MrsMagoo

My AH was recently put on 10 mgs. of methadone - three times per day, mostly for pain management. These are pills, not the liquid.

Of course, as an addict, he initially did not take the prescription as directed but he handed them to me yesterday and asked me to handle it. I'm glad to do it because I didn't like what I was seeing yet yesterday, even taking it as prescribed, he nodded all day long! He can't complete a thought, a task of any kind without nodding.

Will this wear off as his body gets accustomed to the medicine? He said he thought that once he was busy and working again, it would be okay and it wouldn't be such a problem. I worry about him driving, cooking, talking on the phone, etc.

I know the liquid methadone is time-released since it is a daily dose and this is not. Is that the difference? Many years ago, he got liquid methadone in high amounts and held a job and was fruitful. Everything I'm seeing on this low dose is pathetic and scary.

What are your experiences with this?

Marial

Are you sure that he is not taking any other drugs - like benzos? I am new to the forum so please excuse me if I sound a little skeptical. My son was on methadone and when he took Xanax he spent most of his day nodding off

cmc

Hi MrsMagoo,
The information you are asking for would involve some medical expertise.
We are not allowed to offer medical advice on this site. Your son's doctor will have all the answers to your questions about how this drug is supposed to work.

MrsMagoo

AH has been taking Clonopin and Remeron for years. I actually think when the doctor increased his Remeron dose 2 weeks ago, is when this started and maybe the methadone along with the other two meds are what's making it so impossible for him to keep his eyes open or his head up.

The only reason I even agreed to try the methadone route was because of the low dosage so that, I believe, is why I'm a little surprised. When we had discussed the low dose though, he were speaking of him getting the liquid form at a clinic and neither of us thought that his primary care doctor would OFFER to save us a ton of money and let him write a script to get it for free from the VA.

I wonder about those doctors. This one seems prescription happy. I'm not seeking medical advice, I just wanted to see others have experienced as MMT side effects.

zenith15

Liquid methadone is NOT time released, actually. There is no such thing as time released methadone--methadone is naturally long acting. However, when taken for pain, it is usually dosed at several intervals throughout the day. This is because the pain relieving effects of the drug wear off in about 6 to 8 hours, while the effects that control withdrawal symptoms last longer--24 hours or more. Therefore, patients who take it for addiction need only take it once a day, but for pain control, several divided doses daily are needed.

If your husband is experiencing severe drowsiness, and especislly if he is taking a benzodiazepine along with the methadone, extreme vigilance is called for. These two drugs in combination can be deadly--in fact, most methadone related deaths onvolve nbenzodiazepines--sometimes in small, prescribed amounts (for both drugs). It is possible to take both safely but only with very careful, watchful oversight--especially during the early days of therapy. I would definitely report these findings to the doctor and document that you have done so. I would also keep a close watch on hubby, especially at night. If you hear him snoring strangely or if he is hard to rouse, EMS should be called. I am not trying to scare you--methadone is quite safe when used correctly and prescribed correctly, but this situation sounds very questionable. Is the doctor who prescribes methadone aware he is on these other meds as well? They can combine to have a synergistic effect and suppress breathing completely. Please be careful.

littlebird77

you CANNOT mix a benzo with an opiate.
is the same doctor giving these two medications?

if not, let them both know what the other one is doing.

if this was me, and from what i have seen, i would go to the extreme of finding a new doctor that does not write scripts for opiates with benzos... there are other methods of pain management, and or anxiety that are not so toxic and dangerous.

WLDKATZ

LITTLEBIRD IS CORRECT!!!!!!!!!!!!!!!!!!!!!!!


IMO He should not be allowed to drive or use power tools until you call his dr and say hey here is his drugs, I took methadone and yes at first that is exactly what happens but with me it was an overdose because it was too strong for my body.....I would seek medical attention call your dr and if anything weird ( he doesn't wake up) I would go to er....good luck!


Pamm

itisatruth

Hi MrsMagoo
My AH has been on and off Methadone for a few years now. He was not taking anything else when he first started taking it. He nodded off often.......even in line waiting to get on a ride at an amusement park! After a while, he just wanted to sleep all the time. It was for pain, but since he is an addict, he just kept getting higher and higher doses. He never let me control it. His first doctor ended up losing his license for overprescribing. I still think his dose was too high even in the beginning. When methadone is mixed with things, as others have said, its very dangerous. My husband was in an accident while driving on methadone and clonezepam, but the thing was he hadn't taken his morning doses---he was still messed up from the pills he had taken the night before. He was arrested for DUI (thank GOD no one was hurt). Be careful also because the withdrawals can be very bad. My AH has taken all kinds of prescribed painkillers, but he said methadone was by far the worst--it took weeks and he still had pain in his bones. Good luck and be careful.

funkzter

Hi there,

sure we cannot give any medical advise and you definitely need to check with a doctor -should your AH agrees to it- but we can still share our experience. And my experience is that when my abf was on methadone (the liquid one) and followed the daily dose as prescribed, he did great, could function, work etc... He even managed to get clean by decreasing weekly.
BUT when he re-used methadone recently, due to relapse, it was obvious he took something else on the side as he couldn't function at all. Indeed he admited that he took sleeping pills on the side. And if not sleeping pills, alcohol can also have the same effect mixed with methadon.

Good luck to you both. Hope he sees a doctor who will help him control his taken.
Carine

MrsMagoo

Wow! Thank yo so much for your input and your experiences. Zenith - now that is some information I can work with when I talk to AH or his doctors!

The answer is yes and no. Husband gets all medical treatment through the VA. They are completely computerized so all doctor's notes, progress notes and RX are available to any doctor at any location.

The psych. doctor is the one who writes the RX for clonopin and remeron. He knows AH has relapsed and that he was investigating going back on methadone since he had fallen back into the pattern of abusing the Oxycodones. The primary care physician is the one that AH discussed the methadone program with. AH went to a methadone provider first, did the interview, and was told pretty much point blank that he probably wouldn't get in because of the psychiatric meds.

When he told the primary care doctor at the VA that he probably would not get into that methadone program, he offered to prescribe it to him on a 30 day trial basis (regardless of the psych drugs). I thought that was strange too. Obviously the protocol at the methadone clinic is there for a reason and the VA is going to disregard what's in the best interest of the patient just to make the patient happy. This is the same doctor who prescribed all the opiate pills, in various forms and amounts knowing full well my husband was an recovering addict (though he is a substance abuse counselor who had ten years clean - maybe the doctor thought he could handle it). I don't know.

Interestingly, yesterday, my first day giving him his doses, he didn't nod off any last night. I gave him 2 pills in the morning (20 mgs. total) and 1 pill (10 mgs) at roughly 6:00 p.m. and there were no problems at all. He was quite pleasant and helpful actually. Out of curiousity, I asked him if he took all his Remeron that day and he said "yes" so I'm pretty baffled but looking forward to seeing how he is tonight.

I will monitor his sleep as best I can. He barely sleeps in bed with me, though again, he did last night. Last night was different than the past few nights. I guess he doesn't recognize that he's nodding and insists on watching TV in the family room where at any given moment, I can wake up and walk in on him and find him sitting straight up, head slumped forward and a cigerrette, i.e., why I sleep with a fire extinguisher, purse and shoes next to my bed.

I will also inform him that I will be coming to his next doctors appt. That ought to go over well.....

I am scared anyway.

WLDKATZ

YOU ARE A STRONG FORMIDIBLE WOMAN!!!!!
I see such strength and control in your posts, I love to hear when a spouse takes an active role in the recovery process rather than just stand by and wringging their hands.....the drs appointment WOULD be the first step not sure why the VA would do that at all..... Good Luck to you and smart tip on the bed side staples, maybe you should let him know why you feel you need to put them there......might shock him and see what he does....
Good Luck and God Bless you both!!!!


Pamm

nytepassion

I know that benzos and methadone depress the respitory system and the combo can be fatal ...

I also know that the man we are speaking about is an addict who very recently was active in his addiction .. even fresh out of detox he pretty much picked right up where he left off and started abusing his prescriptions.

Then came the court ordeal and he was ordered out of the house, ended up in a motel and used heroin "one time" ... but how much opiates in pill form was he abusing?

When reconsilation was being considered

Then the ultimate solution he came up with was to ween himself off the opiates with methadone which in my opinion and given the circumstances was a way to avoid 'side step' going into recovery and getting clean ...

I am going to be so bold as to say this and I say it in truth and with love ...

He is not thinking right .. he is not making good, healthy decissions that are in the best interest of his recovery... it isn't about recovery for him .. it is about maintaining or disguising an ongoing active addiction. This isn't treatment and recovery .. this is just another option, a way to avoid getting down and dirty, wiggling and squirming in the pain and agony, blood, sweat and tears of getting off the dope. This is a man who is scared ... scared to recover .. scared to let go .. scared to fail .. because he knows he will fail .. why? because he is NOT READY to get real with himself or his recovery and you my friend are not ready to get real with yourself and see it for what it is .. ADDICTION .. this man you love is an ADDICT .. this man you love needs intense treatment to recover not methadone to maintain ... He is on it to what? Ween himself? In the mean time he is nodding off with cigs in his mouth has prescription benzo's that when mixed with methadone can be a fatal conconcotion and to top that off you and you are back to sleeping with a fire extingisher by your bed for just in case a cig falls out of his mouth while he is nodding and you hopefully can put the fire out before it burns down the house or worse burns your children to death. I know that sounds harsh, but it is reality .. you are living on the edge .. and this scenario has all the makings of a disaster waiting to happen.

I love you my friend ... you know I do.

I can scream it from the highest hill tops, but you can't hear me .. any more than he can hear you because you are caught up in your own addiction to him .. hanging on, hoping and trying to believe every little word he says ... doubting yourself and denying what is before your very own eyes. Because he said ...

Hard cold reality .. Addiction at its finest. Manipulation at its best. The blind leading the blind ...

You can't believe what he says, because he is an addict .. active in his addiction ... good judgement escapes him .. because his brain has been hijacked and there is a parasite living in his head .. screaming at him to feed it .. Job? That is his job .. he is a full time employee .. his employer is cunning and deceiving, cruel and heartless, cares about nothing or no one other than itself .. He is enslaved ... to his addiction. I can say that because I know .. and I know because I've been there done that. It doesn't matter what kind of drug you use or how you use it.. .. it does not matter your gender, age, race or creed .. addiction does not discrimate and has no mercy... it will take the addict and everyone, everything around the addict with it...

I highly suggest that regardless of how well it goes over or not .. that you talk to the doctors YOURSELF ... because "J" isn't in any conditon or the right mind to look out for himself or his best interest ..

This is serious stuff here .. read for yourself

Fatal methadone toxicity: signs and circumstances, and the role of benzodiazepines.
School of Public Health, University of Sydney, New South Wales.

OBJECTIVE: To describe the signs and symptoms and circumstances of fatal methadone toxicity and investigate the role of benzodiazepines in these deaths. METHODS: Data were extracted from 1994 New South Wales (NSW) coronial files and cause of death established independently. Cases were grouped according to the likely source of methadone. Data describing the clinical history and circumstances of death were extracted from witnesses' and police statements. RESULTS: Methadone contributed to the deaths of 57 of the 87 adult coronial cases in which it was detected in NSW in 1994. The most commonly reported early signs of severe methadone toxicity were ataxia, slurred speech and evident euphoria. The late signs were unconsciousness, loud snoring and brown pulmonary oedema fluid coming from the mouth or nose. Death occurred an average 5.1 and 6.0 hours after oral ingestion and intravenous injection of methadone, respectively. Benzodiazepines were significantly more likely to have contributed to deaths from methadone toxicity among maintenance patients and people taking methadone tablets for pain relief than deaths involving diverted methadone syrup and deaths to which methadone did not contribute (OR 4.8, 95% 1.7 to 14.4). CONCLUSIONS AND IMPLICATIONS: Benzodiazepines may contribute to deaths from methadone toxicity by increasing upper airways obstruction. Victims would have had a greater chance of survival if they had either been placed in the coma position or given mouth-to-mouth ventilation and an ambulance had been called. Benzodiazepines are more likely to contribute to fatal methadone toxicity in newly admitted maintenance patients and those taking methadone tablets for pain relief.

Cautions

Side effects associated with methadone are similar to those incurred with other mu-opioid agonists, including pruritus, nausea, constipation, confusion, sedation, and respiratory depression. Excess sweating (diaphoresis) and flushing are common with oral methadone dosing. Caution should be taken with initiation of therapy and dosage increases because severe toxicities may not become apparent for two to five days. In a study of patients converted to methadone therapy in an outpatient setting, 20 of 29 participants experienced some degree of toxicity, most frequently mild drowsiness, during initial titration. 29 Side effects such as sedation and respiratory depression are increased when methadone is combined with alcohol or other drugs. An Australian study30 found benzodiazepines present in 74 percent of deaths related to methadone and urged particular caution when methadone was prescribed with benzodiazepines.


If Benzodiazapines must be used…..they suggest using one that is not as abusable as Klonopin or Xanax and named “Oxazepam” as one to perhaps try. One of the things not listed is the obvious.....both Methadone and Benzos depress the respiratory system and that is why it's dangerous to self medicate....can OD real fast or can result in death.


I think this says it all right here ..

(remember "Lost in space?")
DANGER DANGER WILL ROBINSON

Passion

MrsMagoo

Awwww, Nyte.....you totally cancelled out my "good feeling" I got from Wildkatz post about me being a stong and formadible woman!!!

You are a true friend to be so willing to, as we say in the South, "snatch a knot in me" and see through all of the co-dependent lies I tell myself.

The methadone was supposed to be the answer to the pain and an insurance policy against the cravings/potential relapse - so that we can move forward, literally, with our lives. It makes me angry that his doctors are so willing to please their patient, in the name of medicine, that they would gamble with his life.

By the same token, AH knows the same stuff you all do and is willing to risk it in the name of pain relief. He is a big boy and can readily say no. In fact, I think he could probably say HELL NO if he really wanted to. He should be looking out for himself.

Ugh! I get played every time don't I? I can look back on my past threads and see that this always happens to me....I think everything is going as it should and BAM! a perfect stranger can come along and see through all the lies and BULLS*#T better than I can.

And that my friends IS WHY I LOVE YOU ALL SO SO SO MUCH!!! :ghug

littlebird77

Just so you know, just because a doctor has access to medical records does not mean they check them. Most will only check if there is a concern. (I worked in a hospital).

MrsMagoo

You are right LittleBird. It is alot to ask for any doctor to actually READ your chart. I am diabetic and when I was pregant, every OB-GYN doctor I saw was shocked when I TOLD them I was diabetic. They all came in "reading" my chart and would sit down and "read" some more but the reaction was always the same when I mentioned insulin - their heads would fly up and they would say, "What? You're diabetic??" Ha, ha.

Oh well.

zenith15

I will say that methadone, used correctly, is the most effective treatment for opioid addiction available today. It has literally saved my life. I spent 20 long years addicted to Rx opiates and went through 13 abstinence based treatment programs to no avail. I went to literally thousands of 12 step meetings, had sponsors and worked the steps--still, I felt utterly miserable. I finally found out that many long term opiate addicts have done permanent damage to their natural endorphin systems. Endorphins are the chemicals that allow us to experience pleasure and happiness, regulate mood, and help to control pain. Without them, the patient suffers from severe depression (that is unresponsive to antidepressant drugs), anxiety, anhedonia (inability to feel pleasure), exhaustion, and cravings, and almost invariably relapses. For this sub group of opiate addicts (many have done some damage but it can be undone by a period of abstinence--I am talking here about those with permanent damage), methadone (and buprenorphine) regulates the brain chemistry, allowing stable patients to feel not high or euphoric, but normal. It allows them to go about their lives and focus on other things. We all have these natural opiates and living without them is hell on earth. These medications are not meant as "replacements" for the heroin, etc they were abusing, but instead as replacements for the endorphins no longer being produced by the body, in much the same way that diabetics take insulin because their pancreas no longer produces it. Taking insulin if you are NOT a diabetic is dangerous in the extreme, of course, but to those with a deficiency of insulin, it simply returns them to a normal state--and so it is also true of methadone/bupe. Not everyone can manage with abstinence based treatment, no matter how much blood sweat and tears they pour into it or how much they want it, because of this simple biological issue--addiction is often a disease of the brain chemistry, not a moral failing. Many even have an endorphin deficiency prior to becoming opiate addicted, and this may have predisposed them to the addiction.

I knew none of this until I became involved in advocacy work and started reading up and learning, but it is fascinating stuff.

MrsMagoo

It is fascinating and I know some of the stuff. AH is a substance abuse counselor and he has explained before about his brains inability to produce endorphines because the years and years of heroin use provided that and therefore he didn't need to produce it. I guess it gets lazy and never reawakens.

AH was clean for 10 years. He started out on methadone after, like you, many failed treatment programs. He cold turkied off of it after 18 mo. and did fine after the initial withdrawals. He was not thrilled about having to make a decision to go back on it and probably would have chosen suboxone if we had private insurance but suboxone doesn't have any pain killing properties to it and he needs something for pain. The idea was that the methadone was going to be a controlled way of controlling his pain. Never in a million years did either of think that we would be considered for tablet form methadone.

I'm controlling it now and so far so good. He hasn't been nodding that much since I've had it so the nodding may have been from him taking 120 mg. at a time instead of 10 mg. 3 x per day. It also, like several people have suggested, be from taking the benzos in conjunction with the methadone.

We will speak about the benzo issue and I am going to suggest to his physician that he come off of something, preferably the Remeron, if that's a benzo. It makes me afraid that just because a doctor says it, doesn't mean it's the gospel truth like we want to believe. I think it's malpractice actually. AH likes to remind me that it is a medical decision and therefore my opinions don't really matter but I think they really do.

Chino

Reading your post got me Googling and I just found something that might explain some of my daughter's issues. She's had anxiety and panic attacks since before adolescence and once she experienced opioids as a teenager... well, you can figure out the rest.

It appears people who naturally have low levels of beta endorphins may have a ton of problems: memory, motor coordination, gastrointestinal function, temperature control, hormonal reproductive system... the list goes on but these are the things my daughter has always had a problem with.

After her first detox she went on Naltrexone for about three months. The psychopharmacologist she saw had told her it would speed up healing in her brain with regards to endorphins. I just discovered that a low dose of the drug is also being used for fertility treatments. Why? Because it stimulates the body to produce endorphins.

Just the other day she told me she loved how Naltrexone made her feel. I thought she was nuts because it isn't supposed to have that kind of effect. Looks like I'm eating crow!

Thanks for your post! I'm going to spend some more time learning about beta endorphins and pass the info onto her. Coincidentally, she has to see a neurologist soon and hopefully she'll pick his brain.

zenith15

It really is fascinating stuff! I believe I have always been endorphin deficient, and that because of this, I was predisposed to opioid addiction. This is not to say that I am not to blame for abusing opiates--please don't get me wrong--just that people who have naturally low endorphin levels usually have a completely different response to opioid drugs than those who have a normal level. For most folks, they take an opiate and feel slightly drowsy and maybe a bit nauseated or groggy and that's it. My experience was very different. I felt energized, I felt happy, I felt interested in life, I felt motivated to DO things, I had renewed levels of patience and tolerance for my loved ones and others. I finally felt NORMAL for the first time in my life. I had suffered from depression and anhedonia all through my childhood, and as an adult, I had tried Prozac, Celexa, Paxil, Zoloft, Elavil, Trazadone, Wellbutin, Effexor, Bu-Spar, Klonopin, talk therapy, group meetings, cognitive therapy, etc etc without success. I know now that this is because most of those drugs target serotonin, NOT endorphins. In abusing opiates, I was desperately trying not to get high and party down, but to feel NORMAL--to have the strength to get through a day, to have some happiness in my life, to enjoy my family as I saw others doing and to get rid of the balck cloud that followed me everywhere.

However, it didn;t work out quite as I had hoped, unfortunately, because the short acting nature and rapid up and down cycling of these drugs, coupled with their euphoric effects, made remaining on a stable level impossible, and the constant cravings for more and the drive to find more took over my life.

Methadone is a steady, long acting medication that does not induce euphoria in stable patients and enables them to function normally, and in most cases does not promotoe addictive behavior. I am dependent on methadone--I was addicted to hydrocodone. Addiction differs in that it involves not just physical dependence but also a set of behaviors, not present in most stable MMT patients.

I hope youor studies online are able to lead you to a solution for your daughter.