Opioids Methadone and Ayahuasca

[Swimmingdancer]

EDIT: I've edited this post to remove off-topic info as it is an off-shoot from another thread where I mentioned ibogaine.

Ibogaine treatment is available in Canada or Mexico, and I'm sure there are some illicit clinics operating in the US. It's really not as successful for methadone detox as it is for heroin or other shorter-acting opioids. And you have to stop taking the methadone for 24hrs before you can start on the ibogaine therapy. An alternative to ibogaine is ayahuasca, but only ayahuasca "churches" have permission to legally give people ayahuasca in the US. Of course again, there are operators outside the law, there was even an opioid detox program using ayahuasca run by doctors in Canada, but Health Canada told them to stop. There are legal ayahuasca detox centres in Peru. If anyone wants any info I have done a lot of research on these treatments and have personal experience. But given the right intention, set and setting, and ideally supervision, almost any psychedelic can be used to help with addictions, at least the mental aspects of addiction. And many help temporarily with the withdrawal symptoms.

EDIT: The discussion that follows goes into detail about using ayahuasca while on methadone maintenance, particularly the issue of whether or not there is a potential adverse interaction from taking the two together. Please note that I am referring to a traditional ayahuasca preparation made from the banisteriopsis caapi and psychotria vridis plants.

 

[Diamondhead]

ayahuasca-Methadone interaction

Swimmingdancer:

Let me tell you my situation and hope you can steer me in the right direction from your personal experience. My brother has been on Methadone for about 5-7 years and is at 95mg (although he sometimes skips days or does 1/2 doses). Naturally he wants to quit.

From what I've read on-line, I know that Ibogaine treatment center is the way to go. I'm willing to fund his treatment, and although he's open to the idea of Ibogaine he's reluctant to get the treatment out of fear of relapse (and having the treatment $$$ pissed down the drain). He kicked Methadone a few years ago but his wife is also on Methadone and so it was hard for him to stay clean.

Later this year I was planning on going to Peru for my first ayahuasca retreat. Long story short, I learned a few days ago that my medical adviser belongs to a Brazilian church who legally consume ayahuasca as part of their spiritual beliefs. In 2 weeks and a short drive from home, I'll be attending my first twice-monthly ayahuasca ceremony with them. My brother is dieing to attend with me....but nobody wants any adverse interactions with the ayahuasca and Methadone.

I've searched on-line for 2 days about the ayahuasca-Methadone interaction and 99.9% of it is conjecture, speculation, and opinions, maybe's and what-if's...and short, cryptic references to personal experiences. You wouldn't believe how little information there is out there about that subject.

I finally found your 05-06-2012 post, and you're the first person who sounds like they actually have real life experience (and are willing to go into educated detail about it). In your post, you said....

"An alternative to ibogaine is ayahuasca, but only ayahuasca "churches" have permission to legally give people ayahuasca in the US.... There are legal ayahuasca detox centres in Peru. If anyone wants any info I have done a lot of research on these treatments and have personal experience."

It would be wonderful if the ayahuasca did help with his Methadone addiction/withdrawals in some way, but my brother isn't necessarily expecting or intending to use the ayahuasca experience(s) to detox him from the Methadone. My opinion is that the ayahuasca experience will give him the spiritual direction to want to do the Ibogaine treatment.

1. Can you give me personal experience information about any adverse interaction between ayahuasca and Methadone?

2. Can you give me personal experience information about the Peruvian ayahuasca detox centers?

3. Did you detox on ayahuasca?

4. What was your Methadone dosage when you detoxed?

5. Do you know anyone with personal experience with Ibogaine and Methadone? Does it kill both the mental and physical cravings?

Just know that because there is so very little first hand information about the ayahuasca-Methadone interaction, whatever information you can post about your experiences should float to the top of the Google searches.

Looking forward to your reply!

 

[tricomb]

VERY interesting.

Can you call the ayahuasca detox center in Peru and ask them? I'm sure they've dealt with this before, right?

 

[Swimmingdancer]

What I did was ask my doctor beforehand, as he knew what ayahuasca was. He said that with my dosage and tolerance to methadone it would be fine. I think the key is that I don't get high from the methadone because I have been on it for a long time and only take enough to prevent withdrawal - if someone were high on opioids there could conceivably be an interaction with the MAOI or an increase in the sedation, but even then it's not as serious as with pharmaceutical MAOIs. The reason that people who don't specialize in addiction treatment with ayahuasca are very hesitant to give someone ayahuasca who is on any other drugs is because they do not want to be responsible if something did go wrong, which is very understandable. I have never heard of anyone dying from ayahuasca. I know of people who have taken it while on methadone and even heroin. What is usually done is that the person takes a smaller starting dose to see how it affects them. Please note that with ibogaine the dangers of taking it while on opioids are higher. As to your specific questions:

1. No I have never personally had an adverse reaction between ayahuasca and methadone. I do not personally know of anyone who has (although that doesn't mean it isn't possible). There was a methadone doctor in Canada - Dr Gabor Mate - treating his patients with ayahuasca but he seems reluctant to discuss it in too much detail because Health Canada told him to cease this practice. There is a film about it - The Jungle Prescription - but it doesn't say what the protocol was surrounding the people who were on methadone. Ayahuasca can be very challenging at times though, for anyone, and it is not for the faint of heart.

2. I have not attended an ayahuasca detox centre in Peru, but Takiwasi is a popular one. As tricomb said, you could try calling them and ask what they do for people who are on methadone.

3. No, I have been using it to help me taper off methadone. I was having an exceedingly difficult time tapering on my own and was not able to get it down past a certain dose. With the help of ayahuasca I have now reduced my dose by 90%, which is a huge accomplishment for me, and it has been very beneficial for my life and mental health in other ways. I probably would have been able to do it faster if I had gone to a centre where I took ayahuasca more frequently.

4. When I decided to try ayahuasca, I actually started reducing my dose before I even began using it. It somehow gave me the courage to reduce my dose, knowing that I would be doing it soon. If I recall correctly I think I was down to around 30 or 40mg a day, taken in split dosing (half twice daily). The first couple times I did it I took less methadone than usual before the ayahuasca, but I soon decided I didn't like being in withdrawal while on it, so I switched to taking my usual dose beforehand and reducing it afterwards. But I think people should find what works best for them. I know people who just stopped taking it before the ayahuasca and didn't go back to it, or who reduced the dose drastically the day of. Personally I was not comfortable with the idea of just stopping it completely, I felt I had to do it gradually. I am now down to 3mg 2x a day, I just reduced my dose from 4mg 2x a day. One thing I think is extremely important is taking the ayahuasca under the supervision of someone with a lot of experience as an ayahuasca healer/doctor/shaman/etc. And researching it a lot beforehand to prepare oneself.

5. It seems to really depend on the person. Some people say ibogaine healed their mental addiction and physical dependence overnight, others say it didn't work for them. I think that (as with ayahuasca) it is important to be doing other things in your life to help with your addiction, it's not a magical instant cure.

Google ayahuasca forum for more info.

I'm not actually sure if Santo Daime or UDV are the best places for someone wanting to use ayahuasca to get off methadone. There are definitely other options in the US, the churches are just the only legal ones. The dosages they use in Santo Daime or UDV might be lower and gentler though, which could be a good or bad thing depending on how you look at it. I think it's great that your brother has no expectations and I am quite confident that ayahuasca will help him in some way if he is open to it.

Please feel free to let me know if you'd like more information

EDIT: Personally I would actually be concerned about quitting a high dose of methadone cold turkey and then taking ayahuasca. Same with ibogaine actually, although this is done frequently (then again, there have been a few serious problems and even deaths with ibogaine, I can research the details if you like). Quitting methadone CT can be extremely rough on your body and mind. Another thing I just thought of is that some people claim that methadone should decrease the effects of the ayahuasca but I have NOT found this to be the case for me in the least. I have really found ayahuasca helpful with the mental aspects of addiction, like it's made it much easier to bear withdrawals and cravings without compulsively turning back to heroin.

 

[Diamondhead]

Swimmingdancer:

About how many times have you done ayahuasca....and how frequently? The UDV (the Brazilian church) holds ceremonies twice a month.

I think the key is that I don't get high from the methadone because I have been on it for a long time and only take enough to prevent withdrawal
That's how my brother is. He's a maintenance user.

With the help of ayahuasca I have now reduced my dose by 90%,
You mentioned that when you started doing ayahuasca you were doing about 30 or 40mg of Methadone a day, taken in split dosing (half twice daily)....and now you're down to 3mg 2x daily. How many months did that reduction take from the first time you used ayahuasca?

The first couple times I did it I took less methadone than usual before the ayahuasca, but I soon decided I didn't like being in withdrawal while on it, so I switched to taking my usual dose beforehand and reducing it afterwards.
When you were still at high dosages such as 30-40mg, did you ensure that you didn't take Methadone a certain number of hours before doing ayahuasca? If so, normally how many hours before?

I am now down to 3mg 2x a day, I just reduced my dose from 4mg 2x a day.
Congrats on that. My brother has mentioned what big steps the very last ones are.

One thing I think is extremely important is taking the ayahuasca under the supervision of someone with a lot of experience as an ayahuasca healer/doctor/shaman/etc. And researching it a lot beforehand to prepare oneself. I think it's great that your brother has no expectations and I am quite confident that ayahuasca will help him in some way if he is open to it.
It will be taken under the supervision of a shaman with the UDV. I've told my brother what to expect and he's anxiously looking forward to the benefits. If it helps at all with his Methadone addiction that would simply be a welcome bonus.

Some people claim that methadone should decrease the effects of the ayahuasca but I have NOT found this to be the case for me in the least.
Ok, that's a good thing for anyone who combines the two to know.

I have not attended an ayahuasca detox centre in Peru, but Takiwasi is a popular one
I checked them out. Incredibly low prices but their webpage says they require between a 9-12 month stay. That's a bit more free time than my brother has.

Thanks SD for the enlightening answers so far! Once my brother reads your answers, I'll be back in contact with any questions he has.

 

[Swimmingdancer]

livetheopiatedream & noculi - the original post was from a month ago, we are now discussing ayahuasca and methadone

About how many times have you done ayahuasca....and how frequently? The UDV (the Brazilian church) holds ceremonies twice a month.

I started about 6 months ago and have usually been doing it around 2x a month, although I will often do 2 days in a row, (so once a month for 2 days). This is just what has been available to me and what I thought I could handle. A regular schedule would probably be more beneficial. UDV is quite different from the way I have been doing it, I have been following the indigenous Peruvian tradition. It is my understanding that the UDV uses a smaller amount or a weaker brew (though I'm not 100% sure), which might be nice, especially for beginners.

You mentioned that when you started doing ayahuasca you were doing about 30 or 40mg of Methadone a day, taken in split dosing (half twice daily)....and now you're down to 3mg 2x daily. How many months did that reduction take from the first time you used ayahuasca?

Before I began taking ayahuasca I was on 60mg/day for quite some time, then I tapered it for a month or 2 before starting ayahuasca, then I took about 6 months to get down to 6mg/day. That may not seem very fast, but it is an amazing accomplishment for me, since I have been on methadone for 10 years, (with a highest dose of 100mg/day) and was never able to get down below 50mg/day before.

When you were still at high dosages such as 30-40mg, did you ensure that you didn't take Methadone a certain number of hours before doing ayahuasca? If so, normally how many hours before?

I just kind of played it be ear to find what worked for me. I think that it's different for everyone; I am a rapid metabolizer of methadone the effects wear off much faster than for someone who is an average or slow metabolizer. The first few times I just took 1/2 my methadone in the afternoon and took the ayahuasca in the evening, then took the rest of my methadone the next morning. But I was taking a bit less than I would normally take. Just because this was safe for me does not mean it will be safe for everyone though. Ayahuasca affects different people very differently, as does methadone. But I can tell you that there have never been any known fatalities from ayahuasca. If you research it you will find there have been only 2 recorded deaths in connection with it and neither was attributed to the ayahuasca: 1 was nicotine poisoning from drinking tobacco, and 1 was someone who was taking a lot of synthetic 5-MeO-DMT and a non-traditional ayahuasca analogue, the cause of death was not determined. People can get "unwanted" side effects while on ayahuasca, but many people choose to view these as part of the healing. Is your brother going to tell the UDV organizer that he is on methadone?

I think the main reason people are cautious about combining methadone and ayahuasca is because ayahuasca contains a natural MAOI and they have taken the drug contraindications from pharmaceutical MAOIs, which list opioids as something not to take without consulting a doctor. There is also the worry that ayahuasca could possibly potentiate opioids. No one wants to bring bad press to ayahuasca or be held responsible if someone had a serious reaction, so organizers are usually hyper-vigilant about the drug restrictions. The MAOI in b. caapi is a natural reversible MAOI and so does not have as high a risk from food and drug contraindications as pharmaceutical MAOIs do, but people administering ayahuasca want to play on the safe side and with good reason. I do not want to advise you that it will be safe for your brother to take ayahuasca while on methadone, I can only share my personal experiences.

EDIT: I think the "do not take MAOIs with opioids without consulting your doctor" is a blanket statement to offer legal protection to the pharmaceutical companies. I did find an interesting review:

Ever since the initial report by Oates in 1955 there have been periodic reviews in the literature concerning the safety, or otherwise, of opioid analgesics in patients who were taking MAOIs. The enduring difficulty in understanding the nature of the problem is related to several factors. First, the apparent serotonin re-uptake inhibitor (SRI) capacity of opioid analgesics is only partially documented even now, and it is possible they have other serotonergic effects. Also, until recently, there has been a lack of systematic data to accurately define the features of serotonin toxicity; and the spectrum concept of serotonin toxicity, that emphasizes it is a dose-related phenomenon not an idiosyncratic reaction, has only recently been formulated.

Some opioid analgesics are weak SRIs and may also act as serotonin releasers, which could present a serious interaction.

Drug - - Serotonin toxicity reports with MAOIs
Morphine - - None
Codeine - - None
Buprenorphine - - None
Oxycodone - - None
Tramadol - - Definite, and possible fatalities
Fentanyl - - Uncertain. One case of serotonin toxicity, and one possible death reported
Remifentanil - - No cases or deaths reported
Methadone - - No reports known, but unlikely

Meperidine (Demerol) is not listed but it is my understanding that there have been adverse interactions with it and pharmaceutical MAOIs as well.

Read more here and here.

I also found, from a methadone manufacturer in reference to strong pharmaceutical MAOIs, "Monoamine oxidase inhibitors may prolong and enhance the effects of methadone". One may find that ayahuasca allows them to take less methadone, and/or take it less often. It is my belief that it helps in a number of different ways. What my doctor said was that if someone is on stable methadone maintenance then a possible potentiation of the methadone should not be dangerous. So my best advice, to be on the safe side, would be for someone who is on methadone to start out by taking a bit less of their methadone than usual, not taking it too close to when they will be taking the ayahuasca, and/or starting with a small dose of ayahuasca to see how it affects them.

The only other claim I have heard as to why people are told not to take ayahuasca while on methadone is that it might possibly increase sedation. Sedation in and of itself is not dangerous, you might just have to put more effort into staying awake. (In my experience however, I have not been any more sedated than the people around me who were not on methadone so maybe it depends how sedating methadone is normally for you).

EDIT 2: As for Takiwasi, their website states:

Allopathic medicines are not used at any stage of treatment and their use is restricted to emergencies only.

I wasn't able to find any more details than that but that makes me guess they would like people to detox from methadone before beginning treatment there. It would certainly be nice to know for sure because I know a lot of people have questions about that.

 

[tricomb]

Discontinuing Methadone with Ayahuasca

 

[ecore24]

good for you, stay with it my man.

 

[tricomb]

good for you, stay with it my man.

I'm not on methadone, You caught this in the few minutes it took me to create this thread in order to move off-topic posts from another thread to it's own thread for better discussion.

 

[Swimmingdancer]

Maybe ecore24 was talking to me? If so, thank you

And thanks tricomb for making this its own thread. I think it's great to have a thread on this topic because there seems to be a dearth of reliable information out there on taking ayahuasca while on methadone. Many ayahuasca organizers or websites forbid it without even understanding why or whether there truly is a risk. If I find any more pertinent info I will add it here and if anyone else had any questions please feel free to ask

 

[tricomb]

For sure, I also thought it was a good idea as it's own thread.

 

[Swimmingdancer]

Some people claim that methadone should decrease the effects of the ayahuasca but I have NOT found this to be the case for me in the least.

Ok, that's a good thing for anyone who combines the two to know.

I just wanted to go into this subject a little more. I think the reasoning behind the idea of methadone lessening the effects of ayahuasca is because DMT is a serotonin receptor agonist and methadone is a serotonin receptor antagonist. From my personal experience, taking ayahuasca when I took methadone recently did not produce less intense effects than taking ayahuasca when I had not taken methadone recently. And for me, I get extremely intense effects from even a very small dose of ayahuasca, so I don't believe the methadone is blocking the DMT. I don't know too much about the science behind this aspect yet, but it seems like if someone is on a high dose of methadone or has not been on it for a long time (and therefore their brain has not adapted to it) it could potentially lessen some of the effects of the ayahuasca, but I want to caution against people taking a high dose of ayahuasca just because they are on methadone. I have heard people suggest that, but I think it is so highly variable that it is always best to start with a small or standard dose. I have seen people who have never taken a drug in their life take a huge dose of ayahuasca and feel nothing, and I have seen the reverse. The other thing is that ayahuasqueros have told me one doesn't necessarily need a crazy intense experience with vivid visuals and mind-blowing insights for the ayahuasca and the songs to be doing healing work on you.

 

[ecore24]

initally i directed it at tricomb. but i read your bit swimming dancer and i applaud you as well. methadone is extremely hard to overcome and the withdrawals can last up to a month, anyone who can make it through that has the heart of a champion most defintely.