Starting Methadone Recovery - my HELP thread

[LotusExige]

Everyone,

Today I begin my journey of getting off opiate pain medication, hopefully forever. My short story is about 6 years ago a sever back pain issue started me down the opiate road. Hydrocodone, Oxycodone, Hydromorphone (Dilaudid). While I could never get more in a month than prescribed I did cheat often by taking more than I should then having a week or so that would suck since I'd be low. Finally after all these years the side effects are so horrible (mostly the insomnia) that life is really difficult to live. So while a small part of me is scared to not have any opiates to fall back on (I just before this post flushed the rest of my pills down the toilet) I look forward to feeling normal once again. Just as an FYI I don't really drink (beer here and there) but I do enjoy Colorado's finest MMJ rather often. I end my opiate ride on about 100mg of hydromorphone (dilaudid) a day. Good bye.

Now that I'm starting this journey here's the path I'm looking at. My pain doc has prescribed me the Methadone but has me dosing 10mg every 6 hours. I did talk to a clinic that had me dosing 30mg once ever 24 hours. I know the 10mg every 6 = 40mg in a day but I did start out this morning with 20mg since I'm just starting out.

I think my biggest question is what to expect over the next few hours, days and weeks. Should I feel any physical withdrawl symptoms? Given I'm taking 10mg every 6 hours will that steady stream be better than 30-40mg once a day? I assume I'll never feel "high" on these, right? Am I right that you just can't abuse opiates while taking Methadone as that could be deadly? As I said before I don't have any access so it doesn't really matter.

I'm just most scared about how I'm going to feel. I've missed a lot of work lately due to how sick I've been from all this crap and it has to stop quickly. So I want to do everything I can to feel as normal/steady as I can as fast as I can. My biggest issue/symptom lately has been cold sweats/chills - I'll just start pouring sweat but will really feel fine otherwise. Not a fun thing to have happen during a business meeting.

Ok I'll stop rambling, just nervous about all this and I know those here understand and have been through what I'm going through. So please, any advice you have for me I'd greatly appreciate...

 

[downerhead]

Given the fact that you are opioid tolerant/dependant it would probably be best to just take the 40mg at once.You will probably get more relief that way and there is no advantage to divided doses of methadone in opiate tolerant patients.The methadone clinic I used to go to started everyone out on 35mg and bumped you up 5mg per day untill they got to a "blocking" dose that would keep you from getting high from heroin.This dose was calculated by the doctor on staff based on an interview with each patient when he would ask about your dope use.They just counted on your honesty since they only required 2 positive opiate drug screens.They sent the tests to a lab but did not do a quantitative test to see how mush you were using.It's possible to be on methadone maintainance and still over dose.Unless you've been addicted to high doses of powereful opiates for a while,a single 40mg dose when you wake up should keep you from going through withdrawls for up to 24 hours.It may feel like it's not holding at first but within a few days your body should adjust.Hope this helps.

 

[LotusExige]

Thanks so much for taking the time to reply and help me downerhead, I really do appreciate it. Today was my first day and so far the main issue is just exhaustion. That said it may just be that I slept pretty crappy last night (I'm generally a terrible sleeper). I'm hoping if I can get good/solid sleep tonight that I'll feel better tomorrow. I have now taken 60mg today. Took 20mg when I woke up, 20mg about 6 hours later and finally another 20mg 4 hours after that. My plan was to start taking the 10mg every 6 hours starting tomorrow morning.

I understand from talking to the clinic the whole start at 30 and go up thing. So while they were going to give it to me all at once is there any benefit to being able to break it out over time? My doctor isn't allowed to prescribe methadone for recovery, only for pain, so I'm guessing that's why it's prescribed every 6 hours vs. all at once. Does that make sense? Would the benefit of taking it all at once be it would be stronger when I actually feel it vs. just a little always spaced out? Finally is one vs. the other easier to stop in the future as I hope this is the middle step between this and taking nothing!!

As I said after day one the biggest issue is I'm just exhausted, other than that no real bad symptoms. Oh my chills/cold-sweats have been gone for 24+ hours now which has been nice. Changing t-shirts every 4 hours was getting old...

 

[downerhead]

You are right about why your doctor prescribed it spaced out.Only a licensed addiction specialist is allowed to prescribe it for opiate withdrawl syndrome.The benefit of taking it all at once is that in addition to getting more relief from your symptoms,you will probably get a nice little uplifting "warm glow"from a single,all at once dose.Reading back over your past use,you aren't in danger of over-dose since that's a low-moderate dose for opioid tolerant patients.You won't see any benefit to spacing out your dose since methadone has a slow absortion rate and single doses are generally rated at 24 hours for relief of WD symptoms.Neither one is any easier to come off of than the other.A slow taper when you are good and ready is the best plan of detox.If you start feeling withdrawl symptoms during your detox,my advice would be to halt your detox for a couple/few days untill your body adjusts to the new dose.Then resume your slow taper as you feel comfortable.To quote the orientation booklet from the clinic,you are the best judge of how you feel and if you feel that your dose isn't enough it probably isn't.The clinic doctor said the same thing.Remember,no detox/treatment is going to work untill you are ready to quit.Sounds like you're ready to be rid of opiate dependance so I think you have a good chance of success.If you relapse don't feel discouraged,relapse is usually part of recovery and lots of people(myslf included)require more than one attempt at getting clean.Good luck man,you can do this.