I just started a Methadone Maintenance Treatment Program...

[effie]

effie:
I am having trouble figuring out how threads are organized. When I go to OD I am unable to browse through there with any sense of direction and am unable to find my thread that you moved there. I wasn't able to find this thread by browsing either. I had to search for my user name. Is this common?
Thanks
Justin

Um.. it should just appear on the OD front page as it has recent posts, or the redirect will remain in BDD for 3 days so you can find it that way. Let me know if you are still having problems!

 

[issokay]

I'll learn as I go, I guess. I've never really understood how forums and threads worked, but I should be able to figure it out...

 

[Pjkt2501]

@ Tommy boy:

Interesting, I wasn't aware of that. I'm having a tough time finding info on mechanism of action and binding affinities online. Not to disagree, just gotta look for myself, ya know?

That was my impression, given that I've only tried methadone once at a 20mg dose with a 1mg bupe tolerance (it had been out of my system 24hours) and roughly 30-45mg oxycodone tolerance. Your example makes plenty of sense, but I'm still curious as to the actual values for binding affinity.

@ issokay - don't worry about the message board thing, it'll come with time.

 

[Tommyboy]

The blockade effect of methadone is around 60-80 which is why most clinics have their patients stabilize at at least that dose. I think it has more to do with your receptors being more saturated with methadone all day. The higher affinity thing is with bupe or naloxone, which is why they can be used to treat an opiate overdose, since their higher affinity will result in the displacement of the other opiates on the receptors, resulting in precipitated withdrawals, whereas you can take methadone while have other opiates in your system, and you will not experience precipitated withdrawals.

 

[BananasAndOranges]

I regret ever coming back to a methadone clinic. tapering is a Bitch. try not to use while on it it just makes you more uncomfortable later and I used to snort on 30mgs of methadone and man that was dumb. Tapering from methadone the burning up feelings you get while on it tapering are so ......hard to get to go away. I didnt get any sleep for a week last week and into this week every night was miserable as hell just doing 2mg decrease. It is best describable as the feeling you get when your heroin sick but the burning is inside the body outside the body and it just aggrivates the shit out of you. I dont know whats worsebut methadone made me so damn sick before I cant wish the burning up then chills then walking to the clinic after tossing and turning all night only to get fucking cold sweats when its 20degrees. It sucks so hard. Dont use on top of methadone.

as far as pain killing effects go it doesnt work for shit after you are stable and I mean that. I just got over this abscessed infected tooth pain sooo unbearable not even methadone could mask it for more than Maybe 3 hours. Some days it just gets you by. I really can only say if you want to get the most out of its painkilling effects eat foods high in saturated fat because methadone just sits in your belly and for me doesnt ever last as long as I need it to anymore

 

[closeau]

issokay, I started on methadone about 3 months ago for chronic pain. My pain Dr started me at 10mg a day and now I'm up to 40mg. I take them as prescribed but I save on 10mg pill and snort that and a little hydoxyzine and I definatly feel a buzz. Truthfully, Im just looking for relief from the pain but if I can get a buzz too, Ill take it. A lot of people will disagree with this and say methadone dont work used in any other manner than orally. Im just speaking about what I know and experience every day. My tolerance is low so that probably helps. Methadone works for me...to answer your question...sort of, hahaha. Good luck!

 

[issokay]

I have another question: Does medicare pay for MMT? my clinic isn't currently set up to bill them so could I just ask medicare to reimburse me?

 

[_Synapse]

most likely not, a lot don't accept insurance... I just got health insurance and asked about it they said no they just take the 65 a week that you gotta pay, and if youre over 150mg the money goes to 75 or something then 170mg or something just an example till 600mg where you pay like 100+ a week... thats crazy 600mg thats like if youre on it the rest of your life, why bother suffering the WD tapering off that dose ever? its like the first clinic i had put you only up to 200, which i was at 110 and now down to 85, working on tapering only after 4-5 months just so its easier for me to get off of... its easy so far, not noticing any difference, and i drop 5mg every 5-10 days depending on how i think i should go... its been smooth so far... hoping as i go down more (which 85mg holds me and kills cravings just as much as 110 was... i think i was just trying to get on a high dose at it was buzzin me at first after 80mg, hell even 70 was at the time... so i should be in for an easy comedown compared to other long term users i think. and so far i am. but ill reduce when i can if there is no or minimal discomfort... i just want to get to 40 or 30 and at least have the option of going to subs if i want or just being lower so in case i have to get off it easier i can.... why be on a dose that is high and not needed? I regret going on it in the first place but it has helped me especially killing the scoring game out of my life... that circle is gone... they all call me begging me to buy their dope, and as good as it is, and as much as i was snorting... a gram or more a day moreso most of that at one time... i am pleased to laugh and say no im good thanks though, why is it some BOMB SHIT? hahah make them feel even more shitty knowing im in control now not them... the dealers i mean... thats what those fucks get for making me their slave.

even though im now a slave to the clinic essentially its a better lifestyle and its not illegal and im working on getting off... i dont think i will relapse i dont think the quick time in and out of the clinic is a bad idea, i want off of the dependency and thats that... maybe someday if i can control my use ill use sporadic one day one bag uses and not touch it again for a while... if i cant do that then i wont risk the chances of fucking up again...

right now i think i have a bigger problem as im addicted to fucking loads of amphetamine... go figure right? one for another... but it was always both i just had become easilly acquainted with the H and chose that as it was more sensible and not as stressful and still when i could or when i was high i would still use amphetamine to some extent... im in trouble when it comes to addiction, polydrug addiction is a bitch, you all know that though. Without the methadone and the taper from opiods i think id be in a horrible dual addiction but the opiates would still be my main issue... at least there is not the physical dependency with the speed... it is more addicting in my opinion however in a psychological major monster craving way.... the euphoria and powerful superiority is a great sense, and im chasing after something that is not even there anymore thats how i know im hooked shitless to the speed... im chasing after a ghost... why else would you use if you did not get what you are hoping for? we all know this answer... addiction...

so there it is. but methadone is a great helper just gotta decide if it is right for you, and that i originally used it as a pure swap to avoid legal problems then realized it did much more for me than that... much much more... although the one day and only one day i bought 2 bags of good shit and blew them on my 110mg dose out of curiosity mainly in the blocking shit, it blocked it a little but i still got very very high... it scared me kinda as i would have only bought one had i known it would still work almost just as well... minus a little bit but not much... why would that have happened? The quality of the dope maybe? It was great shit to say the least... my tolerance felt like it dropped which sounds insanely wrong but i read that dissociatives cause a lower tolerance and methadone has that effect too in a weak way it makes the methadone unique very very much so in how it works in the long run for you. Is it really a mild antidepressant too? I read that as well..

edit: wow damn dexedrine i thought my shit was wearing off then i scrolled up, and up, and up, and.... fuck me.

 

[Fire&Water]

At least do a CWE on that shite before you hoover it...then fan dry it - yer' gonna permanantly F' up yer beaker! or nevermind, you'll still regret it.

 

[issokay]

I was on crystal meth for several years off and on also. It financially ruined me and almost my relationship. Opiates seemed less harmful until it got out of control and it started affecting finances as well... I'm also wondering how I can find a way to make the $65/wk that I need to pay for the methadone. I have a paypal donate button but nowhere discreet enough to put it. I don't want my family knowing about it so I can't share it on FB, and I really do need to find a way to fund it, it's just not in my budget. Oh well...
*snip*

 

[issokay]

I never snorted it, just ate them,

 

[Fire&Water]

Yes, it is the same methadone. The only difference may be the form that it comes in. Pills are generally prescribed for pain, whereas liquid or diskets dissolved in liquid are used to dose people on MMT. It's the same thing though. The dosages used to treat pain will vary depending on severity. I think that 10mg pills are common, and they may be prescribed 4x a day, give or take. I know of someone on here that is prescribed 40mg for pain.



Yes, and they usually stabilize most people on 60-80mg, and if they need more, the dosage is increased until cravings subside.



Don't take more than what you are prescribed of the ativan, and never combine it with alcohol if you are taking it with methadone. The methadone will provide you with pain relief, so I would hold off on taking any of the norco if you don't need it. Methadone is very sedating, so I don't think that you will need as much ativan as usual, particularly you evening dose.

A Dr. that prescribes dethadone 4 X a day - doesnt know his ass from a hole in the ground

 

[Swimmingdancer]

I am on methadone maintenance and have been for a long time, and am also someone who has chronic pain, (and has experienced acute pain while on methadone), so hopefully I can be of some help. I might be repeating some things that other posters have already said, but that can be good, since you know if numerous people say something then it is more likely to be accurate

1) Is the methadone used to help people kick opiates the same as methadone used for acute pain, and what is a typical dosage that a doctor would prescribe to someone for pain relief using methadone?

Methadone is sometimes prescribed for pain, not often for acute pain but for chronic pain (since it is highly physically dependence-causing, is long-acting, and takes a while to get to a stable level, etc). However it is not the first choice for pain relief and is not very effective for everyone. The dosage that someone is prescribed in either situation (pain versus opiate addiction) varies greatly depending on their history and their opiate tolerance level. If someone was prescribed methadone with no opiate tolerance, for example (which is very rare), they would require a much lower dose than someone who has a high tolerance to opiates and has been on them for a long time.

In addition, when prescribed solely for pain, methadone is often taken multiple times a day, whereas when prescribed for opiate maintenance/addiction treatment they almost always try to make you take it only once a day. One little known fact, however, is that people metabolize methadone differently and for many people the effects of methadone may not last for a full 24 hours, especially in lower doses. Many doctors seem unaware or unbelieving of this and may just keep raising your dose rather than try a lower dose taken twice daily. I am one of these unlucky people, referred to as "quick (or fast) metabolizers", and my current dose of methadone only lasts me for about 9 hours before withdrawal symptoms start. On the reverse end, other people may feel fine for even longer than 24 hrs however.

When using methadone for pain people usually need a higher total daily dose and may need to keep raising their dose as time goes on. Personally I would not recommend methadone to anyone for temporary pain. In fact I see it as a last resort for both (any type of) pain and for opiate addiction treatment. Be prepared to be on it for the rest of your life - for most people it is extremely difficult to get off of once they've been taking it long-term.

2) Is my 30mg (now up to 40mg) dose of methadone a typical dose used to start me off at?

Yes, that is a usual starting dose. Since the effects can vary from person to person they (normally) want to find the lowest dose that works for you in order to prevent physical withdrawal symptoms. From their view it's best to start at too low a dose and then raise it if you complain that it's not enough. It also takes from 3-7 days for methadone to reach peak and (relatively) stable levels in your body, so even if you've not feeling perfect the first few days you might still be on the right dose. You may have difficulty with the fact that you are no longer getting high. Many people when they start on methadone are expecting the same effects they got from heroin. But all methadone really does, when taken long-term at normal maintenance doses, is prevent withdrawal symptoms. In some people, higher doses can ideally help with drug cravings, but don't expect it to suddenly cure you of your addiction and for you to have no desire at all to use other drugs. It alleviates the physical withdrawals so that you can work on your mental addiction and the reasons you "misuse" opiates in the first place, and hopefully enables a more stable life. Some people do get a slight buzz or warm cosy feeling, and some pain-lessening from the methadone when they first start taking it, but this usually goes away after a few weeks or a few months of use.

3) I have legitimate prescriptions for Norco, Ativan, & Baclofen. The Ativan is 2mg 3 times a day, as i have panic attacks as well as insomnia, the Norco is for pain from a rotator cuff injury & Rhabdomyolysis from about 2.25 years ago. The Baclofen is a muscle relaxer for cramps and severe muscle spasms. I spoke with the doctor at the clinic today, he knows about my medication and he didn't express to me any interest in having me try to get off of the Ativan or the Hydrocodone. In fact, he told me to only take the medicines which I've been prescribed, no others, and of course, no drugs. Should I not have to worry about any interaction with the Ativan (a Benzo) at this time since I'm still on what they consider to be a very low dose of Methadone?

You are very lucky that you have a doctor that recognizes that you may have a legitimate need for these medications. Many times when someone goes on methadone and has admitted that they were using illegal drugs/ illicitly obtained drugs/ or "abusing" their prescription drugs, then drs/health care professionals will automatically assume that you have no legit need for any medication and that you are "abusing" them all, taking them just to get high, and that any health or pain complaint is solely an effort to get drugs. This kind of thinking is ridiculous, especially since most people who illicitly use opiates are actually self-medicating for depression or pain (or both), and is totally un-helpful, but it definitely goes on. Once you have been branded as a "drug addict" it can often be very hard to even get any pain meds when you are suffering.

You might want to try taking less of your other meds than usual, as the methadone could definitely intensify the effects of the Ativan and/or the Norco, and possibly the Baclofen too, (I am just not as familiar with the Baclofen personally, but i think the methadone could possibly make you more drowsy or something). Potential drug interactions involving methadone are not just dependent how much methadone you are taking, so we can't say a specific dose of methadone with a specific dose of another medication definitely will or won't cause an interaction. It depends on how that methadone is affecting you, your tolerance, your physiology and metabolism, etc. I would start off by taking lower doses than usual of your other meds and see how they affect you. Talk to your doctor more about this. I am surprised he didn't mention it.

They told me that methadone actually blocks the euphoric effects of opiates/opioids. I'm wondering if the methadone that I'm on will also provide me with some pain relief that I am actually prescribed the Norco for.

It might, but it might not. If it does, it is very possible that that won't last for long.

Also, I'm wondering if I'm taking an extreme approach to quit taking the Norco... I don't think I'm super-addicted to them as far as tolerance goes, I still have to take like 8 to get a good high from them (norcos) so I have some tolerance, is Methadone an ok solution for me?

I've noticed you keep talking about getting "high, that is a very different thing from alleviating pain or preventing withdrawals. What is your goal here? Are you wanting/expecting to continue getting high? Or is your goal just to deal with the physical withdrawal with the idea of quitting all illicit drug use and trying to get a more "normal" life back that doesn't revolve around drugs? Are you ready to not get high anymore?

Whether methadone is the right solution for you is really subjective. It's very hard to give even an educated guess without asking you a million more questions.

How dangerous is Methadone for someone who doesn't do several grams of heroin every day...

That is not very specific... just because someone doesn't use "several grams of heroin every day" doesn't mean they don't use any heroin or any other opiates. And how "dangerous" it is greatly depends on the amount of methadone. Do you mean how dangerous is it for someone to take any methadone when they don't use any other opiates? Or are you trying to ask whether it would be safe for you personally to take more methadone than you are supposed to? Or what? And then there are the dangers of combining methadone with other drugs, or alcohol, etc, which are a separate issue as it's much more dangerous that way than methadone is by itself.

 

[Swimmingdancer]

A Dr. that prescribes dethadone 4 X a day - doesnt know his ass from a hole in the ground

That seems like a very ignorant thing to say. Different people metabolize methadone at different rates and one person may get effects that last for 35 hrs from a particular does while another might get effects that last only 8 hours from the exact same dose. On top of that, treating pain with methadone is very different from using it solely to prevent withdrawals. Any pain-killing effects may not last as long as the withdrawal-preventing effects.

Now as to whether it's a good idea to take methadone solely for pain (especially for people who don't already have a dependence on opiates) is a separate issue; personally i don't think it's worth the consequences and I don't find it to be an effective pain-killer.

 

[issokay]

Swimmingdancer:
I'm definitely fine with not getting high anymore, I can already tell you that I don't want to crave it, and for most of today, being my third day, I haven't wanted to take any more Norco. As far as when I asked how dangerous methadone is for someone who's not doing "several grams" of heroin, I guess what I meant in that question was to say that some of the things that I've read have said that methadone was dangerous even when taken as prescribed. I'm not interested in taking it outside of the dr's directive. I was feeling nervous about starting this treatment and I think that question was rooted in anxiety.

 

[Swimmingdancer]

The ability of the drug to bind to mu-opioid receptors in the brain, and systemically. Methadone has a greater "strength" while attaching, that it won't allow a lesser drug a look-in. Opana IR is one of the few that I imagine wouldn't have difficulties, and Opana is about as strong as it gets (oxymorphone).

Suboxone for instance is known for its ability to block other opiates - this is due directly to the aforementioned reason.

As Tommyboy said, this is not exactly correct. Methadone does not "block" other opiates in the same way as buprenorphine, naltrexone or naloxone. And how much it blocks other opiates depends on how much methadone you take. As far as I know, methadone doesn't have a greater affinity for the receptors than other opiates like heroin, morphine, etc. It just blocks the high from opiates in the same way that taking a lot of heroin or morphine would. If you've ever used a lot of heroin, for example, and you use more, say, 15 min later, you won't feel anything. Methadone is just stronger and longer-acting. If the receptors are already full, adding more drugs won't increase the high you feel. A 30mg dose of methadone probably won't have much blocking effect and someone would still be able to get effects from other opiates (especially the pain-killing effects). They may have to take a higher dose than they would have to take if they weren't on methadone at all, as methadone has a cross-tolerance with other opiates.

Buprenorphine, naltrexone or naloxone work differently on the brain, as they are opiate antagonists - or, in the case of bupe, a partial opiate agonist/antagonist - so what they do is have an extremely high affinity for opioid receptors and compete with other opiates, bumping them off the receptors; this rapid blockade of receptors produces rapid onset of withdrawal symptoms.

 

[Swimmingdancer]

Swimmingdancer:
I'm definitely fine with not getting high anymore, I can already tell you that I don't want to crave it, and for most of today, being my third day, I haven't wanted to take any more Norco. As far as when I asked how dangerous methadone is for someone who's not doing "several grams" of heroin, I guess what I meant in that question was to say that some of the things that I've read have said that methadone was dangerous even when taken as prescribed. I'm not interested in taking it outside of the dr's directive. I was feeling nervous about starting this treatment and I think that question was rooted in anxiety.

What do you mean by "I don't want to crave it"? Did you mean to say that you don't crave it?

What do you mean by "dangerous"? Potentially deadly? I have never heard about methadone being dangerous per se when taken as prescribed (with no other drugs/alcohol), provided the doctor is not an idiot and is not greatly over-prescribing. But perhaps I don't fuly understand what you mean by "dangerous"?

 

[issokay]

No I meant that I don't want to crave it. That's why I started the program. And yes, before I really brushed up on methadone, I really knew nothing about it at all, so as I said, I was anxious about using methadone for the first time, although as it turns out, when they gave me a UA there was methadone in my pee, apparently heroin dealers around here are putting methadone in the heroin to make you get sick faster. So by dangerous, yes I meant deadly. What I read when first researching it was simply not good information, and it made me nervous. That's all

 

[_Synapse]

completely edit.

i see what you mean by you dont want to crave it, that makes perfect sense. That is why a lot of people go into MMT, one of the reasons like you just want to be free of craving getting high on dope and know this is a way to possibly work that out and overcome that with the use of methadone...

 

[Swimmingdancer]

No I meant that I don't want to crave it. That's why I started the program. And yes, before I really brushed up on methadone, I really knew nothing about it at all, so as I said, I was anxious about using methadone for the first time, although as it turns out, when they gave me a UA there was methadone in my pee, apparently heroin dealers around here are putting methadone in the heroin to make you get sick faster. So by dangerous, yes I meant deadly. What I read when first researching it was simply not good information, and it made me nervous. That's all

Hmm, well it depends what you mean by "crave". As I said before, methadone doesn't just magically make you not have any desire to use drugs anymore. You still have to work on your addiction yourself and find other ways to cope. But it can help with the really intense cravings that come from being in withdrawal. And some people find it helps more or less with cravings in general. Methadone is no wonder drug though. It may take you a while to get used to not feeling high anymore and just feeling "normal". Do they have counseling at your methadone clinic? (assuming you are at a clinic?)

A dealer wouldn't put methadone in the heroin to make you get sick faster, that doesn't make sense as methadone is longer acting than heroin. Often dealers will mix morphine, methadone or other opiates in with the heroin simply because the other drugs are more easily accessible or cheaper.

Where did you read this info that methadone could be dangerous even when taken as prescribed? I wouldn't worry about it. The only deadly danger of methadone is overdose (or on the rare ocassion, people can die when they stop taking it abruptly after using it for a long time, but even that is uncommon and is usually associated with other health problems as well). It is extremely unlikely that you could overdose from 30mg of prescribed methadone with the opiate tolerance you have. Most doctors are very careful about how much methadone they give someone as they would be held accountable if they gave someone too much and that person OD'd. If you were going to overdose it would be the first day you take it.

However, I would be careful about the other drugs you take, as they could make the methadone stronger or the methadone could make them stronger. And be extremely careful about taking any drugs you aren't prescribed. And be very careful about drinking alcohol as you will get drunk much more easily.