Opioids Methadone detoxing - hit a brick wall

[keystonelight]

So I have been on methadone for little over 4 years now. I am currently at 11mg and have pretty much hit a brick wall. When I went from 12mg to 11mg a little over a month ago I still get extreme anxiety everyday right around 5pm on the dot (~10 hours after dosing). I am lethargic 24/7, sex drive is non existent, and the general muscle soreness and anxiety is killing me. I am so afraid to go down another 1mg - but i want off this shit!

I have talked to every Doc in the city about getting on ANY type of benzo for my anxiety and the moment mention i am on methadone - even after explaining my low dose and the desire to continue going down they flat out say NO.

I have been prescribed clonidine 0.1 and was directed to take one before bed and one in the morning. Well i have been taking this for about 3 months now but only at night - it literally knocks me out and makes me feel like a zombie - kind of reminds me of serequel. I work full time and there is no way I can be taking this shit during the day.

So... what I have been doing the past month is taking st johns worts, 5-htp, kava kava, and i just got some DHEA since I read that long term opiate/methadone use decreases testosterone. I am not sure if i should start taking the DHEA now or wait until I am completely off of the methadone.

So basically, im wondering if anyone knows of any good remedies while detoxing from methadone or can share their experience. I am mostly concerned about the extreme anxiety and lethargy.

Alcohol works but I dont want to be drinking 5 or so shots every night.
Xanax/Klonopin/etc works - but I cannot get a compassionate and understanding doc to prescribe it.
Clonidine just knocks me out. I would only recommend this if I just wanted to go cold turkey and be in a coma for a week.
I have gotten some 100% CBD tincture and it helps with the muscle pain but CBD's bioavailability is terrible orally which means a $50 bottle will only last me about a week. I wish dispensaries would have 100% vapeable CBD products I cannot have THC in my system at the clinic (even though i live in a MMJ state).

Any thoughts guys? Do you guys know of any Rx that isnt a benzo that acts similar on the GABA receptors? Or perhaps any herbs that work with GABA?

 

[Rabidrabbit]

You may want to look into Gabapentin.

 

[Lilunwell]

Methadone is a tough one to kick! Thus why I much rather suboxone in very tiny amounts. Less than a mg. I do realize everyone is different ofcoarse and different amounts will help different people. I'll be watching this post. Good luck!

 

[rsmith309]

St johns wort is the worst thing to take, flushes the methadone out of your system in 8 hours and putting you in withdraw

 

[tentram]

ask about and look into baclofen for yourself. it's a gaba-b drug, similar to benzo's. it's a muscle relaxant, though. not an anti-anxiety med but does, in my experience, help with anxieties.

 

[laCster]

Yes I agreed with the gabapentin post. Pregabalin works better, but gabapentin still helps with withdrawal...I cant teach you how to get a script, but I can say flat out that if u ask straight up for benzodiazepines that you won't get any because the doctor will think you are trying to abuse them.

I'd take immodium to help with physical withdrawal and I bet it will help mentally, I would get DXM from a local grocery store or pharmacy and take 60-90mgs a day, I would get gabapentin from a doctor ( gabapentin is one of the easiest drugs to get prescribed like ever), I would eat right, force yourself to exercise, take multivitamins, maybe a muscle relaxer if u can't get benzodiazepines but benzos are a lot better, and finally I would stock up on diphenhydramine or doxylamime for sleep but hydroxyzine is more versatile

Best of luck

 

[Swimmingdancer]

It can be very hard to find good info about getting off methadone after being on it for years, since so few people do it and doctors aren't very knowledgable about it. Also every person is different, some of us have a harder time than others. Treatments for heroin withdrawal don't necessarily work the same for methadone withdrawal and what makes methadone withdrawal especially hard is that it lasts SO long. You are being very brave. Try to remember to be compassionate with yourself and try to stay motivated, you've made it this far!

It's extremely common to get to a point in tapering off methadone where you "hit a wall", it becomes really hard, and your body no longer adjusts to dose decreases, so you feel mild to moderate withdrawals every day no matter how long you wait between dose drops or how small you make the cuts. The exact number of mg where this happens varies from person to person, but it happens very frequently when someone is tapering after years of being on methadone. This happened to me at somewhere around 24mg/day, but I had already long been on split dosing and was taking 12mg every 12 hrs, because I metabolize methadone very quickly and it never lasted for 24 hrs for me. I had been on methadone for 10 years.

One thing that can help sometimes is asking if split dosing (taking it 2x/day) is a possibility, since the methadone isn't lasting 24 hrs.

Another possibility is switching to another opioid, stabilizing for ~3-4 weeks, then tapering off that. But, assuming you live in North America, most doctors are only willing to switch you to Suboxone, which can be a difficult switch from methadone, since you have to wait ~1-4 days with nothing in between in order to avoid precipitated withdrawals. Some Drs will let you go on oral morphine or something for a week or so before you start the Suboxone, since you don't have to wait as long between morphine and Suboxone as methadone and Suboxone. Then you would stay on the Suboxone for 2-4 weeks and then quickly taper off it.

Honestly, in retrospect I would have either switched to a different opioid and tapered off that, or just rapidly tapered off the rest of the methadone as quickly as possible, using any other drugs/supplements/herbs/lifestyle changes I could to help with WDs, because my initial solution to hitting the wall was just to taper the methadone even more slowly, which only prolonged the withdrawals, and the sheer duration makes it unbearable and very hard to lead a normal life. I don't think I would have suffered much more if I just tapered the rest of the methadone much faster, and it would have lasted a lot less time. Also not sleeping properly for so long, having this stress on my body, and being too fatigued to get proper exercise etc, have left me with other health problems which I'm now trying to work on. You're going to have to deal with PAWS regardless, but your brain can start to heal sooner if you spend, say, 1 month tapering from 11mg to 0 than 6 months tapering from 11mg to 0.

Anyway, I have a ton of advice and am prone to making really long threads, so please let me know if you'd like to hear more. I have a huge list of supplements and drugs and other things to do that can help. (But nothing is going to make it completely painless, so I think it's really worth it to get it over with as fast as possible).

I'd take immodium to help with physical withdrawal and I bet it will help mentally, I would get DXM from a local grocery store or pharmacy and take 60-90mgs a day, I would get gabapentin from a doctor ( gabapentin is one of the easiest drugs to get prescribed like ever), I would eat right, force yourself to exercise, take multivitamins, maybe a muscle relaxer if u can't get benzodiazepines but benzos are a lot better, and finally I would stock up on diphenhydramine or doxylamime for sleep but hydroxyzine is more versatile

60-90mg of DXM sounds like too much to me, although its effects are different for different people. Also a note about antihistamines such as diphenhydramine is that tolerance to the sedation builds very rapidly (3-6 days) so it can't be used every night, I like to rotate it with other things. And less is more with diphenhydramine - smaller doses are best for sleep/relaxation/calming effects, higher doses are more stimulating. So when tolerance builds you can't just take higher doses of it. Gabapentin is a good idea, but note that it can cause a physical dependence so it's best to take as low doses as one can for as short a time as possible, then taper off it. It's generally less dependence-causing than benzos though.

 

[keystonelight]

Anyway, I have a ton of advice and am prone to making really long threads, so please let me know if you'd like to hear more. I have a huge list of supplements and drugs and other things to do that can help. (But nothing is going to make it completely painless, so I think it's really worth it to get it over with as fast as possible).

60-90mg of DXM sounds like too much to me, although its effects are different for different people. Also a note about antihistamines such as diphenhydramine is that tolerance to the sedation builds very rapidly (3-6 days) so it can't be used every night, I like to rotate it with other things. And less is more with diphenhydramine - smaller doses are best for sleep/relaxation/calming effects, higher doses are more stimulating. So when tolerance builds you can't just take higher doses of it. Gabapentin is a good idea, but note that it can cause a physical dependence so it's best to take as low doses as one can for as short a time as possible, then taper off it. It's generally less dependence-causing than benzos though.

Thank you all for your suggestions, especially you Swimmingdancer - i would absolutely love your insight on supplements/prescriptions. I think i should explain my situation in a little more detail - mainly the fact that I work full time at a job where I interact with big wall street assholes - I am tech support. With that said I can't be taking drugs that make me zomby-like. This is what I found clonodine to do hence why I am only taking it at night. Small doses of benzos (0.5mg) about 3 times a day really really helps, not only with the anxiety but also with staying chipper and professional. But like I mentioned earlier once i mention methadone the doc says no - perhaps i shouldnt even bring it up.

So, my question is does Gabapentin induce the zomby feeling? And again, any recomendations on supplements would be greatly appreciated. As for the suboxone swith - i have thought about it but i do not know of any sub clinics around here. And getting me scripted to morphine i feel just wont fly even if i was willing to pay a premium to see a doc (no insurance).

On a side note - I requested to go back up to 15mgs this morning last night I didnt get a wink of sleep and had to call out of work. I know I am going to regret all the hard work it took me to get to this lower dosage but right now in this time in my life I cannot handle the physical and mental aspects of this current dose. I am hoping 15mgs will bring me back to my normal self and give me the time to find a Doc and educate myself on supplements that will help.

 

[Swimmingdancer]

The thing is there is never really a good time to quit methadone, and the longer you wait the harder it gets. I absolutely wish I had done it earlier instead of thinking it wasn't a convenient time and would be too hard to work. I mean, obviously if you would lose your job or absolutely can't afford to take some time off, that's one thing, but how/when is it going to be different in the future? There is always life that gets in the way and it makes it very easy to rationalize postponing it. Quitting and WDs just get worse the longer you've been on it. I say get it over with as fast as you can if at all doable . So I would definitely make sure you use this time at 15mg to try to work on everything and make it easier for you to continue tapering. Finding a great doctor can really help but can be difficult. It can be very hard to find a doctor who is truly knowledgable and compassionate about coming off methadone and about integrative medicine.

Gabapentin shouldn't make you a zombie like clonidine. It can make you drowsy, but it should be more along the lines of benzo drowsiness. Maybe - if you can get some - start with a low dose and take it when you're not at work the first couple times? Plenty of people do take it during the day. Note that as I said, it can cause physical dependence, so the best thing if you're going to do it would be to try to use it to enable you to taper your methadone the rest of the way really quick, then for a little while after the methadone to cover up any withdrawals, and then taper off it. You don't want to end up just replacing the methadone with another dependence-causing drug.

Sleep is one of the hardest things for me. I don't want to take any one thing for sleep every night and get dependent on it, so I've been trying to switch back and forth between different things and try to use supplements instead of pharmaceuticals as a first-line. I also find I'm not getting enough exercise, which is probably worsening the sleep and muscle/bone aches.

Supplements I've found helpful (*yes this seems like a lot of things to take but if you can afford it and stay motivated to keep taking them it's really worth it. You need more than what you would get from a normal multi-vitamin).

- amino acids in general
- L-Lysine: is calming, has been found to potentiate benzo receptors, might enable you to use lower doses of benzos or gabapentin
- L-tryptophan or 5-HTP: these are serotonin precursors
- Kava: calming/relaxing/sedating, is suggested to possibly work in a manner similar to benzos, different people have different results and I personally find that lower doses are usually better for me because if I take too much it seems like it can make opioids wear off quicker, although not everyone seems to have that problem. How have you found it so far?
- B Vitamins, especially B-6 and B-12 (people on methadone long-term are usually deficient in these vitamins)
- magnesium: can help with sleep, aches/pains, some animal studies found it to lower opioid tolerance (I find it takes a while of taking high doses daily to notice a difference but it's worth taking - chelated magnesium is the best but if it's expensive or hard to find magnesium citrate is better than magnesium oxide)
- Potassium (people on methadone long term are usually low in potassium and it can help with aching muscles)
- Calcium
- Vitamin D
- Melatonin: for sleep, in small doses (large doses can have a paradoxical effect and make you wake up in the night or have intense dreams)
- Vitamin E
- L-glutamine
- Fiber and probiotics for digestive system
- Omega 3 oil
- Adrenal complex
- Many people find L-tyrosine helpful. It's a dopamine precursor. I might have a sensitivity to it as I was getting heart palpitations when I took it which I thought it might be causing, so I stopped taking it, but the majority of people do not have that problem. I might try it again with other amino acids and see if it affects me better. Studies have found it's best to take a balance of neurotransmitter precursors.

*Let me know if you want info about doses, want to know which of the above are the most important (like if you can only afford a few or something), or more details about why any of them are important/helpful. Also yes I would start any supplements incl the DHEA now and not wait til you are off methadone.

Other things:
- Try to get exercise every day, even if it's very light or very brief. Yoga is really helpful.
- Hot baths with epsom salts.
- Get outside, even if just for 5 minutes.
- Sunlight if at all possible. Otherwise light therapy and/or tanning bed (just a really short time is fine if you're worried about it).
- Diet changes: No wheat; restricting grains in general and gluten would be ideal. No processed sugar, no alcohol. Fresh vegetables. I know diet changes can be really hard but they can make a big difference.
- Things for sleep: sleep hygiene (let me know if you don't know what this is), sleep music/binaural beats, meditation, etc.
- Make your home clean and nice-looking and a pleasant space to be in, maybe you could do this on a day when you're feeling ok and have the energy. Your environment can seriously make a big difference in how you feel.
- Hesitant to add this one as I don't want to seem like I'm recommending potentially illegal drugs, but specific psychedelics used in a therapeutic context can be very helpful.

Other meds:
- Some antihistamines can be helpful for calming/relaxing/sleep purposes, and also have antidepressant properties, but are not something you can take every night for sleep as tolerance to sedation builds very rapidly. Also you have to use very specific doses of some of them to get the right effects. There are some that also have other mechanisms of reducing anxiety. Let me know if you want more info.
- Lofexidine instead of clonidine if it's available where you live. It's less zombifying, lowers your blood pressure less, and is just as effective for opioid WDs as clonidine.
- Maybe look around more for CBD-only cannabis products? They are out there or can be made.

Also if you want to describe the exact symptoms you get when you lower your methadone dose I could provide more specific advice. Also if you have any other health problems/symptoms (certain ones are very common with methadone users). Going to stop typing now cuz this is already super-long, lol.

 

[laCster]

60-90mg a day is not too much at all, no offense. methadone is also a nmda-antagonist so it would be best to limit all WD's as possible. also, methadone WD is alot worse than gabapentin WD .

the shit helps definitely get pregabalin or gabapentin

 

[Swimmingdancer]

60-90mg a day is not too much at all, no offense.

Everyone is different was my point, so it's best to initially start with a lower dose and see how it affects you. That would be too much DXM for me, especially to take in the daytime and not feel weird and out of it.