Opioids Methadone potentiation

[negrogesic]

I've been on Methadone Maintenance for about 4 years now. I'm still on a rather high dose due to an abnormally high tolerance. A single dose is 185 mg, but I often double up for 370 mg at a time since a single dose doesn't really do much for me; in fact, I can even begin to experience mild withdrawal symptoms within 12-18 hours after taking a single dose. Taking two does NOT make me feel extra drowsy or any other negative symptoms that would alert me that I've taken too much. I pick up once per week and so I get six take-home doses. I often double up one, two or (rarely) three days of the week, take my regular single prescribed dose 1-3 days, and have nothing for 1-3 days. Needless to say, I only do this when I have absolutely nothing to do and no committments on my days without. Just the psychological factor of knowing I haven't had anything is enough to cause mild physical symptoms and moderate to extreme anxiety if I'm out of my apartment. Normally, withdrawal does not become severely uncomfortable in one or even two days, depending on other factors - which brings me to my question.

Naturally, I've experimented with potentiation many times - Cat's Claw which did nothing, and Grapefruit juice which seems to extend the effect of the methadone, but at the cost of making me feel like shit the next time I don't have any GFJ. It effectively increases my dose, but adds the burden of needing it every time. Anyway, one thing I haven't tried is Dextromethorphan (DXM). I remember a topic long ago where people were espousing the efficacy of taking this before dosing. Since I haven't read about this in a long time and that topic was so old and possibly outdated, I'd really like to ask you guys here.

Has anyone tried DXM and methadone together, and does it work? Does it make the feeling of the methadone better, or simply prolong it (more interested in the latter than the former actually, due to the sporadic way in which I usually dose)?

How much DXM should I take and how long before/after my dose?

Would taking it with a double-dose be too dangerous and risk overdose despite my tolerance (even to a double dose) and the length of time I've been on maintenance??

If anyone else has any thoughts, comments, opinions, etc. I would REALLY love to hear them! It's been a long time since I posted on this board. I've been totally clean of all illegal drugs since mid 2014 and have little to no desire to start again (just the thought of finding new connects, dealing with fraud and ripoffs, fake or shitty product, etc...ugh..is enough to keep me away). However, I still do enjoy the effect of the methadone which is quite nice if it's been a couple days since I've taken a dose. I will always love opiates, and this is the only way I can legally do them now, and without buying anything off the street.

Thanks a lot in advance!! I remember well how helpful this board is!!

EDIT: I'm fully aware that I should be taking a single dose every 24 hours and not messing with it. That leaves me feeling OK but low energy, and even very slightly sick later that night (withdrawal can come VERY quickly for me, especially with a lower dose). I will probably make another topic soon about quitting this varied dosing habit, but I currently find that EXTREMELY hard to do; I could never seem to keep opiates around my place without doing them compulsively, and it would appear that I still can't - even with methadone which lacks a clear euphoria. Nevertheless, I do get the opiate effects and often have much higher evergy and am in a great mood when I double.

I used to take 240mg of methadone in the morning and 140mg at night and still woke up in withdrawal.

No way to significantly potentiate methadone, and believe me, i tried (fluvoxamine even had little effect).

 

[JessFR]

Ok so I've been on methadone for a while now, I've never really messed around too much with ways to potentiate it. The one piece of advice I have is that taking it on an empty stomach appears to be noticeably better.

I used to take 240mg of methadone in the morning and 140mg at night and still woke up in withdrawal.

No way to significantly potentiate methadone, and believe me, i tried (fluvoxamine even had little effect).

Woaaaaah... Dude that's an insane amount.. I think that's possibly a new record for what I've heard people doing, it's almost 400mg a day!

 

[Chloralhydro]

I'm planning to take 10mg of methadone soon. I was going to take a little benadryl and cimetidine beforehand to potentiate. I don't really have very much of an opioid tolerance. When I binge on tianeptine sodium, I typically take a gram per day.
My question is this: Will 10mg methadone plus the potentiators be too strong or dangerous for me? I don't want to overdose, though nodding out is desirable to me.

 

[Señor Moreno]

With no tolerance 10 mgs methadone should be more than enough.
Actually it can be too much for certain people
Watch out if you are light in weight, advanced in age or you have respiratory conditions.
And check out whatever meds you may be taking for dangerous interactions with methadone, there are quite a few that could harm you big time

 

[chicken hoagie]

By this logic, what nobody ever stops to think about, is why wouldnt you take NMDA antagonists on those days off?

First benefit. Your tolerance may be slightly reduced more than usual when you go to get your takehomes again and dose.
2. From my understanding, NMDA antagonists help to mitigate withdrawal symptoms as well, so this would put you at a bit more ease on your days off when you need to get shit done.

DXM imo would be a good drug to take on days off, as would ketamine or MXE, or any other nmda antagonist i suppose. i would stay away from PCP due to risk of permanent brain damage or 'alteration.'

Also, another idea that crossed my mind, albeit not a fun thought. You could go get yourself free narcan nasal spray kits, and you could blast yourself with an opioid antagonist/reverse agonist in order to rapidly regain your tolerance. You can find naltrexone pills also, which would be a much softer antagonist that may not cause withdrawals (as badly). Downside to this idea is, you have no idea if once you spray that shit up your nose or take that pill, if you will get deathly sick. But hey, its just dope sickness. 3/4 of us addicts surely cant make it for very long without running into supply issues, whether its making it to the clinic on time or not having enough money for your shit.

 

[chicken hoagie]

With everything I said taken into context, i would be careful messing around with your methadone at such high doses. Our tolerance is always in orders of magnitudes, so the higher your tolerance is, the more room you might have to play with, but the more ballsy you will get without even consciously being aware of your dosage choices on all of these different mixed substances. Only way to play it safe, is to take it slow and steady. Dont get frustrated because you arent catching that buzz you're looking so desperately for. I know the feeling man. Most of us on here, we tend to spend more time than the average human focusing most of our hours of the day on our polydrug abuse.

 

[chicken hoagie]

Ok so I've been on methadone for a while now, I've never really messed around too much with ways to potentiate it. The one piece of advice I have is that taking it on an empty stomach appears to be noticeably better.



Woaaaaah... Dude that's an insane amount.. I think that's possibly a new record for what I've heard people doing, it's almost 400mg a day!

Oh man, if you think thats high, i have been told by a counselor of a guy that was on over a GRAM of methadone (for the folks who dont know metric well, that is 1000mg). After 500mg, you need to meet special requirements by the doctor to go higher. Most of the time it is for people with abnormal liver function or people that are VERY heavy. But after 500mg, QT prolongation becomes a problem in the heart. Not sure what the actual percentage of that risk is, but many times people dont realize that they are mixing methadone, a drug that is chemically similar to other, neurotoxic and cardiotoxic piperazines, with other drugs which also increase your risk of QT interval prolongation (torsades de pointes), which can lead to fatal heart arrhythmias. These drugs include seroquel, high doses of diphenhydramine and other antihistamine/anticholinergics, and im sure many other drugs. So keep in mind EVERYthing that you are taking throughout your days, as everything, including the food you eat, makes a big difference in how your day and your mood is.

 

[James Peach]

Oh man, if you think thats high, i have been told by a counselor of a guy that was on over a GRAM of methadone (for the folks who dont know metric well, that is 1000mg). After 500mg, you need to meet special requirements by the doctor to go higher. Most of the time it is for people with abnormal liver function or people that are VERY heavy. But after 500mg, QT prolongation becomes a problem in the heart. Not sure what the actual percentage of that risk is, but many times people dont realize that they are mixing methadone, a drug that is chemically similar to other, neurotoxic and cardiotoxic piperazines, with other drugs which also increase your risk of QT interval prolongation (torsades de pointes), which can lead to fatal heart arrhythmias. These drugs include seroquel, high doses of diphenhydramine and other antihistamine/anticholinergics, and im sure many other drugs. So keep in mind EVERYthing that you are taking throughout your days, as everything, including the food you eat, makes a big difference in how your day and your mood is.

My clinic doctor said 3 women at the clinic have QT prolongation at 80 mgs. He said some people especially females for some reason are more prone to it at lower doses even. Interesting

 

[Dopey1323]

Whatever you do, DO NOT listen to chicken hoagie when he said you could always just take narcan to rapidly reduce your symptoms because "its just withdrawl". No sir, that will put you into precipitated withdrawl. And it's NOTHING like normal withdrawl. If you've ever experienced bad withdraws from opiates, imagine on like day 3 or 4 when it's at its worst and you feel like dying. Well take that and multiply it by 10x and then imagine someone put a racoon with rabies inside your body and it's trying to claw its way out of your skin while your body proceeds to spray sweat off you like a water spicket and you throw up and shit all over yourself at the same time wanting to die just to make the pain stop.
so basically, NEVER do that lol. I've experienced precipitated withdrawl one time at the beach I was shooting about .3 grams of fent every hour and 3 days in to my week trip I blew thru my stash and I had suboxone with me and my dumbass decided to load up a 4mg shot of suboxone and Inject it 6 hours after my last dose and it immediately threw me into the worst precipitated withdrawal I have ever experienced in my life as I explained what it was like. I lasted a day and a half until I forced my wife to drive me 3.5 hours in the middle of the night back home to my plugs to get more fent to pull me out of withdrawl. But I've been on methadone for about 6 months now and am on 115mg a day. I went 2 days without it once due to not being able to make it one Saturday and the withdrawls from it alone were only supposedly mild withdrawls but it was so much worse than heroin or fent it was different in a way you can feel it in your bones and skin just feels cold and numb and painful all the time. Needless to say, please don't ever try to put yourself into precipitated withdrawl from naltraxone to lower your tolerance in order to poteniate ur dose or be able to get high or get a buzz off methadone again.
I've found that drinking a little baking soda with water (2 spoonfuls) 20 mins before taking my dose, makes it last longer and for about 3 hours I get a decent buzz. Also you can always just take a day or 2 off and save up your doses if you get takehomes and let your tolerance naturally go down a bit then take your normal dose plus a little extra with the baking soda and youl get a decent high. I do it once a while whenever I get a craving or something to prevent myself from trying to go back to dope. And trust me I myself consider myself a pretty bad addict when it comes to finding ways to get that opiate high again when it feels impossible and it sucks because I had a 12 year battle with heroin and fent which I finally switched to methadone this last year to hope I can stay off the hard shit because i kept overdosing and I came so close to death numerous times and I can't leave my wife like that. Also I want to change for the better. So even though I shouldn't be trying to find ways to get high off my methadone, It's atleast better than where I was at and atleast I'm not injecting fentanyl not knowing if it's gonna kill me today or tomorrow. Il eventually get thru this but I want to help share my experiences with anyone that I can if they are willing to read and listen. But when I saw someone mention to put yourself into precipitated withdrawal to be able to lower your tolerance to get high again I had to comment on here incase anyone was even considering it so that they would know definitely not to do that lol. That's the worst idea ever ! And idc how desperate I ever have been I would never want to experience that again. You couldn't pay me 10000$ to do it again lol. But sorry for the long rambling, I'm new to this bluelight stuff. I've always researched on here for experiences and answers but never posted nor commented on here before. Anyways, stay safe out there.

 

[Synergist1]

ive heard that IVing 100mg methadone can be really amazing, some say better than heroin. I don’t think you can extract the methadone from the syrupy methadose they currently use at most clinics nowadays without some chemistry knowledg, and it’s definitely not something that you want to half ass. You’re likely to lose an arm if you inject even a little of that syrup. The only ppl I’ve heard say how euphoric IVing can be are the ones who are lucky enough to get their dose mixed with water and nothing else, and they gently evaporate the water to a concentration of 100mg/ml, or maybe 150mg/3ml if they have appropriate syringes. I’m Not saying this is safe at all, but if you can find a tek for extraction, it supposedly is enjoyable.
The other way I’ve found to potentiate my dose is to take cymbalta ( duloxetine) with your dose. It’s an SNRI but it also has some crazy interaction with methadone. I have 60mg dr- delayEd release…. I think I used to have 30 mg IR, but I’d still take two. There is some actual studies proving how efficient this can be to potentiate mdone. I’m too tired to find any but just google it and you’ll find some proof. Check it out!! I’m surprised nobody has menttioned this yet.

 

[gonzogal33]

Whatever you do, DO NOT listen to chicken hoagie when he said you could always just take narcan to rapidly reduce your symptoms because "its just withdrawl". No sir, that will put you into precipitated withdrawl. And it's NOTHING like normal withdrawl. If you've ever experienced bad withdraws from opiates, imagine on like day 3 or 4 when it's at its worst and you feel like dying. Well take that and multiply it by 10x and then imagine someone put a racoon with rabies inside your body and it's trying to claw its way out of your skin while your body proceeds to spray sweat off you like a water spicket and you throw up and shit all over yourself at the same time wanting to die just to make the pain stop.
so basically, NEVER do that lol. I've experienced precipitated withdrawl one time at the beach I was shooting about .3 grams of fent every hour and 3 days in to my week trip I blew thru my stash and I had suboxone with me and my dumbass decided to load up a 4mg shot of suboxone and Inject it 6 hours after my last dose and it immediately threw me into the worst precipitated withdrawal I have ever experienced in my life as I explained what it was like. I lasted a day and a half until I forced my wife to drive me 3.5 hours in the middle of the night back home to my plugs to get more fent to pull me out of withdrawl. But I've been on methadone for about 6 months now and am on 115mg a day. I went 2 days without it once due to not being able to make it one Saturday and the withdrawls from it alone were only supposedly mild withdrawls but it was so much worse than heroin or fent it was different in a way you can feel it in your bones and skin just feels cold and numb and painful all the time. Needless to say, please don't ever try to put yourself into precipitated withdrawl from naltraxone to lower your tolerance in order to poteniate ur dose or be able to get high or get a buzz off methadone again.
I've found that drinking a little baking soda with water (2 spoonfuls) 20 mins before taking my dose, makes it last longer and for about 3 hours I get a decent buzz. Also you can always just take a day or 2 off and save up your doses if you get takehomes and let your tolerance naturally go down a bit then take your normal dose plus a little extra with the baking soda and youl get a decent high. I do it once a while whenever I get a craving or something to prevent myself from trying to go back to dope. And trust me I myself consider myself a pretty bad addict when it comes to finding ways to get that opiate high again when it feels impossible and it sucks because I had a 12 year battle with heroin and fent which I finally switched to methadone this last year to hope I can stay off the hard shit because i kept overdosing and I came so close to death numerous times and I can't leave my wife like that. Also I want to change for the better. So even though I shouldn't be trying to find ways to get high off my methadone, It's atleast better than where I was at and atleast I'm not injecting fentanyl not knowing if it's gonna kill me today or tomorrow. Il eventually get thru this but I want to help share my experiences with anyone that I can if they are willing to read and listen. But when I saw someone mention to put yourself into precipitated withdrawal to be able to lower your tolerance to get high again I had to comment on here incase anyone was even considering it so that they would know definitely not to do that lol. That's the worst idea ever ! And idc how desperate I ever have been I would never want to experience that again. You couldn't pay me 10000$ to do it again lol. But sorry for the long rambling, I'm new to this bluelight stuff. I've always researched on here for experiences and answers but never posted nor commented on here before. Anyways, stay safe out there.

Hey man, you seem a lot like me & im watching me fiancé go through p.w. right now. I have a little h (fent) but we don’t know if we should have him do a line of that or take more (1.5mg) of sublingual Suboxone. Please help if you know anything. He’s scaring me & we are long term dope addicts. I’ve been in methadone for 21 years & after “graduation” from it properly/ it wasn’t long I was out in the world & did a line of “dope”. Damn. I’m going back on methadone but my hard headed fiancé hates our clinic & wont do it. Suboxone is terrifying.

 

[Jen X]

The only thing I found that worked was more methadone or adding another opioid.

 

[Jen X]

Hey man, you seem a lot like me & im watching me fiancé go through p.w. right now. I have a little h (fent) but we don’t know if we should have him do a line of that or take more (1.5mg) of sublingual Suboxone. Please help if you know anything. He’s scaring me & we are long term dope addicts. I’ve been in methadone for 21 years & after “graduation” from it properly/ it wasn’t long I was out in the world & did a line of “dope”. Damn. I’m going back on methadone but my hard headed fiancé hates our clinic & wont do it. Suboxone is terrifying.

I would take the smallest amount possible of fentanyl. If they're in pwd adding more suboxone could make him more sick
But I would advise only a tiny amount, not enough for a high just enough to get through pwd. By tomorrow they should be out of it.
Only today though and only enough to feel a little better.
I put myself into I before so I understand and the only time I would say take fentanyl

 

[Keif' Richards]

@gonzogal33 generally, it's best to stick to Buprenorphine (Suboxone; Subutex) once you've started that process. Going back and forth between full agonists like Fentanyl and agonist/antagonist drugs like Buprenorphine does not provide any benefit and in my opinion, negates getting any kind of benefit from either drug in the end.

Tell you fiancee that "hating the clinic" is a petty reason for someone to forego the treatment they need to live a happy life. I'm always blown away by how people are so harsh toward the clinic when they're last "clinic" was a drug dealer who didn't care if they lived or died, did not keep regular hours, made no promises of any kind and likewise was not bound by any sort of agreement and sold drugs of constantly-changing quality, composition and purity. Even in the worst of situations, the Methadone clinic is a better dealer than a dope dealer.

You mentioned a long history of Methadone maintenance in your past. One thing I would definitely stress to your SO is that the entire system has changed drastically since COVID in a way that is beneficial for us users. It is now easier than ever before to get take-home medication. At the clinic here in Burlington, you start coming every other day as soon as you're at a maintenance dose, which usually takes 2-3 weeks. People are generally eligible for a week's worth after getting through 2 months (this includes people still using Cannabis and even Fentanyl in some cases, though this does not apply to Benzodiazepines, which are still a big deal).

It is completely different than how it used to be. It's still going to vary from state to state of course, but in general, the clinic system in America has become significnatly more liberal in its approach. You can tell your fiancee to just put in his time, do the two months, be a good boy and then he only has to show up once a week. It's really not that big of a deal. Believe me, I was on Methadone in Boston over 10 years ago. The clinic was a for-profit enterprise. If you didn't pay them, they could reduce you from Xmg to 0mg in 3 days. If someone at the clinic fucked up somehow, the patient paid the price. If the patient had an issue, there was nobody forcing them to go to the clinic for Methadone.

Try to broach the conversation using this information. It's helped me talk a lot of people in my line of work into going back to the clinic and I'm very happy to say that some of those people are still doing well today.

Now, as far as Methadone Potentiation is concerned, the strongest OTC drug is going to be something like Cimetidine (Tagamet) which inhibits CYP3A4. You might feel a mild increase in potency, but it would be different to differentiate from placebo.

Fluvoxamine (Luvox) is an SSRI antidepressant and an inhibitor of CYP2D6 among others. Fluvoxamine is in a different league though. There are multiple case reports of Methadone-prescribed patients being initiated on Fluvoxamine only to end up with symptoms of Opioid overdose like shortness of breath 5-7 days after starting the antidepressant. There are reports that the potency can be increased by as much as 50% in certain individuals, though a %30 increase seems to be more common.

I can absolutely testify that this is accurate. I tried taking Fluvoxamine while on Methadone maintenance in the past. It led to me nodding out after several days and after taking the Fluvoxamne for an extended period of time, withdrawing the medication caused me to go into relatively severe withdrawal, which ceased after restarting the SSRI.

 

[ChemicallyEnhanced]

I've been on Methadone Maintenance for about 4 years now. I'm still on a rather high dose due to an abnormally high tolerance. A single dose is 185 mg, but I often double up for 370 mg at a time since a single dose doesn't really do much for me; in fact, I can even begin to experience mild withdrawal symptoms within 12-18 hours after taking a single dose. Taking two does NOT make me feel extra drowsy or any other negative symptoms that would alert me that I've taken too much. I pick up once per week and so I get six take-home doses. I often double up one, two or (rarely) three days of the week, take my regular single prescribed dose 1-3 days, and have nothing for 1-3 days. Needless to say, I only do this when I have absolutely nothing to do and no committments on my days without. Just the psychological factor of knowing I haven't had anything is enough to cause mild physical symptoms and moderate to extreme anxiety if I'm out of my apartment. Normally, withdrawal does not become severely uncomfortable in one or even two days, depending on other factors - which brings me to my question.

Naturally, I've experimented with potentiation many times - Cat's Claw which did nothing, and Grapefruit juice which seems to extend the effect of the methadone, but at the cost of making me feel like shit the next time I don't have any GFJ. It effectively increases my dose, but adds the burden of needing it every time. Anyway, one thing I haven't tried is Dextromethorphan (DXM). I remember a topic long ago where people were espousing the efficacy of taking this before dosing. Since I haven't read about this in a long time and that topic was so old and possibly outdated, I'd really like to ask you guys here.

Has anyone tried DXM and methadone together, and does it work? Does it make the feeling of the methadone better, or simply prolong it (more interested in the latter than the former actually, due to the sporadic way in which I usually dose)?

How much DXM should I take and how long before/after my dose?

Would taking it with a double-dose be too dangerous and risk overdose despite my tolerance (even to a double dose) and the length of time I've been on maintenance??

If anyone else has any thoughts, comments, opinions, etc. I would REALLY love to hear them! It's been a long time since I posted on this board. I've been totally clean of all illegal drugs since mid 2014 and have little to no desire to start again (just the thought of finding new connects, dealing with fraud and ripoffs, fake or shitty product, etc...ugh..is enough to keep me away). However, I still do enjoy the effect of the methadone which is quite nice if it's been a couple days since I've taken a dose. I will always love opiates, and this is the only way I can legally do them now, and without buying anything off the street.

Thanks a lot in advance!! I remember well how helpful this board is!!

EDIT: I'm fully aware that I should be taking a single dose every 24 hours and not messing with it. That leaves me feeling OK but low energy, and even very slightly sick later that night (withdrawal can come VERY quickly for me, especially with a lower dose). I will probably make another topic soon about quitting this varied dosing habit, but I currently find that EXTREMELY hard to do; I could never seem to keep opiates around my place without doing them compulsively, and it would appear that I still can't - even with methadone which lacks a clear euphoria. Nevertheless, I do get the opiate effects and often have much higher evergy and am in a great mood when I double.

Cyclizine. Cyclizine. Cyclizine. It bears repeating: CYCLIZINE!
I cannot stress this strongly enough.
100mg + your normal dose. On average I'd say it boosts methadone's effects by 50%, so 185mg [how they fuckedyfuck did you manage to get THAT high a dose??) plus Cyclizine would feel more like 270-280ish. But I have a friend who felt it more like doubled the effects for him, so I'd ASSUME it's gonna double it just in case so you don't OD and then once you know how it affects you, you'll know how much to take.

EDIT: If you're in the U.S., I believe it goes by the name Marezine? Someone from America may be able confirm that?

 

[paranoid android]

Ive heard cyclizine mentioned here and that combo is also mentioned in trainspotting. The book not the movie. Supposedly it replicates the diconal high somewhat

Ie never had methadone but ive had most other opiates on the canadian market here and i found promethazine to be good at potentiating them.

 

[cdin]

the problem here is not a need for potentiation, it's that you're already at the outer limits of tolerance.