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Methadone withdrawal due to insufficient dose?

Discussion in 'Opiate addiction' started by mikezombie777, Jul 23, 2012.

  1. mikezombie777

    mikezombie777 Silver Member

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    Hey guys, hows life?

    As ya'll know I've been on MMT for about 5 months now and my dose started at 20mg. I am currently at 40mg daily. Now, I am continuing to experience what feels like mild withdrawals every morning and late at night before I go to bed. This is the main reason I keep asking my Doctor to up my dose every few weeks.

    Recently I'd had enough of it and began taking vast amounts of Codeine in an attempt to starve off the late night & early morning withdrawals. I also went to my local clinic and spoke to a different Doctor about my withdrawals due to the fact my GP was on vacation for a week. He put me on doses of Diazepam 3 times a day until I can speak to my usual GP. The Diazepam has definitely helped somewhat, giving me a good nights sleep and making the withdrawals easier to handle. My GP returns this coming Tuesday and I have an appointment with him regarding the perceived withdrawals I keep having. I will either once again ask him to up my dose or request he switch me over to Subs. I know Done' stays in your system for 36hrs or so, therefore why am I experiencing withdrawals just hours after my dose? i.e I dose at 12pm and by 10pm I feel like crap.

    I swear my GP just thinks I'm trying to get high or something, but I'm honestly not. Could this be withdrawals or something else? Prior to starting MMT I was taking basically every opiate under the sun daily. 100mg+ doses of Oxy, 500mg Tramadol, 400mg Codeine, 300mg DHC, 160mg Morphine, 125mcg Fentanyl etc (not all of these every day, but over the period of 8 months I rotated between them)

    Maybe I, and my doctor, have underestimated the severity of my tolerance? I even took both of my take home doses at once a few weeks ago (80mg) and I still felt crappy the next morning. I'm just so sick of this, I want to be on a stable dose and get on with my life.

    Any ideas folks?
     
  2. B.K.

    B.K. Newbie

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    I don't know what the laws/legalities of Methadone dosing schedules are Down Under, but in my state Docs can prescribe up to 200mg/daily. When I first entered MMT I was given a starter dose of 40mg, which I could up 5mg every other day. As I had a bad H habit this wasn't nearly enough to hold me comfortably, so I did what every good dope fiend does: I used H to get well.
    It took 3-4 months to get my dose stabilized at a level that held me comfortably till the next day, and I had to ask for increases every time. Oddly enough, dirty urines actually helped my cause as I would only come up dirty for other opiates, not benzos, alcohol or other drugs. This clued in the counselors/doctors that my dose wasn't high enough. Eventually I was stabilized at 100mg/daily and stopped using dope entirely.
    My point is, don't be shy about asking for increases. Get your life together on an appropriate dose, and then start to think carefully about whether or when you want to taper off. It took me about 3 1/2 years. Seems like a long time, but not in the scope of things.
    Just one person's experience. I truly believe MMT helped save my life and sanity (hah!). I hope this helps. O.
     
  3. Fentiful

    Fentiful Titanium Member

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    Mike, I'm wondering, would it be possible for you to divide your dose? Say take 20mg when you get up and then take the other 20 have way through, at least until you get in to see the doc to asses things. Also you can take loperamide to help with the WD's until you get in. 10-15 2 mg tablets 2x a day. It works best if you take 2 tagamet 200mg 30-45 min prior. This regimen can also help you when and if you decide to get off the MMT. Hope it helps. Also here in the U.S tagamet (cimetidine) and loperamide (immodium) are both OTC.
     
  4. Aberdonian

    Aberdonian

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    i personally love/hate methadone, the first week i was on it it was consume on premises and it would never hold me till next day but after that they put me on take home daily for a few weeks bumping my dose each time till i hit 70 and i was good, half in the morning half at night and that worked good for me im a very fast metabolizer and single dosing didnt work for me i was always waiting for chemist to open after a few weeks i was onto pick up mon wed fri and that was perfect, im on oxy etc just now but if i take it as prescribed it lasts no where near 12 hrs ,and last week my doc gave me 12 days worth of 2x40mg contin 2x20mg contin plus 4x20 mg ir oxy daily, it lasted me till sat night ,so as u can imagine last night this morning was VERY uncomfortable i wa rattling to bits till i picked up rest of my ir oxy , i NEED to make 28 20mg ir last me till thurs when i see my doctor and im gonna ask him for methadone for pain instead of oxy im sick of my addict inside taking all the pills when i know im gonna be short and have no money for anything to sort me out, with methadone i hd no problem with this just took my doses and was fine but they are very reluctant to prescribe pill form methadone here for some reason and i also remember how constipated it made me!fk with methadone i could go up to 10 days plus sometimes without going nd when i did it wasnt much fun ! i have ibs and usually other opiates make me fairly normal ,1-2 days max , but if i were you id try to get a split dose you must be like me a fast metabolizer, even with h etc , i know i hd a big habit but w/d would start setting in after 4-5 hr no matter how strong the h was, also i have passed drug tests 2 days after usin h and not even having to drink extra water etc ,but that did bite me in th ass when i got complacent n lost a good job!

    Aberdonian added 4 Minutes and 15 Seconds later...

    fentiful i agree with the lope in helping wd but i would never try that onn mmt id never ever go to the toilet lol id literally be full of shit,well morelike concrete but shitty concrete lol
     
    Last edited: Jul 23, 2012
  5. Fentiful

    Fentiful Titanium Member

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    Lol Aber,

    As long as I took a stool softner and either Milk of Magnesia or Miralax every other night it was straightened out. :) I can relate to the GI issues I too have a metabolic disorder and bowel issues which in turn led to me running into problems and upping and adding to my doses. They finally found out that my body metabolized meds too fast so none of the ER formulas worked for me including patches. Because of this I had to go to IR doses more frequently. Good luck!
     
  6. mikezombie777

    mikezombie777 Silver Member

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    Hey guys,

    Thanks for the replies. Well today I saw my Doctor and he said some things to me that I was quite hurt by. He upped my dose to 45mg, but not before telling me "I think you're more of a junkie than you're admitting". I have listed everything I used to take and how much numerous times, I have used pretty much everything except H in the past. Then he said "mate, I've heard things about you around town", to which I responded "like what?". He said "I have been working this job along time buddy".

    Oh and last but not least, I responsibly asked what painkillers I can take which are appropirate whilst I am on MMT. He said "that's bullshit drug seeking behaviour, you don't need painkillers while on Methadone. The dose you're on would kill most people". Meanwhile I'm thinking riiiight, I know of people who are on hundreds of milligrams of the stuff. I also DO get back and neck pains despite being on Methadone. Oh well, maybe I'll find my own friggin way of getting rid of pain instead doing the right thing and talking to my doctor.

    See, I am in a country town of 5,000 people where everyone knows everyone. Yet I have not lied to my Doctor about ANYTHING since I started on MMT. Yet every time I see him he basically calls me a liar and a junky. If he weren't the only Done' Doctor in town I wouldn't be seeing him.

    Needless to say, I feel very depressed and hate myself at the moment. He really made me feel like a useless disgusting junkie. It just makes me feel oh so fantastic that everyone in town see's me as nothing more than a scumbag. I have NEVER been rude to my Dr or anyone else in town. I already hate what I've become, do I have to have it shoved in my face by someone who's supposedly there to help me?? :(
     
    Last edited: Jul 24, 2012
  7. Aberdonian

    Aberdonian

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    your doc is an asshole,your trying to sort yourself out an hes puttin you down bein rude an makin you feel shit he needs a good hammer to the head ! doctors ae there to help not putu down, is there no towns nearby you could go to get a script rather than be put down like that, that would make me walk out and id end up using again my tempersnaps too easy for assholes like that!
     
  8. Fentiful

    Fentiful Titanium Member

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    Mike,

    I know just how you feel, I have truly had my share of insensitive, uncaring and ignorant doctors during my journey through chronic pain management, and that add pregnancy in there as well, trust me it doesn't mix well!

    Something that helps me, and this works for when I get into it with family, mates, friends etc. I remind myself that I WAS a junkie, or at the least acted like one to an extent at times and it's going to take some time for trust to be established. The non-addicted world has no idea what it's like unless they've walked in the shoes. While it gives no one the "right" to treat you crappy, and of course health proffesionals SHOULD be sensitive and professional we know that in the real world this isn't always the case. Sometimes we can flip the script and use that attitude that's against us to dig deep and "prove" all the haters wrong!

    Instead of flipping out on him, perhaps say I appreciate your concerns doc, but rest assured I am confronting and dealing with my addiction, and despite what you have heard I am committed to cleaning up my life. While you may not believe this yet, due to having so many encounters with "junkies", I assure you this is my focus and goal with MMT. As a matter of fact just as soon as I get stable on it, I plan to taper down and free myself from the bondage of ALL OPIATES! Look him square in the eye and mean it. It may take some time but in the end I have turned around some of the negative encounters I have had with other professionals. Just an idea.....

    I'm sorry that you are going through a hard time, but the truth is to an extent we put ourself in a position to have to deal with stuff like this by abusing and unfortunately open ourselves up to the b.s that comes along with it more often than not. The trick is not letting it push you back out there and give you an excuse to keep using, (as if we really need one ;) ) Good luck and I hope you get it all straightened out!
     
  9. mikezombie777

    mikezombie777 Silver Member

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    Thank you for the support people. I don't know what I would do without this forum. Even my own mother is beginning to turn on me. I try so damn hard and I just get treated like scum.

    I went to see a different doctor today about my issues, didnt drug seek or anything. He prescribed me APAP/codeine 500mg/30mg until tomorrow when I can see my asshole doc again, just so I can get through the night. He knew about my methadone. I go to the pharmacy to fill the script, refuse to fill it and tell me to get out. I broke down in tears right infront of everyone just because of my shitty day.

    I walked an hour home crying wishing someone would treat me properly.
     
  10. missparkles

    missparkles Platinum Member & Advisor

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    That sounds really rough love, I'm sorry that you're having to go through this atm. I know you say that your mum is treating you badly too, but is it possible to sit her down and explain to her how life is for you? Cuz I'm sure all of this shit that you're having to endure would be far easier to deal with if you had your mum watching your back. Tell her that you're trying so hard and that you need her. That might soften her attitude a little. As a mum I know if one of my kids said that to me, however un-supportive I felt, it would melt my heart.

    Sparkles.:vibes:
     
  11. mikezombie777

    mikezombie777 Silver Member

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    Thanks Sparkles :)

    I just dosed and it was upped to 45mg. My Dr wants to see me again in a week to up my dose. He gave a big lecture this morning about how its illegal for other Docs to give me drugs and that if I "pull that shit again" I'll be kicked off the program. I understand that, but what he doesn't understand is that I simply must have a very high metabolism and that if he won't properly help me when I need it, I will have to go elsewhere in order to cope.

    I told him he was very rude to me yesterday, but in a polite way. He just smirked at me like it was a joke.
     
    Last edited: Jul 25, 2012
  12. highganja99

    highganja99 Silver Member

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    SWIM thinks this Doctor is bang out of order, unfortunately many are, SWIM has Cannabis use and a Ketamine and Bezodiazepine Overdose on his file, not being able to sleep correctly for months on and off (although he hasn't slept well for years but things got worse), he sees the Doctor who says SWIM needs to educate himself about sleep and that he would not get any pills, SWIM explained he could get copius amounts of benzodiazepines if that was what he wanted but he was only wanting something like zolpidem as diphenhydramine was no good as it made him fuzzy at work and promethazine did nothing. SWIM was sent away in a huff and immediately went drug seeking even though he had been off all chems for a good while. SWIM is constantly fighting with the urge to get benzo's for his sleeping troubles. Don't let the bastards grind SWIY down, it's like the NHS has a mandate to piss off all known drug users and a right to look down at them, Timothy Leary said something to the effect that a junkie is more enlightened than their doctor because at least they went down a road even though it turned out to be a dead end. (Not sure if that makes any sense in the context). Basically acting high and mighty tells you more about them than yourself. Keep up the MMT and remember that what one asshole in authority says in a room between two people would never be said in public and is normally downright unprofessional whether it is in medicine, education or work and so on.
     
  13. mikezombie777

    mikezombie777 Silver Member

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    So true man! I was recently told by my mother who is a nurse that my doctor has been banned from working at the local hospital because he was constantly upsetting patients. To the point of tears. Apparently, there was a lady who was overweight and in hospital for a related illness; my doctor whilst caring for her in the hospital told her "you're so fat, no wonder you're always in hospital, I mean hello!". My mother is a very clean, honest, straight edged person so I believe her entirely. This wasn't the only incident apparently.

    I think I mentioned this awhile ago in another thread but I'll say it again anyways - I found out that my doctor was being investigated a few years ago by the feds and was taken to federal court for seeing too many patients per day (i.e abusing the universal healthcare system) and they suspected he was merely trying to make as much money as possible rather than actually helping his patients.

    Unfortunately, the next closest Methadone doctor is literally 4 - 5 hours drive from here. In my town of 5,000 people there are three GP clinics and one small hospital. I have plans to move back to Brisbane (capital city of my state) within 12 months. I feel like I'm moving backwards lately, it's like the harder I try the worse things get.

    But anyway, I can definitely feel the extra 5mg I had today. I just wish I could ask for my dose to be upped without being insulted and made to feel like a loser. I always keep my mouth shut because obviously I need the Done' at this point but my god, there are so many things I want to say to this jerk!
     
  14. missparkles

    missparkles Platinum Member & Advisor

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    Unfortunately you get doctors like this the world over. They're a disgrace to their profession. Luckily your mum seems to know the score. I'm glad that you're feeling a little better with the increase you had today, and with a further increase next week perhaps you'll be feeling comfortable enough to start mending fences, getting life back on track so that one day when you've quit using you can give this doctor the finger as you saunter out of the clinic/surgery. That would be the best way of showing him that he's a total dick and that in spite of his insults and lack of care you were able to get your life straightened out.

    Sparkles.:vibes:
     
  15. Princess808

    Princess808 Silver Member

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    Mike, your doctor just makes me sick.. He should not be working with addicts with his attitude. I am sorry you have to put up with that. I don't know what the average doses of methadone are where you are from, however based on my experience and also current studies, and your dose is very low. The appropriate dose should hold you for 24 hours... Period, and unless you are a rapid metabolizer.. Peak and trough tests can be performed to determine how fast you are metabolizing methadone, but I wouldn't even bother with that until you are on a therapeutic dose of methadone, usually between 80-120mg.

    I think you mentioned at one time trying to keep your dose low. While I understand the mindset, in practice it doesn't make much sense using less than what is necessary for stabilization.

    People feel it is easier to come off lower doses, and but in actuality if you never get stable, and you will never feel 'ready' to begin a reduction.. Plus if your symptoms aren't properly managed, the chances of relapse and using on top of your dose.

    Google 'therapeutic methadone dosages' and check out current articles, and perhaps share with your doctor. Also, once someone is at the correct therapeutic dose for opiate withdrawal, you would need additional medication for pain symptoms... Please Google 'treating pain in methadone. Maintenance patients' ". You will find articles to show your doctor that indicate mmt patients need to be treated for pain with medications for use on top of your daily dose, take in order to get adequate pain relief. I i wish I had the exact addys for these articles, and bufti am confident you cannot find them.

    Your doctor is being incredibly inappropriate with his comments. Obviously it is affecting you tremendously based on some of your comments. are there other options, or doctors you could see in your area that are better equipped to manage your treatment?
     
  16. missparkles

    missparkles Platinum Member & Advisor

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    ^^^I think that disagreeing with this doctor, including showing/telling him about articles that prove his treatment to be innadequate (to say the very least) would just inflame him. Some doctors actually encourage patients to take control of their treatment and are willing to compromise. After all, a happy, contented, supported patient will often do better than one who feels their voice is not only unheard, but ignored. If this doctor is loath to prescribe a suitable dose of methadone I doubt that he'll refer Mike for any tests that measure metabolism, and I imagine he'll blow a fuse if its suggested that he also prescribe pain meds on top of the methadone. You really need to take back up (as a witness also) so that the doctor doesn't push you into a corner. Its much harder to bully two people, especially when one of them is not needing that specific doctors help.

    The therapeutic dose of methadone might be in the range of 80-120 mls (according to research) but whilst I was using methadone most of the people I met were quite comfortable on 45 mls and upwards, with a top dose of 75mls. Most couldn't have functioned on 120 mls as its quite a high dose. Now please don't get me wrong, I'm not saying that I'm right about this, I'm just going by what I've seen at one dispensing pharmacy over a 3 year period (picking up daily). You know I can remember a doctor telling me once that 10 mgs of morphine (IV) (according to his BNF) should be enough to ease my kidney stone pain. That's rubbish, it barely touched the pain. So it does work both ways, underprescribing and overprescribing.

    Sparkles. :vibes:
     
    Last edited: Jul 25, 2012
  17. mikezombie777

    mikezombie777 Silver Member

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    Yo folks, I have an update.

    Firstly, my new dose is holding me almost a full 24hrs. But I think 50mg will be the sweet spot.


    Secondly, My doctor (who I will call doctor A in this little story) has threatened doctor B (the one I saw the other day when doctor A refused to help me) with legal action! Since doctor B didn't actually do anything illegal and nor did I, as I didn't ask for ANY drugs what so ever. I simply presented with back pain that doctor A called "bullshit". Doctor A cannot take legal action against Doctor B for illegally prescribing me drugs, so get this: he has lodged a complaint because "he had to wait on hold for too long" before speaking with doctor B. Now, my mother has confirmed that at the time Doctor B was currently seeing a patient. Doctor A said to the receptionist for Doctor B that it was not an emergency and thus Doctor B could call him back when finished with his patient.

    An hour later Doctor A lodges a complaint with the owner of the Doctor B's practice. The owner dismissed the complaint as she knows full well that Doctor A is a bully.

    What the hell is wrong with my doctor? He is the most arrogant, egotistical piece of shit excuse for a GP I have EVER known!
     
    Last edited: Jul 27, 2012
  18. mikezombie777

    mikezombie777 Silver Member

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    Quick update folks!

    My dose has officially been upped to 50mg as of tomorrow. I have two take home bottles sitting infront of me and my Dr has prescribed me 50 Diazepam 5mg during the times when I am feeling withdrawals. They help a lot. He told me to tale 30mg daily when having an issue. I am also on antibiotics for a chest infection. I have taken 15mg of Valium + 50mg of Methadone and it feels like an Oxy high actually, O.O lol

    I also have not had any digestive issues since he put me on laxatives 3 times a day every day :)

    Cheers guys, I'm having a good day today!
     
    Last edited: Jul 31, 2012
  19. Princess808

    Princess808 Silver Member

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    Be very careful of the methadone/Benzo combination, especially since you haven't been on methadone for that long of a time period. Both methadone and Valium are CBS depressants. Even people who have taken both meds long term aren't immune to the possibility of accidentally overdosing on this combination. Your doctor sincerely confuses the hell out of me. Rather than simply increasing your dose so you're comfortable for 24 hours, he gives you a much more dangerous combination of medication.
    I sincerely want you to experience the appropriate level of comfort, but imho, it should be done in the safest possible manner. Please just be very careful

    Princess808 added 6 Minutes and 23 Seconds later...

    Aarrgghh... CNS....central nervous system depressant, not CBS....my overzealous spell check
     
    Last edited: Jul 31, 2012
  20. Twizal

    Twizal

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    Hey chook, have you thought about presenting to a hospital and requesting being monitored by the D and A clinic. They decide dose and then let G.P monitor you. May mean one or two long trips but these folks on the whole treat you better. What's the difference between God and a Dr? God doesn't pretend to be a Dr! Old but true. Be very careful with the Valium mix....personally I reckon a higher Done dose until you are stable without anything else would be safer. Hard to tell what's doing what with a mix . Plus the benzos come with their own dramas . Good luck.

    Twizal added 42 Minutes and 5 Seconds later...

    Sorry, should have written Methodone instead of 'done'.

    Twizal added 3 Minutes and 32 Seconds later...

    Sorry, should have written Methodone instead of 'done'.

    Twizal added 2 Minutes and 28 Seconds later...

    I meant Methadone .
     
    Last edited: Jul 31, 2012