Methadone Question. (Dosing and withdrawl)

[Dan1035999]

So I'm on the methadone program and I'm currently on 47 mgs.
I started on 20mg and then I had an appointment a week later to let them know what withdrawls I was having so they could determine how much to increase my dose to get me on a stable dose.After I got to 30 mgs I had another appointment a week later and then another a week after that to put me up to 40 mgs and then another a week after that one and I was put to 47 mgs.
Between 20mgs and 30mgs I was having bad withdrawls and then between 30mgs and 40mgs they were a little better(Mostly restless legs,body aches,cravings,anxiety).Once I got to 47mg they seemed to go away.That is until yesterday and today when my restless legs came back pretty bad.I have another appointment which will be my last one to get me on a stabilized dose.my question is even though if been on methadone for about a month now can these symptoms i have been having the last few days be withdrawls again?any way it's post acute withdrawl?
Should I tell my doctor tommoro?reason I'm wondering if I should tell him is because I don't want him to give me another dose increase if it's not necessary.
Thank you for reading any answers and opinions would be much appreciated.

 

[Lorne???]

They are only increasing you once a week? And next time is the "last time"-harsh

Only you know how you feel, however most people take a lot more than 49mg, so if you are experiencing mild wd, or cravings, a dose increase will likely help, assuming so far the methadone has helped and doesn't have side effects.

Normally people end up on a very high and often unnecessary dose. However in this case, well don't know the history, however would probably recommend the dose increase, especially if this is the last chance to get stable

Is this an outpatient program?

 

[Dan1035999]

Well I'll get a dose,increase eventually no matter what but tomorrow will be my last appointment for a while to get me on a stable dose.
I'm just wondering if it's normal or even possible for withdrawls to pop back up even though i have been on methadone or if the symptoms I'm having are from something else.
And it's kinda outpatient, I just go every morning to get my dose and have to go to a class at the clinic once a month.

 

[Lorne???]

It?s complicated. I mean wd may not necessarily just stop one day, symptoms wax and wane, and there can be an intermediate of functionality, either at a sub-acute level, or with mild symptoms that can be dealt with (as opposed to writhing in the floor)

Point is, idk how the process was for you; you said at 47mg you felt fine. Methadone typically becomes more effective after it builds up in your system, making it 1.5-2x as potent, and a bit longer lasting

So were you almost immediately fine on that dose, or did it take a day or two? As said don?t know what you went through, how you felt or how you feel now

To make it simple, no, once established on an adequate dose of methadone, assuming you do not skip a dose, wd should not reverse itself back into intensity or magically pop-up; there are complicating factors, certain drugs or medications induce methadone metabolism, and reduce plasma levels and can cause it to be metabolized faster; this would result in mild-moderate symptoms as you describe

Your appointment is Tommorow? Well, guess gauge how you feel tonight and when you go, and if you think it feels like opioid wd, a slight dose increase to ?stabilize? you probably couodn?t Hurt, and could eliminate the symptoms(takes a couple of days to feel the full effects of a dose increase, like stated above

Although more details would be necessary to say either way, just think you should go w/ your instinct and how you feel, and not on what is and isn?t possible or likely; a lot of people take double that, and they?re habits varied widely

 

[pRoDeJaVu]

That's crazy they should be letting you go up 5mg a day until you find your sweet spot, and I've never heard of a clinic not letting the patient determine how much they need. Where I'm from (Tulsa, Oklahoma) its always up to the patient until they reach 120mg. After that you can go up more you just have to see the Dr. first. Can't believe that the way you say they are doing you is even a thing. I just got off 100mg a day, I was up to 140mg daily. Just quit Monday. Not really cold turkey tho I went to pain management and got on opana.