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 Post subject: Methadone Issues
PostPosted: Thu Dec 27, 2012 10:54 pm 
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Hi all,

So I'm going to try to keep this as concise as possible. I have been on MMT for 40 days now to get off my extreme addiction to the high quality heroin in my area and had a huge tolerance going into the clinic. I started at 30mg and found a comfort zone at around 90-110mg and I dose at 110mg currently each day at 6am. However, it barely holds me for the 24 hours between doses, I feel normal and relieved within 30 minutes of dosing but within about 3 hours I'm so utterly tired and I sleep a lot on days I don't work, then don't sleep much at night, get up early to dose, and it's an endless cycle.

I don't have any symptoms of my dose being too high and in fact until I got to 85mg I still had extreme cravings so those have at least gone away but when I wake up at 5am I have upset GI and feel like I need a fix. I really don't want to keep increasing my dose because people say it's bad but also know that I plan on being in maintenance for at least 18 months so this is a long-term thing I've got going here. I've been totally clean of illicits and stopped using heroin completely. My MMT is successful but I've had to work pretty hard to keep it that way.

I just don't know what to do about being so damn sleepy every morning. I was on MMT once before about 2 years ago and had a much lower tolerance. I started on 40mg that time and had euphoria almost all day and know what that's like, this time around I have a much higher tolerance and have had to increase up to over 100mg now just to hold me and feel ok. I function great at work, but on days off like today, I hate it and almost go insane. My clinic doesn't offer split dosing and it's only been open for about 2.5 months but has over 50 patients active. Their highest dosing patient is at 165 so I feel horrible as I approach that number. I want to make sure my dose is at the right number for the right reasons and I feel absolutely no euphoria after dosing, no itching, no consipation like my last time on MMT....I just get super tired is all. Any advice would be great and I'm going to have a talk with the nurse there in the morning.


Thanks so much.
-cw


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 Post subject: Re: Methadone Issues
PostPosted: Fri Dec 28, 2012 1:29 am 
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cwake18 wrote:

I just don't know what to do about being so damn sleepy every morning. I was on MMT once before about 2 years ago and had a much lower tolerance. I started on 40mg that time and had euphoria almost all day and know what that's like, this time around I have a much higher tolerance and have had to increase up to over 100mg now just to hold me and feel ok. I function great at work, but on days off like today, I hate it and almost go insane.



What do you do for work?? is it physical??

I work a physically demanding/manual labor job, and although Im not on methadone, (I once was!! 3+yrs)
If i don't DO SOMETHING,, I'm tired ALLLLLL DAY.

It could be just that simple, especially if you feel "fine" at work, or on days you do work.......
the ideal thing, OBVIOUSLY is to get a FULL NIGHTS SLEEP
lots of people have found good relief with melatonin,,,,
(to sleep at night, and STAY asleep)
it's natural and non habit-forming.........

maybe try excersising a bit, in the morning, maybe an hour after your dose... see what that does,
I know it makes ME feel better/less tired...
the human body is strange machine, that's for sure!!!

its funny that I used to sleep ALL THE TIME, on pills/heroin, but NOW, I work like DOG, and only sleep 5-6 hours a night, but
that's a ""Full night's sleep"" for me,
any MORE sleep than that, and I'm USELESS.....feel like I have a hangover or something!!!

anyways,
I hope I helped, I don't know that probably isn't the answer your looking for........
but I did try :wink: :wink: :wink:


hang in there, you sound really determined, and like you have a great plan in place :wink:

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PostPosted: Fri Dec 28, 2012 5:12 pm 
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I have been on methadone almost two years now and my dose is 170mgs. Don't get caught up in the numbers you have to find the right dose for you. Shit if that's 200+mgs so be it but if you let the number scare you than you'll always have to deal with certain side effects because you arent on high enough dose. You need to keep busy so on those days you don't work start doing healthy activities for example start working out, get together with sober friends or family and so on. As of your dose not lasting long enough between try not dosing so early sleep a extra hour or two and try dosing at 9 for a change. I take my dose as late as possible to last through out the day and sure things are not great in the morning before my next dose but they are manageable. Methadone is like any other medicine you have to tinker with your dose till you find what works best for you. And methadone has a long half life so you should feel to sick in between doses and the fact you are is your body telling you this dose is not high enough.

Hope this helps feel fre to pm me any concerns or questions!

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PostPosted: Sat Dec 29, 2012 3:11 pm 
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Listen to Bboy regarding not getting caught up in numbers. 'Some people think that being over Xmg is bad..' I personally think that you're doing an injustice to yourself by not getting the full benefit out of MMT. I have a history on Methadone myself and was at 240mg daily for years; I ultimately got off that dosage and have not been on methadone in many years so getting off it/switching to something else is possible at any dosage.

It's really important as a patient in a MMT facility to be honest with the dosing nurses and your counselor about how you're feeling and how well your dose is holding you. Procedure for getting a dosage increase is your counselor putting in a dose increase request and most everywhere will increase by 10mg every 3ish days until you reach point of stabilization. By the way, 110mg is really on the lower end of where I typically see people maintained and doing well for long periods of time. I would say that 80-150 these days is pretty average but people fall on either side of these numbers; MMT should be totally individualized...Best of luck!

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PostPosted: Mon Dec 31, 2012 8:16 pm 
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Thanks for all of the replied guys I really appreciate it.

You're all right about not getting caught up in the numbers, I really shouldn't. However, my clinic has only been open for about 3 months and so they're not used to having patients on high doses yet (besides the handful of us that are over 100 and the guy that's on 165mg). I kept increasing by about 10-20mg per week until now I'm at 115mg and I still just don't feel right. Now since I've gotten over 90mg the nurse almost gives me this weird look when I ask for an increase because I'm only 21 years old and maybe they think I can't handle it or something. But even the nurse told me "everyone is different, your dose is between you and the doctor. I have a patient here on 25mg and one on 165mg." I think I just need to keep requesting my increases until I'm truly in the right zone. I had a big habit of very high quality heroin and I was on suboxone for a bit which shot my tolerance up as well. I am not using any drugs at all by the way, not supplementing my methadone dose at all. But something I've noticed is that I crave my next day's methadone dose barely 8 hours after I've dosed that day. Today was bad. Within 3 hours of dosing it had completely worn off and I just went to sleep for 5 hours.

It's depressing. I don't know if it's because of my age or what but now that I'm over 100, the nurse and my counselor both are kind of weird about continuing to submit increase requests to the doc for me, but I don't care. I've read on several sites now including this thread that go along with what you're saying. I agree that the maintenance range these days is around 80-150 for successful patients. I don't know what the right dose is for me yet, but last time I was on MMT, once I got on the right dose, I didn't crave and anticipate my next dose as much as I do now. I'm always at the clinic the minute they open, every day. So that's firming my belief that I'm just not there yet, and I think I need to stand up for myself a bit and just be up front with the dosing nurse that I have to do the COWS sheet and increase form with. "Look, I'm not there yet, and I don't know when I will be, but I had a huge habit so bear with me."

Like I said, I get NO euphoria. At all. And I have NO side effects from high dosage like itching, nodding, constipation, etc. My COWS sheet always puts me in the "moderate withdrawal" grouping. When I was at 110 and requested for increase and scored into "moderate WD" the doc increased me by 5mg after I had been on 110 for a week. That's a 4.5% increase, where a 10mg boost to 120 would've likely carried me further and been a 9% increase which is much better. I just think it's silly that the doctor is inconsistent with his increases. When starting he let me go 30-40-50-60-70, then only up 5 to 75...then 75-85-95-100-110, and finally 115. I need to talk to the nurse and share with her some of what you guys have said. Indeed everyone IS different. If I was on too high of a dose, my parents would be calling my counselor asking why I'm nodding out or slurring my words. But none of that happens. I feel UNDER-dosed yet I'm afraid to say because the staff seems weird about increases now that I'm over 100, but screw it. I'm just going to keep asking and hoping that they help me out with 10mg increases instead of wasting my time with 5mg increases as we're only allowed to increase a max of twice per week, usually on wednesday and saturday. If I switch to disket dosing, they only go up or down on your dose in 10mg increments because the disket pills are only divisible in 10mg segments so the doc would be required to go up by 10 if I request an increase technically. But whatever. Any other advice is greatly appreciated. I felt so off today and like my dose just isn't serving me right. I dosed 12 hours ago exactly and I got a take home for new year's day and I'm already obsessed about my next dose in the morning, but I won't break into that bottle early because I follow the rules.

Thanks again for the input and taking the time to read. This has been frustrating me so much and I just wanna have a normal day where I feel like my dose is serving me good and I can be like the normal people in MMT that hit their target and sit on that dose for 2 years. I want to be THERE. :)

Thanks again,
-cw


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