Opioids Methadone Mega Thread and FAQ

[Tchort]

^ Thank you! They would all work, if used properly and the person really wanted to kick. I just see all of these a substitutions otherwise. And for any program to allow someone to be on for years is just ridiculous. They are just perpetuating the problems...

People have different needs and goals. Many people find it impossible to lead a normal life or a life up to their own expectation of normalcy or acceptability without regular administration of an opioid. Up to 25% of Heroin or other opioid addicts are unable to be comfortable on Buprenorphine or Methadone at any dose of either.

The accumulated evidence plainly shows that individuals require individualized treatment or care- why should a time cap be put on any medical treatment for no good reason?

Mayor Guiliani tried this in NYC- he was going to get all of those poor souls on Methadone (subsidized by the city/state for the poorest addicts) detoxed- those who wouldn't afford to transfer to a private clinic or who couldn't get into one (due to the excrutiatingly long waiting lists in large cities to get into drug programs) almost all ended up back on their drug of choice (generally Heroin). Many died- as a direct result of yanking their treatment early.

What is so unconsciousnable about a person receiving opioid substitution for longer than a year? or 2 years? or for a lifetime?

 

[Pegasus]

^Absolutely, if people need it for years or even life, then it shouldn't be denied to them. They should know how much harder it will be to quit the longer they are on and the higher the dose is, but they should never be denied because someone else feels they have been on for long enough. The downside to this is, let's say you decide to take methadone for three years while you have a great job, then you lose that job and don't have the money to continue... You'll have a hell of a withdrawal to go through. Of course, this is more indicitive of the health care system in the USA, but it is a point nonetheless.

I feel that I may be one of the people that will do well on daily dosing for long periods of time. I've gone on and off of maintenance numerous times, and it's really maddening and I think that possible I would be better off on long-term maintenance. It's certainly a plausible option and should not be denied to anyone. In fact, I think that cheap, government subsidized opiate maintenance should probably be provided by government automatically, not through independent businesses. That is a whole 'nother discussion, though...

 

[Nikolai]

I agree. I'm not going to tell someone who had a serious addiction they shouldn't need replacement therapy after a certain period. I know I would likely need it for a long time. I dont even see a problem with someone taking them for their entire lives.

ADHD is something said to hamper the quality or fullness of a persons life, and some with it are treated with medication for their entire life. Should someone with lasting negative effect on their lives from past addiction get the same treatment?

Addiction is said to be a disease and it can have a long lasting effect on a persons life. I just dont think some believe an addict should get proper support. Addicts are frowned upon by many.

 

[syndeusys]

I figured this was the place to ask this and yes I did use the search engine but how does one enter into a methadone maintenance program? How do they decide whether or not you actually qualify for MMT or if they think you'll be better just toughing it out? My experience with opiates isn't nearly that bad but I just figured should the shit ever hit the fan it would be nice to know how to go about correcting things sooner rather than later.

 

[splenda]

I figured this was the place to ask this and yes I did use the search engine but how does one enter into a methadone maintenance program? How do they decide whether or not you actually qualify for MMT or if they think you'll be better just toughing it out? My experience with opiates isn't nearly that bad but I just figured should the shit ever hit the fan it would be nice to know how to go about correcting things sooner rather than later.

After finding a methadone clinic in your area, calling them usually will get you the required information you need, such as the cost for treatment and etc. Anyone who gives a positive urine sample for opiates can pretty much enter methadone maintenance as long as you provide the money for the intake fees and the medication/weekly-or-monthly fees. If you go to them and tell them you're suffering from opioid addiction, show obvious signs of withdrawal (you should try to show them that you're not nodding out at least), and piss positive for opiates you will most likely get on board without issue.

The only barrier I would foresee would be wait lists in some areas of the US/in certain clinics that are in areas that receive a lot of traffic. Lots of clinics are full or over their limits and understaffed, especially in more rural areas. Make sure to check with your local clinic to see if they're accepting new patients or not before going in.

Most clinics have intake days, usually twice a week. You go to the clinic and a counselor takes you in. They talk to you for a bit, get a nurse to check you out (i.e. blood pressure taken, temperature, urine sample, etc.), and if the doctor is in that day you'll be able to dose the same day you came in, provided you've paid for all the fees. If the doctor isn't in that day you might have to come back the day after to get your first dose. The intake process usually takes a couple hours at least, so be prepared to go through a lot of paperwork.

If you have any more questions about MMT let me know... if you're not suffering from a major, long-term addiction, I suggest you just go for a detox instead of full-on maintenance. Detox can be rapid, up to 21 days, or drawn out, up to 180 days. Rapid detox will obviously be more harsh, but for obvious reasons will be a lot cheaper than a 180 day detox. 180 day detox is preferred as it'll give you some time to sort out your addiction and find some stability in your life/'recover' from your dependency.

 

[bmore$finest]

Ok guys what makes one drug all of a sudden better than another? Why is it ok to be on a substitution program for the rest of your life? But not the drugs them selves? I'm not following the logic here. I mean if methadone is so harmless, or so helpful? Why the strict regulations... I am not saying that proper treatment is not a great help. But lets be honest. How much of the treatment is treatment?

 

[debaser]

Methadone has a lot of "advantages" over the other full mu opiates: its long duration of action, which allows for a once a day dosage, its very good oral bioavailability and quite bad other ROAs, its low euphoric potency, and its low price.
Perfect government opiate.

 

[bmore$finest]

^ yes, most of these clinics don't really try to get people off, just offer them a trouble free supply for cheaper. They just have the most well known stamp "methadone".

 

[Nikolai]

Ok guys what makes one drug all of a sudden better than another? Why is it ok to be on a substitution program for the rest of your life? But not the drugs them selves? I'm not following the logic here. I mean if methadone is so harmless, or so helpful? Why the strict regulations... I am not saying that proper treatment is not a great help. But lets be honest. How much of the treatment is treatment?

There is a monumental difference between a person using their DOC illegally in varying amounts, like shooting heroin into the arm, and being treated or prescribed with a standard daily dose of suboxone or methadone in order to treat withdraw that can ruin a persons life. Severe WD can make a human unable to function. Adderal is a schedule 2 drug just as methadone is, and methadone is strictly prescribed for a serious problem just like adderal is. Psychological withdraw can be devestating on a persons life years and years down the road. Telling those people "tough luck" is an example of addicts being frowned upon by society. The millions of humans with other conditions that can be horrible to go through receive medical help with drugs they need with little or no argument.

 

[DeLee]

When been on Methadone for 6months to a year.
Are you still that opiate heavy" in ure head or do the methadone give you more energy/focused like with Buprenorphine?

 

[Znegative]

I can speak from experience that methadone does not help you focus, nor does it give you energy... Quite the opposite of that.

 

[Tchort]

Ok guys what makes one drug all of a sudden better than another? Why is it ok to be on a substitution program for the rest of your life? But not the drugs them selves? I'm not following the logic here. I mean if methadone is so harmless, or so helpful? Why the strict regulations... I am not saying that proper treatment is not a great help. But lets be honest. How much of the treatment is treatment?

I've made the argument in other threads that it doesn't matter whether it is treatment (with specific protocols and modalities, which Methadone and Buprenorphine have) or for the sake of Harm Reduction providing access to ones drug of choice for however long they choose.

In the latter case, which has been tried with the Heroin/Cocaine/etc prescription program in the UK over the last 90 odd years and the recent programs in Holland and Switzerland, most Heroin addicts who found Methadone and at least 2 other different treatment options unsuccesful to qualify for, left the unlimited, subsidized pure Heroin maintenance within 2 years, which is on par with the median time people spend on Methadone maintenance around the world (18 months - 24 months). Some people will choose to spend the rest of their lives consuming subsidized Heroin for the rest of their lives in the Swiss program- why should anyone step in and say 'You can't do this'. What is the reason? For their "own good"? If thats the case, lets look at the suicide rates for Heroin addicts post-abstinence and talk again about peoples "Own Good". Better dead than on maintenance drugs, right? That really is the alternative.

How many people on this site have had the experience of someone killing themselves at a rehab facility? I know two people of my limited circle of Heroin addicted 'friends' who came back with stories about people offing themselves at two different rehab facilities, and both were treated as normal occurrences.

I don't understand why you ask why, my question is why not to either scenario of maintenance, be it for treatment or harm reduction?

 

[Nikolai]

I've made the argument in other threads that it doesn't matter whether it is treatment (with specific protocols and modalities, which Methadone and Buprenorphine have) or for the sake of Harm Reduction providing access to ones drug of choice for however long they choose.

In the latter case, which has been tried with the Heroin/Cocaine/etc prescription program in the UK over the last 90 odd years and the recent programs in Holland and Switzerland, most Heroin addicts who found Methadone and at least 2 other different treatment options unsuccesful to qualify for, left the unlimited, subsidized pure Heroin maintenance within 2 years, which is on par with the median time people spend on Methadone maintenance around the world (18 months - 24 months). Some people will choose to spend the rest of their lives consuming subsidized Heroin for the rest of their lives in the Swiss program- why should anyone step in and say 'You can't do this'. What is the reason? For their "own good"? If thats the case, lets look at the suicide rates for Heroin addicts post-abstinence and talk again about peoples "Own Good". Better dead than on maintenance drugs, right? That really is the alternative.

The most common reason against it seems to be that some dont believe addicts deserve any help.

 

[Pegasus]

I can speak from experience that methadone does not help you focus, nor does it give you energy... Quite the opposite of that.

You may have been on too high of a dose. Plus, individual results vary. Methadone gave me tons of energy.

 

[bmore$finest]

I've been on and off opiates for over 12 yrs. I'm not someone who doesn't think addicts deserve help, quite the opposite. But I am questioning the methods to which they help us. The most success I have had has been on my own. Coming off some of the "fillers" almost seemed worse... Maybe I am alone here.

 

[pallidamors]

Methadone gave me tons of energy.

It always did for me, too. I think its because unlike most opiates, its an NMDA antagonist in addition to full mu-agonist. The energy it gave me was kind of weird in the way that only NMDA antagonists are though, I'm thinking DXM here mainly. Like jittery and restless thought processes at times.

 

[splenda]

I've been on and off opiates for over 12 yrs. I'm not someone who doesn't think addicts deserve help, quite the opposite. But I am questioning the methods to which they help us. The most success I have had has been on my own. Coming off some of the "fillers" almost seemed worse... Maybe I am alone here.

The thing is most addicts who dislike methadone/buperenorphine are caught up and stuck on/obsessed with the idea of 'getting off' of the treatment instead of making the treatment work for them. Their obsession with 'getting off' of the treatment adds to the hardship of the tapering process and generally makes treatment a lot worse and a lot less successful because instead of focusing on making progress with opioid replacement therapy, they're focused on worrying about getting off of it one day.

This is why you rarely hear success stories from people who always complain about 'how hard it is' to get off of methadone... it's because they focus all their time spent in treatment on the thought of getting off of it one day, thereby never fully utilizing the methadone to their advantage in the recovery process.

I don't understand why people think that they need to 'stop'/'get off of' something if it's working out for them and helping them live their lives to the fullest...???? If someone needs to take something for the rest of their life to be psychologically sane, so what? Why is this 'ridiculous'? I guess it's the lack of knowledge that plays into these biases against the use of beneficial long-term opioid replacement therapy..

 

[Nikolai]

I dont understand whats wrong with what works for someone else. Many addicts have a different story on what it was that helped them, none of them are wrong. Not every addict is the same, they take varying drugs at varying doses for varying amounts of time. What helps one person may not do squat for another.

 

[NCUK]

-is taking his 200mg dose as i type
on the other not i say the just give everyone a life time suply of dilaudid.... paid for by the government of course

 

[lovethoseopiates]

What are you guys on? Methadone is only slightly stronger than hydrocodone. I have no tolerance and it would take me 40mg just to get a decent high.

O.K. I'm sure someone has already addressed the above 'quote' but if I may put my 2 cents in here about methadone. First of all, if you have no tolerance at all to opiates 40mg would F U up for a whole day. When I started on methadone thru the clinic I started at 30mg and I had a major high tolerance but I still got high the first day I took it. I took it every day for six years and got to a maintenance dose of 120mg once a day, which for a lot of people on as a maint drug, that's a fairly low dose (at least at the clinic I was going to). Now, if I were to take methadone every once in a while and wasn't on any other opiates, 10 or 20 mg would probably get me high.

The problem with methadone IMHO (for people who take it daily) is that it worked fine for a while. I felt "normal" and could function normally but wasn't "high" which was fine for a while. Other than major constipation, I was fine with it for a few years. Once the addict in me started to show its face again, I thought well why don't I just take more of this and just see. Well long story short, taking more and more of it doesn't do shit other than waste the methadone and risk God knows what. Eventually I felt so numb emotionally, lost all sex drive and pretty much didn't want to do anything, I wanted off of it. That was the best and worst thing I've ever had to go through. For me coming off methadone was the absolute worst withdrawal process I've ever dealt with. I can't even describe in words the feeling but it took a good month before I could even do anything...I mean anything. Not to mention, while I was on methadone I had two surgeries and even though they were giving me dilaudid through the IV, it barely took care of the post op pain. Methadone absolutely blocks any other opiates, there is NO question about that. Believe me I had already experimented with that notion when I first started methadone.

I'll get off the soap box now and if anyone has any questions about methadone, feel free to ask. That is one opiate I can say I know for sure.