Author Topic: Doctors keep telling me not to increase methadone.  (Read 5228 times)

23yearoldkid

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Doctors keep telling me not to increase methadone.
« on: July 04, 2017, 03:49:43 PM »
Hey guys new to this forum. Am 23 years old. Just turned 24 in June 23. I live in coventry. And attend "the recovery partnership" and also addaction. Is addaction like a add on of recovery partnership? Anyways. I just got diagnosed with hep c this month. I'm on 40mls methadone. And it isn't really enough. And doesn't last even 24 hrs for me. If I took it at 7am. Then I'll need to take it that night  by like 4am. It's not full blown withdrawls. But just the starting. Hot and cold flashes. So basically. I'm always looking forward to my next dose. And when I pick up my weekly prescription I'm at the chemist just before they open. That's no life. And I want to be able to have a hour or two in the morning  before I gotta dose. Ive brought this up to them before a few months back and the doctor said why do you need to go up your not usuing. And since I'm like scared to talk back. I just said okay and left it. Now I got a new doctor. Dr. Mark Larwton. He seems nice. Well I'm starting to use again. And I hate it. I wanna tell him that I wanna up my dose. But I'm scared of the reaction. And feel like I'm letting them down. They also want me to reduce. But since I just got diagnosed with hep c. They said they will ask me again after treatment. Since my last last doctor literally forced me to go down. His name was Dr Barkley. And I complained. This doctor said he wont force me. But always brings it up. And makes it seem like it was my idea. It's cuz I just don't say no. But I have now. And they said they'll wait. But besides that. Do you think they will up my dose. Since I did have a dirty sample last time I went. And will probably have one next time I go in. I just feel like I'm letting them down. And scared to bring it up.. I'm such a pussy. Lol. Sorry. Thanks I appreciate all your guys help. How do I bring this up. Any help?

Odysseus

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Re: Doctors keep telling me not to increase methadone.
« Reply #1 on: July 04, 2017, 04:33:34 PM »
I would argue that an increase is needed as you are withdrawing before you take your next dose.  If you do not want to admit to using you can say that withdrawing is causing you to crave for heroin.  You should not have to experience withdrawal your dose should keep you withdrawal free for between 24 to 36 hours.  You are entitled to a positive quality of life and you do not have to reduce if you do not wish to.  A normal dose is between 60 to 120mg so at 40mg you are being underdosed.  You are letting no one down, they in fact are letting you down by supplying you with poor quality treatment.

OP8S

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Re: Doctors keep telling me not to increase methadone.
« Reply #2 on: July 04, 2017, 05:04:00 PM »
Good to hear from you, you've come to the right place. The National Guidelines ( Orange Guidelines & N.I.C.E. ) are how they should be providing your treatment. These guidelines will tell you ( & your DR ) that the therapeutic dosage for methadone lies between 60mg/ml-120mg/ml. So YES they aren't providing you with a decent enough dose to help you from wanting to score gear. If you think that you are motivated enough to stop using opioid drugs, heroin, pills or whatever then you might be reduced to 40ml sometime but given that you've just been diagnosed with Hep C & still feel like using then you need to make this very clear to your Dr. you need to be on at least 60ml daily for it to help, I'm no Dr. but I would recommend at least 80ml possibly more. Not sure what your Dr is like but he'll probably wan't to put you back on observed a few times a week so that he knows it's for you & you're not getting extra to sell, give to a mate etc. Expect that to happen. From your post though I get the feeling that you're looking for a decent period of stability on meth, your dose lasting the full 24 hours, not craving gear, getting your Hep treatment underway & getting your life sorted out so that you're no longer waking up thinking that you need to score or you need to get your meth earlier than you would want to.
If your Dr is a problem then go to your local PAL's service ( Citizens Advice ), or send one of us a PM. They arsed me about for years on silly reduction scripts, none of it worked, I always ended up using again until I was given a high dose of meth which was increased gradually by a good GP until I became stable. That's what you need just now ( in my humble opinion ), go for it now while you're young. Once you find that stability you can then decide whether you would like to remain on methadone or reduce. The most important goal now is stability & you're not going to get that on 40ml.
Good luck & let us know how you get on. Keep calm & tell them that you need a therapeutic dose of meth as advised by current National guidelines. Take it from there & hopefully things will get better.
Post anytime, someone will get back to you within 24 hours ( usually ).
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

23yearoldkid

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Re: Doctors keep telling me not to increase methadone.
« Reply #3 on: July 04, 2017, 05:33:44 PM »
Hey thank you for the replies. Means so much. I could maybe get to 50 but I think that'll be it. They're so reluctant to up peoples doses here. Espically me. Since I'm a middle classed young person. And I work full time. And pay for my methadone. They also tell me thst the hep c treatment I will get is free from the NHS. Is thst true? And do you know if I wud be getting the new treatment or old interferon crap. But yeah about my dose. I'm going to bring it up to keyworker I see him 2 weeks before I see my doctor. I've been on 40 for a while and to my own fault I always said it worked fine. Becuz it does. Its just doesn't last thatt long. Out of 100 percent I'll say it works 70 percent. It hits peak after 2hours or so. Then. Goes down hill from there. I wake up in middle of the night from restless leg. I can't sleep good at all. And everyone else I know here is on like 50 or 55. I don't think Ive met anyone higher then 60. How is your dose so high. I came from Canada 3 years ago. And my dose over there was 110mgs.and could of went up more if I wanted too. And they don't force reduction on you over there. I've been honestly thinking about moving back to Canada for just the methadone. How fucked is thst. Is this ever gunna change over here? Has it always been like this?i hate it.

OP8S

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Re: Doctors keep telling me not to increase methadone.
« Reply #4 on: July 04, 2017, 05:54:29 PM »
You're paying for your meth ??! I'd only pay for a private script of diamorph, is it because you're not a UK citizen ? That's fucked up if it is.
You've been on a decent dose which I assume worked for you, tell them that you're craving heroin & scared that you'll start using again, that somebody might use a needle that you've used & get Hep. I think you should maybe talk to the CAB PALs service if you're not up to speed on what the NHS or any other DSP should be providing. It's very important that you are optimally dosed on meth, I'd say between 80mg/ml & up until you're feeling comfortable.
If you search Orange Guidelines on this forum or just Google them then you will be able to read the guidelines for treatment in the UK, they should be working to them & if not ask them why not ? I digitally recorded a meeting with my DSP Consultant ( ask consent first ) then they can't give you any bollocks.
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

23yearoldkid

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Re: Doctors keep telling me not to increase methadone.
« Reply #5 on: July 04, 2017, 06:06:22 PM »
I am UK citizen aswell. Because my mom was born here and when I came here 10 years ago to stay for a few years I got my citizenship then. So now I'm Dual citizenship. And they say I have to pay for methadone because I work. Apparently anyone who actually works and tells them your working and its documented. Then you have to pay. What dose of methadone are you on? Do u get it from a place like addaction or from your gp. And I read the orange book. From my understanding these guys wrote there own imaginary book. Fed up with it.

OP8S

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Re: Doctors keep telling me not to increase methadone.
« Reply #6 on: July 04, 2017, 06:32:32 PM »
What you pay prescription charges like 10 for every month or something ? I wouldn't complain about that, saying that I live in Scotland where you don't have to pay for any NHS scripts whether it's antibiotics or methadone. I have always worked & used to pay a yearly prepay for 68, now they won't let me pay even if I wanted to.
I've reduced from 150ml ( that's when I stopped using ) , stayed at 120ml for several years but have now been hassled down to 80ml because of change of prescribing Dr / fuckin Recovery Agenda. I'm not shifting from there, at least not for the time being. Has been a battle to remain maintained but maintenance isn't in any way illegal & I know my rights as a patient. Loads of times it would of been easier to tell them where to shove their script & start using again but I don't want that.
If you have any questions about the last edition of the O.Guidelines then ask Simon ( another board member ) I think he was one of the people who had input into the O.G. which aren't imaginary at all. The people who don't follow them are the problem, print them out , highlight the relevant bits & ask your Dr WHY they aren't following National guidelines.
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

simon

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Re: Doctors keep telling me not to increase methadone.
« Reply #7 on: July 04, 2017, 06:38:14 PM »
Hey guys new to this forum. Am 23 years old. Just turned 24 in June 23. I live in coventry. And attend "the recovery partnership" and also addaction. Is addaction like a add on of recovery partnership? Anyways. I just got diagnosed with hep c this month. I'm on 40mls methadone. And it isn't really enough. And doesn't last even 24 hrs for me. If I took it at 7am. Then I'll need to take it that night  by like 4am. It's not full blown withdrawls. But just the starting. Hot and cold flashes. So basically. I'm always looking forward to my next dose. And when I pick up my weekly prescription I'm at the chemist just before they open. That's no life. And I want to be able to have a hour or two in the morning  before I gotta dose. Ive brought this up to them before a few months back and the doctor said why do you need to go up your not usuing. And since I'm like scared to talk back. I just said okay and left it. Now I got a new doctor. Dr. Mark Larwton. He seems nice. Well I'm starting to use again. And I hate it. I wanna tell him that I wanna up my dose. But I'm scared of the reaction. And feel like I'm letting them down. They also want me to reduce. But since I just got diagnosed with hep c. They said they will ask me again after treatment. Since my last last doctor literally forced me to go down. His name was Dr Barkley. And I complained. This doctor said he wont force me. But always brings it up. And makes it seem like it was my idea. It's cuz I just don't say no. But I have now. And they said they'll wait. But besides that. Do you think they will up my dose. Since I did have a dirty sample last time I went. And will probably have one next time I go in. I just feel like I'm letting them down. And scared to bring it up.. I'm such a pussy. Lol. Sorry. Thanks I appreciate all your guys help. How do I bring this up. Any help?
You aren't letting them down, you aren't on enough, yes we can give you a small dose, yes you won't e in withdrawals buut you'll likely feel bat, it won't last 24hrs and you'll be thinking about it all the time and that leads to...
Can you perhaps write your feelings and thoughts down on paper or email them in and ask for a higher dose?
Sometimes it's easy to get carried along with someone elses enthusiasm - but it's about you, not someone else, you need to feel on enough and not be using before even considering reducing.

23yearoldkid

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Re: Doctors keep telling me not to increase methadone.
« Reply #8 on: July 04, 2017, 06:41:58 PM »
I pay 8.60 for every 2 weeks of methadone. I pick up weekly scripts. And pay every 2 weeks. I get a week's worth of methadone to take home. Since I had clean samples. But my last sample was dirty. And Ima make sure this one is too so I can get a upgrade in my dose. Maybe that'll push them to upgrade me. Other wise they'll say I'm not using so I don't need to go up thays whst my other doctor said last time and.  It's not bad at all tbh. Considering I was paying $5 a DAY for methadone in Canada. So I don't mind paying just want a higher dose. Maybe Scotland has different rules then England? Or is it the same. I would love to be at atleast 80. But don't see thst happening. Ima try to push to 50 and see what happens there.

23yearoldkid

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Re: Doctors keep telling me not to increase methadone.
« Reply #9 on: July 04, 2017, 06:43:59 PM »
Thanks for the reply Simon. May I ask where you are from  and what dose you are on?

OP8S

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Re: Doctors keep telling me not to increase methadone.
« Reply #10 on: July 04, 2017, 06:46:14 PM »
Yea, listen to Simon. That's the best advice. Good luck, keep us informed if you want.
" The problem with the world is that the fanatics are so sure of themselves while the wiser people acknowledge doubts "      Bertrand Russell

simon

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Re: Doctors keep telling me not to increase methadone.
« Reply #11 on: July 04, 2017, 06:47:20 PM »
Thanks for the reply Simon. May I ask where you are from  and what dose you are on?
I'm a nurse working with people with addiction problems.

simon

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Re: Doctors keep telling me not to increase methadone.
« Reply #12 on: July 04, 2017, 06:48:42 PM »
I would argue that an increase is needed as you are withdrawing before you take your next dose.  If you do not want to admit to using you can say that withdrawing is causing you to crave for heroin.  You should not have to experience withdrawal your dose should keep you withdrawal free for between 24 to 36 hours.  You are entitled to a positive quality of life and you do not have to reduce if you do not wish to.  A normal dose is between 60 to 120mg so at 40mg you are being underdosed.  You are letting no one down, they in fact are letting you down by supplying you with poor quality treatment.
Excellent advice, he knows the dose isn't right, you do, I do and everyone else that has replied do.

simon

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Re: Doctors keep telling me not to increase methadone.
« Reply #13 on: July 04, 2017, 06:52:47 PM »
Hey thank you for the replies. Means so much. I could maybe get to 50 but I think that'll be it. They're so reluctant to up peoples doses here. Espically me. Since I'm a middle classed young person. And I work full time. And pay for my methadone. They also tell me thst the hep c treatment I will get is free from the NHS. Is thst true? And do you know if I wud be getting the new treatment or old interferon crap. But yeah about my dose. I'm going to bring it up to keyworker I see him 2 weeks before I see my doctor. I've been on 40 for a while and to my own fault I always said it worked fine. Becuz it does. Its just doesn't last thatt long. Out of 100 percent I'll say it works 70 percent. It hits peak after 2hours or so. Then. Goes down hill from there. I wake up in middle of the night from restless leg. I can't sleep good at all. And everyone else I know here is on like 50 or 55. I don't think Ive met anyone higher then 60. How is your dose so high. I came from Canada 3 years ago. And my dose over there was 110mgs.and could of went up more if I wanted too. And they don't force reduction on you over there. I've been honestly thinking about moving back to Canada for just the methadone. How fucked is thst. Is this ever gunna change over here? Has it always been like this?i hate it.
While it's very nice to hear you're a nice middle class young chap, you do have a brain of similar size to the rest of us, similar opiate receptors.
As you note you did better in Canada, your dose was better, you may be aware of the problems they have with Fentanyl, we have it here now so please be aware of that.

23yearoldkid

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Re: Doctors keep telling me not to increase methadone.
« Reply #14 on: July 04, 2017, 07:12:48 PM »
Yeah I'm aware.i actually started my addiction from oxycontin 80mgs. Are you aware  of those? Oxycodone? They're little green pills. Well they made the pills "abuse proof" so when u try to snort them or shoot them they gel up. And they're fucking expensive.  Pardon my language don't know if u can swear on here. Also, they're putting fentanyl in fake oxy 80s.. I've never tried those fake oxys though. I have smoked a fentanyl patch before though. Ive never seen fentanyl in England though. So do u work in like something similar.  to addaction? What are the normal doses where you work at? Do you like in England?