Methadone 60mg: the blocking dose for heroin treatment

Should methadone clinics support lower doses of methadone for patients being treated for opiate addiction? Or is methadone 60mg the analgesic dose needed to treat opioid abuse? Dr. Burson lets us know taking less than methadone 60mg can sabotage opiate and heroin addiction treatment

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Methadone dosing treatment

In the past, methadone clinics mistakenly tried to keep the methadone dose of their patients as low as possible, and rarely went above sixty or seventy milligrams per day. Since that time, multiple studies have shown that patients on low doses of methadone hydrochloride are more likely to drop out of treatment, or keep using other opioids. Now, good opioid treatment centers try to get their patients to a blocking dose, so that patients get the maximum benefit. Like chemotherapy, if a patient is going to use methadone as a treatment, they need to take enough for it to be effective.

Not understanding the optimum doses for methadone, many family members will pressure the addict to reduce their dose, mistakenly thinking that if they have to be on methadone, the less, the better. However, studies show that patients use less illicit opioids if they’re on adequate doses of methadone.  Patients on sixty milligrams of methadone or more are more likely to be retained in treatment for their addiction.

Semisynthetic opioids discussion

Patients being treated for opiate addiction do better with adequate doses of methadone.  This is why methadone 60mg has become the standard in methadone maintenance treatment programs.  Still, methadone can be harmful if not used properly. And methadone 60mg is not the only or the best answer for every opioid-addicted person.  See a list of effects of methadone here.

But what do you think about the 60 mg dose of methadone?  Has methadone 60mg worked for you?  Are the effects of treatment with methadone worth the outcome?

About the author
Jana Burson M.D. is board-certified in Internal medicine, and certified by the American Board of Addiction Medicine. After practicing primary care for many years, she became interested in the treatment of addiction. For the last six years, her practice has focused exclusively on Addiction Medicine. She has written a book about prescription pain pill addiction: "Pain Pill Addiction: Prescription for Hope." Also see Dr. Burson's blog here.


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  1. My name is dozer. When I was 17 I got hit by a drunk driver, I fractured c 1 2 and 3. fractured my collarbone, smashed my left arm up terribly, 8 fractures, needless to say I barely lived through this car accident and I was airlifted to a trauma center where I spent at least two to three weeks in that hospital. I wasn’t on a morphine drip I was in so much pain, I was on around-the-clock therapy and basically had a huge IV going into my main artery and every hour I would you get 6 mg of morphine sulfate intravenously the following hour hour I would get 4 mg of IV fentanyl along with OxyContin sustained action 80 mg,two tablets four times a day. I stayed on oxycontin and dilaudid as well as fentanyl patches for a 8-9 month period after I came home from the hospital, but by the time I could move my arm doctors just cut me off of everything. Being 18 years old completely naive and Young I thought nothing of it. At first that was fine by the second day I was doing a little bit crazy by the third day I was in such terrible withdrawal I was begging my grandfather kill me I had broke the couch that I had rested on but I was violently kicking, moving and flaring around so much my
    and my mother did not know what to do so she called the doctor and he said oh I’m sure he’s fine he’s probably just experiencing some mild withdrawal my mother was like mild withdrawal dear God what’s going to happen when it really hits them to make a long story short luckily my mother over the year that I was getting my scripps she had saved a little stockpile of medication. being that I was in such a bad state defecating on myself pulling my hair out punching my head she gave me what she had stashed away it was at that point that I put my name on a waiting list for methadone maintenance. Bear in mind it was a two-year waiting list I thought to myself I could be dead by then. Anyways back then the doctors in the regulations were a little more lenient and your first 30 days could go up 150 mg by the time I got up to 150 I knew I wasn’t at the right dose so I went higher I wound up leveling off at about 220mgs/30. the thing is I was back to being myself it felt good. I stayed on methadone for 7-8 years and then I went to prison. After prison I stayed clean from everything I didn’t do nothing I turned my whole life around I studied martial arts you got a black belt in shotokan karate and the guy that had a full-time job full custody of my daughter. One day I came home from work early found my girlfriend why I loved very much sleeping with another girl,that look like a boy. Go ahead laugh all you want when people hear that story they always say what’s the big deal if it wasn’t a guy well it’s different when you’re not invited you’re raising a family,….it wasn’t long after that I had relapsed my addiction was extremely out of control, and now that I had been in prison, and I was a beast and I was a skilled fighter, but I wound up back in the street,at that point that I put my name on a waiting list again. And just like before it was a 2-year waiting list. Anyways unlike back then the doctors in the regulations world little more loose, but once I finally got back on, the guidelines were so much different due to all these young kids with lortabs habits and Percocets and instant release oxycodone which is a joke,,.. LMFAO,compared to the real oxycontin and at one point I was taking 800 mg of MS contin a day and that’s stamped and sealed PF on the back of a hundred on the front anyways now I’m on a dose that is not holding me, and it’s terrible. I think it’s ridiculous about this hysteria over the opiate epidemic, personally if you know history at all the opiate epidemic has been around since the first time sun came up. Worse yet, the people that are making new laws have no idea what they’re doing. Demonizing opioid dependent people, are people too and everybody in this country as some form of civil rights adding to everybody is supposed to be equal especially nowadays but everybody has there rights except those of us who have been labeled heroin / opiate addicts. And now that every doctor from your the Egypt to scare your right eye prescription 4 Tylenol 3 is not helping anybody just making people forced didn’t have to use heroin which is provided by the government as well to get pain relief or just to get to work and on their way to work the pass at least a handful pharmacies all of which contain enough methadone to hold even me so I’m very long time and it’s cheap as hell to make instead we have to parade in like cattle two clinics. Making new connections and using different drugs because now the methadone doctors in the clinics don’t even want to give people who have serious tolerances therapeutic doses I’m sorry but that’s really sad cruel demoralizing painful and I often feel like if I would just have connections in the government or millions of dollars I could just buy my doctor and instead of being a plethora of other meds told me I could literally be on two or three without having to go anywhere for my kitchen cabinet.all they’re doing is criminalizing people like myself who really are just opiate dependent. I personally would like to see some particular doctors with their extreme viewpoints have them become a opiate dependent individual even for just 2 months, and turn around and still hold the same opinion that standpoint on this whole thing because in reality they’re in the f****** dark, and in a country where you have phones that can talk back to you you should be able to get the right amount of methadone and you should be able to do it in a private setting even if you’re just an average dozer, but unfortunately money talks unless you have connections or you know what else,my grandfather would say the Golden fleece, your s*** out of a lock. So, I find it ironical that the reason I was at her exposed to such high amounts of synthetic semi synthetic Andre Lowe. It’s such a young age was directly due somebody under the influence of the worst drug, in my opinion on the planet,alcohol,right at the corner store and it’s cheap, and statistically all Costa tistics there is alcohol kills more people every year than all the illegal drugs combined God forbid you tell that to trust the old small town fireman,”cuz all that matters in life is having good job working all week and pain your bills as long as you do that drinking alcohol it’s completely fine even though makes people in the monsters makes people think they’re tough makes a man hit a woman money normally wouldn’t makes a woman cheating on husband when she normally wouldn’t on good fun night as long as you got a job that’s okay.must be nice. quite frankly I’m getting tired and hurting for 5 years on 140 mg and I should be on 340 mg it’s really sad because there’s so many medications different types of opioids that I could use that would be give me a life I would have freedom but instead I have to go to a clinic every single day to get medicine that is in every pharmacy from here to the other side of all the multiverses.

  2. I’ve been dosing St medmark treatment centers in the northbay area Vallejo ca I tried to kick heroin jaunuary I could not do it so I finally went to a methadone clinic is very been in every line almost prison chowline now a methadone line at first I was hesitant buy now it’
    s December and igr been clean ever since match and im already getting 2 take homes I’m on 50mg and it wome finished keeps me from being sick and now I have my lif heck in my hands no more waking up sick and trying to get well

  3. BLOCKING dose? Eh. There aint a dose of Methadone called blocking dose of Heroin. Buprenohin on the other hand. Shouldnt you know this

  4. Ive read some of the comments and most of u are smart enough to believe that there is no magic dose of methadone, which obviously i agree with. However i do think when an individual reaches say roughly 80+ mgs that other opioids, in my case heroin, no longer are as effective as they “should be”. Even tho it doesn’t “block” opioids the same way bupe does, it does occupy the receptors in the brain efficiently so that when other opioids are ingested, they cannot bind to receptors as well as if one had not taken methadone. Methadone is what’s known as a jealous opioid. Once opioid receptors are occupied by methadone, it makes it difficult for other opioids to attach efficiently. This means that once a person is on a saturating dose of methadone, other opioids tend to not be very effective. I assume that saturation doses vary based on ones drug abuse history, weight, daily usage amount, etc. Now to the person who said their clinic maxes clients out at 100, that totally sucks and i hope u are on a sufficient dose that keeps u from needing to use and cravings minimal. Ive never heard of clinics setting a limit but i dont see what u gain from making it up. Anyway, i just started yesterday back on the methadone clinic. Ita been about 7 yrs since i was last on it. I can only increase when I’ve been on a dose for 3 consecutive days. The take home dose can not be the increase so whatever u take on Sat. Then thats what mg u get for Sun. The doc sets a max dose u can go up to. Mine was set at 150mg n all that means is i can stop whenever i want but in order to go above that i need his approval. Everyone’s max is set based on what they use, how much, n for how long.

  5. 60 mg, for me, was too low. Wether that’s because I shot 4 grams of heroin per day for five years, or because I have an insanely high tolerance, I’m unsure. But, as I said, for me personally it was too low. I leveled off at 132 mgs. I’m a 41 year old female, and upon entering my local clinic, weighed 129 lbs, and am 5’6 inches tall. I’m also not sure if height, weight, or sex have to do with it either, but I figured I’d post my stats in case. Good luck!
    Ps- Since I’ve stated things I’m basically unsure of, I will state one thing I am absolutely sure of and that’s: Methadone saved my life. If I’d never gotten into the program I know I’d be dead. God bless…

  6. I am an addict with 31 years of continuous clean time. The truth is, you can’t treat a drug addiction with another drug. Argue all you want. I’ve been “boots on the ground” in the recovery community for decades. I have yet to see anyone that uses a methadone clinic succeed in recovery. Why? Because every addict goes there because they don’t want to change anything. They want the easy way out of their addiction. However, going to the clinic gets them further into their addiction. I’ve seen it all too often. I’d like one of you “doctors” to explain to me why it is a good idea to give an addict more drugs? It makes no sense whatsoever. No more sense than borrowing more money to get out of debt. The people are being scammed. It’s all part of the medical cartel that sucks every penny out of anything they can make a buck off of. I have an idea….put every drug dealer (on the street or in a clinic) that is apprehended on 120mg of methadone for two months and then put them in a room to go cold turkey with no toilet or sink…..just four walls a floor and a ceiling. I’m tired of the BS that the medical community throws around. These clinics are hurting people. They are keeping sick people sick. In some cases, they are killing people and ruining families with their lies. Time to pull all of your heads out!!!

  7. Then y do they let you get to 150 mg.. let you be there for 7 years, yes it was my choose. I thought they new what was best. I was an addict when i went in, im coming off of it From Indpls. IN iTC

  8. I can only speak on my experience but I am currently on a 80mg dose and found that to work best for me. I’ve been lower and I’ve been higher both were very ineffective in my case. At a lower dose I was miserable more toward the end of the day and at a higher dose I couldn’t effectively do my job at work. I must add that at this dose I have not relapsed in over 3 and a half years. The only drawbacks I can honestly say is that when your on a maintenance program after awhile you start to question the reasoning why its needed at all, with that said I believe that occasional meeting along with proper dosing is much needed. What ever kind is up to you. AA, NA, or just an average “group therapy” type meet is sufficient. Just to remind you why its working, if that makes sense? I hope this was helpful. Thanks. Good luck. God Speed.

  9. I have been on 100mg for about three months. I am stable. but I am suddenly gaining weight. I mean the first thirty pounds was needed the second I am trying to fight off. I have been thinking of cutting back my dosage as I feel it is directly responsible for the weight gain. With out being too graphic, I fell the increase in meds ( i was at 60mg) has clogged me up a little… I am going to try a cleanse and see if that helps clear things up. While I have never had a problem before, its like mud now. I cannot attribute it to anything else. Thank you for listening… Rob

  10. If a person established in opiate consumption takes enough opiates on a daily regimen to not feel withdrawals they will become adjusted to that dosage and eventually it will take more for them to feel the same results. So when they say 80mgs of methadone is the blocking equivalent, what they mean is that 80mgs is enough to keep the substance in your system for 24 hours to not feel the effects of withdrawal. If a person takes 40mgs of methadone, during the 8 hours that the effects of the drug are lasting, it is still a blocking equivalent for that time, but after 8 hours a person may be able to feel the effects of another opiate as the methadone is fading off. The important factor to realize is that at the 80mgs blocking dosage a person will not be able to feel the euphoric benefits of the drug eventually because they are effectively blocked in their brain chemistry until they take the next dose. That is the goal for some treatment centers so that a person is not feeling the ups and downs of the drug all while they are under it’s influence. But is that Really quality of life? At one point I was taking 90mgs for 5 months and I got used to it. I was not feeling the effects from the methadone anymore because I was at a blocking dosage. Eventually a person would have to go up in dosage to feel any effects. I later experienced what it was like to be used to 90mgs and stopped taking any methadone without tapering. I had help from oxycodone but experiencing the withdrawal from methadone for 3 to 4 weeks was more than I was anticipating. Fast forward after seeing that being totally sober in the hospital I could not stop throwing up for 32 hours straight, so now I am taking 70mgs of methadone, and every morning I feel the withdrawal symptoms coming on before I dose. However this appears to be crucial for anyone taking opiates because of this complex brain chemistry situation. What a person truly desires is to feel the pain killing benefits of the opiate. It is the experience of being dope sick and then becoming well again which enables an experienced user to feel this miraculous medicine. Some others disagree but I believe it is correct to be on a dose where you feel the effects of withdrawal starting before your daily dose, because if you take more it will create the blocking mechanism and you will not feel any effects, and you will eventually need more anyways after getting physically used to it. Why would you take a drug if you don’t feel anything from it? Yes we need it to save our lives but mentally it does not make sense to take a medicine without feeling the effects from it. Life is not going to be easy, after all we are addicts, but to be effectively blocked 24 hours a day in our neurons is not the right way to go in my opinion.

  11. I’m 29 years old I been on opiates from the age of 23 to 27(I had them prescribed which is why I was able to stay away from heroin for so long) and then every pain doc I would get would eventually get arrested so I was left with no doctor at the end of my 4 year run. That’s when I met heroin and starting using it even tho i always used to clown the guys that did heroin and there I was becoming a full blown heroin addict. For 2 years I was on heroin my life and luck was at its all time low. From detoxing in jail and several other detox facilities that only lasted a week. I’d be clean for about 3 to 6 months b4 relapsing so as of last year I got sick of being a slave to dope and signed up for a methadone clinic. Did it help absolutely but at the same time u need to remember u don’t want to be there as long as a majority of people do going there for. 10, 20, 30 years and basically never getting off because it’s harder to stop then Heroin. I must say that even though the Methadone clinic has helped stopped the cravings I really wish I would’ve tampered off heroin by using small amounts of methadone like 30mg a day and decrease my week so that ur done within a month. That’s how they did it in jail and I came out of jail in 2 weeks and stayed clean for 6 months. After experiencing that methadone works thays why I decided to join a clinic, again big mistake I should have went to a detox that gets u off the Methadone within a month.

  12. I don’t know .. all I know is that I am trying to get my life back.. from taken ..dang pulls again iàm o. 60 now I don’t know how to act on this meds

  13. Yes I am all for an alternative for a different drug than methadone but if a doctor who only reads literature and doesn’t know what it feels like too go through withdrawal especially in methadone is a complete idiot and really doesn’t care about patients who suffer a lot coming off of the drug who want too immediately put them into withdrawal

  14. Yes I agree at the moment I’m at 50mg and before I was at 80mgs at a different program and that is when I couldn’t feel very much from bagging heroin out i would have to shoot 6 bags and at that point it’s pointless and to expensive I look at it as there is no magic number it’s what works for you doesn’t matter if your at 25 or 185 whatever works for you and I think u should be comfortable for 30hours I feel like if u are still using u need to go up if u are waking up feeling all off you need to go up . Not enough people give it the time for methadone to work u can’t just jump on 80 mgs methadone is very strong and there even a bundle a day user iv can overdose off starting 80mgs of methadone I think if u use that much u should start at 30mgs and work your way up every 3 to 5 days and I look at it as 20 mgs to 55mgs is the dose where your stable not sick 60 to 80 is the dose where your cravings will start to diminish and I feel 80mgs and up will start to become total narcotic blockade and I mean it people I’ve been on suboxone many times and for me this is my second time on methadone and it works a lot better seems to be cleaned the staff seems to care more and if you make a mistake they don’t just throw you out the program like suboxone clinics will and basically tell u to go back to using . Anyways I’ve been shooting dope for 6 years and if my opinion matters I think methadone is more effective I just think it takes alil more time and effort to get to where u want to be methadone clinics are therapeutic be strong people have faith and never give up it’s up to u not anyone else to fix this and takes strength and courage but very possible and always remember we have it good to have medication to help people have it a lot worst doesn’t matter if u are homeless right now there is always someone who has it worst be humble be forgiving, you have to forgive yourself and you will be ok

  15. I will say I’m strongly against the naltrexone implants. I had one 10 years ago and it was the worst experience ever. Its put into your stomach under a genersl anaesthetic and your stitched up and told there’s the door…….no counselling offered or group support. So all you do is try take more gear so you can feel it over the impact…..or turn to other ways to get high. Addiction is the affect or deeper rooted issues so to if anyone every contemplates an implant please line up some support and counselling to deal with the emotional side.

  16. Some great points were made by doctors in this feed and it’s a relief to know little damage and side affects actually do take affect when on methodone. Here in Australia we call methodone ‘liquid handcuffs’…. It does work but it’s so hard to jump off. They can have up to 3 takeaways per week max and it’s $5 a dose. It’s quite annoying going to the chemist nearly every day and I’m on 50mg. It’s definsteky better then the alternative and cheaper but it’s a shame that this is more addictive than the alternatives…..I don’t know what the answer is. Legalise some drugs and distribute in controlled amounts, supervised? The crime rate would surely plummet?

  17. Back in the 70s, I had access to illicit Methadone from clients on a program who sold their dose on weekends, when they had “take-homes” I would buy what I knew was a genuine 80mg. dose and stayed wasted for more than 2 days. I was not an addict otherwise, and risked death every time I did this. Now, much older and wiser and after decades of opiate addiction, I finally got on a legitimate program. Started at 30 mg. worked my way up to 110 mg. and gradually came down to 60, where I’ve been stabilized for 2 years now. I anticipate being a “lifer”, but I lifer on Methadone at proper dosage levels will suffer no harmful side-affects and at 60 mg. will not even get high, but will remain addicted to the Methadone. A much better alternative to being addicted to illicit narcotics. I say this based on personal use and experience.

  18. I have recently started the methadone program I’m finally at 60 millagrams but I’m still using heroine cuz I feel like shit when will I start feeling better I go up to 70 millagrams tomorrow please write me soon with advise

  19. I started methadone 6 days ago on 30mg and the. 40mg for the rest of the week . I am doing a 21 day detox. But I am not doing well. The methadone was not working at first so I kept using , and here I am 6 days later on 40mg and still using . I tried today not to use but the detox was even worse then before . Tomorrow, I was thinking of asking the doctor to raise my mg and therefore I would not be on the 21 day detox . Does anyone have experience with this ? I’m afraid that I now have two addictions going . If I raise my mg, would the detox stop ?

  20. I am a 2nd year medical student and was a paramedic for 14 years. I’m also a recovering addict. I became addicted to opiates after an accident which led to chronic use of opiates. My story of how I became addicted is very common. I’m now on MMT at 65mg. There is no way that I could be a medical student if I wasn’t on this therapy. Everything on this blog is true. The physical and psychological problems are all correct. What I see that hasn’t been talked about (unless I missed it) is the underlying issue. Sure some addicts are addicted because of the high itself. The majority of addicts have an underlying problem. Addiction isn’t the problem it’s a result of a problem. I believe that the underlying condition must be addressed in order for the addict to really be able to let go of the addiction. Take my situation for instance. Yes I began taking opiates due to trauma but once I was addicted pain no longer was the cause for my use. The short story is that my accident caused several psychological issues and I masked those issues by being high. I tried to quit several times but the underlying depression was still present. Once I began to address the underlying problems as well as the addiction, I was able to succeed. At least as of right now. I still have 2 years to go before I’m done with school. I’m assuming that I am likely to go crazy any day until then! 🙂

  21. Ive been on methadone and heroin for 27 years. I live in North England where methadone and suboxone are freely prescribed by doctors and drug clinics and the heroin is Turkish brown street gear which I preferred to smoke, though I have injected for several years in the past. I’ve done several cold turkey withdrawals off both methadone and heroin due to a few stints in prison and believe me it doesn’t matter whether you take 5 ml per day or 50 ml per day the rattle (withdrawal) is the same. It usually takes about 4 weeks to get the initial turkey out of the way and a further 3-4 months before any semblance of a sleep pattern returns . Because methadone has a long half life the first 2 weeks are by far the worst. No sleep for the first 2 weeks, and I do mean NO sleep. Not even 6 minutes. The worst restless legs, cramps,aches,runny nose,eyes ass etc. Throw up and crap yourself at the same time as sneezing 25 times in rapid succession. Your skin feels like it’s inside out and covered in butter mixed with sand and wrapped in cling film and when after 14 days you do manage to sleep, those precious 6 minutes are filled with the most vivid drug use dreams you can imagine though you NEVER actually get to use the drug (in the dreams that is) and when the muscle spasms and vomiting subside,and the pulsing hot and cold sweats deminish, you enter a new phase where every emotion you ever experienced is smashed against every other untill you sink paranoid and shamed into an abyss of guilt that wraps your aching body in a quilt made entirely of sweat, your sweat, all 9 and a half litres of the stinky fluid purged from the dank clammy folds of your body. Nothing tastes right, everything smells weird things feel different but not in a good way.Anything you drink is pissed out within minutes,,,everything you manage to eat tastes and smells like meat and potato pie……then just as you’re seriously considering suicide ,,,,you fall asleep. Bliss. Heaven. And when you wake 18 minutes later you notice through glassy eyes that your Tee shirt is actually dry,not drenched in sweat like it has been continually for the last 23 days and nights.! You can smell bacon cooking downstairs instead of the rank odour of bad feet that appears every time you put on a clean set of clothes?????? . Yes my deflated little wretch, you are on the mend. Soon you will notice your jeans don’t fasten around your waist. Every Tee shirt you own makes you look gay.,! And by Christ you’ve developed muscle mass. You look into the mirror and see a human being gaze back. A far cry from the guy who looked like an extra from The walking dead that had accosted you for so, so ,so many years. So this time I’m using methadone as it should be used, No heroin on top. A steady reduction from 50 ml down to 10 ml per day then a measured switch to suboxone where I hope to reduce at a reasonable rate untill I can dose every other day, then at long long last OFF… Begin living my life. For my family . But particularly for myself. Good luck people x heroin really screws you up and give it a chance it will take your life.

    I started on 40 ml oral linctus methadone nearly 3 decades ago but because I enjoyed heroin so much I ended up using on top of my methadone. I’ve been as high as 130 ml per day oral methadone but that was many years ago before such high doses were seen as too high. Now I’m on 50 ml daily tho recently I relapsed and started using heroin on top. I genuinely find it nearly impossible to get heroin use out of my head regardless of the methadone dose so I’m seriously contemplating switching to subutex which I guess is what you guys in the US call suboxone…?! The reason being, Suboxone had a blocker in it which I believe prevents heroin attaching to the receptors and in actual fact can make you feel very unwell if you do use gear (heroin) . This appears to be the only solution for me does anyone else have this issue.¿?

  22. That’s actually accurate at least for me. I’ve been in the methadone clinic for 6 years and my dose is exactly 60mg they started me at 40 I went up to 93 realized I was too high and went down to 60 now I’ve been perfect at this dose I have not used anything but my dose in the 6 years I’ve been in the program I have my life together I have a full time job just got a promotion have insurance a house a new car and am looking to do IUI to have our first baby so ya to me 60mg of methadone is perfect it saved my life.

  23. I Have been have been in methadone treatment for 5 years now and i have been at a 50 mg daily dose for quite some time now and it is working great for me. I am actually looking at getting totally off methadone because i having been experiencing problem obtaining employment being on it. Like for example: If you want to get your CDL to drive commercially, you are unable to because Federal regulations wont allow the DOT Medical Examiners to pass you on your physical exam. Methadone is the only prescription that you can’t take if you want to get your CDL. I call that discrimination in my book!!!!

  24. Methadone does not truly block opioids like buprenorphine does. Buprenorphine blocks by having an extremely high binding affinity for the opioid receptors, so much so that if it is taken when an addict is not suffering withdrawal, it will forcibly remove the opioids occupying the receptors, precipitating withdrawal until the buprenorphine begins filling the receptors.

    Methadone is a full agonist with classic morphinan effects, and its perceived “blocking effect” is actually from it raising ones tolerance to a level where conventional opioids like morphine in conventional doses have no effect

  25. Hello! I’ve been on MMT for 12 years now, and have been trying to taper off for a few months now. I’m currently down to 25 mg/day of oral methadone, well actually they are methadone tablets called Physeptone.

    12 years ago, I began at 30 mg/day of methadone, so now I’m a bit lower than my starting dose. Before I started, I was using two bags of pretty weak powdered heroin a day, one in the morning and one at night. The dealer was cutting the crap out of it, I’ve had powdered heroin which seemed to be a dozen times stronger. These bags were $50 bags, which I believe here in Australia generally means 100 mgs of powdered heroin per bag. So that would be 200 mg per day of powdered heroin that I was taking.

    What I want to ask, is if my MMT starting dose of 30 mg is a pretty standard equivalent to 200 mg of weak powdered heroin? I’m just trying to get a bit of an idea how much opioid my current dose of 25 mg of methadone is. Does 25 mg of methadone equate to much heroin?

    By the way, when I was talking about powdered heroin above, I am talking about IV administration.


  26. I have been on 65 mg for about 2 years and it is working for me but it took a while to settle in on a dose long term. When I took less I had thoughts of needing to back it up with something else and when I took more I was comatose at times nodding out and scaring my family

  27. I was not at a blocking dose until 85mg. I am on a dose of 100, but still am sweating and vomiting and sneezing every morning due to withdrawals. My clinic has a 100mg limit and no split doses. And they say since I am a tiny femal I shouldn’t need more than 100mg. That is not even how it works. It doesn’t go by size. Different amounts will help different people. At 100lbs and 5ft tall I had a 4-1/2g a day iv heroin habit. I have a huge tolerance to everything like alcohol or even lidocaine at the dentist. There needs to be some serious education and policy changes in this field. Dosing caps should be illegal.
    Thankfully I have reached my 5 year clean mark even with the severe morning withdrawal, and I just took my first step down. Hoping that in two years time I will be free of this med. but that is not to say it has done anything but save and completely change my life when nothing else would work.

  28. I was on the program for 6 years at 120 mg for the last two. I prayed for help to get off and the same day was in an accident totaling my car. When I went in to get it fixed the guy who ran the shop was an old dope fiend who happened to be clean and he helped me get into detox. I had a stash when I got out and needed it but got down to about 20 mg in 40 days. I spent 10 days in a detox (not nearly enough) then flew back to Hazelden Drug rehab renewal center for 10 days. They only took me because at one time I had long term sobriety. When I got back from Hazelden I got some Clonidine and something to help me sleep and with cramps from the VA. My body took years to recover, my mind longer but, I’m almost normal (completely healthy) now, working, happy and mostly positive. It was a long road but worth it. That was in 2008 and I’ve been clean ever since. Next to prayer finding a good support group was invaluable.

  29. I’m on 80 mg. I felt stable at 60 but it was expressed by the clinic Dr. to go a little higher. 80 seems to be fine except I’ve gained 55 pounds and I sweat my ass off. I crave sugar non-stop. I do eat healthy and exercise as much as possible. I was fine for the first 8 months and then I was laid off from work and had surgery. After that I just started gaining. I have tried everything but can’t lose weight and I also sweat like a pig. I am ready to come off methadone so I’m hoping these negative effects will reverse. As far as dosing, I can’t imagine people needing to be over 90 mg. I was using 1-5 bundles a day. Whatever I could get my hands on. I know everyone is different but people over 100 seem to just want to get high off methadone.

  30. I am currently on 70 mgs. of methadone and it seems to be working fine as far as cravings and as a blocker. I have tried heroin not long ago and it is effective in blocking the opiate for sure. I wouldn’t recommend anyone doing that but I was just trying to prove a point. Even my counselor at the clinic was glad that I did not feel the effects of the heroin.

  31. I’m currently at 60mg a day and I’ve been clean from Heroin for 2 weeks now. I think 60 is the perfect number because I still felt the urges at lower doses and now I can go about my day without even a single urge to go back to the dark side. I have seen the light and I will never look back!

  32. Methadone saved my life after 20 years an addicted herion user i couldn’t believe the results i got that first day i got on the program hangin out in da morning for my shot i drank 30mls of methadone and kicked back within a hour my symptoms stopped couldn’t believe it now been five years haven’t been back to jail in that time i don’t do crime anymore im back in my daughter’s lives as a good role model and guide for them.Complete 180 turn around i was so close to doin the brick in jail so close to blowin my brains out so close to doing more armed robberies my ol school people see me and are like wtf bro you look great ya just disappeared off the map.And i intend to keep it that way THANK YOU METHADONE GOD..If your lifestyle sounds a bit like my old one get on the program brother’s and sisters. Straight up 100 per cent

  33. Been in treatment for around 7 years. I peaked at around 120 mg that stopped my opiate cravings but that did not work because I was nodding out and it upset my wife to see me with my head in a plate of spaghetti. I have now been on 60 for 3 years and its working. My wife has pain medicine in the house now and I don’t touch it! Very happy about that!

  34. I am a doctor with 20 years of experience in addiction medicine. Dr. Vorobiev. If you are truly a Dr. and have experience in addiction “medicine” then I truly feel sorry for your patients and your blatant made
    up “truths” and lies. How does Methadone “destroy the body” also just to let you know doc Methadone is a OPIOID NOT a OPIATE, how can a real doctor not know that!?! Please do some research and cite your sources credible ones, if there were any sources to even begin with all you’re providing is anecdotal ideas that you have heard or formed based on certain patients. Jana I’m glad there is one doctor who’s willing to look at different perceptives and research real statistics and facts. The only part I have to disagree with is the 60mg “blocking” dose, Methadone at any dose does not per se “block” you from getting high on opiates, unlike Suboxone in which does truly block other opiates, Methadone fills those opiate/opioid receptors the affinity to (I believe) the Mu and Kappa receptors is very effective the brain therfore has those almost completely filled, that and the tolerance of taking a daily dose of 60mg of Methadone makes it so if a addict uses they would feel very little, hence why a lot of MMT patients stay at 15-30mg cause they know they have their dose for the day and if they can get some opiates then they can get high, now after saying all this, I was on Methadone for 4 years from 100mg to the majority of time being on 50mg, I believe it very well may have saved my life but from my point of view, Methadone is itself as a substance can be very helpful but the clinics that dispense the Methadone is where many problems come in, during my 4 years I went to 3 different clinics, since they are for profit, most (this is just my experience, the counselors are way overloaded and are lucky to even have the time for a 10-15min check in and that’s only if you request it, the turnover for CADC and LADC at every clinic I went to was crazy, only a handful would last more then 6 months, which sucks for the patient, I had 4 counselors in one year, you explain to them your goals, triggers, your hopes,fears then BOOM, they throw you to another person who you’ve never met, after a while it’s like why should I even try to form a close relationship, then the RN’s are always pushing for a dose increase, you go to the window and they say “how do you feel” if you had a stressful night and say “oh, I didn’t sleep so great I was stressed” “Well, have you thought about going up on your dose?” I’m very neutral on Methadone, because even through it does work, too many people who could probably stop using a few Hydrocondone 10mgs end up on 150mg of Methadone which is far worst to have to detox and recover from and the lessened withdrawals are true but I’d rather detox off Herion,Morphine, Hydromorphone, Oxymorphone, Oxycondone,Oxymorphone then Methadone any day, with coming off those opiates/opioid it’s 3-5 days of absolute hell but then you start feeling quite a bit better, with Methadone it just drags on for so long, I can honestly say It was 14(ish) days of anxiety, sweats,cramps, hot/cold flashes, insomnia very lethargic, before I started to feel “normal” and even that was only about 60%, it was about 30 days til almost all the major physical symptom subsided, now I’m not anti-Methadone, its saved tons of life, stopped lots of crime, let people work, go to school, life a functional life, but at the end of the day, you are still addicted/dependent on a opioid, if you can’t stay clean and that works for you, I’m glad, I just want people to realize there needs to be a bit more education and warning about how potent of a medication they are switching to and with anything there will be people who want to get better and stay at a stable dosr, pass their U/As, use there takehomes, go to groups, then you have the people nodding in line, talking about smoking crack,meth swallowing handfuls of Xanax, Valium, or Klonopin, its certainly is great to have for certain people but it can be abused and I’ve met lots of people that had no idea the potency of it and what they had traded their smaller addiction for.

  35. I don’t what ppl would call me but I was put on opioids about 18 years ago for pain and as the pain got worse the more pills I needed which led me checking into a methadone maintenance program.i was started at 25mg and increased up to 70mg before I was stabilized at that dose for 3 years.My family PCP found out I was driving 60 miles each way for treatment and offered to Rx me methadone at 60mg per day FOR PAIN.(I was in legitimate pain) The 60mgs split up into 20mg 3 x a day HELPED with my pain (I found other drugs such as hydrocodone worked better ) but being on 60mg I could take 50mg of oxy/hydrocodone and no relief. This was in 2005 and it’s 2016 and now I take 40mg a day and other “breakthrough” pain opiates still don’t work. Another patient I know is Rx’d 30mg of methadone and tells me 7.5mg of oxycodone gives him relief. So in my opinion they are dead on with the theory that 60mgs of methadone a day will keep cravings away and will keep you off of other opiates because they simply DO NOT WORK at that dose.

  36. I’ve been a heroin addict for 3 1/2. About a gram a day IV. My doctor started me at 20mg of methadone a day which was not helping to much and so she put me up to 30mg of methadone (3 10mg tablets) a day and she absolutely will not up my dose. I’m still not well enough to get out if bed but I do not have restless legs and am willing to sleep…
    She will have me on 30mg of methadone for a week.. My first week clean.. Then next week she will have me at 25mg, 3rd week 20mg.. Etc etc.. So straight from 30mg of methadone fir a week and every 7 days will be lowering my dose..
    What does everybody think about this?

    Last time I went in to get clean, I was at 20mg a day. I had a job though and still couldn’t function on that dose so I was using heroin on the days I had to work to fully function.. She tested me and took me off completely. She’s agreed to help me 1 more time, so this really is my last chance to get clean unless I want to drive am hour and a half away…

    Let me know what you think about this..

  37. My PCP, has had me on methadone for about twelve years for chronic back pain. In October of 2015 she sends me to pain management I had been taking 150mgs three time’s a day. When the Dr. At pain management saw what I was taking along with Percocet 10/325 two every 6hrs he just about had a coronary! I started tapering that day. I am now down to 10mgs 1 every six hour’s of the methadone and same dosage of Percocet. Please anyone that may read this the last four month’s of my life have been like living in hell! I have suffered so much that I haven’t left my bed except for Dr appointment or ? breaks. If you are thinking about taking this drug don’t!! It’s the worst mistake of my life and I am 46 at least for a few more day’s. If I didn’t have children I would have taken my life and I still might, I can’t take anymore of this I hope I find the strength to get me through another day of horrific pain although I am running low on will power. Please I want to save you from this beast.

  38. I am currently on 60mg of methadone per day. I started tapering down from my dose of 120mg a day about a two ago- as I was ready after years of addiction- to start lowering my dose- and eventually taper off completely. I have been at 60mg since may 2015
    I have to option to keep tapering- but I feel not ready. Its hard – and its scary. To some that may seem stupid – but to anyone going through or been through this process- they will understand. Afraid of relapse- afraid of being dope sick again- but for me- its The years I have been taking this medication. Although I hate having to go to the pharmacy every day – I’m sp used to it- that I feel scared stopping completely. Its not only the physical addiction that has me bound- but the mental addiction aswell- when I was at my dose of 120mg- tapering down didn’t seem so bad – because of the hi dose I was on… But now at 60mg- it does scare me. I know this is normal- and I know I will be ready to continue tapering only when I am ready – and that means over coming The mental addiction I have to it as well. I know I will get there. I’m proud of myself today for being 6 months clean and sober off of drugs – so I know I can do this. But like Beating any addiction – you’ve got to be ready yourself- want it foe yourself – and for no one else. Anyways I have been wanting to share this for some while now and came along this website – so maybe I will get lucky and find some support. Its not easy- and to an y one still suffering addiction – know you can beat the demons and free The chains – but no one can do that for you- a person can only say or do so much for someone- until we’ve got to get up and do it for ourselves

    1. Hi, Becca. You’re not alone. We are here to help you. Also, you may enroll into support group near you, and online options are available, too. Good luck!

  39. I have been on 100mg for a year straight without using. When I was using, I was on and off the clinic cause of a ride there and the money. But now that I have been clean and taking the methadone for treatment, I been doing good. I think that 60 and up are a good mg. And people that quit cold turkey are more likely to relapse. If you want to get off of it, do it by coming off of it slowly. For me the methadone treatment has helped me stay home clean. I tried quitting the heroine, pills and patches on my own but couldn’t. The methadone will work for you too as long as you take it for treatment.

  40. I’ve been off/on methadone treatment the last 10 years. I’ve been on as much as 135mg as low as 60mg. Everything I’ve been on methadone at a proper dose for me 90+ I’ve not used on top of my dose. This current treatment center I’m in capped my dose off at 60 would not take me higher. I was able to get about 7 months clean. I did relaspe heavy on the 60mg dose. This is the ONLY time I’ve used full blown relaspe while in treatment. I had been telling anyone who would listen that 60 was not working for Me. Also I told my counselor this and even after the 3 week running relaspe clinic had refused a increase in dose. 60 is NOT a blocking dose for me. I do feel it when I use. The rush is exactly the same with without methadone but I do notice the high dose not last as long I do get a partial block. I have also noticed using while on 60 mg I don’t get any nasty withdraw symptoms. I wish I had not figured this out now aim using as much as I can buy plus not suffering with withdraws.

  41. I’ve been on methadone maintenance for over 2 years. I started out at 16 years old getting addicted to pain pills went to Oxycontin, patches then shooting heroin. This downward spiral continued for 22 years!! 5 times in prison, every crime u can think of committed neglecting my children hurting not only myself but everyone who did care about me. It was awful, sad and sick. I had tried everything. Then I went to the methadone clinic. I truely didn’t expect it to work, I was defeated. I knew I would never be normal I knew I would be an opiate addict for the rest of my miserable life. I’ll never forget it I went on August 29th and I promise you by September 2nd I was OK enough to through away the needles. I never picked anything up again never no drug!! It’s been over 2 years now and I have a life now. I have a job I’ll never have to live in a prison again the real one or the one of my own making! My Husband trusts me, my daughter believes in me and finally I love me and I couldn’t have done it alone I would never have done it without the help of wellsprings. Thank u more than you’ll ever know

  42. I do not believe that methadone as a long term solution works. I have been on methadone for over 19 years of my life. Currently on 26 mils it should be offered for short use only you are not helping the addict only the company supplying methadone.

  43. Hi everyone… I came across this article whilst researching long term effects of babies born to mothers on subutex!! I’m a 34 yr old female who has been an addict for about 18 years… That’s scary when I say it out loud!! I haven’t been a full blown heroin addict over the last 5 yrs- though I can thank bupernorphine for that!! I was on methadone for 8yrs (80mg) and though it helped me gain some sort of normality in my life, I still continued to use heroin and if anything knew if I used enough I could get over my dose to feel something!! On the other hand subutex has been a heaven sent, I know when I’m taking subutex I won’t use as I will NOT be able to feel it! I may think about getting heroin but as soon as I have the thought I immediately know that it would be useless and that’s as far as the thought process goes!! I look back a photos of myself on methadone and I look like a zombie and VERY high!! It was hell to get off- a 100 times harder than heroin its self!! I was sick for months and didn’t sleep for about 4 months.. I know that there is an important use for methadone, but I don’t believe it is a long term help!! PLEASE PEOPLE THINKING ABOUT GETTING ON METHADONE…BECOME WELL INFORMED THAT IT IS ONLY SWAPPING ONE FOR THE OTHER!!! SUBUTEX HAS A BALANCE OF BOTH BEING A BLOCKER AND ALSO KEEPS U CALM!!! SUBUTEX IS SOOOOOOOOO MUCH EASIER TO GET OFF!! ONLY TAKE METHADONE IF YOU ARE HAPPY TO BE ON IT FOR YEARS!!! Good luck on your journey everybody!!! Love and light

  44. If you need it for pain then go for it but if you are like most people I’ve seen in clinics, over 40 years, kicking a habit, then don’t use methadone. Addicts minds will tell them they are a lot worse off then they really are. The last habit I kicked was six years at 120 mg. If I was wise then I would have just kicked and passed on the methadone. I’m drug free for six years now and the only thing I can say about methadone is it ain’t nothing but a ball and chain.

  45. I read some peoples comments, what people need to realize is while the drug is the same it does do people’s bodies differently. What may have inebriated one may not be enough for another. That’s why there are doctors that prescribe the dose accordingly and why there isn’t just 1 standard dose for all. That’s why there are tests like the peak and trough to see exactly how the patient metabolizes the methadone instead of taking an addicts word for it who may just want more. Thank goodness there are some doctors that are taking it upon themselves to learn about things like addiction and methadone treatment. I for one am grateful for methadone, even after the doctor had me on 275 mg. and it took 2 years from the last time I dosed to feel somewhat normal again. I was a wreck, but it was MY journey and I wouldn’t trade one day of it. I may of relapsed by adding pain pills to my prescribed pain pills trying to control my own pain again, but I haven’t went back to heroin yet. And I don’t plan to either. I never want to forget one day of my misery. That is mine to keep and do with as I will, and I choose to never forget it and to pass on what I can to help the next person. Even if I help only 1 person for the rest of my days, it will make it all worthwhile. I still saved someone from some the hell I endured.

  46. This is my 2nd time being on methadone. The first time the doc at the clinic kept asking me if I needed a raise in my dose and I’d say yes. Well duhh, I’m an addict just coming off the streets. But he raised my dose up to 275 mg over the time I was there. This is not a mistype, 275 mg. I stayed on the methadone program and worked a recovery program for 2 and 1/2 years and decided to get off methadone, I had first started using opiates to self medicate, and after detoxing and 3 months of post acute withdrawals I realized my pain had gotten much worse. So I went to a doctor, (because I’ve learned thats what normal people do instead of self medicating) and found out I have several chronic pain conditions. And went to pain management. I was there for 3 years and was fine, but eventually they weren’t controlling my pain enough and I began self medicating (adding to) again. That didn’t last! I chose to go back to the clinic and swore to myself I wasn’t going over 50mg. The doctor and I decided I needed to go over the 50 mg when 50 wasn’t controlling the pain because I knew if I hurt enough I would use. I was very cautious and went pretty slow. I have been there 10 months and am currently at 160 mg, (a split dose) I take 80 mg in the morning and another 60 mg in the late afternoon. I took a peak and trough test and it showed I was metabolizing the methadone quickly. I am still in a lot of pain, if I do much of anything in done for the day, but I’m afraid to ask for a raise in my dose. I remember the zombie that was on 275 mg., and I don’t want to be her again. I feel like either way I look I’m going to feel useless. Addiction and Chronic pain is a very difficult thing to deal with. I am glad I was introduced to recovery early, I don’t know if I’d be able to stay clean without the tools I’ve learned in meetings and from my support group. Using isn’t the 1st thing I think of anymore when something goes wrong, and that’s a great feeling when I notice that or someone brings it to my attention. But when I hurt to where I hold my breath and can’t lay down or sleep or sit or stand for more than 20 minutes tops from the pain for a number of days my mind can tell me you know how to get yourself out of this pain. So that’s my experience and why 60 mg wouldn’t work for me personally. Thanks.

  47. I have to agree with Don, Methadone is the way to go for treatment. Suboxone does not stop the cravings and I lived a much better life, and worked a lot harder on Methadone. Government should not have a right to say I can or cannot do this or that, I just don’t understand why we have to suffer our entire lives over a money game played by Big Pharma. Also Methadone is much cheaper (since on one holds the patient on it) I guess I bought into the lie that America is a “free” country. Drug addiction is not respected as a disease, it’s looked upon by society as a “criminal act” instead of a disease. Wasted lives, I’ve seen so many people have their lives wasted over the prohibition laws then the actual drugs itself.

  48. Ugh really? methadone destroying the body? U know what destroys ur body….spending every bit of money you have on opiates..not sleeping…living off little bits of junk food here and there or possibly living on the street…thats what destroys the body. I’ve been on methadone for about a month im 24 im an afghanistan war veteran and honestly it saved my life…the problem is that too many opiate addicts are used to babying sick this isnt perfect my dose isnt high enough ….I know i’m much happier now…I look a thousand times healthier than when i was on drugs…i run i bike i train daily..sometimes it sucks..sometimes i sweat a lot some days i vomit and just dont feel right..other days are great…but my worst day on methadone is better than my best day when i was using…just remember where you were before u started…and if it wasnt that bad maybe go back and bang your head some more before ur ready to appreciate the small things in life like finally gaining some peace and comfort on methadone…yah we know its bad guys…but im sure the drug lifestyle is a lot worse.

  49. I used to be one of those people who was against MMT,& tried everything else to stop.Now,I’m on MMT,& I surely wish I’d done it sooner.Alot of doctors have now jumped on the bupernorphine bandwagon,thinking it is THE answer.But they can’t seem to get it through their thick skulls that everyone’s different,& I know for me & many,many others,bupernorphine has ZERO effect.It’s more for people who’ve a.been only using a few years tops,or b. have extremely low habits.And then some seem to favor naltrexone-I’d have to think it’s safe to say that they themselves have never been an opiate addict.This whole idea of being off all narcotics is nice,& of course ideal,but some of us can’t afford that.I don’t go around saying I’m ‘clean’-that’s a matter of opinion when you’re on MMT.Of course I’d rather not rely on having to have an opiate,but this is what works for me.The definition of insanity is doing the same thing over & over expecting a different result.Yet doctors continually want you to try what you’ve done & failed at many times.I figured it was time for me to try something different,& it’s really been a godsend.The way I see it is I could be ‘clean’,& then totally crazy depressed & miserable,for what?To be able to say I’m clean?To impress all the AA people?Sorry,but I’d rather feel stable & be able to function rather than to be able to say something.Some may say,’you have to find why you’re depressed w/out opiates’.While this is true,some of us didn’t have any traumatic events,weren’t abused in any way,& have had otherwise normal lives.So I think rather than do what I tried before,which was therapy,meetings,& groups,which really,did nothing for me,I’d rather do something that’s working.I’m not one to care about what others think,& many will say MMT is wrong,but different things work for different people.And it’s important that people get an ADEQUATE dose.Not too much,not too little.

  50. The advantages of methadone are that it is legal and cheap. The disadvantages are that is very toxic and difficult to withdraw from. My belief is that the classic 21 day detox is a setup for relapse, since the time period is not medically sound. The arbitrary 60 mg “blocking dose” is not a good rule of thumb. There are many factors involved. 80 mg was typically a minimum for myself and other addicts with significant tolerance.

    I also personally believe that methadone maintenance is physically, emotionally and spiritually crippling in the long run. The long term medical effects are well known and I have personally seen the emotional dysfunction of maintenance users. The spiritual aspect is based on my personal experience and beliefs.

    I would refute the idea that MMT addresses a natural chemical imbalance. MMT addresses a neurochemical imbalance caused by opiate use. The original mood disorders that may have been partially causal in the developing substance use disorder would most likely have responded to other treatment prior to opiate use. Now they are subsumed by the cycle of MMT. At best, MMT addresses what society considers maladaptive social behaviors. Apart from the convenient half-life, IV diacetylmorphine (heroin) treatment has been shown in trials in Europe and Canada to be far more effective in this same role.

    I have personally experienced cold turkey withdrawal, older type medical detox (phenobarb, clonidine etc.) methadone detox and buprenorphine detox. Buprenorphine can also be used for a maintenance regimen, with far fewer side effects. However (specifically addressed to Don) you cannot go from MMT to buprenorphine, it is guaranteed to make you miserable due to a conflict involving the methadone half-life and agonist/antagonist properties of buprenorphine. Consult with a doctor who is informed about this dilemma, some will even prescribe other opioids until your body has eliminated the methadone and then switch you to buprenorphine.

    I found the buprenorphine the most helpful, the caveat being that you do experience some withdrawal, as opposed to methadone, which will give you that sense of well-being opiates give. This means, used correctly at the right dosage, bup. will eliminate major physical withdrawal, but anxiety, insomnia etc, may still be challenges.

    How you address those challenges may very well be the determining factor in the quality and consistency of your recovery. Moving from an addictive lifestyle to one without substances can be very uncomfortable. Finding strategies and supports in your journey is vital. Using classic benzodiazepenes (under medical supervision) to manage the anxiety and with a long term goal to wean off can be effective in conjunction with these other strategies. It is important to realize that giving your brain time to restore its natural balance will be uncomfortable, you will not feel good initially. However, the reward is that your life will be infinitely more enjoyable in the long run.

    Personally, I use no medication, am very judicious in my use of the socially accepted substances, such as coffee, but focus heavily on mindfulness, therapy, having a productive life and social supports. I do not use the 12 steps, but feel that they can be an important support for many.

    It is critical for the individual to determine what works best for them and advocate for their needs with medical professionals, counselors and other clinicians.

    Also, be nice to yourself. You have been through enough without beating yourself up. Everyone faces challenges and needs help.

  51. I am a certified addiction counsellor, teacher and social worker. I worked for over 20 years in the field of addiction and have been successfully managing my addiction for over 5 years now.

    There are new methods of treatment that are being proven to be more effective than traditional methods.

    Mental health and addiction go hand and hand. Recovery is about erasing old subconscious programming. Without which, your life will unfold, as it is now perhaps, and you will call it fate.

    You DO have the power to change your life. It’s just that we are looking in the wrong place. Like the story of the guy who loses his keys in his house and is outside under the street lamp looking for it because his hydro is out in the house.

    Research that supports harm reduction is influenced by the powers of the government and there is no funding flowing to the real problem – which is addressing the cause of addiction.

    I know that you may believe that there is no cause of addiction and have been told that looking for the cause will be of no avail. I will prove to you that this thinking is dead wrong. There is a cause and it can be treated, and completed erased!


    Don aka Adpage

    Best to all of you!

    I want to thank the creators and supporters of this platform for supporting us in our research!

  52. I’m sorry but you are so very WRONG! My 10 year experience with methadone has taught me so much more than what can be read or “theorized” on. 120mgs makes you inebriated and the only reason the patient dont realize is because you never come down until detox. I never used opiates at 120. I detoxed(quite rapidly) due to the constant fatigue,weight gain,….but I relapsed and went back and went on a lower dose(70) and did not use opiates either. In fact my resolve is more firm and lower doses of methadone to a patient who has been on more is very different than the higher doses. Also Methadone only works short term. In my case,I have spent so much more time on methadone than drugs. How is it OK to have a patient more hooked on methadone than any street drug? methadone is a cruel system that treats every person exactly the same and makes that person so addicted that they are your Prisoner! Your CHEMICALLY INCARCERATED PRISONER! Clinics are not for patients they are for society. As long as they can hold addicts prisoner to a drug that makes them feel entrapped physically,mentally,financially and treats patients like prisoners. Threfore violating The Constitution! ONLY Prisoners are denied such rights! You Methadone Clinics and Investors are getting ready to see the end of your Corruption along with your Outdated Drug!

  53. Thanks for sharing about what works for you, adpage. It seems like you have a very strong awareness of what you need and are taking life as it comes. Perhaps a day will come when an alternative to Suboxone is available. Please let us know if you come across anything in your travels.

    All the best!

  54. MMT restores an imbalance. Just as insulin does. The side effects are less than those of other medications. In fact, I can not find any data on the long term affects of MMT. If there was published data that was valid and reliable and replicated that indicated some nasty negative effect of using this medication long term, then I’d consider trying to stop again. Having said that my only other option, besides a prolonged and protracted, acute and post acute withdrawal, is suboxone. The side effects of suboxone were so nasty, that I had to stop within a week or being on it. I was totally depressed, almost catatonic!
    In my opinion, I am on MMT by choice. I could go through the pain of getting off but would only do so if I could find a medication that put me in another state of mind while I went through it. Which at this point I am not prepared to do.
    I also think, that if a MMT patient decides to get off methadone, they should be weaned off very slowly with morphine instead for at least 6 months to a year, so that the post acute withdrawal phase passes. However, this is not the case now that they have suboxone.
    Now at my age I suffer from pain associated with MVA’s and one major MVA when I was 20 years younger that now are manifesting. So even if I came off MMT, I would need something for pain management most likely. In fact as we age we are likely to experience pain more often on average, so I am on 65mg now, with room to move up should need be the case.
    The only side effect I have had complications with is constipation related, which presently might require day surgery to fix an anal tear. That had more to do with poor habits than methadone. Straining etc., is something I have always done and I have had to stop doing.
    I use Energy Psychology now versus psycho-social therapy because I realise that most of my problems come from my subconscious mind, which can be undone so to speak with regular practice of EFT, Be Set Free Fast, Psych K, etc.
    More on things later.

  55. Hi Christopher. Thank you very much for sharing about your experience with MMT. I hope that it can help others looking for successful recovery.

    And thanks also for sharing the link!

  56. Also I just get so angry when I see these things on TV like Dr. Drew and they advise these long term addicts to go to sober living and then 90 meetings at 12 step groups! As if that was in any way a permanent solution!? That is NOT going to make that brain damage get any better! They are not looking at the overall reality of addiction.

    I personally think that if the issue of brain and neurological damage is not addressed, no addict will achieve truly life long freedom from addiction. MMT and suboxone, etc. definitely are an integral part of recovery if one really wants to stay clean and sober for the long haul.

  57. I am a Civil/Structural Engineer with 2 degrees in engineering. I was able to completely return to work on MMT (methadone maintenance therapy). I also attend 12 step meetings 4 to 5 times per week. I have over 21 years clean. There is one scientific fact that is almost universally overlooked; long term drug use (especially opiod) causes permanent psychological, neurological, and brain damage! That is why addicts relapse; they don’t feel good at all! There have been many medical studies proving this. I developed a terrible chronic depression, anxiety, etc. Once I initially got clean without MMT. Antidepressants are not effective alone. Once I began MMT, my depression gradually lifted as did my anxiety. I also began taking Zoloft with MMT and honestly right now I have never felt better. All addicts need chemical aid in recovering. You cannot ignore the organic damage done by addiction. That is why I myself initially relapsed many times before I got on MMT. 12 steps help but they are not effective against the neurological damage; steps help only with the psychological.

    I think the aforementioned is rarely understood by doctors or addicts for that matter. It needs to be at the forefront of our discussions on addiction! Once I got stabilized on MMT, I found that I no longer had any reason to even consider relapse-I felt normal in my own skin again. No one understands how excruciatingly painful it is long after you detox! You just don’t feel normal at all if you are an addict. The only way I got well was a multi pronged therapeutic attack:

    1) 12 step meetings ( I love AA myself)

    2) MMT – fixes and maybe even reverses structural damage to brain/neurological functions

    3) antidepressants – are synergistic with #2

  58. I also noticed that my social anxiety improved with a higher dose. I used to be really panicky when reading in public. But when I was on a high dose, that seemed to disappear.

    Has anybody had a similar effect

  59. Hi Heather. Thanks for your feedback. And it must be frustrating to feel that you are not getting enough methadone…but have have you asked the clinic directors why they have implemented this policy? It might be good to get the facts first, and then you can file an official complaint (if needed), later.

  60. here in columbus ohio at the comp drug methadone clinic they start you at 30mg and in order to raise your dose you must wait at least 7 days then you have to make an appointment with the dr which can be an all day event then they will only raise you up about 10mg and then you must repeat the process of waiting 7 days and then they raise you only 10 more mg they used to start you at 60 mgs but a couple of addicts who keep in mind were only addicted to vicodin and other low level pain killers said that they felt comfortable at 30mgs or less this clinic is absolutaly ridiculous they really need to be investigated sorry I just really needed to vent

  61. I’m currently at 100 mgs. and yet really get no blocking affect – I do stay well though for 36 hours and it really has been a godsend providing me with needed stability.

  62. for me, it ok an dose of 12mg-25mg, in UE we use lower dose then US( in US they use 80-200mg), even if our heroin is stronger then that in US.
    Some of my fellows use 60mg or so, i am feeling very good with 25mg or lower.

  63. I replaced methadone with bup + naxalone and was crazy depressed, no emotions, and zero sex drive. Like a zombie – scared the crap out of my girlfriend. I later went back on a low dose of methadone, except now even at only 40 mgs, I have no sex drive (like I am on 120 mgs). I also have to take it early, or I end up in withdrawl first thing in the AM. So I am investigating what herbs I can use to increase my testosterone rather than going on medication to do so. Oh, the reason I wanted off methadone was because of the rumours I hear about methodone wrecking your body and destroying your teeth. I found out later, after I went off methadone, that this was misinformation. I found no references to any of these effects and in fact that methadone was one of the safest drugs one could be addicted to. I could be a diabetic and be addicted to insulin, which has a lot more side effects. So before you jump off, get your fact straight. Some people live with pain meds for life, and so what? Some people are on anti hypertensives, valium and anti depressants for decades with lots more side effects.

  64. You should never ever quit methadone cold turkey for many different reasons. You will get very sick and tho that will be horrible in itself, it will also increase the chances of u relapsing. It can cause medical problems if u quit cold turkey so by doing a slow taper, you can reduce withdrawal symtpoms if not cutting them out all together. It takes a LONG time to taper down from methadone but doing it that way is the right way and you will not have w/d symptoms and will be able to go back to a normal life without drugs. I attend a methadone clinic in Indiana and it saved my life from my Oxy addiction. It allowed me to quit oxy, alcohol, weed, and it took away all my withdrawal symtpoms and I feel normal again with no cravings, no high, and no euphoria. I feel sooo much better and I’m glad that I went into treatment before getting arrested or ended up dead…

  65. i have been on 65mg for 2 years on and off for 2 years (i got off it last year but had a relapse) and im telling you it is the hardest thing ive ever trird to give up….. I’ve been off it for 5 days now and i can’t sleep,cant function and basically can’t get on with my life and also my mrs has kicked me out (nice chick….NOT!!!) I went to the doctors today and he pescribed me Diazepam @ 5mg x 3 a day for 10 days …. I’ve already took all of them and i still feel poo….. DONT DO IT COLD TURKEY !!!!!!

  66. Dear Doctor Vorobiev,
    Thanks for writing. Does the government of Belgrade and Serbia allow treatment using methadone or buprenorphine?

    I once attended a presentation by a physician from Russia about the use of oral naltrexone and implantable naltrexone pellets. If I remember correctly, success rates were pretty good. I don’t recall the doctor’s name.

    I would like more information about your program, & your program’s success rates. The U.S. has just started using the monthly injectable form of naltrexone. I believe studies are ongoing to see how it will compare with methadone and buprenorphine.

    Methadone isn’t a perfect drug, but it does save lives. A study conducted in the U.S. in the late 1960’s through the late 1980’s showed mortality rates for heroin addicts not in any treatment was sixty-three times that of age matched controls. (1) This dropped to only eight times age matched controls, while these heroin addicts were enrolled in methadone maintenance treatment, which correlated to a death rate of 1.4% per year.

    I simply don’t agree that methadone “eventually destroys the body,” and I challenge you to produce an appropriate reference for that statement. Yes, it is hard to get off methadone, and it has significant side effects: constipation, sweats, and reduced libido. But dead addicts don’t recover. If methadone keeps them alive, we should use it, until a better method is proven.

    The U.S. has a fairly restrictive system for dispensing methadone, compared to other nations. Fifty-five countries use methadone to treat opioid addiction. (2) Israel has the most restrictive system. It requires limits on the case load of each clinic and each physician, regular urine drug screens, limits on daily dose and limits on take home doses. Methadone can only be prescribed by addiction medicine specialists and only in specially licensed facilities. France’s system is the least restrictive, requiring only monthly drug screens and limits on daily doses.

    In Russia, it’s illegal to use opioid replacement therapies, much as it was in the U.S. from 1920 until the 1960’s. Russia also has the highest rate of heroin addiction in the world, with an estimated five million heroin users in a country with about half of the population of the U.S. (3)

    In Russia, intravenous heroin use now causes about eighty percent of the HIV infections in Russia, where needle exchange programs are still quite controversial. At present, around 1.1% of Russia’s population is infected with HIV, compared to less than two-tenths of one percent in the U.S. (4) Obviously, Russia’s present opioid addiction treatment policy isn’t working.

    Until/unless I see studies that prove naltrexone out-performs methadone and buprenorphine, I will continue to advocate for these treatments.

    If you care to give me your mailing address, I’d love to send you a copy of my book, “Pain Pill Addiction: Prescription for Hope,” which describes the current state of prescription opioid addiction in the U.S., and gives information about the treatment methods we’re using, and the good and the bad of these methods.

    Jana Burson M.D.

    1. Gronbladh, L, Ohlund, LS, Gunne, LM, Mortality in Heroin Addiction: Impact of Methadone Treatment, Acta Psychiatrica Scandinavica Volume 82, issue 3, p 223-227
    2. John Strong, MD, “The International Experience” lecture, ASAM Conference, New Orleans, LA, 5/09.
    3. New York Times, “Russian Scorns Methadone for Heroin Addiction,” July 22, 2008, accessed online at on 7/5/2009.
    4. USAID Russia, HIV/AIDS Health Profile, 9/08, accessed online at on 7/5/2009.

  67. I am a doctor with 20 years of experience in addiction medicine. (Dr. Vorobiev Drug Clinic, Belgrade) I am not a supporter of Methadone treatment. But I don’t deny it. I agree with all that is said here. No doubts Methadone keeps a huge number of former heroin addicts away from their drug with all following consequences. It is true. But you also have to agree that Methadone is also an opiate and also is very addictive. Withdrawal from Methadone is much harder than from Heroin due to its biochemical properties. As with any other opiate, it causes multiple system dysfunctions, immune deficit and eventually destroys the body. It is a fact. As well as the fact that millions of Methadone users are parked in their addiction without any attempts to kick it off cause this situation fits government (it is cheap, it cuts crime, takes the users out of streets). I advocate for Naltrexone therapy as alternative addiction treatment . We successfully use this program for years at v-clinic [dot] eu.

  68. You’re absolutely right. There’s so much variation between individuals as to how methadone is metabolized. Some patients may feel OK at 40mg, but the majority need much more. Doses of 80 – 120mg are the “average” range.

  69. Methadone doses average between 80-120 mgs, with many patients requiring more than that, and some less. In my own experience it was essential to be on a blocking dose (which is closer to 80 mgs than 60 mgs) in order to succeed. The knowledge that you cannot get high on opioids no matter what forces you to seek other solutions to your problems–hopefully healthy solutions.

    Many patients keep their doses too low for comfort, thinking either that they can continue to use opioids and get high, or that it will make it easier to taper off methadone if and when the time comes. In actuality, however, tapers that are started from a position of already being on a dose that is too low are less likely to succeed than tapers begun from an adequate dose. An adequate dose is a dose that keeps you comfortable for a FULL 24 hours–you should not wake up in the morning feeling as though you must dose immediately, or experiencing withdrawal symptoms.

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