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What are the affects of mixing methadone and heroin?
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What are the affects of mixing methadone and heroin?

I need to know the affects of mixing the two together. I have looked online and cannot seem to get a straight foward answer. My friend is on 110 mg of mathadone and how would I know if she was mixing heroin with it. What would the two do together and would she even be able to tell she was doing the heroin?
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495284_tn?1333897642
It's deadly.......
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229538_tn?1300381367
Tell them not to do it ! Sara is right . That is a death , a lethal combination !
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185545_tn?1331078466
Methadone does not have a ceiling effect.
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Avatar_n_tn
Hi, Carla. I am so sorry that you and your friend are having a stressful time right now. A couple of questions: did she take heroin before? Is that why she's on methadone? She is on a methadone program, right? I agree with everyone, she's in a dangerous situation if she's adding heroin to the mix. It's awful to say this, but she'd be safer taking one or the other, not both. If she is even thinking about adding H to her methadone dose, she's not ready for a methadone program.
Another bit of info about dying from opiates: respiratory depression from a big opiate dose can cause fluid to pool around the lungs and heart. This is called cardiopulmonary edema, and the person can "drown" in their own fluids because the O2 can't get to the body. Doghound is right, you can't always save a person who has respiratory edema, because even if you are Ambu bagging them in an ambulance/ER, the O2 still can't get through the waterlogged lung tissue. The other way a person who has overdosed can drown is if they throw up while they are passed out. It's a hideous way to die, because even if they are rescued, after a week or two they can die of bacterial pneumonia from aspiration. I don't mean to upset you for the world telling you these things--it's just that your friend is dicing with her life and she's not talking to us, you are. The info everyone has given you tonight should really up the ante for her knowing just how dangerous mixing these two things can be.
As a friend, could you have a frank talk with her and tell her your fears about her adding drugs to her methadone? Again, even though I feel really bad saying this, if she's going to add H to her methadone, it's safer for her to choose one or the other. Of course, if she's on a monitored methadone program, that's what she should choose. If you think it'd help her, tell her about the forum here. Carla, you are a good friend to worry about her--everyone should have such a friend. I hope she listens to you and does the right thing. Please write again and let us know what's going on.
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Avatar_f_tn
Okay this is what she used to do. She was a snorter at first and then went to iv use. Total time of using was maybe 8 months. (IV use was around 3 months) She is in a methadone program and has been for around 4 months and has been doing very well. I have not even suspected anything and really have no reason to. I just know that one of her associates sell it and she doesn't really talk to him or see him like that, but I really want to know signs of mixing the two together.Is there anyway you can tell and how would the person act?
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185545_tn?1331078466
Theres no real way to discern whether or not someone is either overprescribed legitimate methadone or mixing thier methadone with other illicit opioids ie heroin. They are both opioids and have virtually identical overt symptoms. Any advice on the matter would be highly speculative and certainly not definitive enough to act upon.

Why dont you just ask?  If your friend is uncooperative there isnt much else you can do. It sounds like your friend is doing well so I dont quite understand the quandry. Gunboat diplomacy with regards to treating substance abuse seldom works and can often be alienating. A suggest a softly softly, easy does it approach.

                                      Anyways good luck.
                       Regards Jeremy. Recovered Addict
                         (12 years @ 155mgs methadone )
                     3 years 11 months drug and alcohol free.

@doghound. It's all good. I just thought your initial post around methadone's "ceiling effect"  was a little ambiguous/misleading and required further clarification. No quarell with your expanded explaination. I thought it was very informative. Thanks.
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Avatar_f_tn
I strongly disagree with the comment that if someone is considering using heroin while on a mmt program that they are not ready for methadone treatment, I am a recovering heroin addict and I have been on mmt for 3 years. I was 20 years old when I started using and I also started out snorting and eventually started shooting. I'm a petite girl and my veins were always difficult to hit. After years of iv use the veins on my inner elbows were totally collapsed and my hands and wrists would take hours of stabbing at just to find a vein. I eventually took to shooting in my neck as it was the only place I could hit. I was just as addicted to the needle as the heroin. I feel like I have to say that you would never think this by looking at me. There is a stereotype of what a drug addict looks like, but in our world anyone can be an addict. I'm a pretty articulate, girl. I was Vice President of national honor society at my university.  I was forced into detoxes, rehabs, halfway houses, and 12 step recovery programs when I had been using for about the same amount of time as your friend. I struggled and continued using between treatments for several years. I thought I would never be able to get clean. I lost all hope and honestly believed that I would die a heroin addict.      

I started on methadone and for the first month or so I used daily on top of it while my dose stabilized. After a few months on the program I stopped using pretty much completely. I went about 8 months only using twice. I don't think I could have ever overcome my addiction without methadone. With other treatments I felt like every time I messed up and used I had to start out at square one again. I would get so discouraged that I ruined all my progress that small lapses wpuld turn into full blown binges that lasted months. With methadone even if I had a lapse it wasn't the end of the world. I could go to the clinic the next day, get my medicine, talk to my counselor, and carry on with my recovery.

Herion is a very hard drug to quit. Most of the time lapses will happen. I had to try,try, try, try, try times a couple thousand before I got it right. For most of us that is part of the process. I'm not saying that it is ok to lapse and use drugs, but it is a reality that the majority of addicts will lapse several times before getting clean. I know that many people have the idea that as long as someone is using heroin at all, they are not doing well. I disagree. Kicking heroin cold turkey once and for all is an insurmountable task for most addicts. Things like switching from iv use to smoking or snorting and using less often are a very good start. This is called harm reduction. Sometimes people need to be able to go from daily use to using a couple times a week, to using a couple times a month, to a couple times a year, to not at all. Of course it would be ideal to quit immediately and permanently, but if that is not possible small improvements are just that -improvements-.

It's great that you are wanting to support your friend. Try to be their for her without judgement. Try to understand that what she is going through has consumed her life and is very overwhelming to try to overcome. Having cravings or lapses does NOT mean that she doesn't want to get clean. Be there for her through her good times and her difficult ones. I know a lot of people say tough love is the best for addicts, but personally that made it MUCH harder for me.

To any struggling addicts out there- don't give up hope- it does get better!
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Avatar_f_tn
I strongly disagree with the comment that if someone is considering using heroin while on a mmt program that they are not ready for methadone treatment, I am a recovering heroin addict and I have been on mmt for 3 years. I was 20 years old when I started using and I also started out snorting and eventually started shooting. I'm a petite girl and my veins were always difficult to hit. After years of iv use the veins on my inner elbows were totally collapsed and my hands and wrists would take hours of stabbing at just to find a vein. I eventually took to shooting in my neck as it was the only place I could hit. I was just as addicted to the needle as the heroin. I feel like I have to say that you would never think this by looking at me. There is a stereotype of what a drug addict looks like, but in our world anyone can be an addict. I'm a pretty articulate, girl. I was Vice President of national honor society at my university.  I was forced into detoxes, rehabs, halfway houses, and 12 step recovery programs when I had been using for about the same amount of time as your friend. I struggled and continued using between treatments for several years. I thought I would never be able to get clean. I lost all hope and honestly believed that I would die a heroin addict.      

I started on methadone and for the first month or so I used daily on top of it while my dose stabilized. After a few months on the program I stopped using pretty much completely. I went about 8 months only using twice. I don't think I could have ever overcome my addiction without methadone. With other treatments I felt like every time I messed up and used I had to start out at square one again. I would get so discouraged that I ruined all my progress that small lapses wpuld turn into full blown binges that lasted months. With methadone even if I had a lapse it wasn't the end of the world. I could go to the clinic the next day, get my medicine, talk to my counselor, and carry on with my recovery.

Herion is a very hard drug to quit. Most of the time lapses will happen. I had to try,try, try, try, try times a couple thousand before I got it right. For most of us that is part of the process. I'm not saying that it is ok to lapse and use drugs, but it is a reality that the majority of addicts will lapse several times before getting clean. I know that many people have the idea that as long as someone is using heroin at all, they are not doing well. I disagree. Kicking heroin cold turkey once and for all is an insurmountable task for most addicts. Things like switching from iv use to smoking or snorting and using less often are a very good start. This is called harm reduction. Sometimes people need to be able to go from daily use to using a couple times a week, to using a couple times a month, to a couple times a year, to not at all. Of course it would be ideal to quit immediately and permanently, but if that is not possible small improvements are just that -improvements-.

It's great that you are wanting to support your friend. Try to be their for her without judgement. Try to understand that what she is going through has consumed her life and is very overwhelming to try to overcome. Having cravings or lapses does NOT mean that she doesn't want to get clean. Be there for her through her good times and her difficult ones. I know a lot of people say tough love is the best for addicts, but personally that made it MUCH harder for me.

To any struggling addicts out there- don't give up hope- it does get better!
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