methadone withdrawal

[hambrick]

I am on methadone for chronic pain. My neurologist, dr. Virginia Pact, MD has sold her practice and she really knows very little about how to withdraw someone from methadone anyway. I use to be on 15 mg daily and I took myself down very slowly from that dose to about 7 1/2 daily about a year ago. I was afraid to go all the way down in case my pain became severe again. I got the withdrawal information from the local methadone clinic at that time. (My doctor thought I should just stop taking the dose...very bad idea.)
I am now attempting to get completely off methadone but have no idea how to titrate down without experiencing severe symptoms. Since this dose is so low, what I am doing is shaving (pills are very tiny) about what I think is 1mg from my daily dose. I started this on Thursday and as of this writing I have diarrhea, headache, back pain has increased with muscle pain and general malaise. My plan was to go down by 1mg daily until I was finished, but I am not certain this is a good idea. I am employed full time and do not want to miss work as a result of this so it is important to keep my symptoms to a minimum. What would you suggest? I hope to hear form you very soon. Thank you very much.

***@****

[CannabisDave]

CHINESE HERBS and ACCUPUNCTURE seem to be two of the best ways to treat withdrawal syndrome, and the long-term "post accute withdrawal syndrome" (or "abstinance syndrome"). Methadone has a long-term post accute withdrawal period - sometimes it NEVER goes away. I've heard of people getting off of methdone for a few years, and after being miserable the whole time they get back on methadone - why be miserable when a medication allows you to feel "normal" again? When I read about people putting themselves through torture to get off methadone (or other opioids), I wonder why they are doing it. Methadone in smaller split doses has no bad side effects, but when I have to dose once daily at a clinic I need considerably more methadone to "hold" me for 24hrs. until my next dose (back at the clinic EVERY DAY), and then I suffer from constipation, depression, no libido, etc. That is what "they" are doing to me if I have to go back to a methdone clinic again. If I do need methadone the rest of my life I'm not too concerned - unless I have to go to a methadone clinic again! The only thing that makes being on methadone so bad is the "stigma" against it which is based on ignorance, and the fact that methadone is a very difficult to obtain medication which is only available at HORRIBLE methadone clinics (and a few pain clinics).  I respect "Dr. Steve's" advice, but sometimes other "addiction specialists" are completely ignorant about addiction treatment - especially when they are attached to methadone clinics! The doctors at the methadone clinics I went to were dangerously ignorant, and many people died because of it. I went to methadone clinics for about five years, and they all made my life hell - the "staff" there who forcibly detoxed me (or summarily dicharged me) were not trained medical professionals, yet they told the doctor what my dose would be and the doctor would sign-off on anything they told him. Unfortunately for me, they were sadistic control freaks, so I ended-up without my life-sustaining methadone again and again (I had to use heroin a few times). I could never even think about getting off methadone while dosing just once daily at a clinic, but after my doctor began prescribing the methadone pills for me a year ago I was able to titrate my dose down to just one 10mg. tablet twice a day - I went from 60mg. a day last year when I got summarily discharged from a methadone clinic (yet again), to just 20mg. daily now. Unfortunately, my doctor has been threatened for prescribing methadone since he isn't a pain specialist, so he switched us methadone taking patients to oxycontin (I made it clear to him that he was treating me for chronic PAIN and not ADDICTION, because I know that isn't legal). Now my only hope is a pain treatment clinic, and if they won't prescribe methadone for me there, then I'll have to detox off of oxycontin from my doctor (he is allowed to give me oxycontin or hydromorphone etc., but not methadone!). Going to a methadone clinic again would mean being a "prisoner-client" forced to take a huge dose of methadone to hold me 24hours. Another problem for me at a methadone clinic is that they are discharging people mearly for using marijuana, and I'm a medical marijuana patient. I'm also using marijuana to help me get off of methadone, but they won't allow me to continue using pot if I'm dosing at a clinic. I think kicking people off a methadone program for using pot is completely irrational, and when they are a medical marijuana patient it's even more irrational, but they are doing it anyway!  Re: oxycontin - I find that taking them as prescribed keeps me fairly stable, but the side-effects seem much worse than methadone so far...I'm probably suffering a bit from methadone withdrawal since I suddenly switched medications (methadone to oxycontin), but fortunatly I still have a few methadone tablets left to ease the transfer - I'm alternating methadone with the oxycontin to try and stabilize myself (oxy is hard to sleep on, so I take methadone in the evening). I find that the oxycontin works OK if I take them as prescribed, but I much prefer methadone. Methadone is much cheaper, but it's also a far surperior chronic pain medication, in my opinion. Everybody is different, but I believe that for MOST people methadone is a better choice for treating long-term chronic pain and/or addiction. As far as "tablets vs liquid": I much prefer the methadone tablets, because they seem to absorb slower and last longer. It's quite easy to titrate down using pills - the "Methadose" brand tablets are larger than the other kind of methadone tablets I got (I haven't tried the "Dolophine" brand yet), so it's a little easier to break them into smaller doses, but even the smaller talbets can easily be broken down into even small doses. A 5mg. tablet can easily be broken in halves (2-1/2mg. pieces), and those can easily be broken in half (1-1/4mg. pieces), and those can be broken in half yet again if needed. I think it's much easier to titrate down when you have complete control over your own dosing schedule. Sometimes we all need a bit more methadone for various reasons (increased pain, stress, strenuous phsical activity, urine pH, etc.), and clinics won't let you adjust your dose very often - they insist you stay at what THEY consider a "stable" dose, even though they don't know how you feel. Women often need more methadone during their menstral cycle each month, and that's when the women on methadone at clinics sometimes use heroin since the clinic won't give them extra methadone to compensate for their increased need during their period. Only you know how you feel, so only you should have control over your dosing schedule - unless you're an addict who absolutely can't control your own intake, but that's rarely a problem with methadone. If anyone reading this is suffering from addiction to oxycontin (or other short-acting opioids), please do yourself a favor and switch to methadone ASAP!!!

[Francoise]

Hi Dave:

Great post. I was even sorry to see it end.

I'm taking oxycontin (100 mg/2x) for chronic pain. Have been doing for - well - in November, it will be three years. I hear what you're saying about methadone and in fact will print out your post and show it to my pain management doctor.

If I do indeed switch to methadone from the oxycontin dose noted above, how much methadone will I need? And what kind of side effects will I experience? I'm most sensitive to depression, and would rather stay on the oxy than get into a depressive state.

Something else stays on my mind and that is: my pain management guy is most cooperative. I've never had a problem of any kind with this guy. But I'm 56 years old and since there is much longevity in my family, I might be around until I'm well into my 80s or beyond. My father, for instance, is 82 and still mows the grass and other stuff. I'm concerned about what might happen if or when my pain guy moves to a different city, dies, etc. I don't think it's a given that I'm going to find another like him. And I don't know if this is the voice of reason, or the voice of paranoia. I'm tempted to go the Ibogaine route.

I say that because I don't have any way of accessing my current level of real pain. I know something is still there since when I get up in the morning and its time to dose, I can feel considerable pain in my back and sometimes during the day if I turn my body just right I get an impressive amount of pain shooting down my leg (wedge fracture L4 vertebra, open book fracture of pelvis with dislocation - the pelvis had to be reattached to my spine with a 4" titanium bolt).

Oxycontin most definitely gives me a life, but with side-effects that perfectly mimic exhaustion and all the rest.

Each time I begin to think like this, I remember Christopher Reeve and think how he fell six feet; I fell 25 feet and I can walk.

A guy on this site, Thomas, a great guy, has a good formula for getting off opiates, but I don't know if I'm ready for that battle viz. pain.

Would appreciate having your thoughts. You can post direct at ***@****.

Thanks,
Frank

[trebor]

Hello, i am on a meathadone maintence corse in Ireland and there is a new drug that has come out in Ireland over the last 1 year or so, it called Lefexodean or britlefex (spelling wrong) my brother and a few other people i know have been put on this when detoxing over here and they thought it was very very good nearly taking all the sickness away, the drug was not made for this i dont think, it was made for bringing down blood preasure, if you get on to this drug you might have to go into hospital unless you can get someone to check your blood preasure every day, anyway when my brother was put on it he went in to hospital for about 10 days first you have to be brought down to a low dose on meathadone say about 5mls then you start on the tablets, they start you on 1 aday and when bringing you up on the tablets they bring you off the meathadone after 3 or 4 day you are totaly of the meathdone and put you up to a maximum of 12 tablets a day and then you brought off the tablets over the next week, there are side affects but they are not bad you might feel tired and sleepy but not much more then that and you can not be addicted to this drug, i had another freind who dident go into hospital his mother is a nurse and she took his blood preasure, now i dont know if you can get them in the USA but if you can get them in Iraland i dont see why you couldent get them in America,
I hope this might be some help to you,


Robby.

[Sharp]

I am now detoxing off methadone and I am at 18mgs.  I have been decreasing a couple of mgs a week from 40 mgs.  The withdrawals are really starting to effect me now but I am under pressure to continue to go down 2 mgs a week since I am relocating in a few monthe to an area with no methadone clinics.  I have been reading the posts and I am on my way out to but L-tyrosine, B6, and Multivitamins and zinc.  I have been reading about how wonderful these supplements have been working and am looking forward to trying them.  Does anyone know how much zinc you would need to take daily???  I tried to search the archive but they only give the original questions and Dr. Steves answers but no members responses.  I recall reading several months ago from Pillpappa a posted schedule showing estimated amounts to take. If anyone has this info I would appreciate it.  Thank you.

[Witchywoman]

Hi Sharp,
I've definately noticed a reduction in withdrawal symptoms with the L-Tyrosine, B-6 and Zinc supplements.  Here is the post from Pillppa with his zinc recommendation.  I don't agree with him that the zinc deficiency is the reason for the addiction symptoms, I'd like to see solid research to back up his claims....but I have to admit, the supplementation has helped me a lot.  I couldn't find tablets with his recommended ammounts, so I take a good multi mineral, and add extra zinc tablets to it.
Good luck, and let us know how you are doing.

Here is his post:

Hi Moses - you will not come right until you replace all the zinc/mag you have leached out of your body over the past few years - this is what 'hanging out' really is - it's your body craving zinc/mag (zinc stops cravings/magnesium stops depression). If you don't do this it will take up to 2 years to return to normal as the only other source your body has for zinc/mag is food and then it is in such tiny amounts it takes years to build up again. If you get a blood test done you will find your levels of both are way down on what they should be.


A typical tablet contains somthing like this:

Zinc amino acid chelate 75mg
Magnesium amino acis chelate 37.5mg
Vitamin B6 10mg
Manganese amino acid chelate 10mg
Viatmin A (1000I.U.) 300mcg

Grading your habit on a scale of 1-10 (1 being occasional use and 10 being long term methadone at 100 plus mg's a day) you should take the following amount for a period of one month then slowly reduce to a daily amount of 2-3 per day.

Habit scale/size - Number of tablets per day for a month

10 10
9 9
8 8
7 7
6 6
5 5
4 4
3 3
2 3
1 2
0 2

You will notice that I recommend you never go below 2 per day. This is because zinc/mag depletion was your original problem so you should give yourself an ongoing supplement to make sure it does not happen again. I now take 2-3 per day to maintain my health. I have had no failures with this treatment (everyone OK after less than a month) and have treated addictions (including my own) as varied as methadone and cigarettes. The cigarrete smoker reduced from 2 packs per day to just 5 cigarettes per day in a week without any discomfort. If you suffer any kind of 'hang out' just increase the zinc/mag dosage and give it a liitle longer to take effect (a week or so).
The drugs themselves are not actually addictive but they do leach all the zinc/mag out of your body by increasing the metabolism of them creating a shortage that gets worse the longer you use unless you replace them while you are using in which case you don't hang out when you stop - you just come straight - this is true beleive me I have tried it as have a few other people I know and none of us sufferred any hang out when we stopped.

[Sharp]

WitchyWoman,

Thank you for your help, I went out and purchased all the necessary supplements yesterday.  I plan on a 3mg drop at the end of this week, i will let you know how it works for me
, hopefully I will have less w/d symptoms.