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MedHelp Member's Question

methadone withdrawal

by hambrick, Jul 28, 2001 12:00AM
I am on methadone for chronic pain. My neurologist, dr. Virginia Pact, MD has sold her practice and she really knows very little about how to withdraw someone from methadone anyway. I use to be on 15 mg daily and I took myself down very slowly from that dose to about 7 1/2 daily about a year ago. I was afraid to go all the way down in case my pain became severe again. I got the withdrawal information from the local methadone clinic at that time. (My doctor thought I should just stop taking the dose...very bad idea.)

I am now attempting to get completely off methadone but have no idea how to titrate down without experiencing severe symptoms. Since this dose is so low, what I am doing is shaving (pills are very tiny) about what I think is 1mg from my daily dose. I started this on Thursday and as of this writing I have diarrhea, headache, back pain has increased with muscle pain and general malaise. My plan was to go down by 1mg daily until I was finished, but I am not certain this is a good idea. I am employed full time and do not want to miss work as a result of this so it is important to keep my symptoms to a minimum. What would you suggest? I hope to hear form you very soon. Thank you very much.



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Member Comments (55)

by Thomas, Jul 28, 2001 12:00AM
To: nicee (witchywomen)
I'm glad you're getting some relief from the usual narco withdrawal routine, but I feel obligated to mention this:



I have included a link to a web site dedicated to L-Tyrosine that recommends L-Tyrosine be avoided if you're taking a serotonin re-uptake inhibitor (SSRI). I believe Zoloft is an SSRI. I will give you the link and leave it up to you what to do since it seems to be working so well for you anyway ...



http://www.mindfixers.com/tyrosine.html



Thomas

by Thomas, Jul 28, 2001 12:00AM
To: hambrick
Here's my re-print for the inth time of my cold turkey recipe for coping with narco withdrawal. You may benefit from just getting some brand name Immodium and stopping the runs. The runs leads to dehydration very quickly, which could be conributing to your general malaise. Check out the L-Tyrosine and B6, too. That stuff works on non-junkies as well! Good luck.



Thomas



Here's my tried-and-true do-it-yourself "cold turkey" detox protocol.



Supplies you'll need first:



As many Valium, Xanax, Librium or Klonopin as you can get your hands on.



--- first day off the opiate, use enough Valium or whatever, to, if possible, sleep through most of the first couple days. Then start decreasing the dose until you're down to nothing in about 5 or 6 days. You'll have to do the math. The Valium or one of its sister drugs will help tremendously with the anxiety and, somewhat, with the body aches. Valium may make you eat like a pig and, when withdrawing from narcotics, one usually craves sweets, so I'd be ready to indulge myself, along with some good escapist movies. That always worked for me.



Around-the-clock access to either hot baths or a Jacuzzi.



--speaking of those goddamn mostly thigh cramps that seem to love to show up in the middle of the night, have that hot bath or Jacuzzi at the ready. Don't hesitate to spend the majority of the week in that hot water if that's what it takes to get you through it. You may be wrinkled, but you'll have your sanity. Don't underestimate what the hot baths can do to relieve the withdrawal discomfort. They really work. Heating pads between the thighs can help with those cramps, too, but not as much as the hot baths.



Brand-name-only Imodium (over the counter at the supermarket)



-- if you're a normal hydro addict, you'll be getting the runs by no later than the second or third day off the lorcet. In my experience, it's an especially unpleasant variety. At the first impulse, take two or three and respond to returning urges with two tabs. It's important that you do it immediately.



L-Tyrosine (qty 50 of the 500mg caps) - an amino acid available at the health food store.



chronic use of narcotics depletes the brain of several critical neurotransmitters responsible for well-being and mental performance and attitude.

Plus:

Bottle of 100 mg B6 caps



My experience detoxing with this stuff says take 4000 (four thousand) mg. (8x500mg caps of L-Tyrosine) with two 100mg B6 caps every day for your "detox week" to provide your brain with the raw material it needs to replenish its stores of these neurotransmitters. Many feel the difference on the very first dose. ***Take it on an empty stomach, either first thing in the morning or at bedtime. You can continue this regimen after the first week if it continues to make you feel good. I continue to use it every other day with very few exceptions. After a few weeks, I cut down on the dosage, though, as it can cause the runs at high doses.



Multi-vitamins (most junkies don't eat too well, so this one's just for good sense).



Take a look at this link. According to this doc, you also need to add copper, phosphorus and Vitamin C to complete the dopamine, norepinephrine. You might have to do some hunting at the health food store to find the right vitamin or vitamins to supply all this stuff. I got a pretty good result from just the L-Tyrosine and B6, however.



I also understand from another contributor that zinc and magnesium help replenish and restore vital substances depleted by narcotics use.



Here's a link dedicated to L-Tyrosine ...



http://www.mindfixers.com/pathway1.html



WARNING: This same site says to avoid L-Tyrosine if you're on an SSRI (serotonin reuptake inhibitor) such as Prozac, etc.

by niccee, Jul 28, 2001 12:00AM
You are doing better than me. I am on MMT. I started out at 80mgs. I have been dosing down until now I am at 20mgs. I am going to go to 10mgs Monday. According to my clinic you are doing it right. They recommend 1mg a week. That still may be to much for you. If you can, you may want to do 1mg every two weeks or even longer. I tried to do this 2 months ago and had to go back up to 40-30 mgs after I had got down to 5 mgs because of the withdrawl symptoms. This time around so far has been much better. I pray to God that it will continue so. The only thing I am doing different is I started taking the supplements that Thomas and a guy named pillpoppa recommend. To be honest and not disrespectful I thought they were nuts, but had nothing to lose. Guess what I was the nutty one. I have had a very minimmum of withdraw so far. This was the only thing I did different. I take a multi vitamin, zinc, magnesium, L-tyrosine, B-complex vitamin (you can just take the B-6, but B-complex has vitamin C in it.)

Thomas has also recommended some others, but I am having trouble finding some of them. I think they are copper, phosphorus and vitamin C. I also take an antidepressant Zoloft, but was taking that before also. I hope this helps. Look through the post to get the exact amounts. I don't remember them exactly. Please keep posting and let us know how you are doing.

To Thomas and Pillpappa. I want to thank you again. I truly believe this has made all the difference. THANK YOU SO MUCH.

by Witchywoman, Jul 28, 2001 12:00AM
I will second the information that the supplements make withdrawal a whole lot easier.



I started first with Thomas's recommendation, the L-Tyrosine and the B-6. I noticed less psychological craving for the meds.

When I added the large ammounts of zinc and magnesium, I noticed that I no longer got withdrawals 7 hours after my last dose of hydrocodone.  I will say though, it takes a huge ammount of zinc for me.  I am taking 120 mgs of zinc four times a day, the capsules I take have zinc, magnesium, calcium and manganese. I take a seperate zinc tab with them, since the capsule itself only has 22mgs zinc, I add a 100mg zinc tablet with it.  I took this for a week before I noticed any difference.



According to Thomas, the L-Tyrosine helps your body start to be able to make its own dopamine again. And Pillpoppa said that the opiates create a zinc deficiency, and that supplementing with zinc and maganese and magnesium can let you go off with no withdrawals at all. I am not sure if this is true, as I am still taking my meds for pain, so don't know what would happen physically if I stopped completely, but I can attest to the fact that I can go a long time in between doses with no withdrawals, whereas before the zinc and L-Tyrosine, I would get withdrawals (sweating, chills, anxiety) after 6 to 7 hours.



Last week I went from 3pm to 9 am between doses, no sweating, no chills, no craving..but I did have a little bit of diarhea. You might want to try brand name Immodium for the diarhea.



good luck!

by Francoise, Jul 29, 2001 12:00AM
To: Thomas
There should be a civic award for assisting people get off opiates, and you my friend should be its first recipient.



How are you doing?



Francois

by niccee, Jul 29, 2001 12:00AM
To: Thomas
Thanks so much for caring and sharing. I talked to my docotr about taking the supplements and he said it was okay. So I am going to continue on because it has been a miracle for me. I am still shocked at how much a difference it made. Thanks again.

by CannabisDave, Jul 29, 2001 12:00AM
CHINESE HERBS and ACCUPUNCTURE seem to be two of the best ways to treat withdrawal syndrome, and the long-term "post accute withdrawal syndrome" (or "abstinance syndrome"). Methadone has a long-term post accute withdrawal period - sometimes it NEVER goes away. I've heard of people getting off of methdone for a few years, and after being miserable the whole time they get back on methadone - why be miserable when a medication allows you to feel "normal" again? When I read about people putting themselves through torture to get off methadone (or other opioids), I wonder why they are doing it. Methadone in smaller split doses has no bad side effects, but when I have to dose once daily at a clinic I need considerably more methadone to "hold" me for 24hrs. until my next dose (back at the clinic EVERY DAY), and then I suffer from constipation, depression, no libido, etc. That is what "they" are doing to me if I have to go back to a methdone clinic again. If I do need methadone the rest of my life I'm not too concerned - unless I have to go to a methadone clinic again! The only thing that makes being on methadone so bad is the "stigma" against it which is based on ignorance, and the fact that methadone is a very difficult to obtain medication which is only available at HORRIBLE methadone clinics (and a few pain clinics).  I respect "Dr. Steve's" advice, but sometimes other "addiction specialists" are completely ignorant about addiction treatment - especially when they are attached to methadone clinics! The doctors at the methadone clinics I went to were dangerously ignorant, and many people died because of it. I went to methadone clinics for about five years, and they all made my life hell - the "staff" there who forcibly detoxed me (or summarily dicharged me) were not trained medical professionals, yet they told the doctor what my dose would be and the doctor would sign-off on anything they told him. Unfortunately for me, they were sadistic control freaks, so I ended-up without my life-sustaining methadone again and again (I had to use heroin a few times). I could never even think about getting off methadone while dosing just once daily at a clinic, but after my doctor began prescribing the methadone pills for me a year ago I was able to titrate my dose down to just one 10mg. tablet twice a day - I went from 60mg. a day last year when I got summarily discharged from a methadone clinic (yet again), to just 20mg. daily now. Unfortunately, my doctor has been threatened for prescribing methadone since he isn't a pain specialist, so he switched us methadone taking patients to oxycontin (I made it clear to him that he was treating me for chronic PAIN and not ADDICTION, because I know that isn't legal). Now my only hope is a pain treatment clinic, and if they won't prescribe methadone for me there, then I'll have to detox off of oxycontin from my doctor (he is allowed to give me oxycontin or hydromorphone etc., but not methadone!). Going to a methadone clinic again would mean being a "prisoner-client" forced to take a huge dose of methadone to hold me 24hours. Another problem for me at a methadone clinic is that they are discharging people mearly for using marijuana, and I'm a medical marijuana patient. I'm also using marijuana to help me get off of methadone, but they won't allow me to continue using pot if I'm dosing at a clinic. I think kicking people off a methadone program for using pot is completely irrational, and when they are a medical marijuana patient it's even more irrational, but they are doing it anyway!  Re: oxycontin - I find that taking them as prescribed keeps me fairly stable, but the side-effects seem much worse than methadone so far...I'm probably suffering a bit from methadone withdrawal since I suddenly switched medications (methadone to oxycontin), but fortunatly I still have a few methadone tablets left to ease the transfer - I'm alternating methadone with the oxycontin to try and stabilize myself (oxy is hard to sleep on, so I take methadone in the evening). I find that the oxycontin works OK if I take them as prescribed, but I much prefer methadone. Methadone is much cheaper, but it's also a far surperior chronic pain medication, in my opinion. Everybody is different, but I believe that for MOST people methadone is a better choice for treating long-term chronic pain