Opioids Question about Methadone WD

[zippermike]

I am a 31 year old man. About 10 years ago, I began taking Methadone. I'm not going into how or why. I started by taking 1 10mg tab daily. Slowly over the years I moved up from a single 10mg tab, up to 5 10mg tabs a day, or 50mg in total. Quitting has been....difficult for me. It's been something I've wanted to do for years but just never had the balls to do it.

I tried kicking the habit several times before. The first time was when I was 24. I tried quitting cold turkey off a 25mg daily dose. I was fine for the first day and after that all hell broke loose and my body said hell no. Somehow though, I made it through the withdrawals, which took around a week or a bit more for the worst symptoms to leave. I still had lots of lingering anxiety and other issues, but I managed to stay clean for 8 months. Then I had a cornea transplant the pain and wicked headaches were so bad that my doctor prescribed me Vicodin. Bad idea. I wanted so bad to refuse the prescription. I went out in my car and cried forever. I knew what would happen if I got that script filled. The problem was, my pain was simply too much to bear. I managed it 4 more days before I finally caved and got the prescription filled. Within a month I was right back on Methadone. I was more ashamed of myself then than I think ever.

Now let's fast forward to 2010. My methadone dose was now up to 40mg a day. One day I looked at myself in the mirror and realized what I'd become and it just sickened me. I tried to quit cold turkey again. This time I only made it to halfway through day 3 when I decided enough was enough and started using again.

Now here we are in present day. About 3 weeks ago, my mother passed. I loved my mom more than the world itself, and I promised myself on the night she died that I was getting off this demonic drug. That was the end of July. I was on a 50mg dose daily at that time. Since then I tapered off almost daily until I was down to 20mg, the same amount I was on last time I was able to quit. I know 3 weeks of tapering is almost worthless but I had to try something. It was coming around the time I'd have to get my Methdone supply refilled, and it was either then or nothing. So three weeks tapering was all I could do. 6 days ago, I took my last dose. I have been using pot(which I don't normally smoke) and Lorazepam(again, a newbie to me) to try and manage the withdrawals but they are still downright wicked. Much much more potent than the WD's I went through in times past.

The worst part is the rapid heart rate and increased blood pressure. I already take several high blood pressure medications, Lisinopril and Metoprolol. The increase in blood pressure is noticeable. I have a BP machine at home. My average BP over the past 2 years since I've had the machine was 124/78, which is right in the ideal range. My blood pressure now is 156/98. Now I know thats not super high, but its enough to give me massive headaches and stuff. Also my pulse is much higher. My average in the past 2 years has been 59. My pulse in the past 4 days has been between 71 and 93. I have also been getting these "flashes" where my heart will speed up all on its own, when I am just sitting doing nothing.

I went to the ER on day 4 of WDing. I told them my symptoms, but lied about the cause. The doctor was a familiar doc(I go to the ER on occasion for Kidney Stone issues and problems related to my hiatal hernia) so he didn't ask any questions. So anyway they ran EVERY test you can think of on my heart, kidneys, liver, you name it. They could find nothing wrong(other than my prior health issues that is). I thought for sure they'd find the Methadone and the jig would be up, but for some messed up reason they didn't. So anyway, I considered telling the doc the truth that night, and decided against it. So anyway he chalks my increased blood pressure and pulse up to panic attacks and prescribes me Ativan. These have helped considerably with some aspects of the withdrawals(the insomnia, and some of the anxiety) but they've done nothing for my heart or blood pressure.

So right now it is day 6 of WD. How long do I have left before my heart will slow down and give me a break here? The constant pulse in my ears feeling is driving me nuts, so are the near constant headaches, which I'd imagine have much to do with the increase in blood pressure. The Ativan+pot combo helps me sleep about 4-5 hours a nights, which if I recall from prior WD's is actually a pretty good thing. I am asking pretty much for a timeline here of when I can expect these symptoms to start abating. Restarting the Methadone is simply not an option for me. I took all the rest and flushed them. I will never touch another recreational drug other than pot(which I actually kinda like, which is a shock considering I never really cared for it). And yes I have heard Ativan is used recreationally too but I am only using it until the brunt of my WD's are over, and I always take only my prescribed dose of 1mg 2 times a day.

 

[Deadhead420]

Clonidine. You defiantly want to find some of that. It's a blood pressure medication that also helps with withdrawals. It's prescription but it's not narcotic/abusable so most doctor's won't have a problem prescribing it. When I was withdrawing I just went to a doctor and told him the truth and he gave me a script. You defiantly want to ask your doctor weather or not to continue taking your other blood pressure meds if you get on it though.

 

[zippermike]

Anyone have any ideas? I highly doubt my doctor is going to switch my medications since I am already on a bunch of them for various health problems and such, so getting Clonidine is probably out of the question. I just want to know how long the rapid heart rate spikes and increased blood pressure are going to last. I am on day....7 or 8 maybe and this random heart speeding up and increased blood pressure is the only real WD symptom I am experiencing other than excessive sweating and some aches. The only symptoms I even give a rip about is the heart issues. Like I said, I had my heart tested at the ER 4 days ago or so and it checked out fine, despite the high pulse and blood pressure. However, I am am still worried about it.

 

[sekio]

Methadone should really be tapered, not withdrawn cold turkey... it's very potent and long lasting and as a result so are the withdrawals... (months)

I would avoid taking benzodiazepines (lorazepam etc) because they're worse for you than opioids in the medium and long terms. (longer than 2wks)

If your heart is physically fine there is no need to worry I don't think, opioid withdrawal isn't a cake walk.

 

[Swimmingdancer]

Methadone withdrawals have actually killed people. It makes sense that your withdrawals are worse than in times past, the longer you take it the worse the withdrawals get. The benzos can be helpful in the short term, just try not to take them for too long and only take a minimum amount to make things bearable - you don't want to get dependent on benzos. Your blood pressure meds should help too. Make sure you keep well nourished and well hydrated. Try to take vitamins. Methadone withdrawals can last a really long time - the acute stage that you are in can last as long as 4 weeks, but it really varies from person to person so it's hard to predict how long it will last for you. Don't rule out the idea of being honest with your doctor, especially if anything gets worse. It is pretty easy to get clonidine if you tell them you are withdrawing from methadone.

There are also some threads on here which go into detail about things you can do for withdrawals, for example The Opioid Withdrawal Megathread and FAQ.

 

[Znegative]

I agree with what everyone else has said here. I on Methadine now for maintenance, coincidentally the same dose you were taking (40 mg) but I have in the past withdrawn from 100mg/day and it's a drawn out shitty process. Benzo's tend to help with anxiety and insomnia etc.. But they are, like others mentioned, addictive as well. I'd try gabapentin. IME it works better overall in fighting withdrawal symptoms. Like benzo's it can be habit forming, but it's not nearly as addictive.

 

[-Guido-]

Never go cold turkey with Methadone. Tell your doctor what the fuck is up and he will taper you off gradually and prescribe you Clonodine and a sleep aid. You got nothing to lose at this point bro.

 

[Earthgro]

A methadone taper at the 40-50mg level should be spread out over several months, at least. I had a pal that did a ONE YEAR methadone taper, he would go down in 2-3mg increments (I don't know how the hell he measured it) every few weeks, spreading it longer will make it as painless (not pain-free) as possible.

And, yeah, Mike, your doc needs to know what is going on with you, abruptly stopping methadone when you have blood pressure issues can be risky, even at your age. They can't help you if they don't know what is going on.

You didn't mention how you were getting methadone....klinic or doc's office? Street? This makes a big difference in figuring out what your options are for getting off.

 

[brutus]

I've gone cold turkey on methadone several times and every single time was a living hell.

I suggest tapering to 30mg then switching to either bupe to finish the taper or a shorter acting opiate. Either way, you are going to have to pay the piper eventually and go through withdrawals.

 

[beengerman]

just like wiggi said , have you ever thought about switching over to suboxone and then tapering with that?

 

[Znegative]

At this point the OP wouldn't need to taper with withdrawal. When he jumped off, he was down to 20mg, and posted this 6 days into withdrawal. I would advise that if he were to switch to bupe to ease the withdrawal that he take very small dosages, no more than .5 mg at a time. Buprenorphine's peak agonist activity is equivalent to somewhere around 30 mg of methadone, and the cieling effect is thought to be between 2 and 4 mg.

My point is basically that it would be a mistake to start taking 4mg a day when the OP had tapered down to 20 mg, and has now gone 6 days without anything at all. Taking too much buprenorphine could potentially backfire, raise his tolerance and draw out the withdrawals. It's a decent idea for sure, it would just have to be handled delicately if the goal was to detox completely rather than just getting on suboxone maintenance.

 

[pgcc]

I was on methadone for 6 years at around the same dose as you 40-60mgs a day. I have heard people who got locked up tell me how bad the wd is from methadone, drawn out and the after affects can last for months. You probably should have tapered lower but whats done is done. Also suboxone as a withdrawal tool not as a maintanance drug is awsome really. Thats how I got off. I jumped from 45mgs of methadone to 4mgs of suboxone. Over 8 weeks I tapered down to .25 of suboxone by reducing 25% every 4 days. Then I skipped a day, skipped two days, three days and then 4 days then off. I had no problems at all. Felt a bit tired but not bad compared to methadone wd. But you are in the middle of this now so the best you can do is deal with the symptoms. Yes, clonidine would help, benzos will help but your going to feel like shit no matter what for a while. If you have the option of suboxone I can tell you how I did it, its easy and painless, really. And you could start it right away and feel 100% better because you are already in methadone wd. You have to be in wd to start suboxone anyway. Best of luck.
Also the previous poster is correct you would not need 4mgs of subs to start you could probably get away with 1mg or so which would make the taper off even faster. You would need to experiment with the dose but to me this is the best answer by far and the easiest way off methadone. You just can't listen to the doctors on subs they don't know what they are doing. They will prescribe 16-32mgs a day in most cases. This is harmful and unnecessary and all it does is trade one addiction for another, Try getting off 32 mgs of Bupe. Probably harder than what you are doing now. I went to the doc he prescribed me 16mgs a day, I took the script went home and did my own thing. He couldn't believe when I went back in two months and was clean.

 

[tokenname]

I've gone cold turkey on methadone several times and every single time was a living hell.

I suggest tapering to 30mg then switching to either bupe to finish the taper or a shorter acting opiate. Either way, you are going to have to pay the piper eventually and go through withdrawals.

+1

that or you're in for months of hell. It is what it is.
Sorry.
i did go c/t..it's do-able..but horrible.

 

[zippermike]

Thanks for all the replies and support. Not long after I posted my last message, my heart sped up to around 120bpm and would not go down. I had no choice but to go to the ER. I told them the truth. They were able to get my heart rate and bp down by giving me 4x my regular dosage of Metoprolol by injection. They kept me overnight in the hospital to monitor me and shipped me home. I now have an appointment with my regular doc tomorrow afternoon and I intend to be honest with him for the first time in years. Its going to be hard as he is also a kinda sorta friend(we talk online sometimes), and I know he is going to be disappointed that i lied to him all these years about my drug abuse. However, my health comes first over a little shame. I only hope he can help me.

Honestly, this forum has been a godsend. The support I have recieved from random strangers makes me think maybe we have hope in our world after all. Keep doing what yall are doing! I will update this tomorrow evening when I find out more. Thanks again!

 

[zippermike]

So, I went to see my doc today. As I expected, it was an extremely shaming experience. I really think I need the shame though. I'm going to remember it down the line. Anyway we talked for a long time, I cried a lot. He did nothing but comfort me which made it so much worse, because I felt so bad for lying to him all these years. Again though I need this shame. If anything could keep me from a relapse, it is shame.

So anyway he gave me 2 options. He said he could either give me a combination of Clonidine, Xanax, and Ambien, or he could refer me to a friend of his(another doctor who works in the same clinic) who could start me on Suboxone. I was very tempted with the Suboxone idea, as I hear it can completely stop all WD symptoms. He even brought him in for a minute to talk to me about the possibility of it. However, to me that is just replacing one addiction with another and in the end I decided on the Clonidine/Xanax/Ambien route. He said I could always try the Suboxone later on if this is not working.

He said something that REALLY scared me though. He said that, given my other health problems(diabetes, hypertension, obesity etc.), and the length of time I was taking Methadone for(close to 10 years), that I may have no choice in the end but to go back on it if my body doesn't return to normal heart rhythm and my blood pressure does not come down after a month or so. He said that in some people, particularly those with hypertension and obesity, your body becomes so hard wired to the drug that stopping it is simply not an option. He said he highly doubts that will be the case though, given that I am only 31 years old, and I have only been overweight for the past 10 years or so(I never really thought of it but the Methadone is probably a contributing factor to the obesity, as I never had weight issues when i was growing up or through high school or after). He said he is pretty confident that the combination he prescribed will do the trick in getting me through this.

He also warned me that Clonidine can actually lower my BP and heart rate TOO low, especially when combined with my blood pressure meds I am currently on(Metoprolol and Lisinopril). So he told me I need to monitor my blood pressure for the first few days at least, checking my BP every few hours. He said if it starts getting low(lower than 100/65) to call him day or night and he will decide whether I need to go to the ER or not, but if it goes really low to not even bother calling him and to go straight to the ER immediately, and to be certain to tell them about the Clonidine, since they have drugs that can reverse the effects. That actually kinda scared me alot. However, I trust this man with my life, and if he thinks it is the right option, I trust his judgement.

So anyway he told me to take my first dose of the Clonidine as soon as I got home, which was about an hour or 2 ago(we had a bunch of errands to run as I've been pretty worthless lately). So far so good. I just checked my BP before typing this, and it came down from 164/98, down to 123/82 in a matter of 45 minutes or so. My heart rate is also slowed down considerably. Not back to normal, only around 70ish, whereas my predetox levels were right around 60, but it is still a dramatic improvement over the 90s its been. I am supposed to wait until tomorrow to start on the Xanax, as he wants to see how stable I am on just the Clonidine first. Anyway, heres hoping I can actually get a good nights rest tonight for the first time in like 10 days or so.

Wow this thread has gone on ALOT longer than I ever intended. Again I want to thank those who urged me me to go to my doctor and be honest with him. Without that kind of encouragement I'd probably never have done it. I will update this thread again when I start seeing some changes. I want to thank everyone again for all the help and support!

EDIT: I have one lingering question though, and I forgot to ask my doc about it. I have had literally HUNDREDS of blood and urine tests done over the years, yet not a single one showed up positive for Methadone. How is that even possible?

 

[Swimmingdancer]

So glad to hear you talked to your doctor .

I am curious why you feel that using Suboxone would be "replacing one addiction for another" but not benzos? Benzos are addictive/dependence causing too. You could consider the Suboxone more as temporarily trading a physical dependence for another (Suboxone doesn't have to be an "addiction") and have a plan to taper off it quickly.

As for the drug test thing, sorry but we can't discuss drug testing on here. Normal blood/urine tests for medical conditions don't even check for drugs though.

Glad your doctor was helpful and that you're feeling better. Keep us updated.

 

[zippermike]

Ahh thanks for clearing that up, and sorry if I mentioned something against the rules, I was curious is all. The reason I chose the Clonidine/Xanax/Ambien route is that it is only temporary. My doc said I only should need to be on them for a couple weeks to a month tops, whereas the Suboxone doctor said Suboxone tapering could take much longer, and you can still risk WD's from the Suboxone itself. I figure the shorter time I am on excess meds, the less chance of becoming physically dependent on them, thus limiting yet another set of WD's I would have to go through. My doc did warn me that even being on Xanax for only a month couild cause a dependency, which is why he told me to try and use them as sparingly as possible. I am managing just fine so far tonight without the Xanax, but then again I haven't tried sleeping yet. I can't take them tonight even if I wanted to though as I was warned by my doc to only take the Clonidine tonight, so that I can monitor my BP and make sure it is stabilizing.

 

[Swimmingdancer]

Yeah, if you are already a week into your withdrawals and you only take the Clonidine/Xanax/Ambien as needed and taper off in a couple weeks is probably better than going on Suboxone (provided it works for you and makes life semi-bearable). With Suboxone they normally stabilize you on the Suboxone until the methadone withdrawals should be gone (maybe 3 more weeks) and then taper you off the Suboxone over another 2 weeks, plus a lot of doctors over-prescribe Suboxone and/or encourage taking it for longer than needed. If you can make it through the mental aspects of addiction - cravings, depression, anxiety, etc - is the hardest part and you're doing really great if you have made it this long after quitting from 20mg - that's no easy feat!

The Dark Side is a great Bluelight forum to get emotional support with quitting drugs by the way. (Just check out their guidelines first as it's more for talking about addiction and mental health issues).

 

[BiggDirty01]

Fantastic effort so far! If I may impart a piece of advice I once got: Use this opportunity (when you are feeling better more often than not) to develop a support system and perhaps 12 steps meetings; side note: NA and AA can be fantastic and some can be down right awful so please don't get hung up if you find your first meeting(s) blow and you are falling asleep, keep looking and I guarantee success.

The only other thing I can think of to advise would be are you taking an anti-depressant currently? For me, the right anti-depressant helped me be productive in rehab as the opiates make the brain stop generating the brain chemicals like seretonin and dopamine, so if you aren't on appropriate AD's or meds for some other psychiatric issue, you literally are fighting your own brain in the first few weeks in sobriety until the feel good chemicals are being produced on their own adequately (and thus eliminating one part of your opioid addictions' pull over you?

 

[Swimmingdancer]

^I would recommend taking supplements as opposed to Rx antidepressants. Antidepressants cause physiological dependence and can have a lot of adverse side effects. But I totally agree about working on the mental addiction, whether it's going to meetings (there are more types than just NA too), therapy, self-help books, mindfulness techniques, working on/treating the reasons one used in the first place, etc.