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zenith

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Posts: 1,662 Member Since: 02/21/10

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Feb 21 10 5:35 PM

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There is no one answer to this question--it will be different for each individual. 

There is a common misconception that methadone treatment is supposed to be a quick detox aid for those addicted to heroin or other opiates--something to help them quickly become "drug free".  This is NOT the case at all. The purpose of MMT is to enable the patient to become free of drug ABUSE and to have a functional, productive life while controlling the symptoms of their illness. 

Long term  abuse of opiate drugs shuts down the brain's ability to produce endorphins--our "natural" opiates. One the patient becomes abstinent from opiates, it can be some time before the brain recognizes this fact and begins producing endorphins again. During this time period the patient may suffer severe depression, anhedonia (inability to feel pleasure), exhaustion, anxiety and extreme irritability. 

For some, this will gradually begin to lift as the brain resumes production of endorphins. However, for many others, the damage done to the brain chemistry may be permanent. It may never resume producing endorphins normally, no matter how many meetings they attend, steps they work, or counseling sessions they have.  These folks may require long term---even life long--supplementation with an outside source of endorphins/opiates, and methadone is particularly well suited to this task, as it does not produce a high in stable patients and  remains at a steady level in the blood for a full 24 hours without the highs and lows of short acting opiates. 

Many doctors and scientists believe that some opiate addicted patients may have had low endorphin production even BEFORE they began abusing opiates, and that this may have made them especially vulnerable to the effects of opiate drugs.  Whereas most people taking opiates simply feel somewhat sedated and perhaps a little nauseated, these folks usually felt energized, motivated and  their mood improved--often for the first time--in fact, many say they felt "normal" for the first time in their lives when they took opiate drugs. Unfortunately, standard antidepressants are not usually effective against this form of depression, as they target serotonin rather than endorphins, so many of these folks may have gone from doctor to doctor looking for help with their problem, and ended up self-medicating with opiates. 

Those with lighter, short-term addictions, and those who had normally functioning endorphin output to begin with, have the best chance of tapering off methadone and doing well. Those with long term, heavy addictions and a history of relapses have a much smaller chance.  The relapse rate for those leaving methadone treatment is 90% within the first year--however for those who remain IN treatment, the success rate is 65% to 90%--higher than with any other treatment method. But sadly, many end up leaving treatment prematurely due to several causes--family and friends who push them to "get off that stuff" because they do not understand how it works, or the patient may be unable to afford continued treatment, or they may become fed up with clinic red tape and bureaucracy--and this almost always ends in relapse and sometimes in tragedy. 

Most experts recommend a minimum of 2-3 years in treatment before considering a taper.  It is important that you be stable, no relapses for some time, have a supportive home environment and no major stresses going on in your life, and that you truly want to taper off and are not being pushed to do so by someone else.  It is also suggested that the rate of taper be no more than 10% of your dose every 2-4 weeks. It is crucial that you go all the way down to 1mg before stepping off as well. Many try to jump off from 20 or 10 mgs and become desperately ill. Don't let this happen to you. 

Also, if you feel at any time that you are close to relapsing, go back up a bit on your dose and WAIT until you feel stable and able to continue.

People often blame clinics for "keeping me hooked" if the clinic shows reluctance at the idea of withdrawing from treatment--however, the facts are that clinics have plenty of patients waiting to take the place of anyone who leaves--sad to say--so they are  NOT worried about losing YOUR money. It would be medically unethical for them to recommend tapering when they know the chances of a relapse are 90% and that the risks of a relapse are so serious--jails, loss of job, souse, kids--disease, even death. But if you wish to withdraw after being informed of the risks, they owe it to you to support you in your taper.

Question Authority!

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ltomczak

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Posts: 789 Member Since:02/22/10

#2 [url]

Apr 16 10 8:43 AM

I think ANY patient that is on a long term medication can be annoyed or bothered by it and may ask themselves if it is worth the hindrance of being on the medication.
 
However, the stigma surrounding this medication makes it that much WORSE and actually encourages patients to get off.
 
I would think if I was a diabetic I would get annoyed at having to constantly monitor myself or being "tied" to my insulin - but the people around me (including my Doctor) would remind me that this medication is a vital tool to my survival and it's just something I have to accept.
 
Unfortunately we often don't experience that same level of support or understanding - I can't imagine my loved ones asking when I was going to "get off of that dang insulin" like they would do with methadone.
 
Until we as a society can fully accept this as a disease of disordered brain chemistry, along with  a lot of other mental health issues, it will be more difficult for us to get the support and understanding that we need.
 

lindsaytomcat@yahoo.com For those in and around the Chicago area - feel free to contact me if you need help with your treatment.

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ccccubed

Posts: 13 Member Since:02/25/10

#3 [url]

Apr 18 10 2:41 AM

I must say that MMT saved my life, and more importantly it has given me a quality of life such that life is worth living again.  There is no amount of money or anything in the world which would make me stop taking Methadone.  I don't care if it shortens my life.  I have never found anything to be as effective against my addiction.  MMT done properly (i.e. without taking any other elicit drugs) works exceedingly well, at least for me.  So my answer would be as long as I am alive I will continue to be on MMT.  It is a small price to pay for my freedom and good quality of life.




Chris

Christopher C.

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gcrosswhite1960

Posts: 9 Member Since:05/06/10

#4 [url]

May 6 10 6:13 AM

Heart patients,me being one,can stay on methadone indefinatly,all my dr's know about my methadone use and even though some have suggested I try to taper off it,(of which I did,..TRY that is) I am back at 60 mg after going down to 50 from 140, 4 yrs ago and have decided that I wont be trying to taper again for quite awhile.Now I am not gonna sit here and attempt to explain all that is wrong with me but as most people who have abused heroin or other opiates for many yrs,will tell you,its amazing what all it can either do to you,OR keep you from knowing is happening to your body.Either way I am where I am and thats that.I am not worried about methadone either quickening my decline in health or not,what I do know is that it does allow me to enjoy whatever time I do have so to hell with what some dr or another may say it does or doesnt do,I know it works just fine for me.And I personally would tell that to any one that asks,life is about enjoying the here and now,not worrying about what might or might not happen at some later date.
Enjoy just knowing that for now,everything is just fine.
gene


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ptrsnake13

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Posts: 1,361 Member Since:11/01/10

#5 [url]

Jan 27 11 12:54 PM

I know you don't want to get into all that's wrong with you but maybe you can helk me out. My wife was on 150 mg when they discovered something called prolonged QT's. They took her off methadone in 2 days replacing it with 460 mg of morphine. She's having a very bad time and wants back on methadone at a low dose of 40 mg but they won't permit it. Anyone know anything about this or can give me any advice. If you don't mind you can e-mail me direct. Thanks a lot
Pete
ptrsnake13@aol.com

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ccccubed

Posts: 13 Member Since:02/25/10

#6 [url]

Aug 7 11 2:01 AM

Zenith I have never heard the term anhedonia but IT PERFECTLY EXPLAINS ME! I would say Anhedonia (cannot fee pleasure) or cannot feel OK is one of the main reasons people relapse, AND YOU ARE SO ABSOLUTELY ACCURATE - no matter how many meetings or therapy you do none of that cures this chemical brain problem. I believe for most hardcore addicts we are damaged permanently and the only mechanism out there to address anhedonia is MMT or Sub I guess. I think that anhedonia is so little mentioned and understood by the press and general population!

The first thing I noticed when I got clean the first time in 1989 (solely by going to meetings) is that as the years went on I did NOT feel better at all! My zest for life was obliterated. However, now on MMT and antidepressants I truly feel "normal" and I feel good and can experience a wide range of emotions including joy. To me, this is the missing piece of the puzzle. I always knew that when someone relapsed they just wanted to feel good and could not without drugs due to some type of brain or nervous system damage.

Thank you Zenith for mentioning this!

Christopher C.

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ccccubed

Posts: 13 Member Since:02/25/10

#7 [url]

Feb 25 13 7:18 AM




I think you so much for this article. I have a new counselor at my clinic and she has been kind of pushing me towards a goal of possibly one day detoxing from methadone.  She is herself an addict but I don't believe she was an opiate addict.  Furthermore I don't believe she really understands the ins and outs of methadone treatment.  I have posted here before.  My old counselor never said a word about detoxing.

I stayed sober and clean for over 12 years by simply attending meetings etc. etc. etc.. Not once during those 12+ years did I ever feel a whole complete or normal.  I was under a 24 hour a day seven days a week siege from my body. I had terrible terrible depression anxiety and often could not sleep. I also could not feel pleasure or enjoy anything as I normally did in high school before I ever took a drug. I went to eight years of therapy during those 12 years and I learned a great deal about myself.  I had a sponsor worked all the steps blah blah blah blah. I was expecting after 12 years of sobriety and being clean that I would eventually feel better that thing never happened.  Of course I was totally disheartened and eventually this led to a relapse. I don't think any human being alive can withstand 365 days a year of terrible depression and anxiety it's very similar to living in your own homemade jail.  My body became my jail.

Of course I had a terrible relapse damage my health further totally made my family distraught lost everything etc. all over again.  The wonderful man who told me all about methadone treatment and explain to me while I was still using. I knew if what he was saying is true it would work so I promptly found a methadone clinic with help of my parents and I've been there ever since that was eight and half years ago.


I got my job back and I am now currently totally clean and sober for eight years and I have the love and respect back of my family and society.  I have monthly takeouts. I do still attend AA meetings several times a week - I enjoy and like the support.

I am just deeply concerned that if I get off methadone my brain still has not recovered to normal chemical status nor will it ever.  I appreciate what you said Zenith.  Some people's brains may recover some may not I guess the only way to find out is to try a slow gradual detox as I'm finding it hard to find any literature on this topic on the Internet except for here of course.

I'm not gonna do anything right now but I'm going to get further thought.  Methadone treatment is incredibly effective for me and it is very much a small price to pay for having your whole life,  your health,  and especially your mental health return to you.


My counselor seems to think that there are long-term health hazards for staying on methadone in fact today she even said that methadone is a type of mine control.  I just don't think she really understands what she is talking about.  It is no more a mind control than is our own brain making those endorphins by itself -  that's preposterous to called methadone brain control.

Methadone has given me the highest quality of life I have ever known since the first day I ever took a drug.  I really don't care if methadone takes 20 years off my life or more it doesn't matter to me it is my quality-of-life today that counts!  Of course as we all know methadone does not seem to cause any harm in the short-term or long-term.  I've read a few articles here  and there concerning   long-term health benefits  or long-term detriment to your health nothing conclusive though.

I don't think I'm gonna do anything right now but I will keep researching this site is just awesome!

Chris


Christopher C.

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sapphire76

Posts: 3,678 Member Since:02/22/10

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#8 [url]

Feb 26 13 4:29 AM

Hi cccubed - good to see you again!

You're right in that your counsellor doesn't know what the chuff she is talking about! I'm not sure how methadone is "mind control", that's a new kind of stupid I haven't heard before!!

I am not aware there are any long term negative health effects on staying on MMT, as your counsellor is trying to say. It is a very benign drug as far as how it affects the organs of the body etc.

Regarding knowing if your endorphin system is damaged or not, there is no way to tell apart from by coming off.

I've been on methadone all of my adult life, and started wondering if I could get by without it, and wanting to at least try, but was woried that as I've been on it so long, that my endorphins would not work properly.

I am on a slow taper and I've gone so far from 220mg to 70mg with not much in the way of negative effects.

You should only taper or detox if it is 100% what you want to do. Please don't let some counsellor with zero experience of opiate addiction and no understanding of endorphin deficiency syndrome push you or nag you into doing something that you aren't really sure about.

I was on methadone 17 years before I decided the time was right for me to taper, and if the taper doesn't work I'm not going to stress over it, I'll just get back on methadone.

I'd rather be living a happy life on methadone than a miserable one white knuckling it through abstinence!

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savalast

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Posts: 181 Member Since:02/13/13

#9 [url]

Feb 26 13 7:24 AM

Hi sapphire, I'm new here but thought I read you went from 300 to 220 mgs? Now you've gone down to 70. In 14 years all I've ever done is go up.70 to 100. Then 130, then to 180. Today's the first day I went down 10 mgs from 180 to 170.
 My question is, does your body re act to 70 the way it did at 220. I mean do you get acustomed to the dose and 70 makes you feel as you did on 220. I'm hung up on that and today being the first time I ever decreased I am nervous. Not from the decrease of course but if my body gets acustomed to this dose just as 180. After 1 month, I want to try going to 160 by 1 mg a week because I'm on liquid.
Thanks

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sapphire76

Posts: 3,678 Member Since:02/22/10

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#10 [url]

Feb 26 13 8:53 AM

Hi, my initial maintenance dose was 300mg/day and that dose enabled me to stop using illicit drugs.

After a about 6 months I felt a little tired and over medicated so I taperd down to 220 where I stayed for about 5 years or so and then about 2 years ago I started tapering from 220 to the 70 I'm on now.

Honestly I don't feel the same on 70 as I did on 220, I "felt" my dose at 220, and whilst not exactly sedated or high, I knew I had dosed.

Now I just feel the same all the time, I don't "feel"  my dose after I've taken it.

I don't feel bad on 70, if that;s what you mean? I just feel "normal"!!

I think the reduction for me has been OK because it has been 100% what I wanted to do, not what I am doing for other people, or what I think I "should" do, oykwim?

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