When Do you TRULY
Need A Methadone Increase?
This is something that I personally struggled with
at the beginning of my journey and I know that a lot of newer people to MMT
might have an issue with knowing these things too. Before I got pregnant in February, I had
started the process of decreasing my dose.
I know that some people choose to be on methadone for life and as of
right now….that’s not my plan. I might be
done next year, in three years, in 10 years.
My parents both ask me, “When are you going to be off of that
medication?” like it’s something that I can
definitively know. Anyways, to get back
on track, I was talking about increasing your dose right? I’ve put together a short list of things to
remember and consider while in treatment if you were thinking that you might
need to take more methadone. I also need
to stress, I AM NOT A MEDICAL PROFESSIONAL.
ALWAYS SPEAK TO THE DOCTOR AT YOUR CLINIC BEFORE STARTING OR INCREASING
METHADONE.
When you start
going to a clinic, don’t be afraid to meet with the doctor as often as you need
to. Most clinics
will start a patient off at 30mgs of methadone daily. They ask you how you are feeling and, if you
are still wanting to use and having cravings, (which most of us do the first
few days) they will increase that amount.
At my clinic, they increase you 10mgs every time you meet with the
doctor. This was usually a weekly or
bi-weekly thing for me in the beginning.
You are making a huge change in your life, don’t be afraid to tell the
doctor…I STILL WANT TO GET HIGH. Your
opiate receptors aren’t full yet if you are feeling this way. Be honest with them. I didn’t stop using heroin until I was on
methadone for 5 months. Everyone is
different.
If you are having
thoughts of getting high after a period of stability. You might be on a
stable dose for six months and then BAM-you have thoughts of getting high. It sucks and they come out of nowhere. This doesn’t necessarily mean that you need
an increase, but if these thoughts are persistent and starting to scare you it
might not be a bad idea. The amount of
methadone that you are prescribed is seriously just a number. The higher the number doesn’t mean you are a bigger
addict either. The most important things
are that you aren’t using and that you aren’t physically ill.
If you are still
feeling “sick”. Every opiate user
knows what sick feels like. It’s the
worst. It’s our whole reason for putting
ourselves in the bad situations to begin with right? To non users, being “sick” feels like the worst nausea mixed with
crippling body aches topped with unrelenting sweat and diarrhea. It doesn’t stop until you get some kind of
opiate in your body or if you are lucky enough to get some sleep. It’s awful and these are just the physical
symptoms. Literally nothing else matters
but feeling better. Sometimes if you
aren’t getting enough methadone or if you are metabolizing it fast, some of
these familiar symptoms creep back in.
Stability means that you aren’t feeling like this….so if you are then
talk to the doctor at your clinic. When
you make the decision to start decreasing and to make the transition off, these
uncomfortable feelings might come back occasionally but that is something you have
worked to prepare for. Also, people get sick
naturally too, can you believe it! Make
sure to listen to your body, TALK TO THE DOCTOR AT THE CLINIC and don’t stress
about the number of milligrams. People
don’t stress about how much blood pressure medication the take do they?
Don’t pay
attention to the “methadone glow”. This is a
controversial thing about taking methadone that people don’t like to admit or
talk about. It’s real though and needs
to be mentioned. When you increase your
dose, sometimes you feel a small amount of euphoria or a rush. It doesn’t last very long and your body adapts
to it after about a week. Some people
don’t experience this while others do. Because
we think differently as addicts, we like to chase a high. I used to think that when this little rush
went away that meant that I needed more methadone. That was just the addict in me wanting to
feel good. As a result, I ended up
taking more than I actually needed to.
The whole goal of MMT is to stop using and to lead a normal and
productive life. Sometimes foods that
you eat can increase the bioavailability of the methadone and you’ll “feel it”
too. While I am not a medical
professional, I can say that asking for more medication because it stopped
making you feel good isn’t being really being clean.
If you are
pregnant, you’ll most likely need to increase your dose. You are making a
human and your blood volume is increasing during pregnancy so it’s pretty
common for you to need an increase during this time. There is a big misconception out there that
the more methadone you take, the higher the chance of your baby going through
withdrawal is going to be. I won’t go
into what can help prevent NAS (Neonatal Abstinence Syndrome) just yet because
I want to stay on topic, but making yourself miserable during pregnancy is not
going to help anyone. Some women only go
up 5mgs and others can go up 100mgs. The
best advice that I can give as someone that has gone through a pregnancy on
methadone is to communicate with your doctors and to listen to your body. If you feel yourself going through withdrawal
because you aren’t taking enough methadone, your baby is feeling it too. There’s a reason why women in jail that are
pregnant get to take their methadone daily.
It is extremely dangerous to stop taking it because the little one
inside you isn’t strong enough to handle withdrawal. There is no shame in taking medication that
your body needs to stay well. You are
doing the best possible thing for your child by staying in treatment.
