Ok so me and my BF have decided to make the switch to methadone. We have been both using for 5 plus years on and off. We are to the point where we are both muscling it, it's the only way we can get well. We use BTH and it's just that time! We are both covered in abcesses all the time and it's just really getting old. So my question is about starting on methadone. I know they start you off low and go up from there. We both work and are worried about still being sick in the beginning until we can get up to our comfortable dose. Is it possible to still use after dosing for the first couple of days to get well to get through work? Is my big question. I know it's not recommended and I'm not looking for anyone to tell me it's not a good idea or it defects the purpose. I just want to know if it is possible and will help to get me well enough to get through my work day until I can get up to my right dose or tell it's bareable to make it through the day! If there is anyone that has personal experience with this and can help me out it would be greatly appreciated. I am not looking to be on methadone so I can continue to get high I'm just trying to make it through the first week and still be able to function because I work 2 jobs and can't offord to take time off without loosing my jobs. So if anyone has gone through this please let me know and if you have real advice on how to do it until I can get stable on my dose. I have already tried suboxone and it was he'll I was on 2 mg and still feeling sick! Iam really serious about getting off the stuff and doctors have already told us with the amount we use that suboxone is not the best option. Sorry if I'm rambling but if anyone has been able to do this and has advice on how to please respond back with understanding and no criticism. Thank you!
I'm a little bit offended that I wasn't invited personally to your little sewing circle. Drugs are my thing. I was always told as a child to "do what you love and you'll never work a day in your life", which has been true in many ways, albeit in a twisted meaning separate from the intended.
I was on Methadone for about 3 years and I pretty much owe my relative success in quitting Heroin to the program and 12-Step stuff. I know the latter isn't for everyone. I still smoke trees and was using Methadone when I started, which were both frowned upon. I just never talked about them and was able to take what I wanted from the program. I'm just saying, you might want to give it a try.
I'm not going to wax philosophical here, but I will say that you should only go on Methadone Maintenance if you have a SERIOUS intention to try to get better. Whatever better means, I don't know, but the key here is the mens rea. You know how serious you are deep down. Lots of folks who THINK they want to get better but aren't in reality dedicated to the proces. They end up on high dosages of Methadone at which point their Opioid cravings are satiated and they take the opportunity to use other drugs. They then find themselves with a major crack habit and a Methadone dependency. I'm just saying, consider all of this, I'm not preaching. I understand you've used up your veins and you probably don't have a lot of choice in this matter. For this reason, Methadone is probably the right choice regardless.
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The actual process, what is known as induction is pretty standardized throughout most of the world. I got Methadone in Turkey for a couple of weeks and the guidelines were the exact same as in the United States. This is probably because Methadone Maintenance was championed by a single team of doctors, notably, Dr. Marie Nyswander who's research and seminal work "The Drug Addict as a Patient" created a groundbreaking change in mentality and practice. Her work has defined the practice since she originally started in in the 60's in NYC.
You will go to the clinic. You will talk to a prescriber. They are going to evaluate the extent of your withdrawal based upon symptoms. The maximum dose allowed by federal law in the United States is 30mg on the first day. This is not enough to make you not sick if you're using Heroin. They have to be safe. You need that 30mg so when they ask you about your symptoms, sell that shit like a bad Mypillow infomercial. Your diarrhea is constant, powerful and your stomach feels as if it is being twisted into knots. They are going to look at all of the symptoms. Some are self-reported and others are examined like pupil dilation, piloerection, yawning, lacrimation etc.
You should not have any trouble getting the 30mg, but still, sell it. After your first day, you're going to be required to report to the clinic every day during dosing hours for your dose. A typical progression is that you will be evaluated daily, usually for 5 days. Each of these evaluations will be similar to the initial one in which you will be evaluated and increased by either 5mg or 10mg, but no more. So, by the end of your 6th day, you could be on 80mg if you do your thing. This is much more helpful and would probably keep you well for a day of work.
They will ask you if you're using other Opioids, but in my experience you will not be chastised and in fact, it's even expected. The staff are aware that 30mg is not enough to hold a true addict. It will not effect the rate at which you go up or anything like that.
The good news is, take-home medication is being applied very liberally right now as a result of Covid and you're going into the clinic directly before much of this is to be rescinded as the risk for infection seems to be dropping by the day. Most clinics, at least in the East, will begin giving you every other day take home medication. You go in, drink your dose, then you get a dose to take home for the following day. If you're good, you could end up with weekly takehomes within 2 months enabling you to only go to the clinic once a week.
BENZODIAZEPINES ARE AN ABSOLUTE NO-NO. If you test positive upon intake, it's fine, but if you get caught using Benzodiazepines during treatment, the standard practice is to have your dose cut in half immediately until you can produce a urinalysis clean of Benzos. Common Benzodiazepines like Clonazepam (Klonopin) and Diazepam (Valium) are knwn to be detectable for up to 4 weeks by sophisticated tests. This will also preclude you from any and all takehome medication.
So yes, it's very common for people to keep supplementing their Methadone with dope until they get to a comfortable place. It shouldn't effect your treatment or progress. Do you have any other questions?