Methadone Rehabilitation

Question by Atypical Lover: How long would you be on heroin to need methadone?
I know it depends on various factors such as dosage, purity and route of administration, but how do you know if you need methadone for withdrawal?

For example, if someone was smoking small doses of average-quality powder heroin twice a day for three weeks, and then IV’d tiny doses three times, would they need methadone? If not, how long would the withdrawals last? The person in question is a female teenager, 5’7″ tall and weighs around 125lbs.
Yeah she’s physically sick. Every morning she wakes up feeling like crap until she gets her smoke.

Best answer:

Answer by Will
probably not, it’s hard to say how long, but that doesn’t sound like enogh use for severe physical dependence. they will feel like they have the flu, aids, and been hit by a bus for a few days. after that the mental struggle is the toughest

Answer by J Miller
The person you are describing would not qualify for methadone treatment. In order to get methadone for withdrawal or addiction you would have to go to a methadone clinic and they will only accept you if you have been addicted for at least one year. Some inpatient detox clinics will also give methadone but only for three days and they are not going to give it to someone who has been using for less than a month.

The person you’re talking about would most likely not need methadone anyway. In fact it could do more harm than good in her case. After three weeks of using heroin any physical dependency would be mild if any at all. Nothing that would warrant taking methadone which is a very strong drug that can be dangerous for someone who has a low tolerance which this girl would. In fact it could even kill her at small doses if taken for several days because if the fact that methadone builds up in your system due to its long half life.

It is possible to become physically dependent on heroin if you use daily for 3-4 weeks so it’s not impossible that your friend (or you?) feel some withdrawal in the morning. I would suspect that some of it is psychological though. Either way if she stops now she can get through the withdrawal with some help. Heroin withdrawal will only last for 3-4 days at this point. The worst day is usually the second. After 5-6 days or so she should be back to normal.
What she needs to do is to make sure that she is able to stay home and be sick for a few days (take time off work, etc.). She should stock up with easy to eat and quick to make foods and medications to help with the symptoms. Eating and drinking properly is very important. I’d recommend getting some yoghurt and popsicles in case she will feel nauseas. Saltine crackers help too. Make sure to drink a lot of fluids so she doen’t get dehydrated. If drinking is hard eat popsicles instead. Get a bucket in case she vomits. She most likely won’t but it’s not impossible. Exercise is also highly recommended.

The medications I would recommend to get are Immodium, Ibuprofen, Dramamine, Benadryl and Anti-Nausea Liquid. Immodium will help diarrhea. She probably won’t have that problem either but I’d get some Immodium just in case. Immodium is also an opiate, like heroin, so if taken in higher doses it can relieve withdrawal symptoms. It will not make you high though because it doesn’t pass the blood-brain barrier. I wouldn’t take any more than 20mg. The Ibuprofen will help any muscle ache. Dramamine will help nausea and can help you sleep. Benadryl will also help you sleep and can help runny nose and eyes. Take the Benadryl at night, no more than 2-3 pills. Insomnia is fairly common when in withdrawal. The Anti-Nausea Liquid will of course help the nausea a bit.

If going to the doctor is an option there are a couple of prescription medication that can help. The main on is called clonodine (aka katapress). It’s really a blood pressure medication but it is commonly used to treat withdrawal. Phenergan is also helpful for nausea.
I don’t think this girl will need any prescription medications though. The over the counter meds I mentioned should be okay. Most likely she will only need to take something for 2-3 days. I don’t think her symptoms will be that bad. Most likely not much worse than a cold or a mild flu.

Keep in mind that if she takes any opiate while she is still in withdrawal she will be back on square one. If she would start using heroin again in the future she would develop a physical dependency a lot quicker since she has been dependent before.

I hope she will stop using heroin now and stay away from it forever. Being a heroin addict is hell on earth and after a few months of using heroin you don’t even get high anymore. It’s really not worth it.