Protect Yourself From a Methadone Overdose
Now, I really mean it this time: this is the last I’m going to say about overdoses for awhile. I thought I’d pretty much gotten it out of my system with the urban myths about overdoses and the tips on how to avoid an overdose and how to know one when you see it. But yesterday, someone I know quite well overdosed unintentionally. They have had a lifetime methadone maintenance slot for years now, and if ever there was a success story to support methadone maintenance, he was it: after a lifetime of being a street junkie addicted to heroin and doing crimes to pay for his habit, he’s managed to hold onto the same job (even move up in the company), married a great gal and had a baby with her. Then yesterday, he had a migraine, happened to run into an associate from the old days who offered him a pill to wipe out the headache. He went home, had a couple of beers and woke up this morning in the hospital having suffered an overdose.
It’s that quick, and it’s that unexpected. Don’t think that because you have two, three, 10 or 20 years invested in a methadone maintenance program that you are immune to overdose. Sometimes all it takes is a one too many alcoholic drinks or one pill that unexpectedly mixes with your daily methadone dose to create an overdose situation. Maybe he hadn’t eaten very much that day or maybe he’d just come up or down a few milligrams on his methadone dose through the clinic. Maybe neither. Your body’s chemistry changes as you grow older and if you don’t get to the doctor for your regular checkups, you may not know when you’re developing a chronic issue that will affect how your body processes your methadone dose.
If your methadone dose is 30 milligrams or lower, you can switch to a Suboxone detox. Avoid the daily trip to the clinic, the liver damage associated with long-term methadone use and the possibility of overdose as you work your way toward a drug-free life. In the meantime, be aware of your body and if you are suddenly overwhelmingly tired, having difficulty breathing, have cold and clammy skin or muscle spasms. Any of these or a combination can indicate an overdose and it’s imperative that you get medical assistance while you still can or make sure that there is someone in the house with you who can watch over you and make sure that you’re okay.
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February 20th, 2008 at 7:46 am
There is no evidence of any kind that methadone produces liver damage. In fact, it is safe to take even for those with liver disease such as Hepatitis c. Please research your facts before making statements that might scare someone away from needed treatment–suboxone does not work for all addicts.
February 23rd, 2008 at 10:21 pm
I was takeing lorotab whenever & wherever i could get it from.
I also drank alot of beer. Thursday i started on suboxone. Im 45
it was the best day i’ve had in 10 yrs. note: 2mg evry 6 hr
Friday started 4 mg twice a day.Before i tell you teh rest i wil
say i was takeing about 8 7.5 loratabs a day.
Friday night i started feeling a little over medicated.I started seeing things run across the floor,bugs zippen by,”skitzen”
A couple hours latter i felt bloated and pins & needels on entire body.I went and weighed myself. I had put on ten pounds not to mention i was extremly constipated,it scared the crap out of me.
” NOT ” I was in full body edema with gas pain moving slowly thru my body.I was really scared though, i was 1 sec from calling an ambulance.Anyway i just wanted to tell someone my story, i think i will be ok.Also im not telling you this to scare you about suboxone. It works for some people.
Morral of the story. I have been takeing pain pills for a long time.First for back surg, then for rec. This overdose like sittuation i believe has cured my addiction. thanks for listening!
February 28th, 2008 at 8:13 pm
Methadone ABSOLUTELY DOES cause liver damage and exacerbates current liver damage. Yes, Hepatitis C patients take methadone because the risks are weighed and the best option is chosen. They and their doctor chooses the harm reduction measure which allows for the addict to stop using needles, a more urgent issue than potential liver damage. In the big picture, an overdose with a needle is far more threatening than liver damage, but that is not to say that methadone doesn’t take its toll on your body. It does, and it’s important that you know what you’re taking.
There is no perfect solution for everyone and no one drug is going to suit everyone’s situation, which is why it’s so great that there are multiple choices: methadone, LAAM, clonidine, Suboxone.
And John, the situation you described is serious! At the very least, your dose needs to be adjusted. If it happens again, call an ambulance and either way, talk to your doctor and let us know what happens.
February 28th, 2008 at 11:04 pm
No, you are wrong. I am a former RN, I am trained as a drug counselor, I am very well schooled on methadone and what it does and how it works. I have been completely immersed in learning about this drug for the past 4 years and I doubt there are many scholarly articles I have not read about it. In fact. methadone is the most studied drug ever, and it does NOT damage bodily organs. Recently there was a possible link discovered between methadone and a cardiac condition called Torsades des Pointes, but this was linked to high doses over long time periods and almost always had other risk factors that, when eliminated, solved the problem. If you have major risk factors or are on a dose over 250mg you may want to have an EKG. But it does NOT cause liver damage. Can you cite a scholarly study showing methadone causing liver damage?
February 29th, 2008 at 5:31 am
Sir…most ANYTHING one puts into their mouth has an effect on one’s liver. THAT said, Methadone happens to be one of the more LIVER FRIENDLY drugs! YOU are the one that is incorrect, Dr. I was the president of a non-profit organization for hepatitis C for years and know what I speak.
You tell the story as if this patient did NOTHING to precipitate an overdose? But in fact, this person on methadone treatment added “a pill” for headaches that “somebody gave him” AND drank a couple of beers, for heaven’s sake! Neither one of these things are indicated for people taking Methadone! Thank G-d this person is in the hospital and didn’t die. Thanks for mentioning how his life was changed for the POSITIVE after being on MMT….now I don’t have to say it, lol!…..Carol
http://www.MethadoneSupport.org
February 29th, 2008 at 2:58 pm
Dole, V.P., and Joseph, H. Long-term outcome of patients treated with methadone maintenance. Ann. NY Acad. Sci. 311:181-189, 1978.
Dole, V.P., and Nyswander, M.E. Methadone maintenance treatment: A ten-year perspective. JAMA 235:2117-2119, 1976.
Kreek, M.J. Opiate-ethanol interactions: Implications for the biological basis and treatment of combined addictive diseases. In: Proceedings of the 49th Annual Scientific Meeting of the Committee on Problems of Drug Dependence, Harris, L S. (ed.). NIDA Research Monograph 81, in press.
Kreek, M.J. Medical safety and side effects of methadone in tolerant individuals. JAMA 223:665-668, 1973.
Kreek, M.J. Medical complications in methadone patients. Ann. NY Acad. Sci. 311:110-134, 1978.
Kreek, M.J. Health consequences associated with the use of methadone. In: Research on the Treatment of Narcotic Addiction, Cooper, J.R.; Altman, F.; Brown. B.S.; and Czechowicz. D. (eds.). U.S. Dept. Health and Human Services, Washington, DC, 1983, DHHS Pub. No. (ADM) 83-1281.
Novick, D.M.; Kreek, M.J.; Arms, P.A.; Lau, L.L.; Yancovitz, S.R.; and Gelb, A.M. Effect of severe alcoholic liver disease on the disposition of methadone in maintenance patients. Alcoholism: Clin. Exp. Res. 9(4): 349-354, 1985.
Beverley, C.L.; Kreek, M.J.; Wells, A.O.; and Curtis, J.L. Effects of alcohol abuse on progression of liver disease in methadone-maintained patients. In: Proceedings of the 41st Annual Scientific Meeting of the Committee on Problems of Drug Dependence, Harris, LS. (ed.). NIDA Research Monograph 27:399-401, 1979.
Kreek, M.J.; Khuri, E.; Fahey, L.; Miescher, A.; Arms, P.; Spagnoli, D.; Craig, J.; Millman, R.; and Harte, E.H. Long-term followup studies of the medical status of adolescent former heroin addicts in chronic methadone maintenance treatment: Liver disease and immune status. In: Proceedings on the 47th Annual Scientific Meeting of the Committee on Problems of Drug Dependence, Harris, LS. (ed.). NIDA Research Monograph 67:307-309, 1986, DHHS Pub. No.. (ADM) 86-1448.
Kreek, M.J.; Gutjahr, C.L.; Garfield, J.W.; Bowen, D.V.; and Field, F.H. Drug interactions with methadone. Ann. NY Acad. Sci. 281 :350-370, 1976.
February 29th, 2008 at 3:24 pm
The point of this post is to show that seemingly innocuous actions (a couple of beers, a single pill) can precipitate an overdose, that methadone is not without its risks.
As far as studies supporting the statement that methadone is toxic to the liver–yes, pretty much every drug is toxic to the liver–there are plenty. There are also plenty that say it is safe. In fact, the problem with studies is that you can always find one to support you. It’s not a one-to-one correlation: again, if you have liver damage, liver disease, hepatitis C or HIV, methadone compromises your immune system, which in turn means that your body can’t protect itself or fight off what’s already at work in your system. And again, methadone is an excellent choice for many people. For others, it is far better to eliminate it if at all possible for a number of reasons, one of them being the toll it takes on the body.
I love your passion! I, too, have a Master’s in the physiology of addiction and trained in hepatitis C and HIV counseling, worked as a substance abuse counselor, and in harm reduction, both training others how to do outreach and manning a number of needle exchange programs. I’ve also worked in the field culling research for a number of epidemiological studies on the effects of opiates, maintenance and harm reduction techniques, detox and treatment. I also am/was an addict and I’ve seen and experienced the effects of these drugs as well as how those experiences differ from what the doctors or nurses tell you. So my posts here are based on study, personal experience and field experience and I appreciate hearing about yours!
February 29th, 2008 at 6:44 pm
Sir, I need clickable links that I can read–not references to artcles I cannot access. Can you provide links please?
February 29th, 2008 at 11:29 pm
I did some research for you offline, so I don’t have any online links for these articles. I do love the sharing of information back and forth, so if you have citations or links to share, please do!
March 2nd, 2008 at 7:16 pm
Those who happen to come across your blog and the opinions you express regarding addiction in general, and addiction in particular, deserve to know whether and what financial or other interests you might have in Suboxone/Subutex. If there were such conflicting interests, it would help to explain some of the more outrageously incorrect statements you make regarding methadone. robert
March 4th, 2008 at 3:50 pm
Meditox provides an outpatient addiction treatment using Subutex and Suboxone. Methadone is not denigrated by Meditox at all. To the contrary, there are many situations in which methadone is a better option for drug addiction treatment than Suboxone. I do not believe that any of the statements I have made in this blog are incorrect; they are backed up by numerous studies. You are more than welcome to compare studies and information. In fact, I welcome it!
March 5th, 2008 at 12:24 am
I’ve been on methadone for 10months now and it scares me to death b/c of all the related bad things people say a/b methadone.But i think that methadone saved my life in so so so many ways.I was on oxy-contin very bad-taking five,80mg aday.And up to ten lortabs aday when i couldn’t afford the 25 dallors apeice for the OC’s.Every day was a constant struggel!Every sec. of everyday was spent either trying to find them and trying to come up with the money to buy them.I was ALWAYS sick.If i didn’t wake up and pop a tab or snort a-OC-then i wouldn’t be able to get outa bed ALL DAY!!!And i would almost stop at nothing to get them and normally it wasn’t for the ‘high’it was simply to just ‘feel better’.Then at 23years old could see no light at the end of my tunnel,I thought that i’d be addictive to pills for the rest of my life.Well my boyfriend stopped useing and went to the clenic.He said he’d either do it with me or will out me,so of corse i followed him.It was the best decision i’ve ever made in my adult life.I have held dowm a job now for the first time in my whole life.And have absolutely no desire to go back down the wrong path.But it was a long,painful,and serious problem.A problem that was way to far out of control.But today my life is different.I have now found what drugs took away from me along time ago.I’m a happy person,but on drugs i’m a mean person.I am ashamed of the person i once was.And it is taken me even longer to fix all the bad things i did.The reason for me telling everyone this is so that they understand that methadone is good when used like your supposed too!I live a more productive lifestyle now!And my life is just all around better thanks to the methadone.
March 6th, 2008 at 1:56 pm
Today I woke up to realize I don’t think this will ever be over for me!!I have been addicted to herione and pain pills for many many years. Rehab,Clinics, and self medicating have yet to work.I have tried the new”Wonder Drug,Suboxone” And I agree for the “Most Part” it works!! Here is my PROBLEM: I think I am now HOOKED on this new drug, and I’ve been taking down the mg. to “KICK” and now I am experiancing the same withdrwl as with my addiction. I need help and advise from someone as to how to stop my rollarcoaster ride. Please don’t tell me to go get help as I have no insurance and my revenue is small…
March 8th, 2008 at 9:26 pm
Methadone maintenance definitely has its place in the recovery community and the same person who will do well to stay on methadone every day for the rest of their life is NOT the same person who will do well on Suboxone.
Amber: You are absolutely right and I congratulate you on making the choices that I know firsthand are very difficult. Sticking with whatever treatment you choose and following through are just as difficult as making the decision to get clean and you did both of those. I congratulate you and I wish you a healthy continued recovery.
Debbie: If you are self-medicating and buying Suboxone off the street, then you need to talk to a doctor that can help you with your particular issue. Needle exchanges and free clinics often have nurses and empathetic doctors who come in and they can help you figure out what you need to do. They should also hook you up with access to other free resources in your area. If you have a Suboxone prescription, then talk to the prescribing doctor and tell him/her the problems you are having. I don’t know the particulars of your situation but if you are having problems with a medication and/or withdrawal symptoms then you need a doctor’s assistance. Their advice will differ depending upon your physical symptoms, other medications you are on, the dose you’re at, among many, many other things.
March 10th, 2008 at 3:05 am
I WAS ADDICTED TO PAIN MEDICATIONS FOR 6 YEARS, THEN I WENT ONTO A METHADONE PROGRAM FOR ANOTHER TEN YEARS . I WAS GETTING NOWHERE ,JUST CHASING ANOTHER HIGH BECAUSE THE CLINIC ENABLED ME TO GO OVER 200 MGS. NO ONE NEEDS THAT DOSE FOR 10 YEARS. I STILL WANTED TO GET HIGHER.A LEGAL DRUG DEALER IF YOU ASK ME. I WENT ON SOBOXINE 7 DAYS AGO AND I NEVER THOUGHT I COULD BE THIS CLEAR MINDED AND NOT SICK. I STILL HAVE CRAVINGS TO GET HIGH BUT I HOPE THOSE TOO WILL ALSO FADE IN TIME. I THINK SOBOXINE HAS PROBABLY SAVED MY LIFE OR AT LEAST GIVE ME A BETTER CHANCE TO HAVE MORE STABLE LIFE. THANKS FOR LETTING ME SHARE THIS.
March 11th, 2008 at 7:37 pm
Congratulations, Jillian. That’s a huge change to undertake, and I’m impressed. 200mg of methadone is a HUGE amount. Did you have to detox down to 30mg of methadone before taking Suboxone? How long did that take?
March 11th, 2008 at 7:46 pm
Well, I gotta tell you, Jillian, I am on 240mg and I am DEFINITELY not “high”. It is ludicrous to say that anyone over ___ mgs is “high” or on “too much”. The amount of medication you will need varies by person, by body size, by the habit they had, by their metabolism, by certain disease states (hep C, etc) that can cause a higher dose to be needed, by pregnancy (which can also require a higher dose sue to increased metabolism and higher circulating blood volume), and by many many other factors. Once you are stable on your dose, you should not be feeling anything from it. Most stable patients can double their dose (though I would NOT suggest doing so) and feel nothing more than a headache. If you think about it, anyone on an average dose of methadone for pain (5-10mg) would think that someone on 50mg MUST be high as a kite! And those who are stable on 50mg and feel nothing probably surmise that those on 100mg must surely be looped out of their minds! And those on 100mg think those on 200mg are high–and so on and so on. As I said elsewhere, I know an attorney and activist, a small woman, who has been on methadone for many many years. She is on 1,000mg–that is NOT a typo–and did not even go to law school until she got on methadone. If you met her you would never in a million years guess she was on anything at all–because she is TOLERANT to the dose.
And I assure you that I am not “chasing a high”. Please do not assume that your experiences are the same as others.
March 19th, 2008 at 2:58 am
VALERIE, THANKS FOR THE SUPPORT.I WENT DOWN ON THE METHADONE 10 MLS EVERY 2 WEEKS UNTIL I GOT TO 50MLS AND FELT LIKE CRAP THE ENTIRE TIME.THEN I WENT TO 30 MGS DAYS I STOPPED TAKING IT FOR 2 DAYS AND THEN STARTED THE SUBOXONE. IM GLAD I DID IT, I JUST WANT TO GET DOWN FROM 8MGS TO A STABLE DOSE OF 4MGS.AND THEN START REALLY WORKING ON THE ISSUES OF MY ADDICTION .WHICH NEEDS TO BE THE BASIS OF EFFORTS SUBOXONE, METHADONE OR WHATEVER. I CERTAINLY DONT WANT TO BE ON NARCOTICS THE REST OF MY LIFE. I LIKE THE SUBOXONE OVER THE METHADONE I HAVE ALOT MORE FREEDOM, IM CLEARER MINDED AND IM DONE FEELING LIKE IM ON A ROLLERCOASTER FEELLING CRUDY EVERY MORNING WATING FOR MY METH TO COME ON ,THEN THE NODS, THEN THE ENERGY BOOST, AND BY 8 EXHAUSTION,.NOW I JUST FEEL THE SAME GOOD ALL DAY.
March 21st, 2008 at 9:54 pm
That’s awesome, Jillian. Congratulations. You’ve really been through it. I’m impressed by your staying power and courage to continually try new things until you found what worked for you. Let me know how you’re feeling and good luck as you continue!