Opioids too sedated on MMT 20+ hours after dose-- is it withdrawl? or over medicated?

[walterdini]

Hey all, been on 140mg/day MMT for about 1 year now. I take my dose at around 12:30pm everyday. My problem is, from the time I wake up around 7:30am until I dose a little past noon, I feel mild w/d symptoms and also aam extremely tired to where I am falling asleep uncontrollably in my chair at work. Its almost like I'm nodding where I cannot help it and my eyes close no matter what.

Is this the result of going into w/d?

My first thought was that I was overmedicated. But this uncontrollable sleep is happening 20+ hours after my last dose. Also, it is occuring simultaneously with tightness/soreness in my legs and back, a general achey feeling, and a loss of desire to smoke ciggs. (I smoke a pack a day)---typical early stage w:d sympptoms for me...

After I take my dose, I get an energy boost and mood lift. Nothing major, but I notice the drug kicking in, and going from below zero to baseline produces an enjoyable sensation. Afterwards, I'm normal, not tired or groggy. So from 12;30pm when I dose till around midnight when I go to sleep I'm fine. But when I wake up, I'm passing out on my feet all morning and am slightly uncomfortable. The methadone alleviates both symptoms.

I know methadone is very long acting and I'm on a high dose and I know 'done has its own unique quirks, so I thought it was possible to feel uncomfortable the hours prior to my next dose while also be sedated from my last dose. So I went down 20mgs to 120, I felt just as tiired in the mornings and felt more uncomfortable than before.

What do u all think? Can I be feeling excesively tired in the mornings prior to my dose b/c I'm entering the first stages of w/d? And would raising my dose alleviate this?

 

[Mr.Scagnattie]

Nah, that sounds like you're on too much methadone.. you're not supposed to be nodding like that.

 

[Psychedelic Jay]

Lower you dose...

 

[bingey]

I had the same thing in rehab when tapering and they would hold out my dose for bullshit reason. Sleepy and unconcentrated to the point of nodding. Do you have add/adhd that could be the cause for your type of reaction to methadone. Also it could be the first stages of depression/ low dopamine due to chronic use.

 

[DynoSpec]

thats alot of methadone, over time with daily doses the plasma levels do increase aswell. as mentioned maybe it is a different medical issue

 

[walterdini]

My first thought was over medicated as well, but how does that explain the other w/d type symptoms I feel in the morning the hours before my next dose?

Also its not a real "nod"....while I am uncontrollably falling asleep, It is quasi unpleasant, my muscles are stiff and my stomach is churning...its just how I used to feel in very early stages of w/d wen I was using.

Also, while I've been definately groggy from my 'done, this morning sleepyness just started when I switched taking my dose at 8:45am---first thing in the morning, to 12:30pm, around lunch. When I came in in the morning, I'd feel tired during the day, , but it never come on with such a predictable, consistent, and long lasting nature. Like I'd get randomly grogggy during the day vs being close to asleep from exactly 9-12....it would be at 10am one day then 3pm the next vs...the morning every time and every day.

Despite this I still didn't consider too little 'done as the cause, it was actually my counsler at the clinic who suggested this as the reason. Only after he mentioned this did I look back on the above stated facts/pattern and think hmmm maybe he is right.. I really don't wanna up my dose unecesarily, but I don't want to be receivinbg less than fully efficient care. Since I'm on 'done, I might as well take enough of it for it to work.

Before my counsler suggested too little 'done, I'd been attributing my w/d symptoms in the morning to just what happens on 'done, that since I wasn't "high" I felt outta it, and that even tho I wasn't fully lit up on opiates and was feeling slightly uncomfortable it was still possible for the 'done to make me groggy. And that I could be sedated and in w/d at same time. (However I do acknowledge that fatuige is the first w/d symptom I experience on other opis)

 

[bingey]

^
Other options to prevent a "gap" are switching to tablets (more sustained release/slower peak plasma ) or splitting your dose say half 8 am half 8 pm.

 

[walterdini]

Yep, I self-admin split dosing on sundays when I get a take home dose and it works great. I don't ever feel too medicated and I get a little pick me up in the evening that carries over till morning. My clinic does allow split dosing, but only if ur already on reduced pick up schedule--which I am not. When I start getting take homes during the week, THEN. I can get split dosing....a

I am tempted to believe I could benefit from a higher dose. I would just hate to do it unnecessarily b/c methadone is such a #1) dangerous drug @ high doses and #2) such a bitch to tapper off of. But if taking a higher dose will allow me to feel stable 24/7, to where I am no longer going up and down every day and also rids me of my morning grogginess, then I'm willing to go up.

So bottom line, does anyone know, from reading or first hand experience, if someone on MMT can be in the first stages of withdrawl and also simultaneously be over sedated from the drug?

For this to be possible, as far as I can figure, some effects of 'done would have to last longer than others and/or be cumulative while others wouldhave to be acute. As I understand it, methadone lasts a very long time, but the entire dose doesn't just jump off ur receptors @ the same time, after say 18 hours the 'done starts leaving the brain in a slow trickle. Thus why full w/d doesn't kick in till 1.5-3 days. So it would seem that once the 'done starts leaving the braain, one would feels some w/d effects while still feeling some "high"/positive effects of the drug.
For me specificaally, relief from certain w/d symptoms would have to be an effect that only lasts around 20 hours from the time of last dose. While sedation or grogginess would have to be an effect that lasts at least 24+ hours since last dose.

Is that a plausible theory?

 

[crzydiamond]

I used to be on MMT. I was on a dose of 75 mg and took daily at 5:30 am. Went on vacation n had to courtesy dose at a clinic that for some whacked reason only allowed ppl courtesy dosing to come at 2 or after. I was in the beginning of withdrawal every day from when I would wake up until I went and dosed. I had never had that issue at home when I dosed first thing in the morning but that 2 pm was horrible. I had sneezing, runny nose, and like you describe, tiredness to where I couldn't keep my eyes open but not in a happy noddy way. After the first two days of this I actually got dope to hold me from when I woke up until 2 pm. And what's more I FELT the dope.

I get that extreme sleepiness when I'm headed into withdrawal, so my guess for you isn't over medicated but rather early wd, as also backed up by the fact you feel better split dosing. Methadone is long acting but when you've been on it a long time sometimes it doesn't seem to hold more than 24 hours. And sometimes less.

Strangely though, I kicked it cold turkey from 45 mg (not fun), and the real intense wd kicked in on about day 3. But the minor part def kicked in prior to 24 hours.