If you guys have questions regarding the Methadone clinic scene, I'm likely the best person to ask. Feel free to message me.
I've never experienced Methadone as actually "worse" than withdrawal from any other Opioid. Honestly, I've never withdrawn from an Opioid that made me think it was better or worse than any other. I always found these differences to be pretty subtle. The fact would always remain, if I had used Opioids heavily, chronically, then I was going to experience a painful withdrawal.
To be clear, I've only ever used:
- Heroin
- Methadone
- Morphine
- Oxycodone
- Hydromorphone (Dilaudid)
I say this as I don't have familiarity with some of the more exotic Opioids that feature peripheral action outside of Opioid agonism. I imagine for instance, Tramadol with it's SNRI activity could lead to a compounded withdrawal. Venlafaxine (Effexor) is an SNRI a\nd we all know it is brutal for some people coming off of it.
I understand Methadone also has peripheral action as an N-Methyl-D-Aspartate receptor antagonist. I admittedly am not a wealth of knowledge regarding NMDA, though I'm learning. I know Ketamine, Dextromethorphan (DXM; Robotussin) an Phencyclidine (PCP) all exert some of their effects through NMDA antagonism.
I know one result of NMDA antagonism is a reduction in pain. I've read that Methadone is a good choice for Opioid rotation for, among other reasons. it could have an additive effect to the Opioid in reliving pain. I can see how this could lead to some kind of discomfort upon withdrawal.
I have always said, I believe the majority of the difference between Methadone and the short-acting Opioids is just that, the duration of action. Methadone lasts longer, so does the withdrawal. The psychology of a long withdrawal versus a short one is m
Iore complex than one might think. 14
If you're withdrawing from Heroin, you have 3-4 days of really bad withdrawal before you start getting some relief. Methadone is at least 10-14 days. If you have a life, maybe a family, responsibilities like a job, two weeks of non-functional withdrawal is difficult to work in. The person withrawing from Heroin is likely going to be able to sleep somewhat by day 3-4 and this is a huge relief. Methadone withdrawal means going days without being able to sleep. This starts breaking you down real quick.
I learned that you can't rush it. You have to accept that it will take time and go as slowly as you need to. If it takes you a year, even two years, it's better to succeed than to rush into things and fail.
Anyway, that's my two cents regarding the thread topic.