[ibogaine] hh

HSLotsof at aol.com HSLotsof at aol.com
Sun Jan 18 09:40:07 EST 2004


In a message dated 1/18/04 6:35:43 AM, carlambarnes at yahoo.com writes:

>To ask a question that I wonder about sometimes with
>what some of you are doing in particular with
>methadone. I read a few times that patrick was on 200
>and then doing xanax and 2 or 3 grams of heroin over
>that every day and I thought that was insane, you said
>you were on 180, marc posted how he is detoxing
>someone from methadone who was on 400? (sorry if I got
>the exact number wrong marc I am not reading my
>ibogaine folder i'm only remembering it). Then this
>person is on 610mg of methadone?????
>
>In some ways maybe I am naive and its reaching the
>stage where it would not shock me for someone to speak
>up in the future and say they are on 1200mg or 2000mg
>of methadone and I guess if you keep raising your
>tolerence it is possible but my question is why do any
>of you do this??? Do any of you even feel heroin when
>you are on 180 or 200, I know you can't feel it when
>you're on 610 or am I wrong? 
>
>Why do you keep going up until you are at such a huge
>dose? Do you keep using at the lower doses or not feel
>good and then somewhere at some humongous dose level
>it gets better for you? Does anyone really need 610mg
>of methadone to feel normal or even 400, 200. I was on
>80 and that was a lot. Is there really a difference
>for you between 400mg and 610?
>
>Why keep going up and up when you know that after a
>while you're not even going to feel it anymore and
>then you will be on that dose of methadone. I think
>most states wont even go over 100mg in most cases,
>where is it that all of you are doing methadone
>maintennce that they keep letting you escalate? 
>
>Please understand im not in any way judging anyone i'm
>only wanting to understand why any of you did this to
>yourselves. I know how addiction works but I still
>have a hard time understanding numbers like 200mg,
>400mg, 600mg. I really do keep waiting for someone to
>show up and say 'i'm on 2000mg of methadone, will
>ibogaine work for me?' will it work for them?

Hi Carla,

Well, there are people on 1000mg of methadone and if my memory serves me 
there are a few people receiving 2000mg/day or close to it.   The doses are 
determined by the comfort of the patient.  There are very few methadone providers 
who will dose patients at these doses but, 200 - 300mgs doses are becoming more 
common.  When methadone maintenance was first started by Dole and Nyswander it 
was not uncommon to see 200mg+ doses and then when the program expanded in 
the 1970s the doses initially were in the 100mg range for most patients.  As 
time went on various states and doctors not experienced with methadone limited 
the amount of methadone one could receive or that they would give and you saw 
low doses in the 40mg range that were not sufficient for blockade to stop heroin 
craving.  In 2003, a set of new federal regulations were introduced that 
transferred control of methadone regulation from the FDA to the Substance Abuse 
and Mental Health Services Administration.  These regulations removed dose caps 
and indicated better results were seen in the 80-120mg range of methadone.  
The new regulations were adapted in an attempt to bring methadone maintenance 
into mainstream medicine.  The regulations were less onerous concerning 
treatment of patients than the previous regulations and required accreditation of 
methadone clinics by the same agencies that accredit hospitals and other health 
care facilities.  The federal guidelines set minimal standards for patients 
rights and treatment.  States may provide stricter guidelines in some areas and 
individual clinics stricter guidelines than the states.  Some area where this is 
seen is in the number of urine tests required (the federal guidelines require 
only 8 per year) and how many takehome doses a patient may have (the new 
federal guidelines allow up to 30).

As with all drugs, individual pharmacological dynamics play an important part 
and experienced methadone doctors believe that the correct dose for any given 
patient is one where the patient feels comfortable and heroin and or other 
opioid craving has ceased.  For some patients, this dose may be over 1000mg/day 
of methadone though the vast majority of patients are receiving doses of 
between 60mg and 120mg/day.

For information on methadone:

http://www.methadone.org/library/m101.html#history (contains a linked 
bibliography)
http://www.atforum.com/ (an excellent source of methadone information with a 
site search engine)
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2001_register&docid=
01-723-filed (a bit difficult to read but and interesting discussion of and 
the new federal regulations).

Ibogaine information:

http://www.ibogaine.org/whatsnew.html

Howard Lotsof
Board of Directors
National Alliance of Methadone Advocates



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