Series: 10 Things You Should Know About Methadone (Number 5)

by recoveryhelpdesk on February 7, 2010 · 32 comments

1.  Methadone is a medication used to treat opiate dependence

2.  Methadone prevents withdrawal, limits cravings and blocks the effects of heroin, oxycontin and other opiates

3.  Opiate dependent people who are in treatment with methadone live longer

4.  Long term treatment with methadone is better than short term treatment with methadone

5.  A low methadone dose is not necessarily the best methadone dose.

6.  Methadone is the gold standard treatment for pregnant women who are opiate dependent

7.  Methadone has drug overdose risks and benefits that you should understand

8.  Methadone treatment requires a strong commitment to recovery

9.  Methadone-assisted recovery is real recovery

10.  Methadone is the single most effective treatment for opiate dependence

If you want to get the maximum benefit from methadone treatment, then you have to be at the right dose.

The preferred term is a “therapeutic dose.”

Studies show that most methadone patients have better treatment outcomes at higher doses.  In other words, the therapeutic dose is likely to be found at the high end of the dosing range rather than the low end.

Why would this be?

Think about what the dose needs to accomplish.

At a therapeutic dose you should not experience any significant symptoms of withdrawal.  Any drug cravings should feel manageable.  And your dose should be high enough to block most of the effects of other opiates.

For an opiate dependent person who has been using a significant amount of opiates over an extended period of time, it takes a significant amount of methadone to achieve these effects.

And that is okay.

The same stigma-driven thinking that puts pressure on methadone patients to terminate treatment prematurely, also puts pressure on methadone patients to accept a less than therapeutic dose of methadone.

Methadone patients often feel pressure, including internal pressure, to “get by” on the lowest methadone dose possible.

The feeling is, “I/You shouldn’t be on methadone at all, but if I/you must be on methadone then i/you should be taking as little methadone as possible.”

But the goal is to enjoy the best treatment outcomes.  The goal is to be abstinent from illicit opiates.  The goal is to feel well and feel normal.  The goal is to have a stable home, work and social life.  The goal is to be at less risk for HIV, hepatitis C, incarceration and drug overdose.

We know from research, and the experience of thousands of methadone patients, that this kind of success is not likely to be achieved by placing the opiate receptor sites in your brain on a starvation diet.

So, don’t let anyone make you feel like you are “med seeking” or engaging in “addict behavior” just because you are asking for an increase in your methadone dose.  You and your methadone doctor should be working together to find the right dose for you.

If you are experiencing withdrawal symptoms, you should talk to your doctor about increasing your methadone dose.

If you are experiencing powerful drug cravings that you aren’t able to manage, you should talk to your doctor about increasing your methadone dose.

It often takes a higher dose to eliminate cravings than it takes to eliminate withdrawal symptoms, so it is likely that you will find your therapeutic dose by finding the dose at which you no longer have cravings.

A higher dose is also more likely to block the effects of other opiates, making it less tempting to use other opiates.

Part of the fear some people have about methadone in general, and higher doses of methadone in particular, is that the medication will cause euphoria (a feeling of being high) or sedation (especially to the point that it causes nodding off).

Certainly, methadone can cause euphoria if taken by a person who has not built up a physical tolerance to opiates.  But methadone is a slow-acting opiate, so it still wouldn’t cause the rush of euphoria associated with fast acting opiates like heroin or oxycontin (especially injected heroin or oxycontin).

Contrast this with the effect of methadone on a patient participating in methadone maintenance treatment.

The methadone patient begins treatment at a methadone dose that is low enough to allow the person to go into some level of opiate withdrawal (often 30 or 40 milligrams per day for someone with a significant tolerance to opiates).  Usually, this dose isn’t enough to even make the patient feel well, to say nothing of high.

From this point, the dose is raised (often every day or every few days at first) until the person is at a dose where they are no longer experiencing symptoms of withdrawal, and are not feeling cravings (often 60 to 120 milligrams per day, but sometimes significantly more or less).

Once the patient arrives at a therapeutic dosing level, the patient stays at this dose for an extended period of time.

Over time, the medication builds up in the patients body in a good way, so that the medication is always available to the opiate receptor sites in the brain.  The body becomes accustomed  to this dose of methadone.

A methadone patient may experience periods of sedation after taking their methadone dose during the period of increasing doses.  But once the patient is taking the same dose every day, they are unlikely to experience significant euphoria or sedation.

A methadone patient at a stable therapeutic dose is able to function normally.  They have normal motor skills and cognitive skills.  They can do anything that other people can do, including drive.

A methadone patient who is not at a stable and appropriate dose may feel drowsy, and may not be safe to drive.  Use common sense.  If you aren’t able to function normally, then you aren’t at the right dose.  Talk to your doctor about lowering your dose.

A methadone patient at a stable and appropriate dose feels well because all of the opiate receptor sites in their brain constantly remain occupied and satisfied.  And they function well because they are not high, not sick, not craving and not sedated.  They just feel normal.

Feeling normal, means you can get on with the rest of your life.

{ 25 comments… read them below or add one }

1 Barbara February 7, 2010 at 8:50 pm

Another informative post. I happened to write about methadone today too.

2 jj February 10, 2010 at 3:38 pm

Just found your site today, and I’ve found it very helpful and informative. Just one quick question, is methadone designed to be used for the rest of an addict’s life?

3 recoveryhelpdesk February 10, 2010 at 9:05 pm

Hi jj…glad you found the site helpful!

Research shows that people have the best outcomes if they remain in medication-assisted treatment with methadone for at least two years. Methadone is used as a detox medication, but relapse rates remain high as with all forms of detox (at least the detox itself is more comfortable with methadone).

Many people stay on methadone for a period of years…sometimes 20 years or more. People stay on methadone for a long time because the treatment is working for them, and because long term use is generally safe.

I urge people to continue methadone treatment for as long as they want to continue methadone treatment. At a minimum, I urge people to continue methadone treatment:

1. as long as they have corrections involvement (they are on probation or parole) because the incarceration risk is high if they discontinue methadone treatment too soon and relapse

2. until they are stable in all major areas of their life

3. until the times in life they were using seem like they must have been lived by another person (in other words they have so moved on that they don’t feel connected to that life anymore)

And I encourage them to taper slowly, at their own pace, over a period of six months or more.

They should feel free to stop and hold at a dose until they feel ready to reduce the dose again. And if they feel any sense that their recovery is destabilized, they should consider returning to a higher dose for a while.

The goal should be to avoid the feelings of withdrawal/cravings that can come with a taper that is moving too quickly because this can often result in relapse.

Thank you for your question!

4 jj February 11, 2010 at 1:16 pm

Thank you for your response. I’m just kind of at the end of my rope with a friend who I consider my sister. Here’s a little bit of what I’m going through with her right now, which is why I’m getting information before I just cut her out of my life.

She has been in a methadone treatment program for three and a half years, and while she is no longer popping pain pills like candy, the methadone has had horrible effects on her (lost her teeth, she’s almost “zombie-like” at times). She was going through an “administrative withdrawal” since she wasn’t paying the bills at the clinic and was telling me about some of the side effects of methadone withdrawal, and it seems to me to be worse than the opiate withdrawal. As a matter of fact, she recently told me that while that was happening, she has since paid the bill and is back on the program, she was so “sick” that she was snorting heroin to help her. I am so pissed off at her that she ran for the drugs as soon as things got a little hard and I’m really worried about her daughter. She never went to rehab or therapy to deal with the issues behind her addiction, and the only reason she got help in the first place was because she was pregnant. I’m not sure if it’s time to cut her out of my life, but it’s been many, many years of ups and downs, and I’m tired. I love her and I’ve known her for over twenty years, but her addictive behavior has been going on for almost 10 years now, and I have reservations about having an addict around my teenagers. They know what’s going on with her, and they also know that I told her if she started using again, I was done. Her “real” family is no help, as they are almost all addicts themselves, and are enablers. Right now her brother and his girlfriend, who are both junkies, are living downstairs from her and her daughter, with their (my friend and her brother) parents. She is in a very unstable environment and is not doing anything to get out of it, and I’m very worried that she’s going to start taking pills again, as I know for a fact that she’s started smoking weed and drinking again, as a way of dealing with her family. My sister and I have tried to help her as much as we can, but I think we’re fighting a losing battle and as cold as it sounds, we have families and problems of our own, and she’s kind of making things worse. My husband and I are having a serious battle right now because I want to rent her a house we own, just so she can get away from her family. She does make a steady, livable wage, but my husband’s afraid of letting an addict live in this property again (we had a bad experience with a relative of his a few years ago, and both agreed not to let anyone with drug issues rent from us) and I just want to get her out of this situation.

I’m not exactly asking for advice, but sometimes a stranger’s perspective is needed. Any thoughts would be welcome, and I’m a big girl, so I can take any criticisms directed at me. Thank you.

5 recoveryhelpdesk February 11, 2010 at 9:19 pm

jj –A couple of thoughts…

First, methadone doesn’t hurt your teeth. If her teeth are falling out, it is for the same reason that people who are not in methadone treatment sometimes lose their teeth (lack of good dental care, gum disease etc.).

People on a correct and stable dose of methadone should not be “zombie like.” It’s hard to say if what you are describing is related to her methadone dose or not. People with serious trauma, or other mental health issues may have a flat affect. Or other substances may be an issue.

Isn’t it telling that her medication is used by the clinic as a bill collection mechanism? Don’t pay your bill? See how withdrawal feels!

Can you imagine if an unpaid medical bill resulted in a reduction in someone’s insulin dose, or chemotherapy dose? But people who are opiate dependent are treated very differently than other patients.

Obviously, the decision to withhold medication was a financial decision by the clinic, not a therapeutic decision. This placed her at a foreseeable and serious risk for relapse. And she did relapse to heroin use. This also placed her at high risk for drug overdose.

In my opinion, this is professional negligence. I wish treatment programs were held more accountable, but the victims of their negligence have few resources to hold them accountable.

I can’t tell you whether or not you should distance yourself from her. But your friendship is not enabling her addiction, and your withholding your friendship is not going to enable her recovery. You don’t have that much power.

I don’t know about the specifics of your situation, but there are many opiate dependent people that I would be comfortable having interact with teen children. Her opiate dependent status alone is not a reason to keep her away from your children. Maybe your reservations are based on more than that?

Also, keep in mind that your teens are observing how you talk about her and how you treat her. This is your chance to model your values to your teens.

You have a chance to show them how to treat someone with addiction issues with compassion and respect, support them appropriately –and set appropriate boundaries for yourself and your family at the same time (for example, it may not be sending your teens the best message to refer to people as “junkies.”)

You have a chance to show them that it is safe to talk to you about drug use. You have a chance to help them learn about opiate dependence, and recovery. They may need this information some day –maybe when they are parents.

Keep in mind that if you rent her a house, you aren’t just her friend any more, you are her landlord. It sounds like the friendship is strained already.

A rental house is a serious investment, and you have a family to take care of. You should run your rental business like a business, or you may lose your business.

You’ve also identified that renting to her will likely cause conflict in your marriage.

If she makes a livable wage, she can get an apartment without your help.

If she needs financial help (and you choose to help), it would be safer to rent to a tenant with good credit and a good rental history and help your friend with money rather than a place to stay.

You could help her pay a security deposit or something like that if that is the barrier to her getting her own place.

It’s good to set boundaries that protect you and your family, and it is good to support your friend in recovery to the extent that you are able. These are not mutually exclusive. Just own what you are doing for yourself and your family, and don’t try to present it as something you are doing “for her own good.”

6 Zenith February 14, 2010 at 4:35 pm

JJ I agree very strongly with the advice you were given by RecoveryDesk. I am a Certified Methadone Advocate and recovery educator, and I administer two major websites for MMT patients. I also have a degree in nursing and training as a substance abuse counselor.

A couple of things I would add…..

You say she is drinking and smoking pot. Keep in mind that methadone ONLY treats opiate addiction. It does NOT treat alcoholism or dependence on other drugs. And sadly, the fact is that many MMT patients are poly-addicted (addicted to more than one drug). This complicates treatment.

Most centers that treat other addictions will not accept methadone patients. They (incorrectly) view methadone as “active drug abuse” and will not treat the patient unless they agree to cease their methadone immediately. Of course, doing so would make them VERY VERY ill and put them at very strong risk of relapse, not to mention it would make it nearly impossible for them to participate in any meaningful way in treatment due to being so sick. There are only a handful of places in the US that will continue MMT while treating other addictions. So if you feel she has an actual addiction to one of these other substances you may want to look into that.

Also, as Recovery Desk stated, methadone does NOT cause tooth decay. This is a street myth. Like ALL opiates, methadone reduces the flow of saliva, which can create “dry mouth”–an environment that is conducive to bacterial growth. However, methadone itself does NOT “rot the teeth”. Careful oral hygiene, as well as taking care to remain hydrated and using products such as Biotene (a line of dental products made just for people who take meds that cause dry mouth–available anywhere) should prevent any problems from developing. Many folks neglect their teeth terribly while using. Then, when they get into treatment and begin taking care of themselves, they go to the dentist where the years of neglect and rot are discovered. And they blame……..the methadone! When in fact it was the years of neglect and not methadone at all. There are many street myths about methadone, such as that it “rots your teeth”, “gets in your bones”, “turns your internal organs orange”, “was named after Hitler”, etc., none of them true.

One other thing–you mentioned how she returned to heroin use during admin. withdrawal and that it seemed to you that the methadone withdrawals were worse then heroin withdrawals. I would like to address this.

Methadone WD’s are not “worse” than heroin WD’s–they simply last longer, due to methadone’s long half life. The same traits that make methadone such a good choice for maintenance (stable levels in the blood over a 24 hour period, etc) make it lengthy to withdraw from. However, if we could “cure” patients by simply getting them off the drug, then all we would need to do is lock them in a room for a few days (as with heroin) and let them out once the drug is out of their systems and they would be cured. But it doesn’t work that way.

During an administrative withdrawal, the patient is tapered off at a rate FAR faster than they should be. As a result they are usually made VERY ill within a few days’ time. While I am not excusing her behavior, please know that she was not just dealing with a “little bit” of discomfort–I am sure she was dealing with severe physical symptoms as well as the mental terror that comes from such an event, and I agree with Recovery desk that this treatment is immoral and unethical in the extreme. Just about everyone relapses under such circumstances.

You mentioned that she was not addressing the “reasons” she used in the first place. Most rehabs and 12 step programs try to convince patients that they are using because of various “character defects”–i.e., selfishness, self centeredness, etc–or because of some childhood abuse issues–and that this can be cured by prayer. meditation, making “amends” to those wronged, making lists of every sin you ever committed, and so on. This is not based on ANY scientific evidence and in fact can be harmful to many. Lip service is given to opiate addiction being a disease, but then it is treated as a moral flaw. Success rates for this type of treatment are VERY VERY low. This is due in large part to the IGNORING of the medical aspect of the disease.

Those who have abused opiates over long periods of time usually experience changes in the brain chemistry–specifically in the brain’s ability to produce endorphins, our natural opiates. Once “clean”, it can be some time before the brain begins to produce endorphins again, during which time the pt. experiences severe depression, anhedonia, anxiety, cravings, exhaustion, irritability. For many, this disruption in brain chemistry may be permanent–it may never return to normal–or, they may have never had normal endorphin production to begin with, and were trying to self-medicate the condition with opiates. These folks may require long-term—even life long treatment with methadone to stabilize and normalize the brain chemistry, in the same way that a diabetic whose pancreas no longer produces insulin needs it from an outside source.

Once this chemical imbalance is treated, many patients will return to a normal life (i.e., whatever was normal for them before drug abuse began) without requiring further interventions such as counseling, group attendance, etc. Many patients were simply using to self medicate the chemical imbalance, not because they were “selfish”, wanted to “party”, or were suffering from abuse issues.

Others may require counseling and referrals for various things. I don’t know your person’s situation and so cannot say what she may need–but not everyone is using for the same reasons.

7 corinna February 23, 2011 at 7:10 pm

I have been prescribed 280 percocet for bout 2years of my life which of course graduated to oxycontin abuse I have been on methadone for 3weeks now I am at 60mg but I am still strongly craving oxys in the evening and am sweating wen I wake up until I drink my methadone at 10. Do u think my dose is to low?

8 recoveryhelpdesk February 23, 2011 at 9:41 pm

Hi Corrina –At the right dose you should not be feeling unmanageable cravings and should not be experiencing withdrawal symptoms. It sounds like you should talk to your doctor about raising your dose. The danger is that if you don’t get on a dose that is effective, you will be tempted to give up on methadone treatment and return to the risky patterns of oxy use that you were seeking to change.

9 Zak June 29, 2012 at 12:25 pm

Hi I have been on Methadone treatment for one month now. I am 26 and have been battling Opiate addiction for 5 years now. Methadone has been a lifesaver for me so far. It has gotten rid of my severe depression and anxiety but now that I’ve gotten to a stable dose of 50mg and stayed here for 1 week I am finding that I’m craving drugs again and that I am not as comfortable as I was when I was going up. Do you think that I should raise my dose or stay with 50mg for longer to see if I will stablize better?

10 recoveryhelpdesk June 29, 2012 at 9:35 pm

Hi Zak –Thank you for reading and commenting. You should talk to your doctor about your symptoms. You are at a moderate dose and it is quite possible that you might benefit from a higher dose, especially if the cravings become unmanageable. When talking to your doctor, it helps to be specific about your symptoms. Keep track of these between visits so that you are ready to provide details when the time comes. It may take some time to find your best dose, so be prepared for the process. The results will be worth it. I’m happy to hear that you are in treatment and making progress. I wish you the best.

11 kathy August 9, 2012 at 11:19 pm

I had gone to a pain clinic for chronic pain, nerve damage, surgeries that went bad on the neck, alot of pain. they put me on methadone, 200 for the month. My regular dr. had no problem with it..then my body was getting used to them and he raised my dose to 180 more a month which worked out great. I have been on them now for about 10 years. I like them cause i feel normal. I also have hep c from a transfusion years ago and my liver dr. doesn’t want me to take other pain killers cause it would harm my liver. then my dr. that prescribes my methadone moved out of state and sent me to a new dr. and right away he took over half of my meth away. You can’t talk to him..he is always right. I don’t live the normal life I had before.. I am in pain and have cramps. He told me if I didn’t like the way he took them away he would take them all away. I don’t know how to find another dr that deals with prescribing methadone. All I have found is dr.s that want to take you off of them. How do I look for a new Dr. that deals with that medication? Thank you

12 recoveryhelpdesk August 10, 2012 at 5:09 pm

Hi Kathy, I would look for a pain specialist. A pain specialist might have a better understanding of how to treat your pain than a doctor who does not specialize in the treatment of pain. It might also help to try to find a pain clinic that is part of a hospital that is affiliated with a university medical school. Best of luck to you. Tom

13 Anonymous October 26, 2012 at 1:00 am

I feel guilty/ashamed for being on 250mg

14 recoveryhelpdesk October 26, 2012 at 9:03 pm

Hi Anonymous. It’s not good to feel guilty or ashamed about your medical treatment or recovery supports. Recovery is hard enough without feeling bad about something you are doing to help yourself. It might be good for you to talk to your provider about why they have recommended this dose for you, so that you can feel better about your treatment. My best to you in your recovery. Tom

15 robin December 1, 2012 at 1:07 pm

Im on 100 mgs on a mmt clinic have been for 5 months now, how do i know if im at the rite dose?

16 Pain Patient December 12, 2012 at 2:27 pm

Hello, I am a chronic pain patient, and I suffer from cervical facet disease in my neck causing severe pain in my shoulder blade, which has been going on for 14 years –

I also suffer from lower back pain, and we don’t know the cause of that – all of my MRI’s are normal – and the front of my thighs go numb if I’m on my feet for more than 10-15 mins. This has been a problem (the legs going numb) whenever my weight has gone more than 15 or 20 lbs. over “normal” for my body type since I reached full growth. I had a hysterectomy about 5 years ago, my weight crept up, and the lower back pain has been going on since then, in addition to the numbness.

I also have Hep C, and it may be from intravenous drug use. My ex has it also, I don’t know for how long he has had it, but we shared razors. There was another man who also had it, and he and I had a relationship several years ago, and for about 2 years we actually did use IV drugs together, and though we were careful about the needles we may have inadvertantly shared at some point. It’s a little difficult to keep up with things like that when you’re in the process of using… in any case, I was tested after the divorce and after the drug use and the relationship the drugs were part of ended, and tested positive – so I got it one way or another.

From what I’ve heard and seen and from what some Dr’s who I tried to be honest with told me – no Dr. would put me on any opiod knowin I had a history of IV drug use – and so my current Dr. doesn’t know. Let me tell you, now, the details of the drug use –

It lasted for a period of about 2 years; we used cocaine intraveneously – I used it only when I was with him, I never bought it for myself and never used it by myself. I didn’t even know how. In the beginning it was once every 6-8 weeks, with the usage increasing over the next two years until at the end it was once or twice a week, with occasional binges where it would continue for 48-72 hours straight. The relationship ended, I got away from him, and I stopped using. That was 6 years ago and I haven’t used since.

On the pain side of things – I began opiod treatment for the chronic pain 9 years ago, with hydrocodone, 5-10 mg’s per day. This increased over the next 5 years to the point where I took 90-100 mg’s per day of oxycontin. At that point I felt honestly like the usage was getting out of control – I feared I was using for the high and not just for the pain relief. There were a couple of months I came up short and my Dr. put me on Suboxone. The cravings and the high stopped, but so did the pain relief. I was on Suboxone for about 2 years, and I hated it – my quality of life deteriorated during that time until I almost lost my job, and my kids were having behavioral issues and getting failing grades in school. Then I lost my insurance and told my Dr. I needed an alternative as the Suboxone was WAY too expensive.

He put me on methadone, 20 mgs per day, and over the following 6 months that increased up to 60 mgs per day, and since then I’ve stabilized – and actually found pain relief – and I know I’m not doing it for the high because there IS no high – and finally I feel like I’ve found something that will actually work to get me out of pain but not cause addiction issues – or high-risk behavior on my part.

I wonder if 60 mgs is a very high dosage for a pain patient – and I also would just like to know the thoughts of someone outside my situation who knows my entire history, someone who has knowledge in the field but no actual control over my current care. :)

I wonder if a 60 mg daily dose is too much of a burden on my liver, which will have to struggle with the Hep C also – and I have noticed some swelling in my legs and feet since I’ve been on it that I wonder about. I am careful about my oral hygiene, but I have always struggled with tooth decay, as my parents did, and as my brother and both of my sisters have – both of my sisters have false teeth now, and my younger sister had to get hers at age 21 – as soon as the females in my family start having babies they seem to lose their teeth soon after – but I’ve managed to keep mine until now, but they are so bad right now that as soon as I get my dental insurance back I’m going to have to get false teeth myself. I am 39, will be 40 early next year.

Anyway – I would like to know your opinion just on the whole situation, and any advice you might have for me. Should I be worried about needing to be on this for the rest of my life?

At one point while I was traveling, I had taken about half of my medication with me, and it was stolen. Knowing my Dr. would absolutely not replace it, when I got home I took what I had left and rationed it out for the remainder of the month, basically tapering down as slowly as possible to make it until my next appointment. I lowered my dosage by 10 mgs every three days until the last week I had 3 days of 10 mgs per day, 2 days at 5 mgs per day, then two days without any. Other than being terrified, and feeling kind of bad – but not too bad to function – and other than being in pain – I did okay. I feel like I can taper 10 mgs every couple of weeks and get off of these if I had to, with little to no withdrawals – but I don’t want to, because after everything it always comes back down to the pain – I cannot live a normal life when I’m in pain all the time.

I did go for several years without anything for the pain other than tylenol, ibuprofen, and PT – and it was horrible. I remember at the end of the day, all I wanted was a hot bath and to lie still somewhere, trying not to hurt. I didn’t want to *do* anything and I didn’t unless I absolutely had to. I tried to do “fun” things for the kids, but it was all for the kids – I smiled for them and took pictures and even enjoyed seeing them so happy – but I didn’t get any other personal enjoyment out of it, because it hurt.

So now I just wonder if being on the medication, maybe for the rest of my life, and risking losing it at some point more quickly than I can handle for some reason, the harm it might do my liver or kidneys – and actually getting some enjoyment out of life – is worth it – or is it doing too much harm, maybe so much harm that I would be better off suffering from the pain, so that I can live longer, or avoid possibly having to go through withdrawals with a body that’s been somehow weakened from being on the meds for years and years – I don’t know, would it weaken my body to be on 60 mg a day for years and years?

I would be interested in any opinion you might have – I think the medication is the best choice for me – but I don’t want to make a decision I’ll regret terribly later on down the line.

Thank you!

17 r cox January 4, 2013 at 6:18 pm

since 1999 the va has had me on 300mg of oxycontin amonth about 7 years ago i told my doc they didnt seem to be helping my back pain as much so they added 240 10 mg methadonens in the 7 years they methadone have not been increased and now i am having side effects withdrawals?? cramps terrible in my instepps or shins tore up stomache headache agitated very easy i dont know what to do am i on to little to much it seems im getting immune to the methadone? please give me some advice please. when they put me on the methadone they said it was for pain i didnt even know what it was.

18 recoveryhelpdesk January 12, 2013 at 4:10 pm

Hi R Cox, I would talk to your doctor about the symptoms you are experiencing. Your doctor needs the facts in order to make good decisions. Best wishes, Tom

19 recoveryhelpdesk January 12, 2013 at 4:25 pm

Hi Pain Patient, I enjoyed reading your comment. It’s clear you have been through a lot, and I have a lot of respect for how you have handled yourself in difficult circumstances. As you know, I am not a doctor. But in my own non-medical opinion I think your conclusion that “medication is the best choice for me” is a reasonable conclusion given your experiences and circumstances. Many people stay on methadone for many years and do very well. Quality of life does matter! What works does matter! On the issue of Hep C. Remember that testing positive for Hep C antibodies means that you were infected with Hep C at one time. To find out if you have current (chronic) Hep C infection, you need additional viral load testing. If you do have chronic Hep C infection, then your doctor should be monitoring your liver function. Methadone is generally safe for people with Hep C unless they have serious liver damage. Many people live with chronic Hep C for a lifetime without experiencing any serious harm from Hep C. It would be worth talking to your doctor about this, and asking for a referral to a liver specialist so that you can have peace of mind around the issue of methadone treatment with Hep C. Wishing you the best. Tom

20 michael c January 22, 2013 at 11:08 pm

i have been taken drugs for over 35 yrs. mostly opiate’s . i started the methodone program 10/mo ago. taken 120mg now and have been for 6 months now. i told them i was not feeling so good, a trof was done. came back low side 400. i told my case worker and nurse and they all said ok, we see you need to go up. also, i told them that i felt like i was dope sick, that,s why i told them in the frist place. i felt bad and i was not getting sleep, waking up every 2 hrs or so, and that after 35 years of doing the stuff, i know what feeling bad is .i am not trying to get high for all my pee tests have been clean, yet i know i am starting to feel that sickness all over my body, yet i still hang in there cause i want to be better, do the right thing for me . just when i should get a week take home, that they are not given me, that i worked so hard for, nor are they increasing the dose that i feel that i need to feel normal, like i felt 4 months ago when i was feeling better. now i have gone back to that sickness, cramps, tightness in all my body parts. shakes ,tears, and the feeling that everyone knows when your that sick. i feel like a victum of rape, riped off, ran-over and lied to as well. for after 10 months you get a week carry outs, if your good, that didn’t happen to me so i am pissed off. feel ran over with a bad taste in my mouth. now i am not crying, i will make it, but it sure ain’t the way the program was told to me . i looked your site up to get some insight on hang in there with oppression in my head and all over my body. thanks for listening to my story. michael c

21 SusieQ June 5, 2013 at 9:16 am

I’ve been going to the methadone clinic for 7 years now. They keep you on a blind dose but I know I was well over 100. I detoxed down to about 60 and been there now for a year. My probem is I have these cravings of getting high, so I end up taking more of my methadone then I’m always a bottle or two short. This has been going on a long time now. Where I go I don’t have a councelor right now cause mine has left for a new job. I see a nurse there every 6 weeks and I’ve told her about my cravings but not that I’ve been taking extra. I’m afraid they might take away my take homes and I live 70 miles away from the clinic. I am putting my family in the poor house cause I’ve been buying more. I don’t know what to do!

22 recoveryhelpdesk June 5, 2013 at 6:14 pm

Hi SusieQ,

You can explain to the nurse that your cravings are very high and that you feel that this is putting you at risk for relapse. You can also explain that you were not experiencing these cravings when you were at a higher dose. You can describe what this means for you (for example, “Before I reduced my dose, I never used to think about using. Now I find myself thinking about using a lot and it really scares me. I’m wondering if maybe I’ve reduced my dose too much. My current dose doesn’t seem to be the most effective or safest dose for me.”).

Unfortunately, depending on how enlightened your methadone providers are, there could be some risk in being open about using your take home methadone faster than prescribed and supplementing with non-prescribed methadone. But there is also risk in not being at an effective prescribed dose of methadone. Don’t ignore the situation. Start talking to the nurse/doctor and your new counselor now. You can start by just talking about your level of cravings, but at some point, you may have no choice but to risk admitting that (in spite of your best efforts) you sometimes use more methadone than is prescribed to avoid a relapse on heroin or other opioids (and this is very upsetting to you because both your treatment and your recovery are very important to you and after 7 years you don’t want to put either at risk).

Good luck to you,


23 LJ June 29, 2013 at 10:26 am

Hello, I have been taking 10mg of methadone by pill or wafer everyday for the past 3 years…. I was never prescribed this medication I got it from my other who was on a methadone clinic.. Now, NO methadone can be found for me its been 4 days.. I have experienced restlessness, irritablilty, cant sleep, mode swings ect… I suffer from PDST, Bi-polar and anixity… I take meds for my mental issues and I am in therphy 2 times a week… I have recently starting taking Oxycodone 10mg every 4hrs to relieve my symptoms bc I am also type 1 diabetic and have a insulin pump.. My blood sugars are rising extreamly high with the withdrawl and im scared to go into DKA its not fun and my quality of life is horrible I DO NOT FEEL WELL.. Do you think a methadone clinic can help me??

24 recoveryhelpdesk June 30, 2013 at 4:53 pm

Hi LJ, You have been taking a low dose of methadone for the last three years, and I’m not sure a methadone clinic is the best option for you. I would suggest you have a conversation with your doctor. If you are prescribed mental health medications, having a conversation with the person who prescribes those for you would be your best option, otherwise talk to your primary care doctor. It would also be a good idea to discuss this with your therapist. Tom

25 Chris July 17, 2013 at 10:18 am

Hi my name is Chris and I have been on MMT for approx. 3.5 months after I got out of the military I had back problems and nerve damage I had been going to the VA medical Hospital here in Memphis TN I admit I was a partier in my younger days and I’ve done more than just pills but anyways they started me immediately on Oxycodone and after a while since the DEA was cracking down on people going there just for pain medication I was switched to Hydrocodone been on it for 5 years to make a long story short I broke the narcotics contract and was cut off my medications then I started having horrible withdrawals. The Vet hospital here doesn’t participate in suboxone/methadone programs the Vet Hospital did not even help me get off them and I was on them for 5 years that’s another story. Therefore I had to go to a methadone clinic and let me tell you it has been a life saver It helped my w/d s I began to feel normal again! I am now on 50 mg and people are right about not comparing what others are on it’s what dose works best for you. I have Depression and it has helped that as well I feel better I don’t have to go around popping pills every 4 hours I like how it lasts really long. The only negative side effects I’ve had from methadone was the constipation and my right foot seemed to swell a little bit but didn’t last long I take Mira-lax. I just wanted to say that if it wasn’t for methadone I don’t know what I would do I had thoughts about doing whatever I could just not to feel so bad and on top of that severe depression when I was in withdrawals since I’ve been on Methadone it has helped and even my therapist and Doctor has told me they could tell I feel much better only bad thing is how expensive it is but it’s worth it better to pay a clinic than a drug dealer (just my opinion). I am not sure how long I’ll stay on this but I do know it has helped me tremendously. God Bless Everyone and I hope that everyone stays safe and sober.

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