Society believes that recovering addicts on methadone maintenance will be on methadone forever.
For some, this is true. Some people have no problem with being on methadone for the rest of their life. In reality, who can blame them? Being dependant on methadone is a much better alternative to supporting an out of control heroin addiction every day.
Then, there are those who want to follow a treatment plan and taper off methadone in a designated amount of time.
For everybody’s information, there is NO SUCH THING as a “one fits all” treatment plan that every person follows when it comes to weaning off of methadone.
You have to do what is best for you. You taper off methadone as you see fit. Your dose is lowered at a comfortable rate for you. Together, you and your therapist will create an individual treatment plan. (I do have a post all about creating a treatment plan for yourself which includes a FREE download to create your own.)
Stabilizing Your Methadone Dose
The first step in being in methadone maintenance treatment is to stabilize your methadone dose. A therapist, methadone doctor, and medical staff will work with you and together you will be on a stable amount of methadone.
Typically, it takes a few months to work this out. You will have, to be honest with the doctor and your therapist.
Tell them how you feel.
Whether or not you are physically experiencing cravings.
Let them know how well you are functioning.
Are you tired and sluggish? Do you not want to get off the couch all day? Do you notice yourself nodding out as if you were high?
All of these factors need to be taken into account when adjusting your dose.
When people first begin going to a methadone clinic, it is usual for them to still be using heroin until their dose is high enough to prevent them going through withdrawal.
The goal is not to use any other drugs with your methadone. The faster you get to this point, the better.
You must be honest with yourself, your therapist, and the doctor. The better the staff is able to access the situation, the quicker you will be able to become stable on methadone. You can’t begin to work on other issues until the main problem is corrected.
Once stable, the maintenance period begins. After all, it is called methadone maintenance treatment. The maintenance period begins once you are on a stable dose of methadone. A stable dose entails the following:
- No physical withdrawal symptoms
- Able to function
- Not tired
- No feelings of euphoria
- Holds a person 24-36 hours before feeling the effects of not having it
- No mood swings, irritability
- No sleepless nights
After you are at a stable dose, it is time to begin the actual maintenance period. The maintenance period is when you truly start to work on your recovery. You are MAINTAINING SOBRIETY.
Along with your therapy (both group and one on one counseling sessions), you learn to address the underlying issues of your addiction.
Even if you had a perfect upbringing with happily married parents and a secure home, there are always underlying issues to why you chose to use drugs.
You pinpoint your relapse triggers and learn how to cope with life without the use of drugs. If you need help with that, I have heard great things about The Addiction Recovery Skills Workbook. Try it out for yourself.
Throughout the maintenance period, you will also deal with the wreckage of the past. This will be an ongoing process that simply becomes a part of your life. As time goes on, you will learn how to cope and handle the issues without wanting to use heroin or other drugs.
Your life will slowly but surely begin to improve. Once you maintain your sobriety and begin to easily manage your life, you will feel better. Better about yourself and better about your situation. You will look back in amazement at how far you have come.
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How To Lower Your Dosage
Now that you got your recovery under control and you have built a solid foundation. Your cravings are few and far between. To everyone’s surprise, you have done it. You not only have your family back, you may have even begun your own family. Little kids running around, you love your life. Every week you receive a paycheck from your job. You took care of your legal situation. Everything is going well. Then it happens. The question that is on everyone’s mind.
Are you going to be on methadone forever?
Bam, wake up call!
You haven’t been giving it much thought with all the success that you have been able to achieve since you began MMT. You don’t plan on being on methadone forever but, you have no clue how long it will take to detox.
Or maybe you really don’t care if you are on it forever. Hell, it’s a much better decision than the latter. Despite what others may think.
If you deal with the stigma of being on methadone by family and friends then tell them to read the book, Methadone: Bad Boy of Drug Treatment: What Works & What Doesn’t. It lays out the facts and the myths. Hopefully, it will help them to understand. Or to shut their mouth.
The horror stories of methadone detox begin to fill your head. While they may be nothing more than methadone myths but, who really knows? The logical answer is to discuss lowering your methadone dose with your counselor.
To Each His Own
When you address this issue with your counselor, you decide that it is time to begin lowering your methadone dose.
There is no specific way to go about this. The correct way is to taper off of methadone safe and slowly. You can not designate a specific amount of time it will take you or how long you decide to be on MMT. Methadone Maintenance is a long-term treatment. The National Institute for Drug Abuse recommends being on methadone for at least one year. Most people are on it much longer. Some do not plan on ever tapering off of methadone. Their life has improved and they feel comfortable with the way it is.
People fear to lower their methadone dose. They do not want to become physically sick or experience any withdrawal symptoms. Others are scared that they might even relapse if their methadone dose is too low.
Every clinic is different but, they will only lower your dose by so much at a time. Typically it’s a maximum of either 5 mg or 10 mg.
Yet, when people are slowly tapering off of methadone, they go lower than that. A few milligrams here and there and stop if you feel uncomfortable is the advice medical staff gives one who wants to get off of methadone completely.
There are different reasons people decide to lower their methadone dose.
- Some simply don’t want to be on methadone forever.
- Parents want to be off of methadone by the time their children begin school.
- Being on methadone could be putting a halt on your career.
- Some pay out-of-pocket and simply can’t afford it anymore.
- Others are sick of having to abide by their clinic rules.
How & Why I Lower My Methadone Dose
The reasoning is endless. My personal agenda is for a variety of reasons.
- I want to be done by the time my kids go to school.
- It’s putting a halt on our dreams because we can’t travel and need to for career purposes.
- Want to relocate and there is no clinic anywhere even close to where we want to live.
All of these factors combined with my success in treatment corroborated my initial thought of lowering my methadone dose so I can begin the tapering process.
Here is my personal way of tapering. I began to decrease shortly after my last child was born. In less than a year I have cut my dosage in half without any withdrawal symptoms, sleeplessness, or irritability. It was easy as can be. This is how I do it.
- Decrease by 2 mg a week for 5 weeks. That’s a total decrease of 10 mg. (ex. If my goal is to go from 100 to 90 mg, I will do so in 5 weeks by decreasing 2 mg a week)
- Then, I stop for a few weeks, maybe a month or two if need be and let my body catch up.
- Continue with this method and stop when need be.
- Repeat this process over and over again.
Deciding Factors When Tapering
When I say I let my body catch up, this is what I mean.
Methadone stores in your fat cells.
As you decrease, you are physically ingesting less methadone so, your body is using the methadone that is stored in your fat cells. Your body must balance out again so, it’s equal to the amount you take daily and the amount your body stores in reserves.
This is also why people don’t feel the maximum effects of methadone withdrawal for weeks after they stop using methadone.
A person’s metabolism is also a deciding factor.
Some people metabolize methadone faster than others. While the standard patient is on a daily dose of methadone. There are those people who are medically proven to have super fast metabolisms.
These select people receive split doses. This means if they are on 200 mg of methadone a day. They take 100 mg in the morning and 100 mg in the evening because if they take the full amount in the morning, it doesn’t hold them until their next dose and they will start to withdrawal because their body metabolizes it faster than others.
As you can see, everyone is different. Everyone’s needs are different. This is why you have an individual treatment plan. Each individual needs individual treatment, even when tapering.
The only factor that is the same for everyone is when you decide it’s time to start tapering down, you must do it slowly and correctly.
I taper down 2 mg a week for 5 weeks and stop for a month.
A friend of mine lowers her methadone dose by 3 mg every 2 months.
Another person goes down 1 mg a week for 10 weeks.
They are all different yet, the similar trait is they all lower their methadone dose slowly and consistently.
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Deciding to lower your methadone dose is a personal choice.
You have your own individual treatment plan that is suited to your specific needs. You must be on a stable methadone dose, apply the recovery footwork to maintaining sobriety and treatment, and then correctly taper.
If and when you choose to taper off methadone, do what is right for you. Not what the girl sitting next to you in line does. No one will taper the exact same way. It’s like recovery, it doesn’t matter how you get there as long as you get there.
People who choose to taper off of methadone have the same ultimate goal. They simply take different paths to get there. It depends on your own body and mind. To be successful when tapering, you must lower your methadone dose slowly and safely.
The goal is to do it without experiencing any withdrawal. To continue living your dream life with no roadblocks.
When done correctly, getting off of methadone can be done rather easily.