Can I ever get off methadone? How?

Bill, a long-time addict and alcoholic, has cleansed himself of all chemical dependencies, except methadone, which he cannot quit below a certain level. Apparently driven to try, he asks for advice and help. Two contrasting responses are provided by me and Robert Newman, a long-time methadone maintenance advocate.

Further Reading

Hello Stanton, I seem to have a problem. I want to know how to get off methadone. I have been a severe alcoholic and drug addict (mostly heroin and pain killers but there were years of crack, smoking coke, and everything else). When I reached 40 years old I was about to die from drinking , I was diagnosed with hepatitis C and my life was so unbearable because of severe stomach pains all day, every day.

I decided to try to quit everything , but the pains were constant and severe in my stomach for years, so I kept up a little bit of pain killers to function. After awhile they didn’t work of course and I got on a access medical program to find out why my stomach was so painful, after every test I can think of and cameras up my rear they could not find any actual reason and settled on the fact I was an addict and there was my reason for anything else that could possible happen, and the tests stopped, and it did seem they tried at first to find a reason.

Well I started buying methadone on the street to kill the pain, and it worked, so I bought it on the streets for about a year and finally got on a methadone program. On the streets I was taking 100 to 140 a day or sometimes every other day depending on my pains. Eventually the pain went away, I settled down and dropped to 85 mgs and my life got excellent, I was happy again, no pains, worked all day (started my own business which is successful for all purposes, which took hard work 10+ hours a day with very few days off ever ,and my life was good for the first time since I was eleven (when my addictions started).

Well it has been 6 years on methadone now, and after about 3 good years I decided I was fine and and could start the withdrawal process. By the way I had stopped all drugs and drinking and was clean completely since almost the very start of methadone! So the first time I tried to stop methadone I dropped in groups of 5 mgs or sometimes 10 mgs a month till I was down to 28 mgs. Well all of a sudden severe depression set in I started having stomach problems and after months of that I went back up to 35, even though I wanted more. It did help and I was ok mostly again, so from there I dropped slower down to 10 mgs, well that was a struggle and at 10mgs I tried to stop completely.

Well after 4 weeks off completely, I was so sick and life seemed worthless again I raised my dose back to 28 mgs and it went ok again. I decided that next time I would drop slower like I should’ve and try that. I desperately wanted and still want to be drug free, but normal feeling. Well I dropped 2 mgs, a month which took forever it seems, and I am at 8 mgs. The problem is I am very sick almost always, I feel like I have severe arthritis and my stomach is going off the roof, just like 7 years ago when I started for that reason, although it isn’t quite as bad as it used to be.

I am confused, I am doing this just like they said to and I can barley take it, shouldn’t my withdrawing be much less painful as I am going slow? I keep thinking I am very sick and need to get to a doctor but then I start thinking it is just the dropping and that’s what happens. Like so many I have had bad problems with doctors after they find out I was an alcoholic and drug addict, on methadone, then that’s always the reason for everything and they don’t do much to find out or seek an alternative reason for me being sick.

It seems like when I try to get off the methadone everything from years ago starts coming back, even though I been clean for 7 years. I am confused and am wondering how long does this withdrawal take approx. And should I be sick at this small drop for so long? I been dropping for almost 2 years now, and if and when I reach 0 mgs will I eventually get back to feeling better after a period of time, or am I just what I am and maybe I will never be well again, or just to wake up without being very sick, because as much as I want so bad to be finally off everything, could it be I cant function without it? I realize this was a long question but it is an important one to me, and I find myself confused and unsure of my future, when it was so good for so long. Does it happen sometimes people need to stay on this methadone forever, or am I at just the worst part of a very long battle?

Thanks,
Bill


Dear Bill:

You are interesting person. And I admire you. You have been addicted all your life, and you want to change that. I admire people like that.

Some methadone maintenance advocates say that you always need to be on methadone. But you don’t buy that and want to fight it. I can’t speak about your individual situation, because I am not your therapist. But I like to believe it is possible.

Obviously, others will look at your efforts and say, “When Randy gets below a certain level of opiates, he can’t function. He becomes depressed, his body fails him, and so on.” This seems to be what doctors are telling you.

But one thing you are set on doing is improving your life, and there are many ways to keep doing that – methadone or not — things you don’t talk much about, like exercise, family, friends, work, helping others.

I am copying this e-mail to a couple of people who advocate methadone maintenance, and have much experience with it, to see if they have additional advice or referrals for you.

Stanton


Dear Bill,

A somewhat different perspective than Dr. Peele’s. My view is that when someone has had a problem of life-and-death significance (as you had with opiates), which has made it essentially impossible to function normally (as in your case), and precluded great personal and professional success (as it did in your case), and then that person has the enormous good fortune of finding a medication that has essentially no side effects and that reverses all of the terrible consequences of the condition (as has been your experience with methadone), and then finds that as this safe and effective medication is withdrawn the pain and fears associated with the underlying problem return – then the question for me is why in the world would you want to risk everything by persistent effort to stop the medication?

Yes, there are dumb people – including without question a great many healthcare providers – who view methadone as an evil substance and those who receive it as stupid or weak of bad people. But hell, life is full of dumb people, but why seek to gain their approval by putting one’s very life on the line?

No one “likes” to take medicine. Who “likes” taking insulin, or antidepression meds, or cardiac arrhythmia or hypertension meds, or even vitamins for that matter? And almost everyone on those meds knows that there are folks with the same problem(s) who manage to overcome the need for the meds (e.g., diabetics can overcome their insulin dependency by exercise, diet, stress-reduction, etc etc etc). But while it’s nice to do what one can to be free of the medication, is it worth risking one’s personal and professional success, happiness, health and very life? I don’t think so.

Obviously, if a patient – any patient – wants to overcome the need for a medication – any medication – physicians should do all they can to assist. But at the same time, it would be unethical not to ensure the patient has thought through the potential benefits and the potential risks of such a course.

My own views reflect the fact that I draw absolutely no moral or medical judgments based on whether a former heroin user is living a healthy, self-fulfilling, personally gratifying life with or without methadone or other medication, any more than I consider a recovering alcoholic a better or healthier person if s/he does or doesn’t attend AA meetings, take antabuse, rely on yoga, or whatever. If someone who was largely unable to function with heroin and whose life was at risk several times a day with each and every shot of the drug is today leading a good life, I could care less as a physician, friend, employer, father or whatever whether that person is a graduate of a residential treatment facility, was or is taking methadone, found the way to abstinence through Christ (or through Islam), or just plain stopped without any support at all.

Whatever you do, I wish you the best.

Bob Newman
Director, Chemical Dependency Institute
Beth Israel Medical Center


Bob:

Thanks for taking the time to give your inputs. Bob, you don’t think I’m one of those dumb people, do you? The only thing I think you miss in your heartfelt answer is Randy’s own repeated drive to get free of drugs.

Stanton


Stanton,

Never (hell, it would cheapen greatly the meaning of the Lindesmith Award which you and I both received – the dumb people are those Bill refers top in his message – the doctors and others who blame whatever difficulties a person has on the methadone. You can use my response in any way in any forum you wish – it’ll be an honor.

Bob

Is Bode Miller an Alcoholic?
Misidentifying Clinton's Risk Factors

Comments

9 thoughts on “Can I ever get off methadone? How?

  1. Renea Waite

    Hi, I have been reading all evening about methadone and the pros and cons of long term use and what happens when trying to get off the medication.
    I have been a opiate abuser for over 25 years, but when the crack down came along, it was getting harder and harder to get them off the streets and way more expensive. So I found myself in opiate withdrawal and it was maddening. To make a long story short, I ended up on heroin to stay out of withdrawal, but even that was hard to maintain.
    I just could not get past the withdrawals! So I found a suboxone doctor and he started me on 8mg bid, then to once a day. I was fine on 8mg a day, but then the pharmacy flagged my chart and informed my doctor that my Suboxone needed to be tapered further, as this medication was not meant for long term use.
    Well that absolutely freaked me out! I was not ready for that to happen.
    My doctor got me down to 4mg a day, but I just wasn’t ready. I ended up falling off the wagon for a couple of months and knew I just could not live that lifestyle. I am getting old. I am 54 years old by the way.
    Anyways, someone knew I was in the military when i was younger and recommended I go to the VA.
    There they put me on Methadone 30mg liquid and I am maintaining now on 60mg daily and have been for the past 3 years. Now I am wanting off of Methadone so bad because I am afraid that if something happened that I was unable to get my Methadone, that I would go through what I call maddening withdrawals! Plus being on Methadone has turned me into a depressed, Non functioning human being. Oh and I’m also taking 40mg of Prozac daily which doesn’t seem to work anymore.
    Sorry that I am making this so long, but I truly am concerned about Methadone withdrawal and the fear of not being able to function due to long term abuse of opiates.
    I feel if I wasn’t rushed off of Suboxone I would have been okay. With Methadone, there doesn’t seem to be any rush by the doctors to get off of it. They don’t pressure me at all about it. I mean, reading all the comments on the Methadone sites has scared me to death because so many have taken it for years and years. I don’t want to be that person and am tired of feeling like I’m in a black cloud, that never goes away.
    Why is there such a rush to get off suboxone? Well I know, it’s because it is very expensive and the insurance companies do not want to pay for it long term. Yup, that’s it!
    Well I will close.
    Hope you read this.
    Respectfully, Renea

  2. Skylar Williams

    Bob had some good points about being physically dependant to the more severe drugs. It would take a lot of counseling and therapy to get back to normal life. I need to help my brother get to that point in his life.

  3. Birdman

    Stanton,
    I’m glad that you at least tried to answer the questions of can he get off the drug and how. “But one thing you are set on doing is improving your life, and there are many ways to keep doing that – methadone or not — things you don’t talk much about, like exercise, family, friends, work, helping others.But one thing you are set on doing is improving your life, and there are many ways to keep doing that – methadone or not — things you don’t talk much about, like exercise, family, friends, work, helping others.” Focus on the traits and life situations that lead you to be an addict in the first place. If you have found new avenues for coping besides a substance that is success. Quite possibly that is why you don’t feel the need to continue to take methadone. I am a believer in the fact that your nervous system will eventually learn a new reality and the pains you experience will “go away” so to speak. In 2009 I was in a terrible car accident that shattered my tibia, fibia, and broke my femur into multiple pieces. After 7 surgeries I was left to deal with the pain and heroin withdrawals that were peaked by dilaudid (sp?) in the hospital. For the first 3 years my leg hurt so badly that I could barely walk and enjoy life. It was hell. Today, 7 years later, I am still in pain. But I don’t notice it like I use to. My nervous system has adapted to the new reality and has stopped leading me to believe that the pain I was experiencing needed to be treated. My life is good today. I don’t take any medications for pain…not even Tylenol. You will make it Bill. Steadfast willpower and determination. Strongly you will find freedom from your troubles.

    Prayers

  4. Jamie Anderson

    Years?? Im also on methadone going down 10mgs a day from 190 and im terrified abt the withdrawals…

  5. DashRiprock

    PAWS lasts a few years? You don’t know what you’re talking about. I took methadone for 9 years today I take none, zero, zilch. I went through a rough week but that was all. How did I do it? Buprenorphine patches called Butrans and a little bit of marijuana that as a rule I don’t mess with but someone suggested it and it helped. I strongly recommend these two drugs to anyone trying to kick methadone.

  6. Icare

    @Bob Newman…. Excellent answer… Just excellent. I have been recovering from addiction myself…15 years of off-on again abuse, until I found methadone. I only take 15mg a day. I am a mother of 3, I work and this has tremendously improved my life. I am “me” again. No haziness, no bad feelings…just the urge to want to take narcotics gone. Line you said, if you had diabetes, you wouldn’t think twice about insulin. No matter what anyone says, this is an illness too. If it’s not broke, why try to fix it. Life is hard enough as it is, why make it harder. Of course doctor’s don’t want you to be on it, because if you take that ONE pill that makes everything better, they can’t write scripts for 10 that don’t, and that’s where they make their money.. Anyways…just my thoughts. Hope this helps someone!

  7. Tim clark

    Bob, I’ve got almost the exact same thing. Been on methadone for almost 10 years. Going down slowly but every day my right side hurts sometimes badly to the point I can’t do anything. It’s put me in the deepest rut I’ve ever experienced but I refuse to give up and want OFF this poison asap. I’m down to 17 but I can’t trust the clinic because I’m only $ to them and they will stop my taper with out telling me to keep me there. At this point I’m ready to chain myself to a boulder if that’s what it takes. I haven’t worked in 3 years and I want and need a job but this stops everything. I wish you luck Bob. I wouldn’t wish this on my worst enemy.

  8. P

    I’d like you to re-read what the commenter above this just said: “You are going to go through PAW’s, which lasts a few YEARS…” …YEARS? YEARS!? No one should have to suffer for YEARS when it just isn’t necessary to do so.

    You should listen to the good Director’s advice. You’re fortunate enough to find a medication that works, is non-toxic, and I’m assuming convenient to obtain (if you’ve been in the program for years you probably have take-homes). Why on EARTH would you even CONSIDER not taking your literally life saving medication?

    My guess is mostly because of the stigma attached to the word “methadone”. If you don’t think that’s true, re-read your original post and every time the word methadone is mentioned, replace it with the word pancakes. You’ll see just how ridiculous the question of “should I stop eating pancakes” really is.

    If you found that pancakes, something that is non-toxic, cheap to make, and convenient to eat took away your desire to do drugs, you would not question it. You’d eat your pancakes everyday and be happy. You might get sick of the same old pancakes everyday, but you’d eat em, and wouldn’t question stopping.

    For you it goes two-fold. You also have a crippling stomach pain issue. Methadone, being an opiate, is also helping you manage the pain from that, whilst not getting you “high”. They say there is no “magic bullet” but you might have come as close as one can to finding one my friend!

    We need to start changing the conversation and let people know that it’s ok to be on methadone for life if it makes your quality of life better. Just like it’s ok to eat pancakes in moderation. 😉

    -A proud, lifelong, methadone advocate.

  9. Jason

    Get off the done. YOu have to go through some pain to get to the other side. It’s not going to be easy. When you are on the done you are taking Narcotics, which feel good. But, you have to expect some pain. You are going to go through PAW’s, which lasts a few years, but gets better over time. Don’t give up.

Leave a Reply

Your email address will not be published. Required fields are marked *


1 + three =