Methadone Clinic Stopped Dose Increase At 85 Ml

My Methadone dose increase was stopped by my counselor at 85 ml. I'm on week 5 fresh off Fentanyl and Hydromorphone. The crazy thing is my counselor looked pleased that she stopped my dose as if she caught a drug addict trying to use drugs lol??? So I was told to see the doctor, I entered the office and my counselor came in with me she jumped on the patient's bed Indian style and a smirking grin as my doctor asked what was my issue? I said I'm trying to get to a blocking dose of methadone like 120/140. The doctor says there is no such thing as blocking does of methadone and told me No. What do any of you think about this? Feedback is appreciated good and bad thanks.

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I'm on my lowest dose of 120 since 1970. They said then that 40 was the blocking dose and you couldn't go past 100 ml. Private clinics are VERY, VERY different than state. I always saw people with doses up to 450 ml, especially if they were on other meds such as seizure meds which cut your dose by 40%. I don't know where you live but if you can get off a private clinic, please do so. Like I said, I've been on methadone 51 years and hope I helped.

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There is no mathematical way to convert morphine over to methadone. If there is, please tell your doctor to explain that to you because there is not.

Maybe they believe that 90 is equivalent to 90 milligrams of morphine equivalent but then if that is the case this doctor did not pay attention in medical school. You simply cannot convert methadone to a morphine equivalence!

On the other hand, I have never heard of a blocking dose before either, and if a patient told me that I would suspect addiction also, not saying you are addicted but it would certainly raise my suspicions.

My thoughts are you need off the Methadone, unless using it to wean your addiction. These are highly addictive medications with known significant abuse potential.

If using for pain, then go to morphine sulfate twice a day or lower to something equivalent to morphine milligram for milligram, such as Hydrocodone.

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What is your goal with the Methadone? If you’re 5 weeks off why do you need a blocker?

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I am a chronic pain patient that switched to Methadone about 15 years ago because I couldn’t function on Dilaudid and all of the other schedule 2 narcotics because they made me very impaired...

It doesn’t matter what reason why anyone takes narcotics for whatever their pain issues are; but after 3/4 weeks on ANY NARCOTIC PAIN KILLER YOUR BODY WILL BECOME PHYSICALLY ADDICTED TO IT PERIOD.. Then you’ll be continually needing a higher amount to get the same relief from your pain.

I started at 150mg a day from my pain management doctor and when he retired I had to go to a Methadone Clinic. Over the years I’ve crept-up to 213mgs a day. And that is the dosage needed for my body to be as pain free as possible because when your truly a chronic pain patient you will unfortunately never ever have a completely pain-free day. The best you can hope for is that your pain is controlled enough to allow you to be able to function out in the world.

My clinic is in Santa Cruz Ca. And If I wanted too go up even further on my dose I could. As Can You!! When you're at a Methadone Clinic they have to treat your condition as substance abuse issues period. Methadone Clinics prescribe Methadone as MAT. (Medication Assisted Therapy) per state & federal law.. you can’t walk into a clinic saying your a chronic pain patient and you want Methadone to control your pain period. They will tell you that what you are asking for is illegal for the doctor to prescribe at a Methadone Clinic which is absolutely 110% true because these clinics are set-up for addiction treatment medications that will keep people off of heroin or any other form of pharmaceutical narcotics that you’ve become addicted to; because ANYONE who takes any form of narcotic pain medications for more than 3 too 4 weeks your body becomes physically dependent upon it just to feel “normal” and then you have to take an even higher dose of whatever pain medications your currently taking just to get the same pain relief that you'd gotten from a lower dose.

The doctor was telling you the truth. There is “No Blocking Dosage” of Methadone period. A patient at a Methadone clinic is allowed to test the waters their doses regarding how many milligrams they personally need to feel normal and not physically crave or need the narcotic of their choice.

A Counsler has no say whatsoever regarding how much or how little a patient needs. It is all done by the “Medical Side” of the clinic. Counselors are there for counseling you like a therapist would.. My counselor and I have a wonderful relationship and he’s become my confidant and my friend.. The only reason why a counselor can put a hold on your dose is if you haven’t done something with the administration side of the clinic. They have no medical Authority whatsoever and they can’t handle or dispense Methadone.. The folks who actually dose you are all registered nurses in case you didn’t know and you can and should complain to management telling them that you are not comfortable with your current counselor and they have to reassign you to a different counselor PERIOD.

And if you say that your counselor seemed pleased that your dose wasn’t increased that’s totally not normal because your counselor is supposed to be your advocate period.

I suggest that you take a different tack and just tell them what they legally need to hear from a MAT PATIENT to increase your dose.
I wish you luck and please keep us posted on your situation!

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Re: Anonymous (# 2)

Of course there is. Because of her heart my wife was taken off in one day. It is a ratio of 10-1. She was on 160 of methadone and put on 1600 ml of morphine and was fine.

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I've been on MMT for over 20 years now and it saved my life, I use no illicit drugs. Actually a blocking dose is different for everyone, depending on your tolerance level. I have heard that 80mgs can block out 200 dollars worth of heroin. I am on 140 mg, I think it's a clinic rule that 150 is the max. There are state and federal rules and regulations and then there are clinic rules. But if I attempted to do a few bags (the thought doesn't even enter my mind) it more than likely wouldn't even touch me. But as far as your treatment at this clinic, the staff doesn't seem too cordial. Every patient should be treated with respect and dignity, period. Stick with the Meth, it does work. Good luck.

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What you stated is totally absurd.. I have been on methadone for over 15 years and my starting dose was 100 mg which eventually went to 150mg and then it went to 160mg then to 190mg and now I’m currently at 213mg. Like you initially I was on a myriad of heavy duty narcotics schedule to medication‘s because I’m a chronic pain patient and my chronic pain doctor was the one who actually recommended that I switch to methadone because I could not function on all of those Dilaudid and fentanyl and oxycodone whatsoever. I couldn’t drive because I was impaired I couldn’t cook because I was impaired I might burn the house down I just couldn’t function and it was the best thing that I ever did switching from all of those heavy duty narcotics onto methadone. Eventually my doctor actually died and at that point I started with “the clinic”. I have been with two clinics my original one and the second one because I moved and my experience the medical side and the amount that any patient receives is solely controlled by medical nurses and the doctors. Counselors have no say whatsoever regarding what dosage a patient may or may not need an MAT Therapy.. I have never heard of such a thing and I strongly suggest that you complain to the guy that is running the clinic Director and also I recommend that you switch counselors which you are 100% allowed to do if you and your counselor do not have a good relationship then you’re going to find like you did with this particular incident that things will not be nice and smooth for you because you don’t trust your counselor you will not go to your counselor when you need to talk about personal things about goals that you may have because you don’t trust them it’s just not a good situation for you and definitely not therapeutic whatsoever.. recently my counselor Frank moved on he finally got his grad school diploma and he moved onto a high and paid position at a different company and Frank and I had a wonderful very close relationship which included a strong friendship for over four years and I am going to miss him terribly. I have been reassigned to another counselor which I will have to build a relationship with overtime because that is how it works.. are there any other clinics near where you live or possibly close enough to drive to if it’s in a different county that you can start over at? It seems completely absurd to me that they were that your counselor would state to the doctor anything regarding her opinion on what milligram/dosage you should be on because they are not trained in that aspect because they are not part of the medical staff.. their opinions don’t even matter when it comes to lowering or hiring your daily dose.. if there’s anything else that I can help you with feel free to reply and also please keep us updated on your situation and what’s happening with you.. good luck and I will be keeping you in my prayers..
best regards Lori

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Re: Lori (# 7)

I've never heard of a starting dose that high, it could be potentially lethal. Your body literally will "forget" to breathe. Starting doses are in the 40 mg. range, which is enough to keep withdrawal at bay.

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Re: Lori (# 7)

Wait a minute you said that your starting dose was 100 mg. Totally out of the question, no clinic is going to start you on a dose that can be lethal. No way!

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That councilor won’t last and there is a blocking dose it’s sad when ppl get power or control hungry it’s detrimental to both the patient mental health and trust of the counselor.

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Re: Lori (# 7)

The DEA has the say so and the starting else is 40 given many times I doses of 20 ml. Two doses 20 minutes apart. No state will allow more or the DEA will shut them down! I've been on since 1970 and the 40ml blocking dose has never changed.

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Re: Joseph (# 9)

My starting was 30

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Re: Joseph (# 6)

I do well on the methadone also. Opioids messed me up, and no matter how clean I get I cant find my old self before addiction. On methadone I'm able to be as normal as I can be. Thanks for the reply Joseph.

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Re: Optimistic (# 3)

Well for me I use methadone as a maintenance. What I'm saying is a blocking dose prevents me from looking for the opioid rush. At the same time I'm content to function as a normal person. As normal as I will ever be. Like I said i4m speaking to how if feel and function. I understand what you are saying in your question but for me I will be on methadone for good. Thanks for the reply

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Re: VaCDXX PETE C (# 13)

Same goes for me Pete, I'll probably be on it for the rest of my life and gladly so. I started doing the Doriden and codeine thing, which was the most euphoric and blissfully long lasting experience ever. There's science behind it, there's a lot of info online about them. They were very big in the northeast US. Anyway the government practically forced the couple of pharmaceutical companies that were still making them to discontinue. By that time they were obsolete and the only people being prescribed Doriden, were for illicit use. The Benzodiazepine family replaced the old sedative-hypnotics. So by then the closest thing to "hits", as they were called on the streets, was heroin. So I'm a 27 bottle carrier and living a normal drug free life, and MMT plays a big part of it. Thanks and good luck to you

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Re: Joseph (# 9)

I don’t care what you say my starting dose was 100 and then was increased to 150 and then when I transferred to Santa Cruz clinic call Janus. They raised it first to 160 then to 190 and then my dose now it’s 213 mg. I suffer from severe chronic pain from a motorcycle accident I had when I was 19. Right now my left hip is bone on bone and I’m going to have to get a total hip replacement and I’ve already spoken to my doctor and they’re going to keep me in the hospital for at least a week on very high doses of method of Dilaudid to control the pain.

Back in 2016 I had a routine gallbladder removal which I suffered severe complications from I was in the hospital for over 26 days and I was on a Dilaudid pump every 10 minutes. I got .4 mg and if you do the math one hour of 10 mg hitting the thing gave me 2.1 mg per each hour so I don’t know where you’re getting your information from but in California you are totally 150% wrong... It depends on the severity of your conditions. I’ve never abused heroin or anything like that. I was on a series of fentanyl Dilaudid, Demerol, you name it, and I could not function.

My pain doctor recommended to switch me to methadone and it was the best decision I ever made in my life. I don’t know where you people are getting your information from but you are 110% wrong... I also don’t care what you say about what you think blocking doses or whatever the hell you’re trying to talk about because in my opinion there is no blocking doses. I’ve never had a blocking doses and in times again when I’ve been hospitalized for a myriad of reasons with severe excruciating pain they had to give me a multitude of Dilaudid to even affect my pain relief. And all the while I was still taking my 213 mg of methadone while in the hospital except the hospital had to compound it and make my medication that way... You are 110% wrong I don’t know where you get your information but you are 110% wrong. PERIOD. END OF STORY.

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Re: Lori (# 16)

100 mg is a potentially lethal dose for someone just getting on the clinic. Protocol is 35 or 40 mg. as a starting dose. And that is every where. The clinic can have their licenses revoked. Believe what you want.

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Re: VaCDXX PETE C (# 12)

Correct, that Lori is claiming that her starting dose was 150. Laughable. No way in hell that a clinic is going to start you on a dose that can literally kill you. Standard protocol is 30-40 mgs starting dose.

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I’m a registered college educated the substance of use counselor. You have every right to talk to your doctor without your counselor in the room.

It sounds to me like this is a typical case for the counselor is pushing their own recovery on the client.

Remember no matter what just don’t use illicit drugs. Talk to your doctor and request to do so alone

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That is the reson why I left the Methadone Program and switched to Subuxone. 40mgs is not a high dose and if they are dosing with that red crap you need more.
I got down to 30 mgs and left the program and went on subuxone and I am glad I did

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Re: R P Nick (# 33)

Of course RP Nick, starting a patient off on a dose that high is pure fiction. No Methadone maintenance clinic starts patients off on the huge dose she is talking about, it's a lethal dose, pure and simple. The starting dose is 35 or 40 for everyone. If it isn't holding you you must see the clinic doctor who will probably raise you 10 mgs. But there is no way in hell that they are being liable for a death. Protocol is 35 or 40, regardless of your tolerance, people lie and claim all kinds of things. It's better to be safe than sorry, and they are not going to lose their license because of you and your fantasies.

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Re: Joseph (# 9)

I agree! The starting dose at my clinic is 30 milligrams for everyone! The next day you can go up from 1- 10 milligrams, the day after that is the same then every 2 days. Not sure of the maximum dose because 60 milligrams was too much for me!!

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Re: Lori (# 4)

Well said! Go to another Methadone clinic!

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Re: Joseph (# 30)

Joseph I don’t care what you think and I am not going to defend myself to you any longer.

You apparently are close minded and you are one of those people who is a narcissist and thinks that you know everything. There’s absolutely no reason for a person like me to try to attempt to get a narcissist like you to see the reality and the facts and you are absolutely no one to me. I’ve never met you, I’ve never seen you, I’ve never been around you and I don’t plan on ever in encountering you in person.

You believe what you wanna believe Joseph because it truly makes no difference to me or my truth or what the reality actually happens to be and I have an under no obligation whatsoever to try to attempt to educate you on what reality truly is.

I want to know obligation to try to explain to some stranger who thinks he knows it all it it’s an beneficial to me because no matter what you are a close minded person you think you know everything and people like you remind me of Donald Trump. OK so Joseph I wish you a happy life and I hope that you would sometime in the future take time to educate yourself about every single aspect of pharmaceuticals and individuals and the type of people that wind up taking methadone for whatever their individual personal needs are and how it will help them and their quality of life substantially OK whether they used illicit drugs, whether they had a back injury and got addicted to Percocet, and then got into all pharmaceutical drugs and no got caught up in the vortex of being addicted to narcotics and they had never taken heroin but they somehow a majority of them wind up becoming MMT patients. OK and that’s what’s gotten their life manageable again I am one of those people. I nearly died when I was 19 from a very very serious motorcycle accident and I was lucky to be alive but ever since that day and all the injuries that I’ve sustained that still affect me to this very day they caused me the most horrible pain and issues that it would just take me to Hung to to even describe four or five of them I mean my whole body is just messed up and there is no fixing me OK.

For 25 years I took every single schedule II narcotic that was on the market they tried everything with me. Fentanyl, Dilaudid, obviously the other ones like Percocet, Percodan, Vicodin, Norco, the patches, the Fentanyl lollipops. Used to have shots of Demerol and Dilaudid that I could give myself at home when they needed. It and it made my quality of life I couldn’t drive because I was impaired, I couldn’t cook because I know might nod off and and forget and blow up the house. I mean I couldn’t do anything my life was horrible. After 15-20 years my my pain management doctor suggested that I transfer the methadone and it was the smartest thing I’ve ever done. Granted I still have medication for the breakthrough pain you know on hand immediate release but I use them less and less and the last almost 18 years of my life have been some of the best years of my life and that’s why and then when he died or retired he retired and then he died shortly after I had to go to the methadone clinic and I had been on 150 mg for nine years with my doctor. So of course that was my starting dose and then it wasn’t working so much is good so they raised me to 160 and then like several months later they raised me to 190 and the last race I got was 213. And I’ve been on that for about four years. I want to say I go to Janus of Santa Cruz. You are welcome to call them and ask them what you think, oh and why starter dose is what everyone is an individual and depending on how much opioids they have been taking or the amount of illegal narcotic pills that you know they were taking.

But using that’s how they determine what the doses and then at my clinic and I was with the other one after you’re on it and it’s not working you tell your counselor and they moved in they bump you up you know a certain percentage like with me it was one 51-60 it was like I mean I started 150 and I was like yeah no so they moved me to 163 percentage that they moved me to a 90 and then the next one was 213 and that’s what I had my maintenance on for a good four or five years and it works great. You know I do hear breakthrough pain and I am prescribed dilaudid 8 mg tablets for when it’s super bad but luckily it’s not that often.

So you know why don’t you get off your high horse and start looking at every single one of those patients as an individual OK? There’s people that start or mature that they have like people that have the need. I don’t know the amounts but see they spent $300 down there have anybody who takes that much though he’s gonna need a very very high dose of methadone so they don’t start getting sick. I mean everyone’s an individual. I don’t know what state you live in I really don’t care. I don’t know what experiences you’ve had with those types of clinics but I’m telling you get on the f***ing phone call Janus of Santa Cruz and get 411 and talk to someone there and they will prove and tell you every thing I said.

After this I’m not going to respond you again because you’re ignorant and I don’t want to deal with your BS but you need to stop talking to me and other people that way because you do not know everything you may think you do and you may be educated but you do not know everything and people come visit for them to ask for help and it doesn’t do good when you start s*** with people like me who actually know what I’m talking about OK.

If anything we may have to agree to disagree but I know you’re 110% wrong and I can prove it and I’m done going back-and-forth with some stranger on the Internet who’s a narcissist and thinks he knows everything when I know for a fact what is my personal experience and situation and I’ve been on this now since 2006. So I don’t know where you think you get your information from but you’re 110% wrong.

Goodbye I wish you and your day and a good day and I hope you educate yourself from this point forward and stop attacking people like me who actually know what I’m talking about and I’m not talking about everyone else in the world I’m talking about my experience.. I’m also talking about the at least 50 people that I know closely from the clinic that I go to who who are also living the experience that I have in regards to milligrams dosing and what not so yeah good luck ??

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Re: Lori (# 29)

Lori, please spare us with your lies.

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Re: Nicky Nub (# 26)

New York has its own rules. Every state has its own rules. California has its own rules and in Janus of Santa Cruz where I have been a patient in MMT there for over about seven years now, so I don’t care what you think I don’t care what you say what you do.

I’m an individual, I have an extremely high tolerance to Dilaudid, Demerol, Morphine, Fentanyl, Percocet, OxyContin, everything you can think of. I even had fentanyl lollipops. So I’ve never taken anything illicit.

I've suffered from excruciating severe pains from motorcycle accident when I was 18 years old and I’m 53 now. Ever since then I’ve had to be on some type of severe narcotic schedule two drug. I couldn’t take it, it was too much for me. I couldn’t function. After 15-20 years my pain management doctor started me on 150 and then he retired after eight years or nine years and that’s when I had to go to the Janus MMT program in Santa Cruz. And when I got there they took me from 150 to 160, then a little while later from 160 to 190, and then from 190 to 213 which is my current dose that I’ve had for many years. I don’t care what people say, you’re wrong, that’s it. And I will not be responding to you ever again.

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Re: Nicky Nub (# 25)

For the last time I don’t give a f*** who you are, and I know what my experience has been in the last 18 years and what I take, what I started on and, I don’t give a f*** what any of you say OK.

I’m done talking to you people you’re ignorant you have no idea what you’re talking about. I told you to call Janus in Santa Cruz California and just ask them what their deal is and what their starting doses, especially for someone that transferred from a clinic. I was at a clinic for over 9 years and that's what they started me on because that's what my dose had been for over 9 years at the time. When I transferred to Janus they started me on 150 which is what I had already was on for 9 years, then I was raised to 160, and then I raised again to 190, and then I was raised again and now I’m currently on 213. Goodbye and good luck.

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Re: Lori (# 24)

You may be on 150mgs now, but you were definitely not started off on that huge dose. I have been on MMT since they stopped making Doriden, which is about 1993 and I'm on 140mgs and I'm a 27 bottle take home carrier. I remember when I first got on, the very first day was 35 and the next day was 40. And 40mgs held me pretty good. But a starting off dose of 150, come on now.

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Re: Lori (# 7)

Been on since 1971 and never, NEVER was more than 40 mgs given and I'm in NY City which is one of the best methadone states. Bronx, NY.

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Re: Lori (# 21)

I don't care what your tolerance is, no program would give you over 40mgs or the DEA would close them down and strip their license!!!!

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