I am withdrawing from methadone and need to wein myself off of it, any ideas, please post.

thanks.

garrett

CHCEK OUT A METHADONE CLINIC!

Yeah...methadone clinic is the obvious answer to this one. I used to go to one, if you have any questions I can answer them for you..

The one I went to cuts you down 5mg every 2 weeks until your off, withdrawal isn't bad at all at that schedule

I alwasy thought once on methadone, you had to take it for life. I guess thats changed.

That was definitely never the case.
Opiate replacement therapy is intended as a harm reduction strategy dealing with the negative behaviors associated with active drug addiction.
Many, many, many methadone maintenance patients have successfully tapered and never looked back.
I will say, however, that if you asked them if they believe they would have been far better off just initially stopping their drug of choice, the vast majority would say "yes."
The fear of withdrawal is very often much worse than the withdrawal itself.

i would have to agree 100% omo

Patients who are treated at a methadone clinic are simply avoiding opiate withdrawals by substituting methadone. That's why they take it along with avoiding the dangerous behavior associated with street drug use such as needles, disease, crime, etc. They may or may not be "getting a buzz" depending on what they are loading in addition and/or how long they have been taking it. If they are sticking to the clinic's program (and damn few do), it is probably accurate to say that they have a dependence on the methadone rather than addiction.
Those who are committed to stopping all together then move to a schedule of tapering the methadone. That's the theory anyway.
Someone prescribed methadone for chronic pain is typically on a much smaller daily dose. However, there is certainly a discontinuation syndrome (withdrawal) and potential for abuse associated with this type of treatment also.
There are lots of people in treatment at methadone clinics all over this country who never laid eyes on any heroin.

After my accident in Hawaii I quickly learned they a freely prescribing methadone for pain. I found it control my pain somewhat It is odd how so many meds now, upon reading the drug info pamphlet provided, you will notice towards the bottom it will say something like "med is often prescribed for other conditions not listed here". When i came back to the mainland, the Dr's here freaked at the idea of me on methadone. I guess every geographical area has its "preferred method of pain control"...

Ok, thanks for the info.

and methadone is REALLY cheap too

yeah it is really cheap, much much cheaper than OC for example

Methadone is actually a great pain medicine comparable to morphine. It's a NMDA antagonist so it doesn't lose its effect quickly like other opiates with time. It's much more economical than oxycontin(screw without end) in the long term. You can get a huge tolerance though, because of the long half life.

The best thing is to stay away from opiates unless you desperately need them for pain control. You will get a huge monkey on your back no matter how you handle it.

That is very good advice about the potential dangers of opiate use.
However, methadone is definitely not an NMDA antagonist. Those drugs are typical dissociative anesthetics like ketamine or nitrous oxide.
Methadone is just another synthetic opioid narcotic.

Yeah it may be a little surprising that it's an NMDA antagonist. It's not a strong one such as ketamine but it does have significance as it helps retain the pain killing effect over time and slow down the runaway tolerance buildup associated with opiates. Along with the high potency(as a result of the long halflife) that can equal ridiculous quantities of morphine, this makes it a good choice for chronic pain. But as I mentioned, the monkey will be waiting for you. You opiate receptors will become irreversibly downregulated for the rest of your life.

http://www.sciencedirect.com/science?_ob...005f92bb3991802
http://www.mywhatever.com/cifwriter/library/eperc/fastfact/ff75.html

Interesting background material. There is not, however, a widely held opinion among medical researchers regarding the reported enhanced pain syndrome effect that this stereoisomer has as an NMDA antagonist.
However, as the link points out, it very well may account for the fact that methadone can be a better pain treatment choice because of its reduced tolerance curve.
Regardless of all of that, methadone has no clinical application as a dissociative or anesthetic drug which is the common purpose and definition of NMDA antagonists.
Thank you for the links.

Regarding the first link, I can tell you that tolerance to pethidine develops extremely readily, regardless of any NMDA antagonistic properties. This also may be complicated by the fact that the parent drug has an unbearably short duration of action when continually dosed, whereas the metabolite norpethidine lasts much longer, and can accumulate to produce the problems of CNS toxicity associated with the drug.

I take methadone because I was a heroin addict. But, I don't take it because I'm living in fear of the withdrawl nor do I ever "wish I would have just quit using H", like you say. I'm taking methadone because it is the ONLY thing that can safely keep me from being preoccupied with H (or whatever strong opiate I can find if H is unavailable) all day long every day. I can function at 100 percent, work, go to school, have relationships with family, friends and my lover. While on methadone I work 60 hours a week, I pay my mortgage, car payments, all my bills, shower, wake up early, go to bed early and sleep 8 hours, etc, etc, etc....Basically, I function LIKE A NORMAL HUMAN BEING. It makes me normal and lets me live a life--and I DESERVE that. It has NOTHING to do with tapering, with FEAR OF WD'S, or any other stupid idea a lot of you have. Methadone allows a lot of us, people that everyone thought were completely hopeless, live a life. It's that simple.

There are some negatives I see with methadone. 1.) People on it (and at some VERY ALARMING DOSE LEVELS) that have no business being on it. Usually very young (teen-early 20's), that messed around with pills (Hydro and possibly some Oxy) for a few months, maybe even a year or two (on and off when they had money). But, they ended up in the clinic to try to cop a free daily buzz. They talk the Doc and their counselor into higher and higher doses, and they are in much worse shape than when they originally made it to the clinic. That pisses me off and makes me sick. 10 bucks a day, man, these private FOR PROFIT clinics LOVE these kids. These kids can't function, are worthless on these high levels of 'Done, and are just as bad and hopeless as the addict on the streets. 2.) People that think the party is still going! They found something cheaper than Heroin (or Oxy if they're from Hillbilly regions of the USA(. They take their daily dose of methadone, then they start popping the Xanax. It does get you pretty twisted, and that's how they live their lives. Done in the morning, then popping Xannies all day. Living in "Methadonia" as they call it! These people are SERIOUSLY F-D UP. This is the Methadone Zombie, always on the nod, eyes that just look hollow and completly vacant. Sad, dude, really sad people. 3.) Ah, whatever, that's enough. Those 2 types of people are all I'm going to mention. They're at every clinic and drive us people that are trying to live a new life CRAZY.

Oh, and last thing, if you're going to get on methadone (whether it's for the right or wrong reasons), please follow this advice. Go to the clinic, pay your money, get your dose, and GET THE [censored] OUT OF THE CLINIC! Nothing worse to me than people that treat the clinic as their NEIGHBORHOOD BAR AT HAPPY HOUR. You know the types, the idiots that are usually on doses WAY TOO HIGH and taking Benzos, that take 20 minutes at the dosing window cuz they're chatting away with the dosing nurse. They hang out in the hall, in the reception area chatting away, drinking coffee, standing around for a couple hours every single morning. They bring their kids in, and the kids run around the place like wild freakin' injuns, because they love in their too! God, I flippin' hate those people at the clinic the most. Idiots.

Although you say methadone allows you to live a life you deserve, it sounds like you're not real happy with life at the clinic.
If you are content with your life being like that for the next 5-10 years, then I can see why you have no interest in tapering off the drug.
Take a close look at some of the "old timers" at your clinic and imagine yourself in their shoes some day.
Tapering might not be such an unacceptable alternative in that context.

What people don't understand about MMT is that methadone is not merely a substitute but a treatment to prevent relapse like antabuse. Here in Europe it's not a moral goal itself to get people off methadone because study after study for the last 30 years has shown it's the only thing that can reduce unsafe drug use, disease and crime. Short of pharmaceutical heroin of course, which will be started to be dispensed in my country very soon.

If you take an ex-addict off his methadone, he will very quickly fall back to chronic heroin use. Keep him on it and he will only do it occasionally. The people you often see come to pick up their methadone looking stoned are very rarely on too big a dose(more often the dose is too small). They are most often intoxicated by combinations of benzodiapines and cannabis. The main side-abuse problem with methadone is benzos.

The tragic fact that people often don't realise is that opiates cause irreversible downregulation of the mu-receptors. Once you have been taking an opiate for a number of years, you cannot go back to point zero. Your body has been changed and it will not return to normal by itself. Tapering methadone down makes no sense since you will be having very few opiate receptors left in your body, too few for your endogenous endorphins to bind to leaving you chronically deprived. You will have to fill in the gap with an opiate such as methadone or buprenorphine for the rest of your life. If you could see inside an addicts body you would know what damaged state he is in and why any call for abstinence is futile.

I realise that the above is more or less off topic but I've written it to let people know what they are going into when taking an opiate on a daily basis, whether it's for pain or pleasure.

Naltrexone implants can also prevent relapse, though they are best implanted after withdrawal.

I find it interesting what you say about long-term opioid use causing irreversible tolerance for the rest of your life. I've heard others say it too, but I've not seen a source about this, and would very much like to.

Furthermore, there have been articles about using opioid antagonists (such as naltrexone) to 'repair' tolerance to almost opioid-naive levels. This would correspond with the ultra-low dose naltrexone treatment that is is meant to significantly reduce the rise in tolerance when taken with opioid agonists, and therefore enhance total analgesia .

so what do you think of ibogaine treatment then? i have read accounts of people taking in upwards of 5-600mgs/day of oxycodone. after ibogaine treatment, a 5 milligram percocet worked well on their pain.

also, the longer you take opiates, the more receptors your bran creates to absorb/attach to them, hence tolerance raising, as there more receptors to fill. i am not sure i understand your comment of losing mu receptors, i would surmise you have more, otherwise, tolerance would not grow.

I believe it's firmly established that tolerance stays to some degree. Most medical textbooks on opiate treatment recognise the difference between people that have never been treated with opiates('opioid naive') and those who have. Those who are opioid naive require significantly lower doses because of their initial sensitivity.

The mechanism is simple receptor downregulation and opiates share this problem with many other classes of drugs.

A similar problem in reverse occurs with antipsychotic drugs. Initially they suppress symptoms well by blocking dopamine receptors. But even from day one the brain will increase both dopamine receptor density and synthesis. Heavy dosing with neuroleptics can raise both with 100-200% in less than a month. This is most likely what causes TD and other disabling side effects. These upregulations are also irreversible. Note that irreversible in this context means it will not reverse by itself.

Homeostasis is the great nemesis of medicine. Homeostasis cannot be beaten but it can be manipulated.

Naltrexone/naloxone can actually reset your sensitivity to zero or even increase it further. There is nothing spectacular about it. But in practice this treatment option is limited to very few patients and has more or less been abandoned in favour of mixed agonist/antagonists such as buprenorphine. The primary reason is that people who had their opiate sensitivity restored would often end up overdosing because they took the dose they used to. Naltrexone has to be taken on a daily basis and even an implant is not foolproof since there will be fluctuations in blood levels.

The second reason is that chronic treatment with naltrexone naturally has a very bad impact on your well being. You can't just block out a major hormone and expect to be able to live normally. The side effects of chronic blockade is depression, asthenia, low motivation, hypersensitivity to pain, shivering and a whole lot of subtle symptoms. This is why buprenorphine is preferred over naltrexone, it is also an agonist so it doesn't cause these problems as much.

So you cannot keep a person on naltexone indefinetely. He has to get off after a few months, otherwise he will be a wreck prone to other types of abuse such as cocaine. Then you will have a polyabuser instead.

Naltrexone can reverse tolerance but is only suitable for users that are highly motivated to start a completely new life.

I don't know much about ibogaine but it sounds very promising. I'm convinced it can reduce both tolerance and withdrawals but the question is how much. I saw an example on TV about a guy who got off a fairly large methadone cold turkey using ibogaine. It was obvious that he did not suffer the expected symptoms. It should have made him a shivering wreck but from what I could see he suffered only fatigue and a runny nose. I would like to see it being applied on a larger scale but it's being complicated by its legal status. I don't understand why it must be illegal, it has little if any abuse potential and is pharmacologically related to reserpine.

To get off Methadone I started taking Suboxone. You see a doctor once a month, unlike a methadone clinic when you have to go every day. It's a very strong substance just like Methadone. I'm down to 1mg in the morning and 1mg at night. They will most likely start you off at 8mg in the morning and 4mg at night. Good luck getting off Methadone, I know people who have been addicted to it for 15 plus years and will probably never get off. Move on before it's to late.

You guys are soooo knowledgeable. I appreciate your input. I just learned a bundle here. Skate just verified what I always thought about taking ex-heroin addicts taking meth for the rest of their lives. She sounds like she plans on doing this until she dies. I think I would look alternatives to ridding myself of the heroin addiction. She, you, Skate23, deserve to go free. Theres something out there that can set you totally free from, Im sure of it!

I wouldnt accept anything that would hook me up for the rest of my life! NO WAY!

There are natural remedies to everything on earth! The Bible speaks of this. That God put "healing in the herbs"

He probably did, but heroin comes from one of God's plants in the first place.

It is difficult to know where to start regarding the mis-stated facts or conclusions contained in this post.
There is absolutely no scientific research that confirms that someone treated with methadone or Suboxone as a harm reduction therapy must stay on those drugs for life. That is just not true from a medical standpoint. As to whether a heroin junkie will immediately relapse after discontinuing methadone treatment, that is a very individual consequence that some people have convinced themselves about.
Long term opioid use does not decrease the number of opiate receptors. To the contrary, it increases the number to accomodate the influx of exogenous chemicals being introduced into the body. These excess receptors never go away even after opioids are stopped. That is why an addict cannot return to so-called "responsible" use. Once those dormant excess receptors are energized, you are very rapidly back to where you were when you stopped in terms of tolerance and dependence.
I don't know where you got your information about long term use of naltrexone but it does not "block out a major hormone" (whatever that means). It is an opioid antagonist that interfers with an exogenous opiate's ability to bind to a receptor. And I would very much like to see your source material on the causal relationship between naltrexone and cocaine.
If an addict can discontinue their drug of choice without the interim step of methadone or Suboxone then that is clearly the best choice. However, I don't think anyone should be encouraged to believe that if they choose the interim step, you are making a life-long decision. That is bullshit.
Your original advice is the best overall...just don't go overboard with irrational drug use in the first place and all of this conversation will just be academic.

Methadone doesn't have to be a life-long "problem" and there are things that can help to begin mending the destruction to the brain cause by addiciton. Methadone is like everything else-if used correctly it can do a world of good, but when abused it can turn someones life into a hell on earth. I began taking 5-HTP along with to help increase the seratonine that was destroyed by my years of addiction-I found a web site where I am able to order a very good brand (I have tried others and they weren't as good)I get 400 for $14 and it has helped more than anything else.
I went on Methadone once to becuase I couldn't take the withdrawl from the heroin any longer, and the methadone was so much cheaper-I didn't want to quit using-I enjoyed getting high and the life style it entailed. I hiked my methadone dose as high up as I possible to handle it and stayed comatose for days on it...so of course it didn't do any good what-so-ever and it would have been very easy for me to continue abusing it, and yes-to stay on it for 10,20, or 50 years if I chose. I got tired of going to the clinic everyday and went back on heroin. After almost fifteen years of severe addiction I did decide to finally "get my [censored]] together", but of course this was to be easier said than done. I did go back on the methadone program, this time with the intention of recovery and getting clean. I stayed on a low dose-around 150mg just enough to cut all the craving and withdrawl-with some serious work things did change for me-I became a wife and mother, working 60-70 hours a week, going to school, involving myself with helping others that were going through some of the same things I experienced(poverty,homelessness,incarceration, addiction,etc.etc.etc.)
After about two and a half years I decided it was time and began to detox off the methadone-first with just lowering 5mg every two weeks then less (2mg-5mg) every 2-4 weeks depending on how things were going.The slow detox along with the 5-HTP & helped a great deal in my beling able to get off the methadone without any problems. So yes, it can be a very useful medicaiton, and no people are not destined to be on it for life, just as they are not destined to be addicts forever. It comes down to how bad someone wants something and how hard they are willing to work to achieve it.

Do you not think these clinics are a bit generous with their definition of low doses? 150mg sounds high to me, even though I've seen much higher doses given. The protocol in the UK is to start on 10-40mg, increased by no more than 10mg daily, and no increase higher than 30mg weekly, with a maximum of 120mg daily.

Sometimes seeing the doses people on here are given, it would probably increase their tolerance by starting too high and increasing too rapidly, leading to the need for ridiculous doses that otherwise wouldn't be needed.

LOL

100 mg methadone is probably a good standard dose in terms of prevention. Clinics of course want to prescribe as little as possible but there is not any sense behind it. It takes minimum 60, preferably 100 to archieve the required tolerance. 150 is a moderate to high dose which is often necessary to curb any remaining drug problems. Higher doses are often prescribed for special reasons. You cannot demand that users should be put on a standard dose since methadone is highly metabolised and thus variable in effect and duration. 60 mg in one user may be identical to 150 in another. The guideline is max. 100 mg if you want to drive without doctors permit here.

I would say that being on methadone or buprenorphine(or any other opiate) for the rest of your life is a small price to pay to get out of such a tragic situation(did I mention that it would be better to avoid it in the first place?). But you only have to take it as long as you're in risk of relapsing, as protection. If you manage to put a decent life together with perhaps a girlfriend and kids, you can easily taper it down(it may take up to 18 months for a full methadone dose though). Then you can go on naltrexone for a few months to get as normal as possible. Just remember that it's rather unsafe to do that since you may relapse if your new life falls apart for some reason. Say your girlfriend is unfaithful and you try to 'comfort' yourself. Things like that happen easily. Alternatively you could try and move somewhere where you can't access it so easily but it's hard since there are train stations, red light districts and addicts almost everywhere in the world. Even if you're an average person like me(that is, not doing narcotics) you can always walk up and offer a homeless 10-20 dollars to find the local dealer. You don't even have to be or act like a junkie or even look like one, it's everywhere, where will you hide? Maybe one of the poles?

It's ironic that the best treatment currently proven to work for the majority of heroin abusers is actually heroin itself. It was developed to fight morphine abuse btw. IMHO, fentanyl analogues would probably be better, cleaner to administrate and ridiculously cheaper but they didn't use that in the trials(so far).

Buprenorphine is probably the best alternative if you cannot tolerate the side effects of methadone such as sweating, weight gain etc. or want to progress to a new life. It has also the unique benefit of making you feel fairly normal, as you weren't on an opiate. In that case, you just take like it is your insulin except you do it sublingually.

It cannot replace methadone as treatment for the average user because its receptor blocking only only last for a day or two. Many users switch to buprenorphine in order to be able to take other opiates(of abuse, such as H) several times weekly. It doesn't help with other types of drugs of abuse, it can even exacerbate the problems associated with benzodiazepine abuse that is typical among such people.

Introducing buprenorphine as an extra option is a step in the right direction because it makes users feel better and more normal. But the only true solution to make people stop taking drugs is to make them feel so well in their everyday life that they don't feel compelled to take drugs in order to tolerate life in the first place. In the US, it has been a common way of thinking to look at addicts as morally infected(and capable of infecting others) and that they need to 'suffer' and 'purge', like a sort of catharsis that will 'cleanse' their bodies of this moral disease and bring them back as whole new people. The 'rehab' and 'detox' phenomena come from this flawed way of thinking. When they invariably fail(and they do, unless considering 'getting them off the street' a success, they are perceived as morally evil. Thus comes the bizarre idea of putting people in jail for drug abuse and/or related crimes. In the american mindset, a person that again and again goes out and smokes heroin instead of taking care of his family, such a person is no better than someone who axes his neighbour just for the hell of it. The average american will probably be more inclined to pardon the axe murder than the addict, given the choice.

Very few drug users are in reality evil in the biblical sense. The primary reason for taking drugs is to feel good here and now, quenching the physical and psychological pain, boredom, despair etc., rather than a desire to be wicked. According to another flawed theory, 'the accessibility theory' exposure to drug accessibility will create drug users by itself. If that was true, we would all be alcoholics, smoke cannabis and generally be polyabusers of street drugs because very few people in the world today are restricted from getting them.

Sometimes we forget that most people, a large majority of the population don't *need* psychoactive drugs to get through life and these people don't take them even presented with the accessibility. Even though almost every person today can get many illegal drugs quickly and easily, few people take them and much fewer end up taking them chronically. The reason is most likely that these people have a healthy body and nervous system and also high circulating amounts of the endogenous substances that make them feel good, motivated and relaxed by baseline, plus their body and brain retains sensitivity to these substances.

The only way to bring people in risk of addiction up to this baseline is to change their genetic makeup already before birth _and_ remove a large amount of the social problems that exist today. The last part is probably the hardest but can probably be compensated for by genetics since a significant part of the population still don't like taking drugs even when placed under high stress.

Such people don't need drugs and generally don't understand why others take them. But ignorance is no protection and they too can quickly find themselves in the same situation due to the flawed moral of society. The classic is the otherwise healthy patient who develops a chronic pain problem such as back or leg pain. As he has faith in the authority of doctors(and authorities generally) he rigidly follows his doctors advice and takes the prescribed pills at the correct time of day. The pills may be strong narcotics(his medical record is straight so why not) but he is confident that he will never become addicted since he is prescribed it for a legitimate pain problem and he is under the care of a competent doctor. Besides he would never take his meds to get 'high and he cannot even think of himself as an addict. In fact he thinks they are scum and should all go jail. He votes for old testament politicians and thinks criminals and drug abusers are treated too soft.

Now, this patient doesn't know that the primary risk factor for developing dependency and addiction to opiates is not the desire to get high but the dose and the time(months, years) he takes it. This is the solid statistical risk factor. Whether you take it for pain or pleasure makes no difference at all to the receptors in your body, contrary to the reassuring myth you get from many doctors as a pain patient. In fact chronic pain may be worse in that matter because you may have to take it 24 hours a day rather than in 'pulses'. Like is the case with other receptor agonists, limited but constant binding to the receptors cause more downregulation than high but temporary binding. Another disadvantage that the pain patient has is that he cannot tolerable off time well since his already troublesome pain will be amplified('rebound pain'.

Opiates are notorious for developing tolerance and will eventually require dose increases to cover the same amount of pain(unless the pain gets better). Only very few patients will be able stay on the same doses for many years, most require regular adjustments, typically up. And dependence is invetiable for all who take an opiate for extended perioids of time. Some good doctors understand this logical consequence(dependence and tolerance doesn't necessarily make an abuser) and are willing to go all the way but most doctors will call in the hounds once he discovers his patient in that situation. With these doctors, it would be better to not take the meds in the first place because there is nothing as bad for pain as withdrawal.

After some time(typically more than year), the faithful patient will have had to have some dose increases(thoroughly discussed with his doctor of course) and that has made him a little worried. He thought he would be taking the same dose all the time. He don't like asking for dose increases but he cannot function when he's aching. What is even more worrying is that the meds don't work so well as they did, in fact even the higher dose doesn't work so good as the ones he got in the start of the treatment despite being smaller. It's like the dose is never sufficient for some reason. Once the receptors are downregulated to a certain point, the end-of-dose premature withdrawal symptom shows up. At this state he will probably start to realise that he is in trouble but he tries to hide it from his doctor hoping it at least won't get any worse with time. But it does and then he starts to run out of meds before getting the new prescription. He get a full blown WD the last few days before he can get it filled. The pharmacist notices his runny nose but doesn't say anything(what would it help anyway).

Finally the inevitable happens. He gets in legal and financial trouble(already happening of course) because he tries to manipulate his prescriptions. He goes to several doctors, tries to fill them early, maybe even try to scam a pharmacists or buy some street 'oxy' on the wide black market. He may have more pay more than 1$ per milligram from black pharmacies or even his local drug dealer but at this point he doesn't care anymore. It's no longer a question of getting proper pain relief but of barely staying normal. As the irony reaches its high point, he is arrested as the scum he is. The doctor can of course not prescribe anything to him more. He is sympathetic but reminds him that's it his own fault he turned into an 'abuser'. "If I had known you would abuse your medication I would never have prescribed it" the doctor says.

Now this patient is worse off than before. He hasn't got enough money, he can't hold down a job, he can't get hired, he is going through heavy WD and his pain is much, much worse now which is the logical consequence of opiate receptor downregulation. The best he can do now is line up for MMT and accept his new life as a junkie. He better try to learn the slang such as "dope" instead of medicine and exchange his suit for a stereotypical junkie uniform(hoody and white sneakers). Very cliche but what can one do.

Bottom line: you don't have to act like an addict to become one.

PS: Agonists reduce receptor density, antagonists increase it. The more receptors you have the more sensitive you are. Sensitivity is somewhat more important than the amount of drug, producing a stronger reaction. Increasing sensitivity works most often better than increasing the dose but it's of course harder to accomplish.

While I certainly have to commend you for your ability to type very long opinion pieces regarding the use of methadone or Suboxone, I think it is important to once again point out the facts involved in these treatment approaches.
Tapering methadone of course makes sense. That is how many, many people have discontinued their treatment at methadone clinics and managed to stay clean.
The theory of "very few opiate receptors left in your body" is exactly opposite the clinical facts. If you are asserting that an addict must continue to fill in some imaginary gap with drugs for the rest of their life because of a lack of opiate receptors in the body, I think you have missed the point entirely.
The only thing the addict will be chronically deprived of after discontinuing methadone is their original drug of choice. Which is, after all, the point of all of this.
When people present these misguided theories about opiate addiction, especially ones that sound like a life long imprisonment with liquid handcuffs, I'm afraid that active abusers might see no useful point in approaching recovery from this angle and just keep using until they die.
On the other hand, if your tactic is to make potential addiction sound like hell on Earth forever, then maybe someone will see the light regardless of the facts.
You sound like an intelligent person who has had considerable experience with drug abuse and are in active recovery. Congratulations on that achievement and best wishes for your future.

Weeeeeeell it looks like we have to disagree on at least four counts

One. please do not try to turn me into an addict too(LOL). Because I’ve been close to one and experienced the consequences doesn’t necessarily make me one. I don’t have problems with chronic pain either anymore. But that is off-topic personal info I only discuss over PMs.

2.
There is nothing theoretical about receptor downregulation. It happens with many kinds of drugs especially ones related to hormones, for instance with insulin. Note that there are several ways the desensitizing happens, reduced receptor density and binding is just some of the mechanisms but often the most significant. Strong binding to receptors can reduce their numbers within hours. The body continuesly create and break down receptors, when an agonist or antagonist is present, the balance is merely shifted one way or the other

This explains it very short and efficiently in the case of insulin.
http://en.wikipedia.org/wiki/Downregulation_and_upregulation
And the mu receptor itself
http://en.wikipedia.org/wiki/Mu_Opioid_receptor

Here is some about mu receptor downregulation, the process behind opiate tolerance and addiction.

Mu opiate receptor down-regulation by morphine and up-regulation by naloxone in SH-SY5Y human neuroblastoma cells
http://jpet.aspetjournals.org/cgi/content/abstract/265/1/254

"The human neuroblastoma cell line SH-SY5Y was used to demonstrate morphine-induced down-regulation and naloxone-induced up-regulation of opiate receptors in a mu receptor containing neuronally derived preparation capable of desensitization to morphine. Chronic exposure to morphine decreased the number but not the affinity of mu opiate receptors in SH-SY5Y cells."

Here it is shown that baclofen reduces withdrawal and(interestingly enough) restores the restores mu receptor levels which had previously been decreased with morphine(receptor density)
http://www3.interscience.wiley.com/journal/109580729/abstract?CRETRY=1&SRETRY=0

Here it is shown with etorphine which is an incredibly potent mu agonist.
mu-Opioid receptor downregulation contributes to opioid tolerance in vivo.
http://www.ncbi.nlm.nih.gov/pubmed/11420091

3. The evidence on relapse rates is against you. The relapse rate is very high. Even the most dedicated ones(and they are naturally the minority) that make it through 5 years of heroin abstinence still suffer a 25% relapse rate.
http://www.highbeam.com/doc/1G1-77875249.html
There is no basis for your claim that they can merely 'stop' using. Again, if you could see inside you would not have said that.

4 My only tactic is to merely point out the grim facts. There is nothing here I say that cannot be found with just a few keystrokes on Google. Facts saves lives. It is first and foremost the ignorance of facts(by the western world in particular) that does all the damage and the deaths.

When you understand the changes that opiates(and other drugs) make to your body, it makes it easier to judge when to use them, how to use them and which ones to use or to avoid. This is especially important if you have to order them online from places that may dissappear any minute.

Upon reflection (and reading your profile), I'm thinking that you and I probably have a lot of interests in common when contributing posts to this drugbuyers.com discussion board even though we are on different continents and are familiar with possibly different drug treatment modalities.

Rather than continuing to debate the clinical differences between cell surface down-regulation vs. opiate receptor site growth which would take this discussion even further off-topic, I'll just stress one point that we seem to disagree on.

There is a considerable factual basis for my claim that substance abusers can (I never said "merely") quit using. I did. I have files of hundreds of other people who did and have successfully remained clean. While it is certainly true that relapse rates are dismal, they are not 100%. To even suggest that a drug abuser is somehow sentenced to a life of taking some drug to fill up a hole is a disservice to the thousands of people who work tirelessly as professionals in recovery programs and to the millions of people struggling every day to remain drug free.

Maybe the relapse rate is much worse in Europe and that is the basis for your assertion. In that case, possibly the structure of your treatment programs needs to be re-evaluated. But I seriously doubt that the introduction of medical grade heroin is the ultimate solution, however.

If anything I've said was construed by you as trying to turn you into an addict, I apologize. There are enough already without any effort by me to add to the ranks.

martind, I have to say I agree with you on so many points.

I don't know where to start and don't wish to type a book, but I do know that taking opiates increases the receptors, not decreases. I also know that it's disturbing for anyone to come to a site that has many many chronic pain patients, patients who are terminally ill, bed ridden, etc. and give them no hope for a better life. _99, obviously you are in Europe yes? Here in the US there are so many different opiates for so many different conditions that I don't think they'll ever have a pharma grade Heroin to use, not when we have methadone and subutex/suboxone to get off of any of the other opiates or Heroin or cocaine/crack, etc. Here, they also use low dose blood pressure medicine and low dose anti-anxiety medicines mixed with the lowering of the opiate so that the person isn't as likely to relapse.

Anyone can google, and I believe you won't find a better group of google users than on this site. Anyone who has to deal with chronic pain googles their condition, ways to treat it, the medicines they are on (I've googled ever medicine ever prescribed in the last 12 years or so, and that includes EVERYTHING, not just opiates or scheduled medicines).

I feel like you are either trying to take away hope from people who are trying to stop opiates now that their pain is gone, or you're trying to scare people into never starting. This may be the wrong site, as most people only find their way here after googling their conditions or medicines, which leads them to this site.

There is a misconception that even chronic pain patients can go without medicine if they really wanted to, which is what we try so hard to fight everyday here.

Two examples I've seen recently, even though one is fiction.

First - Let's take the show House for example. Very popular in the US, and since the lead actor is British, I have to assume he's popular in the UK also. Anyway, although the show is on about the 7th season, the storyline for the last year or so has been that he's an addict because he was taking 8 vicoden a day, even though his injury was horrendous and even his doctor friends agreed he would have pain forever. But suddenly at the end of the season last year they started to make it look like it was such a horrible thing, when we have significantly stronger medicines in the US than Vicoden ES and with his injury he probably should have been on them. The end of the season has him checking into Rehab. Well, what do you know! The new season starts and all of the sudden he's not in pain anymore. Now it's just "sore but manageable". Rehab has set him free! Do you know how that makes all the chronic pain patients in the US feel? To see a show where they know the main character is portraying someone with a permanent serious injury and now all of the sudden, because of Rehab, he isn't in pain, and is only in pain when he gets BORED? I love the show, but was sorely disappointed at the direction the writers went. They may have been feeling heat from somewhere about the fact that the main character was openly taking opiates to deal with a horrible injury and are now backpedaling to make it seem like anyone can deal with any horrible injury if they just keep busy and don't think about it.

How about all the people who can't even sleep at night because there is no such thing as a comfortable position? People who night after night are lucky if they can make it until 1:00 am or 2:00 am because of the pain and then they give up and get up? Do you know what THAT does to the inside of the body after a while? Try going several weeks with 2 hours of sleep a night and tell us how well you would function, when taking a pain pill before bed would alleviate that problem and help that person sleep so that they didn't always feel like they couldn't function?

Second example. There's a show in the US; a reality show about people who are or were famous and are addicted to something, whether it be alcohol, cocaine, prescription medicine, etc. The show shows them as they go through the process of Rehab. There was one particular man on the show, Jeff, who was obviously permanently disabled. He'd had more than a dozen surgeries, spent most of his time in a wheelchair or flat out on a bed, and they were trying to get him off of all opiates. They tried the first season but he "relapsed" (actually he'd had two more surgeries and all his medicine was prescribed by his doctor/surgeon). So they have him on the 2nd season and again they are trying to take all his pain medicine away and seem occasionally bewildered when he would lash out at people, or would refuse to go outside and sit around in the sun with everyone. He's a case of someone who is growing older, has severe pain, many surgeries and is the absolute strongest candidate for "give the man the medicine he needs and just shut up about it" that I have ever seen. And yet....you see the Rehab doctor going to his house and trying to get him to stop all opiates after his next surgery *sigh*. Geesh. Some people will be in pain for the rest of their lives and I can promise you they didn't want to be. Any chronic pain patient would tell you they'd rather be who they were before the pain started than pop a darn pill anyday.

I used to jog every single day, and had 2 hobbies that took up my entire day. Now, I just want to make it through the day without too much pain. I just want to be able to wash clothes the kids need, keep the house clean and keep myself clean without too much pain. I don't succeed but try never to cry in front of my family.

I've stumbled upon many of your posts in your very short time here _99, and there is a running theme to them. I'm sorry, but I don't think opiates are evil, I don't believe everyone who has to take them for a year or two and then stop because the pain is gone can't stop, and your scare tactics bother me.

It's a case of being in other's shoes. How many of us here have said "If the DEA could be in our shoes for a week they might leave us alone?" or "if our doctor could be in our shoes....etc.?". I wish you could be in our shoes for just a couple of days and see that even standing long enough to shower, brush your teeth, do your hair, etc. is enough to ruin your entire day before it even starts.

Case in point: Recently I watched a documentary about a doctor who was in an accident. He was used to telling his patients "this will sting a little" when he gave them a shot (I don't remember what type of shot). When he became the patient himself and had to deal with the shots daily until he got out of the hospital, he had a whole new respect and he said now he tells his patients straight up "This is going to hurt a lot".

If only everyone were empathetic to others instead of judgemental about what is going on inside our bodies, because obviously we haven't figured it out for ourselves, Life would be a better place. We wouldn't feel ostracized, we wouldn't be subjected to monthly urine screens, urine screens that are wrong that get people ejected from pain clinics monthly, etc. I hate pain clinics as they are out to get all the money they can from shots, nerve burnings, etc., but at least they would give some medicine to help you through the month. But if you have constant urine screens for years and then one comes up weird, you are thrown out, instead of being given another test. My test said I was taking Restoril when I was on Ambien CR. Have never seen Restoril and can't imagine it would work any better than Ambien so why would I need it when I got Ambien CR every month? And yet I was ejected. In fact, my urine screen looked like 4 different people's urine all mixed up! It wasn't fair to judge me then, by the same people who had been taking care of me for 4 years and I had never had a urine screen come up so wonky. Yet I wasn't even given the opportunity to have another urine test. I was simply ejected.

Life isn't fair, and gets even less fair when people in constant pain, with all the tests to prove it, are being scared to death with your rhetoric.

And sorry if I offended you, but that's my honest opinion after running across many of your posts in the last 2 days.

You are going to be put on ignore because I don't think you are being helpful to the community and you have pulled me and Martind way off topic. (and you've pulled other people off topic in other posts) So this may get deleted or added to the flame wars at the bottom of the page, but maybe you'll see this before you keep on with your campaign agenda...whatever it may be.

Wow Lynx...bravo!

I enjoyed your post and heartily agree, especially with your statements about "House". I'm surprised I haven't seen more posts here about it b/c it bothers me...a lot.

I also think that _99 often brings threads off topic and diverts your and martind's useful and informative advice. Unfirtunately I am doing the same with this post, so I'll leave it at that.

That is exactly why I described the induction, daily and weekly increase RANGES for you.

What was that about spectacles? And not reading posts?

LOL

Doses of course are dependent on how much the user currently uses. There cannot be a real standard number.