Methadone - Home or Clinic treatment?

[LotusExige]

Everyone,

My short story is this - thanks to some sever back pain that started 4-5 years ago I've gotten on the opiate train. Started with Vicodin but now I'm up to 6-8 8mg dilaudid's a day (plus many days a 32mg exalgo too). While I'm generally good about not abusing them I definitely have and did something a few weeks back for the first time that had made me decide it's time to kick this and get better. In short I feel like shit all the time, only when I can take a big dose do I feel any good and then it's only for about an hour.

So I've decided one way or another I'm getting myelf some help. So this morning I setup an appointment at a local methadone clinic as I didn't/don't really understand methadone, other than the idea is it limits/reduces the withdrawl and the cravings and let's you get past it. The real pain in the ass there is going to the clinic everyday (as it's going to add 45-60 minutes to my daily commute). When chatting with my pharmicist today he let me know that since I'm already in a pain management program (that's where I get my meds now) that they would most likely just write me a script for the methadone and I wouldn't have to go daily for it. But I'm honestly not sure if that's best as I'm worried it would be easier to slide and cheat if I were doing it at home vs. the clinic.

For now I have an appointment and am going to keep it and even perhaps start treatment with them. Thinking that perhaps after a month with them that I'd be able to get a script and move things home and save myself all the commute/gas.

Thoughts? Any personal experiences with the same issue? I know I have a problem and I know I want to solve it, now to just find the best way to do that.

 

[neversickanymore]

Hey LotusExige and welcome to Bluelight

If it were me I would ask the pain clinic to prescribe you the methadone first. If you end up abusing it you can always switch to the clinic later. Methadone has a very long half life for many people so it does not promote rapid redosing in people. Even thought the half life is really long its analgesic properties only last six to eight hours. If you are still at the Pain clinic and get to have your medications at home you will be able to dose a smaller dose every six hours or so. This may help control your pain better. You can also go on vacation and other things easier.

I would also add a vitamin D supplement to your diet and consider having your testosterone checked every couple of months if your a male as opaites and especially methadone can cause significant drops in both of these.

Here is some good information
Methadone side effects, separating fact and fiction.

Low vitamin d status of patients in methadone maintenance treatment.
Methadone

There is a strong explination of what methadone is and how it works in this book.
Neuropathic Pain: Causes, Management and Understanding

I found methadone to be a real god send for treating the pain I used to have. I hope it works well for you. Congratulations on recognizing and stepping up and dealing with this before it got bad.

 

[LotusExige]

First NeverSickAnymore I really appreciate you taking the time to reply to me and give me some advice. As everyone who's every gone through recovery from something knows it can be a scary thing.

I did have a really good chat with my pain doc today and she basically is fine with whatever I decide I want to do between her tapering me down on my regular meds (which I don't want to do), giving me a script for methadone or a script for suboxone. After talking with her for a while about it her biggest suggestion was suboxone which of course is the option I know the least about right now.

Tomorrow morning I do have my first appointment at the methadone clinic and I'm going to go ahead and keep it. It's only $100 and at a minimum I'm sure I'll learn a lot and get my questions answered even if I don't fully join the program. My thinking is to start the program with them so I can't cheat at all at first and then within a couple weeks I'd just get the script and do this at home (as I think the daily driving to the clinic is going to suck long term). But now I need to do some research about suboxone vs. methadone to see which I think would be best for me. As my doctor agrees with me that I'm not "addicted" but rather "dependent" she hopes my recovery won't take more than a few months. I sincerely hope she's right and that I'm not totally lying to myself about my behavior. Yes, I've abused them before but it's not something I do on a daily basis nor want to continue. I'd much rather get stoned and as I live in Colorado that's an easy thing these days.

So thanks again for taking the time to give me some advice, even knowing someone random out there is thinking/caring about you means something doesn't it? I may have more questions after tomorrow so I'll post back again - if at a minimum to document my recovery in the event it would help others (as I'm sure there's little information on this out there, right?!?!)

 

[LotusExige]

Well as an update to myself and everyone else I had my appointment at the methadone clinic today. When I pulled up my first reaction was "I don't belong here" - I don't at all want to sound judgemental here but let's just say one of these things was not like the other. I was dressed for work as I went after - again I was the only person there is nice business clothes. After the interview I said something to this effect to the therapist and her response was "you're definitely not our normal patient".

After that and talking with my doc I've decided to get the script and do this at home. I just don't think I can stomach the daily trips to the clinic and, unless I really am lying to myself I don't feel like I have an abuse problem around the dilaudid. If I'm going to get high I'm going to smoke pot as that's absolutely my drug of choice. So I talked with my doc and tomorrow she's going to "swap" my dilaudid for methadone. Told her I'd bring her what's remaining of my script (about 50 8mg pills) so she can throw them away - then I can't cheat as I have no other source/access to these drugs.

So we'll see how this goes - I am going to seek counsling, at least at first, but can do that somewhere closer to work/home that's on my schedule, not some daily thing.