pure hell for a month and a lesser evil hell but still quite unbearable the next month. Never gonna do that again for sure!!! Haha, fucking lame and stupid, but did it and managed to stay off until I started chipping dope again just under half a year later. Since then it has been mostly benzo's that I have resorted to for recreational effects.
 
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