He Re: Methadone Detox PLEASE

[1wickd6]

Hey eveyone,

Im getting ready to go into a detox center in 2 days (tonight is going to be my last methadone dose) And could REALLY use some advice from anyone that has gone through anything like this...this will be my first time and after reading most of the post here on line about methadone detox, I am absolutley terrified to say the least about the "unknown" regarding what I am in for. I have read SO many different things about different things to take and different things to do while youre in WD's to help you get through (ex - Imodim for stomach issues, Klonipin for aniety, ambien for sleep, etc., etc.) and I guess Im just reaching out to anyone that may have gone through something simular that can give me some good advice on both what to expect and also some things that I can do to make my life bearable while going through this.

Just so everyone knows where Im at:

Ive been on 98 mgs/day for about 2 years. Ive never touched another drug in my life other than alcohol and doctor perscribed Vicoden and Percocet. I was taken to a Methadone clinic 2 years ago after being on Vicoden and Percocet for nearly 7 months while my oral surgen and dentist both worked on my dental issues that included jaw surgury. When I FINALLY got everything done, I was taking over 15 pills a day and not knowing much about taking drugs, I just stopped taking all those pills because my pain was gone. 2 days later I was rushed to the ER in severe WD's. They kept me over night and called a clinic to have me picked up from the hospital and admitted to a methadone clinic.....over 2 years later, here I am on 98 mgs of methadone wanting nothing more that to never ever touch or hear methadone again.

That said,

I have a detox/rehab facility here in my area that will get me off the methadone. But as anyone that is on methadone will tell you, most, if not all detox centers will tell you, you should be at no more than 40mg daily before trying to come off this stuff (im currently on 98mgs/day). Reason being is that most centers use Suboxone or Subutex as one of their main tools to get you off. This center however says that yes, they do reccomend you being at as low of a dose that you can be, but they would take me in and detox me at my current 98mgs.

What Im REALLY trying to figure out is, in everyone's "General" opinion (because I know that everyone is different), what do you all think I will go through if I detox to Suboxone at 98mgs vs. waiting until I tapered to something around 40mgs?? (again, I know that everyone is different, so Im not looking for an exact breakdown of what I will feel like hour to hour during my WD period, but rather what everyone thinks about going from 98mgs of Meth to Sub vs. going from 40mgs of Meth to Sub)

Other than that, ANY and ALL advice or reccomendations are VERY much appreciated and welcome, I can use all the help and support I can get. I am scared to death to go to this detox facility not knowing what is going to happen. I went into wd's about 6 months ago and i could and believe I can deal with everything aside from that skin crawling, RLS, juming out of your skin, super high anxiety feeling. So, if anyone has ideas or advice on how to get that specific symptom to subside PLEASE, PLEASE chime in.

Im sorry for the long post, Im just really desparate for help right now... Tomorrow at 5am will be my last dose before I hit the detox center. So Im really counting on everyone here that has helped everyone else I this board. I can only assure you that in return for any help, you will recieve any and all advice that I can give after going through what I am about to in the next few days.

Thanks in advance everyone, I really appreciate it!

 

[JRNeuberger]

Re: Methadone Detox PLEASE

You are making a grave mistake. The proper way to do this would be to slowly reduce your methadone dosage until you get below 30mgs., then switch to suboxone. Doing it any other way will throw you into precipitated withdrawal due to the naltrexone in the suboxone formulary. There is NO way around this.

Going to a detox facility to accomplish this is nothing short of an incredible waste of money. And make no mistake about it, your money is the only thing they are concerned with -- NOT your welfare -- as evidenced in their accepting you at your present dose of methadone.

Certain processes can not be rushed -- and this is one of them. Just a physical fact that can't be altered. You are making a grave mistake, and you are going to suffer incredibly because of it. Step back and do this the correct way. Your methadone clinic will help you with this process. You can't have everything you want just because you want it. This will take time. There is no way around that.

Do YOURSELF a favor and do this the right way.

J.R. Neuberger
National Alliance for Medication Assisted Recovery

 

[oliphill]

Witnessed a load of people switch over from high doses of methadone. Just a little but uneasy for first few days.

They will most likely give you benzos and/or clonidine for 2 or 3 days, then switch you over.

Don't worry about it, you will be OK, it will be a bit uncomfortable for a few days but nothing to worry about. You wont go into precipitated withdrawals.

Getting off fucking methadone was the best decision of my life! I hated being on that shit. Just makes you numb to he world, not happy but not sad. It really upsets me how an addicts first port of call is a methadone clinic, wish I had never gone on that stuff!

Good luck!!

 

[JRNeuberger]

Oliphill,
No, my priority is NOT to get people off of their meds, but it IS to see that people get good, evidence-based information, and what you've provided is definately NOT that! And it is NOT the bup that throws one into withdrawals, it IS the naltrexone. Just goes to show, eh??

I stick by what I've counseled. Your info seems anecdotal and third person, if not made up entirely. This action will be dangerous to 1wicked6, plain and simple.


Here is the message that has just been posted by Opiphill:
***************
Witnessed a load of people switch over from high doses of methadone. Just a little but uneasy for first few days.

They will most likely give you benzos and/or clonidine for a couple of days, then switch you over.

Don't worry about it, you will be OK, it will be a bit uncomfortable for a few days but nothing to worry about.

You wont go into precipitated withdrawals, and I thought the buprenorphine did that not the naloxone?

"National Alliance for Medication Assisted Recovery" clearly helping people get of meds is your priority!!

 

[zenith 15]

PLEASE do yourself an enormous favor and listen to JR Neuberger!!! You are setting yourself up for catastrophe and almost certain failure.

There is no "easy" way to get off methadone--you cannot switch over to SUboxone from a dose like yours, and tapering down to 40 mgs from 98 mgs cannot be done in a quick inpatient setting--it takes months to do safely. Telling you that you can expect to be "just a little bit uneasy for the first few days" is so far off base it's not even funny.

I am a certified methadone advocate. I do a ton of work nationally with methadone patients and run two major websites for patients as well, and I am VERY familiar, both personally and through my work with others, with what this entails. I am not just making this up.

What you need to do is simply taper off methadone slowly until you reach a level where you can switch over to Suboxone--and then make sure you are not switched over too soon. You need to be in mild to moderate withdrawals before the switch.

As for methadone being so horrible, etc--everyone is entitled to their opinion. However, methadone has saved my life, and I in no way feel "numb", emotionless, or anything else similar. I am extremely grateful there is a medication available to help me. People who have abused opiates long term often sustain permanent damage to their brain chemistry, and may not be able to produce natural opiates ever again. Methadone replaces not the drug of abuse, but the missing endorphins in the brain. However, most people require long term therapy, as with any medication for chronic conditions. If you have not sustained permanent damage you may do well in abstinence--but don't blow your chances with this rush towards getting off methadone.

 

[Lolie]

You don't mention the planned length of your detox or any rehab which will come afterwards. Both are important issues to consider. In my experience the shorter and less comprehensive the treatment plan the less likely it will be successful.

 

[sid3]

Oliphill,
No, my priority is NOT to get people off of their meds, but it IS to see that people get good, evidence-based information, and what you've provided is definately NOT that! And it is NOT the bup that throws one into withdrawals, it IS the naltrexone. Just goes to show, eh??

I stick by what I've counseled. Your info seems anecdotal and third person, if not made up entirely. This action will be dangerous to 1wicked6, plain and simple.


Maybe you should spend some time on the Nation Alliance for Advocates of Buprenorphine Assisted Treatment website. It's a great soure of educational material regarding the medication. Your right, evidence based information should always be shared. Apparently, you've critiqued the poster while not accurately understanding how the medication works yourself. In fact, your information is potentionally dangerous as well. Please be more careful when posting facts about a medication. When taken sublingually, the naltrexone is clinically insignificant. I'm fairly certain the BOA of the Naltrexone is around 3%There are countless reports of addicts suffering prepitated wds after inducting with Subutex too soon. Go figure, it's the Bupe that throws the other opiates off the receptors.. NAABT.org will clear things up for you. Third person,or made up entirely, I doubt it......It just goes to show you, eh

 

[oliphill]

good, evidence-based information, and what you've provided is definately NOT that! And it is NOT the bup that throws one into withdrawals, it IS the naltrexone. Just goes to show, eh??

I know for sure bupe can, how do you explain me going into precipitated withdrawals with Subutex once then? I suppose you're one of these people that think you can't inject Suboxone either, because of the naloxone?

I know that it is recommended to get to under 30mls. I am saying I have SEEN people do it at much higher doses. It can be done without going into precipitated withdrawals. It is not going to be completely comfortable, of course not, but definitely not dangerous.

People who have abused opiates long term often sustain permanent damage to their brain chemistry, and may not be able to produce natural opiates ever again.

I know this can be true for some, but I think a lot of people get stuck in this belief when they are experiencing temporary p.a.w.s symptoms, give up and then tell themselves they fit into this category. You gotta have been abuing opiates for a long long time from a young young age to even possibly be able to never produce natural opiates again. I mean I know a lot of people who have abused opiates and been on methadone for years and years, come off it all, and they are leading very happy lives, most definitely they're endorphin system working ok!

1 example, A good friend of mine was a heroin addict at age 15, and was on MMT for 15 years, he's 45 now and 11 years clean. He is one of the most content, spiritual, loving people I know. The sort of guy that walks in the room and everyone just feels better! His endorphin system is most definately working!

I know these people I know are just examples and it doesn't apply to everyone. I just find it sad when so many people get stuck on scripts when they don't need to be, every day making the process of coming off it longer and harder. Obviously I am quite passionate about it as I was one of those people! I know some people gotta be on it. And I wish you well with the path you are taking!

 

[SubDude]

You are making a grave mistake. The proper way to do this would be to slowly reduce your methadone dosage until you get below 30mgs., then switch to suboxone. Doing it any other way will throw you into precipitated withdrawal due to the naltrexone in the suboxone formulary. There is NO way around this.

Going to a detox facility to accomplish this is nothing short of an incredible waste of money. And make no mistake about it, your money is the only thing they are concerned with -- NOT your welfare -- as evidenced in their accepting you at your present dose of methadone.

Certain processes can not be rushed -- and this is one of them. Just a physical fact that can't be altered. You are making a grave mistake, and you are going to suffer incredibly because of it. Step back and do this the correct way. Your methadone clinic will help you with this process. You can't have everything you want just because you want it. This will take time. There is no way around that.

Do YOURSELF a favor and do this the right way.

J.R. Neuberger
National Alliance for Medication Assisted Recovery

Much of what you say is true and makes sense. However, you need to do more research about detox and talk to more people with experience using subs... especially regarding the precipitated WD's. Most rehab/detox centers induce methadone patients to bupe with subutex which has no naloxone in it. But it wouldn't make any difference because it's the partial agonist properties of bupe itself that causes the precip wds.

I can speak from a position of direct experience... In the past, I've been on methadone [off and on] for over 30 years. I switched over to Suboxone nearly 2 yrs ago.

Regarding the "switchover" It was a very difficult process and I personally don't recommend it for people who have been on methadone maintenance for a lengthy period... unless your long term goal is abstinence. And that will take some time after you switch to subs.

I was allowed 2 weeks hospitalization for this transition which was OK but really not enough. But there was a time factor... which resulted in being tapered 10mg daily [from high dose meth] until moving over from 40mg methadone to 12 mg suboxone. Looking back... I wish I would have tried to go ahead and withdrawl completely. It was that difficult. Most methadone patients slowly taper to 30mg and then move over to subs. I'm sure this would have been much smoother.

There was about 2 1/2 days between the time they stopped the methadone and started the suboxone. During that period, they kept me completely sedated with Clonodine and Valium. I didn't eat and only got out of bed for them to check my blood pressure. They insisted I stand up for that. After starting the subs... it took at least a week for me to feel well enough to eat, sleep, and take walks. I should say that I'm in my 50's so [one would think] it can be a lot easier for a stong and healthy young person??

Anyway, I've since tapered to about .50mg-1mg subs daily and feel ok. I tried to quit but have been unable to do that thus far. My point is... don't let them try to taper you off suboxone while in rehab unless you have 3-6 mos AFTER they they induce you to suboxone. IMHO... the lesser of the two "evils" is suboxone... especially for younger people who seek sobriety.