Using Heroin when on Methadone Maintenance

[opi8]

Ok, I hate to admit it because I said I never would but I've gotten myself on a methadone program. $30 a week instead of 1 - 3k a week is just better for me at the moment.

I have a question for anyone who uses heroin on top of methadone. Before going onto methadone I was using at least a gram a day, more when I could afford it or just picked up, whatever. I went on to 80mgs of methadone which was only just holding me and I did not want to go higher, even though my dr wanted me to. I've now gone down to 70mg, and I still find that I need to shoot a lot more than usual to even feel the smack, let alone enjoy it. Is this normal because of the methadone? I'm now shooting a gram per shot and have moved up to 3ml needles because the liquid is just too thick, and I still want more.

Will this get any better if I reduce the amount of methadone I'm taking or have I completely fucked my tolerance again by going on a methadone program. By again, I mean that after I tried an at-home detox with suboxone, 32mgs a day for a week or so, then tapering off that which wasn't too bad, my tolerance to heroin went up drastically (obviously) and I completely regret doing that.

 

[SpiritFolk]

You need heaps and even then its mainly just a rush....

Basically for me was a total waste of time until I was on 20mg daily - 30mg max, and then it doesn't hold you anyways. I spent years trying to find the balance but ended up either nit getting stoned and being just methadone'ed out all fuckin day and looking like crap, or getting high but basically running a methadone and H habit simutaneously.

Glad I'm off methadone completely and just kicked daily opiate use all together.

 

[opi8]

Fuck. That's not what I wanted to hear at all. But thanks for the honesty.

Yeah man, I am trying to taper off this for the last time. I just want to use once a week after my weekly piss test, but it's getting expensive. I'm just hoping it will get better.

 

[Crankinit]

Most of the people I've spoken to on methadone have said it makes getting high on smack more or less unfeasible, even when they skip a dose first.

You could try bupe instead, I find if I halve my dose the day beforehand then skip my dose on the day I want to get high, I can get probably 80% of the effect from a shot of smack/morphine.

 

[opi8]

Because I'm using so much per shot now and not really feeling the effects, at what stage will it become dangerous? 2 Grams, 3?

 

[SpiritFolk]

^^ haha u need a lot of $$ for H to be dangerous on methadone.. You gotta realise how powerful methadone is... I used stupidly waste a G of rock trying to get high at the height of maintenance... sux balls

i would reduce and get on bupe asap personally... then like crankit said you can skip a dose and get high. still doesn't beat being clean and having the discipline to have the odd shot.... oh wait i'm dreaming again.. sorry

 

[rachamim]

Methadone has the strongest receptor affinity of any opiate/opioid, bar none. In other words, opiates and opioids interact with your body by latching onto specific receptorsthough some latch on more firmly than do others. Methadone latches the best. The substance has a huge diffetential between its duration of psychoactivity and its systemic presence. In other words, if you dose on methadone you will nod for maybe twelve hours. At that point you will not be gaining any benefit from the substance. However, it will remain strongly detectectable within your system for nearly another five days. Because methadone is so strongly latched onto your opiate/opioid receptors, no other opiate/opioid...like heroin...can latch on and interact with your body. Typically this is referred to as "Blocking," as in, "Methadone blocks heroin," etc.

Typically, this "blocking effect" will only kick in at 70mg and above and obly then if the consumer reaches a stage technically known as "Therapeutic Dosing," a phase reached at around the six week mark of regular daily dosing. There will be a partial blicking effect in increments leading up to those 70mgs as well, translating into the consumer's need to indulge in higher than usual amounts of heroin.

You state that you refused to increase your dosage and even decreased while still experiencing (and fufilling) the desire to use. If you adequately medicated you will lose the urge to use illicit opiates/opioids. Noone can tell you what is right for you but not wanting to dose adequately makes absolutely no sense on any level excepting fear from old wives' tales about the "horrors" of methadone.7

 

[redsweater]

$100 a week is an unaffordable habit for me, how the fuck can you manage 1-3k

 

[Tommyboy]

Methadone has the strongest receptor affinity of any opiate/opioid, bar none. In other words, opiates and opioids interact with your body by latching onto specific receptorsthough some latch on more firmly than do others. Methadone latches the best. The substance has a huge diffetential between its duration of psychoactivity and its systemic presence. In other words, if you dose on methadone you will nod for maybe twelve hours. At that point you will not be gaining any benefit from the substance. However, it will remain strongly detectectable within your system for nearly another five days. Because methadone is so strongly latched onto your opiate/opioid receptors, no other opiate/opioid...like heroin...can latch on and interact with your body. Typically this is referred to as "Blocking," as in, "Methadone blocks heroin," etc.

Typically, this "blocking effect" will only kick in at 70mg and above and obly then if the consumer reaches a stage technically known as "Therapeutic Dosing," a phase reached at around the six week mark of regular daily dosing. There will be a partial blicking effect in increments leading up to those 70mgs as well, translating into the consumer's need to indulge in higher than usual amounts of heroin.

You state that you refused to increase your dosage and even decreased while still experiencing (and fufilling) the desire to use. If you adequately medicated you will lose the urge to use illicit opiates/opioids. Noone can tell you what is right for you but not wanting to dose adequately makes absolutely no sense on any level excepting fear from old wives' tales about the "horrors" of methadone.7

I don't think that this is correct. Methadone does not have the highest binding affinity of all opiates, and that is not how it blocks other opiates. It is buprenorphine that has the high binding affinity, and that is how it blocks other opiates. Basically the blockade effect of methadone and suboxone is not the same. This is why taking buprenorphine causes precipitated withdrawals if you take it too soon after another opiate, whereas you can dose methadone in combination with another opiate, and as long as it's within a safe dose, the user will be fine.

Methadone just raises your tolerance since you have a high dose opiate in your system for pretty much 24/7 if you are going to the clinic. The analogy that I use to describe how methadone blocks the high of another opiate is that of a heavy drinker. If a heavy drinker is going through 24 beers a day (methadone) then a few shots of liquor (heroin) on top of it won't really do anything. Buprenorphine on the other hand simply doesn't let other opiates attach due to its high affinity, thus blocking them.

 

[SpiritFolk]

Basically the blockade effect of methadone and suboxone is not the same. This is why taking buprenorphine causes precipitated withdrawals if you take it too soon after another opiate, whereas you can dose methadone in combination with another opiate, and as long as it's within a safe dose, the user will be fine.

Totally agree with this. Changing from methadone to bupe, after longtime methadone use was severly painful. Precipitated w/d are terrible. Taking most other opiates with methadone is fine but was often pointless for me.

I do find bupe though a better drug than methadone as I find it was easier to taper and get of maintenace completely. Bupe is mega blocker for sure though.

 

[opi8]

...

 

[Crankinit]

^ I know how you feel, I function better on opiates than I ever did sober, they just give me a motivation and sense of contentment that I don't get in ordinary life, and I think the same is probably true for most opiate users.

Did you not get any relief from methadone? I started bupe 4 months ago and while it's not as good as morphine or oxy, the background buzz it gives is still enough that I can live my life and don't constantly crave opiates.

 

[rachamim]

Tommyboy: All you had to do was look up the Binding Profile of each substance for each of the relevant receptors. If you had done that you would have saved yourself - and me- some time. As for buprenorphine precipitating physical withdrawall due to its supposedly "higher Binding Profile"...that is entirely due to the substance's high antagonism, end of story. Nabulphine will also precipitate for the same teasons or has it suddenly developed a super Binding Profile as well?

 

[rachamim]

Spirit:Your switching from methadone to bupe was so painful because you switched from a full on agonist, methadone, to a highly antagonistic substance, bupe. This is why doctors will tell you not to begin bupe until you are fully in withdrawal. If switching from methadone the guideline is 36 hours after your last dose of methadone. However, I definitely feel tgat is 24 to 48 hours to soon.

 

[opi8]

If I was to switch from methadone to bupe, would it be best pain wise to have my last dose of methadone, then use something with a shorter half life such as heroin or oxy for a week and then go on bupe?

 

[Busty St Clare]

Opi8, excuse my ignorance but why are you on methadone if you still want to use heroin? Are you using it to help taper the heroin habit or are you just enetering the programme half hearted? I don't completely understand the treatment but I thought methadone was used as a replacement while also preventing the action of heroin. Is it common for methadone users to use both (apart from obviously relapse patients) ?

 

[SpiritFolk]

QUOTE=rachamim;10410743]Spirit:Your switching from methadone to bupe was so painful because you switched from a full on agonist, methadone, to a highly antagonistic substance, bupe. This is why doctors will tell you not to begin bupe until you are fully in withdrawal. If switching from methadone the guideline is 36 hours after your last dose of methadone. However, I definitely feel tgat is 24 to 48 hours to soon.[/QUOTE]

Thanks for the info. Yes I went by the guidelines of 36 hours and the first time switch was fine as at that stage I had just been on methdaone for 1 year for the first time. It was the second that fucked me for days. I had been on for 70mg for about 3 years (not that heavy compared to some) at that stage and had other opiate habits previously and the guideline of 36 hours went out the window. Going of how many days I was in painful w/d which was like frying from the inside, very very unpleasant, I would say 72 hours is a better guideline. However sitting on methadone w/d ofr 72 hours is big fuckin ask too.

Busty, I think a lot of users go on methadone not really by choice its just that they can't afford scoring enough H as was my case. So once you get on Methadone you still crave as having a proper shot as methadone just sucks after awhile. So even though I wanted to just use gear I was put in a situation where I couldn't manage it and had to resort to a maintenance program... at that stage I still very much just wanted to use H.

 

[Busty St Clare]

I wasn't trying to be a dick opi8, I was just curious as to how it works. How safe is it mixing methadone with heroin, is the risk of overdose greatly reduced?

 

[Tommyboy]

Tommyboy: All you had to do was look up the Binding Profile of each substance for each of the relevant receptors. If you had done that you would have saved yourself - and me- some time. As for buprenorphine precipitating physical withdraeal due to its supposedly higher Binding Profile...that is entirely due to the substance's high antagonism, end of story. Nabulphine will also precipitate for the same teasons or has it suddenly developed a super Binding Profile as well?

The lower the value on the binding profile, the better the fit and efficiency at the receptor site. That is why methadone having the that high value on the binding profile does not mean it is the reason it blocks other drugs. Morphine which has a lower binding value than methadone at the mu receptor site, but that actually means it will bind more efficiently than methadone at that site. It has a lower value at the other two receptor sites, but those receptors are not responsible for the main effects of morphine Buprenorphine has a very low value on the binding profile, but that means it has a very high affinity. If the drug you mentioned has a lower value on the binding profile, than it has a higher affinity. Opiate displacement (causing precipitated withdrawals) is only possible because antagonists have a higher affinity to the binding site, yet if you look at the binding profiles you will find them at the bottom since the low values mean high binding affinities.

Therefore antagonism, receptor affinity, binding profile, and precipitated withdrawal are all related. Also this confirms the reasons for the different causes of the blockade effect between methadone and buprenorphine.

The info is here. It confused the hell out of me at first because it kept mentioning the very high affinity of buprenorphine, and then showing a very low value, but then I finally read the fine print that explained that lower value meant higher affinity.

 

[opi8]

I wasn't trying to be a dick opi8, I was just curious as to how it works. How safe is it mixing methadone with heroin, is the risk of overdose greatly reduced?

I think it's greatly reduced, and then more so. I don't know exactly, but I shoot way more now than I felt safe shooting before I was on methadone, It kinda pisses me off.

I'm sure someone else knows more about it than I do.