methadone, buprenorphine and other opioid pharmacotherapies

[TeeCee]

Just a heads up, but there are currently plans underway to reduce methadone takeaways by more than half in Victoria.

That's exactly why I've come to bluelight today. I overheard some others on the program at the pharmacy yesterday talking about reduced doses. I thought crap! But I just realised it's for methadone and I'm on suboxone. But still, it's still crap for those on methadone. It can be difficult enough sometimes getting to the pharmacy twice a week if you're working, especially if they only dose 9am to 4pm or something. I really doubt reducing the takeaway doses will help reduce deaths. Some more education about it though might help.

 

[Acanthus]

Hmm the only people who seem to care aren't even on the program, haha. Anyway, does anyone have random periods that come and go on Suboxone where they uncharacteristically feel like they're withdrawing? Eg: it's been only ~9 hours since I took my daily dose, but all of a sudden I just got unmistakable withdrawal symptoms. It usually lasts about 10-20 minutes and ranges in discomfort from mild to medium. Swear I'm not imagining this. It must have something to do with that stupid (pointless) naloxone.

Anyone else get this?

 

[Crankinit]

Unfortunately I don't live in Victoria, so I can't really help, but I really hope such an absurd change to the system doesn't take place.

Hmm the only people who seem to care aren't even on the program, haha. Anyway, does anyone have random periods that come and go on Suboxone where they uncharacteristically feel like they're withdrawing? Eg: it's been only ~9 hours since I took my daily dose, but all of a sudden I just got unmistakable withdrawal symptoms. It usually lasts about 10-20 minutes and ranges in discomfort from mild to medium. Swear I'm not imagining this. It must have something to do with that stupid (pointless) naloxone.

Anyone else get this?

Yes, quite frequently, and especially directly after dosing (which would suggest at least some of the naloxone is getting through).

On the flip side, I also occasionally get times when I dose and actually feel quite high. Not to the point of nodding, but like a medium dose Codeine CWE back in the day.

 

[chugs]

Hmm the only people who seem to care aren't even on the program, haha. Anyway, does anyone have random periods that come and go on Suboxone where they uncharacteristically feel like they're withdrawing? Eg: it's been only ~9 hours since I took my daily dose, but all of a sudden I just got unmistakable withdrawal symptoms. It usually lasts about 10-20 minutes and ranges in discomfort from mild to medium. Swear I'm not imagining this. It must have something to do with that stupid (pointless) naloxone.

Anyone else get this?

This is part of the reason why addiction medicine prescriber will often put you on 2-3X the normal dose, especially with buprenorphine as it has, compared to methadone has worse outcomes at lower doses i.e. people tend to go back to heroin when on a small dose of bupe.

It means your not getting enough bupe.

 

[Bubblegummer]

Hey folks, I've read a few times that apparently benzos and methadone are a no no but my methadone prescriber has happily written me some diazepam to use for my flying phobia as I'm about to go on holidays, but I probably won't use any anyway as it's a small flight and I usually only take it on longer flights.

I'm only on 50mg methadone a day and written for 5-10mg Diaz as needed.

What's the risk of using the two together and if it's do bad why would a Dr prescribe the two at the same time?

I've just taken 5mg as a test run to see if it affects me all that much or not but usually my Diazepam tolerance is pretty darn high to be honest.

Anyway, I just thought I would put up a post and see what you guys think of all the benzo-methadone nay saying I've found on here and in other places.

Cheerio.

 

[Christ!]

Hey folks, I've read a few times that apparently benzos and methadone are a no no but my methadone prescriber has happily written me some diazepam to use for my flying phobia as I'm about to go on holidays, but I probably won't use any anyway as it's a small flight and I usually only take it on longer flights.

I'm only on 50mg methadone a day and written for 5-10mg Diaz as needed.

What's the risk of using the two together and if it's do bad why would a Dr prescribe the two at the same time?

I've just taken 5mg as a test run to see if it affects me all that much or not but usually my Diazepam tolerance is pretty darn high to be honest.

Anyway, I just thought I would put up a post and see what you guys think of all the benzo-methadone nay saying I've found on here and in other places.

Cheerio.

It can be OK with lower doses, particularly if you're on a stable dose of methadone (no longer 'nodding' off) The problem is it's so easy to take more benzos, most people who've had experience with them will know this one. Main danger times are when the person takes more opiates than where their tolerance is at, or when they drink alcohol, or they share their methadone and benzos with someone else - for this reason IMO there needs to be a heap of trust between doctor and patient. If I were a Doctor I'd be very hesitant to prescribe both at the same time - I'm amazed how often it happens.

Sounds like you're being responsible with them and you have a good relationship with your doctor.

 

[Bubblegummer]

Hey guys,

I've never experienced the nods from my methadone use. I've not even thought about abusing it either as it scares me as a recreational drug so I wouldn't even contemplate it.

I've really just posted as I do like to use a higher than prescribed dose of the Valium while flying only cause my tolerance to it is so high and I don't get comfortable unless I can physically feel the effects of it enough to make me sleep while flying so I can literally sleep the flight away so I don't have to sit there anxious as hell!

I'll take 10mg before boarding and see how I go by the time I'm stepping aboard, if I'm still nervous and fully coherent, I'll take another 5mg and go from there dosing till I get the calm effect in looking for.

 

[Christ!]

As for my earlier question, is methadone and bupe the only two opiate maintenance meds in Australia? As I said somewhere else, bupe is only a partial agonist and it's still really hard for me to quit while on sub (Ive only tried once - got to 12 days w/o full agonists but was a mess mentally for the duration). I know methadone is a full agonist but I'm scared of it - the long half life, the toxic effects compared to other opis, horrible w/ds, stigma, etc. If these are the two I have to choose from then I don't know what to do...

Yeah unfortunately those are the only two.

So you've given the Bupe a fair go before? I've always gotten used to it after sticking with it a while. I usually feel 'off' for 2-3 weeks if I'm coming off a large full agonist habit. It sucks because during that time you're wondering if it's ever going to provide the comfort you need, and it's so easy to say 'fuck it' and go back to the good stuff.

Are you needing long term maintenance or just a quick taper?

 

[Bubblegummer]

I'm just seeing if anyone here is on methadone and Seroquel at the same time that successfully smokes pot?

I'm really at a point where I just want to do something that will make me chill out and find that Valium doesn't do much for me at all. I've never been a big pot smoker but am very interested in trying it but don't want to cause myself any unnecessary harm that's all.

So what do you think? Will I be ok to smoke a little bit here and there to step out of my head for a little while at a time?

 

[madmick19]

I'm on seroquel and smoke weed daily, not sure if I'd say successfully (lack of motivation/increased anxiety/depression which may or may not be because of weed). But I'm on Suboxone not methadone and I've only recently just started sub so I can't really comment. You know your body better than we do, if it's not negatively effecting you then go for it. From a HR point of view, I don't see much harm in doing so, except that weed can exacerbate anxiety and other mental issues (and smoke is carcinogenic). If you're already on Seroquel, Methadone, and benzos, perhaps it's not a good idea to add another substance, even if it's not addictive in the same way. But its your choice. If you're finding your current drug use isn't working for you like it once did, you've likely gained a tolerance. You need to take a step back and assess your situation and decide for yourself if increasing doses/adding drugs will work for you (it doesn't for most, and hasn't worked for me)

fantastic response chookmaster, that is some hard earned wisdom right there!

I'm just seeing if anyone here is on methadone and Seroquel at the same time that successfully smokes pot?
I'm really at a point where I just want to do something that will make me chill out and find that Valium doesn't do much for me at all. I've never been a big pot smoker but am very interested in trying it but don't want to cause myself any unnecessary harm that's all. So what do you think? Will I be ok to smoke a little bit here and there to step out of my head for a little while at a time?

what do you mean by chill out? and if the benzos are not working it means an incrase in tolerence is probably what is happening. mixing any other CNS depressant into your mix is not the best idea, id have to go and look at he metabolism routes to see if there are interactions but to be honest the answer is it depends on what you mean by "chill out" is chill out i wanna get high?, reduce anxiety? etc...

 

[Crankinit]

My doctor randomly mentioned today that once someone gets below 4mg suboxone, they can both be prescribed subutex instead of the strips and have the med distributed in monthly supplies like any other medication instead of having to go to the pharmacy daily. I've never heard of this before and when I asked for more details she didn't seem 100% certain about it - has anyone heard of these changes (I'm in SA, maybe a change in state law)? Would be great if it's true.

 

[drinkfekarse]

Man I hate the regulations with bupe dosing at the the chemist daily. My anonymity is..... WAS important to me . No more. I have 3O mg's to do a rapid taper. from 1Omgs daily for 2 months. The next month is going to be interesting.

 

[Christ!]

My doctor randomly mentioned today that once someone gets below 4mg suboxone, they can both be prescribed subutex instead of the strips and have the med distributed in monthly supplies like any other medication instead of having to go to the pharmacy daily. I've never heard of this before and when I asked for more details she didn't seem 100% certain about it - has anyone heard of these changes (I'm in SA, maybe a change in state law)? Would be great if it's true.

WOT.

So happy if true. Thanks for posting dude I will be investigating at my next appointment!

I've gotten to the point where 2mg every day is too much, by cutting back on TA days and only keeping the dose in my mouth a very short amount of time. It's a ridiculous way to taper - sometimes I'll absorb too much and get zonked out for the day...and it's not pleasant at this stage in my opiate habit career when I have important shit to do. Have tried 2mg every second day but that doesn't work for me.

Have known about the limited amount of time they give you on the subutex when you want to come off but I much prefer a gradual reduction. Fingers and toes crossed, would improve my life substantially just not having to go to the chemist.

 

[brighton]

Man I hate the regulations with bupe dosing at the the chemist daily. My anonymity is..... WAS important to me . No more. I have 3O mg's to do a rapid taper. from 1Omgs daily for 2 months. The next month is going to be interesting.

Totes. I see my pharmacist more than I see my family/best friend!

Does anyone have any tips/knowledge on what can speed up the process to get takeaways? Im starting a carpentry certificate soon and its gonna mess with my dosing regimen.... Ive been passing all the urine tests but its only been 2.5 months since I started suboxone....

 

[drinkfekarse]

Totes. I see my pharmacist more than I see my family/best friend! Does anyone have any tips/knowledge on what can speed up the process to get takeaways? Im starting a carpentry certificate soon and its gonna mess with my dosing regimen.... Ive been passing all the urine tests but its only been 2.5 months since I started suboxone....

not sure about spew zealand but in aus my doc said 6 months even though he knew I was legit. Health dept regs he said. I could be M Theresa and still wait 6 months. I decided to try and ct from the 12mgs and survived, just.

 

[Crankinit]

Totes. I see my pharmacist more than I see my family/best friend!

Does anyone have any tips/knowledge on what can speed up the process to get takeaways? Im starting a carpentry certificate soon and its gonna mess with my dosing regimen.... Ive been passing all the urine tests but its only been 2.5 months since I started suboxone....

I believe it varies from state to state, you'd have to check with your doctor or your state's drug & alcohol service.

 

[footscrazy]

Totes. I see my pharmacist more than I see my family/best friend!

Does anyone have any tips/knowledge on what can speed up the process to get takeaways? Im starting a carpentry certificate soon and its gonna mess with my dosing regimen.... Ive been passing all the urine tests but its only been 2.5 months since I started suboxone....

In my experience it's all come down to the doctor and pharmacist and your relationship with them. Some doctors/pharmacists are just more lenient than others, even aside from how legit/trustworthy they see you as, though that definitely plays a part too. 2.5 months seems a really long time without takeaways - are you getting none at all? I feel like the most important thing you can do is keep them informed of your situation and how picking up will hinder your employment/study potential. Maintenance is meant to help you get your life back together and if it's actively impeding your efforts, it's at odds with what it's there for. Unfortunately though there can be such a culture of 'punishment' with maintenance, with some doctors/pharmacists seeming to think making it hard for you is what you deserve as a drug user.

As Crankinit said, there are groups state by state that may be useful to get in contact with. In Victoria, for example, there's 'The Pharmacotherapy, Advocacy, Mediation and Support’ (PAMS) Service.' PH: 1800443 844.

Harm Reduction Victoria's site also has the contact details of the harm reduction/drug users associations of Australia, state by state.

 

[brighton]

^^^^ yeap, no takeaways at all. Sundays when my pharmacy is closed I have to go to the urgent/after hours pharmacy and its agesssss away.
Ta for your input but Im in NZ not ozzie

Also, does everyone know that the 2mg suboxone dissolve a hell of lot faster than the 8mg's ? I get 8 x 2mg

 

[drinkfekarse]

The 2mg films seem thinner so probably do dissolve quicker. Definately time for u to have a word with your sub doc about takeaways. That's utterly ridiculous. Tell him/her that you will do a piss test EVERY DAY if necessary.

 

[brighton]

Good idea Ill do that. What they are doing is using the same rules they have for methadone prescribing on suboxone prescriptions. Idiots.