I have a fairly high tolerance to opiates, i usually take between 60-120mg of methadone for pain relief, 100mg of Tramadol every 6 hours. I am trying to find a substitute for the methadone and got some 90mg dihydrocodeine time release tabs. What kind of a dose would I need of these to get the same kind of relief? Anyone know? Thanks in advance!

well, from what I understand dihydrocodeine is inbetween codeine and hydrocodone in terms of strength, right?

well, I looked up how much codeine would be equivalent to 60mg of methadone and it told me 1500mg (thats 1.5 grams!!) so it would at least probably be around that ballpark. but honestly I don't think you'll get as much relief. methadone is a very strong drug.

Good god, I'd have to take 1500mgs of DHC to get the same relief!!!??? Wow...that seems a bit excessive, lol. UGH

So, lets say...I crush up, oh...6 pills taken orally, thats 540mg...is that even safe!?

I think someone else that knows more than me needs to come in here and say something. I've only had DHC once, I had one of the 30mg instant release ones.

if the only thing in them is dihydrocodeine and you can accept that much of it without overdosing I don't see why you couldn't.

search google and see if there are ceiling doses for this particular drug.

No it's not safe. Methadone will still be in your system and you could overdose on opioids generally.

It would be best to taper the methadone without using a substitute if you can. Switching from one opioid to methadone is done because it is safe. The other way round isn't, because of the long-acting nature of methadone.

Nobody has a clue what 500+mg of DHC does. If you really can't get off the last few mg of methadone, at least get it into a range where you can use clinical doses of DHC or codeine.

I have been off the methadone for 8 days now, I know of the extremely long half life of the chemical. But I still will have quite a tolerance. But don't worry, I won't be taking a 500+mg dose...that just seems crazy. :-)

It's impossible to gauge what tolerance you do have now, which is why just using one drug is often advantageous.

It's great that you've stopped the methadone, but on the other hand it's made things rather complicated.

I am prescribed methadone 25mg-4x a day, Tramadol 100mg 4x a day, diazepam 5mg at beditme, and just recently 600mg gabapentin at bedtime. The DHC's I got from a friend and I was just interested in trying them to see if they would ever be a good alternative to methadone. Since doctors can be wishy-washy and cut you off for no reason, I wouldn't mind having a back up at hand so I don't go through withdrawals for months on end as I've been on opiates for about 2-1/2 years now. I can say with almost 100% certainty that my doc will not cut me off, because I don't abuse my meds, call for early scripts, all that [censored], but you never know. Anyway, thanks for the info

Meant to say i take between 60-100mg of methadone for pain relief, not 120, lol.

Are you saying you discontinued a 60-100mg/day dosage of methadone 8 days ago?
How are you feeling?
Why did you stop taking this medication if it was regularly prescribed to you by your doctor?
That is an extraordinarily high daily dose of methadone to discontinue even with continuing Tramadol.
I'm very interested in your experience accomplishing this.

Me too. I am prescribed methadone also and the doctor may decide to cut everybody off. I heard this from people in the waiting room. One person told me that he plans on doing it to everybody. He hasn't done it to me yet, but I get nervous when I have my visits. Keep thinking it will be my time.

I never seemed to get that bad of withdrawals from any of the opiates I've ever been prescribed, which is most of the regular ones ( vicodin, percocet, oxy IR, etc... The first 2 or 3 days I just felt like I had a cold, then after that I was fine, minus the wrenching pain in my back. I recontinued the methadone last night after learning that the DHC is not a viable option and not being able to stand the pain anymore. Guess I'm one of the lucky ones? hah...

I would say you are one of the very lucky ones.
Still don't understand why you would just discontinue a methadone dose like that abruptly though.

I discontinued because I was going to test the dihydrocodeine as a backup medication, but after finding out that it wasn't potent enough, I went back on the methadone. Yes I was in pain for the days I was off it, which sucked, but if it had worked out, I would have had a backup, but it didn't, lol

If you find yourself out of methadone but with a more usual opioid, the only safe way to use it as a backup is to wait for withdrawal symptoms to begin, and then take the backup med at 'normal' doses, every 2-6 hours of so (depending on the drug), until you feel the withdrawal being attenuated. Then just try to formulate a regimen based on this, taking as little as possible just to keep you comfortable. A titration upwards, in other words.

DHC could be used, but it's the manner in which it must be used that makes it difficult.

But to try to equal methadone with one dose is not viable.

I'm just sticking to my methadone regimen, and will find an alternative if the time ever comes (hopefully it doesn't).