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How much Methadone you on?

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dsd

Bluelighter
Joined
Sep 9, 2012
Messages
152
What's the most amount you seen someone scripted?
Just read another comment where they said they were on 360 ml. I've seen on here plenty saying 180ml even in the low 200s. But 360ml , how can that possibly be an acceptable required dose.

Here in the UK I've been on methadone 30 years on and off, currently on 80 ml.

I've never received more than 100ml and don't recall anyone getting more than 120- 140 ml.
 
I was prescribed 140 at a private rehab in Thailand. They had initially started me at 80, but the wds were still pretty bad. At 140 I was high as a kite, but I reduced to 0 over 2 months. It was hellish, but worthwhile in the end.
 
I’m located in the Midwest, USA. I’ve been on methdone 3 times. I recently got back on the program. I’ve only been at this clinic for about 2 weeks. I’m at 60mgs. They bring you up 5-10mg’s every other day as long as you don’t missed days. They won’t bring you up on the weekends. They give you a carry out on Sundays.The last clinic I went to I was at 150mg’s and couldn’t go up on my dose due to a benzo script. If I didn’t have a benzos script I could have kept going up on my dose. I didn’t need too. I felt my best on 80 to 100mg’s. I actually had energy all day instead of wanting to sleep all day.
 
I’ve never used a clinic always had my own script and found I needed to dose twice a day to stay well (but it was the lowest amount that would keep me well)

I feel like dosing once oer day you’d have to take bigger doses to stay well all day off one dose thus jacking up your dose…or you have to be sick and unable to sleep the last few hours of the 24 hours
 
Methadone for harm reduction should be managed by pain management Dr's. I say this because the needed dose for methadone is very different after the cross-over off the original DOC. However the US government grosses $2.6 million daily from 400,000 patients, this maybe one of the reasons MAT patients are allowed to keep increasing their doses after the intial cross over is complete. I am sorry but not sorry, it does not take 500-700mme for a drug addict without legit diagnosed chronic pain or cancer pain to help with "urge control."

I am 100% for MAT. I feel they should do it differently. Mainly the "urge to use" is helped by making lifestyle changes and doing recovery work. IMO, they should test MAT patient's levels of DOC 1st then decide the correct starting dose. I feel it would be better to start them at a high dose then quickly work the the dose down. Like this :

For high tolerance patients
Day 1-3 = 100-140mg methadone daily with clonidine
Day 4-6 = 75-100mg methadone with clonidine
Day 7-10 = 40-60mg with clonidine
Then decide how to approach after testing how their body breaks down the drug. By doing this it will build up the levels of the drug fast to deal with the worst part of the detox. Someone that uses 1-2grams of street fentanyl, 100-140mg of methadone is not going to hurt them. But making people enter the program at 30mg and titrate 5-10mg every other day is going to make them suffer for a whole month making the transition extremely difficult.

Not trying to piss anyone off. I am proud of anyone that makes this change in their life.
 
I’ve seen people in the greater Toronto area prescribed around 150-180 mg ; back in my teens when I was on it i know the dose cap was 240mg at that time. I thought it was reduced to half that in recent years but I’ve seen people higher than that recently. Even when I had a half ball to a ball of fetty per day addiction, I never needed more than 70 mg to level out. It’s of course an individual thing. I just strongly believe if you’re at the point where you’re nodding off, It’s an over dosage, and you needn’t increase but rather reduce your dose if the goal is actually to get completely off one day. Pain management doses will definitely vary and in my experience on avg it’s about 80 mg per patient. Ive also seen people skate through with a dose no higher than 30-40 mg and come off within a couple of months
 
I had a friend with pancreatic cancer in the 10% survival range that made it 8 years. His tolerance to opioids was insane. he was only on 200mg of methadose solution and had oxycodone 1mg/1ml solution every 3hrs. even he said he could double his dose of methadone and not need another dose 36-48 hrs. he also thought is was crazy that the methadone clinic was dealing out his amount daily for people without severe cancer pain. back when he was couple years into the cancer he would crash a 30 day script of oxycotin OC 80's in 2 weeks and a 30 day script of opana 10mg IR in two weeks, and they would keep refilling for him. he had to stop doing that because the pain meds were not working as well. he was bored, pissed off, in pain, and over the whole situation.

he mainly said Marinol and flower THC & hash & dabs was what kept him alive so long. And using that helped him prolong taking so much pain meds in the morning saving them for the afternoon to evening when the pain was the worst.

the poor guy thought he had friends, he quickly learned that telling people he had so much narcotics or throwing away prescription bottles in the trash without removing the labels was the reason people kept breaking into his house robbing him. the guy went to a secret pharmacy next to a hospital that had no signs out front and kept the door locked only taking appointments to unlock the door. the pharmacy had all the rare solutions and odd ball medicines. refilling a 33 ounce bottle of methadose is crazy stuff with 500ml bottles of oxycodone and 300# opana 10mg.
 
Last edited:
LucidSDreamr said:
I’ve never used a clinic always had my own script and found I needed to dose twice a day to stay well (but it was the lowest amount that would keep me well)
Click to expand...

Well when methadone is prescribed for pain, it's almost always BID although I am informed that for a few parents, smaller doses TID actually work better for them. The variation in bioavailability of methadone can vary hugely between individuals. When the chemists at Horscht first tried it on human subjects, they noted that it wasn't useful for pain due to this huge variability.

Long, long ago someone told me they knew a patient in New York City who had been on a methadone script for decades and was taking 1000mg/day. That person wasn't given to making stuff up and their simple comment was 'I'm just amazed the guy could stand'.

For what it's worth, raecemic methadone is cardiotoxic because 50% of it is dextromethadone (which is 20 times weaker than levomethafone). Some nations now only use the chiral compound and from the reports I read, there seems less variability in it's action.
 
4DQSAR said:
TID actually work better for them
Click to expand...
In pain management when dual opioid Rx's are used :
I found that above 70mg of methadone will block other pain killers from working as they should.

I found for pain management small TID doses like 10mg methadone taken with a base IR narcotic every 4hrs, allows for pain relief from both medications. Though methadone 10mg are IR, the full-life effect makes the methadone act like a sustained release. It allows the base IR every 4hrs to not fall below a certain (point/baseline).

This is how I do it... Roxicodone IR 30mg: 4hrs and Methadone 10mg: 8hrs. If the pharmacy fills 2 days early like they should, that gives 12 extra 30's and 6 extra 10's for bad days or hoarding.

Adding Clonidine 0.3mg: 8hrs & Ativan 1mg: 12hrs along side the narcotics is one of the best pain management schedules.
 
Highest ive been on daily was 120. Wasnt enough and i eventually fell off. Right now im on 95mg, and still going up. Id rather not be on a 1000mg or some shit, but its not keeping me fully well yet. Last weekend i took both my take homes on the same day, wanting to see if together they'd both be enough to keep me well, and it wasnt. Sad shit that 160mg wasnt quite enough.
 
I'm not sure if it was the extreme dose (1000mg/day) or the fact that the person had, apparently, been on such a huge dose for decades is the more shocking.

It COULD be that they are an example of someone with a genetic predisposition to the N-demethylation of methadone so that dose was being metabolized MUCH faster than in the majority of people and/or they were someone who had the means to buy vast amounts of opioids and managed to work up a huge dependence/addiction.

I'm mentioned it elsewhere but of the five chemists I've known who broke Rule 1, two are dead, two are still recovering (after years in AWS) and one is in jail. I accept it's like comparing apples and oranges but for what it's worth, they ALL ended up redosing every twenty minutes day and night and had got up to 5-10mg per dose. I don't think any conversion chart would give a clear picture but I think we can all agree that they had all reached 'peak' addiction.

I mean, fentanyl was around in the 70s, but it was only used in surgeries. I suppose it's possible that a handful of people had discovered a way to obtain it.
 
4DQSAR said:
I'm not sure if it was the extreme dose (1000mg/day) or the fact that the person had, apparently, been on such a huge dose for decades is the more shocking.

It COULD be that they are an example of someone with a genetic predisposition to the N-demethylation of methadone so that dose was being metabolized MUCH faster than in the majority of people and/or they were someone who had the means to buy vast amounts of opioids and managed to work up a huge dependence/addiction.

I'm mentioned it elsewhere but of the five chemists I've known who broke Rule 1, two are dead, two are still recovering (after years in AWS) and one is in jail. I accept it's like comparing apples and oranges but for what it's worth, they ALL ended up redosing every twenty minutes day and night and had got up to 5-10mg per dose. I don't think any conversion chart would give a clear picture but I think we can all agree that they had all reached 'peak' addiction.

I mean, fentanyl was around in the 70s, but it was only used in surgeries. I suppose it's possible that a handful of people had discovered a way to obtain it.
Click to expand...
JESUS CHRIST, 1000mg a day is like 4.7 GRAMS of morphine a day if im converting right.

The redosing so frequent part is one of the worst things about all these highly potent but short lasting opiates. Even though i dont need to shoot a few bags every 3-4 hours anymore, i still cannot sleep more than 2-3 hours at a time. Id love to sleep through the night again.
 
Several liver enzymes, particularly those within the Cytochrome P450 (CYP450) system, play a crucial role in opioid metabolism, and their activity can affect the potency and duration of opioid effects. CYP3A4 and CYP2D6 are key players in this process, with CYP3A4 being a primary metabolizer for many opioids, and CYP2D6 being involved in the conversion of some opioids to more potent metabolites.

Inhibiting CYP3A4 or CYP2D6 can increase opioid levels in the body, potentially leading to increased effects and risks
If a substance inhibits the activity of CYP3A4 or CYP2D6 in the liver, the opioids metabolized by those enzymes will be metabolized slower, leading to higher levels in the bloodstream. This can increase the potency and duration of the opioid's effects, potentially leading to more pronounced pain relief, but also increasing the risk of side effects like sedation, respiratory depression, and overdose.

Strong inhibitors of CYP3A4 :
Clarithromycin, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, tipranavir
Others : grapefruit juice, noni juice
Strong inhibitors of CYP2D6 :
Fluoxetine, paroxetine, quinidine, bupropion, and cinacalcet.

I tried this little hack and it worked on & off (not consistent) :
Take Tums 3-4 minutes before dosing opioids. Then, add a steroid at the same time of the opioids. The Tums helps keep the opioids inside of the liver longer and the steroid helps some opioids cross the blood brain barrier faster & easier. Tums is not good to take everyday and all throughout the day. It raises the calcium levels in the kidneys too much.

These can help to increase the strength of methadone :
tricyclic antidepressants (TCAs), ketoconazole and fluconazole, selective serotonin reuptake inhibitors, erythromycin, and metronidazole

Some medications can decrease methadone levels :
some antiretroviral drugs (e.g., nevirapine, ritonavir), phenytoin and carbamazepine, risperidone, rifampicin, and fusidic acid. Long‐term alcohol ingestion and cigarette smoking can also reduce serum methadone levels
 
RustyCrackleford said:
JESUS CHRIST, 1000mg a day is like 4.7 GRAMS of morphine a day if im converting right.

The redosing so frequent part is one of the worst things about all these highly potent but short lasting opiates. Even though i dont need to shoot a few bags every 3-4 hours anymore, i still cannot sleep more than 2-3 hours at a time. Id love to sleep through the night again.
Click to expand...

Yeah, I absolutely agree than an all-caps response is appropriate in this case. 1000mg/day!

That is why I suggested that the only practical way someone could have developed such a huge dependence was if they had been abusing an opioid with a very short half-life and/or very high potency.

Before fentanyl was phenoperidine which is chemically similar to and was replaced by fentanyl. The point being high potency (x20-x80 morphine) and a very short duration of action. So my own pet theory is that someone found a way around the road-blocks on obtaining phenoperidine and tried to stay high 24 hours a day. It's duration of action is 60-120 minutes but that would still mean MANY shots a day and a rapid rise in tolerance and dependence.

But who knows - you don't ask. If someone offers information that's fine, but you don't ASK.
 
I'm on 170mg a day, split 85/85 morning and evening. Confirmed via peak-trough labs to be a very fast metabolizer, and I'm still not consistently well. Wake up more often than not w/ some sort of wd symptom, but I'm done with continually just edging my tolerance up 10mg at a time. I'm going on vacation in a couple weeks and starting my taper when I get back.
 
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