Hello, I just started methadone treatment. I was expecting more counseling than what I have received and I have SO many questions. Seems like the clinic I go to just reads a sheet of paper, makes you sign, pee in a cup, go to the dosing window and leave. The main question I have is:
How do you know when you are at the right dose?
I'm on 50mg now. I started at 30. I have been sick since I started. I feel okay the first 6 hrs after I dose, downhill from there. I get tired, moody, irritable and extremely nauseous. I'm a 50 yr old female. I started taking opiates to ease joint pain. I kept going to Dr and they kept saying it was arthritis. Foot hurt, they said it was heel spur. I walked on that foot for half a year before Dr would do a bone scan and found acute fracture. I was making worse by walking. I could walk only because I took enough loritabs to keep me upright. I almost lost my house because I'd rather have drugs than have pain.
Couldn't afford the $800 or so I was putting into the pills I was getting off the street. Pain management wanted injections. I didn't want a needle in my foot. Anyways I was taking 60-80 mg of hydro a day. Then I found oxys and took 70 5mg in 5 days. I took what I could find. When in pain, I became desperate, although I never stole or anything like that.
I didn't know if methadone was just for heroin. I asked, received no answer. I told counselor I thought foot was still broke, should I even be here? She looked at me and ask me if I wanted to continue. I left the first day in tears. I felt horrible. Drug addict, I was a grandmother and a drug addict. I went home, had some gin and told my husband.
Okay, I got to rambling there..... How can you tell when the dose is right? Thank you for reading and any answers would be appreciated
I found this dosing information on a Canadian Methadone Clinic website, but it was extremely straight forward, so I thought it would be useful:
Dose
For safety reasons, your first dose of methadone at 15 to 30 mg a day is low or moderate. The effects of methadone vary depending on individual tolerance, and can be influenced by other drugs in your body.
When you begin treatment you may or may not have withdrawal symptoms for the first few days, and you may feel drowsy and/or have drug cravings until your dose is stabilized, usually within two to six weeks. During this dose-stabilization period, you should avoid driving a car, or operating heavy machinery. See here for important information on avoiding overdosing on methadone when you begin treatment.
Methadone is a slow-acting drug, which means it takes a few days to feel the full effects of an adjustment in your dose. It also means that once you are stabilized, should you miss a dose, the effects of withdrawal will come on more slowly than they do with fast-acting opioids, such as heroin.
Some clients are reluctant to increase their dose when they first start treatment. This can result in continued drug cravings, and continued drug use. The first step of treatment is to find a dose where you can stop using other opioids. Once you’ve reached that point, you can then taper down your methadone dose, if you wish.
For most people methadone works best when it’s taken once a day at the same time every day. This helps to maintain a stable level of methadone in your body, keeping you feeling “normal.”
It’s rare, but some people metabolize methadone more quickly, and experience withdrawal well before they are due for their next dose. Usually an increase in the daily dose will fix this problem, but in some cases people require a “split dose,” taking two half-doses 12 hours apart instead of one dose once a day. If you think you are “burning up” your methadone dose too quickly and need a split dose, ask your doctor to test the levels of methadone in your blood over the course of the day.
Methadone is safe when used properly, but it is a potent drug, and can kill. Overdoses are rare, but the ones that do occur usually happen within the first eight days of treatment. Generally, these deaths are the result of mixing methadone with other opioids, alcohol or downers, such as Valium. When you begin methadone treatment, be prepared to give it a chance to work for you. Stay away from other drugs — your life could depend on it.
Taking other drugs in the initial stages of your treatment also interferes with the adjustment of your dose. The symptoms you have when you begin your treatment let your doctor know how much to adjust your dose. Give it the two to six weeks it takes to get the dose at the right level for you. Hang in; it gets easier.
If you do continue to use drugs, tell your doctor or pharmacist. It could save your life. Also, let them know how you feel, if you have any cravings, or if you’re feeling drowsy. They’ll need this information to correct your dose.
A stable methadone dose is generally from 60 to 100 mg per day, and is adjusted according to your individual need. Never compare the amount of your dose with the amount someone else is getting. The dose that’s right for you might be too much or too little for someone else. Each individual has a unique metabolism and his or her own tolerance level for the drug. Your dose is the right dose when you’ve reached a balance where withdrawal symptoms, drug cravings and side-effects are minimal. When your dose has been adjusted correctly, you should feel more energetic, clear-headed, and able to fulfill your responsibilities and pursue your interests.
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So glad you posted-
CK
Thank you very much. That was so helpful.
I'm taking 50 mg but like I said before, it last about 6 hrs. I get nauseous and edgy. Sometimes I do get sleepy. I'll ask for an increase. Hopefully it will last for more than 6 hrs . Thanx again for the response
Hi yes your right I thought id receive a lot more counseling help but no...I actually had a counselor fill out a treatment plan FOR me cause she wad in hurry! Yes when yoiu are no longer feeling sick, etc you are at right dose. The other poster hit the nail on the head! Very good post. Yes never compare your dose to another and don't get caught up in what I call dose war stories. "I'm on xmg".."oh ya I'm on xx mg"...ugh ridiculos..I tell them that's between me and my counselor...by way you can request diffrent counselors if you arnt comfortable with one. And don't expect to see same on twice unless you specifically request (which I do)..I'm advising you now you have to be proactive as they tend to forget...not trying to scare you by any means just so you don't become lost in the ssometimes fustrating shuffle..take care God bless..we are here if you need anything!