Aa
Aa
A
A
A
Close
Avatar universal

Methadone to detox info from the PDR

This website has been a comfort to many, including me, so here is my attempt at a meanginful contribution.

A while ago I posted a question concerning the dangers of becoming addicted to methadone while using it to allay the symptoms of withdrawal from oxycontin/roxicodone/hydrocodone. I have used it for that purpose once in the past and have found it to be very effective (for me, it was almost magic:  no diarrea, no nausea or vomiting, no chills, no sweating, decreased incidence of insomnia, reduction in withdrawal-related anxiety, reduction in the severity of the lethargy that typically accompanies withdrawal, and no adverse reactions after brief usage, followed by tapering and then coming completely off the methadone etc. - no more than five days total for me.).

I posted my previous question after reading some of the horror stories regarding seriousness of addiction to methadone that are posted here and elsewhere. Reliable sources say that withdrawal  from methadone for those who become addicted to it lasts much longer and can be more severe than withdrawal from other opiates (depending on length of use and dosage). So be forwarned, if you intend to use methadone to detox from another opiate, you must be careful not to trade a brief uncomfortable withdrawal for a long uncomfortable withdrawal.  Accordingly, I am providing you guys with what I think is some very helpful information from the PDR.

Disclaimer: I am NOT recommending any course of medical treatment or its appropriateness for you (I am not a doctor and I strongly reccommend that you detox under the supervision of an M.D. if it is at all possible). Further, Methadone is a Schedule II narcotic and its unauthorized purchase, posession or sale is highly illegal. I am providing the following information for you only because I found it to be very informative and helpful. Please consult your M.D. and/or do your own research to learn more before embarking on any course of treatment or detoxification procedure.  

That said, the following excerpt ifs from my hard copy of the 2005 Physician's Desk Reference at page 2756 (as some of you may already know, the book is commonly referred to as the "PDR" and may be availble for free at your local library). For some reason, I could not find a listing for methadone in the 2007 version of the PDR that is publically available for free online or at www.healthsquare.com (you can find the free PDR website is at www.pdrhealth.com, but the M.D-health professional/pay version is at www.pdr.net - I assume the pay version has a complete listing for methadone but I don't feel like paying for it):

"For Detoxification Treatment: THE DRUG SHALL BE ADMINISTERED DAILY UNDER CLOSE SUPERVISION AS FOLLOWS:

A detoxification treatment course shall not exceed 21 days and may not be repeated earlier than four weeks after completion of the preceeding course.

The oral form is preferred, However, if the patient is unable to ingest oral medication, he may be started on the parenteral form initially.

In detoxification, the patient may receive methadone when there are significant symptoms of withdrawal.  The dosage schedules indicated below are recommended but could be varied in accordance with clinical judgment. Initially, a single dose of 15 to 20 mg of methadone will often be sufficient to supress withdrawal symptoms. Additional methadone may be provided if withdrawal  symptoms are not suppressed or reappear. When patients are physically dependent on high doses, it may be necesary to exceed these levels. Forty mg per day in single or divided doses will usually constitute and adequate stabilizing dosage level.  Stabilization may be continued for 2 to 3 days and then the amount of methadone normally will be gradually decreased. The rate at which the methadone is decreased will be determined separately for each patient. The dose of methadone can be decreased on a daily basis or at two-day intervals, but the amount of intake shall always be sufficient to keep withdrawal  symptoms at a tolerable level. In hospitalized patients, a daily reduction of 20% of the total dose may be tolerated and may cause little discomfort. In ambulatory patients, a somewhat slower schedule may be needed. If methadone is administered for more than three weeks, the procedure is considered to have progressed from detoxification or treatment of acute withdrawal syndrome to mainentence treatment, even though the goal and intent may be eventual total withdrawal."

Please forgive any misspellings or typos as I am a terrible typist.  If I could have found the preceeding excerpt on the net I would have simply cut and pasted it in to be certain that there are no typos and to save me the time. However, I bothered to retype it specifically form the benefit of those who might have had the same questions and concerns that I did.  Again, I am recommending no couse of treatment for any of the readers here and, instead, I am simply providing you with some information that did not appear to be readily available on the net and which I found very informative.

My reading of the PDR, suggests that if you follow the regimen suggested, there is little chance of becoming addicted to methadone. Note that addicts are addicts and methadone is addictive, so if it turns you at all on you might want to avoid it altogether rather than risk becoming the owner of a brand-new monkey.

I hope that helps. I have tried to be as responsible as I can in providing the information. Please do your own research before doing anything, i.e. consider your personal history any potential drug interactions etc.

By the way, if you find a typo and/or need clarification or confirmation regarding a portion of the 2005 text, just ask and I will try clarify and/or correct any mistakes (However, I tried my best to be sure that I typed it verbatim and I am pretty sure that I did). I don't think there would be any need to check the 2007 PDR for any changes from the 2005 version above because methadone has been around for so long that I think its unlikely that there would be any changes at this point (methadone was invented by Nazi doctors so that smackheads like Goering could avoid withdrawal), but you might want to check anyway.

Whew, did I include enough disclaimers or what? :)  Sorry for the length. Best of health and good luck to you all.

20 Responses
Sort by: Helpful Oldest Newest
228686 tn?1211554707
It varies according to rules/regulations but the minimum drop is by one half per day. Which is about the same as going cold turkey for most. Since it takes almost two weeks to adjust to a new dose, you'd be detoxing from whatever dose you were at two weeks from 0 day.

This is the kind of thing that shows the methadone industry is just that, an industry, interested only in making money. No care or concern is involved, only the typical desire of profit and control of the masses.
Helpful - 0
279742 tn?1190241522
Oh my bad.
This is what they did at my clinic.  I think they give you 3 or 4 doses right? something ridiculous like that. they cut the dose in half and then in half 2 more times which is pointless I would think. It's inhumane to make someone suffer like that. Especially when it's over money..
Helpful - 0
Avatar universal
I am off methadone now but there is a name for the taper the clinic will give you if you can no longer pay but they drop you pretty fast. The here discussion was about how long to stay on methadne and than taper off and how the clinic tell's you to stick to it for a year or two so i just brought up if you lose your job & can't pay, how they dont care any more about your recovery and drop you fast and your on your own.
Helpful - 0
279742 tn?1190241522
I never heard of them giving you any. However my clinic in Jax,fl would let us charge doses. You talk to your counciler (sp) and tell her why you cant pay today or tomorrow and so on and would it be able to charge a few doses till payday. They let us but I bet each clinic has their own rules.. Why cant you pay? how much is your dose? do you wanna quit? was up?
Helpful - 0
Avatar universal
How many days does a methadone clinic give you if you can no longer pay, is it 10 days or is it based on the dose your at to taper down.
Helpful - 0
279742 tn?1190241522
Methadone = devil!! wd is totally unbareble. Nothing like ct, wd from pills. Cant compare. It's a nightmare..
Helpful - 0
228686 tn?1211554707
Looks like I was wrong after all, folks. Just ignore the ramblings of a confused mind.  :)

Helpful - 0
228686 tn?1211554707
Here, I got this off a medical opiods glossary;


Agonist = a compound that will bind to a receptor to form a complex which elicits a full pharmacological response, peculiar to the nature of the receptor involved.

Antagonist = a compound that will bind to a receptor to form a complex which does not give rise to any response, as if the receptor were unoccupied.

Okay, we were actually both right. I was looking back at some links and they're both terms used to refer to an effect on receptors. I forgot about that! Now, however, I'll have to read a bit more and sit and contemplate my navel to make sure I understand exactly which refers to what, and what is what. I think you're right thought, about suboxone being the partial agonist.

I checked and it seems I was right about methadone being the only full antagonist, which should answer the question I asked you in e-mail.
Helpful - 0
182493 tn?1348052915
Yeah I had read you posted that a few times and I would look at it and say I wonder if he knows that its kinda backwards.. Then I read it today and thought I would point it out.. Figured you missed it or something.. Glad I could be of help.. and glad you didn't take my correction as being bi*chy or anything..XOXO
Helpful - 0
228686 tn?1211554707
Ugh, you're right, I've been quoting that incorrectly without thought from something I wrote in my notes and forgot to fix. Isn't it funny how you say something long enough/see it, and it doesn't register? I can't believe no one said anything before now. It took your pointing it out to make me blink and go "wait a minute"
(open MsWord furiously and fast, and there it is...AAAGH!)   I even had it as antagonist instead of agonist, I can see right where I spellchecked agonist out of existence and the other took over. Thanks for the correct, I wish it'd come sooner! :)


Last time my 21 day detox was a breeze. I didn't suffer at all during it. I was like "wow, this is great! So easy! Here I was, worried for nothing!" I left the hospital detox VERY happy, went out to dinner with my wife to celebrate, etc... two days later the methadone was fully out of my system.

This time has been...harder. Below 15, each drop has been...not really bad, but drawn out over two weeks, tiring, both physically and emotionally. And I'm essentially on a cut back schedule. I don't like to think what it would be like on a full time work schedule.

The drop from 5 to 2.5, I'm beginning to realize, wrecked havoc with my intestinal system. I thought I'd caught a bad flu for a week. My wife pointed out "maybe it's the methadone" and I felt like an idiot. I didn't eat much for three-four days straight. But that was really it. Slept pretty okay, which is to me the most important thing. No, wait, having energy is more important, actually. I'll deal with lack of sleep, sex, having the runs, being jumpy, all of that for the PAWS period if I can just have a decent energy level to get around. That much would make me happy.

My e-mail is: pooka_sighting(at symbol) yahoo(dot)com., I'm on yahoo if you have any other questions. Oh, they dropped you to 1 milligram in the 21 day detox before you went off.
Helpful - 0
Avatar universal
So everyone is crystal clear, I am smart enough to listen to people like Savas who obviously have had a ton more experience with methadone than I have AND I AM RIGHTFULLY SCARED OF THIS DRUG BASED UPON THEIR ADVICE. So I don't care what the PDR says, I wouldn't personally use it for more than 3-5 days...just long enough to get though the worst three to five days of the w/d from a year's worth of fairly continuous roxi/oxy usage. That is all. Longer than that just scares the pants off of me. I'd feel really stupid if I wound up trading one thing for the other. Why would I even do it at all then, you may be asking yourselves...well, because I can't afford to lose a weeks worth of work or have my girlfriend see me up all night sweating and vomiting. That is why.  Other than that if you can drop out of life for a week and/or go public with your symptoms or if your symptoms are not as severe as mind were I would recommend doing it the semi-natural/thomas way.
Helpful - 0
224049 tn?1204591115
Dont you think that being on 2.5 we easier than before??What was the dose when you went cold turkey?Did you have clondine? Valuim.??  I would love to talk more too you. Do you mind giving me an email addy?? ruthie
Helpful - 0
228686 tn?1211554707
I've been on it for almost two years this time. The first time, I did a 21 day detox, was told I'd be fine when I walked out of the hospital. I believed them, didn't know ANYTHING about methadone.

I went through two weeks of hard core withdrawal. In bed the entire time, slept maybe one to two hours a night if I was lucky. Paid a friend to walk the four blocks to the store to get groceries, come in and feed the cats, etc...

Four months later I was still suffering PAWS. Didn't know what it was. Went to the E.R. a few times during all this, knowing something was not right.
Was told "it was all in my head, you're drug seeking, looking for an excuse to use (I had plenty of cash the entire time, so if I'd wanted to, I could have),
   Went to the E.R. twice more, doctor's there wouldn't even see me, essentially kicked me out when they found out I was an ex-addict.

After four months I was in danger of losing my job. I'd taken a month off originally, and they told me four months later if I didn't come back soon, they had to hire the temp person permanently.

Went to a different hospital, they sent me to a methadone clinic. They told me they couldn't take me legally since I was "cured". I had to have opiates in my system.

So I went out (keep in mind at this point, I was facing eviction), got an opiate, and took it. Didn't get high, just felt "normal". Went in the next day and I was put on methadone maintenance. I was told, by the way, I was "permanently damaged", that I'd need opiates "The rest of my life". The usual methadonian justification.

Once I felt better, was mentally stable (sleeping 3-4 hours poorly a night for four months will drive you insane, compromise your thinking ability) and had financial stability, I researched the topic. Found out just how irresponsibly wrong the doctors and everyone had been. How foolish I'd been to trust them.

Fought it when they tried to jack me up to 150 milligrams (they stopped at 70, I knew how to do it right so I didn't need to get jacked to 150).
Dropped to 40 over three months, then over a period of the next year and a half dropped to where I am now. I just went down to 2.5 milligrams a week and a half ago. When I go off, I expect the same exact withdrawal and PAWS, but this time I'll be prepared.

It's sad, such a colossal waste of time. I could have been clean if I'd been properly informed and treated two years ago. But because addicts are just a way to make good money off of now for EVERYone, even the government, I'm probably facing an even longer PAWS period than before.
Helpful - 0
224049 tn?1204591115
Savas How long were you on methadone and what miligram??? RUthie
Helpful - 0
182493 tn?1348052915
All other opiates are not partial agonists... the only partial agonists are drugs like Buprenorphine (Suboxone/Subutex) and there are also a few others.  Codiene, Hydrocodone, oxycodone they are all full agonists.

Here is the definition of partial agonist:
Drugs that activate receptors in the brain are termed agonists. Agonists occupy receptors and switch them on. As a result, they produce an effect in the brain and body. Therefore, opioid agonists switch on one or more opioid receptors.

Partial Agonists can both activate and block opioid receptors. Depending on the conditions, partial agonists can produce effects similar to those of either agonists or antagonists. Buprenorphine is a partial opioid agonist
Helpful - 0
Avatar universal
Sometimes you find info in the most obivious places but do not check, the PDR. It never occured to me to get info from the PDR on methadone. I read about countless drug, but no methadone readings. You know I think it is refreshing to see a new idea. I never heard or seen Methadone talked about as few week detox drug. I am sure I missed that, but I think it is a good contribution spoook, I not writing it off. I am gonna think about it.

Sincerely Bart
Helpful - 0
Avatar universal
Not sure I agree with that assesment, Savas. There is difficult w/d (vomiting, diarrea, insomia, etc.) and there is much less difficult w/d (none of the above). Since detoxing, can't say that I have had any sort of craving for methadone...in fact, my honest opinion is that, while doing it, I felt almost nothing from it. Definitely no rush....apparently I was not on it long enough to develop a physical dependency...therefore I have had no cravings, physically or psychologically, for the methadone.

If anything, I still have pyschological cravings for the little blue devils...not the methadone. My risk of relapse is with the roxis, not methadone...while it can be argued that the psychological aspect of quitting is the longer and harder part of recovery and that the little trick I did with the methadone does absolutely nothing for that...that I will grant you...but I'll take just the psychological part over that over that AND the vomiting, diarrea, insomia etc.
Helpful - 0
228686 tn?1211554707
It's a Full Antagonist opiate, as opposed to a partial (all others). Each has different signatures they can test for. It really depends on the test they're using.  I don't much about the exact details of the testing process.
Helpful - 0
221913 tn?1372276661
Methadone is not an opiate, as it is NOT detected as such with a standard urine test.  TRUE?

billstrong1969
Helpful - 0
228686 tn?1211554707
Heh heh...well...this is the same medical community that used to support the belief that oral sex would inhibit chance of pregnancy later in life if performed regularly...and used to say insane people were actually possessed by demons.
So...you have to take everything you read with that in mind. Methadone is an opiate, and taking an opiate to get over an opiate leaves you with....well, basically you go down to "0", and quite cold turkey, and suffer withdrawal accordingly. It's pretty straightforward. DEA won't allow any other treatment options to be used, I could go on and give links to studies that have been blocked because the drug to be tested for use in addiction is considered "an illegal drug".

But I won't bother. Lets just say that tapering doesn't really work, beyond keeping your body from going into absolute shock from coming off a high dose. Your still going to go through opiate loss/replacement healing. So unless you can take something to heal that, or heal over time, it's going to be uncomfortable.
Helpful - 0
Have an Answer?

You are reading content posted in the Addiction: Substance Abuse Community

Top Addiction Answerers
495284 tn?1333894042
City of Dominatrix, MN
Avatar universal
phoenix, AZ
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is treating glaucoma with marijuana all hype, or can hemp actually help?
If you think marijuana has no ill effects on your health, this article from Missouri Medicine may make you think again.
Julia Aharonov, DO, reveals the quickest way to beat drug withdrawal.
Tricks to help you quit for good.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.