Methadone changed my life... now what?

[OldSchoolDeuce]

I tend to be very wordy but I will try to make this simple.

    After a very sudden separation from my now ex-wife in Feb of 2009 I plunged into a terrible depression, not surprisingly considering I have battled mild issues with anxiety and depression my entire adult life. I had always self-medicated for what has now been diagnosed as fast cycle bi-polar disorder. I used alcohol and marijuana daily for anxiety and and when the depression hit I'd reach for an opiate. After my wife left I stayed completely clean for 4 weeks in a desperate attempt to let my depression fade on it's own...but it only got worse. I began to drink again, then smoke, then I convinced my doc I had sever back pain and viola! Opiates.

    Oldest story in the book, within a few months I was in deep, within a year I was up to 60-80mg a day Oxy and that's only because that's all I could afford, I was still pretty depressed a lot because I was just cycling between withdraw and being high, finally used myself into bankruptcy, lost my job and spent 4 months broke, depressed, addicted and jobless. In august of 2010 I finally got hired into a new position, I really wanted things to change for me and I had a couple friends who had recently begun methadone maintenance for their opiate addiction and they encouraged me to give it a shot.

     It changed my life! No kidding, I obviously quit the pills, then I quit the pot so I could get split doses and take home methdone allowing me to spread my dose out so I didn't sweat so bad at work. I excelled at my new job, for the first time EVER ( I'm 32 now ) I never miss work, I'm excited to be there, a proud worker, a strong dedicated employee. This carried over to my home life, chores done on time, bills paid instead of dope purchased, family ties grow stronger. Now the problem.... I cannot afford methadone and live on my own, I own my house and a car ect. so it is very hard on one very moderate income and my methadone is $260 a month, so it's burying me financially but I am SO scared to switch medications to something my insurance might cover or ween of the methadone because not only did it quell my urge to do other opiates it also got me off pot reduced my craving for alcohol and COMPLETELY ELIMINATED ALL OF MY ANXIETY AND DEPRESSION ISSUES, SERIOUSLY! I haven't felt this good about myself since I was 14 years old and I am just sick thinking about getting off methadone and going back to the anxiety/depression/bipolar problems of the past 18 years :-(

    Should I bite the bullet and switch to suboxone or subutex? Should I reduced my methadone dose and ween off ( 50mg a day since September of 2010 ) ? Has anyone else every been through this exact scenario? Is there an anti-depressant available that will give me a similar emotional lift like the slight buzz of methadone so that I can get off the opiate? Anyone have any thought on low dose methadone as a legitimate treatment for fast cycle bipolar disorder or general depression? I really feel like I could easily reduce my methadone dose to 20-30 mgs a day. I just don't want to ever feel like I did before, I was freaking suicidally depressed and I just can't go back. Thank you so much for reading I really appreciate your time and your thoughts, thanks again.....Sincerely J in the K

[KristenFolkert]

I spent most of my 20s in mental hospitals. I got on methadone for 4 years and no hospitals. My bipolar and depression was stable. When I got off I had a psychotic break and and am just now recovering from intense mood swings. It's been 9 months. I am on psych meds. Wellbutrin affects dopamine and is recommended for opiate addicts. Getting off methadone when your mentally ill is HARD. I couldn't function or work for months. It's a highly personal decision and I wish you the best in finding a solution that works for you

[adpagew]

I also found that when I was at about 110 mgs of methadone and maybe I was taking Effexor at the same time, my social anxiety was GONE.  I didn't realize till then how debilitating the anxiety was; from not apply for jobs, not attending social functions, no speaking in front of a group, etc.  I missed many opportunities in life because of this problem. I tried EFT, CBT, counselling, THE WORKS, and nothing was as effective as methadone.

[HenryS354]

Hey bud,

Bummer on the bad news.  Heres the good stuff...  Is there anything you can do to go back in time to change your past?  I would have to personally say no, but if you can answer "Yes" to that, then we need to talk, cause we could be making some huge cash! ;-)

But really... Does it matter if you caused your low T levels? Or why they are they way they are?  Low T is easily treatable, and testosterone replacement therapy is super easy, not too costly, and results can be seen quite quickly.

So pick your chin up, as addicts we put ourselves at risk for all kinds of medical issues, I mean lets face it, we put our bodies through hell... of course they are going to bite back from time to time.

Stay focused on your path, do what you need to do to get healthy, and keep pushing forward!

BTW, Did you ever hear back from your insurance company?

[OldSchoolDeuce]

     Siggghhhh, I got lab results from my recent blood tests after having sexual dysfunction symptoms... My testosterone level is EXTREMELY LOW. Now I am all beat up. I know that the lower hormone levels could be a direct result of my drug abuse, but I abused drugs to self medicate for depression, and low testosterone causes depression... so which came first.. the chicken or the egg, the addiction or the depression.. wtf should I do? I'm so lost now... was I self medicating my depression or causing it... what do I do now? I'm soooo sad just because I am sooo lost... :-(

[OldSchoolDeuce]

    Darn-it! I awoke late and had to reschedule my appointment with the treatment center supervisor. No big deal, I was just going to ask him:

    "Why the hell do I only have to pay $30 to get into this MMT program, and my Doc refers me to a center that charges $400 intake fee for subutex? WTH is going on here?
    
     I'll ask him on Thursday. Then, I guess call my insurer. Kinda sad that no one read this and could give me any info, or anecdote, or guess at what might happen when I call my insurance company and say... " Hey the Cialis my Dr. gave me is working fantastic so how much is the tier 3 co-pay on that thing and oh by the way what do you folks cover when I switch from MMT to subutex or suboxone?

    I need to get this done very, very soon, I am behind on every bill I have and paying $250/month for MMT, I figure if the 3rd tier copay on my sub and cialis is 50 each I can keep my head above water by taking shorted lunched and getting to work early and staying a tad late everyday... :-/  

     What a mess... please, any info you have, anyone been through something similar? What's it like talking to the insurers? Do I have anything to worry about or is honesty truly the best policy? I know that me worrying about by health insurance is petty compared to some of the things many of our peers are dealing with but if you have anything to contribute that may relate or help please don't hesitate! Thanks guys and gals, much luv.

[OldSchoolDeuce]

    Thanks gnarls, not worried about being dropped for using methadone for psych reasons, I really am a recovering Oxy addict so that's all good, it's just that the methadone did something that not even being high on an 80 did, it makes me...dammit for lack of a better word "smooth". When I was high I was obviously manic, stoned, out of control, but on methadone I am a little hyper but that is my personality! There is no mania, and no depression, just me,,, a consistent me.

    I haven't been this consistent literally my entire adult life that is why I am having such anxiety about getting off methadone. It didn't just get me off the dope, it gave me the freedom from the emotional swings that have allowed me to start a promising retail career with a family owned company and make huge strides in my personal life including fairly successful and fulfilling dating since my divorce more than 2 years ago! Really appreciate your thoughts, feel free to comment back your time is not wasted on me, I will listen to anyone's sincere opinions. :-)

[gnarly_1]

HI....im also bipolar and agree with you methadone does quite down the cycling when I went off it I was right on the edge of a mania but got past it then I sank into a depression  but mostly from the methadone withdrawals and post withdrawals it take a wile to come off of methadone and feel right again....im with IBK there are lots of new meds to treat bipolar none will give you a buzz there not suppose to but I do know this as long as I take my meds I am atable and sont even know I suffer from it except once in a wile if it persist I see my doctor and get my meds adjusted I hope this helps you getting off methadone was one of the best decisions of my life
you may want to try getting off and going the bipolar med way...if they know your using it for your bipolar they will drop you at the clinic good luck and God bless   Gnarly    

[OldSchoolDeuce]

Right on man. I'll ask my treatment center owner for a list tomorrow but honestly he has been, while very kind and understanding, less than encouraging as far as helping me find alternative treatments, for good reasons, he is running a business I guess. The $400 out of pocket I was quoted for intake fee is not a big sum long term but when I am stuggling to come up with 8-9 a day for MMT, well, that makes it an impossible amount in the short term, know what I mean? If my insurance would reimburse me I could MAYBE find a loan from a family member or a friend, but I'm sure you know how difficult that can be when you are trying to rebuild all those bridges burned during a decent into addiction hell :-(

    I meet with the treatment center tomorrow, hope to call my insurer on lunch and maybe have a plan by the evening. I'm sure I will at least have more questions, so I'll ttys, thanks again, and if anyone has anything to add please feel free!

[HenryS354]

Any time bud! You know that great saying "We can only keep what we have by giving it away"?

I certainly did not miss the methadone at all!  Keep in mind, there will be an adaptation phase if and when you switch to Subutex, but hang in there.  My transition was super smooth, but some have a little harder time with it.  Having the freedom of a once a month office visit was quite liberating indeed!  

The ABSOLUTE worst that can happen is... you pay the induction fee, start subutex, and find that its not for you, and you switch back to the methadone. Its all about finding what is right for you!  And while the few hundred $ can certainly be hard to swallow... Its a small price to pay when you are looking at long term freedom. :-)

As far as your insurance goes... Mine would not cover anything related to MMT!  I currently have Blue Cross/ Blue Shield PPO.  When I started sub, the doc I went to was a General Practice Physician that happened to be certified to prescribe suboxone as well.  His induction fee was only $100, which I did have to pay out of pocket.  But the monthly visits simply cost me my $20 office visit copay.  I think the best bet would be to call the docs in your area that can write for sub, and ask them if your particular insurance is accepted.  

Insurance is a tricky one....  My personal thought would be that you already disclosed that you were in treatment so there is nothing to worry about. But keep in mind Im no insurance expert.

HS

[OldSchoolDeuce]

    Thanks a lot Henry. I really appreciate hearing your story, I'm sure you've told it a hundred times so thanks for taking the time to do it again. It certainly is encouraging to hear that what I plan on doing, what I feel like I want to do is exactly what you did! I don't want to be in MMT for 7 years but like you said it took you that long to tire of it, I'm tired of it now just worried that I won't continue the same kind of improvements that I have had if I switch off MMT and go to bupe.

     If I understand what you are saying it's that you certainly did not miss the methadone when you switched to suboxone, in fact not being part of MMT anymore actually helped you feel even better about yourself, is that right?

    I guess my next questions would be regarding my insurance company. When I enrolled in coverage back in November of 2010 I was honest on the enrollment forms and clearly stated that I was in a MMT program and that I was prescribed a daily dose of methadone, I certainly did not want to be denied any coverage later for not disclosing the medication I was currently on. Now I am still a bit worried, maybe for no reason, I hope, about calling my insurer and asking whether or not bupe is covered and what they will pay for. Is that I worry I need not have? Is there no risk to discussing my addiction openly with the insurer? I'm just afraid they, knowing that I am an addict and therefore more susceptible to illness or injury, that they may use that information to find a "legal" and "legitimate" reason for denying be coverage in the future. I hope I am wrong and I hope someone can convince me there is nothing to worry about so that I can go ahead and call them today!   Thank you all again for your input!

[HenryS354]

Hey bud,

I totally get what your saying!  I got some of the same benefits from Methadone treatment, not all, but some. Out of the 7 years that I spent in the methadone program, those first two years were what I called the "Golden Years"  

I remember standing in line every morning, paying my $60 a week thinking "Damn, this is what it feels like to feel normal!"  It wasnt until about two years in that my dose stopped giving me that normal feeling... or so I thought it did.  Whats a guy to do?  Increase his dose! And of course, the clinic did so happily as the clinic I was at charged more for higher doses...  This sent me into a spiral of increasing dosages, and health issues from the related side effects.  

After 7 years of all this, I became tired... Tired of playing the game. Tired of maintaining my addiction as a "Functional member of society" But never really working on myself.

I decided that I wanted to switch to suboxone. With that I started gradually decreasing my methadone dosage down to 20mgs, and went the three days without my meds before inducing onto Suboxone.  The 3 day wd wasnt as bad as I though it was going to be.  I went to my new clinic, paid the $500 "Induction" fee, and started my suboxone treatment smoothly.  Every month I would pay my $20 office visit copay, and $30 RX copay.

I took this time to really anaylze my life, and what I was doing with it.  Through the help of a therapist, I found that the "Normal" feeling I was getting, was remembering what it was like to go through a day without searching for drugs, lying, cheating, stealing...  This produced some additional natural endorphins which paired nicely with my methadone dose to give me that "Glow"  

But I had to question that day that I stood in line and said I felt "Normal"  Was it normal to get up and go to a clinic every day at 5am to get my "dose"?  Was it normal to be spending $250-$400 a month to feel this way?  Was it normal to go through the side effects to feel this normalcy?  Would there ever be a day that I could wake up, feel happy, and productive without the stigma of the clinic system? Or a chemical?  The answer was a huge YES!

I continued my suboxone regimen until I had a better grip on what addiciton was TO ME, and why I did some of the things I did during active use.  I also used this time to allow myself to let go of all the pain I caused to the ones I love... They forgave me, now was the time to forgive myself.  That guilt that we carry can be a real **** when it wants to be... Its a huge part of what keeps us sick bud.

9 Months ago, I detoxed off suboxone, and I now have all those feelings I thought the methadone was giving me.  

Of course I am not saying that suboxone gave this all to me... however I did get a bit more of a realistic mental clarity while on suboxone that I didnt get from methadone.  Not having to deal with the clinic beauracreacy, also lifted my spirits for sure.  

With that said, Methadone certainly had its place in my recovery, and Im not sure I would do anything differently if given the chance.  The things that I learned that 7 years in MMT were huge pre-cursors to gaining the urge to finally taking hold of this demon within.  The answer of one or the other with regards to methadone or suboxone are quite personal and each has its own benefits and downfalls and is quite the personal decision!

If after your research, suboxone (Subutex) is the way you really want to go... there are some options.  There are physician locators that will give you all the numbers of suboxone providers in your area.  You could call around and find each induction fee and what your insurance covers in regards to office visits.  

You can find the Physician Locator at www.NAABT.org

Also, there is the "Here to help" Program  this program offers assistance to those who are currently on or would like to begin buprenorphine treatment that meet certain financial criteria.  There are links to the "Here to help" program on the link provided above.

Hope this helps a bit... Seems like Im just as "Wordy" lol

Henry

[OldSchoolDeuce]

I'm not surprised by your response to how methadone is affecting me, I have yet to find anyone I know personally who experiences the same thing. Within a week of starting methadone was when I realized that it had completely smoothed me out, you know emotionally, there is a slight "kick" almost euphoric about an hour after I dose in the morning ( 30mgs ) but after about an hour I feel NORMAL, normal like I did when I was a kid before my emotions when on roller coaster mode, normal like I spent the last decade or more imagining that other people felt. I sleep like a rock at night and wake refreshed in the morning and I have NEVER been a morning person, but now I want to get up a little early so I can enjoy my coffee and some oatmeal ( helps with the constipation BIGTIME lol ) , I was always the guy who would call into work because I was having a bad day, rough time with the wife, call in sick, cat got sick, call in sick, car has a flat... change it, naw screw that call in sick, now I will do anything to get to work to contribute and support my co-workers. It's changed everything and I am so scared to go back to the way things were.

    I absolutely have been talking to my doctors. In fact I requested a referral to an addiction specialist so I could consult with them about going from methadone to subutex ( preferably, I am not an IV abuser and feel like there is no need for the blocker in Suboxone ) and he gave me a referral then called me and left a message stating that if I did call them for an appointment be prepared to pay $400 up front then work it out with my insurance!!! WTF! The major driving reason behind this is a cannot afford the 9 bux a day for methadone, how the heck do I come up with 400 bones for one visit!!! My insurance company's drug formulary says they cover methadone only for non-addiction purposes, but they do cover subutex and suboxone ( at the highest co-pay of course but still much cheaper than my methadone I am assuming ) , so I am working on the questions you pose about coverage and speaking to my doctor.

    I appreciate the response, I hope my reply covered some questions that others may have about my original post, I was trying to keep the character count down in the first one. As you can probably see I can really lay it out there if you get me going lol! So, in conclusion, I really can't talk to my doctor again until next payday to ask him WHY on earth he thought referring me to a clinic that charges 400 cash up front was a reasonable path of action considering I have shared with him everything I have shared here about how I cannot afford the medication at 9 dollars a day. I am considering switching doctors because he doesn't have a lot of experience in the field of addiction and I just don't think he grasps what is going on here at all. Which I think is pretty obvious after his referral hahaha. So in the meantime I am just searching for other input, opinions, experiences and advice that may help me on the difficult journey.... thanks again friends.

[IBKleen]

Hi,

I am quite surprised at your post, almost speechless really. I have not heard anyone experience what you are while taking Methadone. Neither Suboxone or Methadone produced those feeling for me, but I am not bi-polar so that is surely the difference.

I don't know how much you know about Methadone withdrawal but it is not pleasant and in order to make the switch you will need to either taper down (highly suggested) or make the jump. Either way, you will need to wait to begin a Suboxone program. You cannot just jump from one to the other. You would be risking precipitated withdrawal and that is never pleasant.

I don't know about your insurance, but Suboxone is quite expensive as well. You will need to look into it before hand.

With all of this being said, I need to suggest that you speak with your doctor. There are so many new medications on the market today designed for bi-polar and depression disorders.  In the long run I would hope your ultimate goal would be to get off of any addictive medication and get on something that can target your particular disorder. Neither Methadone or Suboxone were designed for that, as I am sure you know, and eventually you will run into problems.

Again I have to suggest that you speak with your doctor, get honest and share your concerns. I wish you the best and hope you can find something that will help you.