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Thread: Opioids for Depression: poppy tea, buprenorphine, methadone, and now trying tianeptine

  1. i’m a tianeptine sodium guy myself too... helps me be productive and stress less. doesn’t boost my mood the way opiates used to, but it’s the closest thing to it.
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  2. Quote Originally Posted by jaders View Post
    Yes methadone maintenance therapy. It’s a full “agonist” instead of partial which is buprenorphine. I agree that some folks probably need to be on a maintenance program for life. I think it’s just a brain chemistry thing. It’s looked
    down upon by the “uneducated” but I think the addiction specialists are coming to that conclusion as well...
    I have been on both. Two times of detox they used Methadone.

    I prefer the feeling of Methadone. Made me happy as a clam. I am still trying to get the dose right for Sub. Right now my dose of Sub was 8 MG and I took it 6 hours ago. The feeling that I am at is the same feeling as Methadone.

    But one aspect that they differ is that Methadone makes my bones hurt. Whereas Sub I have yet to feel any side effects.
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    Quote Originally Posted by jaders View Post
    Yes methadone maintenance therapy. It’s a full “agonist” instead of partial which is buprenorphine. I agree that some folks probably need to be on a maintenance program for life. I think it’s just a brain chemistry thing. It’s looked
    down upon by the “uneducated” but I think the addiction specialists are coming to that conclusion as well...
    Like your above comment on buprenorphine, being a partial " agonist". I have also read that buprenorphine acts as a full "agonist" when used in low doses for ( pain ) for which it was invented for at the start ( temgesic ) 200mcg and 400mcg sublingaul. Then it fell out of fashion to other pain meds. Then came back in to fashion for opioid maintenance.
    At milligrams rather than microgram measures!! I have read alot about that in the UK on NHS web-sites.....
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  4. Ok. i posted here about the summer being the hardest time of year for me and sure enough i vanished soon afterwards. I survived another summer taking only kratom. But it was very difficult. Methadone seems to be what I need to be happy and healthy. It's difficult to find the tablets online. I found a source in Germany for the Poladdict levomethadone tablets, 30 euros for each 30-mg tablet, which is supposedly twice as effective as the racemic. And i posted in the DNM forum a source of unknown reliability selling the Methadose 10-mg tabs beginning at $8 each. And then there's my old methadone clinic a bicycle ride away where the going rate for people selling their takehome bottles was 20 cents per mg.

    Taking just 10 mg a day, half in the afternoon and half before eating dinner, is a tremendous benefit to me. The cooler weather helps but also the methadone. I have four tablets left.

    I'm gonna have to do something to find something I can take to continue. Last night I purchased by first BTC but the transfer to a separate wallet has disappeared and so i'm reluctant to transfer more money over there in order to make a purchase. I'd been hoping something could have been mailed to me today, strictly medicinal, but not the kind of thing a normal ordinary regular MD would prescribe me.
    Last edited by Trampy; 10-05-2019 at 10:55 AM.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

  5. 1970 was the year of the methadone maintenance law and regulations for clinic operation, takehomes, etc. We've had freestanding methadone clinics for 50 years. I would tell people who think they're better off self-medicating to give the clinic a try if there's one that you can easily get to every day, is well run, and you can afford it. And then follow their rulles and don't be self-medicating with any other controlled subs.

    Use their system and earn the takehomes every 90 days going up one level after clean UAs and consistent attendance, etc. That's my advice to the people here who are miserable and their misery is relieved by opiates. Unless you have state laws imposing a slower takehome schedule you could be going in every 4 weeks or monthly to take an observed dose, maybe give a UA sample usually only observed if they have cause, and then see your counselor and you're off on your merry way with all those bottles in a metal box.

    Going on methadone you would need to convince a counselor that you've been "dependent" on opiates, any opiates, for at least the prior 12 months. When i went on methadone in 2014 i tested negative on the 5-panel cup test because i was taking methadone tablets, which i showed them a pharmacy bottle containing them with my name on it.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

  6. Quote Originally Posted by File Error 500 View Post
    I have been on both. Two times of detox they used Methadone.

    I prefer the feeling of Methadone. Made me happy as a clam. I am still trying to get the dose right for Sub. Right now my dose of Sub was 8 MG and I took it 6 hours ago. The feeling that I am at is the same feeling as Methadone.

    But one aspect that they differ is that Methadone makes my bones hurt. Whereas Sub I have yet to feel any side effects.
    Glad the sub's are working for you. A lot of folks don't like them and rate them unfavorably, when compared with methadone. I've never used either, but the old heads I know used to say that sub's were most effective in the low-dose (2-3mg) range. A lot of these guys also used to take "vacations" and switch back to methadone when they wanted a break from the sub's. One guy I know used to hoard his take-homes and get by on small sub doses in the meantime. He'd then let himself go and shoot his meth over a period of a several days before switching back. I don't even want to mention his doses, for harm reduction sake. What he was taking would probably kill an addict with a modest tolerance.

    Given my opiate tolerance, sub's scare the living hell out of me. I'd have to be sick for days before I could even consider taking them. And, from what I hear, they're not the best option for relief of chronic or acute pain.so I'm not too keen on making the switch. I'm going to stay with modest doses of dihydrocodeine and valium.
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  7. We're living in a world where the vast majority of people are brainwashed and zombiefied by means of the school systems and the media and its nonstop propaganda.

    I don't have any type of the chemical imbalance they drum into you on the TV news and commercials, which merge together very quickly.

    When I take an opiate I feel normal, happy, and healthy. Without opiates I have no energy and am unable to do anything. It's really that simple. But we live in a society that's been demonizing opiates in order to further the goal of our rulers to make all the masses of people into compliant slaves.

    The guy I met outside my old methadone clinic told me the same story i've heard a million times there. Before he went on methadone he was trying to get himself to feel good despite being born with a persistent lethargy and unhappiness.

    While pure buprenorphine as Temgesic or Buprenex in sub-milligram dose might do the trick for many people, others need the power of methadone to enable them to have the energy to go out and live in this world and interact with others. It's truly a miracle drug for people who are immune to the propaganda and demonization of it.

    I've held off on using up the last of my 10-mg methadone tablets from 2014 until last week. All summer long the only opioid i took was kratom, which did hardly anything for me. As soon as i started taking 10 mg a day of methadone the long summer slump was totally over. Yesterday morning i had the energy to ride my bike to the methadone clinic instead of taking my car. So this is it. There is no logical reason for me to avoid taking the only drug which allows me to live and be healthy and happy.

    The red liquid comes in a strength of 10 mg/ml. So i'm taking it undiluted with a 1-cc syringe to measure out my doseof 1.4 ml a day, or 14 mg a day. That's what I settled on, and it shoudl cost me no more than $3/day and after i make some new friends there i can arrange to get it with a phone call and no longer have to talk to strangers. This is my salvation, because without opiates I was thinking that I could not keep going on that way, and life wouldn't be worth living if i had no energy to do anything except lie on the couch all day, which has been my condition for most of the two years since I tapered down from 100 mg/day to zero over a span of 12 months.

    I'm sure I'm not the only one here who was telling myself lies about how I could keep my opiate usage under control. It was a great help to be getting my methadone from the clinic system and being 100% legal, and having clean UAs and good behavior and earning take-homes until reaching 13 bottles with biweekly visits. A number of things happened at the same time and I lost the takehomes and was back to daily observed dosing though my UAs were done in private.

    Daily methadone, going as high as 140 mg before coming back down and settling at 100 mg was like experiencing a miraculous cure from the melancholy and fatigue that's been with me since childhood.

    It's not about neurotransmitters, it's about being happy. The TV won't tell you that you're miserable because Big Brother likes it that way so you can be kept in slavery and not even be aware of the bonds that control your every thought, if you're a normal person, which I'm not.

    People vary in their constitutions and personalities. Some people are happy all the time. Others hardly ever. The eternal optimists often do stupid things that a melancholic wouldn't do because the person who is always happy can't see what can go wrong, because they make themselves see only the bright side and they'd rather not think about all that can go wrong.

    Psychologists have done experiments and shown if you divide people into two groups according to emotional bias, that the melancholics have a greater correlation with "reality" while the ever-happy are much more delusional than their opposites. Happiness is contagious, not just transmissible from one person to another but it's also persistent and self-reinforcing. A happy person will probably be surrounded by other happy people and they create a sort of happiness island where they ignore any challenges to their happiness delusions. And vice versa for the more reality-grounded realists who always focus on what can go wrong. It's a fundamental premise of the new world order that everyone is the same and all are equally qualified for making choices of political leaders and being qualified for jobs. In our new world order there are no distinctions and no preference for any one type of person over any other. Welcome to world communism aka globalism. Aldous Huxley gave the mythical drug Soma a prominent role in his Brave New World. Drugs are being used to control the zombie minds of the normal and ordinary people. The normies are trained to avoid any interaction with people who are not "politically correct" such as myself.

    I like PR because there are intelligent people here who have the courage to think for themselves. Twenty years ago when I'd post about opiates for depression it would cause much more animosity than I get now. This world is dividing into two camps: the conformists and the nonconformists. Which side do you want to be on?
    Last edited by Trampy; 10-07-2019 at 12:03 AM.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

  8. There are people here in this community of drug-buying self-medicators who are in exactly the same boat as me. I can remember my first pain killer Rx, Darvon for a sprained elbow. And then more Darvon after wisdom tooth extractions. Every time I was feeling like I was on speed, staying up late at night and full of energy.

    Medical science in our world of political correctness has no explanation for that. They'd like to pretend that my story doesn't exist or is a mistaken perception. I've had MDs tell me that opiates are CNS depressants so what I tell them cannot possibly be true. They would be totally baffled by my low body temperature and chills when I was tapering down from 10 mg/day and lower to zero. It would make no sense to them so I must be delusional and possibly psychotic.

    Their problem is tunnel vision and being focused on treating isolated symptoms, not treating a whole person. They have no understanding of the complexities of homeostasis. Everything is connected, and if a person is feeling happy there's a good amount of "inertia" that they can draw on to deal with problems. But on the other hand if a person is in a terrible slump, it's very difficult to break out of that.

    Daily methadone given through the clinic system was my salvation. It allowed me to feel happy and healthy, and I needed the big doses of 80 mg. If anyone here is in my boat, check out the local methadone clinics. Go over there with some cigarettes and go in and ask if you can talk to any of the staff about going on methadone. Just check it out is what I'm saying. Maybe it's a hellhole, but maybe it isn't.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

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    Quote Originally Posted by Trampy View Post
    There are people here in this community of drug-buying self-medicators who are in exactly the same boat as me. I can remember my first pain killer Rx, Darvon for a sprained elbow. And then more Darvon after wisdom tooth extractions. Every time I was feeling like I was on speed, staying up late at night and full of energy.

    Medical science in our world of political correctness has no explanation for that. They'd like to pretend that my story doesn't exist or is a mistaken perception. I've had MDs tell me that opiates are CNS depressants so what I tell them cannot possibly be true. They would be totally baffled by my low body temperature and chills when I was tapering down from 10 mg/day and lower to zero. It would make no sense to them so I must be delusional and possibly psychotic.

    Their problem is tunnel vision and being focused on treating isolated symptoms, not treating a whole person. They have no understanding of the complexities of homeostasis. Everything is connected, and if a person is feeling happy there's a good amount of "inertia" that they can draw on to deal with problems. But on the other hand if a person is in a terrible slump, it's very difficult to break out of that.

    Daily methadone given through the clinic system was my salvation. It allowed me to feel happy and healthy, and I needed the big doses of 80 mg. If anyone here is in my boat, check out the local methadone clinics. Go over there with some cigarettes and go in and ask if you can talk to any of the staff about going on methadone. Just check it out is what I'm saying. Maybe it's a hellhole, but maybe it isn't.
    I completely agree with you that the “specialists” understand little to nothing about why certain drugs have such an effect on particular individuals. I remember my exact first dose too, with the same exact results. I’ve been “clean” long enough periods in my life to experience as you do, that life without this med is not good or pleasant. I have been successful at maintaining the same dose for many many years but now the government in its infinite wisdom is making it much more difficult.

    Interestingly, I did watch a YouTube not too long ago where someone claimed that the people most likely to get “hooked” DO experience heightened energy when taking opiates whereas folks who don’t experience this usually feel more of the negatives of opiates - nausea and drowsiness and it does little to nothing for their mood either.

    We have a long way to go to understand this medicine and what it’s useful for...

    If I trusted the medical community I would do as you say about trying methadone, but over and over they have proved so untrustworthy so unless or until I am forced into this route, I’m trusting myself.

    I really appreciate hearing about your experiences with methadone tho!!
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  10. Remember that Methadone clinics are a business first. Any similarity between such methadone clinics and compassionate care are coincidental. It is true, however, that they can allow a patient to increase their dosage without much oversight (in fact this is what they want), but the compliance rules still stand (clean UDs, observed, daily observed dosing for a period, etc.) I personally allowed myself to become lax in recovery because my clinic wanted to retain me - not get me off. When I reduced my dose to a "walk - off" level I was discouraged from leaving, and my counselor actually led to believe that I would not be able to make it on my own.

    I saw a similar special to the YouTube one you refer to. I didn't buy the theory, however. I believe that agonist opiods' negative symptoms (nauseu and drowsiness) are unrelated to the reward-pathways response, but to dosage itself. An individual's sensitivity to euphoria, mood elevation and the like are due to each individual's reaction to the chemical and their pain level in the first place. It is because of this that the euphoric response is reduced over time, and for some, triggers the idea of increasing the dose to repeat the experience. The tough question, however, is exactly what qualities exist in such individuals causing them to "break bad" and stop following doctor's orders or take more than they should.

    An HBO special I saw addressed the recidivism rate of addicts - the likelihood that someone with a true opiod addiction, following a comprehensive treatment plan (including MAT or otherwise), treated for an appropriate amount of time, will go back to using. Unfortunately, much like years ago, today we still see a less than 20% sustained sobriety/cure rate. The HBO special focused on an NIH study that showed that there is actually a defect in the frontal lobe that prevents an addict from making the right decision when faced with the question of going back or not. Leave it to HBO to revert to a constitutional theory - like Neanderthal Man is more likely to become an addict than modern man. I don't buy that theory either.
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  11. Both of you are generalizing about things you have no first-hand knowledge.

    Unless you have health insurance that covers MMT and you choose to use that for payment, your treatment is protected as confidential under federal law. HIPAA does not not apply to MMT treatment. So it's totally disconnected to what you both are calling the medical treatment system. It's separate and apart, with solid privacy protection and confidentiality. Unless your state has (somehow?) waived your privacy and forces methadone clinics to report to a state prescription monitoring system, what i say here is solid truth. See 42 CFR 2 https://www.ncsc.org/sitecore/conten...nce-Abuse.aspx

    And there are all sorts of methadone clinics. They're not all the same. Which is why I have said here numerous times to check out your local clinics and talk to the staff and some clients, advising to bring cigarettes.

    I hate bigots and i hate prejudice.

    My former clinic still charges $250/month if paid within 5 days, $260 otherwise. They have people there who owe them up to $1000 before being forced administrative detox, but they take away their takehomes if client falls behind more than a month.

    It's ridiculous to smear a class of medical treatment facilities based on your biases and fears apparently created by the lies of our media brainwashing machine. Break free from the brainwashing. They want you to be fearful of methadone and that campaign is obviously very effective for the vast majority of people, even here.
    Last edited by Trampy; 10-10-2019 at 12:49 PM.
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    Quote Originally Posted by Trampy View Post
    Both of you are generalizing about things you have no first-hand knowledge.

    Unless you have health insurance that covers MMT and you choose to use that for payment, your treatment is protected as confidential under federal law. HIPAA does not not apply to MMT treatment. So it's totally disconnected to what you both are calling the medical treatment system. It's separate and apart, with solid privacy protection and confidentiality. Unless your state has (somehow?) waived your privacy and forces methadone clinics to report to a state prescription monitoring system, what i say here is solid truth. See 42 CFR 2 https://www.ncsc.org/sitecore/conten...nce-Abuse.aspx

    And there are all sorts of methadone clinics. They're not all the same. Which is why I have said here numerous times to check out your local clinics and talk to the staff and some clients, advising to bring cigarettes.

    I hate bigots and i hate prejudice.

    My former clinic still charges $250/month if paid within 5 days, $260 otherwise. They have people there who owe them up to $1000 before being forced administrative detox, but they take away their takehomes if client falls behind more than a month.

    It's ridiculous to smear a class of medical treatment facilities based on your biases and fears apparently created by the lies of our media brainwashing machine. Break free from the brainwashing. They want you to be fearful of methadone and that campaign is obviously very effective for the vast majority of people, even here.
    But then I have to ask - why aren’t you actually using a clinic yourself? It’s not even just the privacy issue. It’s the control someone else has over my medicine. How much and when and if I make mistakes. I travel for up to a month at a time as well, making this even more problematic.

    True, I would love very much to visit one and talk to them tho.
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  13. I'm not sure if you were referring to me, but, unfortunately I have years of first-hand experience both at MMT's and other MAT systems. I thought I was being quite specific. I have made no secret of my opinion - Medicine is a business first. Period.
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  14. Yes, Jaders, your question makes perfect sense. Why am I no longer in the clinic system? Because it served a very useful and helpful purpose, but it seems I only need 10 or 15 mg a day to feel perfectly fine and they won't take a new patient who needs less than 30 mg a day. They will discharge the person and say they don't need the treatment, and they are right. Observed daily dosing and random UAs and monthly counseling is a lot of work on their part and they have to provide treatment for those who really need it.

    My first experience with MMT was in 2005 when there were very few Suboxone prescribers and I found a very understanding doctor who was director of a medical clinic. After a few months of Suboxone I decided to go on methadone and was getting 80 mg a day when she told me that I needed to stop taking diazepam unless I could get a new Rx. So because i wanted to follow the rules and it was impossible for me to find a doctor who would give me a scrip for it, at that time, I didn't want to be going there in violation of their rules so i quit cold turkey against her medical advice. And then after a few months I found different Suboxone prescribers and then a university clinic where I was on Suboxone for 8 years until my long-term chronic foot pain started to become much worse and I realized I'd been living with chronic osteomyelitis that my body had been keeping in check, which the university clinic doctor said was impossible so I left his care and the university closed his clinic, apparently because i'd had untreated and unrecognized bone infection.

    So then I returned to that clinic now under different ownership and was inducted for my second round of MMT which lasted over three years, which i posted about extensively as being my cure for TRD on the Reddit /methadone. It took me 12 months to taper down from 100 mg to zero. Then I went almost a full 12 months without taking any methadone or any opiates aside from kratom.

    So yes, there is a good reason for to be doing this on my own now and have a strict daily limit of 15 mg. It's making a huge improvement in my energy and overall feeling of being healthy and happy.

    So it's Been There, Done That. If my depression worsens and i find myself needing a higher dose then of course I'd reenroll on MMT. The clinic now seems to be very well run and riding my bike or driving there is like i'm on autopilot i could do it in my sleep, almost. It's a comfort to learn from my new friend that the clinic is on a steady keel. After my induction in 2014 there were staff problems that led to huge crowds of people standing around in the parking lot waiting to dose. One nurse entered treatment herself for sipping methadone on the job and then the next nurse was stealing whole bottles so they'd run out of methadone during the week.

    I could write a very interesting book of stories recounting my experiences at that clinic, which is unique, as is every one of us.

    You say you travel, well travelers are subject to search and would need to conceal any controlled substances. The Holy Grail of takehome status is 4-weekly or monthly. They give you all those bottles and you can travel legally to anywhere except a very few countries that prohibit it. Air travel is fine. But the trip would have to be scheduled around your clinic visit days, so being gone 30 days would not be practical.

    There are a few states that have imposed state laws restricting methadone prescribing and the federal takehome schedule. I'm doubtful that such state laws would stand up to scrutiny as being constitutional but the argument could be made only if someone challenged those laws in court, where they'd almost surely lose.

    There are resources and methadone advocacy groups which i can't name off the top of my head, but they'd have info on state laws and their lobbying efforts to protect patient rights. I happen to be in state where people who enter hospital, or a jail for that matter, are assured that they'll be continued on their daily dose, and that's not true in many other places. And the state PMP has no access to a person's methadone Rxs given for MMT. It's up to the client whether they disclose that info.

    I'm not saying that methadone and MMT is the solution for everyone with TRD. But if that person has learned that they need opiates or opioids to be happy and healthy, that MMT is worth them giving a look to see if they want to try it. If 30 mg a day is all you need, maybe the structure of the clinic system could be beneficial. You'll meet new people and there's all sorts of people there. If it's not being beneficial they'll taper you down slowly from whatever dose you reached. It's not an irrevocable action where once you enter MMT you're locked in. You can decide to leave at any time. Consider it as something new which could be very informative. The stereotypes are very strongly imprinted into most people. It's just people who are the clients there. All different sorts of people.

    Oh the drug testing. They send it to a lab for "opiates," amphetamines, barbiturates, cocaine, benzodiazepines, PCP, and both methadone and methadone metabolites to verify that you're taking your dose and not spiking the urine sample. The opiate test is not triggered by methadone, and i've heard rumors levorphanol could be undetected. The thresholds they use can vary across clinics, and the test most commonly giving false positives is amphetamines so that's the one easiest to get away with. If the counselor is on your side they can sometimes just ignore a positive test and never even tell you unless it happens again, they can have that much discretion in my clinic they did.

    The only time they do an observed UA at that clinic is if you've missed two days of clinic attendance when you reappear they watch you pee in the cup, or if they have some reason to suspect misbehavior. Missing two days is usually from missing Saturday where many clinics close earlier in the day than M-F and they're closed Sunday so if you miss Saturday by getting there late you miss two days, not getting your Sunday takehome.

    Sure, if you've been your own physician it seems very intrusive and a loss of autonomy. But when i entered in 2014 i was living as a total recluse with no social contacts whatsoever. The socialization and structure was a tremendous benefit to me. We're social creatures or social insects as the case may be. Without social contact a human will usually go crazy.

    Oh.The biggest downside of earning the biweekly or monthly takehomes is the sheer impossibility of adjusting your dose up or down. If you're at say 100 mg and you feel it isn't enough, well, the easiest but illegal way to deal with that would be to buy some bottles from another client who also has takehome bottles maybe because their dose is too high. And if 100 mg is too much, then instead of telling teh clinic you could just put aside a few bottles every month because even at the clinic with the nurse watching you, you don't have to swallow it all and can leave some in the cup thrown in the trash. That's the big downside going in weekly or less than weekly. Dose adjustment is often needed with changes in the season, winter to summer, etc. the metabolism varies and those CYP 450 enzyme levels. So people will go back to voluntary observed dosing to adjust their dose up or down.

    Going over all these points could be helpful to you in making up a list of questions to ask them if you do go in and talk to people at a methadone clinic.
    Last edited by Trampy; 10-12-2019 at 05:49 PM.
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  15. All of the pieces of my story fit together. The reason i mentioned my foot pain and what seemed a chronic bone infection was my using Suboxone almost all that time to help with the foot pain, and it did a very poor job. So i was always looking for pain meds online but didn't do any more IVing like i did when hydro/apap was easy to buy from NROPs pay by credit card and delivered by FedEx or UPS.

    So when my PCP and Suboxone doctor of 8 years discharged me as a patient for making up a story about having a chronic infection i went to a private doctor and his Physician Assistant knew that he couldn't write me Suboxone but didn't realize it was an illegal scrip for opiate maintenance when he wrote: Take 40 mg methadone tablet once a day for 30 days. The pharmacist was my friend when she substituted #120 Methadose 10 mg without calling the PA. That was summer 2014, five years ago. So i was taking Methadose 10-mg tablets before enrolling in MMT for the second time and then at my intake they did a 5-panel cup test which was clean of everything, opiates, benzos, clean. That bottle of pills was my only proof of current opiate usage and also had an old 80-mg take-home bottle from 2006 that very same clinic under a prior owner. Yeah, opiate dependence of at least 12 months. Check.

    That bottle of #120 10-mg methadone tablets still has three tablets left in it. All that time prior to going back on MMT and then two years after leaving the clinic and tapering on my own there' s still three tablets left. Talk about worth its weight in gold. Lemme see, gold at $1500/ozt, yeah. More like worth its weight in plutonium.
    Last edited by Trampy; 10-12-2019 at 09:10 PM.
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    jaders has a reputation beyond reputejaders has a reputation beyond repute
    Quote Originally Posted by Trampy View Post
    Yes, Jaders, your question makes perfect sense. Why am I no longer in the clinic system? Because it served a very useful and helpful purpose, but it seems I only need 10 or 15 mg a day to feel perfectly fine and they won't take a new patient who needs less than 30 mg a day. They will discharge the person and say they don't need the treatment, and they are right. Observed daily dosing and random UAs and monthly counseling is a lot of work on their part and they have to provide treatment for those who really need it.

    My first experience with MMT was in 2005 when there were very few Suboxone prescribers and I found a very understanding doctor who was director of a medical clinic. After a few months of Suboxone I decided to go on methadone and was getting 80 mg a day when she told me that I needed to stop taking diazepam unless I could get a new Rx. So because i wanted to follow the rules and it was impossible for me to find a doctor who would give me a scrip for it, at that time, I didn't want to be going there in violation of their rules so i quit cold turkey against her medical advice. And then after a few months I found different Suboxone prescribers and then a university clinic where I was on Suboxone for 8 years until my long-term chronic foot pain started to become much worse and I realized I'd been living with chronic osteomyelitis that my body had been keeping in check, which the university clinic doctor said was impossible so I left his care and the university closed his clinic, apparently because i'd had untreated and unrecognized bone infection.

    So then I returned to that clinic now under different ownership and was inducted for my second round of MMT which lasted over three years, which i posted about extensively as being my cure for TRD on the Reddit /methadone. It took me 12 months to taper down from 100 mg to zero. Then I went almost a full 12 months without taking any methadone or any opiates aside from kratom.

    So yes, there is a good reason for to be doing this on my own now and have a strict daily limit of 15 mg. It's making a huge improvement in my energy and overall feeling of being healthy and happy.

    So it's Been There, Done That. If my depression worsens and i find myself needing a higher dose then of course I'd reenroll on MMT. The clinic now seems to be very well run and riding my bike or driving there is like i'm on autopilot i could do it in my sleep, almost. It's a comfort to learn from my new friend that the clinic is on a steady keel. After my induction in 2014 there were staff problems that led to huge crowds of people standing around in the parking lot waiting to dose. One nurse entered treatment herself for sipping methadone on the job and then the next nurse was stealing whole bottles so they'd run out of methadone during the week.

    I could write a very interesting book of stories recounting my experiences at that clinic, which is unique, as is every one of us.

    You say you travel, well travelers are subject to search and would need to conceal any controlled substances. The Holy Grail of takehome status is 4-weekly or monthly. They give you all those bottles and you can travel legally to anywhere except a very few countries that prohibit it. Air travel is fine. But the trip would have to be scheduled around your clinic visit days, so being gone 30 days would not be practical.

    There are a few states that have imposed state laws restricting methadone prescribing and the federal takehome schedule. I'm doubtful that such state laws would stand up to scrutiny as being constitutional but the argument could be made only if someone challenged those laws in court, where they'd almost surely lose.

    There are resources and methadone advocacy groups which i can't name off the top of my head, but they'd have info on state laws and their lobbying efforts to protect patient rights. I happen to be in state where people who enter hospital, or a jail for that matter, are assured that they'll be continued on their daily dose, and that's not true in many other places. And the state PMP has no access to a person's methadone Rxs given for MMT. It's up to the client whether they disclose that info.

    I'm not saying that methadone and MMT is the solution for everyone with TRD. But if that person has learned that they need opiates or opioids to be happy and healthy, that MMT is worth them giving a look to see if they want to try it. If 30 mg a day is all you need, maybe the structure of the clinic system could be beneficial. You'll meet new people and there's all sorts of people there. If it's not being beneficial they'll taper you down slowly from whatever dose you reached. It's not an irrevocable action where once you enter MMT you're locked in. You can decide to leave at any time. Consider it as something new which could be very informative. The stereotypes are very strongly imprinted into most people. It's just people who are the clients there. All different sorts of people.

    Oh the drug testing. They send it to a lab for "opiates," amphetamines, barbiturates, cocaine, benzodiazepines, PCP, and both methadone and methadone metabolites to verify that you're taking your dose and not spiking the urine sample. The opiate test is not triggered by methadone, and i've heard rumors levorphanol could be undetected. The thresholds they use can vary across clinics, and the test most commonly giving false positives is amphetamines so that's the one easiest to get away with. If the counselor is on your side they can sometimes just ignore a positive test and never even tell you unless it happens again, they can have that much discretion in my clinic they did.

    The only time they do an observed UA at that clinic is if you've missed two days of clinic attendance when you reappear they watch you pee in the cup, or if they have some reason to suspect misbehavior. Missing two days is usually from missing Saturday where many clinics close earlier in the day than M-F and they're closed Sunday so if you miss Saturday by getting there late you miss two days, not getting your Sunday takehome.

    Sure, if you've been your own physician it seems very intrusive and a loss of autonomy. But when i entered in 2014 i was living as a total recluse with no social contacts whatsoever. The socialization and structure was a tremendous benefit to me. We're social creatures or social insects as the case may be. Without social contact a human will usually go crazy.

    Oh.The biggest downside of earning the biweekly or monthly takehomes is the sheer impossibility of adjusting your dose up or down. If you're at say 100 mg and you feel it isn't enough, well, the easiest but illegal way to deal with that would be to buy some bottles from another client who also has takehome bottles maybe because their dose is too high. And if 100 mg is too much, then instead of telling teh clinic you could just put aside a few bottles every month because even at the clinic with the nurse watching you, you don't have to swallow it all and can leave some in the cup thrown in the trash. That's the big downside going in weekly or less than weekly. Dose adjustment is often needed with changes in the season, winter to summer, etc. the metabolism varies and those CYP 450 enzyme levels. So people will go back to voluntary observed dosing to adjust their dose up or down.

    Going over all these points could be helpful to you in making up a list of questions to ask them if you do go in and talk to people at a methadone clinic.
    Thanks again for all that! I'm going to have to read the thread on reddit sometime soon. So - even if I don't have to "tell anyone" I'm on MMT, say I had to go to the hospital or have a blood or urine test at some point, wouldn't the methadone show up on that test (assuming they'd test for it?) One of my biggest concerns is that if I'm already on methadone, and have new pain, would I get any more opiates ever? I suffer from common sinus headaches often and those are the days that I think, if I had to give up opiates, I don't know how I would survive these headaches...

    I really appreciate your input, Trampy
    The cause of all suffering is attachment...

  17. Jaders, it's very clear to me from your posts that MMT is not something you ought to be considering now. maybe 20 years from now if your mental and physical situation deteriorates greatly, yet you're still alive, and you no longer care so much what people think of you.

    or maybe you might come across such a person who tells you they'd rather be dead than be on methadone. maybe you could talk to that person and help them find a way to keep on living.

    maybe down the road is what i'm saying. going online to find codeine or DHC for occasional sinus headaches which doctors won't treat with opiates, and you're not even using opiates daily and opiate-dependent means experiencing somatic withdrawal symptoms on the days you don't take opiates. no. they'd politely send you on your way.

    but speaking as a witch doctor, i'd be talking to you about your headaches and how you can change your lifestyle so you don't get those headaches. it's s sign of something wrong and taking opiates is not solving the underlying cause. if it's not a congenital structural problem, and a chronic inflammatory process my first guess would be allergens or toxins in the environment that your body is reacting to. a lot of people with breathing problems in humid coastal climes find they don't have those problems after moving to arid climes and a higher altitude. it could be a number of factors and you might not be able to do anything about it. or maybe there's something you could do. if you want to discuss it further with me start a new thread or point me to something here where you discuss your sinus problems.
    Last edited by Trampy; 10-13-2019 at 11:44 AM.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

  18. Quote Originally Posted by jaders View Post
    Thanks again for all that! I'm going to have to read the thread on reddit sometime soon. So - even if I don't have to "tell anyone" I'm on MMT, say I had to go to the hospital or have a blood or urine test at some point, wouldn't the methadone show up on that test (assuming they'd test for it?) One of my biggest concerns is that if I'm already on methadone, and have new pain, would I get any more opiates ever? I suffer from common sinus headaches often and those are the days that I think, if I had to give up opiates, I don't know how I would survive these headaches...

    I really appreciate your input, Trampy
    Again, like i said, maybe some time down the road you might qualify for MMT but be grafteful 1) that you don't need it right now, and 2) if you do need it down the road it's nowhere near as bad as the common misconception. It's like something youu don't need now but it's nice to know it's there if you need it.

    Doctors need to have a reason for every test they order. But let's say you apply for a job or already have a job or a security clearance that makes you subject to drug testing. A full-panel test for drug abuse would include methadone. Definitely they'd want to know if you were in MMT. Otherwise, say you end up in the ER and they don't know why you're so sedated then the ER doc would order that full-panel drug screen. Other than that i can't think of a situation where they'd be testing your blood for methadone.

    Now treating pain when you're in MMT that can be problematic especially if you're being seen by a doctor who doesn't know you. Yeah, they might not wanna give you anything. They might not want to treat you at all, and if they feel they're unqualified then that's their right.

    But say you have an injury, the guidelines from pain management consensus bodies is that acute pain needs to be treated with at least the same doses they'd give a non-MMT patient. There is no medical justification to give less than the 5/500 or 10/325 they'd be giving any other patient. And even those regular doses, because it's hydrocodone or oxycodone, can be extremely effective for relieving that acute pain. But since it's an opiate it'll mean that on the MMT drug screen you'll testt dirty for opiates but you have a scrip, so it's OK, you're not breaking the rules.

    Now chronic pain would be a totally different story. If a person on MMT has a chronic pain problem, then they'd better get a pain management doctor who is capable of taking that on. Most of the time, though, the best solution is to stop the MMT temporarily and have the pain management doctor give the patient what they need of the drugs chosen for that patient's pain. Unless it's something short term like a tooth extraction or a broken limb, where the 5/500 or 10/325 is for only a week or so.

    Your sinus pain is not chronic pain. It sounds like you have some kind of chronic difficulty with your sinuses that causes pain, but the pain itself is not chronic pain. It's a recurring problem with your sinuses and the pain comes and goes as the sinus problem abates and recurs.

    Again, your best health would come from changing things so you don't have that recurring sinus problem. If you were on MMT if i had anything to do with it, i'd say you need to stop taking the codeine and DHC for your sinus pain and instead address the cause. It'd be like taking codeine for a headache, even a migraine. There are plenty of non-opiate or maybe surgical treatments focused on the cause.

    So. Broken leg or tooth extraction, yeah, OK, but not for more than a week or so.

    Cancer pain or chronic back pain like from spinal problems degenerative disc disease and osteoarthritis? They'd take you off the MMT most likely.
    Treatment-Resistant Depression is not a Disease, It's a Personality Type

  19. #79
    It is true very small doses of buprenorphine work great for depression. As long as you dont titrate higher (it will only make it more ineffective), because withdrawals from bupe are horrendous. I mean the cold turkey ones when you're on the usual 16mg ( yes 16 MG!) an opioid dependent clinic usually prescribes.
    Keep your doses in micrograms, and remember its a powerful drug with a long (37 hr) half life. Less is more with bupe!
    Hope this helps, good luck.
    Helpful jaders Rated helpful
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  20. #80
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    Quick update for anyone interested:

    Well there we have it.. second time was the charm.. I jumped off 0.4mg and it's been 25 days since the last subutex.. mentally i'm still a bit hit and miss on some days but it CAN be done..

    (Was on 24mg Suboxone daily, tapered by doctor over the last 8 months eventually swapping to subutex 2mg, 1.6mg, 1.2mg, 0.8mg, 0.4mg, 0!)

    Total time ~2 years start to finish on the program.

    Tapering varied between 2-3 weeks and 4 weeks with some alternating days.

    - does it work for pain? Hmm in my opinion yes but not as effectively as Lyrica (back and nerve pains) or any NSAID/in combination with low doses of Lyrica (75mg).

    Opiates have their place in society but the dependence is not worth it if you can steer clear. Becoming dependent without even realising is a literal killer..

    Does it work for depression?? Perhaps short-term I'd say, particularly if you were abusing opioids previously to using it. It certainly won't magically fix depression.

    It's really only a 'magic pill' for people coming off of illicit opioids and high dose opioids in my humble opinion.
    Helpful ludwig1961, pmpl Rated helpful
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