Using Heroin when on Methadone Maintenance

[Crankinit]

I guess the best advice to people considering either bupe or methadone treatment - if you're in a stable enough environment, and take it as directed...give bupe a go first. The transition from bupe-methadone is much easier...and at least you'll know if it's right for you or not.

That seems logical to me. Start with bupe, if it doesn't work for you then swap to methadone. Hell of a lot easier than going the other way.

 

[Crankinit]

^ I agree, a lot of doctors are woefully ignorant about a lot of things.

You have to remember that a lot of medical training is just rote memorization, a lot of that gets forgotten in the ensuing years when they spend their time just laying back and handing out scripts, and a lot of people go into medicine for the money and prestige without any real care for the subject or the patients.

On top of that, with the wide area of knowledge they're expected to have, they usually end up with a knowledge base that's broad, but not deep. Which is why while a doctor would still know more about medicine and the human body in general, anyone who's made the effort to learn about a particular aspect of medicine or condition (in this case, addiction, drug abuse, narcotics etc) can outstrip a doctor in that particular area. I'd say the average BL regular probably knows more about drugs than 90% of doctors.

The sad reality is that for all they like to portray themselves as knowledgeable and infallible, most of them are just regular people making a living and not much more invested in what they do than someone at an office job. And the other sad reality is almost all of them refuse to admit it.

In your particular example, I'm sure most doctors working at clinics see it as a cushy job. They just sit in an office, ask a few questions, order blood tests, write scripts and look down their nose at the 'dirty druggies.'

 

[rachamim]

Tommyboy: Studies have been done showing methadone does not lead to weight gain so it may just be a matter of perception. As for craving sweets, supposedly all opiates/opioids cause this but that is another myth.

Crankinit: I am defencive because that is how people like me get about our substances? Im still smiling ten minutes after reading that. Not that I want to seem even more defencive, but I have been off of Methadone Maintenance for nearly half a decade. I maintain on morphine, there is no methadone in the Philippines. Now, IF this assumption of yours is so baseless, and it is, imagine what other things you have incorrectly put stock in. What I DO get defencive about is incorrect information on a Harm Reduction site. Harm Reduction is a subject near and dear to my heart. Selling baseless information about the "horrors" of methadone could easily lead to addicys in need from looking at the substance as a viable option. Since bupe only holds limited utility, that can easily translate into an addict forgoing treatment and thereby spending their life in prison, or, even their death. I dont "defend" methadone, nor do I prosteylyse...I simply allow interested people to make up their minds based on facts, not opinion.

 

[spacejunk]

^ hey man, nobody's having a go at you. i am really enjoying this conversation - and it is nice to see some familiar cats from other parts of the forum stray into the australian drug discussion...it just seems like a bit of healthy debate to me. disagreement isn't necessarily disrespect!

"facts" are a great thing to work with, but in a world so muddied with opinion, myth and bullshit as opiate addiction (and its various treatments) is, all we have to go on is what we have experienced, what we've read, and what we've seen. nearly every 'truth' is hotly debated by someone - there aren't many absolutes that i can see. again, as Christ! said, i'm not as experienced as some folk - but we all form opinions based on what we see as fact.

but a lot of this does fall back to opinion - which isn't always a bad thing. when it is a matter of ignorance in the medical profession, then yes it's a shitty situation - but i think it just goes to show that even the appointed 'experts' are in the dark about many of the complexities of maintenance treatment.
by that i mean that the textbook cases they are informed by, and the realities of the situation as they present themselves, are often very different.
a basic example of this would be all the myth and misinformation about the naloxone in suboxone - just one of many things the medical fraternity seems to simplify and miss the point with.

i like to think that there is not one truth - but many truths. bupe might not work for every addict, but the more treatment choices people have, the better - right?
opiate addiction is a complicated thing - much like the human organism.

not everybody ends up with a gorilla several-grams-of-smack-a-day habit - but the people hooked on various other opioids, or varying doses aren't any less addicted or in need of treatment. a junkie in a town with really weak smack is going to be in just as dire a position as someone with access to pure, undiluted stuff. their withdrawal experiences may vary, but they're both stuck without a fix.
i think both bupe and 'done have their pros and cons - in an ideal situation, they would only be a couple of the treatment options available to people.

 

[rachamim]

Spacejunk: There is always room for opinion. When a person misstates their opinion as fact, that can easily veer from ignorance into dangerousness. That needs to be addressed. As for their being "many truths," in a Philosophy 101 class, MAYBE, but with issues like greatment retention, adverse side effects of treatment, and receptor affinity, there is only evergoing to be one truth.

 

[Miss Kirsty]

My two cents as someone who has been on Subutex, Bupe and currently on MMT is that personally i wish i had never started MMT....I used subutex many many years ago when it first came out and imo that one is the best...I felt great while taking that...I stayed clean 7 years after my first detox...Then i used again....and got myself another habbit pretty quickly...This time i went on Soboxone as in my area subutex was no longer available....I was on 16 mg per day...I found i could use if i skipped a dose, but it wasnt the same...I changed to methadone as i knew people who were taking it and they were still using gear also...sooo without investigating i asked my dr to put me on MMT...I havent been able to use since i stabilised on 115mg....I am going down slowly and am now on 95mg....While on 115mg i used a full box of 80mg oxy and didnt feel a thing...I prob near died that night when i went to bed!.. I really havent managed to get clean yet but i swapped to MMt about 8 mnths ago and hate it!!
Worst thing i ever did i think...If i had my choice again id be on soboxone for sure....

 

[Tommyboy]

Tommyboy: Studies have been done showing methadone does not lead to weight gain so it may just be a matter of perception. As for craving sweets, supposedly all opiates/opioids cause this but that is another myth.

The craving of sweets is one of the few side effects of methadone that I have seen a lot of people on it agree on. There are plenty of threads on this in Drug Culture where many people that are pro MMT discuss how they never craved sweets at all until they started MMT. If a bunch of people that are on MMT experienced this, I don't see how it can be dismissed as a myth.

 

[Miss Kirsty]

I'm down to 65mg of methadone now. I shot a gram for the first time in a couple of weeks, not expecting anything special but this time I felt a nice rush AND the "feeling" lasted a good hour or so. I was motivated to clean, work, do everything just like the good 'ole days before my addiction got out of control. It's the same gear that I've been using in the past, so that's not the reason. Of course it's nothing like shooting without being on MMT, but at least I don't feel like it's a complete waste of money any more. It's given me a bigger incentive to reduce my dose too.

I am still on 95!!!!8?


Wish i was on 30mg!!!!

 

[opi8]

^ The best advice I can give is to start tapering. The literature says it's not too uncomfortable to reduce your dose by 10% per fortnight. I would give it a trial run, but get a script that says you can dose between 85 - 95mg, that way if you don't think you can cope with the reduction, you are not forced through agony and can go back up to your regular dose.

 

[Crankinit]

Crankinit: I am defencive because that is how people like me get about our substances? Im still smiling ten minutes after reading that. Not that I want to seem even more defencive, but I have been off of Methadone Maintenance for nearly half a decade. I maintain on morphine, there is no methadone in the Philippines. Now, IF this assumption of yours is so baseless, and it is, imagine what other things you have incorrectly put stock in. What I DO get defencive about is incorrect information on a Harm Reduction site. Harm Reduction is a subject near and dear to my heart. Selling baseless information about the "horrors" of methadone could easily lead to addicys in need from looking at the substance as a viable option. Since bupe only holds limited utility, that can easily translate into an addict forgoing treatment and thereby spending their life in prison, or, even their death. I dont "defend" methadone, nor do I prosteylyse...I simply allow interested people to make up their minds based on facts, not opinion.

I didn't say 'people like you,' I just said 'people.' Which is true, people 'do' get defensive about their drug use, past and present, and their opinions about it. Claiming otherwise is just being intentionally obtuse from someone with as large a presence on these boards as yourself. Stating that one substance has a wider side effect profile than the other, that every one reacts differently to drugs and that a lot of people do find bupe to be an amazing, life changing drug, is hardly preaching about the 'horrors' of methadone.

I find it interesting that you rant on about being all for making 'informed decisions' but then insist that bupe is useless and methadone is superior in every way, because the evidence just doesn't back you up. Even ignoring the side effects and taking the two chemicals at their face value, you're obstinately refusing to acknowledge that bupe has a place in opioid maintenance and works for a good number of people with all kinds of addiction histories.

I'm well aware that bupe doesn't meet the needs of some addicts, but I don't think those are an overwhelming majority and I do think that it has more to do with the psychological profile of the individual, their motivations for getting on maintenance and the manner in which they react to the drug than it does whether they have more than a small tolerance.

 

[Miss Kirsty]

Opi8....Am going down 5mg every 7-10 days or so...Prob could do it a bit faster though...

 

[rachamim]

Crankinit: Where did I say bupe was "useless?" To clarify for the third time, it has only very limited utility vis a vis OST and methadone. O will let you continue spinning those misquoting wheels from this point on since you are merely putting your fingers un your ears, humming loudly in between your oft repeated refrain, "No it ain't!!!" If a reference, I'll be happy to look at it but I am not particularly convinced by your opinion...no offence of course.

Tommyboy: Have you met very many humans that do NOT cotton to sweets? Basing your opinion that methadone causes a desire for sweets on methadone clients you know just doesnt make sense.

 

[Tommyboy]

Tommyboy: Have you met very many humans that do NOT cotton to sweets? Basing your opinion that methadone causes a desire for sweets on methadone clients you know just doesnt make sense.

If you do a google search on "methadone and sweets" you will find a lot of peoples testimonials about how they started to crave sweets when they got on MMT. There have also been studies that back this up. Here is a link to a scholarly article about this. I don't see how it doesn't make sense for me to have this opinion based on people that are on MMT that have experienced this. What else can it be based on? Not everything has a scientific explanation for it, but that doesn't mean that it is not valid.

If you still don't agree with that and think that it has nothing to do with tooth problems for people on MMT, will you agree that dental problems associated with MMT are because methadone causes dry mouth which makes teeth more prone to plaque which causes gum disease and tooth decay?

 

[Sublimit]

Arguing whether Subs or methadone is generally more superior than the other seems moot because preference should be based entirely on the individual, circumstance and desire. Having read the thread i really do think the OP'er would benefit from Buprenorphine. Currently on 65mg, OP can spontaneously decide get on and still able to get what seems to be a worthwhile taste... and i think this is one of the OP's habits that stands out as being very detrimental. Buprenorphine takes the spontaneous out of use, and forces one to premeditate their using instead, which is obviously beneficial if the desire is there. In this case Methadone seems to be aiding the use of smack, while i'm sure Bupreorphine would hinder and interrupt the patten of use> iDon't mean to be judgmental but yours comes across as a bit extreme

I really hope you get your shit together sooner rather than later. I know how it feels to feel like you're in a hole that you can't climb out of. There is no quick fix, you need to be patient. There are so many approaches going about minimization and my advise might seem odd, but also feasible entailing the use of H to switch from methadone to suboxone. I'll assume you could afford that method, and the idea is to make the switch to subs not so terrible by not dosing any methadone for 10-14 days and using a shorter acting full agonist like oxycodone or H. switching to Buprenorphine from a significant amount of methadone or H aint any kind of fun, but the time it takes to stabilize on suboxone would be dramatically reduced with the full agonist.

 

[C_Tripper]

Completely anecdotally: I crave sweets when I'm opiated. Always and forever. *shrugs

 

[cassandragemini]

There's heaps of really interesting points in this thread and while it's kind of gone off track i think it's gone into better more helpful discussion. My personal story/opinion is when it comes to choosing what OST is best for just go with what your gut tells you. I went from uncontrollable heroin use, financial destitution and being sick half the time and using codeine CWE's and h when I could afford it, which is a hell of a life, to methadone because i wasn't ready to give up getting high. I knew sub's didn't have much of a buzz so I chose methadone and it was perfect for me at the time. I got high everyday for about a month until I levelled out but would still enjoy the feeling of being loaded up with methadone. But in the end it still kept me in that cycle of getting high, I would wake up sick, drink my dose before I even got out of bed, enjoy for a hour or so and then get bored and then again late at night/early morning be withdrawaling again. I still tried to use h a bunch of times chasing a high and got pretty much nothing out of it, even on 35mg and switching to h for a couple of days I still wouldn't get a decent rush 95% of the time so I started using more methadone, I would take my dose twice or three times somedays and stay 'doned up all day and would then have to use h or codeine to get by in between my takeaways, especially while working and getting 5 take homes in a go. I ended up turning into a mess again, my girlfriend was on the verge of leaving me, I was depressed and tired and unpredictable and was losing touch with some of my best friends. It was then I realised I was sick of the abuse, living day to day and wasting away the best years of my life so I made the switch to sub's in desperation. And it worked a fucken treat, the first 3-4 days were hell, the switch was so brutal I literally couldn't get out of bed and nearly lost my job but all of a sudden I felt better and different and good, not opiate good but just clean old me good. I only twice have ever felt sub's and what I could feel wasn't great, it's surprising that it's quite often abused and sold on the black market - I would rather codeine over subs in terms of pleasure it's so boring, it's like the vanilla of the opiate world. And not the good vanilla the crap one like the vanilla ice cream your mum would bring home instead of goody goody gum drops or chocolate chip. But its kind of that about suboxone that makes it work, it's just a non event, I wake up fine now, have my dose and feel nothing from it and just go about my day, it seems to break that cycle of addiction and abuse, you don't need it daily or every few hours it's just kind of in you keeping you from being sick. I thought I would use more h on subs at first but after one go at it and getting nothing out of a .4 with 30+ hours since my last sub dose I haven't even bothered again. For me it was perfect, I was tired of chasing a high and just needed some mental rest from the amount of thinking and planning and scheming you do while being on other opiates, even methadone - especially when you get down to 40-30mg a day - its really helped me turn my life around. I wouldnt say it's a miracle drug though, I have fortnightly therapy sessions and have to work on it still but it's definitely helped me. Had I chosen suboxone first I would have fucked out and gone back smack within a week, I was chasing a high when I started OST and methadone gave me that and thank fuck for it being there. Its much better it being there than not, even if it only helped me that makes it very worthy to me. Now my attitude has changed and I just want to be clean and stable and happy. Subs give me that, withdrawaling off them to get clean will hurt but that's what I want now. I think OP of this thread should give away the smack altogether and go on a high dose of methadone, go as high as you need to get you high and warm and fuzzy and get some stability back in your life. A 120-200mg daily dose could hold you and hopefully satisfy you enough that you wont reach for the needle, it might still be tough for a while so do whatever you need to dose wise but at least you can get some stabilty in your life and get out of the total chaos that is your life when seriously addicted to h. Then you can just relax and rest for a while and then slowly patch things together. If youre ready to get away from that then maybe switch to sub's and see how it goes. I wish we had more options than methadone of suboxone, having an extended release morphine tablet like they do in a few European countries could really help a lot of people, it'll cause problems for sure but if it keeps 10% of current h users from using and causes more trouble for 9% it's still worth it. And controlled heroin for long time total addicts could help as well, people often choose a drug and only want that, methadone worked for me but if it didnt then having thr option to legally use heroin would at least stop the majority of the damage i did to myself and society. 'd love to see it be at least trialled here. And I would love to have a separate clinic for people who want to get clean, not just maintain. My current doc clinic is a fucked up drug den. People organise deals and swaps outside and Ive bought Valium and serepax off people after an appointment which is terrible, it's almost like a clubhouse where addicts on various drugs can meet and trade. My doctor is talking about starting a clinic where he chooses patients and treats them in a way so they can get clean, he's good too, weird but good. Anyway off track ramblings, goodluck to the op and the rest of us addicts, we need it.

 

[drug_mentor]

^ You really need to use spaces, that chunk of text is huge.

 

[Captain Brewster]

am i completely wastin my cash

Hate to bare the bad news, but I think yes....

Asking your question in The Other Drugs section of this site will yield a lot more/accurate answers.

I'm pretty sure black tar herion is fairly rare in Australia, I'm sure it's there, but from you mentioning it, that made me think your from America. Ask some folks in an American forum for better advice regarding black tar.

Your dose of methadone, and how long you've been taking it for, would be helpful information for people trying to answer your questions

One thing I have heard is, if your on a high dose methadone for a prolonged time, your general opiate tolerance could be redicoulous, you might find that the black tar does nothing to you, and hence become a pointless task (and slightly risky).

Don't quote me on this, but if you go days without methadone so you can get high on H (lowering your tolerance so it works), you could quite easily overstep your H dose and ultimately overdose.

EDIT: after a slack research I've found that you will need redicoulus amounts of H or any other recreational opiate to feel anything you desire (a costly cause), nothing I'm advocating at all, this is a harm reduction site so I'm slightly against what your trying to find out.

I have no experience in this field, but these are what I've found so far.

Research friend, there's heaps of people out there in your position.

 

[sourer]

65mg methadone for ~3 weeks, before that I started at 30mg and went up 5mg every other day. There is a gram sitting and gazing at me in the most seductive way. How much of this will need to be done at once to minimize waste and maximize feeling absolutely ANYTHING?

 

[the_ketaman]

Zero point in trying to use while on methadone. I'm on 85mg of methadone and I need at least a gram usually more. I don't even bother anymore.