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Opioids Methadone Mega Thread and FAQ v 2.0

CasketLottery said:
Also -- There should be a thread for methadone potentiators that are accurate or is there?
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There is an opiate potentiation megathread which is pretty much the same thing. Usually about 50mg of promethazine is what most people report although personally it just makes me even more drowsy to the point I can't stay awake. The general consensus seems to be that cimetadine (tagamet) is far more effective. People report good results with white grapefruit juice too although that never worked for me either. The only thing that ever "potentiated" methadone for me was more methadone......or maybe clonazepam (although the inherent dangers of mixing benzos and methadone are not to be underestimated).
 
CasketLottery said:
Also -- There should be a thread for methadone potentiators that are accurate or is there?
Click to expand...

I'm the master of methadone potentiation. Seriously, it's like a sport to me. You can completely fucking destroy methadone metabolism if you know what you're doing.

@lolz: I can't fully reply, but lipid-soluble drugs are rapidly redistributed from the CNS, to muscle and adipose tissue. This is why diazepam has such a short duration, despite it's insane half-life.

but the effect is dose dependent. With methadone, even a single moderate dose can last close to 24h using P450 inhibitors. But chronic methadone is far better. With chronic administration, the resoirvore(sic) sites become saturated. This allows the full dose to longer in the CNS. It is for this reason that chronic methadone is both twice as potent as acute, and has a longer duration.

As for NMDA antagonism, I actually agree with you. But my point is that it's well established that once someone is on a large enough dose of methadone, they can usually be maintained indefinitely, and NMDA antagonism supposedly contributes to this effect.
 
Lorne??? said:
I'm the master of methadone potent I at job. Seriously, it's like a sport to me. You can completely fucking destroy methadone metabolism if you know what you're doing.

@lolz: I can't fully reply, but lipid-soluble drugs are rapidly redistributed from the CNS, to muscle and adipose tissue. This is why diazepam has such a short duration, despite it's insane half-life.

but the effect is dose dependent. With methadone, even a single moderate dose can last close to 24h using P450 inhibitors. But chronic methadone is far better. With chronic administration, the resoirvore(sic) sites become saturated. This allows the full dose to longer in the CNS. It is for this reason that chronic methadone is both twice as potent as acute, and has a longer duration.

As for NMDA antagonism, I actually agree with you. But my point is that it's well established that once someone is on a large enough dose of methadone, they can usually be maintained indefinitely, and NMDA antagonism supposedly contributes to this effect.
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Lorne- did you say you use CYP 450 inhibitors?...I thought methadone was metabolised via CYP3A4,CYP2B6 and 2D6 pathways? Although having said that I thing cimetadine is a CYP450 inhibitor and that works so I'm a bit confused....I could go look it up but I thought you might know....can you elaborate?
 
Pill__Head said:
Cintiide p450 word wonders for potenating Methadine, no doubt.
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Yeah it does definitely..... Just I thought methadone was metabolised via a different pathway......need to look through some of my medical books I think!!

Edit - the enzymes I mentioned earlier are CYP450 isoenzymes......makes sense now!!!
 
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englandgz74 said:
Lorne- did you say you use CYP 450 inhibitors?...I thought methadone was metabolised via CYP3A4,CYP2B6 and 2D6 pathways? Although having said that I thing cimetadine is a CYP450 inhibitor and that works so I'm a bit confused....I could go look it up but I thought you might know....can you elaborate?
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Cytochrome P450 3A4 :)

Methadone is metabolized by several P450 enzymes, but 3A4 is the most impotant.(Also 1A2,2D6, the other 1A2). But just as important is PH. As I've said, a modest increase in urine PH literally DOUBLES methadone half-life, and also increases the amount of free methadone in blood.

A lot of people seem interested in methadone potentiation. Perhaps I should write up a summary? You know, saving the world, one cytochrome at a time and all...
 
I'm curious, I know there's posts about tolerance build up and such but I'd like to hear peoples personal opinions - to those who've used both Bupe and Methadone, whether recreationally or as maintenance drugs - how did the tolerance build up compare between them if you were taking a regular fixed dose? It helps if you specify what dosage you were on too, since at least with Bupe I found tolerance to barely build up at all at lower dosages but to build up pretty fast at higher ones, and I'm sure higher dosages of Methadone would be more likely to have quick tolerance spikes too.

Long acting opiates always held more interest for me in the long term due to the fact they weren't very moreish or compulsive compared to the short acting ones. Although those short intense rushes are amazing it's nice having a 24 hour relaxed chill instead. After trying AH-7921 though I found that Bupe lost it's appeal a little, being only a partial mu-agonist. AH-7921 fulfilled a similar role, actually lasted longer (36-48+ hours as opposed to ~20-24), and acted as a full agonist, albeit a weaker one. As a result I was always curious about Methadone, being that it's another maintenance drug and yet it's a full agonist unlike Bupe.
 
I made the right decision to go on MMT. If has only been three weeks but i have been clean since, and that is even when I didn't feel good in the beginning, and the other night woke up in "withdrawal,"(what I have learned recently may be a drop in urine pH causing the amount of methadone in my bloodstream to go down) after a horrible nightmare and didn't use. Some bad shit has happened to me that I would have definitely used over. I have had no desire to do dope. I can read about it all day talk to my "friends," about a new dealer who has "fire" for cheap and he lives two towns over, someone could offer me a bag for a new needle (lol, gave it to him for nothing) and not care. I don't know I would respond if a bag was in front of me, I might be curious as to how it would affect me, but I would probably think about the things I didn't care about when I was using. Probation, lol, getting my license back, which my PO told me he needs three consecutive clean urines from me to allow me get my license back. Yada yada yada.
 
Lorne??? said:
Cytochrome P450 3A4 :)

Methadone is metabolized by several P450 enzymes, but 3A4 is the most impotant.(Also 1A2,2D6, the other 1A2). But just as important is PH. As I've said, a modest increase in urine PH literally DOUBLES methadone half-life, and also increases the amount of free methadone in blood.

A lot of people seem interested in methadone potentiation. Perhaps I should write up a summary? You know, saving the world, one cytochrome at a time and all...
Click to expand...

I'd be interested in reading that. I'm not that bothered about potentiating the dose I'm on for pain management as I'm trying to get off it but as a healthcare professional the science interests me :)
 
I've been at my clinic now for 5 days at 60mg and get take homes on the weekends and everything is free

Not bad
 
Okay does anyone have any help with the sweats I have to carry a little hand towel with me now to wipe my face every minute

I'm on 60mg gona ask to go down to 40mg before it's to late since it's only been a week
 
@Lorne, I think summary would be great idea. Perhaps, at some point even as a sticky?

You helped me tremendously when the clinic made me start dosing in late afternoon during week and early am on weekends (cause that's only time on weekends they are open ). Mondays were killing me--34 hours between doses and I metabolize fast. Ugh. And the clinic never explained about pH and such. You did, and now with increasing pH and with the cimetidine inhibitng the enzymes I no longer have to use h on Monday to get thru the day.

I think others would be helped a lot as we'll. I have already seen similar questions where I passed along your info.

Ps. I would include not just potentiaton, but also that info about pH and how methadone's BA is much better in a less acid environment.
 
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crzydiamond said:
@Lorne, I think summary would be great idea. Perhaps, at some point even as a sticky?

You helped me tremendously when the clinic made me start dosing in late afternoon during week and early am on weekends (cause that's only time on weekends they are open ). Mondays were killing me--34 hours between doses and I metabolize fast. Ugh. And the clinic never explained about pH and such. You did, and now with increasing pH and with the cimetidine inhibitng the enzymes I no longer have to use h on Monday to get thru the day.

I think others would be helped a lot as we'll. I have already seen similar questions where I passed along your info.

Ps. I would include not just potentiaton, but also that info about pH and how methadone's BA is much better in a less acid environment.
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Ha, I don't think they'd go for it being a sticky, but I do hope to write something up at some point.

I'm so glad it helped though, man, I mean it is much better than people raising they're dose to unholy levels.

Your experience verifies the importance of understanding methadone metabolism, and that it can truly help people, on MMT, not just people trying to potentiate a high or even self medicate.
 
I've been on methadone for 6 months and it has given me a new lease on life. I was clean off all drugs for a month before i got on it, but in my mind thete was no doubt that i was going back to the grind at some point, so thats why i decided to give methadobe a go. Since i began my treatments i have given up the thoughts of going back to the place i came from, i came so close to death, shooting meth and heroin daily. I ended up in the psych ward and selling myself, and instense psychosis believing i was condemned to hell and vampires and aliens and god and the devil were arguing over me, and the only way to save the fate of the world and to get to heaven was suicide. So, needless to say, street drugs are extremely harmful to my well being, and those around me. But still, some people give me a hard time about being on methadone, and tell me it's toxic and I'm fucked forever now. But to me this drug has saved my life, given me a new life, and the ability to let go of the ridiculous temptation to go back to that hell. I don't know if that makes me weak cuz i can't just kick everything all together and be completely clean i do feel like i need a little something to help me through my days, and im so grateful for the methadone maintenance program here in Vancouver, BC. Maybe one day when I'm feeling confident enough in my self i will come off it. But until then, fuck the haters this shit gave me a new life off the streets and i have an opportunity to live an amazing life! I love bluelight <3
 
I swear at 60mgs I'm nodding so much it feels like there's people in the room and I'll talk to them

It's weird
 
DrinksWithEvil said:
I swear at 60mgs I'm nodding so much it feels like there's people in the room and I'll talk to them

It's weird
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Yeah, people underestimate the potency of methadone, especially with chronic administration. 60mg chronic methadone is equal to over 200mg oxycodone, but with a much longer duration.

Still, going from 60 to 40mg is actually a huge drop. I would try 50mg first, and wait a couple days for plasma levels to drop. Unless you're just high as hell all day. Maybe even 45mg? Remember, even that 5mg is like ~15mg-17.5mg oxycodone, but again with an exponentially longer half-life.
 
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