Opioids Being FORCED to switch from DILAUDID to METHADONE. What do I need to know?

[John_Burrows]

ONOFF: Great point about dilaudid having low oral BA vs methadone's high BA - now it makes more sense that the methadone might "cancel out" the dilaudid.

Anyway, last night before bed I took 20mg and at 11:30am I'm doing fine, so that's a good sign.

FIRE: Hey I almost forgot about plugging, which is ironic since I've always been one of it's biggest supporters. I don't want to IV or snort, but I'd be willing to try plugging. Still, if oral works I'll stick to that. As much as I love my dillies, I'm tired of it running my life (have to inject every 5 hours or so to avoid WD, sometimes tough to find, always worried when the supply dwindles, etc).

As much as I hate to say goodbye to opiates, this might be a good time to try and kick the whole thing and see how my pain is off all painkillers.

TOMMYBOY, you said methadone is great for a short 4 day detox. Can you go into more detail? How would that work, just tapering down over 4 days? That seems like a really short detox after 3 years of dilaudid, but it sure would be nice.

EDIT: And I'd like to welcome all of you to this, my 1,000th post on Bluelight! Such a great forum, heads above any other drug forum I've encountered. Thanks to all of YOU for making it such an invaluable resource.

 

[SUB SHOOTER 2010]

Methadone does take a little while to kick in and is pretty good at combating withdraws. As far as pain goes I'm not sure that it will work as good as oxymorph, oxycod, hydro etc. But I would take more than 10 mg at first. It does take a while to hit you when you eat them but you can chew them up and it wont take as long.

I don't recommend snorting methadone because it feels like razor blades in your nose and those pills break out to a lot when you crush them up. Ive never done the 10 mg methadone pills that you are getting but I have done a lot of the M box rectangular tens.

I know people say you cant shoot them but you definitely can. Its hard to fit a lot of them in the syringe though because the pills have so much mass. Whenever it is IVed Ive noticed that it burns for a second after you shoot it and before you take the belt off but nothing serious.

I would suggest eating them though. I would eat 20 mg and chew the pills or parachute them so that it will hit you quicker. The great thing about methadone is that it does last a long time. When you hear about people being on 100 mg+ a day of methadone its completely pointless and they're doing nothing but setting themselves up for a lot of unneeded pain in the future. There is no reason to have a dose higher than 60 mg a day unless you are just detoxing or something.

Another thing if you are gonna be on any type of maintenance program I wouldn't be on the methadone one. I would ask for subutex. If you do decide to stay on methadone just don't jack your dose up real high because its gonna be that much harder for you when you have to get off it. And some people might disagree but I think a bupe withdraw is way easier to deal with than coming off high doses of methadone. good luck

 

[Tommyboy]

TOMMYBOY, you said methadone is great for a short 4 day detox. Can you go into more detail? How would that work, just tapering down over 4 days? That seems like a really short detox after 3 years of dilaudid, but it sure would be nice.

Sure. Most opiate detoxes in hospital settings keep you there for 5 days, dosing you for 4 of those days. In inpatient rehab I was detoxed off of opiates (I was using mainly 200mgs of oxycodone or 4 bags of heroin via nasal) in what they call a "blind detox." Basically, I was dosed 2x a day with methadone for 3 or 4 days, and then on the last day (4th or 5th) I was dosed once. Since this was a blind detox, I was not told the doses, so I really can't tell you how much they gave me, but I can tell you that it was pretty painless for me.

Here is what I suspect the doses (BID= twice a day) were: Day 1, 40mgs BID; Day 2, 30mgs BID; Day 3, 20mgs BID; Day 4, 10mgs BID; Day 5, 5 or 10mgs once in the morning.

Those doses were actually way too high for me since I had cut down to using 3 days a week for probation, but then I pissed dirty so had to go to inpatient for the month. I would suggest something similar, but starting with 30mgs BID, and following the same pattern as mine, but ending a day earlier, if you decide to do detox.

 

[Captain.Heroin]

Methadone will alleviate pain in the same way dilaudid will, as thy are both full agonists.

The problem lies with methadone not being a pleasant opiate. Yes some people get high on methadone, but due to a high volume of distribution, it becomes an opiate not suitable for IV use.

As your doctor does not know about your IV drug use, he isn't taking into consideration methadone won't be great when IV'd. In fact my friend liked IV buprenorphine more than eating methadone tabs rx'd for pain.

 

[Caspa]

Did your doctor say what type of methadone you're getting? Or do you have the prescription yet? In the US it's most often mixed in Tang (fake juice) and they make you drink it in front of the pharmacist, but it might be different for you if you are ostensibly being prescribed it for pain only. I am on solid tablets, (which are better and more consistent IMO) but it's rare in North America.

I just want to point out that usually, when the methadone is mixed in some sort of juice and administered right there in front of somebody, is when they're at a methadone clinic. And the tablets are quite common in North America, when prescribed for the sole purpose of treating chronic pain. Not trying to be a dick or anything, just saying.

To the OP: Methadone will be no where near as good as the dillies when it comes to getting high, but the pain relief will be outstanding. At least, that's in my experience.

 

[THC2LSD]

All the information I've found says IV methadone is twice as strong as oral, but your pills have microcrystalline celluose and starch, which will damage your lungs/heart if not micron filtered. Also it won't last as long as oral. It works fine orally. Remember it can take 2-7.5 hours to peak, so don't just take a bunch because it doesn't seem to be working. Methadone isn't as euphoric as shorter-acting opioids, but is still pretty fucking strong.

 

[Tommyboy]

^ The oral BA varies up to 90% so it's not likely that IV is twice as strong as oral for many people.

 

[THC2LSD]

Bioavailability is but one factor in potency, often drugs will reach high concentrations in the brain when injected, then redistribute to the rest of the body.Methamphetamine for example has excellent oral BA, but to say oral methamphetamine will feel as strong as IV/smoked just isn't true.Methaqualone also has good BA, but when a hypnotic dose 300mg is injected surgical anesthesia is produced for about 15 minutes, probably why smoking it so popular in India/South Africa, and why it has a reputation more like crack in South Africa whereas it was consider a soft drug when it was around in the US where it was taken orally. If you read the prescribing information for methadone injections it says oral to IV conversion is 2-1. Still methadone is highly bound to plasma protein, so though it may be stronger it probably won't have much of a rush, just stronger and a quicker peak. It also might not last as long, negating the increase in potency.

I'm not saying this to encorage the OP to inject it, rather to point out that if someone does inject it, it may be twice as strong and they should adjust accordingly.

 

[John_Burrows]

Well I really don't have an interest in injecting the methadone. First of all, after all this time i don't even get high anymore from dilaudid, and since everyone says methadone isn't as euphoric as dillies, it would probably be pointless for me even to try. The whole reason I started plugging then injecting dilaudid was for the much increased BA, but since methadone has good oral BA, I'll stick with that. Besides, dilaudid is also a fairly safe pill to inject, not so with methadone.

So two high doses per day is normal? I dunno why my doc said 1 pill four times a day!

Anyway today was my first day off dilaudid and on methadone. Last night I took 20mg (2 pills) and felt fine in the morning. After lunch I could feel subtle withdrawal coming on, so I took one 10mg pill. A few hours later I still wasn't feeling quite myself, so I took another.

Upon getting home, I still was feeling "eh." Not in WD per se, but just tired, a little irritable, stuffy nose and some of the pain that i haven't felt in years slowly started to rear it's ugly head. Oh and definitley I can feel slightly labored breathing. Still, on the WD scale I'd say it was a 3.

Obviously I still have to figure out how much to take, but based on the dosages you guys have talked about, even 20mg (double what my doc perscribed) sounds like a laughable dose for me. Still, I don't want to burn through all these pills in a week if i can avoid it, so I'll see if two 20mg doses a day will do it for me.

I have to admit, the thought of using it to kick opiates for good in less than a week is really tempting. It sounds so easy, why would anyone need to go to a hospital for that? If the methadone got me really high ok yes I can see the problem with quitting - but for this entire month (at least) I'm going to be taking methadone and not getting high at all. So why NOT just slowly take less and less every day? If I don't experience WD I won't even feel the difference.

I'd also like to see just how bad my returning pain will be. Maybe it won't come back at all, maybe it will be tolerable without pills. The only way I'll know is to kick it for a month and see.

If i end up needing to go back to dillies, i guess i should look at the bright side - that first pill after a month of absence is going to be a sweet one!

 

[VaderisBaddAss]

I've been on 8mg dilaudid/hydromorphone for pain issues for about 3 years, injecting for the past year (8mg, 5 or 6 times a day).

At the moment there seems to be a dilaudid shortage, none of the 30 pharmacies I called had it in stock and said it could be weeks before they get more.

So I had to ask my pain doc for a replacement. He's putting me on 10mg methadone, 4 times a day.

First of all, he doesn't know I inject, and secondly, I sometimes question the depth of his knowledge. He promised me the methadone will take care of the pain and I won't experience withdrawals.

Is he right? Will it be that easy? I have my doubts, so I thought I'd ask here for any insight anyone might have...

Note my tolerance is through the roof; the dilaudid rarely gets me high anymore, but it's part of my routine now.

Or at least it was!

So I didn't read anyone else's posts, but right away I went from IV Dilauded to IV Methadone and had no withdrawals at all. The switch was fine and I had no problems. Even when I switched from Methadone to Oral Dilauded then Oral Methadone the switch caused no withdrawals at all. Yea it took longer to kick in, but slowly I got used to it and figured out when I would need to take the pill so when my pain comes back It would kick in. The switch shouldn't be bad for you.

 

[John_Burrows]

You went straight to IV methadone? Is it any better through IV?

At least when the dilaudid kicks in I can feel it! So far, the methadone has absolutely no tell tale signs. I don't feel anything at all. The only way I'll know it's doing anything is if I don't get withdrawals.

And while that's a good thing, it kinda blows that the methadone is so "transparent."

 

[Swimmingdancer]

Thanks for digging in guys, I really appreciate the help.

After reading what you've all said, my biggest concern now is the dosage my doc perscribed. All of you are saying you take one high dose and it lasts all day - but he told me to take one 10mg pill 4 times a day.

What gives?

I never said that, in fact I thought I said quite the opposite. For some people, usually on much higher doses, it prevents withdrawal symptoms for 24 hrs. For me, and many others, who are known as “fast metabolizers,” it lasts nowhere near that long. It is, however, a widely-believed myth that methadone lasts for 24 hrs in everyone. I currently take 18mg every 12 hr but it only lasts for about 8 hrs, then withdrawal starts to set it and I just bear it until my next dose. As a pain-killer, it is even less likely to last for close to 24 hrs. So your dosing schedule is totally appropriate and has the added benefit that the methadone will build up in your system faster (it normally takes about 4 days for it to get to peak levels and be relatively stable).

From what I'm reading it sounds like the less time spent on methadone the better. But I guess that's only if he's not secretly trying to get me off it. Besides, why would someone switch to methadone to help them kick opiates? Why wouldn't your doctor just want you to slowly taper down your regular meds? Especially if kicking methadone is harder!

Because methadone is the common "replacement therapy" for opiate addiction. This is for a variety of reasons. Some of which include that (in low doses) it doesn’t make people who are opiate tolerant “high”, it has less potential for “abuse”, and that while more physically addictive, is not as mentally addictive, in that people generally don’t crave it or take more and more and more. And it’s possible that the “plan” is not to get you on methadone and then make you quit it, it’s just to get you off the Dilaudid. If your doctor thinks that methdone is a good pain-killer (which it often isn’t), he may think that it’s “better” for you to be on methadone since it will be way more difficult for you to get high from it or take it in any manner other than you’re supposed to.

Alright well since I'm out of dilaudid I guess the only thing I can do is bring the bottle to work and what, keep taking them until i feel alright?

I’d still start with the 10mg and wait an hour before deciding whether to redose. It really sucks that you have to be at work on your first day of the switch though!

is there any possibility it WON'T work at all, or is the worst case scenario i'll just have to take a lot more?

If you mean to prevent withdrawals, I’ve never heard of it not working, I think the worst is that you’d just have to take more. As for non-withdrawal pain, it really varies from person to person.

Any difference between dosing on a full or empty stomach?

No.

They are from Roxane labs. A small white round pill, maybe 50% larger than the dilaudid pill. It's pure white, no speckles or anything disrupting the texture, and the number 54-142 is printed on them. It SEEMS like a pure, clean pill, but what do I know?

Good, you are lucky, in my experience that is the best possible kind of methadone available. They should take about 20-30min to kick in, but the peak effect may take up to a few hours. It also builds up over time so even if the first few days are a bit rough it could improve.

It's labeled METHADONE HCL 10mg and I have 125 of them. Does the HCL mean anything?

The HCL just means “hydrochloride” – the full name is “methadone hydrochloride”.

Anyway I'm guessing this might be a good candidate for alternate ROA, but honestly I have no interest in chasing a high with this stuff. I just want to make sure I don't get withdrawals and if another ROA would make it more effective in this regard I'd be willing to try.

I really believe that taking it orally is the most efficient and that seems to be accepted in the scientific and medical community. I also don't think it makes you more high to use it any other way.

Good luck! i really hope it works for you!

 

[Swimmingdancer]

You went straight to IV methadone? Is it any better through IV?

At least when the dilaudid kicks in I can feel it! So far, the methadone has absolutely no tell tale signs. I don't feel anything at all. The only way I'll know it's doing anything is if I don't get withdrawals.

And while that's a good thing, it kinda blows that the methadone is so "transparent."

Yes, that's exactly why it's used to replace other opiates. Because the powers-that-be think it's immoral to get a pleasurable effect or get "high". It's also why it doesn't "cure" opiate addiction - all it does is alleviate the physical withdrawal symptoms, it doesn't deal with the mental addiction, hence so many people on methadone go back to other opiates. But having no withdrawal symptoms is a million times better than having them. And I for one was able to eventually stop using all other opiates because of methadone. i would never ever have done that if I had to go through cold-turkey withdrawal. But now I am stuck with the problem of being on methadone forever :-( It's taken me years just to get my dose down this low and I feel mildly sick and in pain all the time.

 

[IndustrialStrength]

So two high doses per day is normal? I dunno why my doc said 1 pill four times a day!

The reason that your doctor said this is that in opiate maintenance 1 or more rarely 2 large doses per day is normal.
For pain management multiple doses are spread out through the day often times 4 doses.
This is because the analgesic actions of methadone are not equal to the half life.
As such the dosing would differ as it's not being prescribed to alleviate w/d's it's being prescribed as a pain killer.
Thus the dosing would be prescribed according to what would be normal pain relieving guidelines.

I think I mentioned it earlier in the thread but hope that clarifies your question in case you missed it.

 

[debbbideb]

i'm only up to 80 a day but just to answer the glow question...nope. nothing like the oxy glow thats for sure...dam i miss that...

 

[Swimmingdancer]

The reason that your doctor said this is that in opiate maintenance 1 or more rarely 2 large doses per day is normal.
For pain management multiple doses are spread out through the day often times 4 doses.
This is because the analgesic actions of methadone are not equal to the half life.
As such the dosing would differ as it's not being prescribed to alleviate w/d's it's being prescribed as a pain killer.
Thus the dosing would be prescribed according to what would be normal pain relieving guidelines.

I think I mentioned it earlier in the thread but hope that clarifies your question in case you missed it.

Exactly what IndustrialStrength said. Dosing depends on the individual person, the reason they are taking methadone, and the quantity they're taking.

 

[Znegative]

The first few days might be a little rough, since you've been shooting such a large amount of dilaudid, but you should feel fine after three or four days,as far as withdrawals go. Methadone has a really long half life so it stacks up on itself, so eventually you'll have more than forty mg in your system, probably more like sixty or so. It really isn't that good as a high. Even without much of a tolerance I would have to take dangerously high dosages of methadone to get a good buzz going. You'll be okay though for a few weeks

 

[VaderisBaddAss]

You went straight to IV methadone? Is it any better through IV?

At least when the dilaudid kicks in I can feel it! So far, the methadone has absolutely no tell tale signs. I don't feel anything at all. The only way I'll know it's doing anything is if I don't get withdrawals.

And while that's a good thing, it kinda blows that the methadone is so "transparent."

Yea I went from IV Dilauded to IV methadone, but not straight. Like say I had 4 doses a day, they went three Dilauded and one methadone for a few days then switch to 2&2 then 3/1 then all to methadone. At first it was like "just give me the Dilauded methadone doesn't help!!" because it takes a few doses for the methadone to get into your body and for you to start being aware of it. But after a few doses I didn't even notice the difference.
Sometimes I could feel the "kick in" with the methadone, but your right, not all the time. But if your taking it for the rush, stick with the Dilauded. If your actually trying to get off the Dilauded from addiction bc of surgery, like I was, the methadone will help.

 

[John_Burrows]

Thanks again for the help. Sorry DANCER if I misunderstood your previous comments.

So I'm on day 3 now and, happily, no withdrawals in sight. It takes about 8 hours, maybe 10, before I feel the need to redose. I'm tempted to see how long it takes before I really feel WD take hold, but what can I say, i'm not so keen on feeling sick, especially when I'm not sure exactly how long it will take to kick in!

On the other hand, it's not so great for pain. Little aches and pains I haven't felt in years are creeping in. Not awful, but I can feel it. Also, I'm WAY tired. I slept for nearly the last 24 hours.

I've also felt slightly labored breathing, something that I was warned MIGHT happen with dilaudid but never did. With methadone, a walk up one flight and I can feel breathing is a little tougher than before.

I'm also a bit listless and not quite feeling myself, but I figure that's a result of not shooting dillies for the first time in a year!

If i was asked to choose right now, I'd go back to dilaudid, but I'm going to give it at least a week before I even think about calling the doctor and two weeks before I make a decision. I guess it's going to depend on the pain level.

As much as I dont actually like the idea of going back to dillies, in the end they did work and, despite hitting the needle, I have definitely managed as a functioning addict. My life hasn't turned to shit over opiate addiction, so I have to figure if after a year I was ok, I'd be ok at it again.

Still, being a slave to that needle SUCKS; always having to be in a position to shoot up every 5 hours def makes you a slave. If I didn't already take a briefcase to work, god knows how I ever would have hid those rigs! So the temptation to leave dilaudid behind for good is a strong one.

 

[Swimmingdancer]

Thanks again for the help. Sorry DANCER if I misunderstood your previous comments.

No problem at all I hope I didn't sound bitchy when I was clarifying things ;-)

So I'm on day 3 now and, happily, no withdrawals in sight. It takes about 8 hours, maybe 10, before I feel the need to redose. I'm tempted to see how long it takes before I really feel WD take hold, but what can I say, i'm not so keen on feeling sick, especially when I'm not sure exactly how long it will take to kick in!

Yeah, it depends whether you're just interested in using as little as possible to stave off withdrawal or if you want to try to keep your other pain at bay.

On the other hand, it's not so great for pain. Little aches and pains I haven't felt in years are creeping in. Not awful, but I can feel it.

That's too bad. It has definitely been my experience that it doesn't help me at all with pain.

Also, I'm WAY tired. I slept for nearly the last 24 hours.

I've also felt slightly labored breathing, something that I was warned MIGHT happen with dilaudid but never did. With methadone, a walk up one flight and I can feel breathing is a little tougher than before.

Hopefully these side effects will go away after you get used to the methadone. They definitely did for me.

Good luck