Opioids Methadone--wake up every day in wd?

[crzydiamond]

I'm wondering if anyone else has this issue:
I'm on methadone maintenance. Currently at 95 mgs. I normally dosed in the morning, around 8 am. Because I have an outstanding balance I have to go for afternoon dosing (3:30-6pm). When dosing at 8 am I always woke up feeling slight withdrawal. But I would go straight to dose and be fine. Now that I have to go later in day I find that I still wake up the same way--in slight wd that gets more n more uncomfortable until I can go get dosed.

Is it possible that sleep somehow affects the methadone? I have had a plasma test to see if I require split dosing and am waiting on that result. I have had this issue since being on the clinic--I was at 50 mg n felt fine all day but it would wear off so they kept giving me increases. Now I feel overly sleepy within 3-4 hours after dosing (and did when I dosed in morning too--I would have a hard time not nodding in the afternoon when I dosed at 8 am).

But no matter what I wake up feeling hot/cold, sweating, stomach issues n I am like that til I get my dose. Sometime I feel slightly better once I get up n get my blood flowing but not " normal"

I'm just wondering if anyone else has had this issue and what you have done to help? I think I'm going to need to split dose but until I can do all the tests I need to in order to get that, I'd appreciate any help!!

 

[Mr.Scagnattie]

Yeah sounds like you just metabolize methadone fast, as some people do, so split dosing seems like it would be a good option for you. I wake up in very slight withdrawal sometimes too, right around the time I'm heading back to the clinic. But, it's not bad enough where I would want to split my dose. Some people I know though really do need it. Your clinic will probably see that when the test results get back.

 

[The Doc.]

I always just kinda expected that with matinence drug use your not gonna feel good before you dose. I've always had sickness before bed with those long acting drugs every time I've used them. I split my dose now to 3 times a day and I don't hardly feel any w/D's mabye just cold sensitivity in the mornings before dosing and I definitely tell when 6 hours has passed without a dose. I just have a fast metabolism even heroin I had to dose every hour or 2 to keep well it always wore off after an hour then it was just how long can I stand to be in withdrawal and how bad can i get before giving in and dosing again. Usually 3 hours was the Max before I start getting too sick to function. I used to wake up after doing dope at 10oclock before bed every night at 1am sick as hell drenched in sweat and legs flailing until I did some more dope and got well enough to sleep again then it was 5am I wake up sick again then I do some dope and watch TV till I go to work at 7. Then its a hit of dope to get working And every 2 hours from then on

 

[blackjesus]

wow i wish my clinic offered split dosing. i would even prefer a single dose at the 3:30-6 range come in after work and get dosed and be exactly how i want to be drug resistant during the night.

what area are you or your clinic located in? just general country/state would be fine

 

[The Doc.]

Canada BC

 

[crzydiamond]

USA --southeastern Pennsylvania. If you are in the area PM me and I'd give you clinics info...

Yeah I do feel good at night, almost to where I don't want to go to sleep cause I know if I sleep for more than an hour or two I'm going to wake up in AAAAAH... But for me it's not worth feeling like crap for & hours after getting up...

I could deal with feeling slight wd in the morning when I knew I could wake up n go right away n get my dose. But not having to wait like that, at that point I'd rather split dose. I was previously on a clinic a few years back n I was the same way. But they opened at 5 am so I would just go get my dose n lay back down

I don't know if it has anything to do with it, but in other regards I do have a fast metabolism, for example as far as weight I can eat anything n everything and don't gain...

 

[phatass]

Some people just metabolise methadne faster than thers, you can ask your doc to do a test (urine sample i think) and they will be able to see, in which case yes it would make sense to split your dose into 2, half in the morning and half in the evening.

Also do you drink booze regularly, because that highly increases the speed of the metabolism of methadone.

 

[crzydiamond]

No I don't drink at all...Not using any other drugs or prescriptions or anything. Although I did some dope the other day cause by noon I felt icky...and felt the dope fine which on 95 mgs shouldn't happen...

It's weird though it really seems like sleeping makes it wear off faster. (Thru the night, naps I wake up fine). Of course I always woke up sick in the mornings when I had a dope habit. But when I would take a nap on dope it'd wear off faster than if I stayed awake

I know some people say eating takes away their high. For me I guess it's sleep. Not that I'm looking for a high..just to feel normal from dose to dose and that's not happening. And I've been at this clinic since September it's not like I shouldn't be stabilized...

 

[Lorne???]

Your going to think I am crazy, but invest in white grapefruit juice, and tagamet(generic cimetidine, it is much cheaper)

I had the same problem, but then I started drinking a couple gallons of WGJ a week, and a lot of Tagamet. And if done properly, it will completely fucking freeze up your metabolism. But just drinking a glass or two won't work; you need to start with a half-gallon(64oz). Chug it all down in the morning, as you wait on your dose. The next day, another half-gallon. After that, you just drink a half-gallon every few days to keep the effect up(note that it takes day's for the CYP450 enzymes to recover themselves)

Unfortunately I don't have time to give all the details, but trust me, drink a ridiculous amount of WGJ, and high-dose cimetidine, it will eliminate your problem, while also pushing the BA of your dose to 100, and, eventually it will exceed 100%, since very large amounts of grapefruit juice also inhibit hepatic CYP3A4(among others) in addition to intestinal. And of course cimetidine itself is a mild inhibitor, while also reducing hepatic blood flow. The combination effectively freezes methadone metabolism, increasing peak plasma levels, and making the half-life much longer. But, you have to drink A LOT of fucking juice, like I said, even 1ltr won't cut it, though even 1ltr would make your significantly stronger.

I would suggest both, but WGJ is more effective, if you don't mind drinking at least 1 gallon per week. But Tagamet helps to, and it is a helluva lot easier popping a few pills then downing a 64 ounces of juice!

Another thing to keep in mind is that the half-life of methadone(and indeed, the distribution profile) is PH dependent. The BA is also PH dependent. So another huge step to making your dose more efficient is drinking some baking soda, and/or taking tums prior to dosing. This is because methadone itself is an alkaline substance, and thus it favors a basic environment. Therefore, increasing stomach PH prior to dosing will not only increase BA substantially, but will also speed up absorption, reducing the rather long Tmax of methadone, and making it hit you faster.
Finally, as I mentioned, the half-life of methadone is dependent upon urine PH. Even a modest increase in urine PH can literally double the half-life of methadone, while also increasing the amount of free-methadone in blood(free methadone is a good thing?). You can increase urine ph by, again, drinking baking soda. Cimetidine(Tagamet) or an equivalent H2 antagonist also does wonders, but since cimetidine also inhibits CYP3A4(among other things) I would stick with it.

It sounds crazy, but it's science. Look it up if you don't believe me.

But just one question.... Why can you only dose in the afternoon? I mean I know you said it was because you owed a balance, but I don't understand, what does that matter? I mean I have never heard of such a thing. Hell, I owed a balance, and they we're giving me 3 take-homes a week!!! So what gives? I'm curious...

 

[crzydiamond]

That's their theory on making clients pay. As they basically said--they figure if they cause you an inconvenience of not being able to go in the morning you'll be more likely to pay them.
You have to be :under $100 balance for take homes, under $150 for morning dosing, if you are over $500 you can't go until 5 pm and over $1000 at 530 pm. If you have positives for marijuana you also must go at 530 pm. Kinda like a dealer holding your stuff til you pay...at least that's how it feels!
(They are a nonprofit and the county funds people who aren't either insured or covered by medical assistance but then you have a $30 per week copay. Which they basically have no recourse to collect other than changing your dosing time)

For most people it's an inconvenience. For me it causes hours of being really uncomfortable. My counselor had them take blood for a plasma test cause she said how I am is not normal...I went in literally sweat running down my face and freezing...

Thanks for taking the time to post--I will try your suggestions. Idk if I can stomach that much juice not feeling great but I'll try and will def get some cimetidine

 

[crzydiamond]

Considering the fact that urine pH drops during sleep, I believe you may have hit upon the answer to why sleep seems to "pull" the methadone from my system. ...I did some research upon what you mentioned and the relationship between half life of methadone and urine pH is interesting

 

[BigGreenGuys]

Meh! if u can't deal with them withdrawals is going to be so hard for you to kick that shit... I had the same problem wake up sick every morning...but those withdrawals ain't shit compared to coming off methadone ...just wait till your 20 mgs an under the meth would only last a few hours for me be sick the rest of the day for months ..

 

[crzydiamond]

I actually have kicked it twice. Once cold turkey (not by choice); the other doing a slow taper. No matter what dose I wake up the same way. But even on low doses I was fine until I went to sleep n got up.

There really is something to this pH thing--been experimenting with cimetidine and tums, and yesterday even though I felt shaky upon waking, I felt better once I got up and was nowhere near as bad as previous days. Hopefully it continues to improve, today was almost bearable, a little cold sweats but that was it

 

[xtcgrrrl]

Wow, I've learned a lot from this thread. I didn't realize my extreme sensitivity to cold in the morning was a WD symptom. And I've recently acquired A LOT of white gfj, tonic water with quinine and Tagamet. I started drinking a tall glass of a gfj/tonic water cocktail (bleh) to use for swallowing my 4 Tagamet (and I finish the glass, of course, no matter how gross it tastes. Hopefully this will help!

Btw, I'm not on methadone, I'm not scripted anything narcotic. I just take 10 grams of poppy over the course of a day for pain.

 

[gettond]

Hello guys, just have to say my story here. Im on mmt currently and have been fighting a long time with wd symptoms. Started at 85 mg wich was hell to me, my dose only lasted for about 6 hours.. they got me up 105 and i was still in wd symptos. All the long wd got little easier but morning was hell. Okay I have been smoking tobacco since i was kid and took a little investigation for cigarettes effect on metabolism on human body, got a conclusion that if I stop smokin my metabolism will slow up. One day I stopped smoking and about 3-5 days my wd symptoms got ALOT easier!!! So guys just saying if u smoke try to stop, now u got an motivator here if ur dose wont last 24 hours There have been some investigation that smokers have alot bigger doses than nonsmokers, and smoking speeds metabolism almost in every med, but especially methadone. It affects cyp 450 system. It inhibits system when u stop. Ithink it was cyp1a2 enzyme what smokin induces alot and 1a2 have an part on methadone metabolism. Try to google u find some info there. And sorry my bad enghlish :D Cheers everyone who struggles whit wd symptoms on MMT!

 

[crzydiamond]

^interesting. Although, I'm not a smoker. Yep...I'm the odd opiate addict who didn't pull out a cig and light up after a shot lol

Anyway...I went back to work a couple months after this thread and started a payment plan with the clinic so they put me back on morning dosing ( cause I couldn't make their evening hours with my job). Since I've been on morning dosing I've felt fine. Haven't used since I was sick from the wd. I've dropped my dose to 65 mg and didn't even notice the drop. I'm probably going to start a long taper next month--been on almost 2 yrs this time and stable in other life aspects so I'm thinking it's time. I did it before and when done slowly I don't even notice til I get really low

But I do believe there is truly something to the pH level affecting how long the methadone lasts and what the bioavailability is. When I had to dose later the info Lorne provided (which led me to research more about methadone and pH) was invaluable

 

[gettond]

Good to hear that everything is going well! YES I can say that there is sience behind ph level based methaone excretion from kidneys to pee. What more alkaline stomach content and urine slower the excretion of methadone and otherway around. I forgot to mention this, they have investigated ph thing. I think that baking soda is easiest way to manipulate stomach and urine ph content. When my old junkie days I was sleeping I always wake up in wd, no matter was it 10 hours sleep or 2 hours sleep. I think its based on when u sleep your body is going to speed up kidneys when chemicals are going to exit faster. I have also noticed that I have to urinate more often at night than day if I drink before sleep..