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Help!!! Inpatient Medical Detox to Get Off Methadone (or opiates generally)???
  1. #1
    jloops is offline New Member
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    Default Help!!! Inpatient Medical Detox to Get Off Methadone (or opiates generally)???

    The idea is to get a friend off of 40 mg. methadone daily. He's been on for about 4 years and doesn't use any other drugs, and has not used any other drugs for many years. He just wants off of the buprenorphine.

    (I should also note: the biggest concern is that they know methadone and THAT THEY SEDATE YOU SERIOUSLY FOR THE WORST OF IT! Please, let me know -- even if it was for another opiate -- the medical detoxes that BREAK OUT THE HEAVY SEDATIVES!!!)

    Switching to buprenorphine -- at least outpatient -- is just not going to (i.e., has not and will not) work. Waiting long enough / switching to another opiate in order to induce was simply not tolerated.

    Tapering down off the methadone (and probably the buprenorphine) outpatient will take quite a while, I think, and will likely be worse than just doing a medical detox.

    Has anyone done a medical detox from 40 mg. of methadone, or a comparable oxycodone/morphine/whatever dependency (e.g., 300 mg. morphine/200+ oxycodone per day)?

    Does anyone have a location they recommend for accomplishing this?

    If anyone has done this successfully, PLEASE let me know where you went and how it went!

    We're looking at several places. We cannot afford the ultra-expensive places, but they're all expensive, and I think that I can deal with that, especially when one considers the cost of NOT doing this, and doing it right.

    Medical Detox #1: Says they'll switch you from 40 mg. methadone onto oxycodone for 2-3 days, and then switch you onto buprenorphine, and then taper the buprenorphine down to 2 mg over 7 days and then give you the boot. All told, 10 days (or less, they say) spent. I have repeatedly heard that 2 mg of buprenorphine has as much (mu, at least) activity as 32 mg, and that the buprenorphine is equivalent to about 30 mg methadone -- so is this going to accomplish nothing but the equivalent of switching from 40 mg of methadone to 30 mg of methadone, only to face the withdrawals from the (long half-life-having) buprenorphine after leaving?!?!?

    If using buprenorphine for a week long detox has the magical properties it is said to have in some circles, please let me know. Otherwise, I am suspicious that once leaving this place one would simply go through pretty serious buprenorphine withdrawals. Or, are the withdrawals from 2 mg of buprenorphine NOWHERE near as bad as the withdrawals from 30 mg of methadone?!?

    Basically, for rehab #1, the question is: Can a 10 day detox using buprenorphine tapered down to 2 mg then going cold get someone off of 40 mg of methadone and not leave them feeling like total garbage upon leaving?


    Medical Detox #2: Uses buprenorphine like #1. Gets you on the buprenorphine after a switch to oxycodone, like #1. Has you spend about ~5-7 days to get on the buprenorphine in the medical detox setting, and then transfers you to a "rehab" type place where you go to groups and that stuff for another 3 weeks while the buprenorphine is tapered.

    All told, you switch to buprenorphine, and then have 3 weeks to taper off of it while in their rehab setting. I didn't find out how low they taper -- I assume it'll be either 2 mg or 1 mg.

    Is there a lot of value of extending the buprenorphine taper to about 3 weeks in a non-medical setting, expected to go to groups and stuff we're not interested in, instead of just switching and tapering over a total of 10 days in a more medical setting?


    Medical Detox #3: Does NOT use buprenorphine. Switches you to an unnamed short-acting opiate during the first few days. Then tapers you off of this drug during the rest of your stay. They estimated 21-28 days for a methadone patient.



    So, what are your thoughts? All have similar prices, and are (hopefully) feasible.

    Is the 10 day detox reasonable for getting off of methadone? They claim to specialize in it.

    Is a 21-28 day detox better, or just dragging it out?

    And does buprenorphine have the magical properties during a short detox that it's supposed to?

    If it would be beneficial, it is feasible to (legitimately) obtain some buprenorphine in order to "extend" the detox another week or so. E.g., if they let him out after being on 2 mg the last day, we could put him on 1 mg. for a 2 days, and then .5 mg. for 3 days, etc., for 10 days or so, if that is advantageous.

    Would it be?

    Would this 10 day detox + a slight outpatient extension be ideal? Or does anyone with experience with this stuff think that a 3 day transfer process + a 7 day taper will be enough to leave without going through withdrawal? Feeling a little unwell -- that's fine. Feeling abject misery, and actual withdrawal symptoms -- i.e., being unable to eat, puking, diarrhea, SLEEP -- that's UNACCEPTABLE.

    So, whatever method we use, we have to avoid having those symptoms once leaving the detox -- they're expensive enough, and we expect he should be thoroughly SEDATED during the process.


    Please, any and all information you have is VERY appreciated, and I thank you all.

    Please bear in mind: I am not "interested" in outpatient buprenorphine...We tried, and he just cannot accomplish the switch as an outpatient, and we want to get it over with...

    Please, anything you guys know about medical detoxes, anything you can let me in on. People don't really give reviews online for detox centers(!), so I need to hear it from anyone hear who got off long-term methadone in a medical detox.

    Thanks in advance!

  2. #2
    newyorkgal is offline Platinum Member
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    My first concern would be this: If the person cannot even go the 72 hours it would take to switch to sub successfully, are you certain this person is truly committed? Waiting to switch is not unbearable due to the long half life of methadone. In fact, I don't think w/d are even felt til well into the last day. I didn't realy feel bad stopping methadone at 25 mgs. til approximately 60 hours into it. Second, 40 mgs. of meth might be a bit high to switch to sub, in patient or out. It is said you should be down to 30 mgs. or less before switching over. Tapering off bupe outpatient doesnt take "quite a while". Tapering off methadone does. If these medical detox places taper you to 2 mg or even 1 then are done with you, you will have grave problems after you leave. Stopping at 2 mgs. of bupe would be like stopping at 30 or 40 mgs. of meth, pretty much not doable. I went to detox to get off methadone. The probelm was this: They bring you down to a low dose. And then they say goodbye and send you on your merry way. Right when the really challenging part begins. If you are going to do medical detox, make SURE you have knowledge of the Thomas Recipe. Also, meetings, groups, or some other sort of support would be mandatory. Sorry I couldnt be more positive here. I think best case scenario is getting down to 30 or less on the meth (going down slowly from the 40 your friend's on now), going the 72 hours (which would prove commitment and is doable) and switching to sub. If you go to detox, be ready for the hard work after getting out.

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    jloops is offline New Member
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    Quote Originally Posted by newyorkgal View Post
    My first concern would be this: If the person cannot even go the 72 hours it would take to switch to sub successfully, are you certain this person is truly committed? Waiting to switch is not unbearable due to the long half life of methadone. In fact, I don't think w/d are even felt til well into the last day. I didn't realy feel bad stopping methadone at 25 mgs. til approximately 60 hours into it. Second, 40 mgs. of meth might be a bit high to switch to sub, in patient or out. It is said you should be down to 30 mgs. or less before switching over. Tapering off bupe outpatient doesnt take "quite a while". Tapering off methadone does. If these medical detox places taper you to 2 mg or even 1 then are done with you, you will have grave problems after you leave. Stopping at 2 mgs. of bupe would be like stopping at 30 or 40 mgs. of meth, pretty much not doable. I went to detox to get off methadone. The probelm was this: They bring you down to a low dose. And then they say goodbye and send you on your merry way. Right when the really challenging part begins. If you are going to do medical detox, make SURE you have knowledge of the Thomas Recipe. Also, meetings, groups, or some other sort of support would be mandatory. Sorry I couldnt be more positive here. I think best case scenario is getting down to 30 or less on the meth (going down slowly from the 40 your friend's on now), going the 72 hours (which would prove commitment and is doable) and switching to sub. If you go to detox, be ready for the hard work after getting out.
    First off, thanks for your reply.

    Second, the person in question is indeed committed. Stopping the methadone and switching to another opiate in order to get onto buprenorphine, however, was just painful and scary in a weird way (i.e., the way that makes you want to do it under medical supervision), and they weren't comfortable doing it at home.

    They already dropped from 80 mg. to 30 mg. in a single week in the hope of going to buprenorphine. They're definitely committed! (Yes, I know that didn't make the attempted induction any easier, but they were on the 30 for a full 10 days before the induction, and felt fine on it.)

    Thirdly, if leaving off at 2 mg -- which is what all these places seem to do -- after all, the pills don't come lower than that! -- will leave you in wretched withdrawals... then I don't get how these places stay in business.

    Isn't buprenorphine supposed to have some special properties? Where is that buprenorphine magic I have heard about?

    Otherwise, how do I hear about people walking off 2 mg. w/out anything that could be called acute withdrawal (more like PAWS type stuff), whereas you'd never hear about walking off 30 mg methadone without serious acute withdrawal?



    Anyhow, if this is the case with these buprenorphine detoxes that dose you at 2 mg. at the end of the 'detox', maybe we'd be better off with the detox that switches you over to a non-buprenorphine opioid dosed every 4 hours and tapers you off over 21-30 days?

    At least in that case, you'd have at least 3 weeks to get the methadone fully out of your system, and, with a short-acting opioid, you'd know where you stood at the end of the thing -- i.e., if you don't dose the last day, and you're fine to walk out, then that means you're good to go.

    Thoughts?

    Does buprenorphine not make a 10-day detox off of methadone possible, and "relatively painless", i.e. non-hellish (in conjunction with tranquilizers)?

    Or is the 21-30 day detox using a traditional, short-acting opioid taper a better way to get off methadone?

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    newyorkgal is offline Platinum Member
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    I might be out of the loop, but I've never heard of someone walking off at 2 mg. sub with out having serious withdrawal. If you were able to do the taper at home you could break the 2 mg in half to 1 mg., then cut it further to .5 and even .25. Then you can skip days before stopping totally. W/D is relatively mild that way. What other opiod would a detox center use to get you off methadone? Just curious. Bupe seems to be the drug of choice these days for detox. I just think 2 mgs. is too high to walk away from bupe without expecting to feel like shxt.

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    jloops is offline New Member
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    Quote Originally Posted by newyorkgal View Post
    I might be out of the loop, but I've never heard of someone walking off at 2 mg. sub with out having serious withdrawal. If you were able to do the taper at home you could break the 2 mg in half to 1 mg., then cut it further to .5 and even .25. Then you can skip days before stopping totally. W/D is relatively mild that way. What other opiod would a detox center use to get you off methadone? Just curious. Bupe seems to be the drug of choice these days for detox. I just think 2 mgs. is too high to walk away from bupe without expecting to feel like shxt.
    I don't disagree with anything you've said, I'm just trying to get more info...

    I have trouble believing nobody else has been to a medical detox when I read all the stuff people on here have been up to!

    We just want somewhere that'll whack him out good with sedatives for a few weeks and get this stuff out of me using buprenorphine or some other opiate for a quick taper while he's a zombie...

    Is that so much to ask? Maybe I should open my own facility...

    PLEASE, any info on this, any experiences (for drugs other than methadone as well), any info on the drug detox process using buprenorphine at a medical detox, any info on which medical detoxes will just zombify you (other than the ultra-rapid detoxes) while the drugs leave the body?

    Thanks again, nygal, for your response!

    BTW, the one detox uses something along the lines of a strong (morphine level) opioid, at least at the beginning of the taper and/or for larger dependencies, and then tapers you down. They won't say what it is exactly, but I believe a website I saw was referring to this detox in a post where they identified the drug as a well-known strong opioid you're all familiar with.

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    cali1234 is offline New Member
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    Hi.. I dont have time to read ALL of the posts..so my info may be unneccesary, but I just wanted to tell you a couple things from my personal experience..

    First.. I was not on as high of a dose of methadone (I tapered from 40 to 20mg pretty quickly) and after about 6 months I am on 2mg. I have not taken any methadone in the past 2 days however, and I am feeling OK. Mentally, I am constantly telling myself that I am withdrawing, but physically I am fine... The worst part is when I wake up around 4 or 5am and feel ancy and anxious. As long as I move around and keep myself busy, I truly feel fine. The mental part is what keep people thinking they are in withdrawals...in my opinion.

    I wanted to tell you this because no matter what people say, it IS possible to live your life and feel somewhat normal while tapering or stopping methadone at a low dose like 2mg. I know it is different for everyone, but I wanted to tell you my experience.

    I wasn't on a low dose of opiates before I started the methadone either.. i was on 320 mg of oxycontin per day last year.

    Also, I have had 2 friends go to Domas retreat in California for Medical detox (rapid withdrawal under anesthesia) and after 2 and 3 years they are doing great. opiates.com explains this procedure called the Waissman method. It is expensive though.

    This may not have made sense as Im in a hurry..but I would love to help you in any way I can through my experiences... just let me know!

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    cali1234 is offline New Member
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    I was just skimming your other posts... so one more thing:

    I personally was put on suboxone in a medical detox before I ever went on the methadone. They tapered me off in about 8 days, and left me with nothing to take home. This would have been fine if they would have warned me how terrible i was going to feel the next day at home. But they said I was completely detoxed and would not have any further withdrawals. I immediately went out and used oxycontin after 10 days in my detox facility because I felt AWFUL... I thought it was just me being an addict, until I researched what suboxone was.

    The methadone has allowed me to live my life and be free of oxycontin. Over the past week I have needed to taper and stop the methadone due to a drug test... this is why I went from 2mg to nothing.

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    newyorkgal is offline Platinum Member
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    I honestly have never heard of a detox facility that will give morphine like drugs to detox someone from methadone. Wouldn't we all love to be "zombified" and knocked out through detox?? You gotta pay the piper at same point. And that is pretty much one of the incentives not to use again, not wanting to feel the pain. I was in a medical facility some years ago, 21 days to get off methadone. This was pre bupe so they just tapered you down to 0 and 2 days later sent on your merry way home. Unfortunately, meth has a long half life so you really don't even feel the worst of it until 3 or more days have passed. Needless to say, it failed. You will not find a place to zombify you but might get stuff to "help" somewhat. What you don't realize is that if you are getting subutex, you won't need to be knocked out. You will be w/d symptom free. It's the after leaving at 2 mgs. thats the problem. My advice if you go to the 10 or 21 day detox where they only bring you down to 2 mg sub is have some at home to continue the taper. 2, 4 or 6 mg is actually a starting dose for some people, not an ending dose that will be successful, most of the time. You can continue the taper at home and go really low by turning the pills into powder and separating them into tiny doses to use sublingually. I'm sorry to rain on your parade once again, but I really don't know of a detox facility that will meet your standards of knocking you out while they clean you out. If I did, I'd have been there myself in the past and the waiting list would be wayy long.

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    jloops is offline New Member
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    Quote Originally Posted by newyorkgal View Post
    I honestly have never heard of a detox facility that will give morphine like drugs to detox someone from methadone. Wouldn't we all love to be "zombified" and knocked out through detox?? You gotta pay the piper at same point. And that is pretty much one of the incentives not to use again, not wanting to feel the pain. I was in a medical facility some years ago, 21 days to get off methadone. This was pre bupe so they just tapered you down to 0 and 2 days later sent on your merry way home. Unfortunately, meth has a long half life so you really don't even feel the worst of it until 3 or more days have passed. Needless to say, it failed. You will not find a place to zombify you but might get stuff to "help" somewhat. What you don't realize is that if you are getting subutex, you won't need to be knocked out. You will be w/d symptom free. It's the after leaving at 2 mgs. thats the problem. My advice if you go to the 10 or 21 day detox where they only bring you down to 2 mg sub is have some at home to continue the taper. 2, 4 or 6 mg is actually a starting dose for some people, not an ending dose that will be successful, most of the time. You can continue the taper at home and go really low by turning the pills into powder and separating them into tiny doses to use sublingually. I'm sorry to rain on your parade once again, but I really don't know of a detox facility that will meet your standards of knocking you out while they clean you out. If I did, I'd have been there myself in the past and the waiting list would be wayy long.
    Yeah, you're probably right, but it's a shame and it's kind of stupid that it's so hard to find a place that'll just do this the obvious way...

    I've definitely thought about doing exactly what you mention, continuing on with the buprenorphine for a little bit afterwards and tapering it off -- but, then, what the **** are we going to pay all that money for?!?!? Just to switch to bupe?

    I mean, if they dump me out on 2 mg, how many days will I need to taper off of the buprenorphine?

    BTW, we're thinking the other detox that I mentioned is actually using something on a more hydrocodone level based on what I've heard since I posted before...

    They say they've gotten one guy off of 600 mg methadone/ day (but that could mean anything, e.g., he used that much once a week), but I am confident they've gotten people off of steady doses of 100+ mg per day.

    I still can't fathom how people can live and interact in these "bed and breakfast"-type detoxes during this type of misery... I can only imagine that I'd personally need a genuine hospital setting... But nobody does that, for some reason. Even the hospitals don't do their detox in a hospital setting!

    Whatever though, this needs to be done. The one buprenorphine place I talked to actually said that the taper would take a few weeks, and you would spend the last week, drug free, at the place, which would mean that the withdrawals would be finished.

    The place that uses the short-acting opioid to taper you off gets you down to nothing or virtually nothing for the last few days... So, the worst situation is that you're left with the equivalent of a few vicodin in your system... And, you can always stay a couple of days past then.

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    jloops is offline New Member
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    Cali,

    Thank you for your responses, it's helpful to know your experience.

    Is there anyone else out there who has done this? A medical detox from any opiate, or especially from methadone?

    Quote Originally Posted by cali1234 View Post
    I was just skimming your other posts... so one more thing:

    I personally was put on suboxone in a medical detox before I ever went on the methadone. They tapered me off in about 8 days, and left me with nothing to take home. This would have been fine if they would have warned me how terrible i was going to feel the next day at home. But they said I was completely detoxed and would not have any further withdrawals. I immediately went out and used oxycontin after 10 days in my detox facility because I felt AWFUL... I thought it was just me being an addict, until I researched what suboxone was.

    The methadone has allowed me to live my life and be free of oxycontin. Over the past week I have needed to taper and stop the methadone due to a drug test... this is why I went from 2mg to nothing.

  11. #11
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    I was on Buprenorphine (Suboxone, then Subutex, due to H/A's from Naloxone) in 2005 for 6 months.

    I was addicted to Percocet snd Vicodin pain pills and Fentanyl Patches...basically any opiate - up to 30 pills daily - not getting "high", but not getting dope sick.

    I was inducted onto Suboxone after being in W/D for 24 hours (Yes, you have to be in W/D, but not SUPER BAD) They gave me a 2mg tab, about 45 mins later, another 2mg tab, another 45 mins later, 2 more mg. Then, I felt pretty good.

    It was weird, because it truly (for me anyways, not sure if true for everyone) did give me a very nice "high" that first day. Mind you, I never felt that "high" again, and once on this med, never craved that feeling again, not even once!! My daily dose was 6mg and after about 2 mos, I was down to taking 4mg every OTHER day cuz it has such a long half life.

    I was on this for 6 months, then to not being able to afford it anymore (about $300 per month for (30) 4mg pills) I had to stop. The dr. tapered me till I took 2mg every other day, then 1 mg every 2 days, but that taper was easy, NO W/D for me at all.

    I will admit, while on Subutex, I never craved opiates, I was happier, more on an "even keel" - (This med HAS been tested as an off label use for Refractory Depression , look up on Google- no need to increase dose ever, actually the lower doses work BETTER) But, I failed to remain sober. I was back to using within (?? Not exactly sure) -- 6 months or so, maybe less. For me, it was a life saver and I wish to God my Insurance covered it, I'd be on it again in a heart beat.

    I hope my experience helped in some way..... take care, keep us posted.

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    jloops is offline New Member
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    Quote Originally Posted by Debpurpletiger View Post
    I was on Buprenorphine (Suboxone, then Subutex, due to H/A's from Naloxone) in 2005 for 6 months.

    I was addicted to Percocet snd Vicodin pain pills and Fentanyl Patches...basically any opiate - up to 30 pills daily - not getting "high", but not getting dope sick.

    I was inducted onto Suboxone after being in W/D for 24 hours (Yes, you have to be in W/D, but not SUPER BAD) They gave me a 2mg tab, about 45 mins later, another 2mg tab, another 45 mins later, 2 more mg. Then, I felt pretty good.

    It was weird, because it truly (for me anyways, not sure if true for everyone) did give me a very nice "high" that first day. Mind you, I never felt that "high" again, and once on this med, never craved that feeling again, not even once!! My daily dose was 6mg and after about 2 mos, I was down to taking 4mg every OTHER day cuz it has such a long half life.

    I was on this for 6 months, then to not being able to afford it anymore (about $300 per month for (30) 4mg pills) I had to stop. The dr. tapered me till I took 2mg every other day, then 1 mg every 2 days, but that taper was easy, NO W/D for me at all.

    I will admit, while on Subutex, I never craved opiates, I was happier, more on an "even keel" - (This med HAS been tested as an off label use for Refractory Depression , look up on Google- no need to increase dose ever, actually the lower doses work BETTER) But, I failed to remain sober. I was back to using within (?? Not exactly sure) -- 6 months or so, maybe less. For me, it was a life saver and I wish to God my Insurance covered it, I'd be on it again in a heart beat.

    I hope my experience helped in some way..... take care, keep us posted.
    Yeah, that definitely helps.

    May I ask, how long did you take to stabilize at 2 mg and then taper off of 2 mg?

    Maybe if one of these detoxes switches methadone to buprenorphine, one could finish the taper at home within a month?

    It just seems crazy to pay so much money only to do a lot of the heavy lifting yourself...

  13. #13
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    When I first started, I was taking 6mg daily for about 2 months, then went down to 4mg every OTHER day (Buprenorphine has a VERY long half-life). When I knew I had to get off due to price, I went to 2mg every other day for about 2 weeks, then down to 1mg every 2 days for roughly 2 more weeks, then was done. I personally had NO W/D at all with that taper, it was a smooth transition.

    As for detoxing off Methadone, that can be a long and difficult process. IMO, I think it would be best to get down to about 20mg of Methadone daily, then switch to Buprenorphine (Suboxone) and do a 21 day taper. That would be a lot more comfortable.

    Keep me posted and good luck......

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    jloops is offline New Member
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    Quote Originally Posted by Debpurpletiger View Post
    When I first started, I was taking 6mg daily for about 2 months, then went down to 4mg every OTHER day (Buprenorphine has a VERY long half-life). When I knew I had to get off due to price, I went to 2mg every other day for about 2 weeks, then down to 1mg every 2 days for roughly 2 more weeks, then was done. I personally had NO W/D at all with that taper, it was a smooth transition.

    As for detoxing off Methadone, that can be a long and difficult process. IMO, I think it would be best to get down to about 20mg of Methadone daily, then switch to Buprenorphine (Suboxone) and do a 21 day taper. That would be a lot more comfortable.

    Keep me posted and good luck......
    Hey Deb,

    Thanks again for getting back to me.

    Did you move from methadone to buprenorphine, or was it some other drug?

    I just had so much trouble waiting to take the buprenorphine -- I'm just not used to being in withdrawal. I tolerate tapering methadone well (80-30 in a week, only went back to 40 after I tried to do the buprenorphine and that failed). I just can't take not taking ANY methadone. I didn't actually even take the buprenorphine. Just trying to switch to 120-180 mg. of morphine was impossible from 30 mg. methadone. (Admittedly, my actual dependence was probably still closer to 50 mg. at the time since the taper was so quick.)

    Anyhow... I may have to go to one of these "detoxes" that puts you out the door ten days later with your last 2-4 mg. dose of buprenorphine still coursing through your veins.

    How do you think I'd feel when that buprenorphine starts wearing off?

    I have legal access to the stuff, so I could take some once I get out of the detox for a quick taper. I just feel like an a**hole for needing to take buprenorphine AFTER a detox! I want the place to get me off stuff totally...

    Still, I'd rather just let the pros take care of me for a few days, get on the buprenorphine properly, and then finish the taper...

    But, at that point, I wonder why this would be better than just tapering methadone?

    How long would I need to taper off of buprenorphine (and how much buprenorphine TOTAL would I need) and what schedule would I use if I went to a detox that got me on to buprenorphine from methadone and then put me out the door somewhere between 5-7 days after making the switch?

    Would I need 1 month, or 2 months?

    If I get down to 20 mg. methadone, I think it's possible to taper it off in 2 months at 2.5/week... Would switching to the buprenorphine in a detox and then tapering off over 2 months be easier?

    If so, what's the schedule? I know I can get 80 mg. of buprenorphine, which would leave only enough for a taper such as:
    4 mg 7 days (28)
    3 mg 7 days (49)
    2 mg 7 days (63)
    1 mg 7 days (70)
    .5 mg 7 days (73.5)
    .25 mg 7 days (75.25)

    That's 1.5 months after switching off of the methadone.

    Is that reasonable?

    I guess if I have to pay the piper (with cash) in order to get off methadone easily, it's worth it...

    But how much easier is that, really -- to go into a detox that uses oxycodone and other stuff to switch you to buprenorphine, and then tapering off over 1.5 months to 0 -- than just tapering off the methadone?

    Has anyone actually tried tapering methadone off by 2.5 mg per week once at 20 mg and found it worse than tapering buprenorphine in the way I have above?

    Thanks again Deb and I thank you all for your replies to this -- I could use your help!

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    kidmonster is offline Junior Member
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    Hi Jloops/Deb. The last post sounds like a good down phase. I think staying at 1mg for example for 7 days is a great idea. 7 to 9 days seems for me at least, the best way to taper down. Ive been on subs for 3YEARS mostly taking 10mgs a day by taking one orange pill, then later in the day 1/2 an orange pill. by tapering down to 1mg a day and giong on klonopin to stop the aches and sleepless nights (which was hard for me) Ive been off suboxone (god willing) 1 month this week.

  16. #16
    mpvt is offline Platinum Member
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    Methadone is a terrific drug for a heavy addict that needs to stay on ORT(Opiate Replacement Therapy) for life. However there are people who stay on methadone for a time and then feel they can live opiate free which is fine but you have to detox in a very specific way.
    First off you cannot sedate a methadone patient without running the risk of respitory failure.
    Methadone detox is a long journey and follows a very simple rule. Drop no more than 10% every 4-6 weeks. So at 40mgs you would drop to 36mgs and stay there at least a month. If you are not experienceing withdrawls then you drop to 33 mgs for 4-6 weeks.

    If you follow this you can virtually come off methadone without withdrawls. Trying to avoid this will lead to terrible withdrawls that can last 6 months and often longer. Also the withdrawls seem to include excruciating lower back pain which usually ends in relapse.
    So there is no quick way off methadone, you need to do it properly or pay a price that not many can do without relapse...Good luck...Dave

  17. #17
    blahblahMEME is offline New Member
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    Smile 2 mg per week detoxing answer

    I did what you are asking. I was in an outpatient program. Listen. It's like this you can reduce 50% bi- weekly then play it by ear he should be fine up UNTIL HE HITS THE SINGLE DIGITS--meaning 9 mg's and below he should go slow. Methodone has a half dose coming to you from the day before. So take that into consideration.

    When you are in the single digits you will get your symptoms on about day 4-7 depends on his body I guess. I have stopped at 5 mg but it was still rough I finished the program but relapsed from tooth problems because I got pain meds for it. You have to be prepared for everything that will cause a relapse.

    His brain is hard wired to go for drugs for everything. Also, his pain receptors will feel super sensitive just like a baby all pain will be intense for a while everything seems harder. It is good to build new neuro nets in your brain--meaning if you get the craving to do drugs it is because you built that into your brain so you have to break that pattern of thought and replace it with something else like saying "NO" then replacing it with something that makes him forget the craving something positive that he will like. Find more than one thing. We get bored and need fun and want to use, we get emotional and physical pain and want to use. Get hobbies, good strong friends and stay busy.


    I don't know everything I'm sure --but I hope that helps. I am struggling too because I need to implement the last paragraph once I am off methodone again. currently on 2.5mg per day. Have a good one, Me.

  18. #18
    healinghanna is offline New Member
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    Red face The Methadone Detox Dilemma

    Please let me know what you found out about all your questions regarding the BEST, most safe and comfortable Detox off of Methadone.

    I have a family member who is on 80 mg of methadone and she is trying to wean herself off the methadone slowly and this does not seem to be working through a "Trashy Methadone Clinic"......so she went to an MD who is experienced in this detox and he is sending her out the door with an RX of tablets for the month...which is scary for her and for me. He is going to take months to get her down on the methadone and uses suboxone at some point.

    To me, ideally it should go like this:

    STEP 1: 10-30 days of Medically 24 hr supervised Detox using lots of vitamins/hydration/amino acids/all the good stuff with lots of sedatives and tranquilizers. 10-30 days depending on the person, metabolism, emotional/physical difficulty. Ativan/Klonipin/Valium/Clonidine/Trazadone.

    STEP 2: Go to rehab. A good one that deals with dual diagnosis "Truly", lots of physical activity opitons provided, lots of good nutrition and dealing with underlying issues. Minimum of 60 days- Prefer 90 days or much more.

    STEP 3: Continue the care by getting in the Real World, but by having an outpatient support available on a very accessible basis.

    Step 4: Going and Living in a clean and sober environment for at least 2 years. NOTE* This does not have to be affiliated with a rehab. One could go to a spiritual center, an intentional community situation, a volunteer program, just something positive and also incorporate the tools learned in rehab whether it be the 12 step meetings, DBT Therapy, Acupuncture/Yoga, swimming, horseback riding...whatever works for that individual person.

    Please someone respond if they know of any plan like this, any place they received a safe, medically supervised professional Methadone detox . Is there anyone out there who knows ?

    My family member is living in FEAR reluctant to go anywhere. Can someone help us ?

    And to the person I responded to, "How did it work out ?"

    Gracie,
    HealingHanna

  19. #19
    healinghanna is offline New Member
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    Please let me know of any answers you receive as my daughter is going through the same exact issues except for she is on 75 mg of methadone.

    A Long Term Safe Medical Detox with an Addiction Specialist, an MD and a professional staff is needed. INPATIENT for at least 2 -3 weeks for my daughter is needed. Then....comes the Rehab after the Detox. This is her plan. In the meanwhile, she sits in her apt with the shades drawn, only leaving to get her methadone drink at the clinic and then returning home depressed and hopeless and seriously frightened at the Detox she is facing if she wants to have a healthy, spiritually awake, life.

    Where does one go for a "Quality Detox ?"

    Mum

  20. #20
    newyorkgal is offline Platinum Member
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    Unfortunately, I don't know of any place that is long term to get off methadone. There are long term programs like Daytop Village, Pheonix House, and others but you'd have to be off methadone first. A methadone taper takes a long time. It's not something that can be done in a matter of weeks. Methadone has a very long half life and you don't even begin to feel w/d's until several days after the last dose. From 75-80 it isn't hard to drop 10 mgs.every few weeks. At 40 mgs. the drop should be in 5 mgs. increments. The troubles come when you get down to the low doses of under 20. At that point, the best bet is to drop 1 or 2 mgs. at a time then only 1 mg. at a time from 10 on down with a few weeks between drops. There is also a drug called subutex that will help with w/d but can only be started once a person is down to 30 mgs. methadone. You can find out way more about that on this site. I wish I knew of a place like what you're looking for. It might be out there, but I'm not aware of it.

  21. #21
    healinghanna is offline New Member
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    Can you give me the name of the place that gets you down to feeling just like you have a few Vicodin in your system and then can stay a few more days if you need ?

    Appreciate it. Seeking a reputable detox place that takes the time to make sure you are OK before discharging you.

  22. #22
    healinghanna is offline New Member
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    Dear jloops,

    Please give me an update on what you have found out so far, if you do not mind ? Your letter is quite clear. We are seeking the same questions. A safe, professionally trained staff and medical/addiction/pain specialist to do the detox over a period of 2-3 weeks on an inpatient basis. Some do the step-down method, some use subutex, some use suboxone (just for a few days to help alleviate the withdrawal symptoms, some use other opiates as well in the withdrawal process, some use amino acids, Vitamins or Vitamin B IV drips, some use the orthomolecular method in which they fill one full of all "the good nutrients and good stuff for your muscles as they will be cramping".......some just let you suffer a bit.......................so how is ONE to know which Detox center to use ?

    I need names of places and experience of people who have been in these places...PLEEEEZE!

    My daughter is becoming suicidal. Please help people. I would like to talk privately with someone.

    healinghanna

  23. #23
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    Default Healing is Hell...

    I just got off a 5yr methadone stint at between 170mg and 230mgs through the five years I was there.Im a pretty green memeber to this forum but Im well compared to 1 week ago. I went to clinic five long years.Some 42,123mgs of methadone in just this year alone. That stuff is toxic....unless you have no choice for pain controle.
    I was never in pain it just worked me off the pills gave little,little,structure but was legal.
    I probably cant tell you anything you havnt heard but I do have alot of insight to this,five of the last yrs,I did check into a hospital there was structure but no there was no one to keep me in check the next day that I was released. And yes there was uncomfortable times but I was hard pressed to push through. You just got to get that methdone level low when ..........well... you know....Ill honestly check into my friends that used to go and others to see if they new of other alternatives. But its been a week for me I ,since any methadone,wasnt happy all the time in the Hospital but they were there for support and to check my vitals.The nurse told me she had worked with many like me . Very nice people but I wasnt looking for a Siesta just to get my head back after over 10+ years opiate abuse. Sorry to ramble I guess I had nothing to lose so I had to try and now Im Doing.
    I saw this Thread started back some time ago and things are still bad ???????arghhh.....Im so sorry you havnt found the answers your looking for
    but maybe these are the answers and .......maybe theyre not
    It can be done
    The worst problem I had once off the methadone was sleeping .......
    Some would pray that were the worst withdrawl symptom they had
    Everyones different and I feel your fear for your .....family
    must shut up and post this to ya
    Just trying to help
    nuts
    Last edited by mstbenutsbutlookat..me; 09-26-2010 at 04:56 PM.

  24. #24
    aimeepropes is offline New Member
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    Post The Methadone Detox Dilemma

    I Am currently on 35mg. of methadone every other day. I also feel like i am the only person in the world that is as sick as I. Methadone is the worst drug a person should get on. Unless you can not get off pain meds. Then I think there are better medications for that. Methadone is a life long commitment. The clinic I go to are just legal drug pushers that will not take insurance and take 18 yr. old kids in that smoke weed and give them methadone. They have no idea what there in for. I was never told by the clinic how addictive methadone is and all the kids running for the clinic do not have a clue. I was up to 95 mg. a day and was able to drop 5 to 10 mg a week til now. I am scared to drop anymore but to sick not to. I also can no longer afford to go there. But there is no free dosing so no money no done? I am scared for my life. I understand I got myself in this mess but there but why should i have to go through a painful withdraw to. I have been suffering long enough. Does anyone have any suggestions? I have no insurance. I really don't care what they use to get me off the methadone. IF IT WORKS !! And i can feel normal I will do it but with no insurance or money who will help me? If anyone has any idea please let me know.
    Last edited by aimeepropes; 06-08-2012 at 04:07 PM.

  25. #25
    aimeepropes is offline New Member
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    Did your family ever find a place to help your daughter or not? i read this story and prayed for you. I am in the same situation as your daughter. And i am frightened that i will commit suicide and be gone before i realize i am even ready to go. Its a sad sad medication they made available before fully knowing what the horrible side effects it would have 10 yrs. later. I also wonder about SUBOXONE if they have researched it enough. It makes me cry to know i have less then a 5% chance of successfully medically detoxing of methadone. And have over a 90% chance of spiraling into a deep suicidal depression. I did watch a documentary on a plant used in Africa by tribes to get in touch with there spirits and also works for >>>>>> addicts within a day you have no withdraw or cravings after 1 day and you DO NOT have to take any other medications after. I have no family, job, insurance but I WILL find out the costs and blog it AND I WILL MAKE IT TO MEXICO I FEEL ITS MY ONLY OPTION. I PRAY IT WORKS LIKE I HAVE SEEN BUT IT IS NOT LEGAL IN THE USA (surprise).And i am sure it will never be. POPULATION CONTROL. (MY OPINION) SOMEONE PLEASE TELL ME THERE IS SOMEWHERE OR SOMETHING THAT REALLY WORKS IT IS 2012.

  26. #26
    aimeepropes is offline New Member
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    PLEASE WATCH THIS DOCUMENTARY CALLED Facing the Habit It is about a Junkie and former millionaire stockbroker Dave starts looking for more experimental treatments after 10 years of failing to kick his >>>>>> habit. He journeys to Mexico to undergo treatment with Ibogaine, a controversial drug made from a mysterious West African root known as iboga. Filmmaker Magnolia Martin's searing portrait of addiction won Best Short Documentary at the 2007 San Francisco Frozen Film Festival.( I COPYED AND PASTED THE INFO AND TITLE I WAS AMAZED AFTER WATCHING THIS & NOW I AM GOING TO FIND OUT THE COSTS AND WILL LET ALL KNOW & HEAD TO MEXICO.
    Last edited by aimeepropes; 06-11-2012 at 03:53 PM.

  27. #27
    super_mom is offline Junior Member
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    This is an old thread, but I was reading through and interested and wonder if the OP ever came clean that he was the one dealing with this issue himself or what I read what some sort of slip. In one post, it went like this:

    We just want somewhere that'll whack him out good with sedatives for a few weeks and get this stuff out of me using buprenorphine or some other opiate for a quick taper while he's a zombie...


    IT doesn't matter that much, but I'm curious if this guy/gal ever got help and is now a member under a different name, what ended up happening, etc.

  28. #28
    ltibbs187 is offline New Member
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    you cant take buprenorphine for a long time after you taper off methadone I think the dr. waits until your down to 3 milligrams of methadone to even start you on bups. because the half life of methadone stays in your body for so long. I suggest you go check yourself into a hospital for assistance if you cant afford the in patient rehab facility. take my word the bups have this effect its an opiate blocker so if there is any trace of opiate in your system it will send you int the most intense withdraw u will b sorry. but good luck be very careful.

    Quote Originally Posted by jloops View Post
    The idea is to get a friend off of 40 mg. methadone daily. He's been on for about 4 years and doesn't use any other drugs, and has not used any other drugs for many years. He just wants off of the buprenorphine.

    (I should also note: the biggest concern is that they know methadone and THAT THEY SEDATE YOU SERIOUSLY FOR THE WORST OF IT! Please, let me know -- even if it was for another opiate -- the medical detoxes that BREAK OUT THE HEAVY SEDATIVES!!!)

    Switching to buprenorphine -- at least outpatient -- is just not going to (i.e., has not and will not) work. Waiting long enough / switching to another opiate in order to induce was simply not tolerated.

    Tapering down off the methadone (and probably the buprenorphine) outpatient will take quite a while, I think, and will likely be worse than just doing a medical detox.

    Has anyone done a medical detox from 40 mg. of methadone, or a comparable oxycodone/morphine/whatever dependency (e.g., 300 mg. morphine/200+ oxycodone per day)?

    Does anyone have a location they recommend for accomplishing this?

    If anyone has done this successfully, PLEASE let me know where you went and how it went!

    We're looking at several places. We cannot afford the ultra-expensive places, but they're all expensive, and I think that I can deal with that, especially when one considers the cost of NOT doing this, and doing it right.

    Medical Detox #1: Says they'll switch you from 40 mg. methadone onto oxycodone for 2-3 days, and then switch you onto buprenorphine, and then taper the buprenorphine down to 2 mg over 7 days and then give you the boot. All told, 10 days (or less, they say) spent. I have repeatedly heard that 2 mg of buprenorphine has as much (mu, at least) activity as 32 mg, and that the buprenorphine is equivalent to about 30 mg methadone -- so is this going to accomplish nothing but the equivalent of switching from 40 mg of methadone to 30 mg of methadone, only to face the withdrawals from the (long half-life-having) buprenorphine after leaving?!?!?

    If using buprenorphine for a week long detox has the magical properties it is said to have in some circles, please let me know. Otherwise, I am suspicious that once leaving this place one would simply go through pretty serious buprenorphine withdrawals. Or, are the withdrawals from 2 mg of buprenorphine NOWHERE near as bad as the withdrawals from 30 mg of methadone?!?

    Basically, for rehab #1, the question is: Can a 10 day detox using buprenorphine tapered down to 2 mg then going cold get someone off of 40 mg of methadone and not leave them feeling like total garbage upon leaving?


    Medical Detox #2: Uses buprenorphine like #1. Gets you on the buprenorphine after a switch to oxycodone, like #1. Has you spend about ~5-7 days to get on the buprenorphine in the medical detox setting, and then transfers you to a "rehab" type place where you go to groups and that stuff for another 3 weeks while the buprenorphine is tapered.

    All told, you switch to buprenorphine, and then have 3 weeks to taper off of it while in their rehab setting. I didn't find out how low they taper -- I assume it'll be either 2 mg or 1 mg.

    Is there a lot of value of extending the buprenorphine taper to about 3 weeks in a non-medical setting, expected to go to groups and stuff we're not interested in, instead of just switching and tapering over a total of 10 days in a more medical setting?


    Medical Detox #3: Does NOT use buprenorphine. Switches you to an unnamed short-acting opiate during the first few days. Then tapers you off of this drug during the rest of your stay. They estimated 21-28 days for a methadone patient.



    So, what are your thoughts? All have similar prices, and are (hopefully) feasible.

    Is the 10 day detox reasonable for getting off of methadone? They claim to specialize in it.

    Is a 21-28 day detox better, or just dragging it out?

    And does buprenorphine have the magical properties during a short detox that it's supposed to?

    If it would be beneficial, it is feasible to (legitimately) obtain some buprenorphine in order to "extend" the detox another week or so. E.g., if they let him out after being on 2 mg the last day, we could put him on 1 mg. for a 2 days, and then .5 mg. for 3 days, etc., for 10 days or so, if that is advantageous.

    Would it be?

    Would this 10 day detox + a slight outpatient extension be ideal? Or does anyone with experience with this stuff think that a 3 day transfer process + a 7 day taper will be enough to leave without going through withdrawal? Feeling a little unwell -- that's fine. Feeling abject misery, and actual withdrawal symptoms -- i.e., being unable to eat, puking, diarrhea, SLEEP -- that's UNACCEPTABLE.

    So, whatever method we use, we have to avoid having those symptoms once leaving the detox -- they're expensive enough, and we expect he should be thoroughly SEDATED during the process.


    Please, any and all information you have is VERY appreciated, and I thank you all.

    Please bear in mind: I am not "interested" in outpatient buprenorphine...We tried, and he just cannot accomplish the switch as an outpatient, and we want to get it over with...

    Please, anything you guys know about medical detoxes, anything you can let me in on. People don't really give reviews online for detox centers(!), so I need to hear it from anyone hear who got off long-term methadone in a medical detox.

    Thanks in advance!

  29. #29
    Farcry is offline Banned
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    If you still need help, I literally just switched from 80mg a day methadone to subutex 3 days ago. I suffered a little bit, but not nearly as much as I thought I was going to. If you need what I did, respond and I'll let ya know. No precipitated withdrawls and I had taken 10mg of methadone 24 hours prior to subutex. Good luck.

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