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Hi,

Im pretty new to this site, Actually today is my first post, Im sorry if this question has been asked over and over but I can't find the answer to my question.

I have been in the Methadone clinic since May 2010 and my goal was to be off May 2011, I started my detox Dec 1st and was on 135mg and went down 10mg every 7 days, and one time I went down 20mg. I have felt no withdraw symptoms whatsoever and I got down to 25mg. However I did relapse one time due to a close friend dying so I decided to stop my detox because I started having cravings pretty bad. I went back up to 35 mg and have been on 35 for about a month. I think I am ready to start doing 2-5mg decrease soon every week, my question is.... When I get down to that last mg (they said they can give me .50 mg at the clinic) and I take that last dose, am I going to feel the same as someone who came off cold turkey 135mg?

My friend was on 75mg and on Sat. she decided to just STOP going to the clinic and go cold turkey! I told her shes nuts! But shes stubborn and wont listen, she has been having every single withdraw symptom possible and she said the reason she didn't do a medical detox is because she is going to feel the same way at 75mg or 1mg, that it doesn't matter the withdraws will be the same.

Please someone tell me that is not true! I can not be bedridden! I have responsibilites and can not afford to be sick for more than a weekend.

I plan on going down to .5 then .5 every other day, then .5 every 3rd day, ect. I am in no hurry to get off Methadone, I just want to do it right and not relapse. The whole reason I am on it anyway is because I was prescribed 3 60mg ocs a day and 4 15mg ir oxys a day and I didn't think I could detox taking them because I like them too much. Methadone has given me my life back and I love that, I just don't want to feel like total c**p. Is there anyone out there who has gone very slowly off methadone and had NO WD symptoms at all? Or bearable ones?

My counselor kept telling me I should be feeling bad, but after every decrease I felt great! When I dropped down 20mg one time just to see if I would feel bad, my counselor said theres no way I wont not feel bad..... BUT I DIDN'T I felt GREAT!

Any advice for me and for my friend, she looks like shes on the Brink of Death! she can't get out of bed, she can't drive, she has all the symptoms possible! The only thing that helps her is Adderall and she doesn't have a script for it so shes trying to find it but can't and shes mentally breaking down. Im afraid shes going to give up and take opiates after all this shes been through! Plus Im the one that got her into the clinic, she saw me get my life together and she wanted to get hers together, I feel like I should help but don't know what to do! I went over to her house and brought her gatoraide and vitamins and kpins and ambien but I don't know what else I can do for her! I don't understand why she did cold turkey from 75! she should have gotten down to 5 or 10 then stopped. But she said she was tired of not having control over her life.

Anyways, Sorry for the rambling, any answers would be appreciated. Thanks! :)

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Keith Richards reported that when he quit shooting heroin he only got flu-like symptoms and never used it again.  He did it cold turkey.  Now all we can say is that he did say this.  we cannot say he did or did not.  before there was Methadone there was thing called "Apomorphine" which many used to get unhooked.  but it involved withdrawal and for some withdrawal is hell-on-a-stick.  Most people in past had to just dry out like in that movie "Man With The Golden Arm".  Methadone was supposed to be a replacement for Apomorphine and used short term only.  Today its a business- and a bad one at that.  I do not know who your councillor is, but how you feel is how you feel and no one should judge it.  I'll bet yours is an unlicensed formerly active addict who thinks his opinions are best because he's "been there".  In my practice I never had to have a heart attack, a stroke, a broken bone or have diabetes to treat them.  "Being there" is the worst non-qualification there is, with few exceptions.  I wouldn't go near anyone for therapy unless he or she had at least a sheepskin and a license (not a certificate) hanging on the office wall.  And I would never tell a patient how they were supposed to feel (Pisses me off).  Just be there for your friend.  If this is how she wants to do it, you should support her.  the most important thing is that she get lots of water, eat if she can, stay away from any other drugs, don't take too many vitamins or supplements and make the effort to keep limber.  get lots of rest.  I've never seen a full withdrawal go beyond four days.  And there is never, ever an excuse to start using again.  Not even someone's funeral.  (You know excuses don't work.  don't use them).  I am very happy your are clean.  I am very happy that your friend is being so brave in getting clean the way she wants it.  Also, you saw this from me:  "Mental Health and Medical Health" can also be an addiction.  Set your chickens free. (old Hippie saying).
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I was going to the Methadone  clinic  for 2 and a half years. I NEVER wanted to be there that long...but I wanted to make sure I was ready. I leveled out at 90mg and stayed at that for a little while..then I would go down..and level out again. Well the past few months I have REALLY been trying to get off. So I kept lowering my dose 5mg each week. I FELT GREAT!!! I could of went down faster if they let me. Well about 7 days ago I STOPPED at 15mg. I could not afford it anymore.  And it has been HELL since. The 1st day was ok...2nd day ok...then 3-4-5 HELL!!! And I mean HELL!!! I couldnt eat..drink..sleep..anixity was HORRIBLE. Hot and cold sweat..everything!!!!! So i started doing some looking up n the subject of Methadone withdrawls..and I wasnt happy at what I was finding. I was hearing 2weeks will be REALLY bad..and you could feel withdrawls for MONTHS! I was looking for ANYTHING to ease the withdrawls..and I heard Vitimns LOTS of them. Like..Zinc...Pottasuim...fiber...b12. Stuff like that. Your friends body is going into shock..her body WANTS something. And becuz she sick..her body NEEDS extra vitimns. Lots of water. eat SMALL meals. Tell her to TRY to get out of bed. Sometimes laying in bed ONLY mmakes you feel sicker. Sleep is VERY important for the body to heal itself..so tell her Melitoni( think spellt wrong) or Valerian root to sleep. On my 5day of withdrawing I went to the hospital..Im not even going to lie. I thought I was dying. They pumped me with fluids...Said my pottasimn was REALLY low...and gave me a script of 15 .05mg of Xanax. I did NOT want to take anything...but I NEEDED to sleep. At least more then 2hrs at a time.  Its SO hard cuz Mentally I KNOW if I took something this would ALL go away. I really thought I was done with the mental after being at the clinic for 2 and a half years. JUST BE sTRONG!!!!! It didnt take us a day to get in this mess...it sure as hell isnt going to take a day to get out. Good luck. And im sorry that you and your friend are going through this.
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Dear goingononeyear,

See my reply to “8th day of Methadone withdrawal... how much longer will this go on?”, I think you will find some of the answers you’re looking for there.

Methadone is by far one of the most difficult opioids to get off of, and the old story of I got down to 5mg or 2.5mg and couldn’t go any further is a common one. Having a background in anesthesia and from working in addiction clinics, NA and other supports groups, your story is a common one. There are no hard fast rules for everyone, but there are some general guidelines that you can use. And like a former post I saw here, the best rule to follow is, “Like a cow, simply eat the hay and leave the sticks.” What works for others may or may not work for you, you must be willing to stick with your plan and don’t give up hope, there is a way that works for you, just stay with it until you find it.

The story I hear most often for methadone detox is that a person gets to a point where simply stopping is impossible. For me, I got to the 2.5mg level several times and could not go any further. Part of that was because I was cutting up pills into quarter tables and really needed to go a medically supervised route where I could continue to taper with smaller doses. But then again, I’m a chronic pain patient and getting off opioids is not an option. Still I want my intake to be minimal, so I can have as close to “normal” life as possible.

When you reach that point where you have weaned or tapered off as much as you can, that is where your doctor needs to change his plan, begin substituting non-narcotic adjuncts,  beta blockers, alpha blockers, SRI’s, benzodiazepines in a tapered dose are just a few options available to a licensed medical physician certified in addiction management. But please do not go to any old doctor, find a certified addictionologist, I know from my own training, there is no medical school training for this issue, if your doctor has NOT made the effort to be certified in the treatment of addiction, he is ill prepared to take on the job of methadone detox, it's just to difficult to manage.

I’ve also seen a lot of people who go see an anesthesiologist who runs a pain management clinic, thinking they can get the job done. Being a former anesthetist, I can tell you straight up, that is rarely the case, if they do not have that certification in addictionology; they are most likely not qualified to deal with methadone detoxing, my opinion only but not one without firsthand knowledge.

Bottom line, it can be done, but if you’ve been on methadone for over a year, plan on taking a year or two to get off. Start with tapering the dose and when you hit that wall, begin adding non-opioid adjuncts to manage the symptoms slowly. Trying to tapper down 5mg or 2.5mg a week after you hit that wall is not practical and your body is telling you so, you should listen to it, and hold there until you can find an addictionologist who can manage the next 6 months with an altered step down regime and or other non-opioid drugs.

For those who have made it off methadone, the story I hear most often is, once they hit that wall, whether it be 25mg or 2.5mg, the time between dose lowering needs to be extended, stay at that lower dose for a longer period of time, say 3 weeks or a month before stepping down again. If that works, go with it until you hit your next wall, then adjust again, hold the previous does that worked for a few weeks, then tapper down 1mg or 1.5mg and do that for another 3-4 weeks.

The worst thing to do is to push a bad position and rush the process. Your brain chemistry has had a severe assault to it, it is not going to bounce back as quickly as a cut would on your arm. Give it time, but stick with it. If you rush too quickly your risk for relapse goes up by 80-90%, this is not necessary when you are armed with good information, a true desire to get clean and a well educated healthcare provider who has previous experience with treating methadone addiction.

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Yeah..everyone is different of course...but i think your friend is right. Doesn't seem to matter to me how low of a dose you work down to..the first few days will be bad. Depending on how you cope w depression due to chemical imbalance or inactivity will play a huge role it seems to me. Mental pain is the worst..it can actually create withdrawal related phantom pains w a lot of ppl. SURROUND YOURSELF W ALL THE POSITIVE PPL IN YOUR LIFE! Even if they don't understand addiction, they will mold to help you through!

PS No hallucinogens.
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Since my previous posting was over a year ago, I thought I would come back and update it to let others know how my own efforts to get off of methadone worked out. When I got down to a 5mg dose twice a day, I asked my doctor to swith me over to a short acting pain medication, hydrocodone or oxycodone. This was an acceptable substitute because I am already a chronic pain management patient. For an individual who is simply trying to recover from addiction, this approach has risks with it, that of re-igniting thier cravings for a high since these types of meds are those they typically abuse. But, if your detox plan is medically supervised and you are strongly commited to getting clean, it may be a risk worth taking to complete this last step of getting off of methadone. After switching to oxycodone for 30 days, I then went to hydrocodone for another 30 days, and then began a step down program that I completed in less than 60 days. For me, using this approach was a cake walk, I had no cravings, no aches or pains, short of those for which I have for chronic pain is management. And once I was off of all pain medication I was able to have a reassessment of my chronic pain needs and start a new plan that did not include narcotics. Currently I am evaluating all non-narcotics methods for treating my chronic pain and when complete I hope to have a solution that is opioid free. If not, I will at least be able to restart my chronic pain management on a lower dose of either hydrocodone ot oxycodone and this time I will remain with the short acting medication and stay away from the methadone.

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YOU ARE NOT RAMBLING I HATE WHEN PEOPLE SAY THAT ABOUT "ME" WHATEVER I SAY ALWAYS HAS MEANING! I WENT TO A CLINICFOR OVER 10 YRS..ONLY {2WICE A MONTH} STATE'S EXCEPTION OF 13 TAKE HOMES,,JUST LAST WEEK THEY DUSCHARGED ME!! I HAVE BIPOLAR DISORDER I AM 61 FEMALE WHO WAS A PERFECT PATIENT THE COUNSELORS ARE INSANE! UNPROFESSIONAL,INEPT! THEY ARE DEVOID OF KNOWLEDGE RE WITHDRAWALS OR THE SUFFERIUNG WE ENDURE I MEAN HOW COULD" THEY EVEN IMAGINE,,STILL THE DOC WHOSE NAME IS ON MY BOTTLES IS A CREEP WHO NEVER ESTABLISHED PATIENT/DR RELATIONSHIP THUS HE DIDN'T GIVE ME A CHANCE TO EXPLAIN WHY i HAD TO SAVE SOME EMDS AT HOME FROM MY TAKE HOMES,,WHY? BECAUSE ,,I DEMANDED TO BE LOWERED IN OCT OF 2012 COUNSELOR RAISED ME IN JUNE! HE FAILED TO LOWER ME WHEN I WARNED HIM I'D NOT HAVE A RIDE ANBYMORE THAT I COULD NOT DRIVE ALONE 1 1/2 HRS IN THE DARK HRS OF 5AM! THE SUBOXENE COUNSELOR SAID "LEAVE IT ALONE" [LEAVE IT ALONE?] SO THE DR SET UP A MEETING BUTTTT OVERNIGHT I'D HAVE TO ATTEND WHAT WAS A VAGUE DESCRIPTION OF AN APPEAL MY COUNSELOR CALLED IT "LIKE" AN APPEAL WHEN I CALLED BACK ....THEY HUNG UP!! THEY 'WANTED" ME TO BE IN FEAR,,THEY DIDN'T WANT THE DR TO KNOW THEY FAILED TO LOWER ME,,I WOULD HAVE TIOLD THE DR OFF TOO..I WAS AT 36 MILS IN JUNE ASKING FOR THE 1ST TIME TO BE RAISED BUT I DIDN'T IMAGINE THIS ALLEGED DR WOULD HAVE RAISED ME TO 60! THE COUNSELOR SAID THE DETOX WOULD BE TOOOO FAST TO END IN MARCH,,SO THE CONTRADICTIOON IS WHY DID THE COUNSELOR ASSUME I HAD ENOUGH TO DETOX AND FINISH IN MARCH WHEN I'M NEARING DETOX REALLY SOONER? I'TS NOT THE END OF FEBRUARY & I HAVE NOTHING LEFT EXCEPT A FEW DROPS..I WILL END UP COLD TUYRKEY THIS CLINIC WILL HAVE A LAWSUIT SO BIG,,THE LWYERS HERE IN PA ARE "HICKS",,BUT I'LL CALL THE NEWS,,! LAWYERS IN NEW YORK WOULK OR LONG ISLAND WHERE I LIVED FOR 30 YRS WOIULD HAVE FILLED A LAWSUIT ALRERADY! THE MENTALITY HERE IS SANTIMOUNOIUS! JUDGEMENTAL,& IF MODERATORS DO NOT LIKE THIS COMMENT,,TOO BAD IT'S A FACT EVERYONE KNOWS THE CORRUPTION THAT GPES ON HERE! I AM TERRIFEID OF BEING SICK THE COUNSELORS & THE DR WILL""" BE ACCOUNTABLE BY LAW!
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