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PostPosted: Mon Dec 19, 2011 5:37 pm 
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I was reading some post under the Cravings thread of Methadone Maintenance when someone mentioned to another that he might be experiencing precipitated withdrawals. I was going to comment in that thread, but I figure I need to make this a new thread so as to give anyone the chance to read it because this is a very important topic and a lot of clients, Nursing staff, Hospital workers, Doctors etc…are not knowledgeable on precipitated withdrawals and PEOPLE NEED TO BE IT HAPPENS TO BE ONE OF THE SICKEST MOMENTS OF MY LIFE. So with that being said, I should make this a NEW TOPIC. PLEASE take note and NEVER DO THIS. FURTHERMORE……I hope to make a MUCH NEEDED POINT about how doctors, hospitals and emergency care workers needs to get with the times and BECOME EDUCATED in how to deal with events like this one.
I was a newbie in MMT, can't remember how new but I had made it up to my "Stabilizing Dose" so they say at 160 mg of Methadone. It was winter time and a bad snow storm had hit us. I tried to make it to the clinic but due to a wreck in front of me on the Interstate and my clinic closing early, I was unable to get there on time. We had all been called by the clinic and told we had a two hour window to get there and then I guess they were so busy with the extra work, they put their phones on message service and I could not call them and tell them the event in front of me that was delaying me. On a good day it takes me an hour to get to the clinic.
Well my very dearest friend lives a few miles away from my clinic so when I missed the clinic, panicked as hell, I drove to her house. She also goes to a clinic and is on Suboxone, but only monthly, so she could only comfort my panic and try to help me get thru the fears that I in a few hours was probably going to be sick as hell and I found out from another client at my clinic that they had given everyone their next three day doses because of the storm. OMG I was sooo scared. WHAT THE HELL DO YOU DO IN A SITUATION LIKE THAT? NOT THIS......My friend said all she could do was give me three day supply of her suboxone. Well because of the panic I was under and no other solution we agreed that I would spend the night and when I started feeling bad I would take one of her 8mg tablets. We were thinking that 8 mg probably was not going to be as strong as 160mg of methadone, but at least it would help until we could get on the phone with someone at any clinic tomorrow and ask them what to do. So I got all dressed in my jammies (I keep things there to stay with her sometimes to save on the daily trips back and forth to the clinic as I was still in level one or maybe two but I went there a lot) Her Mother had cooked us spaghetti and meatballs and we had rented on cable "The Notebook" one of our favorite movies because we like to laugh at each other for crying etc....It was going to be a cozy comfy movie watchin fireplace warming kinda night. NOT.......
We started the movie and I am trying to defocus on the fact that I was going to start feeling like crap as it had been about 36 hours since my last dose. My withdrawals always begin and end the same way so when my nose started running and I began to yawn and my legs were wanting to tangle up in a pretzel we paused the movie and she got the suboxone. She told me to let it dissolve in my mouth and then swallow it. The second it hit my tongue, it began to fizzle like an alka seltzer. I and she could hear it crackling and sizzlin etc...Hmmmmm she said it didn't do that with her. It dissolves in her mouth but my mouth sounded like the commercial Snap, Crackle, Pop, Rice Krispies. Oh well maybe we both are just being hyper-sensitive. We un-paused the movie and began to watch it. I started yawning, now listen yall, I am talking yawning. I have never yawned so much and so hard that it felt like my jaws were popping in and out of joint. WTF is that all about? And….I was not even sleepy…. not at all. We started laughing hysterically but tried to return to watching the movie and I began to sneeze. Sneezing uncontrollably. Now this is starting to get annoying as even these sneezes were hurting me. The only way I can explain these symptoms to you all is that everything was extremely exaggerated. My nose began to run pure water spout run. At this point, I am thinking to myself, this feels like withdrawals. The only thing that confused me was the Yawning, Sneezing were so exaggerated and I had never had them hurt like that, but anyways back to the movie cause if they were withdrawal symptoms they should subside because 15 minutes ago I had taken that suboxone and it might take a little while to work. Well a sad part/scene began, not the real sad scene, as she had decided to go back to the house to the man who had loved her the most, my favorite scene, but nonetheless, I began to tear up and then I started to cry hysterically. My friend is laughing at me and telling me what a mess I was and that the other symptoms I was having were impacting me and maybe we needed a dinner break before watching the rest. We got up and went to go upstairs to eat and I was dizzy, the room began to swirl around me and I told my friend I had to sit down on the bottom step. I am still crying hysterically and she has gone from laughing at me to fussing at me to get a grip. (We have been friends for 30 years) I get up and go up the stairs sit down at the table with her mother and stepfather and I am still crying and feeling so lightheaded. I looked at my food, jumped up ran down the steps went to the bathroom sat on the toilet and grabbed the trash can and NOW…..I am convinced what I am in is withdrawals bad withdrawals. I am even sneezing and yawning and crying while on the toilet and throwing up. It was worse than any withdrawal I had ever went through EVER I say.
I have no modesty at this time as I was scared to death so my friend and her mother were in the bathroom with me trying to help me get off the toilet and make it to either the bed or couch. Their voices were amplified by the walls in the bathroom and even that hurt my ears. My Friend got a hold on me and was trying to help me up and the sweat on my arms made her loose her grip and I fell to the floor. My hair on my head was as if I had just gotten out of the shower I was drenched in sweat but yet freezing cold, shaking so bad on the floor she was screaming to her mother to call 911 I was having a seizure (I wasn’t). I was screaming to her NO, not to call, because I knew this was something to do with that pill. Even though it felt like withdrawals, VERY EXAGGERATED WITHDRAWALS, I knew it was because I had taken that pill and even though I was so sick and I wanted immediate help, but because of fear of repercussions maybe at the hospital or my clinic, we needed to sum up a story quick. At this point she is agreeing because she is thinking she is going to be in big trouble giving me that pill. So we got me moved to the couch with a trashcan beside me and tried to figure out what to do. I eventually ended on the bathroom floor so I could be close to the toilet too.
We both knew the hospital was a must for several reasons, one being apparently the suboxone was not going to get rid of my withdrawals and two the clinic was going to be closed tomorrow maybe more. My friend’s mom would not let her husband or anyone eat the spaghetti she thought it was food poisoning, but I had only taken one bite of it and never swallowed it (that’s when I ran down the steps). So I am not able to discuss anything as now I am lying on the cold floor, shaking, throwing up and laying in it as I can’t even hold my head up to the trash can. My friends are trying to get me cleaned up, they have called 911, and told them I took one bite of food and became violently ill, they are wrapping me in blankets half undressed cause I have not only thrown up on myself but peed my clothes to. The diarrhea had subsided although the stomach cramps were ever present and painful, I can hear them and feel them talking and shuffling me around to try to get me clothes and warm with little success. And the ambulance gets there and has to park up the road and walk the stretcher down the snow bank to get me. The of course want the low down on what’s happened so my friend tells them that all they can figure is either food poisoning and/or methadone withdrawals as now it had been over 40 or so hours since my last dose of 160mg. They transport me on stretcher thru the snow to the ambulance which compounded the chills I was already suffering. Get me to the ambulance promising to give me something for pain and nausea as soon as they could get an IV set up. I don’t find a lot of comfort there because I know I am a terrible “STICK” so to say and IV’s are very challenging even for the best of professional’s i.e. pediatric nurses and the best of phlebotomists. So I began to add this to my prayers that God will help intervene where necessary and HELP ME. They tried the whole way there even my feet to get an IV started no luck.
NOW FOR THE SAKE OF THE IGNORANCE OF HSOPITAL STAFF REGARDING METHADONE, SUBOXONE, THE OPOID BLOCKING AGENTS OF BOTH, AND PRECIPITATED WITHDRAWALS, I will try to refrain from pointing out HOW STUPID THEY ARE TOO MUCH…….And I hope if any are reading they will actively pursue the necessity in getting an continuing ed program started at the institutions regarding the same. I am rolled into the E.R. crying, dry heaving, wet from pee rolling around in total discomfort and pain from Restless Legs, stomach cramps, hot/cold flushes begging to put it mildly for their help. ANYONE SOMEBODY PLEASE HELP ME. This was in fact the worse withdrawals I have ever noted in my 30 years of constantly getting clean cold turkey and then relapsing more times than I can even remember as so to count.
They roll me in this room and of course ask me all the same questions the ambulance people ask me. I am trying to answer but I am so sick I literally can’t form sentences. They are trying every arm, hand, foot etc….to get an IV started when finally they get one but tell me it is barely in there as they could not thread it because of some valve problem in my vein. NOT MOVE???? I CAN”T BE STILL……My friend steps in and tries to tell them that I take methadone and have not, because of the snow, been able to dose and maybe if they would just dose me all would be well. NOT….First of all I was accused of lying because “No doctor in their right mind would give me that much methadone at one time” But she will be right back….. She comes back in with a doctor who tells me my records were flagged sometime ago for drug seeking trips to the E.R. and if that was what I was doing I was wasting both our time…..OMG could things get any worse, Yes. So they leave me in this room with repeated request to quieting down so as not to disturb all the patients and for several hours. They came in and out first with tramadol and phenergan which I refused because it was on my card to not take the tramadol. Thank God my friend had one of those cards. Each time was a different person/nurse so I had to explain my sickness over and over again or my friend did. Refusing the tramadol was not favored very well by the staff as you can imagine. They did eventually start bringing me morphine but it was not touching the symptoms and so I started telling them that maybe because I was on Methadone the morphine was being blocked. They just told me to be the patient not the doctor. So, all I could do was lay there, crying, moaning, begging, throwing up, freezing several mishaps with diarrhea WTF am I to do. My Friend is calling every dealer we know to try to get me anything as I and she both are sure all I have is severe withdrawals and I had been told by several people that methadone withdrawals were bad, but this effin bad?
My friend had been gone out of the room for quite a while and I started saying her name rather loudly to get her attention to give me an update because I would have resorted to heroin at this point just get me over this hours (I think it was 13 hours before I got relief) of ineffective treatment. When she walked in with this young doctor (maybe mid twenties but what an angel he was to me, I never got his name). He rang for the nurse and began to do a physical examination on me. He ask the nurse a few things like what had they administered and she was really being sarcastic in telling him about me being flagged as “drug seeker” when he interrupt her and said well she’s been doing something about that she is enrolled in MMT. They had taken a bunch of lab test which he was looking at and saying look whether she is here because of not dosing today or by the looks of my lab report something else, she deserves to be treated as a patient should be and he went further to state the reason I was not able to get out of pain was because of the ineffective doses of morphine I was receiving then the nurse really pissed him off when she said we have given her enough morphine to knock a cow out and he said “Hardly so if you knew how to treat a client on methadone” He looked at me very compassionately and said “Don’t worry Miss, I am going to write an Order for the pharmacy as we don’t keep this on the floor but I will wait on it to be filled myself and be back with it to help get you settled”. He looked at the nurse and asks that she change my clothes and bed as I was lying in pee and also told her to find an adequate IV site as that one was leaking and was another reason why the morphine was not helping. When he left, I just busted out crying, the nurse all of a sudden was trying to help get me out of cold, wet, peed on, thrown up on, cover and clothes and a nurse from the pediatric floor had been called down to find an IV site and did so with only three sticks.. I felt so humiliated as I had been put through the ringer about both being a drug addict and a methadone client.
I was emotionally relieved to know it was almost over as I was sure this man was going to help me. My friend told me that she had grabbed him out of another patient’s room and begged him to listen to her for a few minutes and he did. She also told him what we had done by me taking the suboxone when he told her there was the culprit. I had been thrown into what they call “Precipitated Withdrawals” which in a lot of cases is even more severe than the worst withdrawals an active drug addict may ever go through. Looking back I think it to be odd though why he never made that a point to me or the other staff as he did indeed let them know I was being treated ineffectively for a methadone client. He told them even though they thought they had administered a lot of morphine they should have looked up an conversion on what would be effective (for a person on a 160 daily dose of methadone) relief when he returned to my room with my regular snotty ass nurse and a needle with propofol (Michael Jackson Drug) in it (I found that out later). He walked up to my bedside, told my friend and I both that I would be checking out for a little while, but I would be feeling better when I woke up as he was admitting me due to the fact my white Blood Cells were elevated very high and he thinks something more is going on than just precipitated withdrawals. The Nurse gave me the shot in my IV and I was out for the count.
When I woke up….I was on a surgery floor being told by the staff that I had a stone stuck in my gall bladder duct and needed surgery to have it removed. My Husband had been here and had Okayed them putting a shunt in my neck for an effective IV etc….The doctor that came in to explain the surgery etc..To me never mentioned the precipitated withdrawal and the subject of me taking the suboxone went away. The subject of me taking the methadone once again had to be pushed by me and he called my clinic doctor and got my dosage but the nurses most of them I should say always had something to say about me taking 16 little white pills every day. In three or four days I was back to normal pretty much as far as dosing and no withdrawals but I remained quite sick as I was kept for 9 days. I stayed in quite a bit of pain for a few days because they never did the conversion on what would help my pain and me still dosing every day, but I dealt with it as not to rock the boat any more than I already have. It took me a long time to tell anyone what I had done about taking the suboxone because I had a legit cover up story with the gallbladder duct problem, but often times I will tell it to help someone else not make the same mistakes I have. I often times worry about what to do if my gallbladder or kidney stone problem becomes an issue with my MMT as we can’t depend on the medical professionals in hospitals to know how or what to do with conversion charts etc…I am going to find a chart and print it out and carry it in my purse in case I need it, but that can only work when you get a doctor willing to listen. IF ANYONE KNOWS AN EASY ANSWER TO HOW TO GET PROPER MEDICAL CARE WHEN YOU TAKE AN OPOID BLOCKING MEDICATION LIKE METHADONE OR SUBOXONE MY EARS ARE OPEN. I know this is a lengthy post mine usually are but I hope maybe I educated one person on the subjects as there are a few subjects in this post.

finallyachance

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PostPosted: Mon Dec 19, 2011 6:18 pm 
Wow. I am so sorry you had to go through this. I've heard a lot of stories about patients switching from done to Sub and having precipitated withdrawals. Honestly, after all I've read I would never do it..it can be 4-5 days without methadone before it's safe to dose Sub.

You asked about ways to avoid this? I don't think there is an easy one. On my part, I keep a card in my wallet (from RB, I just crossed out the part about naloxone and switched the -oxone to -Tex). That way if I ever need paramedics, they'll know.

I tapered as fast as I could (I'm now settling in at 1 mg/day. I've been on sub 15 months but I got below 8 mg after 2 months) so that if I ever need pain meds for a legitimate reason, there is a possibility of receiving a dose that actually touches the pain. Also, I've read that under 4 mg, since your receptors aren't covered completely, they downregulate, which is basically your brain healing. I'd love to read more about that. Personally, I felt better at 2-4 mg/day than I ever did at 8 mg/day.

Finally, it's very important, like you said, to be personally knowledgeable about precipitated withdrawal. Thanks to forums like these, many of us will never have to experience the pain you did. Thank you for sharing your story.


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PostPosted: Tue Dec 20, 2011 8:41 am 
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If you think Suboxone induced precipitated withdrawal is bad... try taking Naltrexone while on MMT. That was probably the most painful 24 hours I'd ever experienced. But I got through it, and am stronger (or less stupid) because of it.

I remember calling my GP when I started to get sick, told him I had taken 50mg Revia naltrexone after my methadone clinic closed early on me. He said "If you can, get yourself to the ER straight away, I'll ring forward and explain what to do" .. I was like "I can barely get to the toilet" .. he said "Well... You're in for a ride... Remember no matter what, you won't die. Try and find some Valium." And hung up. WTF?

Anyway, he was right. I didn't find any benzos, and I didn't die.

If a person can survive acute precipitated withdrawal... good old bupe / methadone / heroin withdrawal is a piece of cake.


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PostPosted: Tue Dec 20, 2011 1:20 pm 
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I just for the life of me cannot understand why the medical staff was not prepared for me. I mean I had no idea I was in Precipitated Withdrawal I had never even heard of it, but I knew I was in acute withdrawal for some reason. I do think they had made matters worse and had already given me a dose of tramadol already when I was able to catch them and stop them. But they knew I was a methadone client. I failed to tell them I had taken the suboxone, but when my friend told that nice doctor what I had done he knew and when he went to tell the other doctor and nurses none of them knew about it. When I stopped them from giving me the tramadol and accused me of narcotic seeking, she balked at the card I had and flat out admitted she had never heard of such in her thirty years of RN. I mean it’s like sending a fireman to a fire without a water hose isn’t it? And…..the worst to me and what I fear I will not be able to do anything about (because I now know not to take certain things with methadone) is what if….I get my usual every few years kidney stones and/or another stone in my gallbladder duct? I am telling you that is bad pain both of those. And….when I go to tell them I have to know what they are giving me cause I am on methadone then the discrimination starts….they forget my disorder or pain and all of a sudden I am drug seeking etc….Then I got to beg them to please look up an conversion chart to find a suitable amount of whatever to break thru the blocker from the high dose methadone (160mg). At that moment all I can do is pray for an empathetic doctor who either knows about it or will listen without discriminating.


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PostPosted: Thu Dec 22, 2011 12:09 am 
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finallyachance wrote:
I just for the life of me cannot understand why the medical staff was not prepared for me. I mean I had no idea I was in Precipitated Withdrawal I had never even heard of it, but I knew I was in acute withdrawal for some reason. I do think they had made matters worse and had already given me a dose of tramadol already when I was able to catch them and stop them. But they knew I was a methadone client. I failed to tell them I had taken the suboxone, but when my friend told that nice doctor what I had done he knew and when he went to tell the other doctor and nurses none of them knew about it. When I stopped them from giving me the tramadol and accused me of narcotic seeking, she balked at the card I had and flat out admitted she had never heard of such in her thirty years of RN. I mean it’s like sending a fireman to a fire without a water hose isn’t it? And…..the worst to me and what I fear I will not be able to do anything about (because I now know not to take certain things with methadone) is what if….I get my usual every few years kidney stones and/or another stone in my gallbladder duct? I am telling you that is bad pain both of those. And….when I go to tell them I have to know what they are giving me cause I am on methadone then the discrimination starts….they forget my disorder or pain and all of a sudden I am drug seeking etc….Then I got to beg them to please look up an conversion chart to find a suitable amount of whatever to break thru the blocker from the high dose methadone (160mg). At that moment all I can do is pray for an empathetic doctor who either knows about it or will listen without discriminating.
first off, methadone isn't a blocker. shit happens. doctors don't like you "the drug seeker" to infur how to treat yerself...it's happened to the best of us...i kicked 200mg in a 6 by 9 (not bragging)


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PostPosted: Thu Dec 22, 2011 6:53 am 
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Indigo, please explain this to me. I have been told that anything over 60mg is a blocking dose for Nethadone. I myself was quite confused why pain medication at large doses did not hekp me so I ask the doctor and he yold me anything above 60mg was a blocking dose and even harder to breakrhru the higher up you went being 60 mgs would have taken over 1000 mg of morphine to begin to effectively help my pain.

That doctor explained to those nurses and such the reason I was getting no relief is because of the high dose methadone etc....so I am a little confused. I know for a fact when I got the ER bill there were quite a few shots of morphine on there and morphine has always worked for my kidney stone pain. Please explain what you mean about methadone not blocking my pain medication as I need oral surgery but I am scared because of the same.

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PostPosted: Thu Dec 22, 2011 8:11 pm 
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This is a very interesting topic when it comes to, does methadone have a blocking affect or not? And I Indigo is right it is not, to call a medication an opiate blocker it must be able to block all and any dose’s of short acting opiates. But don’t get me wrong methadone can and will block opiates but only to a certain amount. After hours of reading and talking with my methadone clinic counselor, DR, nurses and other patients I have came up with an idea of how this works. Ok once you reach a certain/stable dose of methadone and this dose is different for everyone, your receptors become so saturated that any short acting opiate will not be able to bond or only very little will bond. Thus giving the user believes that methadone is an opiate blocker. But the fact of the matter is large amounts of short acting opiates can and will be able to bypass your saturated methadone receptors if given in large/extreme amounts, making methadone not a true opiate blocker. This is my theory I could be wrong but after much reading up on this and talking with even a methadone DR this is what I have found out like I stated.

As of this post I find it very interesting that you didn’t know that taking suboxone while on methadone can and is very dangerous, I mean my clinic stamped this into our brains. And every clinic gives each patient a card with medications you cannot take on it that is to be kept in your wallet in case of an emergency and you are unable to communicate and suboxone is on that card. Also being on a dose of 160 I take it you have been on methadone long enough to be stable meaning your dose should of easily held you over for one day without dosing. IT would suck but the WDs are very mild and manageable if you get any at all. I don’t know I just find so many things in your post that confuse me about how you went about things and your actions. Im not saying you are lying or anything like that I just don’t understand why your clinic didn’t tell you all these things. I mean my clinic you learn all of this in a mandatory orientation group.

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PostPosted: Thu Dec 22, 2011 9:46 pm 
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Bboy42287 wrote:
As of this post I find it very interesting that you didn’t know that taking suboxone while on methadone can and is very dangerous, I mean my clinic stamped this into our brains. And every clinic gives each patient a card with medications you cannot take on it that is to be kept in your wallet in case of an emergency and you are unable to communicate and suboxone is on that card. Also being on a dose of 160 I take it you have been on methadone long enough to be stable meaning your dose should of easily held you over for one day without dosing. IT would suck but the WDs are very mild and manageable if you get any at all. I don’t know I just find so many things in your post that confuse me about how you went about things and your actions. Im not saying you are lying or anything like that I just don’t understand why your clinic didn’t tell you all these things. I mean my clinic you learn all of this in a mandatory orientation group.


Well I should hope not (you calling me a liar and all) because I would have no reason to lie about any of this. What would I have to gain? I am new to this forum so I guess I assumed that you all like the forums I visit often knew more of my story than I have told. I became a forum poster because of several reasons and my full story has been posted like I said on a different forum. I have been on methadone o little over two years and although it would seem I have had plenty of time to be on a stable dose, I am not. I attended a very poor excuse for a clinic for the first right at two years and to be honest due to this I and many others have suffered in many ways more than just not realizing the consequences to in taking a suboxone while on methadone. But I will begin there with how I did not know about this so, number one: It was on my admit paperwork I signed but I was never supplied a copy after I signed it all at admit to find out later I should have requested a copy so I could have reread it all when I became a little more responsive to the do's and don'ts which were contained in all this paperwork. I just wanted to get admitted and stop feeling so bad. Number two: I was never supplied a wallet card although when I did transfer clinics I have one now, plus a copy of my admit paperwork as this time around, I knew a little more than the first clinic admission therefore, asking for copies to everything I signed. And most importantly and surely the biggest validation of me "telling the truth", Number three: I would never had put myself through such hell had I known, had a wallet card etc., I would have found a different avenue other than suboxone, because despite what maybe being told or in text books it was the sickest I have ever been (although I am sure the stone in my gallbladder duct helped in exacerbating the situation.) With that being said Not "every Clinic gives wallet cards to carry just in case” When I found out about the wallet cards, after I got to the other clinic, I told a friend to see if her counselor at the old clinic would give her one and that's when I found out they did not give out cards it is all spelled out in the admission paperwork. Oh and yeah there was no mandatory orientation group or even a non mandatory orientation group at that clinic or...the one I go to now.

QUOTE: Also being on a dose of 160 I take it you have been on methadone long enough to be stable meaning your dose should of easily held you over for one day without dosing. IT would suck but the WDs are very mild and manageable if you get any at all. I don’t know I just find so many things in your post that confuse me about how you went about things and your actions. Im not saying you are lying or anything like that I just don’t understand why your clinic didn’t tell you all these things. QUOTE

I have not reread my post but I think I did say that my clinic was going to be closed for several days as the day that I missed, was a day they had given everyone 3 snow days of methadone other than that day too so really I was missing out on four days so that is really where my panic was because I did know that one day might be uncomfortable but...four days was really scary to me And any information I have ever received from anyone I have been told maybe not day one but day two three and four would have been immortal hell. Not been there thank god but I was going on what I had been told and so therefore my fear level was coming from there more than just the one day. And...I was thinking the hospitals would do just what they did and discriminate on the very fact I was a methadone patient. But moving on now to dose of 160 being a stable dose, now here is where I had failed to fill in the blanks on this forum as this alone is the very reason I ever turned to forums and the very fact I went to a terribly ran clinic and had to find out somewhere, somehow what maybe I could do or who I could turn to with the information I had. So this just being one very small part of my problem and many others problems with the "clinic number one" we will call it. Real short version. I was admitted into this clinic and upon my assessment and exam I was told I could increase to 160 mgs and if I were still unstable or suffering cravings or withdrawals we would reconvene. So I get to 160 and still have the stomach cramps with diarrhea and nausea, goosebumps, hot and cold flushing, runny nose, sneezes and yawns so and so on around midnight or so nightly. It is required to increase beyond that point to have a Peak and Trough and EKG to increase. NO EXCEPTIONS I WAS TOLD. Well they tried to do the trough part of the test three times within 15 months and we never made it any further with that part because I have a condition with my veins where I am not just a "hard stick" I am an almost impossible stick. (When I am in hospital setting I alwats have IV shunts placed in my clavicle area of my neck) At my admission they had written off me having admitted blood work because they could not get it. But anyways on these three attempts I was stuck 11 times, 9 times then 13 times (I am sure you are questioning the rule three attempts then nurses are not suppose to try anymore, but my necessity to have one over rode that and I gave verbal ok to keep trying) The nurses gave all kinds of reasons not to try anymore they were looking into sending me to a lab but kept failing to get the info, counselors sucked as well. And....NO ONE CAN GET PASS THE COUNSELORS AND/OR NURSES TO DOCTOR OR DIRECTOR and I myself found it best sometimes to let it alone cause I was afraid of going over anyone’s head and the repercussions being stout (which eventually I did suffer some of these) I often just gave up for a while. Plus....I had a whole other complication that made matters worse that the nurses told me would totally jeopardize me being a Methadone client I had QTC Prolongation 540 so at times I would leave it alone as to not rock the boat on that. In fact the ALPHA NURSE had told me I would have to do suboxone instead of methadone (which they did not administer) if I kept making a fuss to increase and I did not want to do suboxone. I did suboxone two times before it was even known about by the general public 12 or so years ago in Florida in a detox facility. And...I was panicked I could not afford it my addiction had ran my husband and I both to the poor house. But anyways a new doctor came on board and wanted to check some charts thank god and mine got pulled for a mandatory Peak and Trough (which I have heard are ineffective but nonetheless this clinic believes in them) and so despite the nurses upheavals and refusals to draw the blood I got one and the doctor said my numbers shows me to be an extremely fast metabolizer and put me on split doses with increases. BUT I PAID HELL BY THESE PISSED OFF NURSES WITH CONSTANT BOTTLE RECALLS, UA's ETC....He also did physical exam at two points, during a peak point and during a trough point and still agreed to my withdrawals and unstabled state. I'm not sure but I think that covers at least the uncertainties you questioned in my post. I know it would be great if all clinics followed a standard of care such as the one you speak of about some things the clinics should and usually do, but this clinic does not stand tall in standards of care being good and/or even adequate. Thanks to forums or at least the ones I have visited to date I have learned a lot of the do's and don'ts and now when in doubt I ask unlike I didn't do in the beginning. Oh yeah btw, Thank You for giving me the info on the methadone blocking/not blocking. This is why I enjoy sharing on forums because eventually someone will make sense to a matter/subject that either I am confused, misinformed, or ignorant thereof. Is there any way to figure and/or calculate what might help someone in pain relief that is on 190 mgs of methadone and in acute pain from kidney or gallbladder stones? I am sure if this happens (and it will as I get kidney stones every few years for the past thirty or so years) no one will listen to the "drug seeking addict" laying there in pain. But just in case I were to be able to have another angel of a doctor like the one I spoke of in this post or atleast one that would listen to the rationale. Someone on another forum told me a thousand millileters or milligrams (not sure which will have to find the post) of morphine but wow could that be true and even possible? Of course that doctor hlped me out last time, but I fear such being a random act.

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PostPosted: Thu Dec 22, 2011 11:26 pm 
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Tonya Baldwin wrote:
Bboy42287 wrote:
As of this post I find it very interesting that you didn’t know that taking suboxone while on methadone can and is very dangerous, I mean my clinic stamped this into our brains. And every clinic gives each patient a card with medications you cannot take on it that is to be kept in your wallet in case of an emergency and you are unable to communicate and suboxone is on that card. Also being on a dose of 160 I take it you have been on methadone long enough to be stable meaning your dose should of easily held you over for one day without dosing. IT would suck but the WDs are very mild and manageable if you get any at all. I don’t know I just find so many things in your post that confuse me about how you went about things and your actions. Im not saying you are lying or anything like that I just don’t understand why your clinic didn’t tell you all these things. I mean my clinic you learn all of this in a mandatory orientation group.


Well I should hope not (you calling me a liar and all) because I would have no reason to lie about any of this. What would I have to gain? I am new to this forum so I guess I assumed that you all like the forums I visit often knew more of my story than I have told. I became a forum poster because of several reasons and my full story has been posted like I said on a different forum. I have been on methadone o little over two years and although it would seem I have had plenty of time to be on a stable dose, I am not. I attended a very poor excuse for a clinic for the first right at two years and to be honest due to this I and many others have suffered in many ways more than just not realizing the consequences to in taking a suboxone while on methadone. But I will begin there with how I did not know about this so, number one: It was on my admit paperwork I signed but I was never supplied a copy after I signed it all at admit to find out later I should have requested a copy so I could have reread it all when I became a little more responsive to the do's and don'ts which were contained in all this paperwork. I just wanted to get admitted and stop feeling so bad. Number two: I was never supplied a wallet card although when I did transfer clinics I have one now, plus a copy of my admit paperwork as this time around, I knew a little more than the first clinic admission therefore, asking for copies to everything I signed. And most importantly and surely the biggest validation of me "telling the truth", Number three: I would never had put myself through such hell had I known, had a wallet card etc., I would have found a different avenue other than suboxone, because despite what maybe being told or in text books it was the sickest I have ever been (although I am sure the stone in my gallbladder duct helped in exacerbating the situation.) With that being said Not "every Clinic gives wallet cards to carry just in case” When I found out about the wallet cards, after I got to the other clinic, I told a friend to see if her counselor at the old clinic would give her one and that's when I found out they did not give out cards it is all spelled out in the admission paperwork. Oh and yeah there was no mandatory orientation group or even a non mandatory orientation group at that clinic or...the one I go to now.

QUOTE: Also being on a dose of 160 I take it you have been on methadone long enough to be stable meaning your dose should of easily held you over for one day without dosing. IT would suck but the WDs are very mild and manageable if you get any at all. I don’t know I just find so many things in your post that confuse me about how you went about things and your actions. Im not saying you are lying or anything like that I just don’t understand why your clinic didn’t tell you all these things. QUOTE

I have not reread my post but I think I did say that my clinic was going to be closed for several days as the day that I missed, was a day they had given everyone 3 snow days of methadone other than that day too so really I was missing out on four days so that is really where my panic was because I did know that one day might be uncomfortable but...four days was really scary to me And any information I have ever received from anyone I have been told maybe not day one but day two three and four would have been immortal hell. Not been there thank god but I was going on what I had been told and so therefore my fear level was coming from there more than just the one day. And...I was thinking the hospitals would do just what they did and discriminate on the very fact I was a methadone patient. But moving on now to dose of 160 being a stable dose, now here is where I had failed to fill in the blanks on this forum as this alone is the very reason I ever turned to forums and the very fact I went to a terribly ran clinic and had to find out somewhere, somehow what maybe I could do or who I could turn to with the information I had. So this just being one very small part of my problem and many others problems with the "clinic number one" we will call it. Real short version. I was admitted into this clinic and upon my assessment and exam I was told I could increase to 160 mgs and if I were still unstable or suffering cravings or withdrawals we would reconvene. So I get to 160 and still have the stomach cramps with diarrhea and nausea, goosebumps, hot and cold flushing, runny nose, sneezes and yawns so and so on around midnight or so nightly. It is required to increase beyond that point to have a Peak and Trough and EKG to increase. NO EXCEPTIONS I WAS TOLD. Well they tried to do the trough part of the test three times within 15 months and we never made it any further with that part because I have a condition with my veins where I am not just a "hard stick" I am an almost impossible stick. (When I am in hospital setting I alwats have IV shunts placed in my clavicle area of my neck) At my admission they had written off me having admitted blood work because they could not get it. But anyways on these three attempts I was stuck 11 times, 9 times then 13 times (I am sure you are questioning the rule three attempts then nurses are not suppose to try anymore, but my necessity to have one over rode that and I gave verbal ok to keep trying) The nurses gave all kinds of reasons not to try anymore they were looking into sending me to a lab but kept failing to get the info, counselors sucked as well. And....NO ONE CAN GET PASS THE COUNSELORS AND/OR NURSES TO DOCTOR OR DIRECTOR and I myself found it best sometimes to let it alone cause I was afraid of going over anyone’s head and the repercussions being stout (which eventually I did suffer some of these) I often just gave up for a while. Plus....I had a whole other complication that made matters worse that the nurses told me would totally jeopardize me being a Methadone client I had QTC Prolongation 540 so at times I would leave it alone as to not rock the boat on that. In fact the ALPHA NURSE had told me I would have to do suboxone instead of methadone (which they did not administer) if I kept making a fuss to increase and I did not want to do suboxone. I did suboxone two times before it was even known about by the general public 12 or so years ago in Florida in a detox facility. And...I was panicked I could not afford it my addiction had ran my husband and I both to the poor house. But anyways a new doctor came on board and wanted to check some charts thank god and mine got pulled for a mandatory Peak and Trough (which I have heard are ineffective but nonetheless this clinic believes in them) and so despite the nurses upheavals and refusals to draw the blood I got one and the doctor said my numbers shows me to be an extremely fast metabolizer and put me on split doses with increases. BUT I PAID HELL BY THESE PISSED OFF NURSES WITH CONSTANT BOTTLE RECALLS, UA's ETC....He also did physical exam at two points, during a peak point and during a trough point and still agreed to my withdrawals and unstabled state. I'm not sure but I think that covers at least the uncertainties you questioned in my post. I know it would be great if all clinics followed a standard of care such as the one you speak of about some things the clinics should and usually do, but this clinic does not stand tall in standards of care being good and/or even adequate. Thanks to forums or at least the ones I have visited to date I have learned a lot of the do's and don'ts and now when in doubt I ask unlike I didn't do in the beginning. Oh yeah btw, Thank You for giving me the info on the methadone blocking/not blocking. This is why I enjoy sharing on forums because eventually someone will make sense to a matter/subject that either I am confused, misinformed, or ignorant thereof. Is there any way to figure and/or calculate what might help someone in pain relief that is on 190 mgs of methadone and in acute pain from kidney or gallbladder stones? I am sure if this happens (and it will as I get kidney stones every few years for the past thirty or so years) no one will listen to the "drug seeking addict" laying there in pain. But just in case I were to be able to have another angel of a doctor like the one I spoke of in this post or atleast one that would listen to the rationale. Someone on another forum told me a thousand millileters or milligrams (not sure which will have to find the post) of morphine but wow could that be true and even possible? Of course that doctor hlped me out last time, but I fear such being a random act.


I just had oral surgery btw, I received analgesia thru fent, prop, versed.....google the question u asked me, i ain't no bodys beeeotch 8)


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 Post subject: dont take this personal
PostPosted: Thu Dec 22, 2011 11:59 pm 
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but, it sounds like you're very dramatic....if u r sooooo worried about what could happen in the future- taper of methadone and get on duragesic or something....that is if you suffer from chronic pain...i lost track reading your book


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 Post subject:
PostPosted: Fri Dec 23, 2011 12:51 am 
Bboy42287 wrote:
But the fact of the matter is large amounts of short acting opiates can and will be able to bypass your saturated methadone receptors if given in large/extreme amounts, making methadone not a true opiate blocker.


This is also true for buprenorphine.

By this logic, neither buprenorphine NOR methadone are "true opiate blockers."

They both are, though.


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PostPosted: Fri Dec 23, 2011 11:38 am 
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indigochild wrote:
but, it sounds like you're very dramatic....if u r sooooo worried about what could happen in the future- taper of methadone and get on duragesic or something....that is if you suffer from chronic pain...i lost track reading your book


I am not sure how you take a legitimate concern and come to the conclusion she is dramatic. Pain relief is something that concerns us all, whether on bup or methadone.

I would like to thank you for sharing your story, like you said not all clinics are created equal and not all people on methadone know about the dangers of taking sub. You are not the 1st person that has done this and if just one person reads your story that did not know about the dangers of taking sub while on methadone than it is worth it.

It is easy for people in hind sight to say "why did you do that" or "you should have done this" but they were not in your position with what little info you had been given. I too would have been panicked to know I would be going 4 days without and it would have been great if you did everything correctly but in life things rarely work out that way.

Welcome to the forum and I hope you continue to post!


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PostPosted: Fri Dec 23, 2011 1:04 pm 
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I did reread my posts this time to see if I possibly said something to offend either one of you? Maybe I am missing something but I am sorry if I did. I certainly did not mean to. I guess because I am new at posting on forums I have not read between some line and figured out which forum welcomes new people and which one's don't, or moreso I guess which ones you can ask questions on and which ones you can't. Is it because I am on methadone not suboxone? or maybe dranatic people need not post on this forum as yes I can at admit in moments of panic etc....I can be dramatic. I mostly am just a recovering drug addict finding where I fit in the world of recovery because i have tried rehabs, detoxes, abstinence, suboxone and lastly nethadone and finally despite a few gruntled family members have found something that keeps me on a semi sensible path. Sorry I stumbled up on this forum and if there is some reason either of you took a disliking to my post I would think you could just move on to the next post and not be so rude. Maybe I am overstating myself with the word "rude" for BBoy as he didn't actually call me a liar, but.....And...answering a question I might ask does not constitute me making someone my BBeeootch by any means it's a simple as don't answer please as I am sure someone will follow behind a respond to the question. Like I said above in moments of panic I can be dramatic and in my sharing this experience I did not censor it for dramatics, but maybe it might help someone else that might attend a poorly ran clinic and not have all the information they need and my dramatics might make an impression in someone remembering the hell it actually was for me and not make the same mistake as I, like Breezyann have heard stories where others have done the same. Once again if I said something that made me appear to be a liar, overly dramatic and seeking for a bbeeootch sorry, I was sharing my story. Thanks fellow posters that read my post and welcomed me to the forum despite this post, I have found this site to be very thorough and supportive.

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PostPosted: Fri Dec 23, 2011 2:22 pm 
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Tonya - I'm sorry if anyone made you feel unwelcome. I hope you'll stay on the forum to spite that. None of us are perfect and as addicts, well, perhaps we even have more issues? I don't know if that's true, but it's definitely its own subject.

If methadone is what fits YOUR needs, we respect and support you in that. In fact, others on this thread are on methadone right along with you! I'll let them identify themselves for you as that's not my place.

I hope you remain on the forum and keep posting. We're all human beings and have strong emotions and heads do butt at times. It happens to the best of us.

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PostPosted: Sat Dec 24, 2011 12:16 am 
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Im on 170 mgs of methadone.

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 Post subject: yea , I have issues
PostPosted: Sat Dec 24, 2011 12:34 am 
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hatmaker510 wrote:
Tonya - I'm sorry if anyone made you feel unwelcome. I hope you'll stay on the forum to spite that. None of us are perfect and as addicts, well, perhaps we even have more issues? I don't know if that's true, but it's definitely its own subject.

If methadone is what fits YOUR needs, we respect and support you in that. In fact, others on this thread are on methadone right along with you! I'll let them identify themselves for you as that's not my place.

I hope you remain on the forum and keep posting. We're all human beings and have strong emotions and heads do butt at times. It happens to the best of us.

Tonya. As hat said.. I'm bi-polar, schizo, currently on a manic high, dope fiend, in chronic pain, ...sorry, feel comfortable now? (seriously, welcome to the forum, there are many nicer memebers than my manic arse, and methadone isn't a blocker') it's a long answer with tons of info, maybe you could google and share with us?...oh, and about the methadone thingy- I also take a butt- ton of methadone too! :twisted:


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 Post subject: Merry Christmas everyone
PostPosted: Sat Dec 24, 2011 12:27 pm 
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Thanks so much for the responses. No harm here hope no harm there. And....by the way Finallyachance and Tonya Baldwin are one in the same....I realized after I registered that everyone uses nicknames and I did not need my name blaring out there for possibly someone in my clinic(s) to use against me as I also use forum watchdog to post and sure enough someone caught onto who I was. So from here on out I will be logged on as finallyachance. MERRY CHRISTMAS to all and I hope everyone HAS A WONDERFUL NEW YEAR I sure could use a GOOD YEAR.


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PostPosted: Sat Dec 24, 2011 5:14 pm 
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First off i apologize if u felt attacked from my post. My post was not meant to be mean but more so to understand why u did the things u did in that panic. Basiclly your reply to my post waz all i was getting at i wanted to get the facts as to why you choose the route you did. We are addicts we dont know how to think in a panic i can relate to that. But the main thing that gave me reason to question your post was u took suboxone and u r in a meth program. I was wrong bc i thought all clinics aware each patient about drug interactions with methadone especially about drugs related to bup.

I wish you the best have a fun safe holiday and welcome to the family.

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PostPosted: Sat Dec 24, 2011 5:38 pm 
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First off i apologize if u felt attacked from my post. My post was not meant to be mean but more so to understand why u did the things u did in that panic. Basiclly your reply to my post waz all i was getting at i wanted to get the facts as to why you choose the route you did. We are addicts we dont know how to think in a panic i can relate to that. But the main thing that gave me reason to question your post was u took suboxone and u r in a meth program. I was wrong bc i thought all clinics aware each patient about drug interactions with methadone especially about drugs related to bup.

I wish you the best have a fun safe holiday and welcome to the family.

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