Methadone/Buprenorphine Clinic (ATODS)

[Nozphexezora]

Hello,

Three to four weeks ago I had a relapse, and I am currently using 700g-1kg poppy seeds a day, which isn't much but it's rapidly increasing. I was 5 weeks clean before I had a relapse and took codeine "just to see what it's like again." Obviously it hasn't worked out well, and I'm going nowhere with this shit. I went to a psychiatrist about my addiction and depression, and he claims that I can't be treated for depression until I get out of this addiction at least slightly. So he suggested that I go see ATODS (Alcohol, Tobacco and Other Drugs Services) on Monday and there I will meet a physician. He said that they would most likely put me on methadone since last time I tried quitting I had terrible withdrawals (vomiting, muscle spasms, no sleep, no eating, cold sweats, body and muscle aches etc.)

I understand that the methadone program is a good substitute, provided that they give me small doses. I think I can manage with small doses of methadone, as I don't want to entirely substitute one addiction for another. However, I'm worried that they won't give me anything at all. I have gone to my GP twice, gone to two other GPs a year ago, and gone through a psych ward where they put me on valium for 8 days (the detox phase); and none of them even mentioned this program. I feel that it's ideal for me, as I seriously cannot do this by myself. I have my Dad and Step-Mom and a Drug Arm councellor, but words only go so far - especially when I know that taking any more just worsens it. I feel as though I should have been put on some medication to help cope through all of this to begin with, but the most I was given was antidepressants and valium during my PAWS. I don't just want to get high and exploit these programs, because I'll bloody take naltroxene and go cold turkey if I have to, so long as there's something to aid my attempt this time.

I made this thread with the hope that my fellow bluelight members could give me some advice; is methadone/buprenorphine/other in a clinic a good idea? If so, do you think they will actually administer the medication or just send me on my merry way like the last few times? Should I explain to them the concept of "poppy seed tea", or should I just say morphine and codeine so as to avoid that confusion that can so easily be identified by the doctor's facial expression? Sorry if this is in the wrong area, again, but I thought Australian drug discussion would be able to help considering the laws are relative. I just feel like there's no fucking point in going to these clinics and seeing these doctors, because all they do is send me off to someone else or give me a website address or give me some half-arsed advice. My GP didn't even give me sleeping medication until I was 4 weeks sober, and even then the sleeping medication was an anti-depressant substitute (Avanza) and it barely even works as an anti-depressant. I always feel like shit both physically and mentally.

Sorry for ranting, i'll just wrap this up.
Leave any advice or helpful experiences below and I'll get around to reading them.

Thankyou in advance,


Nozphexezora

 

[Nozphexezora]

I just read my fucking GP's referral as well, and it's just a crock of shit. He says that I was prescribed valium and I took twice the prescribed amount, and that I was begging him for valium. Jesus fucking christ - I have never ever been prescribed valium, nor have I ever abused valium. The only time I was given valium was in the psych ward, and even then I had nurses to deliver the valium at times set by doctors. I have no hope of getting help now. What's the fucking point.

 

[TaSiPtR]

Hang in there mate go see the intake nurse or doc at the ATODS see how you go from there you may not need methadone for a relatively small habit maybe try suboxone ? anyway there is hope mate don't give up yet

 

[Nozphexezora]

Hang in there mate go see the intake nurse or doc at the ATODS see how you go from there you may not need methadone for a relatively small habit maybe try suboxone ? anyway there is hope mate don't give up yet

Thanks for the advice, I do appreciate it a lot. They agreed to put me on suboxone, not because of the poppy seeds but because of the codeine, but I have to wait two weeks before I can get put on the program. I basically just have to keep using the shit until then.

 

[footscrazy]

^ Sounds like you have had some resolution.

Do you know what dose they're wanting to put you on? They'll probably start you on 8mg which will be overkill; suboxone prescriptions always seem to be way too high. If you do start on 8mg, I would highly recommend dropping that as quickly as you can, I think 2mg would probably hold you, and that way you're not making your tolerance uneccesarily high. If you can drop pretty quickly you shouldn't have too much trouble, but if you go any length of time at a higher dose, it's going to make it a longer, drawn out process when you do decide to stop, or even try to lower your dose. The one benefit I've found from being on a way too high dose is that it seems a lot more effective in calming down cravings, but I think you could get that benefit from 2, 3, 4mg, probably even less. You'll find out what works for you I'm sure.

I would also recommend getting a prescription from an addiction doctor rather than going through a clinic, if you can. It may not be the same where you are, but here in Melbs there seem to be a lot more rules and guidelines you have to adhere to when picking up your dose from a clinic. Going through a private doc I've been able to pick up 7 takeaways a week, rather than having to go to a clinic most mornings to dose, get drug tested and so on.

Hope it all goes well for you.

 

[Nozphexezora]

^ Sounds like you have had some resolution.

Do you know what dose they're wanting to put you on? They'll probably start you on 8mg which will be overkill; suboxone prescriptions always seem to be way too high. If you do start on 8mg, I would highly recommend dropping that as quickly as you can, I think 2mg would probably hold you, and that way you're not making your tolerance uneccesarily high. If you can drop pretty quickly you shouldn't have too much trouble, but if you go any length of time at a higher dose, it's going to make it a longer, drawn out process when you do decide to stop, or even try to lower your dose. The one benefit I've found from being on a way too high dose is that it seems a lot more effective in calming down cravings, but I think you could get that benefit from 2, 3, 4mg, probably even less. You'll find out what works for you I'm sure.

I would also recommend getting a prescription from an addiction doctor rather than going through a clinic, if you can. It may not be the same where you are, but here in Melbs there seem to be a lot more rules and guidelines you have to adhere to when picking up your dose from a clinic. Going through a private doc I've been able to pick up 7 takeaways a week, rather than having to go to a clinic most mornings to dose, get drug tested and so on.

Hope it all goes well for you.

For some reason I forgot to ask. I would assume 2mg would be enough, though, like you said. Do they do films in 3/4/5/6/7 mg anyway? The nurse told me that it was only either 2mg or 8mg. I am getting them from a clinic, and they say that I just have to present a urine test and some withdrawal symptoms during the visitation on the 27th and, from there, I will have to receive my film there every day for a week or so before I just go to a pharmacy and get it there. I know there's a pharmacy nearby that does it, so it's no problem. I've had to go through a lot of shit to finally come to this resolution; as I've gone through 2 doctors last year where they did nothing but give me some pseudo-philosophical lecture, the psych ward which just put me through unofficial detox by sticking me in the ward for 8 days, the GP which had the impression that I was trying to cheat valium off him despite the fact that my Dad was there at the appointments and the GP has been his doctor for 20 years, and finally the psychiatrist who said he can't help me until I get off the drugs. I just want it over with and start a fucking routine again - even if that routine does involve going to the hospital every morning.

Thanks for the response, too.

 

[Halif]

the psychiatrist who said he can't help me until I get off the drugs.

I haven't seen any counsellors or psychs for well over a decade now. I think it was the last psych I saw who said the same line which I quoted above.

In the first (and only) consultation, we chatted for about 20 minutes or so and then he just gave me that line. He asked if I was going to stop using drugs. I said "no". He wrapped things up and told me that until I got off the drugs, we wouldn't be able to make any progress. I was really pissed off and felt abandoned. I had expected to get some sort of guidance or advice or at least some help in getting motivated to ditch the substances - instead I got a hardline, take it or leave it approach. So I left it.

Now, all these years later I'm still on drugs. Harder stuff than I ever used to use back in the days of that psych visit.

I'm responsible for my development and actions. It is not up to anyone else to 'make me better', or to work out my issues.

HOWEVER, as a young (20years old) man who was using drugs to self-medicate (what was then) an undiagnosed mental illness, I thought - and still think - that the psychiatrist's approach was back to front. It's like if you're an addict, or a regular user, you're not worth bothering with because you're already a lost cause.

I hope that things are looking up for you real soon, Noz. Take care.

 

[Nozphexezora]

I haven't seen any counsellors or psychs for well over a decade now. I think it was the last psych I saw who said the same line which I quoted above.

In the first (and only) consultation, we chatted for about 20 minutes or so and then he just gave me that line. He asked if I was going to stop using drugs. I said "no". He wrapped things up and told me that until I got off the drugs, we wouldn't be able to make any progress. I was really pissed off and felt abandoned. I had expected to get some sort of guidance or advice or at least some help in getting motivated to ditch the substances - instead I got a hardline, take it or leave it approach. So I left it.

Now, all these years later I'm still on drugs. Harder stuff than I ever used to use back in the days of that psych visit.

I'm responsible for my development and actions. It is not up to anyone else to 'make me better', or to work out my issues.

HOWEVER, as a young (20years old) man who was using drugs to self-medicate (what was then) an undiagnosed mental illness, I thought - and still think - that the psychiatrist's approach was back to front. It's like if you're an addict, or a regular user, you're not worth bothering with because you're already a lost cause.

I hope that things are looking up for you real soon, Noz. Take care.

Thank you for the comment, Halif.

Fortunately the ATODS is what the psychiatrist directed me towards after explaining that he can't professionally treat me while I am still using drugs. I assume that he can't treat me because my psyche can't be genuinely investigated while it's being altered by these drugs on such a frequent basis, and I thought that, for my case, it was a rational conclusion.

I was hoping if you, or anybody else, could answer two questions which I have regarding the day on which I get put on buprenorphine. They asked for a urine test, and that I make sure that I'm in withdrawals during the time I get the suboxone. Firstly, since I have to be in withdrawals, what if I wait it out too long and end up passing the urine test? Will they stop delivering the suboxone and stop treatment alltogether? I'm not trying to get suboxone for the high, it's just I'm worried that my body will flush the drugs out of my system fast or something in the drug test will go wrong and I'll be refused treatment once again.
Secondly, what if I can't go through the withdrawals and I break and just have some before the buprenorphine? I'll assume that they won't be able to administer it seeing as how the drug has adverse effects when competing against other opiates? I know it's a piss-weak duration to be in withdrawals, but I have a very, very addictive personality and sometimes the cravings just take over my mind and I end up stealing money or drugs without any thought. I'm almost certain that something is going to fuck up and I'll be back at square one again, because an opportunity like this just sounds too good for it to go ideally.

 

[TaSiPtR]

If you are that scared of 24 - 36 hrs no opies then try & this is often recomended by drs take low doses of some benzo's pref long acting like valium the day before you have to go in & what they generally do is give you a piss test then observe that your in WD's & dose you straight up in clinic setting anyway the test results won't come back for cpl days & they generally push you onto something like subs as quick as they can ime

 

[JeanJM]

God it sounds like you are being dicked around like I am with my so called 'professional doctor' who writes BS in their statement letters. Don't let them stick you on 8mg! Say you want to try the lowest first and go up from there if you need to. My crazy CADS Doctor put his other patient who was taking 300mg Codeine on 8mg Suboxone, I mean WHAT! Then said if I was to go on Suboxone I would have to start on 8mg for 150mg Codeine....They have no idea what they are doing.

 

[footscrazy]

I would assume 2mg would be enough, though, like you said. Do they do films in 3/4/5/6/7 mg anyway? The nurse told me that it was only either 2mg or 8mg.

As far as I know, they do only come in 2mg or 8mg doses. I'm on the tablets though which makes it very easy for me to break them into whatever dose I want to take. I didn't think about the fact you would prob be on the film. I have no experience with the film so I don't know if it's easy to cut into smaller doses, but I think if you got onto 2mg, that'd be your best bet.

When I got down to 2mg last time I was on bupe, my doc brought up the possibility of moving onto subutex, which he said comes in smaller doses than 2mg. Though, I just did a quick search and as far as I can see, subutex comes in doses of 2mg or 8mg too. There seems to be a bit of reluctance to prescribe subutex rather than suboxone too.

How long does it usually take you to feel withdrawals? I've always waited for about 24 hours after my last PST to dose sub, I'll be feeling mild WDs by then, and since PST is long lasting, I've always felt it's safest to wait at least 24 hours before taking sub, just in case of precipitated WDs. I think if it'd been around 24 hours since your last dose, it'd def still come up in a urine test, and you'd prob be feeling at least mild WDs by then? What I've been told is to wait 24 hours for longer lasting opioids like those found in PST, or 12 hours for something like codeine or smack. So worst case scenario and you're finding it really hard not to use, you could probably get away with a CWE upto 12 hours before your first dose.

 

[Nozphexezora]

As far as I know, they do only come in 2mg or 8mg doses. I'm on the tablets though which makes it very easy for me to break them into whatever dose I want to take. I didn't think about the fact you would prob be on the film. I have no experience with the film so I don't know if it's easy to cut into smaller doses, but I think if you got onto 2mg, that'd be your best bet.

When I got down to 2mg last time I was on bupe, my doc brought up the possibility of moving onto subutex, which he said comes in smaller doses than 2mg. Though, I just did a quick search and as far as I can see, subutex comes in doses of 2mg or 8mg too. There seems to be a bit of reluctance to prescribe subutex rather than suboxone too.

How long does it usually take you to feel withdrawals? I've always waited for about 24 hours after my last PST to dose sub, I'll be feeling mild WDs by then, and since PST is long lasting, I've always felt it's safest to wait at least 24 hours before taking sub, just in case of precipitated WDs. I think if it'd been around 24 hours since your last dose, it'd def still come up in a urine test, and you'd prob be feeling at least mild WDs by then? What I've been told is to wait 24 hours for longer lasting opioids like those found in PST, or 12 hours for something like codeine or smack. So worst case scenario and you're finding it really hard not to use, you could probably get away with a CWE upto 12 hours before your first dose.

Thanks for the advice. It usually does take 24 hours or so before the withdrawals kick in. I'm not sure why I was so worried now, I should be fine. I'd imagine the film would be even better to distribute into smaller doses, as it's strictly rectangular and easier to cut. I want to try the 2mg at first, because I'll assume that that's enough as I'm only up to 1.5kg of seeds in my relapse at the moment, and I plan on keeping it that way for the 2 weeks. Before I was in the ward I was on a much larger dose. Just another quick question; when I am to go to a pharmacy to pickup the suboxone, will I be required to dose there? I assumed that the procedure would require me to do so, so that I maintain a routine, but what you're saying, and many others, it seems to me as though they let you take it home, especially considering suboxone has naltroxene.

God it sounds like you are being dicked around like I am with my so called 'professional doctor' who writes BS in their statement letters. Don't let them stick you on 8mg! Say you want to try the lowest first and go up from there if you need to. My crazy CADS Doctor put his other patient who was taking 300mg Codeine on 8mg Suboxone, I mean WHAT! Then said if I was to go on Suboxone I would have to start on 8mg for 150mg Codeine....They have no idea what they are doing.

Yeah, whoever that doctor is - he's a full-blown retard. I'm guessing he has some irrational grudge on recovering drug addicts and wants to "punish" them further. My step-dad sounds a lot like your Doctor - he used to threaten me with childish bullshit like turning the internet off or taking my car-keys in order to punish me so that I don't use drugs again. He was, and still is, a complete wanker.

 

[footscrazy]

when I am to go to a pharmacy to pickup the suboxone, will I be required to dose there? I assumed that the procedure would require me to do so, so that I maintain a routine

I think usually you do have to dose there, at least some days of the week. I've just been lucky in that the pharmacy I go to is incredibly lax. Even when my prescription has said I only get 3 or 5 takeaways a week, my pharmacist will give me the 7. Or when my script has run out, she'll keep supplying it to me, but I don't think that'd be the normal experience...

 

[JeanJM]

I think Subutex isn't prescribed so much is because of a drug called Temgesic and it lead to a lot of abuse even though my CADS doctor said you can't get high from Buprenorphine (what a joke). If I was going to be forced on Buprenorphine then I asked for Subutex 0.5mg but my CADS Doctor said only people under extreme circumstances can get Subutex. It should be automatic for those that don't have a history of IV, snorting, selling medication and who have health problems. I read Naloxone can prevent the body from producing its natural endorphins so you became reliant on Suboxone and why a lot of people have such a hard time coming off it.

The films are much easier to cut than the pills. They look like Listerine mouth freshener strips.