Opioids Methadone Taper

[beklotz86]

Hey guys, I'm a long time lurker but this is my first time starting a topic. Anyway, I need some advice about tapering methadone, preferably from those who have been there and done that.


I've been on methadone for 3 years now, most of that time I've been at 120 mgs a day, that is my current dose, and I'm ready to try to get off the stuff. I've read a lot about coming off, and a lot of people say they drop 5 to 10 mgs a week, but what they don't mention is whether they drop the chunk at the beginning of the week then stay at that level for a week or drop a little each day.


My goal is to drop on average one milligram per day. So when I start off, would it be better to go to 113 mgs and stay there for a week and then 106 for a week, etc., or should I go 119 mgs one day then 118 the next and so on? It seems to me that going down 1 mg each day would be a good way to come off, am I wrong about this?

 

[crzydiamond]

I detoxed methadone slowly and it was successful--easy and painless

I was on about 90 or 95 when I started ( years back, foggy memory lol). I came down 5 a week at first. In one drop at say beginning of week. Then your system adjusts to it. Then I would do the same the next week. I went to 3 mg per week drop around 40 mg, and once I hit 20 mg I did 1 mg/week drops. I had to re-stabilize at 20 mg for a few weeks and again at 4 mg. sometimes your body has to adjust and it takes longer than a week

I don't think I would do daily drops. Your body will never have those days to adjust itself. Maybe in the beginning it's not such a big deal dropping 1 mg when it's less than 1% of your dose. But as you get lower and lower and the. Percentage increases, your body will never have that chance to stabilize itself.


I am currently back in a methadone clinic. I was at 95 mg some months back. I have been randomly dropping 5 mg. no set schedule this time. Just tell them one week to bring me down 5 mg. then a few weeks later I do it again. I'm currently on 55 mg, should be dropped to 50 mg this week. I have not felt one of these drops at all-- no symptoms. I don't focus on it though. I don't ask for a drop and then go in for the next week asking what my dose is.

So basically/ I would say drop your 5-7 mgs once per week and let your body adjust to the new dose. Most likely you will be fine most of the time to do weekly drops. If you need to stop at a dose and give your system a chance to feel normal.

Good luck. Methadone is not hard to come off slowly. Its reputation as a hard detox comes from the cold turkey detox. Which lasts forever. I've done that too. But slowly is painless and you'll be fine !

 

[George27]

The right rate is 5-10% per week, 2-3 months to cut to half the intake.
I agree with crazydiamond that there could be a step at 20mg.
At 20mg your endorphine system starts working again, while 120->20 is just a matter of building down tolerance.
Yes the taper is pretty long but mild; the idea is to do it only one time in your life and then be opiate-free forever,
so some more months is no a real issue.

 

[Znegative]

the last time I got off methadone I got cut off and put on what was called a 'financial detox' which took me down 3mg a day (from my maintenance dose of 45mg), so I was down to 0 in like, 2 weeks and a few days or maybe less, can't remember don't feel like doing the math. But even at a low dose of 45mg to start with, I didn't notice that much pain coming down 3 mg a day until it got down under 20, and even then it wasn't so bad. Now granted had they stopped and then kept me on 9mg/day for a week, I probably would have started to feel withdrawal symptoms as the previous doses drained from my system, but I still thought it was kind of crazy that even my final dose of 3mg, I felt and it held me much longer than expected (I didn't think it would even do anything and had been contemplating skipping the clinic that day).

It's also been my experience that its really easy when you're on a relatively high dose like the OP 100mg or over, to drop down really fast. Everyone is effected differently but when I was at 110mg I was able to easily cut my dose down by 10mg a week, and it wasn't until I got to fifty that I started to feel a little uncomfortable.

Another thing to mention is that when you start getting down to the lower numbers, like 20 or 30mg, you should stop decreasing your dose by say 5mg, and instead decrease it by maybe 10%. I've actually read that people usually do good cutting their doses down by 25% at a time, at first that sounds drastic, as it would bring someone on 20 to 15, but then it would go from 15 to 12.5, 9.25, etc. Just some ideas. Honestly what I would do is ask for a blind taper because its amazing how much knowing your dose effects the severity of your withdrawal symptoms.

 

[beklotz86]

Thanks for the input guys. I have been thinking about trying a blind taper, I'm not sure if my clinic does that though.

I started using opiates when I was 21, I'm going to be 30 this year. Ever since I've first started using, I've been on something. My brain's been flooded with opiates for almost a decade. Most of that time I was "clean", but I was on either subs or methadone, so it's been a long time since I've been on nothing at all, so I'm a little apprehensive about coming off.

Does length of one's addiction affect the severity of their withdrawal? I mean, obviously if you only use for a week or two, it won't be that bad, but will withdrawal be worse for someone who's been addicted for 5 years vs. 10 years? I feel like I have to have fucked up my brain somehow after this long of a period of opiate dependence.