When to consider methadone?

[Somethingelse3221]

Hey everyone. Ive finally decided to join BL. Ive done quite alot of reading here & it has definitely thought me alot of harm reduction when it come to using drugs.

I currently take 800mg of codeine a day with 25mg of doxylamine to help with the side effects & add to sedation.
I take about 100-200mg of diazepam a week & 200-400mg of temazepam too which isnt prescribed. The most ive taken is 200mg of diazepam in one dose & 400mg of temazepam in one dose but usually take smaller doses a few times a week.

Im currently on disability pension & unfortunately I spend alot of it on oxycontin or heroin. I always IV the heroin which I usually take 2 bags or I chew or IV between 80-160mg of oxycontin. I only use 2-3 times a month because it's all I can really afford

I phoned a drug & alcohol hotline & they gave me a number to a methadone clinic & Im considering maybe getting on just a low dose of methadone. But Im unsure if this well eventually cause me more trouble & tolerance in the future to the problems I already have now.

Really I just want to save money. I dont wanna have to spend time cwe'ing, pharmacy shopping & dealing with opiate & benzos dealers. I suffer from depression & dont really wanna give up taking opiates but do u think it would lead to a worse situation if I get on methadone later down the track?

Im sure they give u an appropriate dose for ya tolerance but Ive heard about how hard methadone is to get off so Im not sure if it would be a wise decision. Obviously I would save alot of money & time but like I said, the only opiate I use daily is codeine. So it would be a far jump from codeine to methadone but I could take an appropriate dose like I said. I still get a good effect from codeine. I actually prefer codeine, some doxlyamine & a few valiums over 40mg of oxy & Im thinking the methadone could replace the opiates & maybe my desire to take so many benzos.

Ive tried Subeutex before but I dont really want to quit opiates. I guess it would be insane to think I could just permanently stay on opiates. & Im guessing u would slowly build a tolerance to methadone too.

So do u think the benefits of taking a small dose of methadone would outweigh the life-style of spending alot of my money & time on benzos & opiates, or do u think I should just quit opiates now while im not to addcited, taper down the benzos & maybe get a script for a benzo just to take when I really need it & maybe try an antidepressant?

I think deep down I know what the right choice would be but having depression & an addictive personality makes it really hard for me to stop taking drugs. I'm guessing most ppl regret ever starting methadone but if I simply cant stop taking drugs it would probably be an option. It would just make things alot easier. atleast for the short-term.

 

[Swimmingdancer]

You rapidly build up a tolerance to any "high" caused by methadone, although you don't easily build up a tolerance to its ability to keep you from going into withdrawal sickness. People on long-term methadone maintenance just feel "normal" and many, if not most, still crave our drug of choice. I would only recommend methadone to someone who has already tried every other way of quitting, is physically dependent on opioids, can handle the idea of potentially being on methadone and chained to the clinic or pharmacy for the rest of their lives, and understands that it is just a tool to get some stability back in your life and avoid withdrawal symptoms so that you can make changes to your life, work on your mental addiction and treat the reasons you were using in the first place.

You should also know that they will randomly drug test you for opioids and benzos while on methadone, and you will have consequences for a "dirty" drug test which, depending on the doctor/clinic can range from taking away any privileges you have earned, such as being able to have take-home doses, to sometimes even kicking you off methadone. It will also change the way you are treated by medical professionals and you will no longer have the option like a person who has not been identified as an "addict" to be taken seriously and prescribed pain meds or benzos when you need them.

Are you physically dependent on opioids right now? (as in do you get sick if you stop taking them for a day?)

 

[Somethingelse3221]

nah not really. I dont get to sick. I dont think anyway. Ive atleast been taking codeine every day & benzos atleast once a week for quite along time. nothing i wish to throw away my privileges to pain meds & benzos for. I just have depression & opiates & benzos give me a clean mood list like no other drugs. I mean antidepressants & stimulants have alot of side effects. I guess i was just hoping to save money i guess. I actually wouldnt have wanted my dr to know. As he is considering prescribing me xanax.
Could I go to a methadone clinic & list a different dr to the one I actually see. Just another dr ive seen a few times. not the one that's actually treats me?
I do not want my dr to know im an addict.
I might add that over the years. although when Ive had a break from codeine & take it again it'sn a little stronger. my tolerance plateaus & I got the same sense of well being every day. Ive just had 800mg 20 mins ago with 25mg doxlyamine. no valium today although I can get it if i want it. The feeling of codeine to me is better than oxycodone although not as strong. I guess that just means I like morphine better. Ive only had little experience with morphine, only popping some tablets a few times but they gave me IV morphine in hospital which I got them to up the dose a few times. I was maybe up to 20mg. Ive also had fentanyl in hospital which was quite nice. I kept pretending i needed further pain releif lol even though I wasnt feeling a thing. & than i walked out with 30mg IR oxycodone so & they even gave me 50mg of temazepam. Which i was meant to take at bed time. Yeah right
Does ya tolerance plateau on methadone or keep rising?
im chasing the high. I use opiates to treat my depression & benzos to treat anxiety.

btw I have a friend who i can get subutex from. Ive tried them before & they didnt have effect although wikipedia say they are recreational. I was taking 8mg a day for a while. If I take like 32mg will it have an effect anything like codeine?

 

[Swimmingdancer]

nah not really. I dont get to sick. I dont think anyway. Ive atleast been taking codeine every day & benzos atleast once a week for quite along time. nothing i wish to throw away my privileges to pain meds & benzos for.

Then I would not recommend methadone to you, as someone who is not physically dependent on opioids already.

I just have depression & opiates & benzos give me a clean mood list like no other drugs. I mean antidepressants & stimulants have alot of side effects.

Uh, so do opiates and benzos!!! lol And their withdrawal is awful :-(
I guess i was just hoping to save money i guess. I actually wouldnt have wanted my dr to know. As he is considering prescribing me xanax.

Could I go to a methadone clinic & list a different dr to the one I actually see. Just another dr ive seen a few times. not the one that's actually treats me?
I do not want my dr to know im an addict.

I think that's pretty unlikely. Doctors can look up a list of all drugs you are prescribed.

Does ya tolerance plateau on methadone or keep rising?

I don't know anybody on daily methadone maintenance who was able to get at all "high" off it for longer than the first month or two. I really wouldn't consider it a replacement for the mental effects of other opioids, that's why so many people keep using other opioids when they are on methadone. Methadone is really only good for keeping you from getting withdrawal sickness. Then you will become dependent to it and if you stop taking it the terrible withdrawals can last for months.

btw I have a friend who i can get subutex from. Ive tried them before & they didnt have effect although wikipedia say they are recreational. I was taking 8mg a day for a while. If I take like 32mg will it have an effect anything like codeine?

I think Wikipedia just means that Subs are sometimes taken by people who they aren't prescribed to or people sometimes "abuse" their Rxs, not that they're a good high. I would NOT suggest taking 32mg of Subutex.

 

[opi8]

I went on methadone when the only other option was suicide. I wouldn't recommend waiting that long.

 

[Swimmingdancer]

I went on methadone when the only other option was suicide. I wouldn't recommend waiting that long.

The OP has plenty of other options and methadone is not going to solve his/her problems when he/she is not even physically dependent on opioids. Methadone did help me, as I was in a similar situation to you, but for the OP I think it would have way more downsides than benefits.

 

[somewherehappy]

Methadone Maintenance. Serious decision which could effect the rest of your life

Make your decision carefully as it could have consequences that last for a long time. Methadone is harder to get off of than heroin according to a lot of people. You'll be a slave to it having to get your dose all the time and if you miss it will go through the same withdrawals your right now thinking can be avoided.

 

[opi8]

The OP has plenty of other options and methadone is not going to solve his/her problems when he/she is not even physically dependent on opioids. Methadone did help me, as I was in a similar situation to you, but for the OP I think it would have way more downsides than benefits.

I started on codeine too, I was just adding my 2 cents.

Also, I wouldn't ever recommend methadone to anyone. I'd say fucking suck it up you pussy cunt and go through the pissy little withdrawals you will deal with now, rather than make them much worse, which happens inevitably. But I'm not an asshole, and nobody would listen to that anyway. I also never said "go on methadone", I said "I wouldn't recommend waiting that long."

I'm also in a bad mood, so I mean no offense with my direct attitude.

I read all of somewherehappy's post, and this person did hit the nail on the head.

I have depression and anxiety like you, like you I also used opiates to self medicate. I ended up using hundreds of dollars of smack a day, bought in bulk, and my life was falling apart. If you think it can't happen to you, you're deluding yourself.

If you are going to kill yourself, methadone is an option.

If you're not at that stage yet, you will be if you keep using opiates as self medication.

My advice is to stop while you still can. People don't say opiates are bad because they make you feel good and you're missing out on something special. We say they're bad BECAUSE THEY WILL FUCK YOUR LIFE UP, like they have ours.

Get out while you can, without methadone or bupe.

 

[Swimmingdancer]

I started on codeine too, I was just adding my 2 cents.

Also, I wouldn't ever recommend methadone to anyone. I'd say fucking suck it up you pussy cunt and go through the pissy little withdrawals you will deal with now, rather than make them much worse, which happens inevitably. But I'm not an asshole, and nobody would listen to that anyway. I also never said "go on methadone", I said "I wouldn't recommend waiting that long."

I'm also in a bad mood, so I mean no offense with my direct attitude.

I read all of somewherehappy's post, and this person did hit the nail on the head.

I have depression and anxiety like you, like you I also used opiates to self medicate. I ended up using hundreds of dollars of smack a day, bought in bulk, and my life was falling apart. If you think it can't happen to you, you're deluding yourself.

If you are going to kill yourself, methadone is an option.

If you're not at that stage yet, you will be if you keep using opiates as self medication.

My advice is to stop while you still can. People don't say opiates are bad because they make you feel good and you're missing out on something special. We say they're bad BECAUSE THEY WILL FUCK YOUR LIFE UP, like they have ours.

Get out while you can, without methadone or bupe.

Thanks for the explanation. It sounded like you were saying "don't wait, get on methadone as soon a possible before you end up in a situation where it's that or suicide" ;-)
Thanks for clearing that up.

 

[josie]

I agree and disagree with a lot of the things said here.

First off, if you are not physically dependent on opiates, avoid methadone. Three times as long the withdrawl as heroin, doesn't make you high, PLUS you have to get up super early and get to the clinic every morning! (Well maybe you could get out of that because of disability)

I reread your post and basically what it looks like you are saying is you dont want to quit using, you want to get high, but you want it to cost less and still feel like heroin/your pill cocktail of choice. Did you know that this is a wet dream every heroin addict (at least that I know) has had? Maybe in heaven.... kidding...

Anyway I have had tremendous success with Suboxone but it is pretty expensive (I take 2 films a day, runs me about $15 a day) but when you think about it that's a heck of a lot less than I was spending on dope. I get an increase in energy, but I dont get high off it. Where its real benefit is is the way it tricks your brain into thinking (at least chemically) that you aren't craving opiates, so you can put some distance between yourself and the drugs and increase your chances of quitting.

This is kind of a pointless conversation, though. If you don't want to quit, you're not going to until your ready and want to. You may try methadone and hey by all means if thats something you want to try, you're an american you have the right. But when I didn't really want to quit and I tried going on methadone, I'd end up doing both that and H, then go back to just the H, and start over... also I just kinda wanted to throw you a warning (I know you've probably already heard this, but I actually learned this the hard way, I at first had no idea xanax/valium were addictive) to watch those valium pills and how often you take them. Withdrawls from them are brutal and can kill you.

From the way you are talking I think you know you have a problem but you aren't ready to change. It also sounds like you might want to ask your doc to try out a few other different kinds of antidepressants. I have had serious depression problems, and one time it took me 4 different med-switches to find the right antidepressant for me without crazy side effects. A lot of your depression could be caused or amplified from this drug use, because you are basically depleting your brain of the chemicals that make you feel good and happy (antidepressants and suboxone help put some back in) Methadone will not give you the high you are looking for. As far as lists of clinics and stuff, google is a marvelous thing.

 

[ezkapaid]

I've been on methadone since late '09, and I feel my problem has been amplified by methadone. It is the strongest opiate available and when you make the choice to switch to a daily pay clinic, you enter into an agreement with those people to pay them an average of ~300 dollars a month for your treatment, or roughly 4,000 a year. Your counselor at the clinic will not push you to stop at all, and after you become totally dependant on them for your mental stability and productivity, and also considering the demand for most young people to perform some humiliating labor to compete for that 1800 dollars a month you need to survive... frankly there will be a wall higher and wider between you and your stress-free existance than most want to realize at that first clinic visit. There will continue to be one to several awful days every month. You 'could' eliminate this factor down to one serious withdrawal day a year and some general malaise if your fortitude is ever vigilant and the counselor has a genuine connection with you, but remember; eventually, you will be leaving the clinic with a week or more worth of the strongest drug, one that makes some addicts feel 1000% stronger and more vibrant as long as they are on the constant course of taking 'just a little piece' more than they are supposed to. But the nature of the clinic is only half the issue when you talk about why methadone is a last resort.

The reason you are in the position you are in is because you fear withdrawal. When you let the clinic do its thing, they want you on a 'saturation dose' of 50mg/day (at least, but some clinic docs are methadone fanatics that push 80mg and let you keep digging yourself deeper for months in the name of prevention) to be sure that no reasonable amount of hydrocodone/apap pills, or any less than a $50 shot of boy is going to compete for your affection. The first day I went to the clinic, I was on $65/day minimum of boy, plus morphine whenever possible. The initial standard 30mg of methadone put me to sleep for 40+ hours, just in time for an increased dose on the third day, and everyday or every other day until I was on 50mg. I was lucky that the old state-run clinics were $3/day, and I could afford to be bedridden for the first week. After they are satisfied you are 'stable' and assuming you don't keep asking for more and complaining of cravings (methadone produces less dopamine in your brain: you adjust with a little time and comparatively no effort), you can more or less continue as if you are drug-free. ASSUMING YOU HAVE THE MONEY, RESIST EXCESSES, AND CAN GET THERE DAILY. I don't know anybody who wound up in this situation because they loved their job, had a stable home life, and could take drugs or leave them alone. And eventually, and usually at the worst possible time, you will have to face a lack of some form putting you off the dose. At that point you must face the reality of what you have chosen, particularly the fact that methadone has been relentlessly suppressing your endorphin production for months straight, and now you face TWENTY TO THIRTY DAYS OF SEVERE PHYSICAL AND MENTAL WITHDRAWAL. Not the week of work you might have missed by quitting heroin or oxycontin. A true test, rather, that may have the side result of burning every bridge and personal relationship you've got. Bottom line: If you are a casualty of American life like I am, and you didnt quit once you realized what was happening the first time, this is no kind of answer.

As for what you can do that's better: Let me just list a couple things that have helped me. These are not popular with everybody and seemingly contradict much of the logic seen up until here. Unfortunately, I must list in order of cost, as money or its lack prevent us from being healed.

1. For $5000, you can buy a quick fix in the form of a 5-day Ibogaine resort treatment. Ibogaine is a hallucinogen strongly suspected of reverting your brain to pre-abuse conditions in some capacity which stops the cycle long enough to change your habits. Anyone who says a hard trip isn't the answer hasn't endured this level of anguish for any length of time. I know a bit about both methods and I trust this method far more than the Weismann (sp) method of sedating you until you are clean. If sleep could fix this I wouldn't bother writing about it.

2. $300/ month: Get on Suboxone (buprenorphine). From the standpoint of withdrawal, buprenorphine in moderation has a much easier withdrawal profile because it is a PARTIAL-AGONIST opiate, meaning your body is making some kind of endorphins, even as the amount of the drug in your body peaks. But that is the sole difference between Suboxone therapy and methadone clinics. I think its appropriate to call methadone full-agonist when you consider the agony it causes by comparison. Its a shame nearly every other opiate is also technically full-agonist, because it might be a useful designation of methadone's relative strength otherwise. Another consideration is having a month's supply at once when you see a private Suboxone dispensing doctor. I believe that the temptation to overdo it when you have a lot leads to buprenorphine's bad name. Rather than getting on the dispensary wagon at your local doctor, buy 12 8mg suboxone strips from somebody and give them to somebody you trust that cares about you. Take 8mg/day for one week, 4mg a day the second week, and 2mg a day for a third week and then quit. I wish I could get this together, I'd be taking this practical step rather than:

3. ($0-everything) What I am in the process of doing is going broke in the middle of a very slow, debilitating methadone clinic detox and depending on someone I love to share 10mg a day just to soften the blow for a couple weeks and make sleep and eating breakfast possible. The day I get used to taking 10mg I am going the rest of the way off. I'm day seven, going crazy with boredom and malaise, and trying to incorporate as much of my final suggestion as possible:

4. ($200?) Marijuana relieves a major portion of the withdrawal symptoms, and it distracts you from being miserable for an hour at a time. Get a dime or get an ounce, call your job, tell them the twins died you'll be back in a week and hang up, put some stuff in a bag, throw your phone in a drawer, and go by yourself to one of America or Europe's fine larger state parks. Preferably a good distance from your house. Pop a tent by the water, put some Bob Marley or some positivity in the headphones, and smoke out for a couple days while you get through the worst of it. Pick some berries, splash some water, have a barbeque. Whatever you can handle, just try not to be the fool that got you into this. Prone to paranoia when you smoke? Great. Self-doubt and self-reflection will follow, leading to an occasional epiphany and a pleasant somnolence. All of the mechanisms that help our endorphin system are well at home outdoors and you will be much improved by any exercise and general away time you can muster. Smoke bowls so it lasts and you don't overdo it. I dug a hole down into an apple today, and a connecting hole to the side, and I might never smoke any other way again. Just eat or smash it when you see the police. I practically lived at a park or on hiking trails for several months in 2010 and the emotional and physical benefits were great, too spiritual and hard to explain to get into now. It was a shame at the end of it I had just enough money to get back to the clinic and full-time, low wage work. That's not what troubled people need. Next time we'll do better.

 

[itsok]

i would refrain from methadone usage. However, I would see an addiction psychotherapist and psychiatrist to work on ur issues. As u dont seem ready to stop using, pissing dirty on Methadone could give u unwanted consequences and it would be just another addiction on ur back and a bigger, heavier burden than ur current regime. For example, in my clinics, a dirty urine, automatically increases one's dose by 10mgs. Considering that the dose was already knocking me out, making me sweat, and nod a inappropriate times, yet not curb my cravings really made it dangerous to drive and difficult to hold a job.

I find mxe for 2 days helpful in combating my opiate physical w/d's, but u dont get physical w/d, lucky and try to keep it that way.


Try to explore other solutions to ur depression/mental health issues before things get out of hand.

 

[ezkapaid]

I definitely agree with the above, if you can afford psychoanalysis. But the same problem can arise if you end up at a psychiatrist. Less talk, more drugs. We all have a reason why we can't stand being sober, you need to identify if not counteract the issue.

I wrote another long post about how going up too high (over 70mg) on your methadone dose might cause a secondary system of elimination to kick in. Gone. Frustrating. Long story short, this bodily defense is similar to a future diabetic's increased production of insulin, producing more enzymes which eliminate methadone. The animal brain cannot find balance simply by reducing endorphin production, and so it effectively goes on 24hr rinse cycle as long as possible. This is unproven (?), but makes sense of why nobody feels better at 120mg than they did at 60mg for very long. So watch out for that if you do decide on methadone. Chasing a heroin high using methadone will leave you with decaying teeth, deadly colon-cancer serious constipation, , irritability, and a lack of will to even go to the clinic. By comparison and through numerous anecdotes and personal experience, I feel a daily dose right around 45mg for a 150lb man or slightly smaller woman (methadone is fat retained and women store more of it) can balance out in a month to a very productive, strong-feeling high from the second hour to the eighth following your dose. I was talkative, productive, and most importantly, not bored, regardless of how poor the day turned out. similar to prozac. Complete opposite of tendencies at 70+ mg. I don't think those results are to be expected, but certainly the balance is key. This is assuming you don't screw it up by mixing in another drug that increases dopamine, norepinephrine, or serotonin (amphetamines, opiates) and resets your brains' expectations of these neurotransmitters to a degree methadone can't touch. And yes, that was a way shortened version.

Another thing about a clinic as a harm-reduction tool: If you are outgoing and outspoken, you may find the clinic to be a big group of similar drug users who you are drawn to share your experience with. After that exchange, you might confess a recent slip up or some such and in turn, you get a similar story, including the name of the other addicts' drug of choice. 10 minutes later you are doing said drug with said addict. In my case, the first time it was 2x stronger heroin than I'd ever done, for 30 dollars cheaper per gram, delivered. My girlfriend had us hang out with the clinic patient at his house a few more times and then we cut him out. The next time it was a dude that just wanted to hang out and gave his pills away, and since then I am as short as possible with people at the clinic, and that includes my counselor, unfortunately. IMHO the methadone clinic is just as likely to be the maturation of your addiction as the recession.