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What is a tolerable dose of methadone to quit cold turkey?

Discussion in 'Opiate addiction' started by Trapped_under_ice, Dec 21, 2009.

  1. Trapped_under_ice

    Trapped_under_ice

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    SWIM has been addicted to opiates the last 15 years with only very short breaks. First codeine, then oxycontin, then heroin, then methadone. SWIM has been on methadone for the last 10 years, about 150 mg/day. Methadone has drained SWIM to point of being near a living dead. SWIM takes it only to feel normal, he got on methadone because it was so much cheaper and easier(big mistake).

    Now, SWIM has been reducing his dose from 150 mg/day to 10 mg day(divided into three doses) since mid-summer. He has done a couple of light cold turkeys in the past with the before mentioned substances but never methadone. SWIM would like to ask:

    -What is the 'ideal' dose of methadone to quit cold turkey from? SWIM is very weak and drained, he has trouble taking a severe withdrawal this time. Would it be better to reduce the dose further down? It has been very time consuming for SWIM to get this far, it seems like the lower he get, the smaller reductions he can make.

    -Which medicines would be ideal for reducing the pain, hypothetically assuming SWIM knows a doctor that will prescribe him anything? SWIM will not get addicted to other drugs, he doesn't like them. He doesn't even smoke or drink.

    SWIM is finished with opiates. It means nothing to SWIM anymore, even when his friends smokes right next to him. SWIM would like to get his life back :)
     
  2. dihydromoron

    dihydromoron Silver Member

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    Hi and welcome to drugs forum

    SWIY can probably find all the information he is needing by performing a quick search using the search button above

    many members' cats have come off of methadone before, and some of them have even kept journals, detailing all the ins and outs of their personal withdrawal stories.

    As for meds to help, again there are MANY threads dealing with this
    one thing SWIM would comment on is where SWIY said:

    'SWIM will not get addicted to other drugs, he doesn't like them. He doesn't even smoke or drink.'

    Addictive drugs don't care if SWIyou like them or not, when swiyou take them for a long time, swiyour body becomes dependent on them, and
    will cause swiyou to withdraw when stopped abruptly. SWIY should bare this in mind, as otherwise swiyou could make the mistake of swapping one addiction for another
     
  3. JaWill88

    JaWill88

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    SWIM said....

    i don't know but i was at 150 for over a year. i have gone down 2mg/day with no discomfort yet. and i am at 102mg. good luck. you can do it. if you can (which is what i am doing) get to 80mg or less and find a suboxone certified doctoer (they are everywhere) and have them put you on oxycontin for 6 days and on day 7 start the buprenorphine, wether it is Subxone or Subutex (i'm doing subutex). any questions please pm me.
     
    Last edited by a moderator: Dec 21, 2009
  4. Trapped_under_ice

    Trapped_under_ice

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    Thank you, SWIM will see if he can find any threads on this topic. SWIM initially tried to look around but this site is HUGE.

    @JaWill88
    Are SWIY meaning to use buprenorphine as maintaince or as a way to prepare for quitting cold turkey? SWIM wants to get his drive and energy back and is not sure if switching to bup. would help that.
     
  5. Curiouscat22

    Curiouscat22 Silver Member

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    Here is a little bit of info about Buprenorphine as treatment, it may help.

    Use of buprenorphine in treatment of opioid dependence
    Whilst much of the work on substitution therapy has focused on methadone,
    several new synthetic oral opioids such as LAAM (L-alpha-acetyl-methadol), slowrelease morphine and buprenorphine have been investigated as potential
    therapeutic agents in the treatment of opioid dependence. Buprenorphine in
    particular has been undergoing extensive clinical testing for treatment of opioid
    dependence and is likely to become the medication used in the management of
    opioid dependence not only in specialized clinics, but also in primary health care.
    Its pharmacological properties and resultant clinical characteristics – especially
    its relatively long duration of action and high safety profile – appear certain to
    ensure buprenorphine an important place in the overall treatment of opioid
    dependence.
    Pharmacologically, buprenorphine is a partial agonist at the mu receptor and a
    weak antagonist at the kappa receptor. Because it binds tightly to, and dissociates
    slowly from these receptors, buprenorphine exhibits an agonist ‘ceiling effect’,
    most noticeably in its respiratory depression effect, which accords the medication a high degree of clinical safety. Its tight binding with slow dissociation from receptors also provides a blockade for the effects of subsequently-administered agonists, precipitates withdrawal in patients maintained on a sufficient dose of full agonist, and provides prolonged duration of action with poor reversibility by naloxone. Furthermore, buprenorphine’s weak antagonist effect at the kappa receptor renders it devoid of psychotomimetic effects. Further research has demonstrated buprenorphine’s limited levels of reinforcing efficacy in comparison to opioids, and established its ability to suppress heroin self-administration in opioid-dependent primates and humans.
    The formulation containing both buprenorphine and the opioid antagonist naloxone has been recently introduced for maintenance therapy of opioid dependence. Adding naloxone to buprenorphine aims at reducing a risk of diversion and injecting use of prescribed buprenorphine. Over the past decade a series of controlled clinical trials, using such outcome measures as illicit opiate use, retention in treatment, craving and global rating of improvement, have substantiated buprenorphine’s clinical safety and efficacy. When used in opioid substitution treatment for dependent pregnant women, it appears to be associated with a low incidence of neonatal withdrawal syndrome. Due to the above features,
    buprenorphine is a useful drug in the facilitation of withdrawal from opioids.

    Sources: Barnett, Rodgers & Bloch, 2001; Fischer et al., 2000; Ling et al., 1998.
     
    Last edited by a moderator: Apr 30, 2017
  6. Spucky

    Spucky Palladium Member

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    AW: Re: What is a tolerable dose of methadone to quit cold turkey?

    80mg. is too much for a change to Subutex,
    don`t do that!!!

    40mg. is recommend by Essex-Pharma but the hungry, noisy and multicolered Cat think even that dose is too high,
    she recommend 20-30mg, less Methadone will help!

    If someone do that he/she will be in a horrible Withdrawal
    in between 30min. with no help,
    a Doc can`t intervene in this case!

    Edit: aaarrrrggghhh, now i understand it.
    Please excuse my horrible English!
     
    Last edited: Dec 23, 2009
  7. missparkles

    missparkles Platinum Member & Advisor Donating Member

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    From 80 mls to bupe would send SWIY into heavy WD. The idea is to reduce the methadone to the lowest level (usually between 25-30mls) stay on nothing for about 36 hrs, then take the bupe.

    Then SWIY will have some of the meth out of their system, and the bupe will work well enough to hold SWIM without sending him into WD. Then the bupe is gradually increased until SWIY is comfortable, left at that dose for a short time for them to stabilise, then the bupe taper begins.

    Sparkles got down from 150mls to 30 mls of meth, (had her last dose of meth on Friday morning) and started her bupe on Monday evening. She felt ok and it wasn't as uncomfortable as she expected. She was on 4 mg of bupe to begin with, and it did stop the meth WD that had begun.

    So please, don't make the jump from 80mls, you'll gain nothing, apart from horrendous WD, which is what SWIY is trying to prevent...right?

    Sparkles.:vibes:
    Bupe= subutex, suboxone.
     
  8. jloops

    jloops Silver Member

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    SWIM also thinks making a switch directly from 80 mg of methadone to buprenorphine is a bad idea, but since swi is switching to oxycodone for a week before starting the buprenorphine, it'll probably go a lot better than a direct move from 80 mg methadone straight to buprenorphine.
     
  9. Trapped_under_ice

    Trapped_under_ice

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    There seems to be very positive feedback about buprenorphine here. SWIM has read much technical detail about it and understands how it works, however how does it feel compared to methadone or even being completely off opiates? Can one function normally on it? Methadone feels like a pillow over ones head and being castrated at the same time, in short close to being dead. Is bup. an improvement? Would it get one back to say, 80% of what one was before?

    Also, how is buprenorphine cold turkey compared to methadone? Does it last shorter/longer? SWIM can handle 14 days serious withdrawal but 30 days or more is too much.....
     
  10. Spucky

    Spucky Palladium Member

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    AW: Re: What is a tolerable dose of methadone to quit cold turkey?

    For swim it was always easy when he done it very slowly
    but even a Quick-Withdrawal like 10mg. in 21 Days have been possible
    and in his opinion less bad than a Methadone-Withdrawal!
    But we are all different, no-one can say how it will be for swiny!

    If someone decrease the dose like 2,5%- 5% each Step (3-5 Day`s) it`s like a long Walk but easy.
    If People do a combination with a psychological Training the chance for a Success is very high!
     
    Last edited: Jan 28, 2010
  11. jholdaw2

    jholdaw2 Silver Member

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    Re: AW: Re: What is a tolerable dose of methadone to quit cold turkey?

    this is the first time swim has heard of switching from methadone to oxys THEN to bupe. It doesn't seem like it would work very well because swim remembers when he was going to the clinic and would take an 80mg oxy instead of his daily juice and it would do absolutely nothing...swim would still be in methadone withdrawal that day.
     
  12. Spucky

    Spucky Palladium Member

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    AW: Re: AW: Re: What is a tolerable dose of methadone to quit cold turkey?

    Damned, i see the difference, thanks for the hint!
     
    Last edited: Jan 28, 2010
  13. KS78

    KS78 Newbie

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    Someone was on a detox program for heroin. They started him from 180mgs of methadone and tapered down to 10mgs in about a month, then he spent another week clean of opiates. At the end of that week, they gave him Naltraxone (which also is in Bupe) and after 30 minutes he started going through a very harsh withdrawal even if his drug screen showed that he was totally clean from all opiates. That tells me that if one goes from 80mgs of Methadone to Bupe in such a little amount of time, they will definetely go through some precipitated withdrawal and believe me it will be worse than cold turkey. Just something to consider. Good luck.
     
  14. keepitnatural

    keepitnatural Newbie

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    I would agree with everyone saying to switch to suboxone. Just dont stay on it for too long there is no reason to. Just like there was no reason to be on methadone for 10 yrs, you dont wanna be pulled into another cylce like that. I would get down to 20mg of the meth and then switch to 24mg of suboxone a day for a week then swith to 16mg for a week then 8mg for 2 weeks then 4mg for a week then 2mg for a week then 2mg every other day (since it has a 48hr half life) for a week then be done with it.