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  • BDD Moderators: Keif’ Richards | negrogesic

Opioids always wondered what determines what maintenance you receive ( methadone vs bup )

In Ontario Canada they asked me which i wanted and explained both. They recommend methadone for me because I was recovering from surgery on my foot and it would be better for pain.
I had a bad reaction to Talwin years ago and it was in my file and apparently they are similar
 
FutureReference said:
It depends almost entirely where you live. Also, if there is an actual need for opioids. In the US, both are easily obtained but there is a huge difference between the 2. If you truly have chronic pain but have become addicted to standard opioid medications, a Pain Management doctor will offer Methadone. If MRI's, etc can prove the severity of the pain, chances are take-home Methadone won't be an issue.

If there is no pain involved and it is purely recreational; here in the US, Suboxone is going to be the route they choose usually. Since a Pain doctor won't help, you will have to go to an addiction specialist. Over time they will give you Suboxone to take home but usually you must take your dose in front of them. You can choose to go to a Methadone clinic but they are not nice places and many wish to avoid it. I cannot speak for other countries, but it truly comes down to preference. If you wish to be on Methadone, you can go to a specialist who will get you into maintenance. Insurance usually is a deciding factor between the 2 options. Many people choose the Bupe as if it is purely recreational, the doses of Methadone are relatively weak.

Definitely a slippery slope and if pain is involved Methadone wins by a mile but for maintenance Suboxone truly is an awesome medication.
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Is there no Substitol in your country? In Austria there are just Substitol (morphine) or methadone... Would the substitol be better for you? Yeah I know your answer it is pure morpine :D
 
Methadone is better for maintenance. The drug itself. Hell if I'm gonna be hooked up on an opiate, it better be a full agonist and give me cloud 9 pain killing.

However methadone comes with much more regulations. You cannot keep a packet of methadone in your wallet and dose as needed. And have to deal with a clinic. But you cannot get high on subs (perhaps only the strongest fent) and will have to be sick one way or the other to feel other opiates and get back on subs. Also, subs only do so much and may not work for many.

If you feel good on subs and not using on top it would probably be best to try. If you are not feeling good and still trying to use, then methadone would be better.

Oh and here you can go to any clinic at 5:30am and be dosed as a new patient by 6:30am. So easiest way out if you are kicking dope and realize you cannot work and want to try something else. Basically getting on methadone is very easy. Just need to dose and roll. Subs require induction. Doctors.
 
I don't know if it's true but I heard getting off methadone is worse than heroin itself?
 
If you run a 2 year heroin addiction into a 10 year 120mg maintenance run, yes...you have now fried your brain and will be hell.

If you run a 2 year heroin addiction into a 6 month methadone stabilize (30-50mg) and taper will be 100x easier than kicking that dope. Methadone is not used right. They push your dose to obscene levels and treat you as a lifer from day 1.
 
negrogesic said:
I think it did eventually stop having the same level of euphoria but it still feels like strong stuff.

My theory is that people should be allowed large doses of methadone so they are fully satisfied. Hopefully, like me, they just eventually get bored.

I never got full tolerance to the sedating effects of high dose methadone. I'd take my first dose in the morning (200mg) and two hours later id take a wonderful nap (when i wasnt working). In the afternoon id take another 180mg.

I was covered 24/7 and pretty toasty all the time. Eventually i just got bored and tapered off.

Problem was i never told them i was tapering off. I recieved all my methadone in 10mg pills (38 pills a day) and went only once every 3 months. I tapered down but saved the extras. It amounted to thousands of pills by the time i was off. I didnt touch them for years but eventually i did slowly use them all and did catch a very low level habit (like 20mg a day). The withdrawal was surprisingly bad from even that dose.

Those extra thousands of pills got me high as fuck. I would love a 40mg dose right now, bet I'd get high for 18 hours, with all that lovely methadone itching.

One of the best opioids imo, and ive tried a massive variety.
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Interesting. Thanks for sharing.

I'm in a similar boat with buprenorphine at the moment. Although even keeping my doses low so that I 'feel' my next one, when I do feel it after taking it in the morning, I feel very tired and bored within a few hours and this feeling of lethargy lasts the rest of the day. Redosing in the same day rarely is of any benefit.

I think people should just be given a safe supply of their opioid of choice, including shorter acting ones and then let them choose if or when they'd like to taper off and be done with it. Bupe is so boring that I'm finding that I need stimulants or other things just to 'feel' anything at all.
 
TheInvisibleStoner said:
This. He needs methadone :) Subs are just blah to so many. Also I think the antagonist plays into that. On methadone you do feel good for the most part. Hits your receptors proper and you feel pleasure.
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Sounds logical. I would love to at least try methadone, but the process is just too rigid for me. I can't be going to a clinic daily for it.

Subs can feel amazing when one has practically no tolerance, but thanks to it's ceiling effect, partial agonism and extreme half life, it doesn't take long for tolerance to kick in to it. It does help keep me from drinking or doing dumb shit everyday, but if there were heroin or another full agonist in front of me right now, I wouldn't hesitate to gobble it up. I wish the US would start offering more options or less restrictions on methadone, so people can choose rather than feel like they're stuck with just bupe.
 
I think it depends on where you live honestly. I was on suboxone for about 4 years but I chose it. I did get on methadone for a min but it was a hassle having to go and wasn’t getting take homes at the time so I always like sub better. Also I’m not sure if this is the same as other detox’s in other states but this one detox place I went to a few times, they would only give the kids under 25 suboxone, and anyone over could choose which one. Not sure exactly why but that was just one specific place and never saw it at another
 
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