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PostPosted: Sat Apr 28, 2018 11:29 pm 
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I didn't really know where else to put this, given the methadone forum is for maintenance and not reduction.

I'll post my experiences on my methadone reduction here. I do my first drop (30mg -> 25mg) this week coming.

Fun times ahead!


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PostPosted: Sun Apr 29, 2018 1:24 pm 
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Thanks Teejay. For others, understand that methadone and buprenorphine (and other opioids) are by definition 'cross-tolerant', so there are many similarities when coming off either one.

Teejay, I've work in a methadone program for the past few years in addition to my buprenorphine practice. I don't know if you're tapering after being on methadone for a while, or if you are using methadone to detox. In the latter, people are placed on around 30 mg of methadone and rapidly tapered off. But after longer periods on methadone, people generally tolerate reductions of 5% every 1-2 weeks. Going from 30 to 25 mg is almost a 20% reduction, and most people would have discomfort after decreasing that much.

For people on buprenorphine, remember that your brain does not care what pushed your tolerance higher. There is NO truth to the idea that one opioid is easier to stop than another, other than the effects of a medication sticking around a bit longer - which extends the time by a week or two but lessens the peak intensity of withdrawal symptoms.

When people stop either, I shoot for about 5% reduction every 2 weeks. That pace can usually be maintained for weeks or months. If you go faster, you will likely need to pause now and then and let tolerance catch up to the reduction in dose.


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PostPosted: Fri May 04, 2018 7:34 am 
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Thanks Dr J.

I've been on methadone maintenance since late December 2017. I only started my reduction this week.

I'm doing this little known thing called a "blind reduction", which means I have no idea when my dose is dropped. They even didn't tell me when they started my reduction. I only have a gut feeling (literally) that I've recently had my first reduction. And the main way I can tell is that I have to run to the bathroom more than usual in the mornings. Heavy emotions come up too prior to dosing after I wake up in the morning

I have the feeling they're dropping me 5mg until I get to 15mg, then I'll be doing half ml reductions (2.5mg) weekly until I'm off. That's the regime most people in my reduction program are doing.

This is the program:

Quote:
M.A.P is a unique innovative program developed for the clinic by the counsellors who have had over 30 years experience in drug and alcohol treatment. It has been developed for those clients who wish to achieve abstinence through support groups such as Narcotics Anonymous.

M.A.P is an intensive program involving weekly counselling, in house groups and NA meetings. Participants are introduced to the 12 step model of drug free living which requires a high level of commitment. To support them with this choice, they are provided with free treatment during an agreed period of time. As well as access to 12 step groups, M.A.P clients are supported through their reduction regimes and learn to understand better the nature of addiction in their lives. Groups range in theme from group sharing, relapse prevention to education.

At any time in their program of reduction clients may slow down or adjust their levels to better cope with the changes in lifestyle that occur with such an intense program. Different assistance is provided so that should they require a selective detoxification admission or access to a rehabilitation program then this can be arranged. M.A.P has an ongoing successful relationship the WHO’S MTAR methadone rehabilitation program.
M.A.P is a unique program that to the best of our knowledge is the only one operating in Australia.


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PostPosted: Wed May 09, 2018 11:17 am 
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Good luck, TeeJay! I hope it goes well!

Amy

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PostPosted: Wed May 16, 2018 6:39 am 
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Thanks all.

The reduction is going quite well. The fact I don't know when they're doing each drop is really helping.

However I'm processing some of the things that caused me to relapse, namely this:

https://www.foxsports.com.au/afl/merv-keane-on-open-mike-richmond-champion-opens-up-on-traumatic-month/news-story/8488a47f3577569bb822874d4ffd4b8a?nk=d3515f4a4aee8d70fedc055ee75a810f-1526466837

I was very connected to this drama. I don't feel the need to go into details, but in my head is a belief that maybe it wouldn't have happened if I wasn't around.

Survivor's guilt fucking sucks donkey balls.


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PostPosted: Wed May 16, 2018 7:10 am 
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Just read the story TJ. Sad indeed and she was lovely. And ill. . I hate how guilt can drive us all down the wroug path. Take care T J, keep up the good work you are doing. razor..


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PostPosted: Wed May 16, 2018 12:44 pm 
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Teejay, you have mentioned this young woman before. That you dated for two weeks and then she revealed that she was a very sick individual who ended up stalking you. (If you want me to delete this part, please let me know.)

Now after reading this article, I know that her mental illness started long before your very short association with her, and continued on after. Her father speaks of the many ambulance rides and hospital trips before she ever met you. To me that implies substance abuse, but also suicide attempts. I'm not saying that her death was inevitable, but it was probable.

It sounds like this young woman was surrounded by loving family members. Teejay, if her own family was unable to keep her from her self-destructive tendencies, how much chance do you think you would have had even if a relationship with her had developed?? It is very likely that she perpetuated this cycle of self-sabotage and self-destruction many times before. Whether she was sick or not, she used you to repeat this sick cycle for her own mechanisms. You are an innocent victim of her unfortunate, severe mental illness.

Likewise, there was no way you could have predicted her mother's subsequent suicide. To me, her death reveals that there was an origin of mental illness that was passed down to her daughter.

This story is tragic and it highlights the scourge of mental illness. However, these two women were not your responsibility, Teejay.

I hope that you can take my message to heart, or that you have already determined this to be the case and will work on believing it.

Amy

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