First of all: Can I ask you in which country you live?
How is that a wider variance? 14-55 hours is a commonly reported half-life for methadone. It is exactly the same.
You misunderstood me. I wasn't comparing that to methadone, but to my previous statement of LM being between 33h and 55h. I then discovered that it can be even lower than that. You are reading my words completely out of context.
To say that it "can have twice it's half life" is meaningless in itself, if the variance is so huge anyway.
All the studies you can read on both methadone and LM agree that these agonists have a strong interindividual variance in half life, so take the lower end with a huge grain of salt because that is basically never corroborated in real life. I have yet to see an LM patient who starts getting wd after 14h are over. This is why I mentioned studies only in a complementary way and pointed out that I rely on experiential and anecdotal evidence. You on the other hand are getting hung up, or shall I say bewitched, by "paper magic". It is a fact that people who take LM need to take less in dosage and less in frequency. Ofc that doesn't mean that everyone does (because your habitual mind knows that you have always taken it daily, so you continue to do just that, lest you want to deal with placebo cravings) but some like me do.
Methadone can have twice the half life of methadone
I'm confused.
That doesn't mean that in general, it has twice the duration.
Yeah I'm probably just hallucinating it. I'm just hallucinating that my wds start after the second day.
But if you can find multiple sources, I have yet to see a single one.
Ok, let me ask you this question, because perhaps I can then better understand what the fuck you are actually trying to convey here: what IS a drug's half life, HOW does it affect the drug's pharmacodynamics/-kinetics and WHY does an increased half life not lead to an increased duration? I'm asking you this because so far, all you have done is explain the what and not the why. It's easy to say "no it doesn't do that". No go ahead and tell me WHY it doesn't.
I am not an armchair theorist
You keep systematically misunderstanding me. I wasn't calling YOU an armchair theorist, but those who write those guidelines you tout so much about.
In contrast, a lot of people will laugh at the "trust me bro, my friend told me so" anecdotes' evidential value.
Ofc it looks stupid in contrast if you leave out the OTHER half of what I said. You are also grossly simplifying what I said about anecdotal evidence. When someone says they have experienced something, that might be coincidence, placebo, exaggeration, etc. But if those people add up and their reports are consistent, then I tend to not dismiss them. Especially not if my own personal experience corroborates it. But go ahead and distort again what I have said. I'm sure it makes you sleep sounder at night.
I have never HEARD of levomethadone having...
Oh now wait a minute! What was that again about "trust me bro, my friend told me so" you were saying earlier? Rules for thee but not for me. That seems to be your motto, isn't it?
Uhhh... Yeah. That's because it's double the potency. That is, in fact, 100% in line with what I said.
Potato, tomato. I was referring to the first half of that sentence. What you said was that LM has no meaningful difference in dosage. Now, dosage and potency being two sides of the same coin, I was trying to show you the contradictory logic of your statement by highlighting how the fact that half the dose is used, is direct evidence that there is a meaningful difference in dosage, otherwise why use half the dose?
You don't twice as much methadone, twice as often, as levomethadone
I'm not sure I understand you correctly. Are you saying that given a specific dose of LM, you wouldn't need to take double the amount of methadone to catch up to that? That is not correct. When I was hospitalized I was put on methadone because the hospital didn't have LM. I was on 30mg LM back then. While in hospital I had to take 60mg methadone in order to not get dope sick. I didn't need to say that. The doctors immediately knew from the very first day that twice the amount of methadone is necessary in patients who are dependent on LM. And yes, given the fact that you can take LM in less of a time frequency (once every ~48h) than methadone, you are by comparison taking methadone twice as often due to its shorter duration.
Look buddy, don't believe what I say. Just go ahead and take LM for a while and then abruptly stop. You WILL see that you can wait twice as long until wd kicks in.
If it really reliably had double the duration, and yet it was prescribed to people at the same dosage interval as racemic methadone, there would be BODIES.
NO! A longer half-life does not automatically mean that a potentially fatal amount accumulates when the medication is taken daily
BECAUSE ELIMINATION CONTINUES BETWEEN EVERY DOSE!
The fact you do not know this proves that you have no idea what the effin fuck you are talking about!
Here, let me demonstrate it to you with a bit of math.
Suppose, purely for illustration:
Methadone:
100 mg once daily
Levomethadone:
50 mg once daily
Avrg. methadone half-life =
24 hours
Avrg. levomethadone half-life =
48 hours
Assume complete absorption and a simple one-compartment model.
Now, for a drug with a 24-hour half-life, approximately half of the previous day's amount remains when the next dose is taken:
| Day | Methadone remaining before new dose | After adding 100 mg |
|---|
| 1 | 0 mg | 100 mg |
| 2 | 50 mg | 150 mg |
| 3 | 75 mg | 175 mg |
| 4 | 87.5 mg | 187.5 mg |
| 5 | 93.8 mg | 193.8 mg |
| 6 | 96.9 mg | 196.9 mg |
| 7 | 98.4 mg | 198.4 mg |
It approaches a steady-state of approximately
200 mg of drug-equivalent amount in the body immediately after each dose.
Now let's consider LM with a 48-hour half-life. After 24 hours, 70.7% remains.
If we gave
50 mg every 24 hours:
| Day | Amount remaining before new dose | After adding 50 mg |
|---|
| 1 | 0 | 50 |
| 2 | 35.4 | 85.4 |
| 3 | 60.4 | 110.4 |
| 4 | 78.1 | 128.1 |
| 5 | 90.6 | 140.6 |
| 6 | 99.4 | 149.4 |
| 7 | 105.6 | 155.6 |
It eventually approaches approximately
170.7 mg immediately after each dose.
So why doesn't it keep accumulating and cause "bodies" as you so poetically said?
Because elimination continues
between every dose.
At steady-state, the amount eliminated over
one dosing interval becomes
equal to the amount
administered. The body therefore reaches an
equilibrium rather than accumulating indefinitely.
It is like this:
Longer half-life → more accumulation → longer time to reach steady state.
And
NOT this:
Longer half-life → concentration keeps increasing forever.
But I guess you will still go ahead and keep telling me how wrong I am, using your confusing, non-sequitur, strawman fallacy type of rhetoric. Since I have better things to do with my time, I'll pass if that is what you wish to do.
