Can you do a Methadone detox at home?

Can you do a Methadone detox at home?

In theory: Yes. In practice: No.

It is a nice idea that you can stay at home, take some methadone and your opioid use disorder is cured. Sadly it just doesn’t work like that.

In order to understand why this won’t work you need to know what opioid use disorder is, what causes it, how it is treated.

Methadone is an exceptionally useful medication that, absolutely, sits in the middle of a successful treatment plan. However, as useful as it is, Methadone is only part of the process.

Opioid Use Disorder is not something that can be treated just by taking medication.

We are addictions clinicians.

Each of us has over thirty years experience in assessing, diagnosing, prescribing for and treating people struggling with addiction. We have prescribed Methadone for hundreds, if not, thousands of people.

Here we share our knowledge and experience with you so you can make an informed treatment choice.

We know all about Methadone detox.

What is Methadone and what is Methadone detox?

Methadone is a fully synthetic opioid.

This means that, unlike Heroin which is derived from plants, Methadone was invented in a laboratory.

It was not designed for opioid use disorder treatment just as Viagra was not designed for erectile disfunction.

A lot of medications are licenced for uses that were not apparent when they were first licenced.

Methadone comes in liquid , tablet and injection form. Within the arena of opioid use disorder treatment is given in liquid form. If you are going on holiday, later on in a treatment plan, you might be able to take tablets with you. Don’t worry, we will explain everything!

In use for many decades, Methadone is used in hospices for pain control, especially in bone cancer and for controlling hiccups.

It is inexpensive and because it comes in liquid form it makes prescribing it very straightforward.

A Methadone detox , in itself, is quite straightforward.

The science of detox with opioid use disorder

When you take opioids/heroin for a prolonged period, your brain adjusts the way it works to accommodate them.

This is known as physiological tolerance.

The problem here is that you will need more and more to have the same effect as the amount you first started using.

Because your brain is now used to opioids if you stop using the brain will not be able to make immediate changes. Incorrect chemical messaging occurs and hence why you experience symptoms known as withdrawal.

Hence addiction and withdrawal is everything to do with your brain: not your body and nothing to do with willpower, or the lack of it.

What does Methadone do and what is Methadone detox?

There are more myths about Methadone than there are about the death of both Princess Diana and Bruce Lee: combined.

It doesn’t rot your teeth or damage your bones. Forget what well meaning people tell you.

Methadone activates the same receptors on the brain as heroin and opioids do which is precisely what you want it to do.

It is a fully synthetic opioid agonist. This means that it opens up chemical channels leading to the release of naturally ocurring chemicals.

These , in turn, block pain signals and symptoms of withdrawal if you have stopped taking opioids and heroin.

Methadone also works on the locus coeruleus within the brain to stop the release of noradrenaline. It is this, naturally occurring chemical, that produces the symptoms known as withdrawal.

Why can’t I just go cold turkey instead of Methadone detox?

Why?

Because it can be fatal.

It is an old adage that you can treat yourself from heroin and opioid withdrawal with a bucket, some toilet roll and a bottle of water: You can’t.

Within hours your brain will start to dump massive amounts of noradrenaline into your system.

This will cause severe physical symptoms, known as withdrawals.

It will be like the worse flu imaginable as well as explosive diarrhoea.

Your blood pressure will skyrocket, as will your anxiety.

Sadly, it can be fatal.

Please don’t ever attempt this.

A methadone detox is a significant medical intervention.

Can I get Methadone from A+E and can they help with Methadone detox?

No.

An accident and emergency department is never going to give you methadone.

If you loose a methadone script (most services deliver the prescription to the chemist for you) or you loose your take home dispensed methadone it will not be replaced: Under any circumstances, whatsoever. Not even a crime reference number will help you.

If you are on script for methadone that doesn’t mean the hospital is obliged to give it to you if you are admitted. This is especially true if you are at the very early stages of a treatment plan.

Accidental overdose

The biggest problem with going cold turkey is accidental overdose.

When you stop taking heroin (or reduce too quickly) you will start to experience a massive increase of noradrenaline and this is what causes withdrawals.

Your brain simply can not cope with the immediate change, hence why the noradrenaline is released.

You know that if you take heroin/opioids the withdrawals will stop.

Your brain, desperately wanting to get a quick repair, will reinforce this message.

The problem is that your brain, as soon as you stop using (or reduce too quickly) looses it ability to process opioids and heroin.

Thus, if you use , while withdrawing, you are likely to use an amount your brain simply can not process and you will overdose.

An opioid overdose is a real medical emergency.

Unless you get emergency drugs, fast and continuously you will not survive.

Forget the Hollywood notion that one round of Naloxone will save you: It won’t.

How would a Methadone treatment programme work?

A methadone treatment plan starts with stopping the opioid you have been using and taking enough methadone to minimise/stop withdrawals.

Normally, this means taking 30MG a day increasing until you don’t experience any withdrawals or they are extremely minimal.

Typically, an effective treatment range is between 60-120MG a day.

Some people need more, some people need less. Don’t get hung up on a figure: Everyone is different.

How long should I take Methadone for?

Here lies the golden ticket.

An ideal methadone treatment plan should be that, once you have eliminated withdrawals you should stay on that dose for one year and then reduce very, very, slowly.

Clearly, for most people, this is impractical.

The reason why you should wait a year is because your brain will take a long time to readjust.

People who reduce as soon as they eliminate withdrawals and reduce rapidly are at the highest risk of relapse.

Can my GP prescribe Methadone for me?

No.

Due to way NHS GP services are commissioned your NHS GP can not prescribe Methadone for you.

There are one or two “shared care” NHS GP addiction services left in the UK and one of our clinicians has worked at one in Nottingham but they are now very rare.

In any event, because of the way Methadone is dispensed you need an installment prescription (which is blue) and your GP doesn’t have access to these.

Can a private GP prescribe methadone?

Possibly.

If you have a private GP (or your GP does private work) they may have a “pink pad” (private controlled drug prescriptions).

They have to apply for this and the vast majority of private GP’s won’t need these.

There is no control over how much a private GP can charge you for issuing you with a pink script and no control over how much a chemist can charge you for dispensing it.

How can I get a Methadone prescription?

Easy: Through your local authority funded community addiction service.

You will need to prove you are addicted to opioids by providing one or two urine drug screens.

That doesn’t mean you can just walk in and get a script.

You will have an assessment with a keyworker (someone who may be in active recovery themselves) and then you will be seen by a clinician.

Getting a script means you have to attend keywork sessions and groups or your script will be curtailed or stopped.

Methadone is not about saving lives but, in a community setting, reducing crime.

How does a community Methadone prescription work?

Initially you will need to go to the chemist, daily, to have your Methadone under supervision. This means you will need to take it in front of staff at the chemist.

After a time, if your urine drug screens are clear of drugs, you may be able to collect your Methadone once a week or fortnight to take at home.

However, if you start to test positive for drugs this will be reversed.

If you do not go the chemist for three days (supervised) the chemist can not give you methadone and you will have to go back to the addiction service for review.

Can I take Methadone on holiday?

Yes.

If you have been on script for sometime, are unsupervised and provide regular negative screens then the service may provide a tablet prescription for your holiday.

It is essential that you get a letter from the service to take with you and that you check that the country you are going to (and transiting through if you are changing planes) allows you to be in possession of Methadone tablets.

You must inform the service at least two weeks before you go with proof of travel/accommodation, etc.

The service is under no obligation to provide you with a holiday script.

Turning up at the service five minutes before they close the day before you travel without prior notice will not bear fruit.

You can only have a holiday script if you are on a maintenance dose.

A Methadone script is surely all I need?

No.

Sadly life is not that simple.

People who use community addiction treatment services (provided free by the local authority) tend to be people with very long chronic histories of opioid and poly substance use disorder.

The emphasis is on crime reduction because, sadly, many people who commit acquisitive crime (shoplifting, theft, burglary) are opioid and crack cocaine addicted. If you provide free Methadone the need to commit crime diminishes.

They benefit from long term Methadone maintainence programmes.

Addiction is a serious illness that is also a symptom of an underlying issue.

Psychological trauma, low mood, relationship issues, chronic pain are all contributing factors.

Unless you address these issues, a Methadone script, alone, is not going to do anything.

Sure, you can get a Methadone script from your local authority service and reduce on it as an outpatient, at home, but it won’t work.

Why do I need rehab with Methadone detox?

Why? Because only rehab provides the four essential elements needed for recovery:

• Detox
• Therapy
• Relapse prevention
• Aftercare

A detox is essential as your brain will not respond to therapy if you are still using.

If you are already on a Methadone programme, to save money, you can arrange a reduction in the community to an agreed level with the rehab centre.

Methadone is the mainstay of opioid treatment. There are other options.

A minimum of 28 days will be needed in rehab for a Methadone programme.

If you are not already on it, the centre clinician will prescribe increasing doses until you are no longer in withdrawal then a collaborative reduction plan with you so that you have finished before you leave.

Therapy in rehab and Methadone detox

Addiction is not a choice.

No one chooses to be an addict.

People take drugs to escape trauma, psychological pain and the grim realities of life.

Using a group therapy approach, you will get the opportunity to lift the lid on those thoughts and emotions that you have been suppressing.

Group therapy has been the mainstay of rehab treatment for nearly one hundred years.

Every centre in the world uses it, from your local independent family run rehab to the most expensive offerings in Switzerland.

It doesn’t matter if it is a 12 step model or not: It really doesn’t.

If you think group therapy is not you because you don’t like speaking in groups then you are exactly the person who will benefit from it.

Every centre provides a weekly session of individual therapy.

Many people, going into rehab, have undiagnosed low mood and anxiety. Therapy can really help.

You don’t need to believe in God or follow any religion to attend a 12 step centre. It is nothing to do with religion.

Relapse prevention with Methadone detox

When you stop using drugs and then methadone, your brain is now functioning on all cylinders.

After you go home, you will be responsible for regulating your emotional responses: Not your dealer with a wrap of heroin.

Knowing how to deal with stressful situations is now your remit.

With psychological skills training you can do this.

Relapse happens: Fact.

If you think of addiction as a serious illness you can see the parallels with conditions such as asthma and diabetes: There will be periods of stability and periods of crisis.

Think of a relapse as an opportunity to dig deep, use your new found skills and reach out to the sober network you have created while in rehab.

As Churchill said: Never miss the opportunity of a crisis.

Aftercare with Methadone detox

Aftercare, following rehab, is essential.

This is sometimes overlooked but just as essential as the other elements.

Normally, this is regular telephone check in and a weekly alumni support group (in person or online).

If you are struggling, there will be a dedicated number to call for immediate support.

How can Find Me a Rehab help with Methadone detox?

We are addictions clinicians.

Each of us has over thirty years experience in assessing, diagnosing, prescribing for and treating people struggling in addiction.

Some of us have many years experience working in rehabs prescribing methadone.

As we are not tied to any centre, our advice is impartial as well as being free and confidential.

It matters not to us where you go for help only that you you get free, confidential and impartial advice before you make a treatment decision.

Get help: today with Methadone detox

Call, email, livechat or Whattsap one of our experienced addictions clinicians for advice on any aspect of addiction, detox, rehab, home treatment, therapy, relapse prevention and aftercare.

We can advise on treatment options, treatment plans, locations, costings and logistics.

Only legally registered services are signposted.

We understand Methadone detox.

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