1. Dear Drugs-Forum readers: We are a small non-profit that runs one of the most read drug information & addiction help websites in the world. We serve over 4 million readers per month, and have costs like all popular websites: servers, hosting, licenses and software. To protect our independence we do not run ads. We take no government funds. We run on donations which average $25. If everyone reading this would donate $5 then this fund raiser would be done in an hour. If Drugs-Forum is useful to you, take one minute to keep it online another year by donating whatever you can today. Donations are currently not sufficient to pay our bills and keep the site up. Your help is most welcome. Thank you.
    PLEASE HELP
    Dismiss Notice

get off methadone by switching to a short-acting opiate and tapering that

Discussion in 'Opiate addiction' started by jloops, Nov 21, 2009.

  1. jloops

    jloops Silver Member

    Reputation Points:
    164
    Joined:
    Nov 11, 2009
    Messages:
    123
    Male from U.K.
    Anyone who has any experience switching from methadone to something else, esp. a traditional short-acting opiate, please let swim know how it went. SWIM is thinking about using a detox that switches you to a hydrocodone(ish) drug and then (blind) tapers you off that for 3 weeks, which should be relatively painless for coming off of something like 20 mg methadone, right?

    Anyone ever tried switching from methadone to hydrocodone or, for you guys in England, Canada, and apparently many other countries, from methadone to dihydrocodeine for taper? (Or to heroin in some sort of reasonably controlled way? I'm imagining this ended in a C/T rather than a taper!) If you switched, what dose did you switch at and how much of the new drug did you take at first?

    SWIM has tapered methadone down to 30 mg (and hopes to get to at least 20 before going to a detox) from 80 mg, and is looking at this detox place that switches you onto something like hydrocodone/dihydrocodeine or even oxycodone possibly, and tapers you off over 3 weeks...

    They don't give you Vicodin or anything, they give you very high doses of the ([di]hydro/oxy)co(done/deine) in a liquid cocktail with some other meds, every 4 hours (including in the middle of the night).

    Anyways, it ain't bupe, and it's a weaker opiate than methadone.

    Basically, who out there has switched to a short-acting opiate and had success getting off the methadone in that way?

    SWIM is thinking that it would circumvent much of the BS associated with getting off of a long acting opiate... In 21 days, the worst of the symptoms associated with getting methadone out of the body would have passed, and you'd just be dealing with a short-acting opiate withdrawal when you get to the end of the taper... They said that on the last day, you're taking almost nothing, so when you walk out you're probably taking something like 4 mg of hydrocodone per day, a single vicodin per day, which is basically nothing... swim will request that they get him down to 0 3-4 days before leaving, though, so as to avoid any nasty surprises.

    Any thoughts on this? This seems like the best plan swim has heard for getting off of methadone... Bupe induction seems like a real pain and swim can't see how that would work better than this plan, especially since bupe is still throwing the long half-life curve ball at you...
     
    Last edited: Nov 22, 2009
  2. Helene

    Helene Gold Member

    Reputation Points:
    2,389
    Joined:
    Jul 27, 2009
    Messages:
    1,230
    Female from U.K.
    Swim has never tried this herself, but it's a relatively common method used in the UK for doing that very last bit of a methadone reduction taper. Drug services often prescribe dihydrocodeine (DF118's) for this very purpose.

    Obviously, for maintenance purposes DF118's aren't really suitable, as they are so short acting. But for finishing off that final bit of your taper, swim agrees that this is a very good idea. When you get down to methadone doses of 5mg or less, switching over to a short acting opiate such as dihydrocodeine really is an option worth considering. Swim knows some people who have successfully gotten clean using this method, and they have reported it to be much easier than coming straight off the methadone.

    Anyone in such a situation should have a chat with their prescribing physician, if they feel that something like this could aid their detox plans.

    H

    PS - Swim should just point out that hydrocodone and oxycodone are very different from dihydrocodeine. Both hydrocodone and oxycodone are considerably stronger than dihydrocodeine (roughly 10 and 20 times stonger respectively, depending on which conversion table you look at), and swim believes that they have slightly longer half-lives as well. Dihydrocodeine really isn't comparable with either of them. Swim's above post refers to using dihydrocodeine for the reasons described, she would like to make it clear that she does not think this would be a good idea with either hydrocodone or oxycodone, they both hold far too high an abuse potential and have far too strong a narcotic effect. Especially considering the person is gonna have a very reduced tolerance, as it's likely that they will have reduced their meth down to levels lower than they have been on for a good while. And if one of these drugs were the patients original DOC, well, in swim's opinion a step in that direction would be completely counter-productive. Nor is swim aware of either of these drugs being commonly prescribed for detox purposes.
     
    Last edited: Nov 22, 2009
  3. jloops

    jloops Silver Member

    Reputation Points:
    164
    Joined:
    Nov 11, 2009
    Messages:
    123
    Male from U.K.
    Yes, swim knows there is a good deal of difference between dihydrocodeine and hydrocodone and oxycodone (and even between hydro and oxycodone).

    However, this is how this detox facility does it for methadone, and apparently with some success. (swim thinks they also use hydrocodone or whatever for short-acting opiates and suboxone [i.e., people who can't quit the suboxone] as well.)

    Hydrocodone has to be a significant step down from methadone, of course... easier to come off...

    Why wouldn't it be a good idea for that, Helene? This is done in a detox and everything, why would that be a bad idea? It can't be any worse than a methadone taper! (This is one of the few detox places that will take people on mammoth doses of methadone, 100+, 200+, etc.)

    BTW, swim wishes he could get to 5 mg on his own, but doesn't know if it'll be possible, and probably will be going to a detox somewhere between 10-20 mg, right now on 30 mg.

    This has to be better than trying to get straight off the methadone, and easier than using bupe since there's no need for induction ... right?
     
  4. LiquidHandcuffs

    LiquidHandcuffs Newbie

    Reputation Points:
    158
    Joined:
    Nov 15, 2009
    Messages:
    72
    Male from U.S.A.
    Perhaps Swim missed something along the way, but he has been under the impression for quite some time that Methadone is primarily used as a substitute for short-acting opiates, and that those who are unable to quit the short-acting opiates are placed on MMT in order to help them straighten their problem(s) out.

    In Swim's personal opinion, he thinks that Swiy would be making a mistake if he abandoned MMT to detox with a shorter-acting opiate (though he is not certain).

    Swim is finding CT off 65mgs of Meth to be a(n) (much) easier kick than his 80mg/day/1 year OC habit.

    This is because Swim has easily been able to overcome any physical withdrawal he has experienced in his short life, but has not been able to overcome the Psychological/Physiological withdrawal dynamic as the cravings always proved a bit too much for Swim to handle.

    Perhaps Swiy feels more confident in combating the Psychological/Physiological Withdrawals than he does the Physical Withdrawal?
     
  5. Spucky

    Spucky Palladium Member

    Reputation Points:
    3,000
    Joined:
    Feb 9, 2009
    Messages:
    2,401
    Male from japan
    AW: get off methadone by switching to a short-acting opiate and tapering that

    We can say that "Short-Acting Opioids" rise the Tolerance quicker
    as well as that they create a more intensive Addiction!

    A Withdrawal from short acting Opioids will be earlier finished
    but harder to quit.

    The Cat think that a long acting Opioid will be much more successful.
     
  6. alaskazagnut

    alaskazagnut Silver Member

    Reputation Points:
    126
    Joined:
    Sep 23, 2009
    Messages:
    114
    Male from U.S.A.
    The only thing that worked for my friend was crystal meth. She said she felt no restless leg syndrome, the insomnia was actually being high and she was not ill, flu-like or achy. Amazing. I think crystal meth totally hi-jacked her brain and it binds to every possible receptor the brain has. Of course crystal meth has a whole separate addiction and negative side effect issues, but it is mostly psychological unless SWIY keeps using it for months on end.

    She will never to go back to methadone unless it is to ween off of H or Oxy. Methadone withdrawals are the worst she had ever felt. One time she went cold turkey for 4 days and she said she could understand suicide due to the sheer hell and agony. Scary. She said, for her, all the true opiate withdrawals started to get better after the 3rd day. With methadone, she said, the 3rd and 4th days were increasingly worse. Especially when trying to sleep.

    Has anyone on this board ever heard of anyone being on methadone for over 6 months and successfully going cold turkey?

    AMENDMENT by alaskazagnut

    My statyement "I think crystal meth totally hi-jacked her brain and it binds to every possible receptor the brain has." is obviously an exaggeration of what happened chemically in her brain. Statements like that either have no place here, or they need to be quantified fro what they are. Attempts at light hearted humor.
    Although "for her" the only thing that worked was crystal meth, that is unfortunate and she did not try weening or other medically approved treatment options. She tried for years to quit methadone both by weening and cold turkey. She went cold turkey and had virtually no withdrawal symptoms except psychologically missing the high and physical insomnia. I do not "know" why crystal meth alleviated all her withdrawal symptoms. But to get off of methadone in 8 days cold turkey with only meth used every other day is amazing. It worked. Unfortunately my laymans terms, and only personal experience, the only way this could happen is if some aspect of the crystal meth affects the opioid receptors. I have searched and I cannot find any proof that it doesn't. But I have found other posts on this forum supporting this phenomenon. Period.

    Kratom does, so why can't crystal meth. I do not "claim" this as fact to be the case, only that "for her" this is what seemed to happen.

    I realize crew forum need to demand as accurate information as possible but I am not a PHD in chemistry or medicine. I speak frankly and truthfully about personal experience. I apologize if sometimes it is misleading. If someone told me three years ago that you could go cold turkey from methadone with crystal meth, I would say they were misleading too. But I now would have to agree with them. Sorry opiate FC or whoever gave me neg, rep but it might seem misleading but it is the honest truth in my experience. They still don't know exactly why mescaline causes hallucinations so maybe current knowledge can be misleading too about what affects the brains receptors and what doesn't.
     
    Last edited: Nov 30, 2009
  7. jloops

    jloops Silver Member

    Reputation Points:
    164
    Joined:
    Nov 11, 2009
    Messages:
    123
    Male from U.K.
    Yeah, swim has definitely taken enough methadone for enough years to straighten everything out and hasn't used any other drugs during this long period.
    Definitely... at least inasmuch as swim is not fond of illicit opiate use, and was able to handle licit opiate use quite well, and would at least not 'relapse' to illicit use...

    SWIM is definitely committed, BTW. Already done 80-30 mg, which is something, in a short period of time. (Dropped it in something like 10 days, but then got mixed around trying to switch to buprenorphine and ended up being at 30 1.5 months since the drops started.)

    SWIM should be clear that he was talking about a short-acting opioid taper as an INPATIENT -- i.e., at a detox! SWIM didn't mention that key fact earlier, apparently!
     
  8. alaskazagnut

    alaskazagnut Silver Member

    Reputation Points:
    126
    Joined:
    Sep 23, 2009
    Messages:
    114
    Male from U.S.A.
    I agree, I highly doubt that methamphetamine binds to "every" receptor in the brain, I do not claim that. But I "think" it does or more proper wording I should have used is "seems" like it when my friend is high. It definitely gets rid of all (for her) her opiate withdrawal. Methamphetamine is not an opiate but it seems that in part, it binds to her opiate receptors. Proper wording, avoiding generalizations, and not assuming basic information is shared by all is important on this forum, which I am learning.

    Thanks for noting my misleading over-generalization or exaggeration on my point. I also do not recommend doing this. I am just stating the experience.
     
    Last edited: Nov 24, 2009
  9. LiquidHandcuffs

    LiquidHandcuffs Newbie

    Reputation Points:
    158
    Joined:
    Nov 15, 2009
    Messages:
    72
    Male from U.S.A.
    Ahhhhh! much better clarity!

    First, congratulate Swiy on his 50mg dose decrease on behalf of Swim! Swiy has successfully (and rather quickly!) reached a point where he is dosing only 37.5% of his original dose of 80mg! Awesome progress!

    As far as the Inpatient short-acting Opiate Taper, Swim now sees this as a more viable option for Swiy!

    Swim can never be too confident with the idea of trusting "one of his own" to be scrupulous in managing his/her own taper. <--Swim certainly thinks he would struggle mightily!
     
  10. sasafrass

    sasafrass Silver Member

    Reputation Points:
    62
    Joined:
    Jun 3, 2009
    Messages:
    148
    Male from U.S.A.
    Methamphetamine was used in California for opiate w/d's in 1960's. It did work. Nobody knows how, as there was no follow up. Bad press killed it.
    Methadone's much weaker chemical cousin darvon, if you get down far enough, will keep you sane if taken every 3-4 hours. Its pretty rare to become dependent on it, or it work very well either. But it helps.
     
  11. jloops

    jloops Silver Member

    Reputation Points:
    164
    Joined:
    Nov 11, 2009
    Messages:
    123
    Male from U.K.
    SWIM bets that methamphetamine worked for people who were in very mild withdrawal (which is more like some of what is called PAWS) or who were in PAWS already... That is, it cured the fatigue and feeling of weakness.

    Being on methamphetamine during acute, moderate to severe withdrawal would be ugly though -- you don't want to be crapping and vomiting your shaking, goosepimpled a** off while of speed!

    Also, SWIM thought Darvon would be useful since it's related chemically, but no one seems to use Darvon for withdrawal at a detox facility, although you could definitely get a doctor for it...

    Thanks for the supportive words and info, everybody. Swim would really love to hear anyone who has made a similar switch, in any context, but especially for detox.
     
  12. Ethyl

    Ethyl Newbie

    Reputation Points:
    145
    Joined:
    Feb 21, 2007
    Messages:
    263
    Male from portugal
    You can use codeine as a substitute.

    SWIY says it uses 30mgs of methadone per day. That is easily replaced by 300mgs of codeine 3 times daily.

    So SWIY can swicth to 300mg x3 of codeine and then start the taper from there.
    But SWIY should use codeine in 300mgs x3 for a week or two before he starts the tapering, after that time SWIY can start the codeine tapering but first make sure SWIY have cleaned your self from the methadone so that way all possible methadone withdraw will be gone before SWIY starts the tapering.

    SWIM says codeine because its easy available in Canada.

    NOTE: Oral codeine is 10 times less potent than oral methadone, so thats why 300mgs of codeine substitutes 30mgs of methadone.



    Good luck!
     
    Last edited: Nov 24, 2009
  13. Piglet

    Piglet Titanium Member

    Reputation Points:
    673
    Joined:
    May 28, 2005
    Messages:
    1,272
    46 y/o Male from U.K.
    Most people find that codeine doesn't prevent withdrawal too well. That's why in the UK doctors will usually prescribe dihydrocodeine at the end of a methadone taper. It isn't much stronger than codeine but it is longer acting (6 hours as apposed to 4 for codeine) and although their IS a ceiling dose, it's somewhat higher than that of codeine.
     
  14. Ethyl

    Ethyl Newbie

    Reputation Points:
    145
    Joined:
    Feb 21, 2007
    Messages:
    263
    Male from portugal
    Most people convert codeine to morphine in 10% of the codeine ingested.
    Morphine is a full mu agonist that will prevent withdraw in all people.

    Only a small percentage of people don't convert codeine into morphine that well, but i think its only 6% of the Caucasian population (the common population in Canada), in Asia the % of people that convert codeine to morphine with greater difficulty is more than 10% but far lesser than "most people" as you say..

    I think you were trying to say that most people dont get high from codeine when they have previous tolerance to opiates, but as far as withdraw for most people codeine is indeed a great withdraw preventer, but if you are talking about getting high from codeine thats different, but as far as withdraw prevention 90% of the Caucasian population have great success with it because they will convert 10% of the codeine ingested to morphine and other metabolites too, like 1% of the codeine ingested is converted to hydromorphone (dilaudid) and others.

    Codeine isn't prescribed in doses above 60mgs in the medical community, but that doesnt mean it can't be used in doses above 60mgs, as most recreational users know the average ceiling is about 400mgs of codeine BASE for the average male user, and that's above the dose needed to substitute for 30mgs of methadone. 400mgs of codeine would substitute for 40mgs of oral methadone, the user only needs 300mgs cause he is only using 30mgs of methadone.

    EDIT: CORRECTION: Its not 10% of the population but 6%!
     
    Last edited: Nov 24, 2009
  15. Breedlove

    Breedlove Silver Member

    Reputation Points:
    97
    Joined:
    Apr 8, 2009
    Messages:
    50
    64 y/o Male from U.S.A.
    The bonehead used heroin to get off methadone the first 4 times he kicked that dreadful shit. Bone doesn't think codeine, or hydrocodone, or percocette are gonna do shit to you. Methadone is some pretty lethal shit. The method is not for the faint of heart though... Ya' gotta be pretty goddamn committed. Hmmm... not sure whether this good advice. But, if any method works for you, use it. Getting off methadone is a good thing, no matter how you do it. The bone is not a big fan of methadone!

    Breedlove
     
  16. jloops

    jloops Silver Member

    Reputation Points:
    164
    Joined:
    Nov 11, 2009
    Messages:
    123
    Male from U.K.
    Swim can tell. :)

    How much dope did you need to stay well and off of what dose of methadone did you jump?
     
  17. Ethyl

    Ethyl Newbie

    Reputation Points:
    145
    Joined:
    Feb 21, 2007
    Messages:
    263
    Male from portugal
    Some who isn't Ethyl used 400mgs 3 times daily instead of his daily 40mgs of methadone one day that he was far away from home and didn't had taken his methadone with him.
    It worked like a charm! In fact he even felt a small euphoria.
    Dont know about hydrocodone or oxycodone, but morphine is a full mu agonist that will prevent withdraw for all opiate addictions, and because codeine converts to morphine then it works if the methadone daily dose is equal or bellow than 40mgs.
    The exception is if swiy are one of 6% of people that don't convert codeine to morphine that well but if swiy aren't then about 10% of swiy's codeine will convert to morphine and 1% of the codeine will convert to the even stronger hydromorphone (dilaudid).

    Codeine may not get a tolerant people high due to the slow conversion to morphine inside taking time... But one thing that will do is prevent withdrawal.

    If the dose of methadone is above 40mgs then codeine will not cover all withdraw symptoms cause it has a ceiling of 400mgs in most people, and thats only equivalent to 40mgs morphine IM.
     
    Last edited: Nov 25, 2009