Fentanyl use while taking methadone

[typhilly33]

Ok so I've been on the methadone program for about 90 days now. I am on 100mgs.About a month ago I had started to use fentanyl again. Idk why so please don't ask. I've been using it pretty much every day with skipping a day here and there. I was wondering if I stopped the fentanyl use completely will I go through any kind of withdrawal or will the methadone prevent it. Also I am given my dose every morning in a bottle that I can put aside and save if I need to. So I was thinking maybe do the fentanyl alone for like 2-3 days then when I stop the fent take maybe a double dose of methadone for a few days to curb any kind of withdrawal? I'm just curious on anyone else's experience with this.

 

[Just a little pinprick]

Ok so I've been on the methadone program for about 90 days now. I am on 100mgs.About a month ago I had started to use fentanyl again. Idk why so please don't ask. I've been using it pretty much every day with skipping a day here and there. I was wondering if I stopped the fentanyl use completely will I go through any kind of withdrawal or will the methadone prevent it. Also I am given my dose every morning in a bottle that I can put aside and save if I need to. So I was thinking maybe do the fentanyl alone for like 2-3 days then when I stop the fent take maybe a double dose of methadone for a few days to curb any kind of withdrawal? I'm just curious on anyone else's experience with this.

My experience is the clinic MAKES you drink your dose at the counter right in front of the nurse,,,, but if you were able to save up your bottles and save them my guess would be that after 24-36 hrs after your last dose of methadone that you’ll start feeling sick,,or at least I know I would,,,I’ve tried going on the program and continued to use everyday just so I didn’t wake up sick but after3-4 weeks I bailed on the program because at the end of the day methadone withdrawal is 10x worse than any heroin/fent withdrawal…

 

[typhilly33]

My experience is the clinic MAKES you drink your dose at the counter right in front of the nurse,,,, but if you were able to save up your bottles and save them my guess would be that after 24-36 hrs after your last dose of methadone that you’ll start feeling sick,,or at least I know I would,,,I’ve tried going on the program and continued to use everyday just so I didn’t wake up sick but after3-4 weeks I bailed on the program because at the end of the day methadone withdrawal is 10x worse than any heroin/fent withdrawal…

I think u misunderstood my question. I didn't mean I want to stop using methadone. I meant I want to stop using fentanyl. I been using 100mg of methadone plus fentanyl every day. I meant if I stop using just the fentanyl will my regular methadone dose stop me from going through withdrawal from stopping the fentanyl. N wat I meant by saving up the methadone I meant I would use fentanyl while I saved up the methadone then when I stopped the fentanyl I would have a few doses saved up to stop from going into withdrawal

 

[WellTram]

Just try taking your methadone without raising doses. If u notice any discomfort use add-on meds like nsaids, sedatives (clonidine, tizanidine, dextrometorphan, old antihistamines, low dose sedating antidepressants or low dose sedating antipsychotics, benzos but don't get addicted, pregabaline or gabapentin or other related drugs).
It's best to not screw your tolerance what Is something u are doing by taking fentanyl.
Any discomfort should be lasting for only few days because of short half-life of fentanyl. I think u can get through it with some non-opioid painkillers and sedatives. Don't take too much of them.
Save your methadone for emergency situations and u will also don't need higher than 100mg doses just because u used them to quit fentanyl. I hope u won't feel full WD symptoms.

 

[typhilly33]

Just try taking your methadone without raising doses. If u notice any discomfort use add-on meds like nsaids, sedatives (clonidine, tizanidine, dextrometorphan, old antihistamines, low dose sedating antidepressants or low dose sedating antipsychotics, benzos but don't get addicted, pregabaline or gabapentin or other related drugs).
It's best to not screw your tolerance what Is something u are doing by taking fentanyl.
Any discomfort should be lasting for only few days because of short half-life of fentanyl. I think u can get through it with some non-opioid painkillers and sedatives. Don't take too much of them.
Save your methadone for emergency situations and u will also don't need higher than 100mg doses just because u used them to quit fentanyl. I hope u won't feel full WD symptoms.

Ok so ur saying I can just stop the fentanyl and continue my normal daily dose of methadone and I should be ok? I can handle just a little bit of discomfort but I was also thinking that it shouldn't be too bad cuz I'll still be putting an opiate(methadone) in me. I feel like it's the same kinda thing as when I originally got on the methadone. I was doing over a gram of fentanyl a day and then started on just 60mg of methadone and it took away my withdrawal. So I think I should be ok stopping the fent with minimal discomfort as long as I take my methadone. I hope lol

 

[Them Witches]

Yes you will feel the withdrawals from stopping the Fentanyl... Anytime you increase your MME dramatically then drop dramatically there will be an obvious difference. The 100mg of Methadone will offer some extended warranty protection. Time span will come down to hydration, sleep, exercise, and not doing dope.

Your former self does not want to let go of the street dope. Now you are playing both sides of the street and if MAT finds out which they will at some point. This happens then you will be on the street dope side of the street again.

 

[Just a little pinprick]

Yes you will feel the withdrawals from stopping the Fentanyl... Anytime you increase your MME dramatically then drop dramatically there will be an obvious difference. The 100mg of Methadone will offer some extended warranty protection. Time span will come down to hydration, sleep, exercise, and not doing dope.

Your former self does not want to let go of the street dope. Now you are playing both sides of the street and if MAT finds out which they will at some point. This happens then you will be on the street dope side of the street again.

That’s not how maintenance works around here,if you piss dirty you just won’t get THB’s,,,,I believe you need 4 clean urines to earn a THB so basically you earn 1 a month,,up too a max of 6

 

[Them Witches]

That’s not how maintenance works around here,if you piss dirty you just won’t get THB’s,,,,I believe you need 4 clean urines to earn a THB so basically you earn 1 a month,,up too a max of 6

Wow... MAT gives the "OUD" patient a red carpet and carries the luggage for them. Like cuddled, pampered, and diaper changed cubs of the medical maintenance system.

Over here in pain management dropping one dirty or off pill count it's curtains. Sounds like MAT is the place to go because a ton of MAT patients claim to slip their "chronic pain" self-diagnosis into getting more Rx dope. Totally bypassing the usual stairs to climb of exhausting medical treatments, procedures, doctor/patient relationship growth, and no need for medical opioid Rx evidence.

MAT is genius. I want to bomb 4qty drug tests and get my 750MME still. Shit they might increase the MME because I obviously need more dope to stay of dope.

 

[4DQSAR]

100mg/day is a fairly significant amount of methadone. If fentanyl is still producing psychoactive effects, it's likely to simply increase your tolerance and dependence.

I would suggest not taking any fentanyl for at least three days. IF the methadone still mutes or even stops AWS, I'm sure you will know.

I know it's far easier to say than to do, but as others have indicated, the range of stratergies used by various HR agencies can be quite strict. Often the conditions will be changed with little or no warning. So I would be careful because it does seem your local HR agency is at the less rigerous end of the scale.

 

[Them Witches]

100mg/day is a fairly significant amount of methadone.

Your right it is. It is 300MME. It's IR and sustained release. Any medication that lasts 24-48hrs after one dose is strong. Methadone after 60mg complies like a pyramid with a large base. Once
a therapeutic balance of Methadone is established and the patient has progressed past the initial opioid cross-over, the patient can double their daily dosage in one sitting that will last 48hrs. Yes... It will last that long.. Obviously, the patient can feel they need to redose but easy feet for a seasoned opioid tolerant patient. I used to do it when I
was on Methadone 100mg (Mallinckrodt 10mg IR -- king over the clinic)

To clear the air -- I am all about MAT and it being a tool in recovery. But they have to realize and be educated on the facts of what actual cancer patients, chronic pain syndrome patients, and how much they limited the acute chronic pain patient now by law. I have been in pain management for almost 40 years and I know a lot of people's business and how much they get prescribed. I also bang a pharmacy tech/manager not at my pharmacy's employee. I know these people's business because we exchange hard to come by thoughts.

There are many people in "stages 4-5 cancer" with MME's well below at MAT. I went to the "Methadone clinic" before MAT was coined. In the 90's and early 2000's they were pumping out 180-220mg per day for the methadone patients then. And they are still doing it today.

Many in pain management are taking far below MME that MAT. Is right... IT's subjective and the new patients and estabilshed patients need more eval work. My point is for MAT patients to take it serious because it is ruff out here in the rest of pain management country.

 

[Gridlink]

Like others have said you probably will feel some wds when you stop the fentanyl. But it depends how much fent you are using. If you're only smoking 2 pills a day then you won't feel a thing when you stop. If you're smoking 20 pills a day then you'll get significant wds. You can always raise your methadone dose to take care of the wds though. And then if you want you can lower the dose a week or 2 after getting off fent.

Don't worry about exceeding 100 mg of methadone either. It is silly to artificially establish a dosage level that you won't go beyond. Basically your methadone dose should be enough to take care of wds and cravings, and if that dose is over 100 mg so be it. Then, if you want, you can work your dose down slowly after getting to a stable dosage.

 

[4DQSAR]

There are many people in "stages 4-5 cancer" with MME's well below at MAT. I went to the "Methadone clinic" before MAT was coined. In the 90's and early 2000's they were pumping out 180-220mg per day for the methadone patients then. And they are still doing it today.

Firstly, many thanks for filling in the (huge) gaps in my knowledge.

Someone on a now defunct BBS devoted to opioid usage mentioned a patient in NYC who was being prescribed 1000mg/day. Now obviously I couldn't confirm the veracity of that statment but the poster wasn't given to inventing such things. They concluded with the observation 'I was surprised they could even stand up'.

I know enough about the US to realize I don't know enough but could such a situation occur?

I know that the N,N-dinor methadone metabolite is cardiotoxic so assumed such a dose would be fatal.

 

[Them Witches]

Firstly, many thanks for filling in the (huge) gaps in my knowledge.

Welcome. I learn a lot from you. I answer any questions you have.

I know enough about the US to realize I don't know enough but could such a situation occur?

yes there a MAT patients clearing 200mg to 1000mg Methadone daily. I do not agree to allow patients to go this high. The MME value is staggering to give to people not in cancer pain, chronic syndrome pain. MAT should do things opposite IMO. They should bring the patients like this :

Extreme patient accessment, opioid level testing,
-- day 1-3 100mg-150mg per day with Clonidine
-- day 4-7 80mg- 125mg per day with Clonidine
-- day 8-10 60mg-100mg per day with Clonidine
This takes care of the initial opioid cross-over for the most part. After 10 days, a pain management doctor should take over from there and the patient can truly be accessed after that determine if they stay at the dose or go up. I do not agree to titrating an addict there for OUD months into a program for "urge control" b/c it is bullshit. Once a stable dose of methadone created after 10-30 days it should stay that way. The recovery process is about learning to change character defects and learning "control urge."

 

[Stassi202]

Welcome. I learn a lot from you. I answer any questions you have.


yes there a MAT patients clearing 200mg to 1000mg Methadone daily. I do not agree to allow patients to go this high. The MME value is staggering to give to people not in cancer pain, chronic syndrome pain. MAT should do things opposite IMO. They should bring the patients like this :

Extreme patient accessment, opioid level testing,
-- day 1-3 100mg-150mg per day with Clonidine
-- day 4-7 80mg- 125mg per day with Clonidine
-- day 8-10 60mg-100mg per day with Clonidine
This takes care of the initial opioid cross-over for the most part. After 10 days, a pain management doctor should take over from there and the patient can truly be accessed after that determine if they stay at the dose or go up. I do not agree to titrating an addict there for OUD months into a program for "urge control" b/c it is bullshit. Once a stable dose of methadone created after 10-30 days it should stay that way. The recovery process is about learning to change character defects and learning "control urge."

How long have you been sober?

 

[Them Witches]

How long have you been sober?

I love to talk. Give me the floor.

In 40 years I have 2 years off all drugs prescription and illicit. I am too Rx dependent now to even taper properly before I die. I have my MME down to 435.

I have started a medical report of how to treat opioid dependent and tolerant after almost 40 years of documented pain management & poly dependent to Alpha2, Benzo, sedative/hypnotic, Z-drug, anxiety.

I am PCA and they call me the "whole patient" at the ER and hospital. The cocky doctors always say "your on a lot of medications." They would be scared to see someone like myself through to the end. An absolute product of their environment and I cannot function without drugs. Everyone knows.

People put too much thought into detox... the first 3 days suck. just have to push through one hour at time. I guess more experience means it easier but not. it sucks for everyone.

Comfort meds -- 7-OH, Kratom, THC, Clonidine, Ativan, Seroquel, Droperidol, gabapentin, Phenobarbital, Lunesta, Busbar, Vistaril PAM, Promethazine, Haldol....let's fucking GO. !!!!


How can I help?

 

[Them Witches]

How long have you been sober?

I have also did 454 meeting in 454 days with 2 conventions and 2 sponsors. That knowledge is how I do not fuck my Rx's up with.

Many months I give my Rx's to my mom and my debit card to my Dad, when I feel blue. I know how my mind works. "the Lion behind the tree." they know why I do it. secrets keep us sick.

No plan no recovery. Always unmanageable from being powerless.

How long have you been sober? Are you medically screwed too?

 

[Them Witches]

How long have you been sober?

Sorry I am aggressive. Yes I know about the Fetty. more than this new crowd knows about heroin#4 70-90% pure and.or cutting it with morphine sulfate. The 80's to 2011 were lit. The feds got rid of the dope and replaced with Fetty. no war for poppy and more money.

back in the day, Junkies would ralley together to happily buy #4 90% for $175 a gram. It blows away this new "scramble dope" in Philly. I am from Baltimore, Richmond, and Hampton/.Newport News area. NYC is 3-6hrs away.

Don't be rolling up on me taking benzos and slam this 90%. I do not want to do CPR and call EMS. We didn't have NARCAN back then in the 90's til 2010's. It had to be cut for 70% of the tolerant. Like Pulp Fiction...

I have a prescription for NARCAN lol... Like my PO meds are going to kill me.

 

[Stassi202]

35 inpatient treatment centers in the last 25 years. I have been addicted to heroin that became fentanyl and went cold turkey 2 years ago now on suboxone. I can’t even begin to explain my history my struggle my situation. Too exhausting and too much to tell. I’m not suicidal nor do I feel sorry for myself but I’ve lost the motivation to do anything. My current situation is really bad but I’m still getting high. Cravings get me every time. Getting sober is not the problem. Staying sober is.

 

[Them Witches]

35 inpatient treatment centers in the last 25 years. I have been addicted to heroin that became fentanyl and went cold turkey 2 years ago now on suboxone. I can’t even begin to explain my history my struggle my situation. Too exhausting and too much to tell. I’m not suicidal nor do I feel sorry for myself but I’ve lost the motivation to do anything. My current situation is really bad but I’m still getting high. Cravings get me every time. Getting sober is not the problem. Staying sober is.

Keeping it real is all we got. Sometimes keeping it real goes wrong. Some people are meant to work on poppy farms.

I am looking to make travel friends. I meet this Boost mobile business owner from Northern India near the Golden Triangle. I can stay with his family and he wants me to go there and build a auto business for his brother. Organic food, poppy fields in India and Golden Triangle. Sounds like life. $100 USD a month your good.

I am going to the poppy fields to share Roxicodone 30mgs. Oh they are going to like me or kill me. Sounds like the US about now?

If you break a bone or whatever, they give you 250mg/500mg/1000mg of diamorphine. one fill, taper yourself down. no refills unless serious.

 

[4DQSAR]

35 inpatient treatment centers in the last 25 years. I have been addicted to heroin that became fentanyl and went cold turkey 2 years ago now on suboxone. I can’t even begin to explain my history my struggle my situation. Too exhausting and too much to tell. I’m not suicidal nor do I feel sorry for myself but I’ve lost the motivation to do anything. My current situation is really bad but I’m still getting high. Cravings get me every time. Getting sober is not the problem. Staying sober is.

Repeated to amplify.

I've noted (and recently so has my local HR agency) that obtaining and using drugs can end up being the only structured (ish) thing in a client's life. So people get clean, sit down and wonder how on earth they are going to fill that void and exactly what is the 'pay off' for getting clean.

If someone is time-served then it's quite likely that many if not all of their circle of friends are actively using so hanging out with them poses many risks. Most hobbies and pass times cost money so quite often those were given up long ago.

I don't claim to have answers. These are just things I have observed.

BTW I don't know if this is unique to the UK but it seems IF one hobby is maintained, it's books. A LOT of books.