Maintenance cut short by business trip

This site is so cool, I wish I found it 12 years ago!  I found this site out of desperation.  I am a 12 year veteran heroin addict and am currently going through one of those fix myself up phases.  I got back on a methadone maintenance program with good intentions and for the most part have been doing very well and then it happened, my worst fear about starting the program has come true.  My boss called me today and is sending me on a two week business trip to Newport UK.  I am freaking out!  I want to tell him I can't go but can't think of a good enough reason and no way am I telling him the truth!  I am conflicted...part of me wants to stock up enough china white to get me through and my sober more rational side is making me think I need to face it like a man.  I have some xanax, and trazadone and clonidine but don't know how to detox myself with these, and do you really think these could help to fight off the sickness enough to go to work?  I saw the list of vitamins you all seem to swear by and plan on securring these first thing in the morning.  No matter what I have I can't help but feel screwed.  I still have a week, I'm thinking I will taper 5 mg tomorrow and another 5 mg Friday and then try to stop over the weekend to see how bad I get.  I would taper up until the day I leave but the program here is lame and only lets you reduce your dose 10mg every two weeks so I think why prolong the inevitable.  I guess I am looking for someone to tell me I have a good plan, or tell me I am insane and offer some suggestions.  I am desparate right now and will try anything if I thought it would help me get through these coming weeks.  Also, does anyone know a good dosage plan if I decide to use the trazadone and clonidine?  I'm an addict so of course if I decide my dosage myself the bottles will be gone in maybe 3 days at most but I am also afraid I might go out with them.  I want to be safe but I also must be comfortable and able to be productive at work.  From what I have read in this forum you guys are always so supportive and helpfull, I had to sign up right away.  I feel like I am home, like you are all my peoples and you can understand where I am coming from.

[frankie165]

I am by no means educated enough to answer your questions.  But I wanted you to know that you are right this is an awesome place with tons of support.  

i am sure someone with more experiece will be able to give you a good plan.

[taiwan_expat]

Thanks Frankie, your my first hit.  Just by responding you've already helped!  I think the coolest thing about this forum is it's real recovery and it's not a bunch of people trying to shove a bunch of steps and slogans down our throats.  There really is another way aside of being brainwashed ;-)

[mr.lucky66]

To be truthfull, if you can't take methadone on the trip, it could be a disaster. all the best

[taiwan_expat]

started this week 5mg less, dropped another 5 yesterday.  Wanted to drop another 5 today but couldn't do it, tomorrow have to.  feeling bad already, weird though cause it's coming and going.  Getting harder to concentrate and the hot/cold/clamy flashes to much had to leave work, thank god it;s the weekend.  I leave next Saturday, I'm screwed.

[Savas]

Do you have a clean record at your clinic? Is your job provable? The trip as well?

If so, you can contact Oasis and get them to deal with your clinic and mediate to get you the bottles necessary for the trip.

This is why I always save out from my dose. I have hundreds of milligrams saved from doing this, and never worry in case of fire, earthquake, or business trip. :)

[taiwan_expat]

My clinic doesn't test, a little different in Taiwan, the doctor here puts you on and never wants you to get off.  Testing consists of "Do you want to use?"   The trip is provable though.  I once was in another hospital here and had to drive 2 hours everyday to get my dose, he wouldn't even approve take homes to another hospital!-*******!  Lucky You Savas, you wouldn't by any chance be taking a vacation to the UK this weekend are you?;-)

[taiwan_expat]

urges too strong, quitting too fast. I failed, i gave in to my temptation.  Now I get to kick both on my trip...what a bleeping idiot am I!!!!  I hadn't had urges until I started tapering too fast.  I lasted 7.5 days until I gave in to it.  I went down another 5 mills today too, does that balance the two out so I can just call it an even stevens day?  i finished already and am fighting calling back for more.  Methadone really does fight the urges to use heroin but I am finding out the hard way that stopping too fast brings back the urges too fast to handle as well.  Hate to admit it but a smokey NA meeting and a stiff cup a coffee could do me some good right now.

[taiwan_expat]

urges too strong, quitting too fast. I failed, i gave in to my temptation.  Now I get to kick both on my trip...what a bleeping idiot am I!!!!  I hadn't had urges until I started tapering too fast.  I lasted 7.5 days until I gave in to it.  I went down another 5 mills today too, does that balance the two out so I can just call it an even stevens day?  i finished already and am fighting calling back for more.  Methadone really does fight the urges to use heroin but I am finding out the hard way that stopping too fast brings back the urges too fast to handle as well.  Hate to admit it but a smokey NA meeting and a stiff cup a coffee could do me some good right now.

[taiwan_expat]

what is Oasis?  and how do I contact them?

[Gogeyi]

I wish I had words for you taiwan_expat.  You sound absolutally tortured right now.  I will pray, if that is ok with you.  I don't know if I'm even allowed to say it here.

Unfortunalely, that is all I am capable of doing for you right now.

Peace.
Gogeyi

[mestiza]

HOW SOON ARE YOU LEAVING? YOU DONT HAVE TIME TO CHANGE OVER TO SUBOXONE? THEY GIVE YOU ENOUGH FOR A THE FIRST DAY, THEN FOR A WEEK AR SO THEN YOU GET A 30 DAY SUPPLY WITHOUT HAVING GO GO IN EVERYDAY TO DOSE, IT HELPS TREMENDOUSLY, I HAVE BEEN ON IT FOR GOING ON TWO MONTHS.  I'VE BEEN ON METHADONE BEFORE ALSO.

[Savas]

Oasis is a group that handles conflicts between patients and clinics, an advocacy group. But You're in Taiwan and I'm not sure what the setup is there. I'd look into it. I'm not sure if they're multi-national or not, or if you have an equivalent group of your own over there.

I'd say go to the "AT Watchdog" website. They're pretty much experts on this sort of thing. They deal with methadone rights and the like. They're based in Texas (the site), by the way.

[taiwan_expat]

tanks, I'll check it out.  I have tried to get sub here before but doctors here are a little backwards and don't even know what it is.  I think dealing with addiction is sort of new to the Taiwanese.  hating life today, all sick...hating it:-(

[taiwan_expat]

by the way, I think they call suboxone subutex over here in asia.  I remember last year when I was living in Singapore there was this big deal about a new wonder drug for addicts that was of course being abused so they banned it

[Savas]

Ah, one other thing you can do is if you find a clinic in the area you're going to, you can have your clinic and that one work together and "guest" you for your trip. Ask your clinic if they'll do this. It's not uncommon here.

[taiwan_expat]

working on that.  UK has a strange waiting list program.  You have to first register with the government for drug misuse then your put on a waiting list.  Once you receive your government letter you can take this to the doctor to get help.  I am in contact with agencies over there to try and find a way around the red tape, tick tock tick tock...The way I feel today no way I can go.  I might have to face the music and own up to my boss.  This will not be good.  I told my wife I messed up yesterday and she took my son and left this morning.  Things are just spiriling out of control now, might as well go all the way down.  Sometimes it's easier to start over with nothing than trying to put back pieces.  I can't believe how bad this has gotten so fast.  I was doing so good and now I've relapsed, lost my family, and very likely will loose my job if I don't go.  What the hell just happened?

[Savas]

Tapering is never a good idea when you're under alot of physical or mental stress, at least when you get down to the dregs.
As long as you haven't been using for more than a few days, you should be okay. I'd advise going back up in your dose and waiting a week or two before starting.

As to the trip...I'm never one for telling your boss the truth about this kind of stuff. I know something about the differences you've got work/social-ethic wise over there (harder than America), so I'd suggest telling your boss straight out in a stern (but polite and respectful) fashion that the business trip is not possible for you to take at this time for personal/ medical reasons.

Tell him this is a temporary situation, and shouldn't be an issue in the future. Apologize for the inconvenience but don't grovel!
He may fire you, it may affect your status with the company...but at least he'll still respect you.

Then... make plans for this in the future. You should have some sort of "reserve" of SOMETHING to get you through travel emergencies. The fact is, most countries don't allow for this kind of situation or disaster situations (you know how many addicts died over here when Hurricane Katrina hit??!?!)

I'll warn you, you've got to have self control to do this. Most addicts don't. Having a "do not touch in case of emergency" reserve that doesn't mean "I've had a hard day" so I can dip in...well...you get my point.

I always say; When you feel like you've lost control of the situation, and are about to go down and out...
act like you know exactly what's going on and you planned it this way and are bloody well happy with how things are going! At least if you go down, you'll go down with style.

[taiwan_expat]

right on, I like your style.  I told my boss pretty much exactly like what you said.  He hinted that it was an unwise decission for my future with the company, that pissed me off so I let him have it reminding him he begged me to leave my US boss to work for him locally.  Probably not my finest moment, I've been really short fused since I cut my dose.  I haven't used for two days now and since I have been tapering I can really feel my sickness.  I should go back up but I think I've come this far so keep going just slow it down now.  I hope I don't lose my job over this and it consumes my every thought but I am trying to act like you said, master plan.  It trips my coworkers out, they think I'm crazy but at least when I do go I will still have my dignity!  My wife came back and man she is pis sed and she should be.  She asked me to promise never again and as much as I wanted to, I didn't.  I can't make a promise like that no matter how good my intentions.  She won't sleep with me, fine for now since I'm kicking, barely talks to me and is just itching for a reason to bail again.  I'll just take care of myself and hopefully this will show her I mean business.

[Savas]

good for you. Just remember to try not to lose your temper. When I'm like you are, I have to remind myself every minute of the day it's the withdrawals making me short fused, not the people around me.
I don't suppose your wife could come on here to talk some of the people on here? It might give her a better understanding of what your dealing with so she isn't so p.o.'d at you. :)

[1eagle]

Wow!! I don't know exactly what to tell you, bud. It seems to me like Savas has some good advice. Stocking up on chi white wasn't the best thought. The methadone is different from the white and is probably harder to quit rapidly. Some things just have time as an answer. Don't give up when you are so close. I tried to quit the methadone too rapidly and was really blindsided. I don't see how you coulld function adequately in a business mode when you are getting that out of your system. Seems to me that you made the right choice. There are more multi national jobs around. Also please keep in mind that the mood changes are real and they happen to most people. A change of mood isn't a reason to throw in the towel. If the wife came back, you must have something going for you.

[1eagle]

Well, after the flashbacks and Thanksgiving subsided I had a little more time to think about your situation. I really hope that everything is working out for you. It is probably a wierd twist to have to deal with Eastern frame of mind while you are going through this stuff. Especially in an emploment mode.

I am no stranger to china white. The boys outside of Bangkok used to drive around with pallets on forklifts full of chi white. And while they were doing it they were apologizing for only having "ti, ti" amounts available(that translates to small, small)

Maybe you should chuck the western approach for a minute and see if the local Buddhist monks have anything going that might help you out. A "good friend" utilized this approach. Seems like the description was something like an herbal opiate suspension boot camp.Please bear in mind that they have been dealing with this opiate thing even longer historically  over there than we have in the west. At least that is a thought that i had. IF you have the self discipline, I would be tempted to try to taper from the white instead of the methadone. My previous clinic would only let you taper maybe 2 mg per 2 weeks. I now know why. My first methadone trip was a total disaster. That stuff is just  another drug to quit as far as I am concerned.

I will keep you in mind and hope for (and pray for) the best possible solution to you situation. Remember that the sun will come up tomorrow morning and the stars at night no matter what.

[taiwan_expat]

Things are getting better now.  I was able to reschedule the trip to middle January with some added responsibilities throughout December but it was worth it.  I feel like I can exhale now.  Funny that tappering off the white maybe better than tappering methadone, believe it or not my doctor actually suggested the same thing!  I just saw him today and that is exactly what he offered.  The other was a benzo / analgesic cocktail but that would make me sleep all the time.  He said that Taiwan has not released sub yet so that is not an option.  My wife is having a harder time than me, she has been fluxing between 15 and 5 mils for the past two weeks.  Everytime she drops to her last 5 she gets too sick and goes back up the next day.  I still have a ways to go before I get that low but everytime I drop 5 it takes me 3 more hellish days to adjust.  I have been dosing her with .1mg of clonidine in the mornings to help her get started but I think a lot of it is in her head.  I am afraid of trying to taper off the white, I am pretty sure what starts as a taper will go full blown again before I know what hits me.  Thanks for thoughts and prayers and yes I am trying to control the temper but the lower I get the meaner I'm finding myself being.

[1eagle]

Really good to hear that your employment conumdrum might be resolved. My experience with the methadone would make me skeptical of dropping 5mg very often. Maybe go down by only a couple mg's at a time. That stuff is not easy to handle. Thinking of you.Hang in there, your wife needs you. None of us are in this alone no matter how we feel at first.

[Savas]

That is tricky. In one sense, it makes a lot of sense. But there is the control issue. If you can't honestly say you can control yourself while doing it...well, it's not a good plan.

Mate, I'll tell you I'm on 2.5 myself right now and the only way I've been able to make it possible is by splitting my dose, half night. half morning. I could give you theories for why it works, but for me, it just does.  There's certain things that I do in dropping down, and without them, I don't think I'd have gotten this far.

The clonidine is helpful, btw...but... my worry is that if you take it to long, you'll develop the rebound effect and then it won't be as useful if you actually come off. Clonidine should really be saved for when you come totally off. After about two-three months of it, it loses it's efficacy in helping to moderate the withdrawals.

[taiwan_expat]

Thanks guys, I have no one to throw ideas around with here, even my doctor can't really speak english and even if he could he seems to be a "quack" to me.  I think it's quite possible that I am more qualified than he is to do his job.  He was throwing around words like hypnotic and tranquilizer when I was trying to discuss methadone alternatives with him yesterday.  When I brought up subs and benzos he kind of got this blank look on his face and started ya-ya-ing me as though I could help diagnose treatment plans for him.  I doubt he even understands addiction and just follows the guide book on suggestive methadone treatment.  We have no choice but to drop 5mills at a time here, they go by 1cc units and each cc contains 5mills.  I am trying to drop 1 every 3 days but if I'm too sick I hold until the sickness seems steady enough to drop again.  I plan on dropping 1cc again tomorrow if I feel ok enough.  I am not gonna try the taper from white, I wish I had that kind of control!  My wife wants to try it but I know she'll end up using too so I won't let her.  I have her planning on her last 5 mills on Thursday then by Friday afternoon she should really be feeling it but then she'll have the weekend to kinda adjust.  I didn't know the clonodine can become ineffective, that sucks!  I stopped giving it to her for now and will use it on her this weekend when she's off everything.  I wish I had take homes so I could split our doses, that would be perfect and I know that would work out.  I really think my wifes biggest problem is mental.

[1eagle]

Yeah, its just not right when the patient has to both procure and implement the therapy. But at least you have the head to do it. I frequently find myself wondering just what happens to those that can't understand polysyllabic words? This may not be fully kosher - but did you ever think about subox through a net pharm? I wouldn't bring that up to many people, but I feel that maybe you could handle it. Really, the sub isn't a buzz. And I don't think that you could make it one. It wasn't really expensive over the net, if I remember it was really only a couple a bucks. And you do have some people to bounce things off of now. Thank Al Gore I guess. Stay strong.

[Savas]

Just be careful with the clonidine. As addicts, we tend not to take stuff like that seriously but their are dangers. I'd suggest keeping her on a very small dose to avoid hypertensive rebound if you're planning to have her take it again this weekend.

Tell her to be aware of if she feels any racing heart, dizziness or faintness. Normally i suggest getting a blood pressure cuff and monitoring your blood pressure just in case. (I'd suggest she wait two weeks if possible before trying again for this reason, and to make sure it works well).

The clonidine should be taken 3x daily after stopping (I think the dose is .01 or .02, not sure).

As far as splitting your dose...you aren't being given injection, right? I know all kinds of tricks for trying to get around in-person-oral administration. A cotton ball in the corner of your mouth right before drinking works wonders (squeeze out immediately after dosing). It should give you sufficient quantity to split your dose some. It's not a great way to do it, as the dose you get varies, but hey, you work with what you get. That's assuming they aren't crawling around in their to make sure you drank it. :)
With practice you could do this, pop it in right before (15 seconds, don't want all saliva!) drink, and say "thanks" and walk away.

BTW, when you drop in dose, it takes 2 weeks before you stabilize at the new dose. So if you drop 5 from 40 every three days over two weeks...your body will be reacting as if you dropped almost 20 milligrams at once by the end of those two weeks!
This isn't a commonly understood fact, and why people who do short term dose drops tend to relapse/fail.