Opioids Methadone Mega Thread and FAQ v 2.0

[lolwhatzdrugs]

If you have never been on Mmt how can you say people shouldn't be on 100mg after 2 years. Everyone metabalizes it differently. I used to think the same thing untill I became a Mmt patient again. The bottom like is people have to take responsibility for thier dose but there will always be the ones who chase it as high as they can.

That's not really what I said.

" methadone clinic without a taper schedule is a cash cow and should be illegal. No one should be on 100 mg of methadone for two years." I should have added "for two years, without the option of tapering/without a choice to get off of it." but the previous sentence makes that entirely clear. I'm not trying to push guilt on anyone at all, if you're stable on methadone and living well, all the power to you. The previous sentence kind of made that a bit clear.

If you need to be on MMT for the rest of your life to keep from shooting heroin daily and maintain a stable life, then that is what you need. You should probably still try to reduce ULTRA slowly, but if you need it, you need it - it saves lives for sure. But the longer you're on it at a high dose, it's more likely that it will be harder and harder to get off of it. Again, you shouldn't feel guilty for being on a legal opioid - you should feel responsible for doing something about a life shattering problem.

Hell, if you read the rest of the thread I already made this completely clear. There were people discussing that some clinics were less than accommodating in helping people leave the program at their preferred speed. Some may have been dragging it out because they are experienced and know how common relapse is, but there are seem to be other programs where they want your money daily and your welfare (other than being alive to prevent lawsuits and keep the money rolling in) such as helping you make educated decisions about what is happening, seems to be furthest from what they are trying to accomplish. In these uncaring cases liquid handcuffs seems the most appropriate term. In cases where clinics are helpful, it is a lifesaver from drowning in brown liquid.


I read a blog post about a mobile methadone clinic that went down to try and help out getting doses to MMT patients during hurricane katrina, and one clinic treated them nicely, everyone else was like 'GTFO we don't want help' and there were people in full on withdrawal in the street because clinics didn't show up or give information at all about what you needed to do during the hurricane. The people in the mobile clinic were awesome and caring people, and the state officials of Louisiana seemed not to care (lthey warned some of the clinics that 'loony people from the North were coming to stir up troube,' and the clinics didn't care about their clients or try and help them find relief.

The guy (a Dr.) in the mobile clinic was barred by law from prescribing methadone in LA and couldn't really do anything short of prescribing/handing out clonidine and other non-opioid symptom management. Imagine how less likely you might be to flee a storm/take the warnings seriously if you're at your apartment in withdrawal from 100 mg/daily.

Now corruption/assholes/inefficient and incompetent bureaucracy seems to haunt this state. It's poor, stupid, and full of crime (on almost every objective measurement..... education, real GDP per capita, murder rate per capita, money taken for welfare from the Federal Government). This means that services to the most vulnerable people are crummy, and people live in abject poverty which fuels a viscous cycle.

 

[Lorne???]

^^^ If people are upping they're dose annually, they are missing the point.

Part of what makes methadone so damn effective, not to mention legal(and even encouraged) is that, once you are stabilized on a HIGH DOSE, you generally don't need to adjust your dose. That is kinda the point. I mean methadone is an NMDA antagonist, which helps make it self limiting.

And the simple fact is, despite what many claim, nearly every MMT patient ends up on a dose that is in (often far) excess of what they're actual physical dependence was before starting treatment.

Of course that is also the point; by putting patients on a high dose, it helps to reduce the chance of relapse, not to mention the fact that jacking up your tolerance makes getting high extremely difficult,(though certainly not impossible) and even if you do get "high", actually achieving any euphoria is basically fucking impossible.

Also, you need a high dose to ensure that once-daily dosing is sufficient. Despite methadone's long half-life, the duration is(like most opioids) dose dependent, and so a larger dose holds longer.

Remember that methadone is very lipophillic, and thus, with a single dose, it is rapidly redistributed from the brain, to other body tissue. This is why acute methadone sucks.
If you've ever injected a small-moderate dose of 'done in WD, you'll see that it brings rapid relief, and 20 minutes later you feel pretty good, but, a couple of hours later, the peak has passed. You still feel normal, but that's it.(basically PNS effects, which might interst you, LOLZ )

But a few days later, after your system is saturated with multiple(larger) doses of methadone, that same dose IV'ed feels fucking amazing, and it hits immediately, instead of taking 15-20 minutes.
On the other hand, a single, large dose will fucking last 24 hours on it's own, and even longer with some skillful inhibition.

But I digress. All I am trying to illustrate is that they're are many reasons why they employ high doses in MMT, but it isn't because you NEED 100mg, to actually keep you from withdrawal, when most people we're if they could afford a gram of oxy a week.

Seriously, it would probably fucking amaze people to know just how strong 100mg of (chronic) methadone actually is. Of course, if you take 100mg of methadone, every single day for a couple of years, then for some reason lose your clinic, well, you'll see then, when it takes 1000$ of dope a day to feel normal...

 

[Emme80]

Down to 4mg..... ! God, it's like a tease..thinking of when I was between140/150mg! Soooo close. I've taken 1mg drops since 7/8mg. Only once did I feel a noteworthy impact from 10-4mg. Which makes to felt drops since 20mg.(14mg. I felt) I feel...like I'm waiting for the sky to fall down upon me..! I do feel easily irritated..but nothing remarkable. When I drop, I may feel like skin is easily goosebumpy for a day or two...legs may ache, but nothing over a...2..2&1/2- from a 1-10. WTF? Perhaps it will swiftly kick me in a cruel way at 1mg. Maybe it will be wishing for death when I go to 0... I've been patiently awaiting for the ball to drop. I'm prepared, have all the necessary "comfort " meds....I just thought at this point I'd be way more ...fucked up. Sick. Not saying I WONT be...just thought I would be at this point. Confused. Anxiety over being anxious waiting for the hard core anxiety to kick in. Yup...an odd dynamic going on here. Hope everybody is doing well!
~Emme80~

 

[Emme80]

I'm curious-with others who have taken(what I think is) a medium paced methadone taper, how long it took body to feel and then "adjust" to a dose reduction-especially what I'm curious about right now, is anything under the 5mg mark(or any mg. Mark would be good info.) How was your taper? How quick /slow did you take the last 5mg.? Did anyone have a minimally painless time doing so? I'm having slight hints...i.e. Leg aches, spine ache(but that is bad issue with or without any kind of wd) slight chills here and there and bit of lethargy... But these pass within ...2days if onset... Confused. Anybody have it like this( I'm doing 1mg. decreases). Thx.

 

[lolwhatzdrugs]

^^^ If people are upping they're dose annually, they are missing the point.

Part of what makes methadone so damn effective, not to mention legal(and even encouraged) is that, once you are stabilized on a HIGH DOSE, you generally don't need to adjust your dose. That is kinda the point. I mean methadone is an NMDA antagonist, which helps make it self limiting.

And the simple fact is, despite what many claim, nearly every MMT patient ends up on a dose that is in (often far) excess of what they're actual physical dependence was before starting treatment.

Of course that is also the point; by putting patients on a high dose, it helps to reduce the chance of relapse, not to mention the fact that jacking up your tolerance makes getting high extremely difficult,(though certainly not impossible) and even if you do get "high", actually achieving any euphoria is basically fucking impossible.

Also, you need a high dose to ensure that once-daily dosing is sufficient. Despite methadone's long half-life, the duration is(like most opioids) dose dependent, and so a larger dose holds longer.

Remember that methadone is very lipophillic, and thus, with a single dose, it is rapidly redistributed from the brain, to other body tissue. This is why acute methadone sucks.
If you've ever injected a small-moderate dose of 'done in WD, you'll see that it brings rapid relief, and 20 minutes later you feel pretty good, but, a couple of hours later, the peak has passed. You still feel normal, but that's it.(basically PNS effects, which might interst you, LOLZ )

But a few days later, after your system is saturated with multiple(larger) doses of methadone, that same dose IV'ed feels fucking amazing, and it hits immediately, instead of taking 15-20 minutes.
On the other hand, a single, large dose will fucking last 24 hours on it's own, and even longer with some skillful inhibition.

But I digress. All I am trying to illustrate is that they're are many reasons why they employ high doses in MMT, but it isn't because you NEED 100mg, to actually keep you from withdrawal, when most people we're if they could afford a gram of oxy a week.

Seriously, it would probably fucking amaze people to know just how strong 100mg of (chronic) methadone actually is. Of course, if you take 100mg of methadone, every single day for a couple of years, then for some reason lose your clinic, well, you'll see then, when it takes 1000$ of dope a day to feel normal...

What I was saying was that not providing you with a taper schedule, if they desire, was fucked up. A person should have an option to always move in the lesser direction. The people here who have gotten down to sub-5 milligrams are

For the NMDA antagonism part, how does this contribute to it's self limiting nature? I mean - even at high doses you will never get full on NMDA antagonism effects, and if taking it 7-9 days a month did anything to NMDA tolerance, it sure doesn't reflect when combined with a real one (I know methadone's effects are real, but it ain't no 3-MEO-PCP).

I dunno about the acute dosage part, I never took it for MMT and 100 mg in two hours would have me feeling good for 10-15, but I had pills so I'd just pop another every two or three hours. I'd have 900 mg and it would last me about 7-9 days. I also can't speak to IVing it. I wouldn't even begin to think about that unless I had IV ampoules. Personally I wanna try some of that levacetylmethadol (OrLAAM) with a 2.6 day half life. Since methadone's euphoria lasts IMO 10 hours or so with one good acute dosage, would this stuff last a full 24? How is methadone redistributed out of the CNS?


Anyone see the new episodes of Arrested Development where Tobias Funke goes with his wife to take acting lessons, at a place he thinks is called MethodOne acting? He thinks that they teach the "Method" or method acting. He gets hooked on what he constantly calls his "acting juice."

 

[MMT]

I'm curious-with others who have taken(what I think is) a medium paced methadone taper, how long it took body to feel and then "adjust" to a dose reduction-especially what I'm curious about right now, is anything under the 5mg mark(or any mg. Mark would be good info.) How was your taper? How quick /slow did you take the last 5mg.? Did anyone have a minimally painless time doing so? I'm having slight hints...i.e. Leg aches, spine ache(but that is bad issue with or without any kind of wd) slight chills here and there and bit of lethargy... But these pass within ...2days if onset... Confused. Anybody have it like this( I'm doing 1mg. decreases). Thx.

I think doctors should be allowed to prescribe a mild narcotic,say lo dose codeine, for the first 60 days or less if that's what the pt. wants,on the jump to 0.. You might have a special gene or something that's making it easy for you but I assure you,99.9% of us are gonna suffer. And I think the codeine would take a big edge off those first 60 days while your body eliminates what's left of the methadone and begins to live it's life without it.

 

[Emme80]

I feel like yes...I'm experiencing some days with said mildly irritating and achey wd's after a few days of a decrease . Indeed, It's there...the ol' familiar pains...but I'm sleeping. I'm ok. Yet I'm waiting for the sky to fall&the ground beneath my feet to break away. I just don't know when it's going to go all sideways on me. Wondering why it hasn't happened. That's torturing me...waiting for the big car crash...as i'm certainly set to & deserving to suffer. My body and mind have a debt to pay-to crack&fall apart.
Suppose I'll just keep waiting for the fall, as I'm sure I must be close to the ledge. I wish it would just happen.

 

[anniebananie]

Follow up question

I realize I am pretty stupid, but I took 8 ml of methadone yesterday at 7 pm. It was liquid, concentration was 10mg/ml. I didn't realize how strong the concentration is and am just happy to be alive. That was approximately 30 hours ago. I still feel a little lethargic, dizzy, my eyes have trouble focusing. But the nausea has stopped and I feel fine. Am I out of the woods, or do I need to worry about going to sleep tonight and dying? Any advice is appreciated. Thank you so much in advance. Annie

^^ Last post from the end of the last thread, just so it doesn't go to waste.

 

[anniebananie]

I should be clear: this was oral methadone and I took it orally.

 

[Ormazd]

Ok so here it goes, I've been takingsubsuboxone strips for the past 2 months about 8mg a day ssometimes 16mg a day when I feel really shitty. Its not prescribed and I've been taking it for pain. I recently went to my doc and was put on long term opiate therapy for pain. 5mg methadone 3x daily. Obviously I didn't tell my doc about the subs. My tolerance is so high I need to get it down before I switch so the methadone is effective. I'm trying to do this w/o going through wds. What's my best option here? Taper off the subs? How quickly can I make the switch?

 

[lolwhatzdrugs]

I realize I am pretty stupid, but I took 8 ml of methadone yesterday at 7 pm. It was liquid, concentration was 10mg/ml. I didn't realize how strong the concentration is and am just happy to be alive. That was approximately 30 hours ago. I still feel a little lethargic, dizzy, my eyes have trouble focusing. But the nausea has stopped and I feel fine. Am I out of the woods, or do I need to worry about going to sleep tonight and dying? Any advice is appreciated. Thank you so much in advance. Annie

We can't tell you for sure whether you're safe or not. But if you already stopped being nauseous, and it has been 30 hours you're probably safe, but the word probably is key. You should call someone up and have them come sit with you, awake, for another few hours if you're still worried. The half life of methadone is about 24 hours (unless you are a slow metabolizer which is kind of rare) which means that the amount in your system should be 35-40 mg left. You've been up since then?

Honestly, if it's been that long, and you didn't nod out and die you're safe. Again though, I'm not going to say anything for certain as I don't know your tolerance or even what a lethal dose is for a non-tolerant person. Next time be very aware of what you're taking. A 'recreational' (some say it isn't at all, I disagree) dose of methadone for someone with no tolerance whatsoever is like 2-4 mg. Methadone is a powerful drug, but it is really strong if you took that dose daily, then it builds up, where 1.35 mg of methadone chronically (after like 3-5 days) is equivalent to 10 mg of oral hydrocodone, but that's after days of taking it. For a single dosage I'd say that it is more like 3-4 mg = 10 mg oral hydrocodone.

Next time research your tolerance and the strength of what you have before you do it. Did you vomit at all? Methadone can be pretty dangerous due to the fact that it is probably well absorbed before you start to feel it's effects, meaning that, unlike oral hydrocodone, you are less likely to clear much of it when you vomit. It is always easier and WAY SAFER to add more after two hours, you can't un-kill yourself. You should have started with .25 ml (2.5 mg) and worked your way up from there.

Ok so here it goes, I've been takingsubsuboxone strips for the past 2 months about 8mg a day ssometimes 16mg a day when I feel really shitty. Its not prescribed and I've been taking it for pain. I recently went to my doc and was put on long term opiate therapy for pain. 5mg methadone 3x daily. Obviously I didn't tell my doc about the subs. My tolerance is so high I need to get it down before I switch so the methadone is effective. I'm trying to do this w/o going through wds. What's my best option here? Taper off the subs? How quickly can I make the switch?

You're like several orders of magnitude above 5 mg/3x a day. 16 mg of buprenorphine is A LOT, it's no where near 15 mg of methadone. I have no experience using buprenorphine for W/D, and only used it recreationally at like 200-500 ug (microgram) when I was opioid naive. Someone else here may be able to help you out, but you should prepare to not only not have your pain covered, but to be in withdrawal. This isn't good. You should probably be honest with your doctor. I don't understand what's going on, because most doctors won't start you on methadone for pain unless you've already tried other weaker stuff like hydrocodone. You might want to elaborate on the whole scenario.

 

[DETROIT*edm*JUNKIE]

so iv been using codeine and vikos and oxys a ton...


im ready to take the next step up..



I can cheap ass methadone but its good..

I can get heroin too.. but its gonna be way more expensive than the methadone..


which way should I go bros?

I kno im on the road to addiction..

but should I even bother with the heroin?

I feel like that'll send me too far down the rabbit hole..

idk.. on Xanax codeine and alcohol right now.. and I just want more. Lol.

 

[DETROIT*edm*JUNKIE]

going to bed.. update me tomorrow bros.. im not here for the fucking addiction lecture either. let me make my own mistakes in life and learn from them.

 

[BigG]

idk.. on Xanax codeine and alcohol right now.. and I just want more. Lol.

Grow up

 

[Ondine]

Hey, so I was diagnosed with Complex Regional Pain Syndrome about a month ago. It's been steadily getting worse.
I'm currently on 40mg of oxycodone IR a day, probably increasing it to 60-80mg soon. I live in Vermont which has become insanely draconian regarding opiate painkillers. I literally have to fight every day to keep myself on an inadequate amount of OC.

Anyway, we finally made the trip to a pain clinic out of state where they were much more helpful and willing to discuss. Just as a background about me, I've used heroin off and on (IV and nasally) for about 3 years. I've used a significant amount, but never long enough to experience a real physical withdrawal.

Back to the health issue, they're going to be conducting a ketamine infusion trial in a few months which both they and I have huge hope for. However, as I brought up, and they agree, I need to focus on my immediate pain issues.

I've noticed that many people with CRPS seem to be on combinations like duragesic patches or Opana ER with short acting opiates for break through pain. But these people all seem to be older. I'm barely in my 20s, and it seems like getting started on extended release medication might be a huge mistake.

The pain specialist instead recommended Methadone, because it acts on NMDA receptors in the brain and appears to be more effective at treating nerve pain. I've never used it before though. Can anyone speak to its efficacy as a pain reliever, and not a way to ween off of heroin? Should I try to fight for break through medication like dilaudid on top of it? Or is there too much contraindication there

 

[Ondine]

I should say also that the unfortunate situation with opiates for me is that they don't actually treat my pain. It's just that whatever sort of intoxication or euphoria I get from them helps to make the pain bearable. It sounds like the methadone might actually treat the pain.


But I also have really high hopes for the ketamine infusion, so I'm wondering if I shouldn't just try and fight for high doses of opiates until that trial begins, since there's also evidence of ketamine helping with opiate addiction.

 

[BigG]

I should say also that the unfortunate situation with opiates for me is that they don't actually treat my pain. It's just that whatever sort of intoxication or euphoria I get from them helps to make the pain bearable. It sounds like the methadone might actually treat the pain.


But I also have really high hopes for the ketamine infusion, so I'm wondering if I shouldn't just try and fight for high doses of opiates until that trial begins, since there's also evidence of ketamine helping with opiate addiction.

I'm scripted 180mg methadone (60mg x3/day) for chronic pain along with 600mg pregabalin. The combo is highly effective especially for painwith a neuropathic component due to the strong NMDA agonism. My pain problems are currently in remission however and I'm trying to get off which isn't that easy with methadone unfortunately. A friend of mine on BL (doomed2pain) suffers from CRPS and knows a lot about various treatment s as hers is quite advanced and has spread to most of her limbs. You may want to pm her as she will undoubtedly be able to answer some of your CRPS related questions. She is I believe on fentanyl patches with IR morphine for BT. She was unable to tolerate pregabalin though. I'll send her a text message today and ask her to drop you a pm.

On the subject of BT meds on top of methadone, its usually prescribed as a stand alone without any BT meds and as its analgesic duration of action is much shorter than its WD prevention duration, it is usually scripted TDS (x3 / day) for pain I.e. once every 8 hours as oppose to once a day when prescribed for WD prevention. Personally I find methadone the most effacious pain reliever I've ever been prescribed, more effective than fentanyl, oxycodone, morphine, hydromorphone or any other. I think it really depend on the nature of ones pain and as you mentioned, methadone is a NMDA agonist as well as a mu receptor opiate agonist and so will help more with pain that has a strong neuropathic component. Take care and I hope you get some relief as I know what a horrible condition CRPS is.

BTW.......I'm sure I remember doomed2pain saying something about the ketamine infusion trial only being available in Germany and something about risk of irreversable coma or even death but don't quote me on that as I could well be mistaken

 

[Ondine]

BTW.......I'm sure I remember doomed2pain saying something about the ketamine infusion trial only being available in Germany and something about risk of irreversable coma or even death but don't quote me on that as I could well be mistaken

Yeah to my knowledge there haven't been that many trials done in the USA and it takes a lot of work for a state run hospital to get them going. At best my doctor says I could hope to start a 2 week course by the end of summer. Apparently in the EU, when patients have any unexplained nerve pain after an injury or surgery, they tend to be given low doses of ketamine right away. From what I understand, it's a horrible condition that can be cured if it'ss noticed right away.

It's great to hear that the methadone helped your neuropathic pain. That's just what I was hoping to hear. I'm hedging my bets on the ketamine and some intensive PT giving me a complete cure (I'm in the early stages), so now that I've got a little more confidence with my doctor, I'm going to try and ask for methadone or another long acting opiate and something for break through pain to keep me functioning until I start seeing results from non-narcotic treatments.

Sorry for this being a little OT

 

[CasketLottery]

I have been on and off of methadone for the last 3 years. I currently go to a methadone clinic and I have a pretty good tolerance to methadone. I have tried many different potentiators to boost my dose and I filled a script of promethazine today. I have briefly read that promethazinepotentiates methadone. About how many milligrams would of phenergan would help me feel my 80 mg dose of methadone? Any other suggestions?

 

[CasketLottery]

Also -- There should be a thread for methadone potentiators that are accurate or is there?