Opioids Methadone

[ovo1024]

Hello, im currently on 80mg a day at the clinic. Was debating on going up to 90mg or maybe even 100mg but I was wondering if this dose I'm on is considered a high dose or not?

 

[BK38]

I think it really depends on where you are, how big a habit you had to previous opioid(s) etc. The "goal" after all is maintenence, not to get high. Most people I've talked to are around 80mg per day (some more, some less). When I was on methadone for 2 months they started me at 80mg but that wasn't enough (I had a pretty sizeable heroin habit), they pushed it all the way up to 140mg and that was too high, I was high as a kite. I did a rapid detox from the methadone over 2 months as I didn't want the proverbial "methadone handcuffs" for life. That was tough af. Anyhow, this was at a private rehab in Thailand and I know gov clinics are a different kettle of fish. The person I know who has the most experience with methadone is @negrogesic , he might be able to chime in with some numbers/info, be well!

 

[Coffeeshroom]

From my experience I never needed more then 80mg to keep wds at bay and was able to drop my dose down to 40mg within a week and was stable on 40mg for another 2 weeks which after I dropped down to 20mg and was still stable which I then switched over to bupre. Personally I found that methadone isn't needed in high dosages and should be dosed just to take wd's away. So you shouldn't be debating on taking more but less if you don't want to be tied down by it.

 

[Pain_in_vain]

It depends on myriad of different reasons and most of them are personal. Few questions I would ask myself is: Why am I doing it? Is it for the fleeting feeling of feeling good as more methadone accumulates after few days?, Does this dose doesn't hold you/Are you having bad cravings? Do you see yourself as a "lifer" or are you planning to kick it down the road? How is it affecting your body at this level? Do you have some underlying health (cardiovascular) problems? Did you manage to replace the time that you previously dedicated to doing H/fent with some meaningful pursuits or hobbies?...this are just few questions for the "debate" part that I would ask myself but you can skip them if you find them irrelevant.

Regarding

im currently on 80mg a day

I was wondering if this dose I'm on is considered a high dose or not?

BK38 gave you what seems a pretty solid info about average methadone(from now on - mdone) dosing around the world. From what I have gathered blocking effects of mdone come more from tolerance increase than from inherit mdones molecular profile. I could be wrong there but as I watched numerous friends "blasting through" mdone with H while being on 80-120 mg of mdone I don't see mdone having blocking effects like buprenorphine. I think thats why when someone comes and has a history of doing only codeine/morphine/oxycodone in "regular doses" (~300mg of oxycodone) doctors seem to be conservative with methadone and are generally upping mdone to 60mg max. But if someone was shooting 3G of very pure heroine they would go to 100mg+ fairly quickly. I dont know how much people on fent and ridiculously potent analogues are getting now but I would imagine more than 100mg. I am from EU and over here we are not yet (fingers crossed) receiving fent in our dope so I have no real life case studies to confirm that.

So 100mg of methadone is regular dose for a very opioid tolerant IV user. But who gives a F what is considered? It all comes down where are you at in your recovery and what recovery means to you.

Negrogesic is an outlier regarding methadone doses he was prescribed. I wouldnt consider his 380mg regular dose but then again he is not a regular guy. What I would like from him is to elaborate a bit if he doesn't mind, what is the reason why after taking 50mg (chronic) of mdone oxys are rendered pretty much useles but people can blow through 80mg with good quality heroin. They were increasing the dose of heroin to counteract mdone, and there were many ODs and lives lost, but nevertheless they were able to full on enjoy H even though they had chronic dosing of 80-120mg of mdone cruising through their body. If they were on 16mg of buprenorphine I do not believe that they could do that. And that left me wondering how much of methadone blocking effect is cause of its high affinity to opioid receptors (the way buprenorphine works) and how much is block simply cause of tolerance increase.

@BK38 can probably explain this to me , and I am not sure how much @Coffeeshroom is versed in pharmacology but everyone can play this game.

 

[BK38]

@Pain_in_vain. It might be something to do will full vs. partial agonists, differing receptor sites etc. I have no experience with bupe and have never tried to push heroin past methadone. So take all of this as pure conjecture as I don't know the answer to the pharmacological reasons why addicts can break through while on bupe/mdone.... stronger binding affinity maybe? Anyhow, hopefully someone more well versed will chime in to answer your pharmacological questions.

 

[Jen X]

Methadone don't really have blocking effects. Hydromorph and a few others have higher binding properties and fentanyl would definitely get through. I was ok on 60 but like most i went up more then needed trying to catch a buzz. I took 40mg of oxy when i was on methadone and i felt it.

If you're not in withdrawl or craving bad i would just stay at 60mg. The higher you go the longer to get off of it. But if you're craving bad go for a higher dose before taking street drugs. In 15 years of pretty heavy use last year i used something i never though i would, fentanyl, when i got off methadone and i od'd. 80 isn't extremely high but please take more methadone then street fent.

 

[ovo1024]

Methadone don't really have blocking effects. Hydromorph and a few others have higher binding properties and fentanyl would definitely get through. I was ok on 60 but like most i went up more then needed trying to catch a buzz. I took 40mg of oxy when i was on methadone and i felt it.

If you're not in withdrawl or craving bad i would just stay at 60mg. The higher you go the longer to get off of it. But if you're craving bad go for a higher dose before taking street drugs. In 15 years of pretty heavy use last year i used something i never though i would, fentanyl, when i got off methadone and i od'd. 80 isn't extremely high but please take more methadone then street fent.

Well I'm not at 60mg I'm at 80mg, I believe you misread that lol. It's okay. And well too be honest, the 80mg has pretty much completely took care of the physical withdrawals (I was using Fentynal) but I'm still having MAJOR cravings. To the point I'm still using like every other day. (Smoking blue Fentynal pills) do you guys think increasing my dose up to 90 or 100mg that will cut down my cravings?? Thank you.

 

[Jen X]

I never missed it at all. I said what I needed and why I went up.

 

[BK38]

Well I'm not at 60mg I'm at 80mg, I believe you misread that lol. It's okay. And well too be honest, the 80mg has pretty much completely took care of the physical withdrawals (I was using Fentynal) but I'm still having MAJOR cravings. To the point I'm still using like every other day. (Smoking blue Fentynal pills) do you guys think increasing my dose up to 90 or 100mg that will cut down my cravings?? Thank you.

Fentanyl is such a potent opiate that it may necessitate a higher dosage of methadone to help stabilise you and keep cravings at bay. With that said, you may also just have to deal with some degree of cravings, knowing that fentanyl is a far more powerful/dangerous drug than methadone. Personally, I think you'd ideally want to be at a level where you go up just a touch and see how you feel, incrementally, until your cravings are tolerable but not gone, then hopefully with some clean time from fentanyl, those cravings will become less powerful. I'd rather be hooked on a high dose of methadone over fentanyl anyday. I also think a question you want to be asking yourself is if the goal is stabilise, maintain or stop your intake of opiates all together. "Methadone handcuffs" are a real thing and some people just stay hooked for life and the higher you go dosage/duration wise the more likely that is to occur @ovo1024

 

[LucidSDreamr]

I really don’t think going higher on the methadone will take away your craving and will just add danger and opioid tolerance to your situation.

Your fent cravings are psychological and it’s more the whole ritual, the taste, the foil, the instant onset of fent vs slow onset of methadone is what you’re craving. That instant hit that comes all at once. Even if you’re high as shit on methadone you’re still missing out on all those thing so I doubt raising your methadone dose is going to address those cravings

Those cravings are only going to disappear by you realizing that fent use is going to lead you into misery …the cravings won’t even stop, you’ll just have the fortitude to realize it’s not worth it anymore

 

[Dextro .45]

Methadone don't really have blocking effects. Hydromorph and a few others have higher binding properties and fentanyl would definitely get through. I was ok on 60 but like most i went up more then needed trying to catch a buzz. I took 40mg of oxy when i was on methadone and i felt it.

If you're not in withdrawl or craving bad i would just stay at 60mg. The higher you go the longer to get off of it. But if you're craving bad go for a higher dose before taking street drugs. In 15 years of pretty heavy use last year i used something i never though i would, fentanyl, when i got off methadone and i od'd. 80 isn't extremely high but please take more methadone then street fent.

I’d have to respectfully disagree. I was on Oxy-IR, Dilaudid, Hydromorph-Contin, I.V. HM / H / Oxy

Methadone 30mg is the starting dose at clinic, at around 40-50mg Methadone for months it has significantly occupied most of the mu-receptors and oral opioids didn’t have an effect

I’ve been on Methadone 80mg for 10-15 years now for chronic pain …..I took four(4) Oxycodone CDN 80’s original formula PF Canada in Pickering Ontario, pulverized into fine powder removing all green shell material, filtered, slammed and didn’t feel SH!T …..4 freaking 80’s IV injected intravenously and didn’t feel a single hint of that beautiful Oxycodone euphoric warmth

Methadone 80mg-100mg is standard for an opioid tolerant patient using high dose potent opioids.

It’s a lethal dose for an opioid naive individual, could propose kill 3 large men, 2 for sure.

Whatever is good for you…..so you’re comfortable, then gradually reduce weekly or whatever plan you have with your doc.

 

[Jen X]

I know many people who get high on methadone. There's drugs with higher binding affinity that will break through methadone. Buprenorphine fentanyl and hydromorph are 3 but there are more

 

[OntarioGuy]

I know many people who get high on methadone. There's drugs with higher binding affinity that will break through methadone. Buprenorphine fentanyl and hydromorph are 3 but there are more

Im on 240 mgs of methadone a day. I was still able to get high on fent before I quit smoking it and sticking just to my methadone

 

[ovo1024]

How hard would the withdrawal be if for example I had to detox rapidly off of 80mg?

 

[Jen X]

@ovo1024 it would be rough. I would try to taper down first. Takes 3 days before it really hits you. Slow taper is best but if you need to drop 10mg every 5 days or more if you can.

 

[somnilicious]

How hard would the withdrawal be if for example I had to detox rapidly off of 80mg?

Unbelievably horrible and it will seem to last months. I walked off 90mgs 6mths ago.

 

[axe battler]

Unbelievably horrible and it will seem to last months. I walked off 90mgs 6mths ago.

How hard would the withdrawal be if for example I had to detox rapidly off of 80mg?

Yeah I'm currently on 90ml/mg and I couldn't imagine going cold turkey off that amount. Did you do that somnilicious? I'll bet that hurt, in fact Id imagine it would actually last months.
I'm dreading coming off it, but I would really like to some day. I think 5mg/month drops until I'm starting to feel it, then I'll slow it down further. That's medically advisable way.
I've also heard great things about using memantine to reduce the withdrawal.
I also know people that have used ketamine to get off methadone successfully.

 

[TheUltimateFixx]

I have never tried to push heroin past methadone.

I don't recommend doing that either ; at least not if you're on a high dose of methadone. I nearly topped myself by accident a few times.

 

[TheUltimateFixx]

How hard would the withdrawal be if for example I had to detox rapidly off of 80mg?

Will be brutal and I'd only do so under medical supervision.

 

[Juniper Bruhmomentius]

Nowadays if you are American imo 120mg-180mg is starting to be a big dose, cause of the fentanyl. If you are from uk, a proper heroin country, or somewhere similar its a pretty high dose.

If you were doing fent dont worry about it being a big dose, just get to a dose where you dont use shit anymore