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Methadone - liquid or pills?

Discussion in 'Methadone' started by Zeke, Aug 29, 2009.

  1. Zeke

    Zeke Newbie

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    Hi! Please forgive my english, this is my first post in english ever.
    I have been in a methadone-program for 1,5 years, I have 160mg a day.
    This monday I changed my dose to liquid methadone from tablets. I had sixteen 10mg pills a day, and I thought it would be much easier to just swallow 32ml of liquid instead. But the effect wasn't as good as I thought it would be. I find this very strange, the content is almost identical. Does anybody recognise this or is it just in my mind?

    What you would choose? and why?
     
  2. adictsdvtchka138

    adictsdvtchka138 Newbie

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    i am on 90 mg of methadone and live in the US I havent heard of my clinic using tablets.... did you feel different just that day or a few days, maybe it was just your mind playing tricks on you... ya know what i mean?
     
  3. Highland.habit

    Highland.habit Silver Member

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    In the UK as far as i know, you only get the tablets if you tell them you cannot keep the juice down. Plus here SWIM's liquid methadone was 1ml to 1mg, so you would need to take 160ml of juice to get the same as 16 x 10ml tabs.

    SWIM rathered the juice as i used it for tapering & it is easier to taper of liquid than tabs.
     
  4. electros[h]ock_patient

    electros[h]ock_patient Silver Member

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    swim takes the liquid (clear, by mallinkcrodt... called Methadose - Sugar Free Oral Concentrate __EDIT: it's 10mg of Methadone per every 1ml / 1cc of distilled water__). Anyways, swim wouldn't know the difference in efficacy between this liquid and swiy's (or swiy's old pills). Swim's only guess is the pills may be taking longer to fully take effect and give the perception of "holding one longer".

    swim's best advice is to try splitting the dose. 80mg in the morning, and 80mg later in the day. this is how most clinics should deal with the issue if they haven't brought it up already.
     
  5. CrookedEye

    CrookedEye Palladium Member

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    SWIM had taken the clear liquid, and the red liquid, but it seemed to him that the strongest doses came from the orange wafers he tried. Often he could halve his dose when taking the wafers, and it seemed to achieve the same effect.
     
  6. SepCulpa

    SepCulpa Newbie

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    Does anyone know about how much 100mg of liquid methadone is as far as a general measurement? I do not have anything that can measure milliliters. But I am looking at a bottle of the clear liquid and it seems to be a relatively small amount. The owner of the bottle has assured me that that is the entire 100mg but I have no way of knowing. Any suggestions? Like how many teaspoons would it be approximately?
     
  7. cpalka

    cpalka Newbie

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    30ml - 10mg pill
     
  8. TheBigBadWolf

    TheBigBadWolf Cold Member Palladium Member Donating Member

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    As you say there is not very much of that liquid in the bottle and it is supposed to have 100mg of methadone in it, this will most def be 10 ml of a 10mg/ml solution.
    But you can't tell, nor can you effectively measure a dose that would fit you.
    Don't believe me, I could as well be perfectly wrong with the dosing.

    Bad idea to try and guesstimate the contents of a bottle with liquid.
    Get yourself a syringe or pipette to measure with. Teaspoons are for cough syrup, not for very strong narcotics like methadone.


    If you get the dose wrong,- you will land in ER or in a box.

    Methadone is nothing to play with. It is a substance that can take away your life, by chance.

    Get yourself decent measurement devices.

    TBBW
     
  9. Cartoon_Pickle

    Cartoon_Pickle Silver Member

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    56 y/o Female from Linden, NJ
    I agree w/CrookedEye, I am currently on 50mg daily of liquid Methadone, but while on vacation, 2-10mg tablets kept me feeling fine, no sickness whatsoever.
     
  10. dkane180

    dkane180 Newbie

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    The rule at my methadone clinic was 1ml = 10mg. I'll take the liquid over the pills anyday.
     
  11. BrandonJCdude92

    BrandonJCdude92 Newbie

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    The liquid onsets alot quicker it seems to me. Relief within 15 to 30 minutes after dosing if your sick. With pills more like 45 to an hour to feel withdrawal symptoms dissappear. Plus the liquid produces a stronger glow/buzz and then 4-12 hours into more of a nod, sleepy type feeling you all have come to know very well. Liquid is stronger in 9 out of 10 peoples opinion but seems to get out of system quicker than wafers or 10mg pills. My clinic is liquid only. Until you get to the point where you come in once every 2 weeks, or once every month to pick up take homes, then you get only wafers...
     
  12. TheBigBadWolf

    TheBigBadWolf Cold Member Palladium Member Donating Member

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    How do you get this insight?

    Do you have any sources to cover your view?

    I can very well understand the slower onset of the tabs,- but it seems unlogical to me that the same dose of the same substance, taken by the same ROA should need different time to clear out of the system,- this applies even stronger to methadone due to the extremely long half-life time and the resulting accumulating effect.

    TBBW
     
  13. BrandonJCdude92

    BrandonJCdude92 Newbie

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    I dont mean out of system, and I have no sources backing me up. I just mean I always notice that Im always a little bit sicker feeling on the way to the clinic to get my dose in the morning if i did liquid the day before.
    However if i skip the clinic and take my dose in 10mg tabs, the next day on the clinic I still feel completely fine and can almost wait 48 hours in between doses rather than with the liquid I MUST dose every 24 hours or I am miserable. Maybe its just me, but just sharing my opinion...
     
  14. TheBigBadWolf

    TheBigBadWolf Cold Member Palladium Member Donating Member

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    Thanks for clearing that.
    I was only irritated by you "9 of ten people" construction.
    Just try to state that it is your opinion rather than construing a sentence to make it sound good, eh? ;)

    I had a similar experience:
    Normally I am prescribed PolamidonTM which is levomethadone.
    When my doctor was in holidays, the one substituting me made an error on the prescription form and I was served rac-mathadone in the pharmacy.
    I thought,- well- the dose is right, so what.
    SAme experience as you had,- I began to withdraw at 5 am, whereas my levomethadone keeps me comfortable for at least two days, even if I skip a dose there is nothing that would remind me to take it.

    I have heard this from other people on differnt medications that, when they got generics instead of their original med, they had problems because of difference in the properties.
    I read somewhere that this could be due to the different fillers and binders in tabs, having different influence on the active substance.

    TBBW
     
  15. east_of_eden

    east_of_eden Titanium Member

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    I agree with Brandon that for me as well, I've always preferred the liquid. I'm on pills now and if I wait too long to take them and start feeling sick, it takes about 45 minutes for the pills to kick in and to start feeling better.

    The liquid works within a few minutes. This is only my experience, but I remember the years of being on a clinic and showing up in the early stages of light withdrawal and by the time I'd left the building and walked back to my car, I'd already be sorted out.

    But my friends and I have debated pills vs. liquid often and it's interesting because the general consensus among friends is that if you're on pills, you're going to prefer the liquid and if you're on liquid, you prefer the pills. I guess it's a matter of what you're body (and possibly somewhat mind?) get used to.

    So, I'm surprised you didn't find the liquid strong enough. As long as the dose is the same, maybe in a day or two, you'll adjust to it. The only problem I find with liquid compared to pills is the liquid seems to kick in faster but not last as long. Or maybe it's all in my head, but I definitely feel a difference. :s

    Sorry that post wasn't much help, just sharing my experience.
     
  16. MoreOnMethadone

    MoreOnMethadone Silver Member

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    [FONT=&quot]Abstract: It is the author’s intent to show via various United States patents as well as various DEA controlled substance act numbers and different molecular structures of methadone that all methadone is in fact, NOT the same. In today’s atmosphere of what is said to be “a problem of epidemic proportion” of the use and abuse of prescription and or street narcotics one is often only left with an option of going to a clinical methadone maintenance treatment (MMT) facility to help avoid the extraordinary physical and mental agony during withdrawal that can be caused from opioid substances use for periods of as short as a few months. Herein illustrates the huge problem of the myth that all methadone is the same. The author has devoted and an enormous amount of time and effort to explore the differences of various methadone preparations and the varying strength of the different methadone tablets dispensed for pain management compared to MMT clinical liquid methadone (racemic mixture) in order to educate those in both the medical and clinical arenas as to the extreme differences in potency of various methadone preparations in the United States.
    [FONT=&quot]The reason the author has devoted this time and effort is due to the fact that a close family member was on the pain management tablet form of methadone for over one decade, after the pain management medical practice was sold to a another practitioner who ultimately decided not to dispense methadone, the family member of the author was forced to use MMT liquid methadone. This person was able to completely control his pain and maintain a somewhat normal life while taking an average of 60 mg to 90 mg of Rx methadone per day for over 10 years, the individual was then forced into a MMT clinical atmosphere due to financial considerations and the current governmental regulations that have been put on physicians in the United States, making it difficult if not impossible to find a medical practitioner that will dispense an adequate amount of prescription methadone medications in the years between 2011 to 2013.
    [FONT=&quot]During the four months that this individual was using clinical MMT liquid methadone, an extraordinary amount of withdrawal symptoms became evident. This phenomenon occurred for over 100+ days while the individual was on 2 to 3 times the amount of tablet methadone that he had taken for the previous decade. How is this possible if in fact all methadone is of the same potency and is controlled under federal FDA and DEA standards? It is curious to the author that although the individual had been on prescribed methadone for over a decade without one instance of requesting an early refill or misplacing, losing, or having the methadone lost or stolen during the pain management treatment, never the less, current USA MMT regulations do not allow for a patient being on Rx methadone for any length of time to be transferred into the MMT clinic atmosphere allowing for the previous responsible usage. Hence an individual with a long-standing history of responsible methadone usage must begin at a methadone maintenance clinic as though he had never ingested methadone responsibly. In other words, even an individual that has demonstrated complete responsibility with the schedule II narcotic of methadone, the current MMT regulations do not allow for said individual the “credit” for their responsibility when switching to a MMT clinic atmosphere, even though the federal regulatory division of the DEA is able to access an individual’s past and present use of what is purportedly to be the very same substance in a clinical atmosphere.
    [FONT=&quot]It is the author’s belief that this is extraordinarily prejudicial toward any individual, even more so for an individual with over a decade of utilizing the very same narcotic substance. If all methadone was the same, then the individual mentioned above should have had absolutely no problem with any physical or physiological withdrawal symptoms during the time of switching between Rx dispensed methadone tablets and MMT liquid methadone, yet this was completely not the case. Furthermore; the individual mentioned above knew another MMT liquid methadone patient who had been on a daily dose of up to 255 mg daily, however during emergency situations in which that individual could not make it to the MMT facility, 100 mg or less of the pharmaceutically prescribed methadone tablets not only completely arrested all withdrawal symptoms but left the individual feeling unusually better than the days that the MMT methadone was dispensed. This was not a placebo effect, but quite the opposite, since the individual had expected to feel much worse because of the decreased amount of pharmaceutical Rx methadone available, this happened on more than a few occasions.
    [FONT=&quot]Due to the aforementioned unusual occurrences the author has decided to investigate the claim that “all methadone is in fact the same”. During this ongoing investigation it is shocking to the author that a FDA and DEA [FONT=&quot]Schedule II controlled [FONT=&quot]Narcotic substance [FONT=&quot]can in fact, be substantially different in potency and have extraordinarily huge differences to a human being’s central nervous system. It is worth mentioning that the author believed the statement that: “All methadone dispensed in the United States is the same”. Nothing could be further from the truth.
    How can a Schedule II Controlled Substance in the US prescribed as “Methadone”, have a variable potency of 1:1 to over 30:1 Mg to Mg ratio to Morphine in the USA, yet the proof is in the US patents. What a patient receives is considered to be: ‘All the same’ as per the “Abbreviated New Drug Application” regulated by the FDA in the USA. No wonder there have been so many overdose reports claiming methadone as a primary or secondary result of death. To explain this, let’s look at molecular methadone.
    [FONT=&quot]There are 4 isomers of methadone: [FONT=&quot]
    1) d-6-Dimethylamino-4,4-diphenyl-3-heptanone[FONT=&quot] (d-methadone);
    2) l-6-Dimethylamino-4,4-diphenyl-3-heptanone [FONT=&quot](l-methadone);
    3) d-6-Dimethylamino-5-methyl-4,4-diphenyl-3-hexanone [FONT=&quot](d-isomethadone);
    4) l-6-Dimethylamino-5-methyl-4,4-diphenyl-3-hexanone [FONT=&quot](l-isomethadone).
    Methadone's production process yields all 4 isomers. During the production process isomers (3) and (4) can be easily removed, while separation of (1) and (2) are difficult and more expensive.

    All racemic mixtures of DL-methadone on market are a mixture of two isomers; it is one mixture of dl-methadone, and has the DEA CSA # of 1095-90-5. This is the liquid "racemic mixture” of methadone that is the form commonly used clinically in MMT settings. The D-Isomer of methadone also contains N-methyl-D-aspartate, the NMDA receptor antagonist activity; as such, this is the preferred substance to be dispensed in a clinical atmosphere to prevent opiate withdrawal as well as making it very difficult for a person using the racemic mixture to feel the effects of any supplemental usage of opioid substances. This mixture of methadone is 90% D-methadone to 10% L-methadone and does not vary from various manufacturers.

    The final products in the USA contain both d-methadone, and l-methadone isomers leaving the final methadone products with various ratios of dl-methadone. Currently there are different United States patents for making methadone HLC, at least six, as listed in the references below. It is completely baffling to the author as to why an FDA approved medication can be made with substantial varying effects and resulting in completely different molecular structures, yet named the same.


    Various “methadone” Controlled Substance Act (CSA) or CAS numbers are listed below:
    1095-90-5; 1095-90-3; 125-58-6; 125-79-1; 15284-15-8; 5967-73-7; 76-99-5; 76-99-3;
    297-88-1; 60263-63-0; 5653-80-5; 61849-14-7. 12 distinctively different CSA/CAS numbers, all “Methadone” with variable D-L Methadone ratios, again proof that ALL Methadone IS NOT the same.

    The amount of analgesia in any particular form of methadone is due to the ratio of DL-methadone dynamic factors. There seems to be increased potency presumably because of the NMDA receptor antagonism of the d-isomer. This is why the calculated equianalgesic dose of Methadone to Morphine can range from nearly 1:1 to as much as 30+:1 in the USA. In other countries that use formulations of DL-methadone with nearly none of the D-Isomer included the equianalgesic ratio can be as high as 40+:1. With an empirically clean L-methadone mixture, eliminating the d-isomer and its NMDA receptor antagonism effects, the analgesia of Methadone to Morphine is a 50:1 ratio; this is in fact the result of Levomethadone, legal in Germany.

    [FONT=&quot]L-methadone, with 50 times the analgesia potency of D-methadone, is used for somatic pain management. L-methadone is responsible for respiratory depression, QT interval prolongation as well as physical and psychological dependence. The United States does not allow for a patent that is 100% pure L-methadone, but limits the ratio of DL-methadone of L-methadone and D-methadone with no NMDA receptor antagonism effects. As one can surmise from this combination of DL-methadone, it is the preferred method of delivery for those patients needing analgesia for moderate to severe discomfort. This is the Methadone HLC tablets dispensed by a pharmacy for pain, however even the non racemic forms of the pills seem to abide by their ‘patent of choice’, hence the Roxanne pills seem to be manufactured different than the Mallinckrodt version of their Methadone pill. After speaking directly with both mentioned manufactures as well as others, the claim that by use of the “Abbreviated New Drug Application”(**), that it matters not what is used to make the various forms of Methadone, they all meet the FDA requirement that the end product is allowed to be dispensed as Methadone for USA consumption.**

    USA patent number 6897242** states:
    "Compositions of non-racemic (Pill*) mixtures of d- and l-methadone and a method of treating pain using the composition. The composition is especially useful for treating pain of mixed origin. For predominantly neuropathic pain, a mixture of predominantly d-methadone, up to about 90%, is used. For predominantly somatic pain, a mixture of predominantly l-methadone, up to about 90%, is used (IE: Mallinckrodt Pills*). The non-racemic mixture of dl-methadone may be* further combined with a pharmacologically effective amount of a nonopioid component. In another aspect of the invention, the methadone can be* combined with an opioid antagonist such as naloxone, naltrexone, or the like."
    Please note that this patent does not state must be”* - * - Comments by author.

    Further, there are three distinctively different forms of Methadone, all of which will identify as ‘methadone’ in drug screens:
    1) D-methadone
    2) L-methadone
    3) DL-methadone

    It is also worth mentioning that both D-methadone and L-methadone have the identical Molecular Weight: 309.445180; that being of significance since L-Methadone has a DEA CSA number of 125-58-6, while D-methadone CSA #: 15284-15-8 and DL-Methadone HLC has many various CSA numbers. DL-Methadone Molecular Weight: 345.9059.

    If all methadone was in fact the same, then there would be ONE, and only ONE molecular structure or ‘chemical footprint’, and ONE CSA number. This is absolutely not the case with ‘Methadone’.[FONT=&quot] To view the various chemical structures of Methadone and how much they vary simply go to ‘Google Images’ and type in “Methadone chemical structure”.

    The author will continue in the effort to clarify the differences to clinicians in MMT and Pain management arenas.
     
    Last edited by a moderator: Apr 30, 2017
  17. Roll1N

    Roll1N

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    The Methadone clinic I go to has both pills and liquid.
    I'm currently on 45mg of the liquid kind.

    I believe they use the Pills for people who have digestive problems or something like that.
    They crush them up and put them in juice or water..
     
  18. adam525

    adam525 Silver Member

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    Technically, the doses are exactly the same. Where I go, some people like the wafers better and some people like the liquid better. I'm on the liquid, but really have no preference. I think lots of times people get the wafers because they are easier to sell (because it IS really hard to eyeball the liquid and see if you're getting what you're paying for).

    If I was taking 160 mg's, rather than choking down all of those wafers, or having to go through breaking them down every day, I would definitely go with the liquid.

    If you asked a doctor if one was stronger than the other, they would tell you that it's exactly the same (obviously, because that's what the clinic gives you). People get in their minds that one is stronger than the other and they truly believe it. When I took hydrocodone, I swore by the name brand blue watsons. Later on, when I was into OC's, I hated the generics, for different reasons (the generics had more filler in them). When you start to like a pill more than another for reasons like that, you get in your mind that one is better (more potent) than another.

    In fact, all pills that are marked as a certain potency ARE the same potency. Manufacturers, the FDA, and others make sure that this is the case.
     
  19. wesc775

    wesc775 Silver Member

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    I know this thread is old, but what the hell I will add my 2 cents... I have always been on the 1ml 10mg Clear Roxane Methadose from my clinic. They also do the Wafers there, but, you must have proof of having some kind of stomach issues to take them. I don't see why. But, I do know that it is easier for the people who get pills and get take homes of them easier to sell a pill then liquid. A guy just got busted for diverting his wafers as a matter of fact. But, I believe why people say the pills work better and last longer is a type of placebo effect as well as I believe the liquid hits you faster, the pill takes longer to break down and hit your system, so in theory it would take last what? maybe a hour or two longer in a way then liquid would. OR so it would seem, it is just that it takes longer to get into your system. What Adam said above me about Hydrocodone also holds some Value, but, I still do believe that norco from Watson brand is much better than the same drug that mallinkrodt makes. Mallinkrodt has been known for making shitty pills since the dawn of time and many people will attest to that.
     
  20. MoreOnMethadone

    MoreOnMethadone Silver Member

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    I attempted to show in quoting the USA Patent below; there is L-Methadone and D-Methadone. They can be likened to L-Morphine (Morphine Sulphate) and D-Morphine (Dextromethorphan).

    "USA patent number 6897242 states:
    "Compositions of non-racemic (Pill*) mixtures of d- and l-methadone and a method of treating pain using the composition. The composition is especially useful for treating pain of mixed origin. For predominantly neuropathic pain, a mixture of predominantly d-methadone, up to about 90%, is used. For predominantly somatic pain, a mixture of predominantly l-methadone, up to about 90%, is used (IE: Mallinckrodt Pills*). The non-racemic mixture of dl-methadone may be* further combined with a pharmacologically effective amount of a nonopioid component. In another aspect of the invention, the methadone can be* combined with an opioid antagonist such as naloxone, naltrexone, or the like." - Please note that this patent does not state “must be” - * - Comments very important to author."


    This is only ONE (1) of many USA Patents for "USA Methadone". I too agree that various different manufactures' of say Hydrocodone, Codeine and even Morphine seem to have different effects on different people, however 'Methadone' in the USA can, and DO, have different ratios of the L-Methadone (the 'good' methadone) and the 'D-Methadone' (the opiate receptor antagonism agent - or 'bad' methadone). Both L-Methadone and D-Methadone will prevent opiate withdraw, however it is the L-Methadone that is the methadone that blocks/attacks the pain... That was the primary point of the previous post.

    I hope this post helps to clarify my point.... However, the author is still completely baffled as to how a Schedule-II opiate narcotic can have a D-Methadone to L-Methadone ratio that can vary from the 10% D-Methadone - 90% L-Methadone ratio; all the way to the racemic mixture ratio of 90% D-Methadone to 10% L-Methadone. It simply makes NO sense; the difference on ANY human being's CNS will be quite different, period.