He Wants to Go Off Methadone
An AiR member recently wrote in about her son’s desire to go off methadone on his own. Dominique Simon-Levine responds to her concerns below.
“Hi, Not sure how to get info. I am dealing with a loved one who is on a methadone treatment plan. He is absolutely hating this, even though it was his choice years back. It has been 6 yrs and it seems there is no way out.
Problem is that while not arriving at the location in time, one day’s dose was missed and since he “dealt” with the ups and downs that day, now he feels that he can go off of this alone. I am terrified that it is going to spiral even further out of control. I REALLY want him off this plan BUT I feel he is over confident about doing this on his own.
He doesn’t talk to any counselors outside the facility. He hates talking about this at all. How do I help?”
Your son left his methadone clinic after missing his daily dose and now wants to “go off of this alone.” He wants to stop taking methadone.
I am sorry you are going through this. You are right to be concerned about this.
I also understand why your son wants to leave the clinic. 6 years is a long time. I don’t think many people sign on to a treatment, expecting to be attending 6 years on. In my opinion, methadone providers believe being on methadone is the safest thing to do, so there is little motivation on their part to address the end game. It takes a long time to taper off methadone but I encourage your son to consider doing it. The alternatives, as you will see below, are also not great.
This Will Be a Big Challenge
Getting off of methadone is very hard. It has a long half life (the time it takes for 50% of the drug to leave your system); it will feel like it is hanging on forever. If your son isn’t mentally prepared and supported for what will quite possibly be weeks of withdrawal, there is a chance your son may relapse and use again to make himself feel better.
One option is a detoxification program. This would address the worse of the withdrawals but he would still need to be mentally very strong not to use opiates during and after this period. He will leave the detox not feeling well, and this will last for some time afterward.
Consider Medication-Assisted Treatment
Another option is Suboxone treatment. This would provide your son more freedom than methadone. It doesn’t solve the problem of being dependent on an opiate, if his wish is to be completely drug free, but the support, privacy and freedom of being treated by a doctor might address some of your son’s concerns. It is not like methadone: suboxone is prescribed by a private doctor, who provides a weekly prescription to start. Your son wouldn’t have to go to a clinic every day to be dosed.
To be prescribed suboxone, your son will need to be clear of the methadone….at least 72 hours, maybe more. He needs to ask a suboxone doctor about the length of this wait period, as it depends on the dose of methadone he was on. If the Methadone isn’t out of his system, the suboxone will kick in a serious withdrawal.
Finally, some people succeed in becoming opiate free by tapering off of another opiate. Again, I am not a doctor but I think your son will understand this.
Will your son read something you give him? Read this article from The Fix about getting off suboxone, which most agree is easier than methadone. The article does two things. It sets out the difficulties of getting off suboxone and suggests some ways people have succeeded. It also makes the case that for some, suboxone works.
Be Prepared for Relapse
You should probably be prepared in case your son relapses. Your son probably knows this but his tolerance will drop precipitously even a few days off the methadone….he cannot use in the amounts he used to prior to going on the methadone. This is critically important. Please read up on Narcan (here is a piece on how to get and use it; you should have some ready).
Can you give your son the piece from the Fix and this post and have a conversation with him?
→ This link helps you find a suboxone doctor in Massachusetts.
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