It is currently Wed Jun 28, 2017 1:34 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 13 posts ] 
Author Message
 Post subject: Methadone question
PostPosted: Sat Nov 12, 2011 4:52 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
I have a question about methadone and I am hoping someone here can help explain why this would happen. As you may have read there was a girl in my home town that relapsed on methadone and died. She got it from a friend (he actually used to be my sisters best friend growing up) that had been on methadone maintenance for at least a year and a half but maybe longer. He has had take homes for a while and for at least the last year has and is still prescribed 240mg a day!

My question is why would someone be prescribed that high of a dose and for that long?. He is not a pain patient and he is young, only 23. I just don't understand how it would benefit someone to be on that high of a dose and to me it seems they are just giving him a legal way to get high. That is why I am asking this question because I could be wrong. I understand people with pain requiring a higher dose for a long time or even for life but to me this just seems it would do more harm to an addict in recovery than good. Thanks in advance!


Top
 Profile  
 
 Post subject: Re: Methadone question
PostPosted: Sat Nov 12, 2011 10:50 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Fri Mar 12, 2010 12:43 am
Posts: 1019
Location: Buffalo New York
Breezy_Ann wrote:
I have a question about methadone and I am hoping someone here can help explain why this would happen. As you may have read there was a girl in my home town that relapsed on methadone and died. She got it from a friend (he actually used to be my sisters best friend growing up) that had been on methadone maintenance for at least a year and a half but maybe longer. He has had take homes for a while and for at least the last year has and is still prescribed 240mg a day!

My question is why would someone be prescribed that high of a dose and for that long?. He is not a pain patient and he is young, only 23. I just don't understand how it would benefit someone to be on that high of a dose and to me it seems they are just giving him a legal way to get high. That is why I am asking this question because I could be wrong. I understand people with pain requiring a higher dose for a long time or even for life but to me this just seems it would do more harm to an addict in recovery than good. Thanks in advance!



Honestly Breezy it all comes down to the clinic you are attending.

_________________
Yes these drugs saved our life's. But does that mean we have to give the rest of our life to these drugs?


Top
 Profile  
 
 Post subject:
PostPosted: Sun Nov 13, 2011 12:15 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
I understand all clinics are not created equal. I guess what I was trying to ask if you think this is a super high dose for a non pain patient? To me it seems so but like I said I know little about methadone. I worry that his treatment may be causing more harm than good. He is not serious about recovery and is completely using the methadone to get high. He also continues to use other drugs. It just seems to me that this clinic is helping an addict to get high. I do not think methadone is bad and it helps lots of people. I just think this is a bad situation and would like your take on it.


Top
 Profile  
 
Our Sponsors
 Post subject: MG DOES NOT MATTER!
PostPosted: Sun Nov 13, 2011 1:39 am 
I was on 240mg of methadone for years in a maintenance program setting. It is a high number (notice how I didn’t say dose?!), but in maintenance settings, dosages are increased by only 5-20mg at a time, so tolerance develops very quickly. It is much more typical for chronic pain patients getting methadone tablets through physicians/pharmacies to be on lower dosages than MMT patients. To be completely honest with you, like I said I was on that exact dose for years and was completely tolerant to the dose, as in I functioned completely normally and was not the least bit intoxicated. I have had doctors tell me when I was able to document that I was on the dose at the time tell me that it was impossible and that I would have to be completely intoxicated if I was actually taking it, but they obviously didn't understand tolerance. One nurse couldn't enter that high an amount in my primary care DR's computer, the computer kept telling her it was an error! I wasn't able control pain I was having at the time through MMT because of the once-daily dosing factor, so I eventually started getting it in pill form through my Dr, who wouldn't keep me on that high of a dose for very long because of the amount of pills he had to give me monthly (I was taking 24 10mg pills daily when I got it in pill form) and tapered me down a bit and eventually switched me to MS Contin and OxyIR. Like I said, on Methadone I wasn't intoxicated UNLESS I took benzodiazepines or Soma with it, which I did almost daily for the last year or so I was on it and it was at that point, in that cocktail, the most intoxicated/non-productive time of my life.

MMT is a long-term to indefinite maintenance therapy as well as detox therapy and at a dose of 240 it's more than likely a very long-term maintenance thing, so why would it be unusual that this person is on it for years? It's the same as saying "Someone is on 24mg of Suboxone for 2 years" in a negative context. Mg is pretty meaningless. At one time .4mg of Buprenorphine was standard and 2mg total daily dose was an almost unheard of.

Sounds to me like this guy was in a dark spot in his recovery if he was willing to dole out methadone to people who are in a position to OD taking it. He's more than likely not getting high himself off ANY dose of methadone, though, unless he's mixing it with other sedatives. The whole thing is very unfortunate!

-Travis


Top
  
 
 Post subject:
PostPosted: Sun Nov 13, 2011 6:35 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
Thanks Travis, like I said I know nothing about methadone so thanks for explaining. Yes he does mix it with other drugs, the day after the girl OD'd he took so many somas that he had to be rushed to the hospital. Also i know he is still using other opiates, so maybe he skips days and takes extra other days? He does not hide the fact that he is still getting high and I wondered if it was normal for people to be high on 240mg. Thanks for the info!


Top
 Profile  
 
 Post subject: tolerance
PostPosted: Sun Nov 13, 2011 7:55 am 
Offline
6 Months or More
6 Months or More
User avatar

Joined: Thu Sep 10, 2009 8:38 am
Posts: 211
is a key issue, like travis said. Honestly, I don't know how much I have to offer, but feel compelled to type something, since methadone has been a big part of my life- recreationally, MMT, and finally for chronic pain thru a PM Dr.

Ok, when I was 18 yrs old I went to a shrink for the first time. He gave me Xanax at 18- How could I not like this dude! ... at the time, I was a soon-to-be undiagnoised bi-polar patient. I went to see him for depression and anxiety. It's no bull, I self medicated my anxiety with budweiser and my 180 1mg xanax script (initial script, first visit). So here I was, a young kid with a shit-ton of footballs, beer, and a few ms-contin 100s that fucked me up. I bought these for 30 bucks a peice and was taking 1 every other day/ po

I embelished my opioid problem to my shrink and he sheepishly suggested a methadone clinic. hrrrmm, I thought, whats a methadone clinic!!!?? my shrink saw hunger in my eye and tossed that idea quick- probably wishing he never mentioned it to me

next morning @ 5:00am: like a good junkie in training, I went to our local clinic non opioid-tolerent and they started me @ 40mgs (docs orders anyway, right!). I was high as a kite! I still remember the liquid hitting me ten minuts after I drank it like it was yesterday. It was dope (for 6 bucks) every morning for 3 weeks- until I'd go on oxy benders. I was learning at this point methadone has a cross-tolerence....so I'd go off the little 40-50/mgs that got me RIPPED daily onto 80 ocs. I'd abuse the clinic; only going when i was dope sick-back and forth, back and forth


Ten years later, on the other side of the coin- I barely have any veins and check back in the same clinic (28yrs old?). This time I was serious about MMT. I thought I'd be a 'lifer' . I went to the ceiling dose of 200mg and was PISSED because it's one daily dosing. I'd be in WDs before the 24 hours and would NOT sell A MILLIGRAM to ANYONE! that was the difference between 18 and 28. The clinic feed my addiction (safty net) and I had no place being there @18... when i was 28 with collapsed veins, strung, on the verge of death...yes, it was a godsend...I would envy the high people, the women in there for hydros, the zit- faced non opioid -tolerent 18 yr old faggot that made the line longer....

Pertaining to your question, methadone affects everyone different. It's a great, funny, strange, evil, drug- pending who you ask . I hate to say 'hard-core', but the women demagraphic that come into methadone for 7? loratabs/day and have a dose of 100 mg/day is just a slip in the cracks. people will not be adequatly treated or either will be wasted- nodding off everyday, all day

like bboy said, every clinic is different, and like travis said, tolerance!

methadone clinics are not air tight and have many leaks- for someone like me (now), they blow- but, there will always be a fond place in my heart for this drug.

*I hope my rambling made some sence...it might be too confusing now that I look at it


Top
 Profile  
 
 Post subject:
PostPosted: Sun Nov 13, 2011 11:05 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
Thanks Indigo, that actually was a great answer to my question. I was more curious to know if there were some procedures in place to stop the people that are not in recovery and looking for legal drugs. There is a rumor floating around that this person had gave methadone to another guy a few months back and he also OD'd. I have no idea if its true or not. Do you think with what happened that the methadone clinic would be wary of giving him that much?

I know an addict is going to use no matter what and that ultimately it is not his fault but I also feel like him having this much methadone on him is a danger. He obviously doesn't realize how dangerous it can be for others or just doesn't care. I am hoping this death woke him up, he tried to commit suicide the day after.

I guess the 2nd part of my question is, how can it be ok to let an addict take that much home with him? I know he gets at least a 2 week supply at a time but it could be more now, (that was like 6 months ago).

I was also taking the opportunity to learn a bit more about methadone. I appreciate you sharing your story and am glad you and Bboy have found so much help thru it.


Top
 Profile  
 
 Post subject:
PostPosted: Sun Nov 13, 2011 3:03 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Fri Mar 12, 2010 12:43 am
Posts: 1019
Location: Buffalo New York
Yea Indigo and Travis have hit every point just about and done so very well i might add.

Well Breezy to the second part of your question. You have to understand if he is getting a two week supply that means he wont be in the clinic for that time. So that gives him more than enough time to use illegall drugs for a full week. Than clean up get those meds out of his system go back on the methadone. He goes in takes a drug test passes with flying colors the clinic would not see this as a danger at all, actually the complete opposite they would see him as a modle patient. Bc they have no idea what he is really doing. At one point he prolly took his meds properly and built up trust with the clinic so they would have no reason to consider him a danger to anyone including himself. And the procedure you are wondering about is drug testing but one thing you have to understand is there are hundreads of people who go in and out of that clinic every single day, so they cant keep track of everyone and like indigo said they just slip through the cracks. Get increase after increase next thing you kniw you are on 200 plus mgs. At the end of the day to most clinics you are just a number with a dose that is sad but thats how it is.

BUT not all clinics are bad, now a days new patients are kept on much lower doses and so forth.


PS
One thing i just want to point out is methadone is very strong and must be taken in small doses till you build up a tolerance to it. But even a addict shhoting a bundle a day of pure china white would noy be able to take 240 witout getting very sick. Even half of that would be to much for a person who is not use to this drug.

_________________
Yes these drugs saved our life's. But does that mean we have to give the rest of our life to these drugs?


Top
 Profile  
 
 Post subject:
PostPosted: Sun Nov 13, 2011 9:00 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 15, 2010 5:08 am
Posts: 1503
The first time I went on methadone I started on 30mg. I was about 20 years old, and my tolerance was quite low. Admittedly, I just wanted to stop using heroin, yet remain nicely buzzed.

I actually puked the first day or two from its intensity. It was the first time I'd taken an agonist by swallowing it though, so perhaps my gut wasn't used to it. But I was quite baked. By two weeks into treatment I had stabilised, and wasn't feeling stoned in the slightest, but I liked that feeling, so I asked to have my dose increased at my monthly appointments. I slowly creeped up to 90mg that time.

Methadone isn't too different to buprenorphine in some ways. I've found that when I raise my dose of both drugs, I can feel a bit stoned and it fades away over a week or so. The difference b/w methadone and buprenorphine IMO is that with methadone, that high feels more intense. Also, I felt more urge to increase my dose on methadone.

I've seen people increase their Sub dose to feel high as well. In my country, Sub costs the same no matter what dose, so more people wander around on 32mg "because they can", and while they look pinned, they don't look "washed out" like the methadonians.

The other reason a non-pain user would be on a high dose would be because of their tolerance. Tolerances in addiction vary so much. Early in heroin addiction, most people only need 0.05g of white or less. I've seen people need 3+ g of the same gear in one hit. Tolerances just vary wildly.

While you can overdose on buprenorphine, and it's ugly, it's rare for it to be fatal. When methadone's abused, it's just as deadly, if not more, than heroin. Methadone overdoses require being on a naloxone drip and to stay in hospital for 24-48 hours. Heroin overdoses can be treated on site with one shot of naloxone.

Unfortunately, the only thing that can be done to save people from overdosing on relapse is drum some awareness. We can't stop people relapsing, nobody could ever stop me! People gotta know that relapsing is one of the riskiest times for overdose, and their hit / dose should be adjusted accordingly.


Top
 Profile  
 
   
 Post subject:
PostPosted: Sun Nov 13, 2011 10:36 pm 
Offline
6 Months or More
6 Months or More
User avatar

Joined: Thu Sep 10, 2009 8:38 am
Posts: 211
Breezy_Ann wrote:
Thanks Indigo, that actually was a great answer to my question. I was more curious to know if there were some procedures in place to stop the people that are not in recovery and looking for legal drugs. There is a rumor floating around that this person had gave methadone to another guy a few months back and he also OD'd. I have no idea if its true or not. Do you think with what happened that the methadone clinic would be wary of giving him that much?

I know an addict is going to use no matter what and that ultimately it is not his fault but I also feel like him having this much methadone on him is a danger. He obviously doesn't realize how dangerous it can be for others or just doesn't care. I am hoping this death woke him up, he tried to commit suicide the day after.

I guess the 2nd part of my question is, how can it be ok to let an addict take that much home with him? I know he gets at least a 2 week supply at a time but it could be more now, (that was like 6 months ago).

I was also taking the opportunity to learn a bit more about methadone. I appreciate you sharing your story and am glad you and Bboy have found so much help thru it.


Bboy said it: he's played the system...he's taken his medication (supervised) and has clean UAs. model patient, right- wrong, he is on such a high dose and is trusted with so many take homes, he can take less and sell some. Trust me, he isn't going to be the slightest bit sick from selling a few 40mg wafers...happens all the time...like, tearjerker said, methadone can plain kill and is much , much, much easier to OD on than bupe.

Of course this death affected your buddy if he tried to commit suicide. No brainer. It's not air tight and has many leaks. Methadone is a unique drug too. Diversion of suboxone is likley not to kill but methadone.....look up peak and trough levels- it should give the Dr an accurate reading od the blood or plasma levels and how that individual metabolizes the drug. my clinic wouldn't let anyone rise over120mg with out the peak and trough blood test.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Nov 14, 2011 11:06 am 
MMT is obviously going to vary from state to state if not clinic to clinic. Indigo brings up a good point about peak and trough tests though. When I was first in MMT, it was very unlikely anyone would get above a certain doses (at the time the definition of this dose was 100mg or so) without getting regular peak and trough tests. If someone was a fast metabolizer/needed split dosing or a high (over 120mg) dosage, they were going to have to go out of their way to get peak and trough tests, that was a given. Today, though, around here I don't really see that happening; it used to be MMT patient lingo, now very few people except those who were in MMT programs in the 80's-90's know what they are. Any of you new methadone guys/girls around here know what we're talking about?


Top
  
 
 Post subject:
PostPosted: Mon Nov 14, 2011 12:02 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 21, 2011 10:43 am
Posts: 893
Location: AZ
I guess this is just another example of govt having double standards and their procedures make no sense. Sub prescribers are only allowed a 100 patients at a time and like was stated above an od will really suck but sub od on its own is not fatal. Methadone clinics as far as I understand can see a revolving door of patients and can absolutely be fatal if overdosed.

It seems to me that if a patient cap was going to be enforced anywhere (which I don't believe the govt should ever tell a doc how many patients they can handle) it would make way more sense with methadone. It would also seem to me that it is just irresponsible to give that much methadone to an addict to take home. They couldn't control their opiate intake prior so I would assume a lot of addicts would have a hard time controlling that much methadone.

I thank you all for your info and experiences. I feel I know a bit more about how methadone clinics work.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Nov 14, 2011 4:40 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Fri Mar 12, 2010 12:43 am
Posts: 1019
Location: Buffalo New York
Breezy_Ann wrote:
I guess this is just another example of govt having double standards and their procedures make no sense. Sub prescribers are only allowed a 100 patients at a time and like was stated above an od will really suck but sub od on its own is not fatal. Methadone clinics as far as I understand can see a revolving door of patients and can absolutely be fatal if overdosed.

It seems to me that if a patient cap was going to be enforced anywhere (which I don't believe the govt should ever tell a doc how many patients they can handle) it would make way more sense with methadone. It would also seem to me that it is just irresponsible to give that much methadone to an addict to take home. They couldn't control their opiate intake prior so I would assume a lot of addicts would have a hard time controlling that much methadone.

I thank you all for your info and experiences. I feel I know a bit more about how methadone clinics work.


Breezy I understand what you are saying 100%. Who in there right mind would give a addict that much methadone to take home. But to his clinic he is no longer a active user/addict, he is now an addict in recovery in an opiate replacement program. So what im trying to say is he is not a drug addict to his clinic but a recovering addict who is doing great with that dose of methadone. Sure you know the truth but methadone DRs are not on the streets or know whats going on. They only see him or her passing drug test for said amount time. Doing what they r suppose to do and thats that.

And to other part of what you said its is the samething as suboxone in a sense. You first start out seeing the sub DR every other week. As time goes on you seem steady and are doing well now you only have to come once a month and so on. BUT this is were methadone is much different and this will def help you understand a lil better. You have to realy really earn take homes, im talking months even years for some people so this kid started out with sunday TH, proved he could do that now he gets weekends an so on. So he at one point passed a weekly drug test for months before he got sunday take homes. And than continued to do well and passed all his test to earn two weeks. So he did really good for a long time at his clinic meaning they have no reason to think one its dangerous two he cant handle them.

If you really wanted to at the end of the day. You could find out which clinic he goes to call and tell them whats going on.

Travis i dont know if i had that test but i had to go get blood work done before i could go above 130. I am now at 170 and that is bc the severity of my injuries/tolerance to opiates.

_________________
Yes these drugs saved our life's. But does that mean we have to give the rest of our life to these drugs?


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 13 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group