Just went into HARD wd but take methadone? What is happening?

[Dotherightthing]

First time posting here. Sorry this is long but I am at a loss. I just got home from the ER due to going into HARD withdrawal all of a sudden after having a large, painful bowel movement yesterday afternoon. I cannot wrap my brain around what just happened to me. And I have been googling trying to find out ANYTHING on what I've been through & can't find even anything remotely close to what just happened to me. This sounds absolutely crazy. I know it does. Trying to explain it to the ER doc was ridiculous but I was in such misery that I didn't care how it sounded. But I'm really scared about what I just went through and don't want it to happen again(obviously).

I have been going to a clinic getting dosed methadone for years. I have not touched anything illegal in almost 2 years. I get take-homes & have been doing really good. I have been having stomach issues, like severe constipation so much so that I have to use a suppository just about every time in order to have a bowel movement. Suppository use has been going on for about 6 months now. So yesterday I had to drive my daughter to work at 3pm. Before we left, I forgot I had not taken my methadone dose for the day so I get one of my take home bottles & take the 79mgs of methadone like usual. By the time I had dropped off my daughter at work & am driving back home my stomach starting hurting like I had to have a bowel movement asap. I breathed through the pains & made it home, and started getting goose-bump cold chills but that wasnt anything unusual for me cause somtimes if my stomach hurts bad & I have to go I've had cold chills before. Well I go to the bathroom & I'm sorry (tmi) but it was like my intestines fell out of me & it was a ton. I stand up & get this feeling of like being drained of everything out of my body. I got really dizzy & out of it, started sweating profusely & having those goose bump, cold chills all over my body just like I had immediately started hard-core, opiate withdrawal? It wouldn't stop. Constant hard sweating & violent chills & I told my mother somethings wrong, maybe I'm having a heart attack or ripped my insides from the violent bowel movement. I asked her 20 mins later to take me to the ER, something is wrong.

At the ER, still having violent cold chills all over my body & the horrible sweating mixed with NOT being able to sit still or fall asleep, It felt too much like opiate withdrawal & that's what I told the ER doc. He couldn't give me any clonidine or anything until after the MRI of my stomach. And I requested they drug test me because I know there are things that could cause one to go into instant withdrawal if u mix it with suboxone & an opiate or I heard when they give you naloxone that you go into immediate withdrawal so of course I'm thinking the new people at the clinic maybe did something to the methadone. All the regulars quit a few weeks ago on the same day so we have had different dosing nurses in there every day over past 2 weeks. I don't want to think that someone at the clinic would do this but wtf like I was in severe, instant withdrawal out of the blue?

This sounds absolutely crazy. I know how this sounds. I brought my take home's with me to the hospital, and when I realized this was withdrawal, I took another whole bottle of 79mgs of methadone for Saturday's dose. It didn't touch me. They gave me clonidine after the results of MRI of my stomach came back normal & when My urine came back having methadone in it, Nothing else. Nothing helped. It was like I was in precipitated withdrawal. They released me after midnight & when I got home I tried to sleep but couldn't from the God awfulness of the cold chills & severe sweating. At 4am after having gone thru heavy withdrawal for 12 hrs, I remembered that I had a small stash of methadone on hand in my medicine cabinet from a couple of months ago. I had saved a couple of doses for just in case. Desperate for some relief, i took a big sip and tried lying back down. I woke up 2 hours later with no cold chills, light sweating still, no "kicking" anymore. And have been ok since. I'm really weak & have a massive headache still but I'm not in withdrawal anymore. That was 12 hrs ago that I took that dose I had put away for an emergency.

But none of this makes sense. How can someone who has taken methadone daily for years, all of a sudden be sent into severe withdrawal after a huge, painful bowel movement? I'm trying to think of all the reasons this could have happened. This just doesn't make any sense at all. I don't go back into the clinic until monday. I feel like I should tell them what has happened to me. I don't want to accuse the clinic of anything, cause what if it was my body that just somehow emptied off my receptors when I went to the bathroom? That sounds crazy! But what I've just went through is crazy. I don't want it to happen again.

Does anyone have any answers as to what just happened to me? This sucks.

 

[losangeles1993]

Okay soo let me remind you..you cam still use methadone and other opiates and not go into precipitated withdrawl..only suboxone will cause that...i have buddies who have slammed H and popped all sorts of pills while being dosed 100mg of methadone few hours earlier...I remember reading if you focus on your symptoms your symptoms become worse..maybe you overreacted your cold chills and they stayed with you...see your body will believe what your mind tells you..so if your telling yourself Its immediate withdrawal your body will believe it....and maybe someone spiked your methadone with naloxone or something...make sure your not taking any medication that can cause it...very weird tho.

 

[Dotherightthing]

Yes, I used to do H when I was being dosed methadone at the beginning. It's been almost 2 Years since I've done anything illegal or used. Ive only taken my daily methadone doses everyday.

Reading back over my post, It seems to me that something sent me into precipitated withdrawal or spontaneous withdrawal. But how and What? I think I should definitely talk to my counselor at the clinic next time I go in on monday. This is just too weird. And my body is still trying to recooperate from the violent chills, sweating & kicks. Ugh

 

[Jabberwocky]

I mean is it at all possible this was some freakish kind of virus? I mean did you feel like you might have been about to come down with a cold, or where you in conditions that might have made you more susceptible to a virus or infection than normally? It's just a random thought I had, so don't necessarily take it too seriously.

 

[Dotherightthing]

No, at first I thought that. That some kind of crazy thing was going on but all the symptoms pointed to hard withdrawal. As soon as I went to the bathroom, the cold chills, sweating, sick feeling started. I even started the sneezing 50 times in a row, that cough/puke thing & yawning constantly with tears literally 5 mins after I went. Then when I was in the hospital bed, I soaked the bed, blankets, my hair but my body was almost numb from the constant goosebump chills. I was kicking. When they were trying to give me an iv & get blood, ct scan etc, I couldn't stay still or fall asleep for even a minute to get relief. I've been through withdrawal 100s of times before although its been a couple of years. It was definitely withdrawal that came on instantly. Only thing I took right before it started (maybe 30-45mins) was my usual methadone take-home dose. Those symptoms lasted a full 12 hrs. I took probably the equivalent of 3 take home's during those 12 hours trying to get it to stop & it finally stopped when I fell asleep after taking MORE stashed methadone from my medicine cabinet I had put away from clinic "just in case". I am still kind of sweaty. But it's manageable & no chills which are usually the worst part of wd.

I really don't want to go in accusing the clinic of anything. Idk if it's even possible that the nurse had put in subutex tabs ment for someone else & accidentally mixed my methadone in the bottle would that even be enough to cause precipitated Withdrawal? I had methadone in my test at ER but doc said there wasn't anything else. Idk if subutex would even show? Or if by some strange chance, when I went to the bathroom it caused me to go into HARD core withdrawal ? But that sounds crazy! And I dont even think thats possible.

As you can see, I'm all kinds of confused.

 

[Dotherightthing]

Ok update. I just checked my take home bottles. One of them has a few milky pink looking, thick chunky like residue pieces on insides of bottle. Not like the normal looking methadone residue in the other bottles. I am SO Pissed! I have to go into this clinic tomorrow morning. The nurse mixed in subutex with my Methadone? I went through absolute hell. It came on instantly. Omfg. I'm shaking.

 

[Reanimator13]

10 years of morphine pain management use. Once or twice a year I would let myself get bound up and not notice it ( Constipation ). The end result was always withdrawal symptoms. Used to make me sick for 3-4 days. Real sick. Talked about it many times with my doc and she had no answers. I used to tell her it was like my medications were not absorbing. I think she thought I was a little off. Happened too many times for it to be in my head. Solution was to better manage my bowels... But life always got in the way.

R13

Edit - Wanted to add... It always felt like one end was blocked and the top end was desperately trying to clear it. Like a giant cauldron of liquid in my gut working its way through my system trying to clear the blockage. Wife and I had a name for it even... The Purge.

Edit 2 - Wanted to add now that im thinking back to those first few times. I thought at first I was getting bogus pills from the pharmacy lol. Thought I took the wrong dosage. Etc... All the crazy thoughts.

I think its just the bodies response to a bad situation. Absorption slows and the priority becomes getting rid of everything. Anyways... 10 years of 300mg of morphine daily. My 10 cents.

 

[losangeles1993]

Holy shit dude are you serious? did you have any beef with nurse ? go get her ass fired dude she laced your methadone..
you can sue theyre asses...let me know how this goes please ..this is interesting amd scary..im sorry you had to go thru that man

 

[Dotherightthing]

I went in today and my counselor & regular dosing nurses were genuinely concerned. Told me that that nurse is already gone & is not coming back so not to worry in the future. He was like a temporary, fill in nurse that I saw twice over past 2 weeks. But the director wouldn't even give me 5 minutes of her time. My counselor told me I have to report what happened. So he calls down to the director & she tells him to tell me that what happened to me doesn't concern her. And would not even speak to me to let me explain or show her the weird crap inside my bottle. I'm furious. But in order to get my methadone dose today & take home, I had to give them my empty bottles.

The clinic put me through total, agonizing hell. And risked my years of sobriety by me possibly going out & using to get out of the hell I was in. I didn't use anything but you know how it is when you're sick like that. Not to mention, the clinic knows I have severe health issues. I had open heart surgery & 5 artery surgeries all within the past 9 months. They know about my health. I've been going to this clinic for years. And they wouldn't even acknowledge what I went through?! It could have gotten real serious. Just the spontaneous withdrawal hell was torture enough for me to deserve an "I'm sorry" or "lets test the bottle or view the security footage to see what happened" . Yeah, I'm pretty furious.

 

[Dotherightthing]

I honestly believe that it was not mixed on purpose. This nurse was just a temporary fill in that I didn't know. The clinic has been crazy busy lately so it was an honest mistake made. Probably put subutex into a take home bottle, forgot it was in there, then when I came back to dose just filled methadone on top of the subutex. But a damn serious mistake. I suffered bad. I at least deserve an I'm sorry. It's messed up.

 

[Jabberwocky]

Wow. Sounds like you unfortunately have found one of the shittier clinics out there. At least you have figured out wtf was going on now though! If I were you and lived in an area with more than one clinic, unless you know it's even worse, I'd switch clinics. Something like this happening is more than enough legitimate ground to transfer clinics. Shit, you could sue your current clinic for malpractice if you wanted to.

 

[jdfisse]

Yeah that sounded like my experiences of being dosed with sub when fully loaded with opiates. The only difference is that violent feeling you felt stayed on me for 3 days and then got slightly less over a few weeks. That is because I did everything wrong that you could possibly do. Uglu UGLY UGLY wouldn't wish that on anyone. I stayed high several extra years just to never feel that way again... detoxing was a breeze compared to precipitated w/d. You may have just got some bupe dust. I slapped a 20mcg bupe patch on and slept for about 10 minutes because it instantly drained the life out of me...yeah ten minutes later I met God. That is some real unprofessional stuff going on in that clinic if that did happen though. They could conceivably kill someone with an accident like that.

 

[Dotherightthing]

Yes! That was exactly how it felt. Like I instantly had the life sucked out of me. Makes sense cause the subutex instantly kicked or was trying to kick all the methadone I've been taking & storing for years off of my receptors & out of my body. Ugh it's total agony. Didn't think I was ever going to have to deal with that crap again but I guess when taking methadone there is always that possibility of having to go through some level of withdrawal.

The clinic, I feel is dead wrong for not letting me speak about what happened to me, offering an apology or hell acknowledging that they caused me tremendous suffering. It could have gotten real serious as in heart attack etc considering my health history. Definitely not just letting them get away with brushing this under the rug.

 

[Mike93]

Yes! That was exactly how it felt. Like I instantly had the life sucked out of me. Makes sense cause the subutex instantly kicked or was trying to kick all the methadone I've been taking & storing for years off of my receptors & out of my body. Ugh it's total agony. Didn't think I was ever going to have to deal with that crap again but I guess when taking methadone there is always that possibility of having to go through some level of withdrawal.

The clinic, I feel is dead wrong for not letting me speak about what happened to me, offering an apology or hell acknowledging that they caused me tremendous suffering. It could have gotten real serious as in heart attack etc considering my health history. Definitely not just letting them get away with brushing this under the rug.

Definitely do not let them brush this under the rug! You could have died, especially considering all those surgeries you mentioned! I bet you're not the first and only person this has happened to either. I would even try and report it to the state/whoever runs it to ensure that they don't hire incompetent employees who can't tell the difference between a Methadone pill and a Subutex pill! I would definitely check your take-homes from now on before leaving the clinic after they give them to you and that way you can address the problem right away instead of going through the entire ordeal that you just did!

 

[jdfisse]

Well I wouldn't get too crazy. They do hold all the cards in this situation. Are there other clinics near where you live in case your report causes them to get shut down? Cutting off the nose to spite the face is definitely a possibility. The free market only works when there is competition. And generally high levels of competition lead to better monitoring and service. So I am guessing that you don't have a ton of options available to you. Providing service to a methadone dependent individual is not a requirement to my knowledge so getting too crazy might lead to an expulsion.

 

[Reanimator13]

I just went out and did a quick search on pain meds not working while constipated... there are threads out there on this. Im going to quote a post from a methadone user...

"I really would like to find out the same answer. I know 100% for a fact it affects painkillers. I have been on methadone for years and when I get extremely constipated I start noticing withdrawal symptoms, and my methadone does not provide relief and it gets worse. Now after I originally looked it up I assumed it was just the constipation causing these withdrawal effects, although as soon as I have a good bowel movement the next day when I take my methadone I get a kick from it for a good week until I am even more constipated then before. I have been on methadone for years and it does not give any effects other than a prevention of sickness after the stabilization period. I have been on the same dose for years. So why is it I get no effect when constipated and actual get opiate withdrawals then the day after a large relief I get a buzz from the methadone. It isn't all in my head I have been doing it for years and know this for a fact."

There is a link there... It effects enough other folks out there besides my self for it to not be a real thing. Before going all postal on the clinic do your own research on this. The info is out there... Trying to help you...

R13

 

[Reanimator13]

One other thing I wanted to point out... You need better bowel management. Not a bottom up approach but a top to bottom approach. Starts with what your eating. Kill the constipating foods. Exercise. My bowel routine was miralax and senna plus. These types of products along with opiates tend to suck the magnesium and potassium out of your body. Almonds and spinach are your best friends.

If you don't manage your bowels a whole world of hurt is going to come down on you... You can do some serious damage not just in toxin build up but in diseases like diverticulitis.

Trying to help...

R13

 

[Dotherightthing]

I completely agree about needing to fix my constipation issue. I unfortunetly got into the whole, "imodium to ease withdrawal crap" a few years ago for about a month and ever since then, have had horrible bowel problems. That's why my first thought was bowel related when it started. Or heart attack cause of the chills & sweating initially. But then the other symptoms of sneezing, yawning, tearing, kicking & not being able to fall asleep made me realize I was in hard withdrawal. I can see even slight withdrawal symptoms happening due to stomach issues, just not what I experienced. I add everything up coupled with the severity of it, I am 110% positive I was in precipitated withdrawal.

The mix up was not done intentionally. I know this. Mistakes happen. This was a fill-in nurse that wasn't one of our regulars who was not paying attention & was probably rushed due to the ridiculous amount of clients this place keeps taking on. But this was really fucking serious. I was in agony. It could have turned out really bad. They risked my sobriety & put me through a (almost full) weekend of hell. What if it had caused me to have a heart attack? Or what if I had been pregnant & lost the baby? Or what if I had been driving when it came on suddenly & I hurt someone else or myself? The list goes on & on. Luckily none of that did happen & although I suffered tremendously, it wasn't fatal. You know what I mean?

I have definitely been thinking about all of my options here. I keep going over everything a million times. There are a few other clinics in the area. Granted they are not my first choice, this clinic is - or was. It's the only self-pay, no insurance accepted clinic around here. Its the nicest, cleanest, quickest & most expensive clinic around. You get the idea. The others I could transfer to but that could take over a month to get in. Although my current clinic could NOT just kick me out, they'd have to do an administrative detox which would take several weeks.

I want them to acknowledge what I went through. But I just have this feeling that I'm not going to get from them what I feel I deserve, an apology.

 

[spacejunk]

First you need evidence of wrongdoing, and unfortunately, people on ORT are unlikely to be treated the same as other patients because of the stigma of opioid addiction.

It sounds like your concerns were dismissed out of hand, which is certainly shabby treatment - but frankly, i wouldn't hold out too much for an apology.

I personally am a little sceptical it was buprenorphine that caused this, because it has a really low oral bioavailability (as i understand it).
To me it seems more likely that there was either a fuck-up somewhere along the way - do the staff at the clinic dilute your methadone?

Or - and this may be a bit of speculation, but is there any chance someone in (or with access to) your home has diluted/adulterated your take-home doses?

I don't mean to sound dismissive, but i think it is important to be as factual as you can possibly be if you are going to follow this up.
Everyone here is merely speculating - which is fine, but it doesn't mean you know what happened.
I'm sorry it happened to you, but it might be a good idea to further investigate your GI issues and how they could potentially cause problems with methadone absorption.

 

[Reanimator13]

I think Spacejunk nailed it on the really low oral bio-availability of buprenorphine. There are post out there of folks who have eaten them and had no withdrawals. At least thats my understanding.

A few other things on bowel management. Never ever ever EVER take something thats going to bind you up ( imodium ) while your on a regular opiate regime. This can end up being life threatening. Think blockage and toxicity. If you need to firm up do it naturally ( Rice/cheese ). When you start to get toxic pain meds stop working real well. And you get all the symptoms associated from withdrawal from the infection/toxicity. You get real sick.

A person abusing opiates goes through highs and lows. On the lows their system empties. Management has no lows ( Unless you miss a dose )... Your always in a state of bind. You have to manage this.

Talk to your doctor. Do some research. Make some changes... best of luck.

R13