[nunan1]

I am in a position where I will not be able to take my prescribed methadone for 12 hrs. I have been on it for quite a long time because I don't do well with discomfort. What is legally out there that will get me through this? Please help.

[bev49]

I personally don't believe you need to take anything if you will only be without methadone for 12 hours. Methadone has a very long half life which means that in 12 hours you probably still have the same amount of meth in your system that you did to begin with. What dose are you on? When you go to a methadone clinic, you only get dosed once a day and noone needs more 12 hours after the dose. You can even skip a day with minimal ill effects. I've gone 72 hours without methadone and I had been on it for many many years. Didn't feel any discomfort until about 60 hours after dosing.

[nunan1]

I do feel it when i am even a few hours late. I am at 115mgs. I feel it in my stomach and also I get hot. I have been on it for a long time!

[gripster]

long hot baths, benedryl, xanax or clonipin, do something to keep ur mind off it..the time will pass if your doin something or with someone, go for a drive if u have a car...sorry man i know the feeling and sometimes u cant do anything..i dont think ur sick just scared for what might come..i kicked meth in jail and im my case it took two days before i got sick but was sick for over two weeks...good luck, its already been a few hours!

[Cats Meow]

I have to agree with Bev, and w/d after 2 hours is all in your head, there's really nothing you can do besides wait it out, it really should be no big deal.
Why are you running out anyway? Get serious and take your meds right, and toughen up re discomfort, come on.

[franniesam]

There is not much you can do. The only thing that can really help is if you can substitute another opiate for the methadone. But then again, you said legal remedies. Just keep thinking that the worst part is mental. Actually lthough, I'm not really sure what it matters. If you feel crummy mentally, you will probably feel just as bad physically. Just remember that methadone has a half-life of between 24-36 hours. You should survive w/o too much difficulty. Of course, that's easy for me to say. Hang in there. It will end.

[nunan1]

Originally Posted by Cats Meow

I have to agree with Bev, and w/d after 2 hours is all in your head, there's really nothing you can do besides wait it out, it really should be no big deal.
Why are you running out anyway? Get serious and take your meds right, and toughen up re discomfort, come on.

I'm new to this stuff, and that is maybe why I have never gone on to a site like this. Ever. So even though I don't think the reason for my running out is any business of yours, I will tell you. I didn't bring enought Methadone with me when I came to visit my son in another City. No, I can't go dose. I should have been back, but the needed me to stay a bit longer. As far as toughening up goes, you have no idea what I am or what I do. I only asked if someone had some advice, not to grandstand and judge

[bev49]

Please dont get so defensive. No one was being judgmental. When someone says tough it it, its not an indictment of you, it just saying there isnt much you can do so just go with the flow. As far as length of time on meth, I think I hav ethe record. I was on methadone for 33 years before I finally switched to sub. I dosed once a day in the am and never got sick during the same day I dosed. I realize everyone is different but really, all you can do is tough it out. The suggestion of taking another substance is dumb because the meth in your system will block any opiate you would take anyway. So stay strong and youll be feeling better real soon.

[methadonede]

Methadone is one of the longest acting opioid medicines out there, and "missing" a dose for 12 hours should pose no difficulty for you. Even going a full day or more should pose no problem. So don't fret this.
J.R. Neuberger
National Alliance for Medication Assisted Recovery

Originally Posted by nunan1

I am in a position where I will not be able to take my prescribed methadone for 12 hrs. I have been on it for quite a long time because I don't do well with discomfort. What is legally out there that will get me through this? Please help.

[purpledog]

i went from a friday dose of methadone, all weekend without, and still went into precipitated withdrawls changing to subs. which shows how long methadone stays in your system.
i have never heard of 12 hour dosing for methadone, its once a day. unless for pain i guess.
harden the f up pal.
if you have been on it for ages, surely you know this. its probably more the fear, you will not hang out after 12 hours on 115mg. NO WAY.

purpledog

been on methadone for years, and have had to hang out occasionally along the way. you will get through this.

[bev49]

all us methadone people have had to hang out without from time to time. Sometimes fear and anticipation makes you THINK you're sick but its scientifically not possible. The proof I got is when I switched to sub. I had not missed a daily dose in YEARS... I dosed Friday a.m. slept fine friday night, was fine all day saturday, slept ok sat night (with the aid of a Klonopin, not gonna lie), was ok half of sunday, ********py the second half of sunday but not unbearable, did fall asleep sunday night (more klonnie aid) woke up at 3 a.m. in heavy duty ********py full blown w/d. But I was able to hang on til my sub appt. at 9 a.m. (By 9:30 I was back to normal, by the wya). Just telling this story to show how long meth really does stay in your system. Its not like heroin or short acting opiates where you really would get sick in 12 hours. If it was, it would be so much easier to kick, wouldnt linger so freaking long.

[keemo7]

If that is correct, you really shouldn't have a huge problem because methadone is a longer lasting morphine-based drug, with a significant half-life of approximately 20 hours. Depending on your metabolism, it can last from as few as 4 hours, to as many as 130 or even 190 hours. I'm hoping you'll be OK for 12 hours. I've been able to go for over 24 without big trouble. Best of luck to you!

[Debpurpletiger]

First of all, Methadone is NOT Morphine based! Morphine is a natural opiate from the poppy/opium flower. Methadone is a synthetic pain reliever, etc.... Methadone, if used for pain, usually does seem to "wear off" sooner. But it does have a long half life and many people can go 24 hours without any ill effects.

You are on a high dose, though and that may be why you are having withdraw symptoms earlier. If you are seeing a dr. for this, I would ask for a breakthru pain med to take every 8 - 12 hours, like Percocet. Yes. you CAN take them both with no ill effects.

Another alternative, if you are using this for pain, would be Fentanyl Patches. They go on your skin and give continuous pain relief for approximately 72 hours, although many people say they don't last that long...which I believe.

[mrmichael67]

I've been on it a long time too and you will not be in physical wd in such a short amount of time. No way. I can go into the 50 hours mark before I start to feel wd......54, 55 hours or so. Fortunately, methadone accumulates in the body and when one is stable on their dose, their tissue methadone levels will surpass serum (blood) levels. So, when one goes without their dose for a short period of time, their body is able to pull off of the reserve. Percocet won't get through the blockade a 115mg dose provides. Methadone can be given along with oxycodone or another short acting opiate, but the methadone dose needs to be low.....like 30mg or less. The reason being is methadone is an nmda receptor antagonist.....so is dextropropoxyphene......and both of them prescribed with a short acting opiate can help increase pain relief and help keep tolerance down. The problem with methadone is as you keep increasing the dose, the blockade becomes increasingly stiff. The dose range of 80-120mg is considered the blocking dose range. If you google nmda antagonists and pain and short acting opiates, you will get a lot of stuff to read.

[bev49]

MrMichael, you appear to be quite knowledgeable as far as the scientific information goes. I have a question. I was on methadone for a very long time, switched to subutex. When I was on methadone I had to have major surgery. The pain management team was aware of my methadone usage (about 40 mgs. at that time) so they gave me more than the norm, starting with dilaudid in a pump i believe, moving down to oxy and percocet, I think, not really sure. But went from the pump to injections to pills so however they do that is hwo it went. I was definitely "drugged up" but still, the pain was quite intense. Now I'm on sub and am very fearful of what would happen if I needed sudden surgery or pain management (I'm 60 years old with health issues). I'm down to less than 1 mg. a day of sub but I understand it blockage effect is huge, more than methadone. How would they work that or would I just be screwed? Thanks.

[Cats Meow]

Hey Bev, for emergency analgesia you are pretty much SOL, about all they can offer is Toradol, and you probably know it's just a strong NSAID, it helps some, but pretty much forget getting any serious relief.
If you had a planned scheduled surgery you would want to consider going off Sub to a full agonist well before hand, unless the pain isn't expected to be very severe and a bump in Sub will suffice. That's the biggest drawback to Sub, ER analgesia.

[Cats Meow]

The OP could take a full agonist with (or in place of) the methadone, but methadone hogs up most of the receptor, very little of it can get in, something like only 20-30%, it's a big waste.

[bev49]

Thanks so much cat... so all i gotta do is make sure any surgery is planned well in advance and make sure no emergencies come up LOL... That is some scary shiit......Are you saying that its harder to get pain relief on sub than on methadone maintenance? Well there is one great reason for getting off this stuff as soon as possible....

[Cats Meow]

If you're asking about post or perioperative pain mgmt, definitely Methadone is more manageable. It also occurred to me that possibly a spinal tap would be effective, Idk though, it's a guess on my part. For some injuries local anesthetics will prove effective, short term.
A big problem with methadone is so many ER doctors don't understand or have a great grasp administering pain mgmt and control and are reluctant to order adequate doses in fear of OD.

[bev49]

This is why I'm so lucky I live in NYC (outer borough). Methadone maintenance is so big here and the huge hospital I ended up in for my burst appendix surgery and affiliated hospital for my hysterectomy 10 years later had pain management departments where they are extremely knowledfgable about methadone. In the last 4 years I ended up in a hospital in Chorpus Christi, TX and again in Newport News, Va. I wes thanking God above that pain management wasn't an issue. I happened to have take out methadone so never even told them I was on a program and just used my take outs. This might have just been my NY conceit, lol. They may have been just as aware as the NY Hosps, but I wasn't taking any chances. My feeling was I'd be the only one in the entire hospital getting daily methadone (for maintenance, not pain). Now, I just do not like the idea of being on a drug that works so well for its intended purposes that you are shiit out of luck if you need something to break through.

[andrew]

I took 130mgs of methadone for just under two years, and took it in one dose, which lasted well over 24 hours. So -- I don't know, maybe the 10mg tablets are different, I took the orange wafers. But I could even skip a day and no problem.
Now methadone w/d is hell when you get off it completely -- I won't even go there. But I don't think 12 hours will be a problem, I really don't. If the 10mgs don't last as long, then I'm wrong, and my best advice is not to think about it -- sometimes withdrawal is a lot worse if you let yourself freak about it. A muscle relaxor would help, and something like klonopin, also. But again - 12 hours, nah, you'll be good. Really.
Sorry if this wasn't too helpful, and good luck to you.

[Cats Meow]

Here's a very long excellent piece of text Re: Methadone detox, I can no longer link to the original document, but I think anyone seriously interested in methadone detoxing will find this invaluable. I suggest you copy and paste it for future reference, and it's in multiple pieces.
Cats



‘There is no free lunch.’ Last updated 3/21/05 I believe in the search for truth…the following monograph is what I know to be true about the use and withdrawal from methadone. I also understand that in life, the truth is constantly evolving. My 18 years on the road to recovery probably taints my judgment somewhat…but friends—I know recovery from the bottom rung. I’ve written countless e-mail replies to those of you who wish to discontinue methadone. In order to save myself time I’ve decided to write as much as I can on one, or two, pages…the truth as I see it…to assist you in your endeavor. I will be adding and subtracting as more information is made available. Certainly, you may perceive your truth to be different. If you think that going to the methadone clinic every morning to get your dose for the rest of your life…gives you quality of life…then read no further and God bless you. I assure you, the standard medical establishment does not have an answer for withdrawal. In fact, the new way of thinking is that many of you will have to be on methadone for the rest of your lives. Nothing could be farther from the truth. They will try and convince you that sudden withdrawal will cause your untimely demise. Another falsehood, although the truth is you may feel like you’re dying. I consistently work with people stopping cold turkey and have better luck than lowering the dose over time., I’ve NEVER had an in-house methadone withdrawal case leave the program early…all have gone cold turkey from 60-150 mg per day…Many do this without the aid of other mind-altering prescriptive drugs…even though I’m licensed to prescribe these drugs. There are exceptions, for those that I detox out-patient, and for those that are on other medications when they come in for treatment…I’ll cover those medications in the following paragraphs. Personally, I urge all to consider in-house Detox for methadone…especially if going cold turkey. Although in my personal experience I’ve never seen any advantage in lowering the dose over time. Especially, if one is at 45 mg or less per day. Methadone Detox can normally be accomplished in 3-5 weeks. For information on natural methadone detox, in-patient, please visit <http://www.theriversource.org/> The most important issue in treatment for withdrawal is not so much treating the disease state but treating the individual. One specific protocol designed to treat a disease is standard medicine’s answer to all disease states. This is mechanistic medicine. It does not take into account our genetic variability…we respond to treatment in different ways…not just through biochemistry, but also on the emotional and spiritual levels. For the last 4 years I’ve been using nutrition—Intravenous and oral—to rebuild and repair the biochemistry pathways in the body and mind. Over four years experience —this includes heroin, and all n the 20th century. The reason for this is a) its long half-life (24-36 hours)…b) it is a synthetic morphine, c) the diabolic symptomology associated with withdrawal and the length of the withdrawal symptoms. Methadone, like all opioids creates profound changes to gastrointestinal function… In layman’s terms this means that regardless of the food you eat--absorption of the vital nutrients is impaired. If nutrients cannot be absorbed in sufficient quantities and associated quality…all biochemical pathways in the body are affected negatively. Chronic fatigue, sleeplessness, aches and pains, depression, anxiety, are all signs and symptoms of these deficiencies. Methadone also has profound effects on brain neurotransmitter production and function. It is also known that it creates havoc in what is called the hypothalamic-pituitary-adrenal axis…which accounts for the chronic fatigue. And like all opiates, methadone down-regulates opiate receptors in the human body thus the long lasting aches and pains associated with withdrawal. Methadone withdrawal is particularly insidious because, left untreated; these symptoms can last literally for months. Also the longer you are on methadone the more profound these changes in body and mind function. 4) Regardless of the level you decrease the dose before quitting…you will suffer some level of withdrawal…Frankly, I’ve never been able to discern much difference in the withdrawal intensity between 1 mg or 80 mg…it’s always difficult. The withdrawal is unique to each individual…I’ve had some come off 65 mg or more, and while uncomfortable, hardly seem to break a sweat. Others coming off low doses and be in pure agony. One must treat the individual, not the disease. Nutritional treatment is essential in the recovery and withdrawal phase of any type of drug or alcohol dependency. To clarify nutritional treatment, consider the following statement: The body on methadone, or any other mind altering drug or alcohol, is like the house that has been damaged in a storm. If you were repairing the house what building materials would you need? You would need lumber, sheet rock, shingles, and etc for the major supplies…these are the equivalent of the bodies need for protein, carbohydrates, and fats. How would you hold everything together?…nuts and bolts, nails, and screws—these are the equivalent of the bodies need for vitamins and minerals. To make the repairs we need the proper tools to cut the lumber and fit it into place…one would need the saws, the equivalent of the bodies production of enzymes…these are made from the proteins we eat…one can draw analogy after analogy to explain the necessity for nutritional treatment to facilitate one back to health…only one thing needs to be clearly understood…you put back into the body the things it needs to come back to health.

[Cats Meow]

Any nutritional therapy should be adhered to for at least 90 to 180 days regardless of how you feel. Just like it takes time to alter profoundly the body’s biochemistry with drugs…it takes time to repair with proper nutrition. Oral nutrition is best but often is difficult for those in their first week of detox and recovery. Proteins, complex carbs, and essential fatty acids are necessary building blocks for repair and return of proper function of organ systems and brain neurochemistry. Vitamins and minerals are “co-factors and co-enzymes” which work on the building blocks to do repair and rebuilding. Additionally, it is always counter-productive to move from the complex to the simple…my philosophy is to start simple and move to the level of complexity that works for you…remember all patients are unique in the way they process nutrients and in their ability to maximize therapy. For more information on these necessary supplements go to www.happydestinysupplements.com <http://www.happydestinysupplements.com/> The following I suggest for those who wish to detox out-patient: 1) Pharmaceuticals: Clonidine 0.1, or 0.2 mg, twice to three times per day. Clonidine is an anti-hypertensive medication that is commonly utilized in opiate withdrawal syndromes. You must come off this medicine slowly—rebound hypertension may occur…especially if you already have high blood pressure…this medication is non-addicting; Vistaril 50-100mg…three times daily…this is a sedating antihistamine which helps with anxiety and sleep…down side is that after 10 days or so it loses its therapeutic efficacy; phenergan 25 mg tab…one every 6 hours for nausea and cramps. I may use these medications on my out/in-patient clients depending on the severity of symptoms. Imodium A/D works well for diarrhea. 2) Intra-Venous Nutritional therapy: In patient or out-patient…typically every day for the first 5-6 days, than every other day until the symptomology has subsided. These nutrient bags can contain proteins, vitamins, electrolytes, and other elements necessary for the body-mind to heal. The advantage of IV therapy is that all essential cofactors bypass compromised gut function. Only when the healing occurs will the symptoms of withdrawal disappear totally. Diarrhea is uncommon in those that receive IV nutrient therapy…but for those not so fortunate, Imodium A-D seems to work well in most. If your are a medical professional and wish I.V. treatment protocols contact me at thesourcenmc@msn.com <mailto:thesourcenmc@msn.com> 3) Oral nutrition: Increase the right proteins!!!! Proteins are the building blocks for neurotransmitters and neurotransmitter receptors…as well as the building blocks for your natural opiate receptors · For 3 weeks you must remove all red meats from your diet. Red meat has chemical components that increase inflammation and pain. Fish, chicken, eggs are good sources of protein. If you are having a hard time taking in solid foods go to a health food store and buy protein powders that can be made into smoothies or drinks. You absolutely must have increased protein intake…proteins are the building blocks for all enzymes, neurotransmitters, and enzyme receptors in the body. No chemical works in the body without receptors. Just like opioids have to have opioid receptors—which are down regulated during methadone use—this is the reason people have long-lasting pain and aggravation coming off methadone…this isn’t much of a problem with heroin use because of it’s short half-life…proteins are essential for the repair work in recovery…I now use a formulation made by Neuroresearch…their Neuroreplete/D-5 protein formulas works well for those coming off of methadone, methamphetamines and benzodiazepines or any drug for that matter…for more information on this product go to www.neuroresearch.com <http://www.neuroresearch.com/> or www.neuroreplete.com <http://www.neuroreplete.com/> and try to find a doctor close to you that will help you get his product…in fact I treat all my methadone withdrawal patients with this formula · L-Methionine—a sulfur bearing amino acid…necessary for the production of S-Adenosyl-methionine (SAM-e)…SAM-e is a necessary cofactor in the production of the master neurotransmitters—serotonin, dopamine, adrenalin, and nor-adrenalin…this must be added to any amino acid therapy directed at rebuilding neurotransmitter production and function…500 mg—two twice per day · Increase your intake of raw fruits and vegetables…you get little or nothing from canned foods…fresh fruits and veges are loaded with fiber which help bind and remove toxins from your body…they also normalize gut function · Stay off candy, and other sugar heavy foods · Drink lots of good water, green teas are good for the antioxidants and anti-inflammatory properties…no cokes or soda waters for three weeks · When capable you must start exercising…swimming is best because it is low impact exercise…yoga…tai chi…walking daily…detoxing or otherwise…exercise is a normal component of good health Supplements: Some need less and some more…remember the efficacy of all nutrition and supplement use is ultimately guided by your genetics…and we are all different to some degree…This is the value of seeing a good Naturopathic physician in the state you are in…The fact is that very few Medical Doctors know anything about nutrition…70%-75% of the standard medical schools in this country have absolutely no nutritional classes what-so-ever…in the other 25 %--nutrition is often a 14-20 hour block of education and this is commonly an elective…Naturopathic physicians that are educated in a medical school environment are taught nutrition extensively with the associated biochemistry.

[Cats Meow]

I use the following with all types of drug and alcohol recovery…. · Multivitamin with a strong mineral component: in gel caps only…an excellent quality multivitamin is absolutely necessary…remember that vitamins and minerals are cofactors/coenzymes for repair, healing, and normal function of the body…most times I have patients double up on multivitamins for the first 3-4 weeks · Mineral complex: see above · Fish oils, or flax seed oil.: necessary for repair and proper function of cellular membranes…anti-inflammatory…these need to be mixed omega 3, omega 6, omega 9 oils—4000 to 6000 mg per day in split doses…although some can be purchased as liguids and mixed with your smoothies. · If you don’t do the drinks…get proteins as free amino acids…double up · L-Glutamine 500mg caps…at least 2000-3000 mg per day…split the dose so that your doing it at least twice per day…helps heal the gut and the building block for GABA…the primary inhibitory neurotransmitter…helps slow things down…Do not take GABA as a supplement…GABA is make in the brain…when out side the brain the molecule is to large to cross the blood brain barrier…the building block for GABA is L-Glutamine or Glutamic acid…these building blocks readily cross the blood brain barrier. · Valarian Root 450 mg: Botanical that reduces anxiety and helps one to sleep…Kava, Jamaican Dog Wood, Lemon Balm, Avena are all nervine botanicals which can be used together or by self…I find the doses for each individual varies but typically 1000 to 1500 mg every 4 hours. · Melatonin…dosages vary…this is a hormone released from the pinal gland in the human body at night time for sleep…this is essential for those coming off opioids…in my experience as little as 1 mg to 30 mg has been effective…do what you have to do…I’ve had addicts coming off $100.00 a day habits sleep 4 hours the first night…start low and add 3-5 mg every half-hour till sleep…research on healthy volunteers using up to 100 mg of melatonin in a single dose shows little side effects…Melatonin is also known as a very strong antioxidant with 1000 times the potency as Vit E…Take only at night when you would be going to bed at the regular time…the room must be dark…that’s the way this hormone is released in the natural state… · Full Spectrum antioxidants: relieves inflammation and helps normalize inflammatory pathways and reduces damaging molecules (free radicals) present in the system while detoxing · Vitamin C: 2000-3000 mg per day divided doses… · Reduced L-Glutathione 300mg per day: Helps liver detox metabolites of methadone…Detoxing agents can be found in many products…most in combinations… · Adrenal Support: Research has shown that methadone, and drug use in general, has profound effects on the adrenal glands. In fact, research shows that there is a profound negative effect by methadone on the hypothalamic-pituitary-adrenal axis. This is why those that withdraw from methadone have protracted fatigue and problems with anxiety and insomnia. I often use freeze dried adrenal extracts in treatment with fairly good results. You’ll find these products listed under names such as Adrenal Plus, or Adrenplus…the starting dose is around 1000 mg per day in split doses. · Milk Thistle with alpha-Lipoic Acid is one combination that I use extensively---for liver repair and detoxification…1200 to 1500 mg of milk thistle and 400 mg of lipoic acid per day in split doses This is the basics. There is absolutely no way to eliminate all the problems associated with withdrawal from methadone...one must have a supportive environment and often with daily visits from a compassionate health care provider…This will not kill you…it will be a miserable event…what kills most is the movement back to street drugs to ward off the side effects of withdrawal. If fact, cold turkey deaths coming off opioids and methadone are rare and usually associated with other health problems, or overdosing on prescription medications…withdrawal from methadone is much less of a risk than total withdrawal from alcohol. I wish you all luck on this endeavor…My compassion and empathy goes out to you…Ultimately, I know that you can do this…after all…it has to be done. CURRICULUM VITAE David Arneson was born on September 22, 1949 in Sidney, Montana. He graduated from Philomath High School in Philomath, Oregon in 1967. He entered the U. S. Army in 1968 and was honorably discharged in 1970. After his Army service, he went to Oregon State University for one year where he majored in Liberal Studies. In 1971 he moved to El Paso and worked for several years in the customer service industry. In 1976 he started his own contracting business to which he sold majority interest in 1992 and the remaining limited interest in 1996. In 1988 he took the opportunity to return to school and entered the University of Texas at El Paso where he received his Bachelor of Science degree in 1992 with a double major in Biology and Psychology, graduating with Honors. From 1994 to 1996, he continued his education at the University of Texas at El Paso and the El Paso Community College. In 1994 he received the necessary training to be certified by the American Board of Hypnotherapy in clinical and regression hypnotherapy. In 1996 he entered into his medical training at the Southwest College of Naturopathic Medicine where he received his Doctorate in Naturopathic Medicine in August 2000. From 1988, he has worked in both the volunteer and employee capacity in the field of addiction, as well as with the seriously mentally ill, working extensively with both adult and adolescent populations. Since October of 2000, to July 2002, he served in the capacity of Clinical/Medical Director at the Naturopathic Detox Program, a non-profit 14-28 day residential naturopathic drug and alcohol detoxification facility. Presently, he is Medical Director of The River Source Naturopathic Detox and Treatment Program in Mesa, Arizona. He is currently a part time Clinical Instructor of Naturopathic Medicine at the Southwest College of Naturopathic Medicine and Health Sciences where he supervises and trains student doctors in clinical settings. He also maintains a private practice, focusing on treatment of alcoholism, drug dependency, and chronic disease.

[purpledog]

that was an excellent read.
thanks catsmeow.
cool

[Debpurpletiger]

Wanted to know how you are doing since you first posted.......

[Debpurpletiger]

How is everything since your original post?