Opioids Metabolizing Metadone

[RunRunRun]

*I have never posted a new thread before. I just always came here for information. But I had a few questions concerning metabolizing methadone.

I was an iv user for a few years and used a few years before that as well. I just started at a very strict methadone clinic. A new rule that started right before I joined the program is that patients can't go over 80mgs unless they do a peak and trough test. The peak and trough test is $80 and I know the withdrawal symptoms I get are strong enough that I could for sure go up after they saw my results of the peak and trough test. It just sucks because during the day I feel fine then by the evening and next morning I get diarrhea, bad stomach cramps, the painful cold chills, and just a miserable feeling, and it gets worse as the days go on. It is very hard to talk to a doctor there and the nurses don't really know anything it seems. But I was just looking for information about the peak and trough test, what can influence the way your body metabolizes methadone, if something can influence the test results, and any other useful information on it.

I hate hearing about how clinics everywhere else seem a lot more laid-back, understanding, and helpful. I am just concerned about getting the proper daily dose I need to feel even just somewhat normal you know? I hate that I have to pay $80 for the test too just to even see the results to see if it's ok to have more. But I know I should be easily getting more. I think our clinic is just so strict because it is full of 20 years olds who just popped vics, percs, hydros, or snorted roxys and oc for a year at most. I hate that kids like that exist and are just still trying to get a fix which makes it harder for people who really need a higher dose. I know all the iv users out there who have tried going to or still go to a methadone clinic know that 80mgs of methadone a day doesn't cut it when I used to slam 16mgs+ of hydromorphone and 40mgs+ of oxymorphone er in one rig. And trust me, I knew how to prep and shoot them without using a flame and burning anything off and losing some of the drug. I hope this is even the right place to post this and hope to get some useful information on the subject. Thanks.

 

[sekio]

A peak and trough test should just be regular blood draws to measure the metabolism and excretion of methadone in your body.

There are a lot of factors, but genetic variance is one of the major ones. Urinary pH is probably another.

 

[lazylazyjoe]

Alcohol will metabolize it very quickly. Don't drink.
But, if your like me, it doesnt matter the dose you're on. I would just acclimate to a higher dose and I still seemed to be sick most every morning. I just needed to dose twice a day, not increase my single dose. I found saving some of my take home to take during the week helped alot. Or even buying someone elses's take home. I found most people were willing to trade on takehome day(if your clinics closed sunday).

 

[RunRunRun]

It just sounds like such an unreliable test as well because the methadone used in the US has two parts to it -- these "isomers" look the same, except they are mirror images (like your right and left hands). The important thing is that only one of the isomers is active (l-methadone), the other is inactive (d-methadone). Everyone metabolizes the two isomers at different rates, but the test does not differentiate between the two forms. It's possible to have what looks like an acceptable level, but your active methadone could be low and your inactive could be high. The test is misleading because it does not tell you how much active methadone you have.

From what I've read. But I'm not too worried. I'm sure I could easily go up. I just hate having to experience ups and downs again from feeling alright half the day to starting to get slight wd symptoms and also my mood altering.