So, I took my first naltrexone dose last night ... I took one drop last night, which apparently was too much.
I think the person who encouraged you to try naltrexone overlooked important factors. They're well-intentioned but didn't consider your unique scenario, particularly body chemistry. If a doctor had done the same it would be deemed medical negligence (but doctors just follow guidelines which they can use as an 'excuse').
In your case, your body chemistry (ie general condition) seems to be in a fairly vulnerable state. You described methadone and amphetamine physiological dependency:
FYI, I take [160mg] methadone daily...since February, so I'm now totally physiologically dependent.
...
I had prescribed amphetamine on board (taken daily... used to be dex for years but had to switch to adderall)
Both buprenorphine and methadone have problematic effects (besides the opioidergic) which undermine proper body functioning. All conventional opioids have a disruptive influence on endocrine (hormonal) function which is worth taking seriously as this in-turn impacts metabolic function (ie disruption of the metabolic system).
Your chronic use of amphetamine meds will have incurred significant issues also. Amphetamine reliably disrupts hormonal regulation (
outlined here) and the metabolic system (particularly the HPA axis). It helps "treat" ADHD via dopamine, noradrenaline, and activating
"fight-or-flight" mode (aka stress response via HPA activation) which works via adrenaline. This helps produce hyperfocus & hypervigilence which "treats" ADHD but it has a broadly disruptive influence in the long-term.
Amphetamine also influences histamine (big link between opioids & histamine) and may have indirect opioidergic effects. This seems relevant to your experience with naltrexone.
So what I'm getting at is that these are fairly important factors which should inform your chosen strategy (whatever that may be).
5. There's another really weird data point. The day following the experience I described before, I tried 1/3 the dose (approx 1 mcg) of naltrex and was okay. Then, two nights following that, I experienced something similar but even more intense---without dosing the naltrexone again ... I have no idea what happened
Did you ever consider if naltrexone isn't appropriate for your current condition? It may be appropriate at a later date.
Putting aside methadone, I'd consider chronic use of amphetamine a key causative factor in your 'unexpected' reaction from naltrexone. Tbh I could see why it might be inexplicable & confusing if someone wasn't considering the bigger picture.
sounds to me like, if i want to approach tolerance reduction----naltrexone is preferable
Besides its opioid properties, naltrexone is particularly helpful thanks to it's property of TLR4 antagonism. Many things have this TLR4 blocking property, including dozens of otc items. There's other ways to reduce tolerances besides via TLR4. As an aside, it's worth considering that you'd be addressing the tolerance from 2 different drugs, amphetamine and methadone.