Correctly doing methadone maintenance?

[NateJW]

Hey this is my very first post ever. And im not sure if this is the right place or appropriate for this, so sorry in advance If I messed up. I did a lot of searches on this before I posted and never really found what I was looking for, if there even is an answer for me.

But anyway, ive been an off and on addict for about five years, had about a year of genuine twelve step sobriety, but the rest of my clean times were just jail terms.

So I got out and just relapsed again a few months ago, and you know the story it got bad again quick, and for once I wasn't on probation nor did I have any warrants out for me, so I tried methadone this time. Started on 30mg and now on 50. I kept using at first cause it wasn't holding me, but I kept using and now I can't tell if the dose isn't holding me or if I just keep pushing my tolerance even higher by doing both.

Every morning after dosing I feel decent, but by the time I get off work I start feeling bad. Not necessarily physical withdrawals but I definitely dont feel normal, so I do some dope, sleep, then wake up in full blown withdrawal and race to the clinic to get well.

So I want to hear from anyone who is on mmt or have been on it before and did it successfully. I'm not worried about tapering off or any of that yet, I just want to go a full week without using or feeling like I have to use to make it through the day. Are there vitamins or supplements, should I change my diet, should I exercise? I have an apartment with my girlfriend and we have a newborn, and I work during the day, so it's not like I have free time to just sit around and think about getting high, I know it's not just a mental thing.

I should add that I install granite for a living, so maybe the hard work is pushing it through my body faster? And my clinic caps the dose at 80 mgs so I'm worried about just raising the dose again and again and then being stuck but still not feeling better.

 

[thedawn]

Hi Nate,
I was on MMT for 2 years ending in summer 2014 when I changed to subs.
I dosed in the morning and it almost held me in the sense that withdrawals never came full on.
but in the beginning it's bound to be uncomfortable.

so yeah,it WILL hold you and MMT can be done clean from opiates.

I smoked crack,took benzo's and smoked weed heavily while on methadone.
something about the methadone made me just crave other drugs.
they knew bc of UAs but kept me at around 100-150 over 2 years.they didn't even check for weed.very liberal I guess.
I jumped to suboxone at 30mg,it went ok,a little uncomfortable.

maybe subs would be a good alternative for you too?
the dope has no effect on 8 or higher mg Suboxone.
nowadays I take my subs,go to meeting,no narcotics,I do however smoke herb 1-2 times a month.
a nice present for not being on hard drugs anymore discounting the subs.

 

[Tod silvia]

I have currently been in a methadone maint. program for three months.. It was the BEST decision I have ever made & it saved my life, as cheesy as that sounds. The biggest piece of advice that I can give you is to NOT stress or worry about how high your dose is and thinking it is going to keep you there longer. Your primary focus right now should be getting yourself to a dose that will stop your withdrawals and stop your cravings as quickly as possible. The therapeutic dose for most users is between 80-140 mgs. Obviously this depends on a lot of factors such as your drug of choice, how long you were using and how much you were using. The medical staff there should be educated enough to know what dose works for you. And because your clinic caps at 80mgs, it might be in your best interest in going to a different clinic if your therapeutic dose is higher than that. Because there is no point in going to a clinic and continue to use. The clinic I go to told me that they pretty much expect people to use while finding their correct dose, but once you reach your correct dose, you will have ZERO withdrawals and ZERO cravings. You won't even be thinking about buying or doing drugs. You want to get to a point where you take your methadone because it is time to do so and it's just another thing you need to do everyday... not because you don't feel well or are having cravings. Then, after you reach a stable dose and stop using, you can focus on other aspects of your life that you have been neglecting due to drug use. Then, after everything is in place and you are doing well, you can talk to the doctor about starting to decrease your dose over time and eventually be off methadone and all other substances. I know at the clinic I go to, the doctor gives all new patients a dose that he thinks will be stable based upon what he is told about the patient's history. However, if the patient reaches that dose and it isn't working, the patient has the opportunity to go to their counselor and petition to get their max. dose raised. Remember, closed mouths don't get fed! Be proactive & ask for what you want/need to reach a point that the methadone is doing what it is supposed to do and you're not using or feeling sick anymore.

Also, methadone begins to take affect 30-45 minutes after you dose and reach its peak at about 4 hours after dosing. Your body may be metabolizing the methadone too quickly. There is a test that can be done for this that is administered through the clinic. Just talk to your counselor or medical staff. If you are metabolizing the dose too quickly, there are options such as dosing twice a day. You also may want to do some research as to what foods to avoid while on methadone. There are things such as vitamin C that causes your body to metabolize methadone faster. I also found vitadone (available on Amazon) and cinnamon (taken as a supplement) helped address a lot of the unpleasant side effects of methadone and helped to keep my endocrine system in check.

The only way your recovery is going to be successful is for you to be proactive. Don't stress about getting off methadone when it sounds like you haven't reached a dose that keeps you stable. If that dose is over 80mg, then you need to find a different clinic. Even if it's farther away, of course it will still be worth it because then you won't be using drugs anymore. Talk to the staff there about getting the test to see how fast your body is metabolizing the methadone & avoid foods/supplements that cause your body to metabolize the methadone quicker than normal. Congrats on taking the first steps. You're so close... just get to your stable dose as quickly as safely possible! Feel free to message me if you have anymore questions. I would be more than happy to ask MY counselor regarding any questions you may have if you don't have the opportunity to do so. If you don't have any other clinics close by or it's not feasible for you to go to a different clinic and need a higher dose, you can find a private doctor that will provide you with a prescription for methadone or as the user above me suggested, switch to suboxone/subutex. You usually will have to stop taking methadone/all other opiates for 72 hours before being able to switch to bupe which is hard for a lot of people... but you definitely have options. You're on the right track. Let me know if there's any other way I can help & good luck!

 

[My3sons]

It took me awhile to stabalize on mmt. I started the first week in nov and double dipped the first week or two. of course no where near the amount of was doing. I had a pretty heavy IV habit. As my dosage went up double dipping decreased. I cheated one time in January 3 weeks ago and did 4 bags but it wasn't even worth it. At this point I am under control and happy. It took awhile to get here but i now can control my cravings. I only really get them the day after a drug dream. I am so happy i made the choice to do mmt. I live a total normal life. I dont get high from the done at all. At the end of the day I do fall asleep alittle earlier watching tv than I used to but thats it. I work for a surgeon and even scrub in for procedures such as face lifts and blepharoplasty. so that goes to show if you are honest with the nurses they will get you to the right dose. Some people just want to get high aren't ready for mmt yet or didnt need such a severe course of action to get clean! Thats where all the horror stories seem to come in. If done right it can be very successful. Beats the alternative for me anyway! Oh and I am on 110 mgs. I am a fast metabolizer and wish I could split dose but its not an option at my clinic. Wish i could do 80 in the am and then 30 around 4 or 5pm. My counselor told me not to be afraid to increase bc if u need it and are still craving and showing signs of wd then u aren't getting the max benefit of the program. She says you dont have to be sick sick to be wding and thats where people go wrong bc you aren't supposed to crave and if you are its the beginning of wds. She also said if u need done u need it and whats the difference in the grand scheme of things? It will just take alittle longer to taper.

 

[Ziebug]

Cool yall are talking about this because I'm going to try to get back on maintenance but at this point I feel methadone would be way more beneficial... Last time I was on subs, they didn't really help with my panic/craving although it did stop my wds pretty good... I don't know if it is because I've been using too long and too much for subs to work right or what but I'm seriously considering methadone but I'm a little apprehensive BC I've heard it harder to get off than dope... Idk, I'm so tired of desperately wanting to get clean and failing miserably everytime... MMT sounds like my last resort at this point in time.....
Any advice is appreciated, thanks!
Ziebug

 

[My3sons]

I did subs the first time around and just couldn't catch the second. Being on mmt beats being in active addiction. it may not be a perfect solution but its much better!

 

[thelung]

It sounds to me like your dose isn't holding you. try asking for an increase in your daily dose. if you aren't worried about having to taper off, i believe that around 100mg is a good therapeutic dose that will hold you through the day and keep cravings away.

I've been on mmt for about 7 years. i've been on 65mg for a while now, it holds me all throughout the day with no w/d. i don't really want to go any higher because i know how hard it is to detox off of methadone. so i'll stay where i'm at for now

 

[average extreme]

I did subs the first time around and just couldn't catch the second. Being on mmt beats being in active addiction. it may not be a perfect solution but its much better!

yeah thats true for sure. i can work now and live a pretty normal life. i often complain about the methadone but i got to say it saved me!

but i also have to say that i don't improve further now. i am allready years on mmt now, i got kicked out of it several times for using but right now i am relatively stable. everytime i try to drop my dose i feel that it isn't enough. 90 mg are perfect for me but i just beat myself up that i need it because i know that i would be a lot more productive without the methadone and i just feel stuck. i allways try to tapper and then i relapse, right now i am on 75mg i think since last week and i allready feel that it isn't holding me.. but i just can not accept that i have to take this for the rest of my life. it is better than being out there and shooting dope all day but it is not optimal, it is a trade-off (still a good one)..

i am with thelung op, just increase the dose if you can not wait for your body to adjust to the 50mg....

 

[NateJW]

Hey guys just wanted to say thanks to everyone who took the time to reply, I got a lot of good out of it. The paperwork went in today to up my dose to 60 so hopefully in the next couple days it will go through. Although I still can't say how well it's working for me since I still use almost every day. It's a whole hell of a lot less than before I started mmt, but still just about every day leaving work as long as my wallet allows it I get a small amount. I get a slight rush but all noticeable effects are gone very quickly, it's just that I no longer feel sick after doing this so I can make it comfortably until the next morning when I can dose again.

I found out my counselor has ONE client who is on a hundred mg, so I guess it is possible to go above 80 as long as theres a legitimate reason for it. So I'm not too worried about that anymore. And also ive tried suboxone and subutex, and neither of them work for me for any long period of time, not to mention it's more expensive than the methadone. My clinic does discounts If you pay weeks ahead of time so I've been taking advantage of that.

I also had my first drug test today since the preliminary one. Obviously im gonna fail it but my counselor knows my dose has not been holding me so im pretty sure he's expecting it.

But I do wanna ask average extreme you days you got kicked out for using? I know every clinic has different policies about that but do you mind telling me what happened in that situation? This is the most stable my life's been in a long time and it keeps getting better id be in a bad spot to get kicked out right now.

 

[thelung]

At most clinics, it usually takes quite a few dirty UAs to get kicked off the program. they'll give you plenty of chances. people get kicked off for other dumb reasons like drug dealing on site, fighting, violence, things like that. They'd rather have you ON the program than OFF the program because they want your money. Its the sad truth, especially at the for-profit cash-only mmt clinics

 

[average extreme]

But I do wanna ask average extreme you days you got kicked out for using? I know every clinic has different policies about that but do you mind telling me what happened in that situation? This is the most stable my life's been in a long time and it keeps getting better id be in a bad spot to get kicked out right now.

they kicked me out after about 8 months of dirty UAs the first time, they told me often that they'd do that and that they want me to go to detox and then they'd continue but i didn't go so they just said we kick you. but here are plenty of clinics.... so this is not that much of a problem. alot of people i know got kicked out of it for selling their take homes... so usually this is really no problem as long as you stick to the obvious rules and are honest with them. i was homeless when i first started mmt so it was very difficult to stay away from drugs.

 

[NateJW]

8 months? Like continuously once a month? Or once a week? Did you fail for anything besides opiates?

Im pretty sure im gonna fail for benzos now that I think about it, which sucks cause I legitimately have zero problem with them it's been weeks since I had a couple that I took to help me sleep my first week on mmt and didn't really even like them enough to think about it since then. It makes me unable to function and I have a newborn with my girlfriend and getting up and feeding him in the middle of the night is impossible in a xanax stupor. If it is still in my system I'm gonna tell my counselor and be honest I'm just scared to death that it's gonna get in the way of my dose increase. I took them cause my dose wasn't high enough in the first place.

 

[average extreme]

I failed for cocaine in every UA and sometimes there was all sorts of other things in there. The funny thing is at first, when i paid for it myself, they didnt even ua me, they only did that after i had insurance
i am in germany btw., we probably have other regulations here.

When i go to a real methadone clinic it is very difficult to get kicked out and it never happened to me there it only happened if i was getting itfrom a regular doctor that not only did mmt but had normal customers too

 

[NateJW]

Well I didn't fail for benzos and I really don't know how. But oh well, I did get moved up to 60 and now im barely even feeling the dope when I do it. So I think I'm gonna go for another ten next week and I should be good on that dose, it's a full blocking dose and I can deal with slight withdraws in the morning I guess.