Day 2 Methadone - MMT - advice- when will it get better?

[wife]

Any advice pls....my husband has just started Methadone to deal w Fentanyl dependance. Big step for him. Just at Day 2 - 30mg dosage. Felt ok for a few hrs and then started to feel just terrible/withdrawal.

I have read all the posts and we are aware it takes a number of days/weeks to get up to the right level. He feels so terrible he is talking about not being able to take it if tomorrow's dose does not make him feel any better (even getting thru the rest of the night until next dose in morning is going to be tough)

He wants to continue with this and try to get some part of his life back- and of course I want him to as well....he will also have his dose upped but not until Tuesday.....any advice out there about feeling better after Day 3? or timing when the Methadone level will start to help you feel better?

Looking for some support to relay to him......thanks in advance....

 

[Tommyboy]

He can try taking tagamet (cimetidine) which will slow the breakdown of the methadone which will result in a slightly higher level of methadone in his system which can help a little. He should be better with each passing day even before they up the dose, because the methadone is going to build up in his system due to its long half-life.

I'm going to move this to the proper forum.

Homeless --> BDD

 

[Swimmingdancer]

Here's a graph that shows how long it generally takes for taking the same dose of methadone every day to reach steady levels in the blood:

He should keep taking his methadone, there is no reason to stop it just because it isn't providing complete relief yet. Why would he not want to take it? In order to rationalize going back to using fentanyl? Or do you mean he is just considering bearing the withdrawals with nothing instead of MMT?

He should definitely tell his doctor about this as soon as possible and see if he can get his dose raised.

Remind your husband how brave he is being and that you understand how hard this is, and that if he can just be strong and get through the first few days it will get better and he should soon be at a point where the methadone completely alleviates his withdrawals.

If he can't see his doctor soon, he could try potentiating the methadone with things like grapefruit juice or cimetidine as Tommyboy mentioned.

Also, even when just taking the same dose every day it can take up to a week for methadone levels to peak in one's system, so the first few days can be tough. Many people do end up using a little of their "drug of choice" on top of the methadone for the first few days, and doctors are generally understanding about that in my experience, but if he does do that he should be very aware of the risks involved and try to take a very low dose of whatever other opioid. Not saying I encourage that, it's a much better idea to try to just stick with the methadone if at all possible, but just saying in case he is thinking of using. I think that would be a better scenario than just giving up, stopping the methadone completely and going back to using fentanyl at least.

It can also take a while to get used to dosing methadone once a day if someone is used to using a drug multiple times a day, as we are so conditioned to feeling withdrawals after a certain number of hours. It is also easy to assume the methadone is not working properly because one doesn't feel high, but it can still be alleviating withdrawals.

If you or he needs any mental support The Dark Side forum is a great place for support/advice for people recovering from addictions (or their loved ones, or anyone going through a tough time) and you can talk to others who have been in the same situation.

Sorry that was so long, just wanted to be detailed as I know very well from personal experience how hard in can be to be in your husband's situation and how alone one can feel.

 

[wife]

Here's a graph that shows how long it generally takes for taking the same dose of methadone every day to reach steady levels in the blood:

He should keep taking his methadone, there is no reason to stop it just because it isn't providing complete relief yet. Why would he not want to take it? In order to rationalize going back to using fentanyl? Or do you mean he is just considering bearing the withdrawals with nothing instead of MMT?

He should definitely tell his doctor about this as soon as possible and see if he can get his dose raised.

Remind your husband how brave he is being and that you understand how hard this is, and that if he can just be strong and get through the first few days it will get better and he should soon be at a point where the methadone completely alleviates his withdrawals.

If he can't see his doctor soon, he could try potentiating the methadone with things like grapefruit juice or cimetidine as Tommyboy mentioned.

Also, even when just taking the same dose every day it can take up to a week for methadone levels to peak in one's system, so the first few days can be tough. Many people do end up using a little of their "drug of choice" on top of the methadone for the first few days, and doctors are generally understanding about that in my experience, but if he does do that he should be very aware of the risks involved and try to take a very low dose of whatever other opioid. Not saying I encourage that, it's a much better idea to try to just stick with the methadone if at all possible, but just saying in case he is thinking of using. I think that would be a better scenario than just giving up, stopping the methadone completely and going back to using fentanyl at least.

It can also take a while to get used to dosing methadone once a day if someone is used to using a drug multiple times a day, as we are so conditioned to feeling withdrawals after a certain number of hours. It is also easy to assume the methadone is not working properly because one doesn't feel high, but it can still be alleviating withdrawals.

If you or he needs any mental support The Dark Side forum is a great place for support/advice for people recovering from addictions (or their loved ones, or anyone going through a tough time) and you can talk to others who have been in the same situation.

Sorry that was so long, just wanted to be detailed as I know very well from personal experience how hard in can be to be in your husband's situation and how alone one can feel.

Thank you to both of you! It's 1am and just read your comments to my husband. We needed to hear from ppl who understand this - and the advice given helps. Also knowing other ppl have gone thru this and survived helps...will check out the Dark Side for some additional support - and may be back here again...we will see how tomorrow is.....day by day right?......thank you so much

 

[spooky1]

Wife, I am on MMT as well. I know its scary at first, but it will get better, I promise. He is getting sick because his methadone levels are still too low, and he is going into withdrawal. Make sure he keeps working with his doctor at the clinic to find the right dose. It will get better, it always does!

Trust me, I went through the exact same thing when I first started treatment!

BTW swimming, that's a great graph!