5 Good Reasons to Get Off Methadone

In this hub I am specifically referring to people who are on a methadone maintenance program for treatment of opiate addiction at an accredited clinic. I understand that many people abuse methadone, they buy it illegally on the street or have a prescription for it for the treatment of pain, their medication is not closely monitored (or monitored at all), and they end up getting hooked. In those cases, where an opiate dependency was not present in the brain before getting into methadone, there are many great reasons to get off of it, either through a regulated methadone detox program, or inpatient rehab. However, this article is intended to focus on those individuals who already had a heroin or painkiller addiction before they made the decision to seek help via methadone maintenance.

I could say that when I got on methadone eight years ago, it saved my life, but a truer statement would be that it helped give me the strength to save my own life. I was nineteen-years old and a sophomore at Temple University in Philadelphia when I fell hard into addiction. The descent was brutal but what made it more excruciating was that it happened so slowly; you don't choose to get addicted, and you don't realize you're addicted until you wake up one morning with physical pain and a mental longing you cannot control. I was one month into my heroin addiction when I knew I wanted to stop--so I did. Cold turkey withdrawals ravaged my body for two days but I hadn't been doing it for that long so the pain subsided fairly quickly. I assumed that once I got past the physical symptoms that would be the end of it, and I'd never look back down the dark alley streets that were so skilled at trapping me. But I didn't know that the chemistry in my brain had already been altered after the very first line I sniffed, so I didn't anticipate the mental fixation that would kick in, which was in some ways worse than the physical pain--the anxiety, the racing thoughts, the completely warped logic and asinine justification over why it was okay to just do it one more time. "One more time" turned into a hundred, turned into a thousand, and I watched from the backseat as my life rerouted seemingly without me, onto a trajectory that would carry me two years away from the path I knew my life was supposed to be.

I tried to stop many times after that: I didn't have the resources to check myself into a rehab, and I was too ashamed to let my family know what I'd been doing, let alone ask them for help. But there were numerous cold turkey attempts, the longest of which succeeded for about a month, a brief stint with a methadone detox program, and finally, towards the end, in 2003 when Suboxone and Subutex has just been approved by the FDA to be prescribed by doctors in their offices, I found a doctor who had been an addiction specialist for 17 years and was licensed to prescribe it, and I found a pharmacy that would actually fill it (CVS, Rite Aid and other chain stores would not fill a buprenorphine script back then). Unfortunately, it didn't work. Even though I followed the doctor's instructions to a T, my first dose set me into worse withdrawal than I was already experiencing (having abstained from heroin for 36 hours beforehand). He didn't understand why it was happening, and although he phoned colleagues around the country for advice, not much was widely known about Suboxone at the time. I was such a wreck that he wanted to call for an ambulance, but I knew heroin would be the only remedy, so I procured it as soon as I left the office against his better judgment. Still, I was determined to get my life in order, and I tried to start Suboxone two more times with him, with no better luck. We also tried Subutex three times, and although it didn't rip me apart and make me worse, it also didn't make me better. After my sixth visit failed, he said to me, "Some people just do better on methadone."

I made an appointment at a methadone maintenance clinic the next week. I stabilized at 120mgs and stopped using heroin altogether before the month was out. I am now ready to get off of it, and at 5mg a day, I am slowly getting closer to reaching my goal. Being done with methadone was a decision that I struggled and wavered with for some time, but I am secure in my direction. Here are just a few good reasons to get off it.

Because your life has stabilized. Addiction wreaks havoc. The first part of your brain that drugs affect is the part that controls the ability to make sound decisions. When addiction rears it's head, you cross boundaries that you never thought you'd cross and break rules you never thought you'd have to make. Methadone fills the screaming opioid receptors in your brain so that your every waking moment is no longer consumed with thinking about how you're going to get high, and then getting there. Methadone enabled me to get a better job, catch up on all the bills that had been haunting me for years, pay my rent in advance, and buy a new car. I was in a steady, healthy relationship with someone who had never been an addict, and was thinking about going back to school. My life had stabilized and was better than ever.

Because you have a good, solid amount of consecutive clean time. As it stands today, I have six and a half years clean. I am far removed from the drug world, I don't live anywhere near where I used to buy, and I don't associate with anyone who is still using. My best friend in the entire world struggled with a heroin addiction for far longer and more intensely than I did, and I am grateful every day that she finally escaped...but I didn't even allow myself to hang out with her until she had six solid months clean.

Because you feel safe and secure in the knowledge that you are ready to put that time in your life behind you. I was a heroin addict for two years. I've been on methadone for eight. I'm not necessarily ashamed of that fact, I tapered slooowly on purpose and at a rate that worked extremely well for me. I've gone from 120mgs to 5mgs with virtually no discomfort and no withdrawal symptoms whatsoever because I decreased only 1-2mgs a month, and would pause the decrease to let my body stabilize at the new dose if I ever did feel uncomfortable. Over the past year, I've become even more determined in my desire to detox completely, although I'm still doing it slow because I'm doing it smart. I'm 29-years old now, my life is amazing, and I look forward to starting a family one day soon. I don't want to be on methadone while pregnant, and I don't need to be.

Because you have a support system in place that was on your side while you were on methadone, and will be on your side when you decide to come off it. I feel blessed to have a family that is beyond compare. When you make the decision to get off methadone, it is essential to have a strong support system in place. Although I've attended a few meetings here and there, I never got into NA; it's great for a lot of people and I'm glad it exists, it's just not for me. Whether you rely on AA/NA, your friends and family, or a combination of both, make sure they're aware of what you're trying to accomplish. Having them as your foundation will be invaluable.

Because you are on an adequate dose that successfully controls all mental cravings for opiates as well as physical withdrawal symptoms. If you are on a daily, regulated dose of methadone and are still having cravings, or your dose is not keeping withdrawal symptoms in check for at least 24 hours, then you're most likely not on an adequate dose. Now would not be the time to attempt to detox--it'll only get worse, and the relapse rate is astronomical. Talk to your doctor because the best thing to do would be to increase your dose marginally until you stabilize to the point where one dose holds you fine until the next one. Once you find the adequate dose, sit there for a few weeks, months, or years (whatever feels right for YOU and gives you a chance to get everything else together in your life) before starting to taper.

These are obviously my opinions based on my personal experience with heroin addiction and methadone maintenance. I very much welcome input from others who have experiences of their own. Good luck.

"Out of suffering have emerged the strongest souls. The most massive characters are seared with scars." --Khalil Gibran

UPDATE: As of Monday, October 10, 2011, I AM NO LONGER ON METHADONE. I did a very successful, slow decrease down to 1mg, and when I felt ready, I stopped taking it altogether. I feel amazing, and will continue to post with my progress.

*For an alternate take on this topic, please refer to the follow-up hub, 5 Wrong Reasons to Get Off Methadone