An atypical methadone regimen.

sayarsan's picture

Methadone was always something i looked down on as a cop out. Something like a government approved drug addict is how i looked at it until i found that even after being an almost trouble free client for nearly 20 years there was still plenty of room for disapproval by them that makes the rules. In the beginning i consulted an old associate with some experience in these things and was advised to consult a private psychiatrist (Dr. Eastwell) who is no longer practicing unfortunately for brisbin's drug addicts. I presented as a 35 year old who had begun using opiates experimentally at the age of 17 and regularly at the age of 21 and at the age of 35 was no longer prepared to devote the time and energy required to keep me in the habit to which i would like to be accustomed. My use at that point had peaked when as a producer i was able to take 4-6 shots a day of ~150mg/shot. This was much more than i was using when i started methadone. By then i was keeping the wolves at bay by getting dihydrocodeine (paracodin) in the form of cough lozenges (a story in their own right) which could still be found after lots of searching. They were becoming harder to find and prohibitively expensive so clearly the sun was setting.
The doctor queried me about my background and usage of drugs in general, family and work histories, and general health history before talking about what i expected from methadone. I answered all his questions honestly since there was nothing compromising in the answers anyway but when i told him how much methadone i wanted he refused saying i would have to start on a smaller dose. I understood his position and after a couple of weeks my dose was up from an initial 30mg to 150mg/day where i stayed for 5 years or so after which it increased to 180mg. After an initial few months of picking up every day i was allowed to pick up 3 days/week and when i picked up i was given 1/2 the dose in the shop and the other 1/2 came as a take away with the next 2 days' doses. At the same time he was able to prescribe diazepam, alprazolam (xanax), and oxazepam (serepax) but not together and he wouldn't prescribe rohypnol. Anti depressants were freely prescribed if i wanted them.
Things went like this until he ceased practicing unexpectedly in early 2010. Unexpectedly for me at any rate tho' he probably new what was coming but was in no position to offer any help. After my prescription expired at the end of the month there was nothing which is a very dim prospect for someone used to taking 180mg a day. I looked and asked frantically but it was clear that nobody was prepared to offer the sort of care he did and i finished up going to the Melleleuca Clinic at Prince Charles hospital at Chermside which was 1 1/2 hours by bus away from where i lived. The closest available place for public patients.
At Melleleuca i was given a reality check. Absolutely no benzos, i had to pick up from a chemist a suburb away i.e. 20 min walk there 20 min back every day and worst of all i was forced to drink the entire dose on the spot. I still believe this nearly proved fatal and would have had i acquiesced. Abrupt denial of benzos had the effect of driving up my rather heavy alcohol consumption to in excess of a bottle of spirits or its equivalent each day and usually i drank the equivalent in cheap plonk which does nobody any favours but is worse if you are on lots of methadone. I found that taking all the methadone meant that a large portion was passing unabsorbed through the gut so i was often feeling a deficit of opiates in my system. Sleep was terribly elusive and i would have suffered more if not for a good supply of yandii thanks to an old friend. It wasn't uncommon for me to find myself nodding off and missing my stop on the bus and worse, spewing the contents of my stomach then dry retching for 1/2 an hour on the footpath in the rain. Seems pater had some foresight after all.
Between the booze and all the metro (done) my stomach was in a terrible state and this was complicated by extensive dental work which made it very difficult to eat even when i figured out what i could eat. I complained repeatedly to the doctor at the clinic who smiled nicely implying that everything would be okay. Finally it reached the point where i was being a collaborator in my own destruction in a way that surpassed all my previous efforts so i simply emptied the methadone into a bottle and took it home to drink slowly. Anyone who has a rudimentary understanding of how to administer drugs would be aware of how ridiculous it is to give someone a dose like that all at once and 2 of the chemists where i picked up never said anything about it when i emptied the stuff into a bottle. I didn't do so in front of them but after my remonstrations on behalf of my poor stomach they didn't hang around to watch me drink the stuff. The head pharmacist, manager i should say of the franchise was in a position of responsibility, wasn't so easy going and since he was usually the one who did the dispensing it wasn't long before he 'caught' me and i was informed that if i did it again he would tell the clinic. I kept doing it and in a few days i had to go to the doctor to answer for my behaviour. I told him i couldn't be expected to be complicit in my own demise which is what this farcical routine amounted to and that the dosage regimen amounted to nothing more than drug abuse which was what i was trying to avoid. Eventually he managed to get approval from his superiors whoever or whatever they are in this sick pantomime and i am now allowed to drink about 1/3 of the dose in the shop and take the other 2/3 home but i have to pick up 7 days a week. Fortunately they or he managed to convince the chemist next door to take me on after they refused to my face twice in the past but can't or won't dose me on weekends so 2 days a week i got to the more distant one which means more exercise but i have separate bills. No thanks at all to the clinic i have stopped drinking booze, stopped taking pills, and stopped smoking except for a very occasional cone or joint. The lesson i learned is that you get by with help from your friends, something i knew already but it never hurts to be reminded of the fact.


felix's picture

I think I'll write one on my experiences going public v private.

sayarsan's picture

It helps to have comparisons, i know there has always been a difference but i suspect it would be more stark these days for some reason. The only comparison i can make is between Eastwell ( who could be seen as the last of his kind) and the clinic. I had a close friend whose comparative experiences between Belmont Private Hospital and Lowson House at RBH painted a stark picture but that was in the 70's before Medibank.

sayarsan's picture

This was when i was on holidays in brisbin in '88, squatting and wanting to keep the place clean i was having trouble finding Paracodin or Codeine Linctus and felt cornered. I went to the clinic at Sth. Brisbin and told them my story which they probably didn't believe so they treated me as a malingerer i suppose. They might do this to everyone for all i know but the treatment was a joke and the people working there much the same. They were telling me i was positive for benzos when i wasn't and positive for morphine after i had some codeine. I even heard a counsellor at front desk telling one of the clients that the body turns morphine into codeine and when i tried to explain that there was an enzyme in the liver that cleaved the methyl groups from di-methyl morphine (codeine) turning it to morphine they said it wasn't true. I wished i had my copy of Bowman and Rand to hit them over the head with the information but pretty soon just quit in disgust and went back to Codeine Linctus, Prosana Relaxing Tonic, and Tuscodin Lozenges (containing Paracodin) when i could find them vowing never to go back to such a pathetic excuse for a clinic.

sayarsan's picture

Prosana was a drug company in Queensland which marketed a brand of codeine linctus and a tonic which had about 170mg per bottle of codeine phos which isn't really much but it wasn't adulterated with anything more nasty than a ton of sugar. A good name for a drug company they ran foul of the Health Department which isn't hard to do in this state.

Knoll is a German pharmaceutical giant which put out Paracodin Cough Linctus. It was famous in it's day and allowed all of us to thumb our noses at the clinic. It will hold you for a long time, not much of a stone but when the wolves are at your heals so to speak a bottle was real security. It enabled me to sneer at the clinic for a long time and more importantly it doesn't interfere so much with your sexual appetite.

After it became so popular that the gutter downstairs from our flat in Darlinghurst, and the door way inside, were often littered with empty bottles of the stuff. A 200ml bottle was 380mg dihydrocodeine/DF118 which is more than the clinic will give you first up. It disappeared from the market country wide. We would stop in country towns as we drove interstate hoping to find some dusty chemist who still had bottles on the counter. City pharmacists were wise to it of course and occasionally would refuse when i pointed to the bottle saying "some of that, please"...."okay, i wouldn't expect you to you miserable old tight-arse". As it disappeared a perusal of the MIMS showed an alternative lay with Tuscodin Lozenges, also peddled by Knoll. They had always been around but they contained lignocaine and clorhexidine which made me suspicious. Enquiries put my mind at ease and i was soon eating two packs of 20 lozenges a time which was 80mg less than 200ml of Paracodin. Thankfully Knoll soon re-released these lozenges in a new packaging format of 24 lozenges per pack which pretty well made up the shortfall.