I haven’t blogged about this experience until now, because frankly, I been too sick to sit in front of the computer for more than a few minutes at a time. You see exactly 2 weeks today, I stopped taking one the most physically addictive substances known to man.. Methadone! (Some might say even worse than heroin). But rather than doing it the smart way by slowly tapering the dosage down, I decided to stop taking it…. cold turkey! Believe me, this is a place you never wanna go.
Because I had been on a relatively low dose for only 11 months ( 25 mg), I mistakenly believed that I could stop taking the drug without tapering down first. I thought I could do this safely and suffer only minor withdrawal symptoms. I mean, how bad could it be?
Let me just say that detoxing of this drug was one of the hardest things Ive ever done in my life. You wouldn’t believe the incredible hold this drug can have over you. There were times I didn’t think Id make it.
I’m not totally there yet, but I’m definitely heading in the right direction now and can finally see some light at the end of the tunnel. As of this past Monday, there were no detectable levels left in my blood.
If you remember, about 11 months ago at the suggestion of a palliative care specialist, I began a trial of low-dose methadone to help quell my worsening dyspnea. It was felt that being placed on a maintenance dose of methadone would provide better around- the- clock coverage than the short- acting opiates that I had been prescribed previously.
Within the first few days of taking the drug, I didn’t like the way it made me feel and almost stopped taking it right then and there ( In retrospect I wish I would have). But after adjusting the dose, the unpleasant symptoms went away and I pretty much forgot all about it. Methadone just became another pill I had to take everyday to function. Other than the usual side effects that you would expect when taking opiates (mainly constipation) my dyspnea actually did improve. No doubt about it, methadone did help in masking my shortness of breath to some degree and it also gave me the perceived extra energy I needed to exercise the way I wanted to.
There’s always a catch
Yes, I was breathing better, but during this past year I started noticing that every time I was discharged home after a severe asthma hospitalization, I would suffer these really weird flu-like symptoms…only much more severe. Not a lot of fun to feel like you have the flu when you’re trying to recuperate from a severe asthma flare. At first I thought it might be from all steroids or maybe from some of the sedation meds that I receive when on the ventilator, but this had never happened before prior to last year.
Then about 4 weeks ago, right after being discharged from my most recent hospitalization, it happened again, only this time the symptoms were a hundred times more intense. We’re talking violently ill. Severe chills, restless legs, agitation, anxiety, insomnia, etc. I knew I was experiencing some kind of opiate withdrawal, and the only thing I was doing differently was taking methadone. Sure enough, as soon as I would resume taking the drug, those horrible symptoms would instantly go away. I was physically addicted.
It had finally dawned on me that the reason I had been suffering these mini withdrawals after coming home from the hospital, was because I was NOT receiving the drug while in the hospital. I later discovered that the half-life of methadone is longer than any other opiate ( 15-32 hours ), so most people don’t start experiencing withdrawal symptoms for several days after their last dose. This then would explain the delayed withdrawal and why they wouldn’t start until I got home from the hospital. Things were starting to make sense now, but I did not like what I was learning.
I’m not sure why they didn’t give me methadone during some of my hospitalizations. Maybe in all the commotion of trying to stabilize me in the ER during the more severe attacks, the drug just got overlooked or something. All I know is that in 2 of the 3 hospital admissions I had during that time period, methadone is not listed on any of the itemized hospital bills , nor is it listed in my medical records. In any case, that was the deal breaker for me. If there’s anything I hate more, it’s being a slave to something that has so much power over you. What if 5 years down the road I lost my health insurance and was unable to get my daily fix? Id be in some real do-do then. I figured it would be in my best interest to get off this poison immediately. So on Tuesday Jan 4th at 5 am, I took my last 20 mg dose. No weaning, no tapering, just cold turkey. A mistake? Maybe, but I wanted this s**t out of me as soon as possible.
I may be just a tad impulsive, but I’m not a total bonehead. I knew there would be some nasty withdrawal symptoms, so in the hours leading up to my quit day, I tried to do some research to find out ways to make them more bearable . I went to the local GNC and purchased the ingredients needed for a modified version of the “Thomas recipe” that I had found on the web. The science behind it seemed right and for the most part I think it helped. (The only problem for me was the sheer quantity of pills and capsules I had to consume everyday, about 30 capsules. They made me extremely bloated , which in turn made it hard for me to breath).
Let me preface this paragraph by saying that I have a very high tolerance to most forms of physical discomfort. My history of life -long lung disease has toughened me up in a sense. Having said that, I’m also 56 years old and like I said…. have very severe lung disease!
Perhaps I was a little hasty in making my decision to stop cold turkey, because by day # 4 I wanted to blow my brains out and from there it just got worse. I don’t think Ive ever been so sick in my life, at least not while being conscience.
Methadone withdrawal is considered within the opiate dependent community, as the worst opiate withdrawal a human being can experience. The thing about this drug (and I suppose other opiates,) is that when you stop using it, your brain starts flooding your body with extra adrenalin. You can’t sit still, your limbs go crazy, your skin becomes hypersensitive and you get this souped up version of restless leg syndrome (RLS). You wanna jump out of your skin. It’s awful. But I think the worst thing about detoxing from methadone is the insomnia. Not only do you have to endure all the horrible withdrawal symptoms, but you can’t use sleep as an escape.
By day 6 my blood pressure was getting so high that my doctor was worried I’d have a stroke and wanted me to come into urgent care center to be evaluated. Needless to say she wasn’t too please at my decision to go cold turkey from this drug in the first place and tried to talk me into re-starting the methadone so that I could safely taper. I figured I had endured this hell for 6 days , there was no way I was going to back to it, no matter how fast it would have ended my suffering. Sympathizing with me, a Nurse Practitioner at the clinic agreed and prescribed me Clonidine, which is a blood pressure medicine that also helps reduce the severity of some opiate withdrawal symptoms. She also gave me a little Valium to help with sleep. That night I got 3 hours of sleep, the first sleep in a week. By day #8 most of my symptoms had peaked and I was gradually feeling better. I could finally see some light at the end of the tunnel.
It’s now been 14 days, and while I’m still having some residual symptoms, such as intermittent chills, insomnia and mild depression, they’re not as intense as before and I’m finally starting to feel half way human again. I’m now in what they call the post withdrawal phase, which will probably continue for several more weeks. It’s a period in which cravings for the drug can be overwhelming for some people, especially for addicts and those who have been on high doses for a long time. The temptation to end one’s suffering by just popping another a bill can be a tough wall to hurdle when you’ve been through weeks of this hell. Fortunately for me, I was never on real high doses of the stuff and never got a “buzz” from it , so I don’t seem have a psychological dependence for it at all.
What I’d like to know is why was I never told or warned that withdrawing from the drug abruptly, or even slowly, would bring on such severe withdrawal symptoms? The only thing I can think of, is that the doctor who prescribed it to me assumed that I would be taking the drug for the rest of my life, so why bother. Who knows.
Things that helped
I believe exercise played a huge role in hastening my recovery. Starting around the 4th day of withdrawals, I forced myself to get outside and walk at least a couple of miles twice a day. I did this in the rain sometimes, and even did it while having a fever and severe chills. Not only does exercise make you sweat out the drug faster, it also helps reduce the RLS symptoms and make you feel emotionally better. I also found that by taking frequent hot baths offered a few minutes of welcome relief from the unrelenting chills and RLS. Finally, I can’t over emphasize just how important the support you get from online chatrooms, forums and even Youtube are in trying to get though the worst days. Reading about others who were going through it, or who had been through it, helped tremendously.
I still believe that opiates have a place in alleviating the suffering that comes from the breathlessness of severe lung disease or conditions that cause retractable pain, but I think you have to consider all the pluses and the minuses before going down that road. And by all means, people need to informed that these powerful drugs are extremely addictive and that they come with a lot of not so pleasant side effects. Unless the person prescribing this drug is an expert in the field of medication withdrawals effects, if you ever go on this drug, make sure you seek the advise of addiction specialist if you ever decide to come off it.
UPDATE: 11-6-2011 It’s now been full 10 months, almost to the day, since I quit methadone cold turkey. As I mentioned in the original post, the worst of the withdrawal symptoms last about 10_ 14 days. Looking back on it now , I can tell you that I continued to have residual symptoms, especially evening chills and RLS for at least 4 months. It wasn’t until about June ( or 6 months from when I quit )that noticed all of my withdrawal symptoms had faded away.