Opioids methadone dose not lasting long enough! WHY??

[hardknoxkicker]

So I have been on methadone for 6 months now, currently on 160mg. The problem is that my dose isn't lasting like it should! Around 10pm my stomach starts to hurt and I start to feel icky8(. Come morning I am full blown in withdrawl. I don't feel the heroine anymore all it does is take away the w/d symptoms. As a note, I only use once or twice a month. I used heroine for 2 years about 1gram a day. The weird part is I was prescribed methadone pills for 2 years before using heroine and only needed 80-100mgs a day and didn't wake up as sick as I am now. But did feel a little rough in the am. My husband and I pay $650 a month in for MMT and hate the clinic we go to. It takes about a month everytime I need to increase my dose and this last time was told 160mg was the highest they will let me go which is total bs!! One of the nurses suggested that I could split my dose, take 80mg in the am and 80 mgs in afternoon. But I don't think I could make it to my afternoon dose because the 80mgs wasn't enough to hold me. I really need some good advice here because I really want to not use anymore and being 34 yrs old I have already ruined 10 yrs of my life and want to live the rest of my life happy and clean and make my family proud of me. I am getting so frustrated, aggitated and anxious. And, my counselor is a total b***h!! ANY IMPUT OR ADVICE would be greatly appreciated!!

 

[LilikoiMoon]

I use methadone for dry out spells every few months, like when I want to take a break. Suboxone gives me bad migraines and makes me feel icky, but the methadone is great.

I can't advise you on high doses but just on what I do and that is that I dose twice daily the first few days, then wean down and completely off for a few weeks clean.

What's happened recently to make your cravings change? Stress? Physical changes? Is it worse after you use H?

After researching methadone and knowing my body, I could never go over 30 mg if I wanted too. Just 20mgs takes me all day, but that's either 10mgs then another 10mg 6 hrs later, or 20mg at once.

Maybe the nurse is right, maybe splitting doses will help. Under their supervision, of course.

Good luck!

 

[dirzted]

Your focus should definitely not be on increasing your dose, it sounds like you already have done so multiple times so all its gonna do is hold you for another month and then you'll be back right where you started... Like they have suggested you're going to have to start splitting your dose, or something similar, i will sympathize that it SUCKS your dose for whatever reason isn't holding you, but if you've been using at all then there's already a possible solution- STOP using H ENTIRELY, then on top of that, if 80mg doesn't hold you, what about like 140? or 120 maybe? then by taking another 20-40 at night it could prolong your dosage so you wouldn't have to be sick in the morning. Other than that I would recommend trying to take grapefruit juice or something similar in order to prolong your dose, but then again that would also just lead to a tolerance increase.

Im sorry you're in this predicament, but there are many other possible ways to get out of it other than just increasing your dose.

 

[rhun]

Increasing your dose is pointless, your tolerance will just increase and you'll be right back where you are now. And you're already on 160mg, there's no reason to be on a dose that high after a gram a day habit.... you're just making getting off methadone 100x harder if you ever want to and you're raising your dose due to addiction, not for a valid reason.

Some people have a high metabolism and the methadone doesn't last as long. The nurse was right, you need to do split dosing. I know it's hard, but you need to look at this rationally... taking half your dose the first day of split dosing isn't going to be that bad, you may have some moderate withdrawal but it won't be that bad and you'll be fine once you take your second dose later in the day.

Half a day of some withdrawal is worth not having withdrawal every night like you are now, right? A lot of the fear is of your own making, it really won't be that bad and it's the only real solution here.

Using heroin while on 160mg of methadone is completely pointless and a waste of money, it will not work. I think that if you want sobriety and a better way of living for yourself, you need to take a long hard look in the mirror. You may be on methadone but all your addictive behaviors are still alive and well. Please consider switching to split dosing then slowly tapering as well as adding some kind of recovery to your life... whether it's 12 step, group therapy, outpatient treatment, etc is up to you.

 

[hardknoxkicker]

rhun, thanks for responding to my thread. I totally agree about not using heroine at all anymore. But, I do have a recovery plan that is in action. I go to 2 group classes a week that is for methadone patients. I have only used heroine one time in the last 3 week and soon it will completely done with the shit. I am a very strong willed person and when I put my mind to it I usually get it done. I want nothing more than to be clean (just on methadone). I also might have to be on methadone the rest of my life.

 

[inthetriptank]

one thing that worked for me, specially when tapering and dealing with constant minor withdrawal symptoms, was taking 1-2 tums every day before my 'done. apparently it makes the methadone stick around longer in your system. i definitely noticed a difference in how long my medicine lasted.

 

[wezface]

Your focus should definitely not be on increasing your dose, it sounds like you already have done so multiple times so all its gonna do is hold you for another month and then you'll be back right where you started... Like they have suggested you're going to have to start splitting your dose, or something similar, i will sympathize that it SUCKS your dose for whatever reason isn't holding you, but if you've been using at all then there's already a possible solution- STOP using H ENTIRELY, then on top of that, if 80mg doesn't hold you, what about like 140? or 120 maybe? then by taking another 20-40 at night it could prolong your dosage so you wouldn't have to be sick in the morning. Other than that I would recommend trying to take grapefruit juice or something similar in order to prolong your dose, but then again that would also just lead to a tolerance increase.

Im sorry you're in this predicament, but there are many other possible ways to get out of it other than just increasing your dose.

This is my advice as well.

Have you started exercising recently or done something else to increase your metabolism?

 

[phatass]

At my clinic they did a test to see how fast i metabolized methadone, somemetabolise way, way, way fastr than others, needing to split doses, morning and afternoon, and take higher doses maybe... also do you drink booze regularly? Alcohol inreases the rate of methadone metabolism a lot i believe....

 

[hardknoxkicker]

If I do split my dose wont i go into withdrawl in the am from going from 160 to 80 twice a day?? I dont drink alchol either

 

[nauticaustin]

You just have a naturally high amount of CYPxxx enzymes in your system.. it's metabolizing the Methadone much faster than it normally should.

CYP2D6 is the primary enzyme Methadone uses in it's metabolic pathway. Additionally, it's responsible for the majority of pharmaceuticals metabolism.. so I have a question. Do a majority of pills you've taken generally seem to kick in quicker than most?