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Opioids Is this logical? (getting off methadone)

DopeFiendWTM

Greenlighter
Joined
Jul 24, 2010
Messages
17
Okay, I'm on 50mg of methadone/daily right now from a clinic. This is my second time trying MMT and have been on that 50mg dose for 10 months now. My dose is on the verge of not holding me anymore so I feel slight w/d effects in the mornings. I really dont want to up my dose and have been thinking a lot lately about getting off. I'm only twenty and its just an embarrassment being on methadone. I try not to tell anyone but for one reason or another, people find out. But besides the social implications, methadone is just to sedative. I really need to start looking beyond today and methadone just has no part in my future.

The problem is that methadone just lasts so damn long in your body. The first time I tried getting off methadone (110mg/daily) I went to a detox center then a 30 day NA based rehab. I went through the w/d's with just valium, muscle relaxants, and clonodine (no opiods) and spent a total of 12 days in detox and 31 days in rehab. By the time I was out of rehab I still had RLS and trouble sleeping. This lead me back to snorting oxys then eventually back to shooting dope. Total sobriety time was probably around 60 days and I STILL had PAWS. I was just so fed up and frustrated.

So this is my plan:

*My dad's a doctor and has a lot of doctor friends that know about my situation and want to help. So if gone about correctly, I have access to many medications which arent normally used.

In the past, before methadone, I would always use morphine as kind of a maintenance drug. 200-300mg would usually suffice. With a much shorter half life/duration of action than methadone, would I be able to use morphine as a maintenance drug for 2-3 months then either taper or cold turkey from the morphine? IMO methadone is very hard to taper down from and if done cold turkey, the PAWS last far too long. So if I use morphine or another shorter acting opiate as a buffer, could I, in effect, drain the methadone from my system then only have the shorter acting opiate to contend with?

Converted, 50mg of methadone is roughly equal to 190mg of morphine. It would probably be wise to split that dose to 80mg BID. And just for the peace of mind of my dad and the prescribing doctor, there is a medication which combines morphine and naltrexone to make it less abuse-able. I believe its called Embeda.

I know staying clean is a whole other issue, but I believe I've made great advances in my life and have thus far stayed clean on methadone.

Opinions?
 
I recommend tapering the methadone down to maybe 30mg ASAP, then from there trying to transition to another opioid. 50mg is a lot of methadone and you will likely experience withdrawal even going to the equivalent dose of another opioid due to methadone's somewhat unique properties (I experienced some symptoms even when going from 20mg methadone to bupe...)

In general, I'd say this is a pretty good idea, though morphine is not the best choice of what to switch to IMO... It is one another one of the more difficult to quit opioids due to it's somewhat unique effects. Buprenorphine would be your best bet IMO... Oxycodone or similar would be better than morphine.

My 2c...
 
Thanks for your input!

Forgot to say, BUPE IS OUT OF THE QUESTION! Haha. I know if I dont say that Ill get everyone and their mother saying "why not suboxone/subutex?"

I just hate bupe. I gag at the taste (strips, tabs, whatever), its never held me, even after 72 hours of being clean then using suboxone, it didnt help.

The only reason I say morphine is because of my past experience with it and that it is available with an antagonist. I think they either do have or are going to make oxy and naloxone/naltrexone combo but I'm not sure. That would be the ultimate choice but I dont think the doctor would be to fond of going back to a drug I had major problems with. And with all the negative media, oxy has such a bad name that even doctors fail to see that its just another opioid with different characteristics.

Also morphine has the ability to be used for maintenance w/o have a constantly inflating tolerance.

I guess what I'm also asking is, are there any other formulations of agonist/antagonist that have or are being used for maintenance? I'm running through the list of opioids/opiates in my head and morphine seems to be contender #1.
 
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^ If you are referring to Embeda, the morphine/naltrexone preparation, it was discontinued in the US a couple of months ago.

"King Pharmaceuticals Inc., a wholly owned subsidiary of Pfizer, has voluntarily recalled from U.S. wholesalers and retailers all dosage forms of EMBEDA® (morphine sulfate and naltrexone hydrochloride) Extended Release Capsules CII because a pre-specified stability requirement was not met during routine testing."
http://www.embeda.com/
 
Itll be back. And thats just an example. There have been a lot of complaints with Embeda's potency too. So i'm not saying it has to be that per se.

If you were going to do something like this, which opioid would you pick?
 
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