MMT/Bupe therapy

[Jabberwocky]

Hi all,

As you all know I've been battling with opiate addiction for about 6 years now and I'm getting tired of the whole illegal process of obtaining the stuff, dealing with the withdrawals I have to combat when I don't have it etc.

I'm 20 years old - and I am thinking seriously about jumping into a maintaince programme. I'm really unsure on which opiate to settle on however, but I know that if I tried I would even be able to maintain legally and prescribed under a psyciatrist using oxycodone. However, oxycodone is riddled with problems most impotently that of tolerance build up etc. I'm not sure of any other opiates that can be used for maintaince for a long term type therapy - however in the UK guidelines state that any full opiate agonist can be used to maintain a patient upon their request and at the discretion of the psyciatrist.

Has anyone been on both the drugs mentioned? Methadone and bupe? If so - which have you preferred to use, and why? I think I'm wanting to jump on this programme for many reasons. I've tried to come off opiates numerous times but it just leads to relapses and me feeling shit about myself. I have a huge network of support in real life, but I thnk now I just genuinely have a problem that is going to be lasting and I really should hop into a programme where I can be monitored, assessed and I can get my prescription legally without having to go through all this hiding and bullshit that I'm just sick and tired of.

Thanks for all your suggestions and help.

 

[Pagey]

I think trying to get into a legit programme sounds like a really good idea. Plus it'll get you out of the whole illegal drug dealing world that would probably be more likely to make you relapse.

I don't have experience with either methadone or bupe but I've spoken to a few people who do, and the general consensus seems to be that bupe is easier to taper with - mostly because methadone withdrawals are apparently a really hellish process.

 

[Jabberwocky]

I think that I'm looking for more of a long term solution though. With bupe it's a fantastic drug to use in order to come off opiates, however I couldn't foresee how you could use it to maintain an addiction to them. When the time came I think I would use bupe to come off methadone. Does this sound reasonable to people?

 

[Mass08]

I have only used methadone in a medical detox facility and it does make detox a breeze. I personally enjoy bupe more though. A lot of my friends are on bupe for maintenance and I have used it for a few weeks at a time and I must say it is really conducive to recovery. Bupe gives me energy and puts me in a really good mood, there isn't a buzz, certainly it doesn't make you feel high either. It just makes me feel motivated and look forward to tackling the challenges that lie ahead that day. I would recommend bupe for a long term solution.

 

[Jabberwocky]

I was considering using methadone due to its long half life, and it's stable dosing platform. It would only be taken once a day - which eliminates the need to continually redose, I found that the case with bupe and also I've heard it maintains a somewhat euphoric element to it. Bupe did lose its euphoric side quite quickly which had me relapse soon after I lost that initial type euphoric feeling. When I say long-term I'm perhaps talking about 6 months of maintaince and then getting off for good.

I just don't know about bupe. Like I said, it was great to use to come off a habit rapidly and without pain, but maintaince wise it was dreadful. It made my desire to use higher in some regards and when it didn't work oh boy I bit the bullet and really put myself in danger regarding overdose.

I've also pondered perhaps the use of dipipanone too. I could have access to this in terms of maintaince theapy.

 

[crzydiamond]

At age 21, I went into MMT for much the same reasons. For me, it allowed me to stop the "illegal" lifestyle, hold a decent full-time job, and live without focusing on "how am I going to feel normal in the morning" as that was pretty much my main concern every day.

For me, at that time, best choice. Allowed me to live normally. When I got to the point I felt I no longer needed it, I slowly came down. I personally did not have trouble coming down SLOWLY. Key --slowly. With re stabilizing as necessary

The drawbacks--you are still dependent on a drug. If your clinic is well run, not an issue. If you have a place that is not really about helping but about how much money can we make and therefore cram in cash paying clients while trying to kick out stable patients on assistance, not a good thing. Saw many times people forced to do a 21 day detox due to lack of funds. Horrible.

If you choose MMT, resist the temptation to keep upping your dose. They offer all thetime. I found myself on a dose where it was hard to not nod out randomly during day. I got tired of living like that, and came down to a more appropriate dose. Just remember, whatever you stabilize at is what you eventually must come off of!!

That said, at the time, MMT was good choice for me. I can answer any other specific questions you may have.

 

[Mass08]

Dude if your looking for euphoria from your maintenance drug then you have a snowballs chance in hell of getting clean and sober...The point of maintenance is just to keep withdrawals and cravings at bay. You shouldn't be trying to catch a buzz man your trying to put that all behind you and start a new way of life. I think if your choosing methadone because a major reason is the chance that you'll be catching a buzz at first is a grim mistake and you need to do some serious reevaluating. Not trying to be a dick or anything I just think that is a major red flag.

 

[birdcatcher]

Syn,
I am coming up on 4 years of bupe maintanence (3mg/day for the last 1.5 years) and was on methadone for a year before that (30mg/day). Bupe has worked well for me with minimal side effects. The thing I remember not liking about meth is that it made me nod all the time like almost falling asleep when driving or any other time I wasnt active. I am in my early 40's and have only had very short stints of complete sobriety since I was 14 yo so I really havent ever known what true, sober life is like but the bupe makes me feel as if this is what "normal" is like with the added benefit of curbing a days aches and pains but mainly I like to say it "passifies the beast" I call addiction.
Also I find MMT or BMT does a good job of numbing a good bit of your spirit and emotions. I have had to enter the early stages of W/D's for short periods more than a few times over the the last five years and one of the most painful parts is realizing, during these times just how my spiritual/emotional health has been surpressed

If I was 20 again I would be shooting for abstinace cuz dragin' this addiction thing out your whole life sucks.
My plan in the next year is to do Iboga. From extensive research I believe this is about the best shot for a spiritual and neurological reset for me. If I lived in the UK I probabley would have already tried it.

 

[phatass]

if you are an IV user don't go for subutex, subuxone or methadone would be better.... i would recommend you try buprenorphine first as it has a lot less of the "negative" side effects of opiates like sedation, high dose MMT will likely zombie you out a bit and makes one very sweaty. Also if your DOC is oxy you might actually prefer buprenorphine because it a somewhat speedy opiate like oxy but less euphoric.

Allthough you stated you may be able to get prescription oxy, as you said tolerance will be an issue, and more importantly it won't break the cycle of addiction, allthough you will still be physically dependant, mmt and bupe can play a role in treating addiction.

 

[Toz]

I have been on both, and I would choose none. Eventually, as time catches up, you will realize you are not the same person you used to be. Both MMT and BMT has, as birdcatcher here already said; a numbing effect on the mind. While this may be welcome at first, after years and years of maintenance therapy, I felt empty inside. It felt like I might as well lay down and wait to die. I wasn't really depressed, it just felt like nothing mattered to me anymore. I lost my appreciation for music and other interests and I was always annoyed and angry with everyone and everything.

I'm now off buprenorphine maintenance and for the first time in years, I'm starting to feel alive again.

 

[Jabberwocky]

Hmm... I'm not an IV user - and by euphoric feelings I really mean the continual state of being under the influence of an opiate. I've tried several times to jump off opiates, unsuccessfully and each time I jump back on the wagon I approach opiates with a more and more dangerous view. I've been tempted several times with the use of needles but have managed to control myself that much that I didn't jump on that wagon. As I relapse the reckless abuse gets worse and worse, and only recently have I really had to shake off not turning down the IV route. For that reason I really think that jumping on a programme where I can be maintained for a short while, see the outcomes to the therapy, be it positive or negative react to that. Taking doses orally of upwards to 400mg of oxycodone and a handful of benzos each day is what it's turned into many times, and it's usually at the end of the day when I want to unwind and just get away from the world for a while, well it started that way and has now progressed to day time use and even on occasion first thing in the morning when I wake up - I can manage abstinence from opiates for a good while, but I eventually succumb to using again and in more dangerous ways.

I appreciate all your opinions on the topic, and I've also been advised by a few to jump on a progrmme for a few months to see how I go on it. It would eliminate the enormous expenditure on oxycodone every month, the period of time when I'm dry or out of opiates (which in turn leads to further reckless behaviour) and not have to be continually held down by my addiction as I know the methadone is availiable, as I'd have take home doses. It also removes for me the continual hiding and compulsive lying associated with my drug use too. It really has a snowball effect on everything.

All your opinions are really appreciated - so thank you, and keep them coming!

 

[thelastclubkid]

At age 21, I went into MMT for much the same reasons. For me, it allowed me to stop the "illegal" lifestyle, hold a decent full-time job, and live without focusing on "how am I going to feel normal in the morning" as that was pretty much my main concern every day.

For me, at that time, best choice. Allowed me to live normally. When I got to the point I felt I no longer needed it, I slowly came down. I personally did not have trouble coming down SLOWLY. Key --slowly. With re stabilizing as necessary

The drawbacks--you are still dependent on a drug. If your clinic is well run, not an issue. If you have a place that is not really about helping but about how much money can we make and therefore cram in cash paying clients while trying to kick out stable patients on assistance, not a good thing. Saw many times people forced to do a 21 day detox due to lack of funds. Horrible.

If you choose MMT, resist the temptation to keep upping your dose. They offer all thetime. I found myself on a dose where it was hard to not nod out randomly during day. I got tired of living like that, and came down to a more appropriate dose. Just remember, whatever you stabilize at is what you eventually must come off of!!

That said, at the time, MMT was good choice for me. I can answer any other specific questions you may have.

all this ^

MMT for me basically allowed me to get my life back on track.... that being said its a huge pain in the ass and the red tape is a bitch... still compared to continually scoring illegally its the obvious choice...

 

[Jabberwocky]

I would really like to jump on MMT, I have a very reliable psyciatrist who is willing to prescribe me methadone in take home doses weekly. I think it would give me a good quality of life back, and removal all this stupid illegality around drug use. I think it would really benefit me at the moment, and of course my long term goal is to come off compeletly and I would do this slowly and taper properly.

I think I'm going to go ahead and jump in to the programme, if it doesn't go well I can always hop back onto oxy. What dose do they usually start you on? I have a relatively big habit - 2-300mg a day. What dose would I be taking/titrate towards?

 

[cire113]

The only way to live relatively normally on long term opiates for extended periods of time is with either methadone or bupe honestly...

Yeah technically you could just live on short acting but the cycle an peak of blood levels and drop gets annoying after a while..

Imo oxycodone is a terrible choice for maintenance; too short acting and tolerance is a joke; You will have to dose multiple times a day and always have pills on you;


See you say long term but say 6 months;; to me 6 months is short term for opiate addiction; I would go for BUPE all the way and taper;

Methadone is really like a last case scenario dead end type deal no offense to those on it;

Methadone or bupe maintenance is general should be used only in the severe cases of addiction where life is threatened and really harm reduction is goal;

Honestly bupe or methadone do a really good job at giving people there lives back; It is 10000% better than the alternative;

Personally myself Im thinking of switching to methadone because bupe really just isnt holding me like it used to after many relapses

 

[Jabberwocky]

Thanks for all the support and knowledgable information guys! Yeah I'm really looking to get my life back, on oxy it's not going very well, and I can't cut it without the opiates. 6 months is relatively short term yes, but I've tried bupe in the past and as I said it didn't cut it for me at all with regards to maintanance. It only helped in a fast detox from opiates which led to another relapse shortly after, and didn't actually help as much as I thought. In terms of its effects I couldn't see myself maintaining on bupe.

Ill go and see my shrink tomorrow. I'm going to opt for MMT and perhaps benzo support too.

Does anyone know the titration doses equivalent to 2-300mg of oxy? What are the starter doses, and how long does it take to get adjusted to methadone? It says on the converter websites up to 1000mg of methadone orally! That cannot be correct.

Thank you all!

 

[thelastclubkid]

the standard protocol is to start you on up to 30mg... then you get increases each day until you atre stabilizied... but you have the conversion way wrong my 2 orders of magnitude.... methadone is an extremely powerful agonist and once it has built up in your blood/tissues the dosing is pretty small to maintain powerful results... so the equivalent dose to 200mg oxy is 25-30mg methadone...

 

[Jabberwocky]

i see, so i guess i would be maintained at around 30mg of methadone for the entire duration? sounds about right really, if it would starve off cravings and maintain me in a way that would keep me "up' with an opiate feeling.

 

[thelastclubkid]

depending on what country you are in you can get more no problem... my clinic had no problems letting me go up as much as i wanted... i ended up at 95mg and nodding off at work, lol...

just keep in mind that every step you take up is one you have to take down if/when you finally want to quit MMT...

 

[crzydiamond]

Im in the states. But here they start you at 30 mg (as someone mentioned) then go up from there. Places I have been ar you can increase 5 mg per day until you feel it holds you. Your situation is a little different, still, I would start at 30 mg and go up in the same way. Average doses at clinic I was at were around 70 mg. Note I said average. I knew ppl at 30-40 and ppl at 120

Studies show a blocking effect to other opiates to happen around 70 mg. Not sure if that is the saturation point or ceiling effect or what

Personally, I have maintained on doses between 40 & 95 mgs. The 95 was, as I said in another post, too much--spent days nodding and unable to stay awake at times. I spent most of my MMT around 60-70 mgs.

Like I said, stabilize at where you feel good, and where you don't crave other opiates. You should find a point you feel good without the nodding. It may take a bit of moving up and down to find it. Remember, dosage build so it takes about 10 days until the pile on effects basically level out.

Good luck, and keep us posted