methadone reduction?? I DON'T KNOW ANYMORE

[5 meo dmTed]

Hey guys, I know I've kinda been on and off lately, I know I posted my story here and I got a lot of support some time back. Well, here I am again. I started on methadone to treat my addiction to oxycodone and eventually hydromorphone/heroin, and I've abstained for almost two years now. I use methamphetamine now and then (still IV), and sometimes cocaine, but I still can't get over the "benzo" hump. I started off taking my script of clonazepam to counteract the jitters of being an 8 year old coming off of amphetamine (dexedrine), and this cycle continued well into high school, where there was no shortage of dope and people to show me better, more efficient ways of using... Anyway ffwd to now, why I'm posting. I'm now at 160mg methadone, and have been at this dose since September. I'm noticing withdrawals early, all the signs of a dose wearing off early (I know I don't have to explain that much further here). However, this is the maximum dose I can have, plus the 10mg valium and .01mg clonidine 3x a day, I wake up in despair, literally as I type this I'm sweating, I'm shaking and I've no idea what to do. I want to start going DOWN on my dose, it's been two years of this already. People are looking at me like I haven't tried to kick, but really, it's the methadone.. Anyone have any ideas? I'm open to trying anything at this point.. My doctor won't help me, my family won't help me, and of course my friends will "help" me, but we all know that won't actually help. This week I wandered a little outside of my script and got some clonazepam to help soothe this hopefully brief period of what feels like full blown withdrawals. But to no avail. To sum it up; I've been switched to a 160mg methadone, 30mg diazepam and .03mg clonidine habit from the junk/clonazepam habit..
I don't even know what I'm doing anymore.
If anyone has any suggestions, I highly appreciate it.. I would do anything to soothe this.

 

[T. Calderone]

This sounds rough and you could be one of those people who metabolize methadone quickly. Do you take your dose all at once? It might help to break it up to 80 mg twice a day which may give you better relief.

 

[neversickanymore]

^ sound advice.

The half life for methadone is often dramatically different between people.. with the shortest seen being 4 hours and the longest being a whopping 150 hours.

Methadone's elimination half-life (8-59 hours) is longer than its duration of analgesic action (4-8 hours)

>source<

however the terminal half-life is extremely wide ranging (10–150 hours)

>source<

Methadone usually has a strong synergism with benzos especially xanax. What is the schedule you are taking the diazepam and clonidine if you want to share. Is the shaking a normal withdrawal symptom you have had from opiates. Also the clonodine is often used to suppress adrenal levels and response so if you are on the wrong schedule for taking this you may be getting some rebound adrenal spikes and this may be the cause of your symptoms as well.

I would add a daily dose of vitamin D into your regiment and consider having a blood test for vitamin D levels. Also if you are a male I would absolutely get a testosterone level done as the dose of methadone that you are on is likely greatly repeating your testosterone level. This can have a HUGE impact on how you feal, I dont think it has anything to do with the sweats and shaking.

I would also seriously consider going back to your doctor and requesting a basic metabolic blood panel and other relevant tests as the symptoms you are having may not have anything to do with the medication and may indicate an underlying condition that needs to be addressed.

I hope this helps and please keep us informed if you choose to pursue any of these avenues.

 

[5 meo dmTed]

^ sound advice.

The half life for methadone is often dramatically different between people.. with the shortest seen being 4 hours and the longest being a whopping 150 hours.

>source<
>source<

Methadone usually has a strong synergism with benzos especially xanax. What is the schedule you are taking the diazepam and clonidine if you want to share. Is the shaking a normal withdrawal symptom you have had from opiates. Also the clonodine is often used to suppress adrenal levels and response so if you are on the wrong schedule for taking this you may be getting some rebound adrenal spikes and this may be the cause of your symptoms as well.

I would add a daily dose of vitamin D into your regiment and consider having a blood test for vitamin D levels. Also if you are a male I would absolutely get a testosterone level done as the dose of methadone that you are on is likely greatly repeating your testosterone level. This can have a HUGE impact on how you feal, I dont think it has anything to do with the sweats and shaking.

I would also seriously consider going back to your doctor and requesting a basic metabolic blood panel and other relevant tests as the symptoms you are having may not have anything to do with the medication and may indicate an underlying condition that needs to be addressed.

I hope this helps and please keep us informed if you choose to pursue any of these avenues.

Thank you guys so much for your responses, I've been in to see the doctor and I have asked about split dosing, and that ended with an abrupt "no. our urine tests would tell us if you need that". They refuse to move the dose any higher as well.
I'm glad you asked about the clonidine. Not a single person has brought this up. Since day one I've been taking them regularly, one at the time of my dose (9-10am), two at bedtime (it's the only way I can get any sleep). They're 0.1mg. And the diazepam, I try to stick on schedule with it, ie 10mg with the morning dose, 10 mg at lunch 10mg at night, but a lot of the time I end up not needing the morning 10 until the afternoon (by then I'm usually real glad I saved it). My prescribing doctor also told me I could stop taking clonidine as if it were Tylenol with no rebound effects, but I'm starting to wonder if it may be the soul cause of these problems..
Also this week I started taking l-theanine for memory and anxiety during the day and melatonin before I hit the pillow, only difference I've noticed is dreams. Also, on the topic of benzos having synergistic effects with methadone, I actually find the opposite, though I was on benzos long before opiates my tolerance is probably ridiculous, I eat 8mg clonazepam and 40mg diazepam if I want a buzz (which I would also like to point out that I don't do, I don't mess with my benzos either in dose or schedule unless necessary..too many problems I've found out the hard way. >.<; I'm so agitated. I go in again tomorrow.. I'm gonna try the vitamin D supplements as we just so happen to have some laying around the house, and I think I'm going to pursue your idea and check for underlying causes outside of medication side effects, as well as test for the deficiency and demand metabolic test? I know a few people on split dosing, if it's necessary or at least plausible as a theory in the issue, I think it should be ruled out. Is there anything else I should ask about?
Again, thank you guys for even giving this a look.

 

[5 meo dmTed]

I feel like I'm dying.. God, do I ever hate this.. I'm praying the clonidine and diphenhydramine will take effect soon. I'm gonna smoke a joint and hope I can fall asleep. Goodnight, bluelight!

 

[neversickanymore]

Hey.. 5.. not to question your doctors but I doubt that the greedy bastards would spend the money to get a test that showed levels. im sorry to hear that your struggling. what have you done to address your addiction.. I only ask because no matter what nonsense they tell you.. and I say this without a sliver of judgment. but methadone causes tolerance.. tolerance tries to return a brain to homeostasis.. homeostasis will return the the things you have tried to avoid forever.. what are you doing to begin to address and heal from what makes you miserable

 

[lolwhatzdrugs]

Hey.. 5.. not to question your doctors but I doubt that the greedy bastards would spend the money to get a test that showed levels.

All doctors should be questioned!

Especially at methadone clinics where many are contemptful of their clients, and yet at some, there are truly caring people.

 

[sinclair1984]

If it's not enough to stop withdraw it's not maintenance treatment. your doctor should be fired. I'm sorry your going through that, it sucks we all know. Hope you feel better soon and if at all possible I'd try to find another clinic or doctor. I quit once before with methadone and my starting dose was much much higher though I did'nt go through a clinic. [some magical ghetto elves dropped it off at my door in large bottles in the liquid form] I did succeed in quitting though unfortunately I relapsed recently. feel better. love,light and chemistry

 

[THECATINTHEHAT]

Jesus, I'm sure glad our health system doesn't push drugs on people from a young age the way you've had them pushed on you. I would be even more fucked than I am now if they were.

Methadone is a filthy substance that should be taken off the prescribed medicines list. I've never heard of anyone who has been prescribed it for any reason and been through the process of detoxing that has a good word to say about it. My dosage had to be pushed up a bit when I was put on a script but 80mg did it for me after about a fortnight of settling in.

If you are unlucky enough to be one of those who metabolise it incredibly quickly I would suggest your only option is to start going through the pain of reduction now. You're going to have a lot of pain coming up in the future but realistically it's the only option. If you find someone who is going to bump up your dosage you will probably just end up in the same situation you are now a few months down the line but at an even higher dosage.

The silver lining in this cloud is that if you have such a high metabolism it suggests that your body will adjust to the process of detoxing quicker than others and the withdrawal period after jumping off at the end will be shorter than for others.

Don't underestimate the power of your mind either. When you wake up feeling shitty jump in a warm shower get yourself clean and wrapped up in some nice warm clothes, this process always makes me feel better when I'm starting to feel like wd is in the post.

 

[5 meo dmTed]

Jesus, I'm sure glad our health system doesn't push drugs on people from a young age the way you've had them pushed on you. I would be even more fucked than I am now if they were.

Methadone is a filthy substance that should be taken off the prescribed medicines list. I've never heard of anyone who has been prescribed it for any reason and been through the process of detoxing that has a good word to say about it. My dosage had to be pushed up a bit when I was put on a script but 80mg did it for me after about a fortnight of settling in.

If you are unlucky enough to be one of those who metabolise it incredibly quickly I would suggest your only option is to start going through the pain of reduction now. You're going to have a lot of pain coming up in the future but realistically it's the only option. If you find someone who is going to bump up your dosage you will probably just end up in the same situation you are now a few months down the line but at an even dosage.

The silver lining in this cloud is that if you have such a high metabolism it suggests that your body will adjust to the process of detoxing quicker than others and the withdrawal period after jumping off at the end will be shorter than for others.

Don't underestimate the power of your mind either. When you wake up feeling shitty jump in a warm shower get yourself clean and wrapped up in some nice warm clothes, this process always makes me feel better when I'm starting to feel like wd is in the post.

I think that's what I'm going to do. I don't want to shock my system too badly though, I'm having some issues with chest pain and tachycardia (hopefully panic attacks/low serum levels of diazepam, I do smoke, though I also try hard to use snus <oral tobacco> instead, so I'm not interfering with the liver enzyme that processes diazepam. I'm not sure how true smoking diminishing the effects of benzos is, but in my case it seems to, though this may be subconsciously because I've read/heard that it does), so I'm already having some pile of trouble getting through day to day. Sometimes I can't even leave my house >.<". I'm gonna get my doctor to start the taper schedule at 3mg/time...I have a good friend at this clinic that suffers with similar issues, and he recommended I try going down by 3mg's instead of 5's and 10's, he told me the pain of wd is still there, but it's quite manageable. I trust his judgement on the issue considering he's gone from 145 to 30mg already and he looks great. Shit, am I ever afraid, though.. I'm scared that if I do get stuck in desperation from wd that I will order up some junk or hydromorph.. If only I still had my clonazepam. Back when I was prescribed clonazepam, a friend would also sell me his diazepam script monthly, and so I'd take the diazepam to keep in my system so I wasn't constantly in and out of benzo flu on top of the dopesickness, and then for breakthrough panic attacks, clonazepam to stop the bastard in it's tracks. But alas; apparently no doctor in their right mind would prescribe both a short and long acting benzo for maintenance and emergency, especially someone in my position; having "medicine" given to me since I was a kid I had, and still have, a tolerance that would've competed with that of old Hunter S.
Well, I will be talking to my doc tomorrow when I go in, about both split dosing and reduction. Thank you guys so much,
One more thing; the clonidine. Is this an issue I should bring up with him? I take 0.1mg with my dose at between 9-10AM, and then I take 0.2 mg + 100mg diphenhydramine at 9PM for sleep, because it's the only way I can sleep at all anymore.. And if it helps, I also smoke/consume medical marijuana on a frequent and daily basis. Again, thank you..your answers are much appreciated and helpful. Thank you especially to take the time out to actually give a shit, and I'm not being sarcastic. I really do appreciate the support..I don't get much around here.

 

[5 meo dmTed]

Also, once I jump off the methadone..well, I do actually have chronic pain issues in the base of my spine, on the left side where there's supposed to be a single nerve root exiting, I have 6 there. The right side, however, is normal. just one. So it's likely I'll need a painkiller for the rest of my life in order to function properly... I've heard wonderful things about subutex, what do you guys think of that? After the methadone detox, of course..I'll never use bupe with any sorta dope in my system again..ever...

 

[THECATINTHEHAT]

Fuck man, all I can really do is wish you luck.

The process of reducing on methadone is pretty nasty unless you go mega slow, but I would suggest that's not a good idea if you can't even stay on a stable dosage as it will just prolong the pain. I think it took me about 3-4 months to reduce from 80mg down to 20mg which is pretty fast from what I understand and by the end I was so sick of the process I just jumped off. I had a handfull of subbies, df's and valium but not much and it was pretty horrific.

 

[5 meo dmTed]

There are more clinics in my area, I'm going to look into switching to the care of another doctor. But I'm really wondering; I felt fine for almost two months before this started happening again..if I go up another 5-10mg I'll probably be in the same state in a couple months, just a higher dose..but I'm worried as well because this weekend I got desperate enough to dump approx 20mg from today's bottle into yesterday's, and it was more than sufficient but now I'm suffering for it bad today. I feel so stupid for allowing it to get this bad; I honestly felt this would help me, not fuck me up even worse than before >.<

 

[Fatjosh]

ok i have never been to a clinic but i have done short 6 day methadone detoxes both times i have kicked oxy, have you thought of maybe switching to one of the shorter acting opiates for a few months so that your body could become dependent on that opiate instead of methadon and then do a quick methadone detox before jumping off? i have heard of people going back to dope because it is easier to get off then methadone. if your could find a decent supply of ms contin i would think it would probly be easier to come off than methadone. it would make your withdrawl more like a short sprint than a marathon like methadone detox. i could be completely wrong but it was just a thought. and i used ms contin as an example because it is pretty good at fighting withdrawls but not for getting high unless u use a needle then you r just heading back down the path to what brought u to the methadone clinic in the first place. either way i wish you luck, you can do it!

 

[5 meo dmTed]

ok i have never been to a clinic but i have done short 6 day methadone detoxes both times i have kicked oxy, have you thought of maybe switching to one of the shorter acting opiates for a few months so that your body could become dependent on that opiate instead of methadon and then do a quick methadone detox before jumping off? i have heard of people going back to dope because it is easier to get off then methadone. if your could find a decent supply of ms contin i would think it would probly be easier to come off than methadone. it would make your withdrawl more like a short sprint than a marathon like methadone detox. i could be completely wrong but it was just a thought. and i used ms contin as an example because it is pretty good at fighting withdrawls but not for getting high unless u use a needle then you r just heading back down the path to what brought u to the methadone clinic in the first place. either way i wish you luck, you can do it!

Thanks mate, but yeah, sadly I'm a needle junkie, and at 160mg methadone I'm actually a little afraid to blast morphine/hydromorph, though yes, I have thought about just switching back to either dope, hydromorphone, oxycodone or morphine, but I'm afraid I'd just end up not only shooting superhuman doses of whatever I decided on, but I'd be on the same track as I was before the program..
This is getting to be a weighing topic, but I'm completely at a loss. Not to mention even upon my consideration of using gear or hydro I've absolutely NO idea where to even START with a dose now, with 160mg methadone hogging my opiate receptors. &#55357;&#56860;
<snip>

 

[Avalzaunt]

Methadone takes the longest to kick than any other opiate.....weeks instead of days if you have to go cold turkey. Don't try to substitute something else for it, just taper down as much as you can until you can reach the point you can try it one day at a time. At 160mg, if you suddenly stop, you may end up in a hospital labelled as a drug seeker then everything will be worse. Once you get that tag, you will never be able to find pain relief even though it may be legit because those who write the scripts will be afraid to help you out. So, just try a slow tapering off until you can go for a day without. Then, try for two. If you have to go back, do just enough to keep the physical effects down, not to get high. Then keep trying. It will take awhile with methadone but you can do it. Don't give in to peer pressure because they aren't in your skin suffering. Try to find something else to focus on instead of the demons clawing at your back. If you fall back into old habits, just keep trying. With your will, you can find the way out of the hole you're in. It's just gonna take some time and willpower. Good luck to you.