Trouble adjusting to methadone

My son went on meth in 8/03. It took them two long months to get his dose right.  Then he kept throwing up the liquid so they put him on pills last week.  He got sick the past two days and threw up a few times (could be stomach bug)  When his dose is disrupted or less than adequate he seems to quickly go into meth withdrawal. And then he gets heroin to get him through this until the next day's meth. Do most people go into withdrawal so easily?  How can he deal with this without seeking illegal drugs?  He said the ER will only give him clonidin (sp?); they tell him to wait out the withdrawal.  He's spent as much time on heroin as on meth since 8/03 due to this.  What can he do?

[Roger Gould, M.D.]

There is not much to do medically if you can't get the cooperation of the methadone clinci operation since they control the substance.  They may suspect that your son is not fully committed to this treatment and uses a tolerable withdrawal for the purposes of going back to heroin.  You and your son may think he is just very sensitive and needs a bigger dose.  You have to work this out with the clinic, and tell them your concerns; and also have an honest conversation with your son.