Monday, June 17, 2019

When Do You Need To Increase Your Methadone Dose?



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.