Opioids Here we go, Methadone pills will be gone, stuck with liquid

[Methacodone]

Ok, I already posted a thread about my clinic banning the pills, in the beginning of april, or until all the pills are gone. The clinic says the reason we're getting rid of them is because--

"Hassle to count everyday, easier for nurses to steal, and DEA is recommending to stick with liquid"

Here's the part that I myself will say is BS. Reason I think that is BS is because the clinic has been open for well over 30 years, THIRTY YEARS. They've had the pills/wafers ever since they opened.
So now, all of a sudden, they're taking them off the shelves. Which really pisses me off.

They've been doing it for 30+ years, with no problems whatsoever.

I asked the nurses themselves, pills are way more pricey than liquid, right? They said 'A LOT MORE EXPENSIVE'
That's where it got me, I can almost guarantee they're doing this for MORE money. Liquid 'done is a 1/4 of the price of pills, which I totally understand that of course the more money they make, the better for them.
MMT is an ALL PROFIT industry.

In the middle of my placebo saying pills work better than liquid, I decided to try liquid to test the waters, and wow, 80mg of liquid DID NOT hold me, 80mg of pills, hold me perfectly. So how is that placebo?

The doctors, nurses, supervisors, will all tell their patients 'its the same'..

If they're the same, why does that happen? Why do the pills hold me, and liquid doesn't at the same dose? That's IMPOSSIBLE to be the same if I experience w/d with liquid and not the pills at the same dose.

So basically, they're MAKING me raise my dose, because as I stated, 80mg of liquid methadone doesn't hold me for the full 24 hours, the pills, I can go 36+ hours and still not be in w/d.

So, I don't know what to do, it's either I go through the pain of w/d until my body adjusts to the level of liquid methadone, or get a dose raise, im basically trapped.

What do you guys think I should do? I DONT want to get a dose raise, yet the dose of 80mg of liquid doesn't hold me.

Would you guys get the dose raise, or go through at least a month w/d til my body is adjusted to the dose of liquid methadone?

 

[speedballs_over]

I'd raise the dose, that's just me. I was on MMT for four years at 200-mg. Then switched to bupe, so I've never w/d from method. If you think you will someday, then a dose increase maybe not such a great idea. The big thing is not to crave and cave and start using other opioids to supplement methadone. If that happens, definitely increase dose. That's my take. Best wishes.

 

[when I dream]

As you have been told before, it's a placebo effect. You had it in your mind that the liquid wasn't going to work as well even before you tried it. The stress of even believing that you are going to experience withdrawal is enough to make you actually feel like you are.

No one is making you raise your dose except yourself.

 

[Keif' Richards]

The mind is a powerful and unpredictable thing. In addition to the placebo effect some experience, from day to day Methadone absorbtion can vary depending on several variables. As a lot of us are aware, patients being treated for pain in hospital have been administered saline/placebo and have in turn reported pain relief. Pretty crazy right? Here's just one example, there are many articles claiming similar phenomena.

http://www.pnas.org/content/104/26/11056.full

There is just no way that a pharmaceutical company could get away with something like this. The only significant difference between the liquid administration and solid pill administration is that the pills will take longer to be broken down than something already in solution. Maybe this could account for your experience with pills holding you longer than liquid.

Accidents happen all the time. People make mistakes so of course it's within the realm of possibility that dosages could be different from pills to liquid, but the federal government is so heavily involved in the dispensing of Methadone for maintenance purposes, you can't tell me that they're not analyzing these products to verify potency. You probably have reinforced in your mind that the liquid is worse than the pills, which will only contribute to the placebo-like effects that you describe.

Again, I'm not saying you're wrong, this type of error is possible but is highly unlikely. I'm sure your experience is valid in some way because you seem to be deeply convinced of this, that belief had to come from somewhere. Just keep an open mind and take a serious inventory of the effects experienced from both the pills and the liquid and the difference therein. Write some notes down in a notebook, or even better, make a retrospective trip report. Good luck

 

[Methacodone]

Wow, I am I still seeing placebo posts on here?

Yes, any form of sickness, I even believe is about 90% phsycological. But like I said in my OP, I tested the waters on liquid form instead of tabs on a random day, to see if it is/was actually placebo, I felt 100% different when I dosed the liquid. When I dosed my usual pills the following day, I was feeling good/normal again, so how is that possibly placebo?

Anyways, I didn't make this thread to argue with anyone, so anyone can say it's placebo or not, im not going to argue with anyone.

I'm actually going to talk to my doctor/physciatrist to try and switch to Subetex. Because honestly, this very thing my clinic is doing is total BS and pissed me the fuck off, its like they don't give a shit about their patients, just more $$$.

So, if my doctor wont be able to RX me an opiate to hold me for a month then switch to subs, im going to taper myself down all the way from 80mg to 30mg, so I WILL be able to switch to subs on that dose.

Theirs only 2 ways to switch to Subs from methadone.

1. If you're over 30mg of methadone, you need to be off methadone for a minimum of 30 days to switch to subs, and you are allowed to take other opiates until then, e.g. Oxycodone, Hydrocodone, Morphine, etc. to hold you for those 30 days before you switch.

2. If you're 30mg or under on methadone, you need to be off methadone for only 3 days, compared to 30 days when your dose is over 30mg. You may also, take other opiates for those 3 days until you switch to subs, any opiate besides methadone.

So im def. going to do 1 or the other, once the pills are gone. Fuck that liquid methadone bullshit just to make even MORE profit than they already are.

 

[Keif' Richards]

No one is doubting your experience man. It's totally possible that your methadone was of varying strength. It's just very unlikely and it would be unfortunate to cause hysteria among people that could ultimately prevent them from getting help through MMT.

We all know how the addict's mind and for that matter, the human mind works. Telling someone that their drugs don't work or are underpowered is enough in itself to cause severe doubt. It's just important to understand that this experience is an extreme statistical outlier.

I'm sure this will sound like a stupid question, but are you taking liquid methadone from a bottle with a non-intact seal or are you dosing at the clinic daily?

OP and anyone else who's concerned could put their uncertainty to rest by having the two mediums analyzed.

 

[when I dream]

That proves nothing as far as whether or not it is a placebo effect. The only way that would work is if you were somehow able to blind dose with either the pills or liquid. As in, someone gives you either pills or liquid without you knowing which one. As long as you know that you dosed with liquid as opposed to pills you will always get this effect until you can get over your whole liquid aversion. Trust me, if there wasn't the perscribed amount of methadone in that liquid the clinic would definitely know it because a lot more people than just you would be complaining. You clearly are not going to accept this so do what you want.

I never knew that all sicknesses were 90% psychological. I'll have to keep that in mind next time I meet someone with cancer.

 

[siq]

Its the exact same, its science...The rest is in your head my friend...

 

[siq]

If you were really withdrawing from methadone, you wouldn't even be able to get on the computer and type... believe me you'd be feeling that shitty.

 

[Wonka]

Sounds like a shady clinic if the nurses are known for hijacking the goods......try another clinic since u know your right and you have a right to be pissed or switch methods on quitting your drug detox with subs perhaps but then again you need to stick with whats best for you.....and also try to mellow its all about the feria with the drug companys

 

[Methacodone]

siq-

You don't even know what you're talking about, am I on liquid yet? no. Did you fully read my OP? I'm guessing not.
I specifically said the last order of pills has been made already, in can finish as early as april 1st, if not, they're going to use the pills until they're entirely done.
I spoke with the dosing nurse today actually, she said we still have a pretty good amount, probably another 2-4 weeks until they're entirely gone.

Also, why in the world would you think I would w/d THAT HARD? that I cant even type on the computer? LOL.
I'll say it again, the Liquid Methadone doesn't hold me as long, and doesn't seem as potent as the pills....it wouldn't put me in full blown w/d, obviously. That would be impossible...so idk where the fuck you came up with that..


Jcdenton-

You're really going to compare cancer with other sicknesses? Cancer is an untreatable sickness, as we all know.
So obviously, cancer isn't a phsycological sickness, you didn't have to point that out.
What are we talking about here in THIS thread? Methadone.
So when I mean 'sickness', I'm referring to Withdrawal, which IS a treatable sickness, unlike cancer.

Keif Richards-

You're honestly the only one who made sense so far as far as other posters on this thread...
and yeah man, honestly, my only choices would be to stick with liquid methadone with a 10-20mg dose raise, or get off comepletey and move on to Subs.

I'm honestly thinking of leaving MMT.

I hope my doctor would be able to help me out with this situation with my up coming appointment, next Friday.

if she's able to RX me an opiate, to hold me for 30 days then switch me to subutex, my dream will come true.
It'll be hard, REAL hard, because Schedule 2 Narcotics are incredibly hard for Doctors to RX, esp. now a days, where America has become the Narcotic Pill Nation of the world.
But, ill have proof to my doctor of some good things,

#1 Quitting smoking weed, been 40+ days now without ganja

#2 Starting college this upcoming July. have proof of schedule, and which school im going to, what im going to study, etc.

I'll keep my fingers crossed.

 

[LilikoiMoon]

We talked about dosing twice daily, right? Methadone burns off so quick with my metabolism, I have to dose twice daily when weaning down/off.

Sad that it's come to raising your dose.

 

[Keif' Richards]

"I never knew that all sicknesses were 90% psychological. I'll have to keep that in mind next time I meet someone with cancer."

^haha, I think he was using a little bit of hyberbole to get his point of across, but yea, 90% is a little excessive, especially when you're bent over the toilet vomiting as if someone had their hands around your stomach wringing it out like a wet towel. Fear of withdrawal make things seem pretty dire. In my experience, the fear of withdrawal was equivalent to the fear of outright death, like your life and the world are going to end and it's going to be a painful process. I would experience these extreme emotions knowing full well that opioid withdrawal is not lethal (unless you're old, weak, infirmed, diseased etc).

Methacodone: I'm not here to tell anyone that they're wrong or stupid or crazy or ignorant. We can all get out points across without putting other people down. I think most fellow BL'ers have the same mentality. When I said your experience is valid, I'm not patronizing you. Your experience is "real" no matter what anyone else thinks. All information is valuable in our dialogue. If one does enough research and doesn't rely on a single post to make big decisions, they should be able to come to a reasonable conclusion.

Also, I think we've all read the thread about a BL'er getting prescribed high-dose CII opioids to make a smooth transition to buprenorphine (I think that was it) from Methadone. Believe me, I salivated like one of Pavlov's dogs when I first read that. Unfortunately, I think that this is a highly unlikely treatment plan. Writing controlled substances to known/admitted drug addicts puts doctors in a very precarious position. If you can find a doctor that will, more power to you and I would say go for it, but in most cases MD's are going to go the more orthodox route; that being tapering to ~30mgs, skipping a few days of dosing, analyzing withdrawal symptoms and inducting you on buprenorphine when ready. Pain and discomfort are inevitable no matter the route you take.

If a dose increase truly makes you feel more comfortable and holds you, I say go ahead and do it. Even if it is all psychosomatic. I do encourage you to keep some kind of journal or inventory highlighting the perceived differences between liquid and pills. It might end up changing your mind on things or it might cement your current feelings. Either way, it would be of use to you and other people on the forums (if you choose to publish it) who have similar doubts and questions regarding the different media of methadone.

Also, mind what you put in your body from day to day as there are many variables that effect Methadone absorbtion. Stomach contents (especially fat/lipids), antacids (cimetidine being the obvious one, but anything that reduces the acidity of your stomach), certain antidepressants (fluvoxamine is the only one that comes to mind), herbs (cat's claw, st. johns wort; the former potentiating and the latter weakening) and grapefruit (juice or whole fruit). The list goes on an on, and not being aware of these things could possibly account for your perceived difference in effects. I don't know you or your habits, just throwing some of this out there.

-Fin

 

[Methacodone]

Lilkoimoon-

I don't have an option to do split dosing at my clinic...you dose once a day, anywhere from 6:00am to 1:00pm on weekdays, and anywhere from 7:00am to 10:00am on weekends.

BUT, the good news is, im getting my take homes back next week, so maybe that'll help me to split doses.
you're 100% right about methadone leaving your metabolism earlier than expected, that's true for me, on liquid methadone.

I think I found the problem as why liquid doesn't hold me as good as pills.

#1- Liquid methadone enters your metabolism earlier, which means hits you faster than the pills do, and by that, it also mean it will leave your metabolism quicker also.

#2- Pill form methadone, doesn't peak into your metabolism until at least 4 hours prior to your dose, so maybe that's why it hold me 'longer', because it stays in my system longer.

It's starting to make more and more sense, the more I re-search and read posts on here.
In almost every forum that discusses drugs, DO SAY that liquid methadone peaks much faster than pills, therefore it will leave your metabolism faster also.

Split dosing, will be probably be my best option if im stuck on liquid. I am getting my take homes back soon, so ill be able to do that, just for a couple days at first of course.
Since I've been a patient at my clinic for over 2 1/2 years, you get your take homes back faster. Instead of waiting 3-6 months to add on 2 take homes to your pile, its 3-6 weeks for long term patients like myself.

So, I can get my 6 take homes back in just a few months.

But im still questionable, because I really want to switch to subutex.

We'll see what my doctor says, I'll do exactly as my doctor orders, as he knows best.

Keif Richards-

I know 100% where you're coming from. Any doctor, will have a hard time writing CII Narcotics to any patient now a days.
Even pain management doctors, are having hard time writing these kinds of scripts.

But, trying wouldn't hurt me. I'll try my best. I'll def. let my doctor know im not trying to get a long term Narcotic script from you, it's just to hold me until my body is ready to take buprenorphine. My doctor doesn't have to write down what im really taking them for, he can write a script for pain anytime he wants, but the problem I see, the biggest problem, is RX'ing a strong enough narcotic to over power methadone, which I know I will NEVER get anything stronger than methadone, and I don't want anything stronger than methadone to be honest. I'll take anything that will hold me until im ready to switch over to subs.

If he tells me detox down to 30mg on methadone, then come see me, that's exactly what ill do.

 

[TheRapperGoneBad]

Definitely has to do with it beIng liquid vs solid pill.
also dosing all at once.

I would let it adjust down to where your at its not all bad to taper mdone till you on a lower dose Even then.

you said your self you were thinkin of leaving why subs?

 

[crzydiamond]

In your options you mentioned having to wd for 30 days til your body adjusts to the liquid methadone. I don't think it would take anywhere near that long. I've done dose reductions (and came completely off one time) and never had my body take that long to adjust. It DID take 32 days when I quit cold turkey to feel completely normal, maybe that's what you're thinking and it got jumbled

Must you dose all pills or all liquid? If not, perhaps you can transition like 60 mgs pills/20 liquid, then 40/40 then 20/60 then switch totally over a period of those weeks where they still have pills.

And you're not imagining it. I know others who had that issue with the wafers, needed less on wafers to stay stable. Also I had issues last year with dosing time. If I dosed morning to morning I was fine. But when I had to dose in the afternoon I was in mild wd from when I woke up til I dosed. Even though it wasn't 24 hours. My issue had to do with sleep and pH. But I'm saying I know it's frustrating when you know you don't feel right and others feel you it's in your head

Yes most likely it holds you longer due to not taking effect as fast. Anyway good luck with the switch. If you have to go up 10 mg or so I would do it. You can always come down once you stabilize. Or if you go on subs good luck with that. I personally hate suboxone lol.

 

[Methacodone]

Yeah my clinic doesn't work like that, there is no way they will give you both kinds of methadone. You can't get half pills and half liquid, it's one or the other. But the pills are going bye bye anyways. So I can't do anything about that.

But I think that's a very good idea, to split dose once I get my take homes back. Each dose comes in a single bottle, sealed. You have an option to fill the little bottle with juice or water, I always go with water. So ill have it filled to the top with water, that way will be easier to dose the amount I want accurately. My dose is 80mg, so half the bottle would be obviously 40mg, it can be on and off a few mg higher or lower, it wouldn't make a huge difference, its impossible to be 100% accurate if you don't have the dosing syringe to measure the ml to get the desired mg. The liquid is cherry red 10mg/1ml.

When I get my take homes back, ill switch to liquid and see how it goes, even if they still have more pills on hand, today, I talked to the nurse again and asked her how many more bottles of the pills do you guys have, she said 2 bottles of the 40mg wafers, and 9 bottles of the 10mg pills. So I would say, at max, theirs 2 weeks left of them. Of course it wouldn't last that long if everybody in the clinic was on pills, but theres less than 10% of patients on the pills, that's why they last a little more than they should. Everytime someone sees me dosing, the person behind me, he/she always asks "whats that"? cuz they don't know they have pills/wafers, I got a few patients to actually switch from liquid to pills, and no bullshit, they THANKED me because they're like WOW, the pills are WAY better, stronger, and lasts longer. So I'm NOT the only one who "thinks" that, I don't think its placebo at all, even if 100% of you guys disagree with me, I wont argue but I still wont say its true. Because I have experienced BOTH, and they don't feel the same at all.

The pills are made for chronic pain patients, I doubt, any pain patient will get RX'd liquid methadone, for pain. Reasons being, dosing accuracy, etc.

Anyways, I thought HARD about it, and IM NOT getting a dose raise, no matter what. Because 80mg has been holding me fine this whole time, if the liquid doesn't hold me as well as the pills, I'm going to taper down to 30mg and get the fuck out and get me some Buprenorphine. They're NOT going to over power me to raise my dose to keep me their even longer.

I can't wait til I go see my doctor/phsyciatrist next week. I'm guaranteed a RX for benzos, a re-fill of my Clonazepam, or my doctor said let me know if its not working as well as other benzos you have tried, and I wouldn't mind switching you to the one you feel best on. But, I love my Klonopin, and I am going to keep my RX for Clonazepam. Good strength, amazing long half-life, good muscle relaxing properties, and is overall my favorite benzo. The 1st time I tried it, I fell in love with it.

But yeah, i'll keep you guys updated once I switch back to liquid methadone and see how it goes for me. I KNOW I wont be in severe w/d where I cant function, the most it will do is not hold me long enough, where ill probly need a 10-20mg dose raise. Which like I stated above, im NOT going to do. If I do feel like that on the liquid, im going to taper down to 30mg and get on subs.

 

[Lucy Bookit]

The thing about nurses doing it is absolutely plausible. Now a days with cameras and electronic inventory it's easier to catch, where in the past it would've been a bit harder. Liquid would be a lot easier to keep in stock because you can't pocket one of those big ass bottles. But I'd be surprised they would tell you that openly.

 

[Johno88]

Well there you go! You wanted the DEA to tighten their control on pills and now you're complaining. You had all the great ideas in your other thread but now it happens and it effects you it's terrible. God, you wanted pain patients going to doctors to have their pain meds counted weekly!

 

[Methacodone]

Johno88-

Methadone clinics already have their own strict of rules, you have to go In and dose EVERYDAY. AND, those with TAKEHOMES, get CALLBACKS to check in on them at least once a week...

Methadone clinics and Pain Management are 2 totally different settings. If Pain Management had rules like MMT clinics, then what? Exactly.

The reason I said what I said about the DEA/FDA not doing RX rules and regulations right is because, as we ALL KNOW, there are RX Narcotics EVERYWHERE, being sold to people who don't need them, but abuse them. Yes, of course im a addict also, but they make it TOO EASY to get these Narcotics, they can absolutely strict up the rules and at least try and stop whats going on, the biggest thing that pisses me off is the DEA/FDA always complaining about Narcotics being sold on the streets, and yet they're doing squat to stop it.

Lucy-

You're 100% right, Liquid Methadone is almost impossible to steal, because of the big ass bottles they come in. Yes, stealing/pocketing the pill form of methadone is absolutely way easier, but that is what inventory is for. They count the bottles, and each bottle contains 100 pills, and each dose goes through the computer, so, they'll absolutely know if they're being stolen or not, so that's not the case at all of them getting rid of them IMO.

Like I said, MMT is an all profit industry, and they'll do anything for more profit. They can give 2 shits about their patients.