Methadone is designed to be a 36 hour drug. This is true in a sense. Take methadone long enough (2-3 months) and you’ll find a dose will often last for 24-36 hours. However, in the early stages of taking methadone it actually only lasts for 12-18 hours. The logical recourse would be to administer a split dose (half morning, half night).
Methadone withdrawals can last about two weeks. Other opiates last about 3-4 days. Methadone PAWS can last for months, sometimes up to a year or two. Other opiate PAWS last (usually) about 3-4 months. This is likely because methadone is a full antagonist drug where other opiates are generally partial antagonists.
PAWS (Post Acute Withdrawal Symptoms) are a milder version of withdrawal symptoms. It’s often described as having a low level flu, while feeling weak and drained of strength and energy. Which while doesn’t sound so bad, over 3 months to a year can be incredibly debilitating, especially when no doctor will offer aid, and few will offer sympathy.
PAWS are one of the main factors in drug relapse. PAWS are not officially recognized by the medical community or ************** centers. Treatment is rarely offered or provided if asked. Often addicts will be met with hostility and insults by doctors who accuse them of “drug seeking” and tell them it’s all in their minds. Is it any wonder there’s such a high relapse rate?
But this drug is about control. Regulation and law doesn’t allow for split dosing. Clinics find it’s too difficult and time consuming to practice this. Besides, 90% of all methadone rules are designed around controlling where the drug actually ends up. Split dosing would double the amount of methadone in the hands of the populace (via take home bottles) and the system has deemed that unacceptable.
This is why so many people end up on doses of 150 milligrams or more. In the first month, the patient comes in complaining their dose isn’t lasting a full 24 hours. Since they can’t split your dose, they offer you a dose increase as a sop. (This has the added bonus for them of getting their patients up to high doses that are VERY difficult to come off). Split dosing would have patients on much lower doses. Forty, fifty milligrams would easily take care of any addiction.
I’m speaking about split dosing because, frankly, it’s crucial to true methadone detox taper;
Part 3: Tapering off Methadone:
First and foremost, the most important thing in detoxing off of methadone is to STOP ALLOTHER DRUG ACTIVITY. If you’re using additional opiates, taking occasional other drugs, etc…you’re just spinning your wheels. If you can’t handle stopping playing about with drugs for a few months or years, then I doubt you’re able to handle getting off one of the most addictive drugs in history. Your mindset is wrong, it won’t work. This is a LONG process, and takes will, determination, and fortitude.
You aren’t just fighting an addiction here, you’re fighting a society that looks down on and disdains you as a lost cause as well as a system that is only interested in the profits it can make from your illness. This is a BATTLE in the WAR of your survival and self respect and almost EVERYONE is your enemy. (Think of yourself as one of Hogan’s Heroes in that Nazi prison camp. You may as well have a sense of humour about it, it’ll make it easier!)
When you drop in dose during taper, methadone temporarily CEASES to be a 24-36 hour drug. For the two weeks after the initial dose drop, you’re back to the drug lasting in your system for only 12-18 hours. This effect is magnified according to the amount you drop, as well as how low you are. I found that in the high dose range, the effect is minimal. Under 20 milligrams, it’s greatly magnified.
Which is why I spoke about split dosing. To truly effectively taper with minimal negative impact (symptoms), you need to split your dose.
“But”, you say to me; “We aren’t ALLOWED to split dose! How do I manage to do this then?!”
The first answer is earning the “privilege” of take home bottles. If you can get 3-4 bottles a week, you can work out a fairly effective split dosing system that will get you by. It’s not ideal but it’s passable.
Say you get a bottle on Tuesday Thursday, Saturday and Sunday (a common scheduling for four days).
You take your Monday dose. Wake up on Tuesday; take a half dose morning and night. Wednesday go in and take your full dose. Thursday split morning and night; and so on…
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