kleinerkiffer
Bluelight Crew
- Joined
- Dec 9, 2012
- Messages
- 5,702
v1.0
v2.0
From sixpartseven:
v2.0
From sixpartseven:
I decided to make this FAQ to be a companion to the buprenorphine FAQ phrozen created. With these two FAQ's, anyone considering some for of opioid maintenance will have two resources to use to compare and contrast the differences of the two drugs, helping them come to a decision of which drug would be better for them.
Some of the information contained in the FAQ was not authored by me. I have listed all the sources used at the bottom of the post.
Methadone FAQ
What is it?
Merck methadone information
Methadone is a full mu-opioid agonist. Methadone also binds to the glutamatergic NMDA (N-methyl-D-aspartate) receptor, and thus acts as a receptor antagonist against glutamate [1]. NMDA antagonists such as dextromethorphan, ketamine, and ibogaine are being studied for their role in decreasing the development of tolerance to opioids and as possible for eliminating addiction/tolerance/withdrawal, possibly by disrupting memory circuitry. Acting as an NMDA antagonist may be one mechanism by which methadone decreases craving for opioids and tolerance [2].
Methadone, a long-acting synthetic narcotic analgesic, was first used in the maintenance treatment of drug addiction in the mid-1960s by Drs. Vincent Dole and Marie Nyswander of Rockefeller University. There are now 115,000 methadone maintenance patients in the United States, 40,000 of whom are in New York State and about half that many are in California [3].
What is a normal dose?
There really is no normal dose. The dose required for maintenance therapy is highly dependent upon the dose of whatever other opiate you were using before getting on methadone. However, most clinics normally start you at a dose between 40mg and 60mg, and increase by 5mg or 10mg every day or two until you get to the required dose.
The most common and traditional dosing regimens, however, tend to fall far short of providing optimum or even sufficient results for a number of patients. This is due to the ceilings many clinics place on dose levels [4].
What are the withdrawals like?
The withdrawals from methadone are similar to every other opiate, although they have been reported to be much more severe if the dose is too high when the patient cuts off usage. Physical symptoms include nausea, sneezing, vomiting, diarrhea, sweats, chills, joint pain, elevated blood pressure, fever, runny nose, and increased tear production.
The psychological symptoms can include depression, anxiety, paranoia, panic disorders, delusions, decreased sex drive, prolonged insomnia, and fatigue or exhaustion.
Is there a ceiling dose?
No. Your dose of methadone can be increased as high as it needs to go. One thing to consider when that starts to happen is maybe entering a detox program to get your dose back down and possibly even taper off of it completely.
What is methadones bioavailability?
The bioavailability is between 40 - 80%, with a half life of 24 - 36 hours [5]. The Wikipedia article has it listed as 40 - 90%, and more than one other source, including Bluelights own thread on bioavailability, have put it closer to 80 - 90%.
Other Notes:
Methadone is Schedule II in the US.
It is metabolized by the enzymes CYP3A4, CYP2B6 and CYP2D6 [6]
Half-life: 24 - 36 hours
Drug Test: Not detected in standard 5-panel test, but can be tested for.
I took the FAQ portion of phrozen's buprenorphine FAQ and copied it, adjusting it to pertain to methadone, so credit goes to phrozen for the layout, questions, and some answers that went unchanged.
Q: How long after my last methadone dose can I take an opiate and feel its effects?
A: With methadone, the higher the dose, the more heroin it can block. It also depends on how long you have been taking the methadone. Wait at least 24 - 36 hours before trying to dose another opiate if you want to be sure you feel the full effects from it.
Q: Is methadone a good replacement for buprenorphine?
A: Maybe. Some people with a high enough opiate tolerance may not be held by bupe at any level, even at the highest(ceiling) possible dose. Methadone does not have a ceiling dose, so your dose can be raised as high as it needs to be raised to make up for tolerance. You should research both before deciding what to go on, as they both have different positives and negatives in regards to their use.
Q: I'm thinking about switching from bupe to methadone. At what bupe dose should I be when I switch?
A: Switching from bupe to methadone is MUCH easier than switching from methadone to bupe. The latter means you would have to taper your dose of methadone down to around 30 - 40mg before making the jump. Going bupe to methadone, you dont have to get your bupe dose down, because again, methadone does not have a ceiling and the dose can be taken as high is it needs to be taken to compensate for tolerance.
Q: Will I still have cravings on methadone?
A: Its possible, but since methadone is a potent mu-receptor agonist, generally the cravings will be well taken care of. But, if your dose isnt at the exact place it needs to be (too low), you may experience some cravings.
Q: Is methadone good for depression/anxiety?
A: Just like any other full-agonist, it can cause depression. And again, like other full-agonists, it will help ease anxiety.
Q: Is it safe to shoot methadone?
A: No. It can cause many of the same complications as shooting other pills. The best advice is to use a micron filter if you absolutely must try to shoot. If you get liquid methadone from the clinic, you should most definitely not shoot it. The sucrose and syrup contained with-in are horrible for your veins.
Q: Is methadone recreational?
A: Yes. It is a full mu-receptor agonist. Someone using methadone for maintenance purposes may not be able to get high from it unless they take a very high dose, but for someone who is not on maintenance and has a somewhat low tolerance, it is perfectly recreational.
Q: Can you overdose on methadone?
A: Yes you can. Methadone is very potent and very easy to overdose on. Be careful and always start small.
Q: Can I still get high on other opiates if I'm on methadone?
A: Yes. You can "shoot through" your dose of methadone with a larger amount of your prefered opiate than normal, but the risk of OD is huge in this scenario. Its best to wait 24 - 36 hours, that way you can feel the full effects of the opiate without risking a massive OD.
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![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
I'll keep posting, esp when the "fog" and pain start to really clear. 
