Detox Forum Opiate
Added warning about injecting pills with talc
I just added it yesterday, I thought it should be mentioned since there are some who still try and inject the pills. They usually do a tedious filtration thinking it will remove any harmful ingredients but it WILL NOT. It will only disperse the particles at most. The same goes for any other pills containing talcum, from ritalin to oxycodone. Injecting the liquid methadone is usally safer but it's still *not* a good idea because of the high volumen of liquid required, plus the various soluble additives. There is really(or should not be) not much motivation for injection since the bioavailiability is around 60% orally. There is actually a rush yes but it disappears(or rather, is greatly reduced) after a few months of use. It is possible to get 'high' from methadone in the start but it doesn't take long before it's gone for good. Larger doses may get you feeling 'wasted' but the euphoria will be gone. The number one problem with methadone is something else: the number of deaths/suicides involving combinations of other drugs and methadone.
Besides that, methadone is a good drug for both maintance and pain relief provided it's used correctly. It's one of the few opiates that will not require endlessly higher and higher doses, possible due to its NMDA receptor antagonism. It will not completely prevent concurrent abuse of other drugs but it will *greatly* reduce it. Many junkies on methadone still do occasionally heroin as a side abuse when they have the money. But it's nothing compared to the daily hunt they used to do everyday before. Remember that there is no permanent treatment of opiate addiction so far, only harm reduction, This is what methadone does. By the way, it's not really harder to get off methadone than other opiates although it must be done in a different way. However it takes more TIME because one has to take into account the long half life of methadone. This means it takes much much longer to taper off than short acting opiates. You can only reduce the daily dose with 5-10% every month even when you're down to one pill of 20 mg. Personally I think we will have a real cure(possibly an ibogaine analog) for opiate addiction within 15-20 years. M99 87.59.103.3 (talk) —Preceding undated comment added 19:27, 25 May 2009 (UTC).
"Controversy"
I noticed the "controversy" section has some unsourced statements, particularly the first sentence. Can this be deleted, or is that a violation of protocol? —Preceding unsigned comment added by 68.80.193.90 (talk) 10:26, 31 May 2009 (UTC)
Price clarity
The statement, "In late 2004, the cost of a one-month supply of methadone was $120" is unclear as no specific dose amount is given or associated with that time interval. Cost depends on dose and dose depends on patient need. 500 mg/day would obviously incur a greater cost per month than say 5 mg/day. —Preceding unsigned comment added by 76.180.195.34 (talk) 14:09, 3 June 2009 (UTC)
Maybe it would be a good idea to improve the side effects section regarding acute vs. chronic use
For instance, with short term use methadone is stimulating, euphoric and invigorating(which, along with the intense euphoria, is what get people addicted). Like other opiates such as morphine it has a doping effect when used in sport. But with chronic use(say >3 months), the opposite happens with tendency to weight gain, sleepiness, chronic fatigue and possibly depression. Methadone in terms of unpleasant side effects is certainly the most physically taxing of the opiates, with the exception of LAAM. One of the most hated side effects with chronic methadone use besides the fatigue is sweating and heat intolerance. Some doctors prescribe anticholinergics to ease this side effect but it's my impression that it doesn't help much except perhaps reduce the sweating a little. It will not stop the hot flashes and the intense vasodilation that makes users sweat and suffer during the summer. When someone looks at the side effects, it may be a bit confusing since the side effect profile is very different(like most other opiates) with acute vs. chronic use. The solution could be to arrange the side effects in a table instead of a list. M99 87.59.79.24 (talk) —Preceding undated comment added 19:02, 3 June 2009 (UTC).
Origin of urban legend regarding "Dolophine" source.
William Burroughs, in his 1954 book "Junkie" states that, about 1950 whilst an inmate of the government treatment facility at Lexington Kentucky, he was given "Dolophine, a synthetic horror, appropriatly named after Adolph Hitler" . This, the first mention in literature of this common fallacy, leads me to think that Mr Burroughs is the source of this myth.
118.92.223.205 (talk) 00:41, 5 June 2009 (UTC)
Elimination Half-Life
A 22 hour mean terminal elimination half life doesn't seem right to me. Most sources/studies report longer. Some values on the web:
http://www.medscape.com/viewarticle/441934_3 : Mean = 31.8
Google Books: Principles and Practice of Anesthesiology : Mean = approx. 35
www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2042854 : Range = 33-46 (small sample)
Some one should look up some articles and compile a good average. Right now I'm changing the mean to "approx. 32 hrs" —Preceding unsigned comment added by 24.196.111.104 (talk) 08:23, 10 June 2009 (UTC)
honestly i wonder who they use to determine these halflives. are they reasonably naive, or are they people who are on a stable dose of various levels ?
i mention this because from experience i dont think it could be as high as 35hrs. and that upper range of 46hrs is perplexing. i also wonder if they were careful to control the sample for any liver pathway abnormalities. i dont think im so unusual in feeling that as the vast majority need dosing everyday the claim of 33hrs is even too high. im fairly confident that the many people ive talked to have the experience that methadone does not have as long a halflife as buprenorphine. —Preceding unsigned comment added by 220.101.91.57 (talk) 13:03, 2 February 2010 (UTC)
History
In the history section there's a somewhat confusing run-on sentence referencing two people named "Laura Clyde" and "Dr. Dickson". What's the relevance of this? Neither of these names is linked to another article and neither is mentioned in the History section prior to this sentence. I don't want to unilaterally delete it because I know very little about the topic, but I do think it would be a good idea for someone who does know about it to either explain or delete the sentence (actually, the sentence makes perfect sense both grammatically and logically up to the the comma following "World War II" and only drifts off into incoherence following that point). —Preceding unsigned comment added by 68.107.60.161 (talk) 17:39, 2 July 2009 (UTC)
History
The History section contains the following paragraph:
This is not logical. What findings were dismissed by Laura Clyde? Probably some previous editing operation left this paragraph in an unfinished state?
Jpalme (talk) 18:53, 25 July 2009 (UTC)
Side effects
How can a drug cause both anorexia AND weight gain? —Preceding unsigned comment added by 98.213.120.190 (talk) 04:07, 8 August 2009 (UTC)
Abuse of Methadone?
I have heard that methadone can be abused? I can't find very much as far as references, but I've heard about this in an unpublished research study on rural lifestyles. Rhetth (talk) 19:40, 9 August 2009 (UTC)
Three points.
1) Article contradicts itself; who made it first, Mallinkrodt or Eli Lily?
2)Amidom name mentioned with no explanation
3)"Methadone is useful in the treatment of opioid dependence." No, it's not; what it does is maintain the dependence. True treatment would leave the addict drug-free. —Preceding unsigned comment added by 194.159.125.240 (talk) 15:50, 25 August 2009 (UTC)
Cost
There really should be more coverage of the actual cost of Methadone, as compared to seriously inflated costs by treatment programs who are astute enough to find that they can inflate costs to at the least, 5 times it's actual cost. The difference between a person filling a prescription at a licensed pharmacy, for a monthly cost of $30.00 USD and a clinic that might charge as much as $240.00/week is huge.--Leahtwosaints (talk) 00:23, 8 September 2009 (UTC)
Under the Analgesic section, I added a bunch of references to it being preferred for pain patients due to lower cost. However, I had quite a hard time finding any specific costs. The only way to get specific cost data seems to be calling pharmacie
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