We Speak Methadone (and buprenorphine)

A NAMA Recovery Forum for Medication Assisted Treatment patients, family and advocates. (Issues or Questions about registration and/or the forum? Email zac@tnmethadone.org OR sapphirematthews@gmail.com)
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 Post subject: My first time, first day
PostPosted: Wed Jun 08, 2016 6:14 pm 
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Joined: Fri Nov 06, 2015 5:44 am
Posts: 22
Yes, this is my first day as a methadone patient, and I have some concerns/questions about today. I was slightly in withdraw when I was dosed today. The doctor ordered 20mg. as my first dose, though I was hoping for 30mg. because of fear that the dose would not be enough. I'm afraid it wasn't because it's 6:56pm. and I don't feel liked I dosed at all, though not real bad, just not comfortable like I thought I would be. Also, I think the doctor was telling me today that they have this new 21 day assessment, in which the nurses assess a patient (me) on the same dose for 4 or 5 days in a row to see how they do on it. Thinking about this now makes me nervous and not just because I've never heard of this practice with patients before on this or any other forum I have read, but because I know I will need a higher dose tomorrow than 20mg. I was wondering if anybody could tell me if they are supposed to raise my dose every day until I reach an optimum dose? I mean raise it slowly? I hate to think that I'm a guinie pigeon in an experiment or test, if that's what this is, I don't know. Maybe I'm a little paranoid! But I really hope they aren't going to keep me on such a small dose for any length of time when I'm not comfortable on it. Also I hate to feel like they have so much power over how I feel and how I will feel. I hope they are compassionate and caring as they seem to be. I'm kind of scared. I've had so many bad experiences with authority while in different rehabs in the past. Anyway, I'll be waiting and looking forward to someone's opinion on my day, I have no real experience with this. Thanks :) Liz


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 Post subject: Re: My first time, first day
PostPosted: Thu Jun 09, 2016 11:46 am 
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Joined: Fri Nov 06, 2015 5:44 am
Posts: 22
Well today was totally different. When I went to clinic for medication, I spoke to the doctor, and he raised my dose! I always seem to expect a negative outcome. I need to work on that. :)


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 Post subject: Re: My first time, first day
PostPosted: Sun Jun 19, 2016 9:39 am 
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Hi Liz, many clinics these days have a 3-5 day wait in between dose increases for new patients. This is to ensure that firstly people don't get increased too quickly and become overmedicated, and secondly that if they're still using illicit substances that they don't OD because the clinic have put their dose up very quickly.

If you're looking particularly sick when you go to dose in the morning, and are showing severe signs of WD, they might increase you daily up to a certain dose, or they might not, it's all down to what your clinic policies about titration are.

Have they raised your dose again since? What dose are you at now, and how is it helping you? Your optimal dose should have you WD free for 24+ hours, so that you're not desperate to dose again in the morning, and deal with the majority of your cravings.

What is the clinic like? Are you finding the staff helpful and caring so far?

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 Post subject: Re: My first time, first day
PostPosted: Sun Jun 19, 2016 11:32 am 
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Joined: Fri Nov 06, 2015 5:44 am
Posts: 22
Hi Sapphire! Thanks for writing! Well, you were right! I'm so glad I made the decision to enter the clinic for my addiction treatment. :) Yes, they have raised my dose again and I'm on 40mg. now. After it was raised to 30mg. on the 9th, it was raised again after seeing the doctor on the 15th to 40mg. On the 17th I felt some symptoms of withdraw, so it was raised 5mg. more after assesment by the nurse. But on Friday night and Saturday morning I felt kind of nauseaus and a bit over medicated (I think), so on Saturday I asked the nurse to drop my dose back to 40mg. and told her my symptoms and it was dropped back. Do you know if it is normal to feel overmedicated on such a small dose? Don't most people have their dose raised somewhat higher than this before they feel no withdraw symptoms, or overmedicated? I have a slow metabolism and am also hypothyroid, for which I'm prescribed Synthroid, I wonder if that is the reason I felt overmedicated, but I have been having a bit of anxiety, being a new patient and all. My first group was Saturday and it was great, I really felt like I belonged there. Just one problem and that is my insurance won't pay or reimburse my $400 a month payment which leaves me with almost nothing from my monthly check. I'm going to try and get on Medicaid, because it covers everything in my state. The staff has been mostly helpful and nice and I'm grateful for that. Well I'll send another update soon. Take care! Liz


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 Post subject: Re: My first time, first day
PostPosted: Fri Jun 24, 2016 6:53 am 
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Things like metabolism, and any other meds or conditions a person might have are pretty crucial to determining what dose they need. It's really important to not think of it in figures, but just to concentrate on how you're feeling.

Plenty of people (most in fact) will get sedated a little at the start of treatment, as their body is not used to methadone.

Your optimal (right) dose should last you for 24+ hours, so that you're not dying to dose again in the morning, and it should also deal with the vast majority of cravings you have to use.

If your dose is not doing both of these things, then you've not yet reached your optimal dose.

For some people, 40mg would be a smallish dose, but we're all very different, and the doses we need are very individual. As long as you're WD free and craving free for 24+ hours, that is what matters!

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email:sapphirematthews@gmail.com

Please email me if you have any issues with the board, be that logging in, spammers, or anything else at all!!


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 Post subject: Re: My first time, first day
PostPosted: Wed Jun 29, 2016 5:30 am 
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Posts: 22
Hi. Well I'm up to 50mg. now and Ithink I want to stay at that. Does anyone ever feel out of breath a bit, and if so, does that mean they are overmedicated? I'm having a bit of anxiety this morning too, but I think it's because I'm worrying too much. I have to go now, I'll write again later :) Liz


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 Post subject: Re: My first time, first day
PostPosted: Wed Jun 29, 2016 7:08 am 
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Hi, no methadone shouldn't make you feel out of breath, whether you're overmedicated or not. It sounds more like the anxiety you're experiencing has more to do with the breathing problems than anything else. But it's certainly not the methadone (unless you were to the point of being nearly unconscious, and that could slow your breathing. But if you're up and about, I would think that the being a bit out of breath is far more likely to be a symptom of the anxiety.

How do you feel at the 50mg? Is it holding you for 24+ hours, so that you're not desperate to dose again in the morning, and is it dealing with the vast majority of your cravings? If it's not doing both of these things, then it's still not your optimal dose.

When we start in MMT, we can often get quite sedated by it, as it's a very strong medication, as because of that some people think they're 'overmedicated' when they really aren't, as sedation can also be caused by a person being undermedicated.

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Sapphire Matthews - MAR Patient Advocate
email:sapphirematthews@gmail.com

Please email me if you have any issues with the board, be that logging in, spammers, or anything else at all!!


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 Post subject: Re: My first time, first day
PostPosted: Wed Jun 29, 2016 7:53 pm 
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Joined: Fri Nov 06, 2015 5:44 am
Posts: 22
Hi! Well, I spoke to the doctor today about my symptoms and he thinks I am undermedicated and put my dose to 55mg. I feel fine today. I have to get my sleeping habits straightened out because I don't sleep very well at night, haven't for a long time and it causes me to fall asleep during the day. It's become quite a problem as I drop off quickly, even sitting at the computer....it's a good thing I don't drive! As far as cravings go, I have none at all, and I think this dose might cover me but I'll have to see how I feel in the morning. This morning I had a lot of anxiety. Thanks so much for sharing you're knowledge and helpful advice. Talk with you soon. Good night! :) Liz


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 Post subject: Re: My first time, first day
PostPosted: Fri Jul 01, 2016 6:40 am 
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Joined: Fri Apr 26, 2013 7:09 am
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Hi Liz, I'm glad that you're feeling somewhat better! Just keep in mind that what can happen is that some people get an increase, and they feel fine and think it's their 'right' dose, but then 4-5 weeks later WD symptoms start creeping in, and the dose stops lasting them all day. This might not happen with you, but if it does, just be prepared that you might need to increase a little more.

It's also important not to give in to the urge to nap in the day, as that will affect your sleep pattern at night massively.

Good luck, and I hope that things carry on going so well for you!! :)

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Sapphire Matthews - MAR Patient Advocate
email:sapphirematthews@gmail.com

Please email me if you have any issues with the board, be that logging in, spammers, or anything else at all!!


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 Post subject: Re: My first time, first day
PostPosted: Sat Jul 23, 2016 12:30 pm 
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Joined: Fri Jul 22, 2016 6:58 pm
Posts: 6
Hi Liz,
One thing to know is, it can take a while to stabilize. It's perfectly normal as you adjust to the dose while the opiates leave your system. Over time, you'll start feeling normal with no high or nodding off and falling asleep during the day.
I've been on MMT for a little over 5 years now and it took me a good month or so to stabilize. I started on a low dose, 30mg and I had withdraw symptoms at night for the first 2 days then they went away. And like you, I felt high and nodded off in the middle of the day and couldn't sleep well at night. After a couple weeks or so, the nodding went away and finally the high went away after about a month and I felt normal for the first time in 5 years. It's an awesome feeling! Be patient, give your doses a chance to work and you should start feeling normal before your know it.

Lee


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