Opiate withdrawal, the opera (a playlist)

Take some music along with your paracetamol and vitamins. Ease you down gradually. You’ll really feel this stuff kick in as the opiates wear off. You won’t have that numb tolerance to music any more, so go easy.

 

Methadone Maintenance Man – Tony Scheuren. A James Taylor parody that sounds more like James Taylor than James Taylor.

Stop. Where Is My Mind? – The Pixies

Suffering. Black Water – Timber Timbre

Exhaustion. I’m So Tired – Fugazi

Pain. Used To – Wire (Chairs Missing)

Misery. Miss Misery – Elliott Smith

Angst. Drug Life – The Mountain Goats (East River Pipe cover)

Boredom. Loughborough Suicide – The Young Knives

Frustration. That’s Entertainment – The Jam

Change. New Slang – The Shins

Repeat. Marquee Moon – Television

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How to Quit Methadone, Part 1: Do Not Quit Methadone

Don’t. Switch to something easier to stop using and less dangerous to quit, like heroin. Maybe time-release morphine for six months to two years depending on the duration of your methadone maintenance. Buprenorphine, even. Really, methadone withdrawal is incredible torture and medically dangerous. I think it fucked me up permanently.

I once watched a man dying from methadone withdrawal in a redneck county jail. He was in his forties. They wouldn’t even give him clonidine. After two days he stopped getting up off his bunk. After three days you could smell death coming on him, like a sick animal smells at the pound. Pretty soon it made you want to vomit if you got within ten feet of him. He really was dying, so the redneck jailers took him to a hospital where doctors shot him full of morphine. This was out of character for the kind of scum that ran that county jail, so you can understand how sick he was. He came back looking fantastic, like he’d been to a dinner party where Jesus Christ did magic tricks. Now, he didn’t willingly subject himself to that. But you can, if you want.

If you have strong motivation, you will find you have the willpower to do just about anything. Most junkies develop a strong will. It takes a lot of willpower to go out sick and score, suffering all manner of degradation and discrimination. Most junkies don’t quit in the face of this because they don’t want to. The will to continue using is stronger. The two opposing desires can coexist simultaneously; both an exercise of willpower.

If you want to quit methadone (or any opiate; the others are easier), whoever or whatever your motivation is, it will have to move you on more than a practical level. Quitting to save money is a practical reason. Beyond the impulses of the lizard brain, intellectual and emotional reasons are the only true motivators. Those who do have the emotional will to quit but lack intellect will gravitate towards adopted ideologies as a coping mechanism. Those are the crazy-eyed ex-junkies who go to AA meetings and shout about abstinence with desperation. They have relapses you could set a train schedule by. That’s because they sought out an ideology to suit their needs instead of finding what they believe in. Willpower is an existential urge. It doesn’t really matter what motivates you, but you have to believe in it to the death.

There is no opiate harder to quit than methadone. If you never intend to quit and never have to, methadone is ambrosia, a cure-all elixir, a miracle drug, a fountain of youth. If you want off methadone, it suddenly becomes the kind of thing Nazi scientists tested on freezing Russian prisoners.

If the quitting doesn’t kill you (or seriously harm you) and you make it all the way to the other side, you will suddenly find you have some questions for Nietzsche; because while quitting methadone will kill some people, far more people will survive with lasting damage and new health problems. That which does not kill us makes us stranger.

With or without complications, you will feel like your brain needs rewiring. You will remember that you quit methadone because all it did was make you feel normal, only to find that you can’t feel normal without it, even after your unforgettable withdrawal is a distant memory. You have evolved into Homo morpheus. You will literally become like a fish out of water.

The quitting may leave you so broken you have to get back on methadone for health reasons totally unrelated to the chemical dependency you just beat. When you get to the final stages of tapering (assuming you’re not insane and didn’t try going cold turkey after years on the stuff), you may find that methadone was treating medical conditions you didn’t know you had: anorexia, anxiety, depression, eczema, hypotension, stomach disorders (yes, Kurt Cobain wasn’t just whining). What else? Who knows? Only junkies. Doctors won’t even be able to explain how methadone treats your suddenly revealed health problems, because no modern doctors have bothered studying opiates for anything but pain and addiction. You will probably never find the explanation, because the doctors from ancient cultures that knew the medical value of opium are all dead.

Now that you have stigmata to match your stigma, no drug the doctors prescribe will treat your symptoms as well as methadone did. You will wonder how people suffer these various illnesses without opiate treatment. If you suffered from depression or anxiety while on methadone, you will really have some problems waiting for you. SSRIs are toxic, ineffective garbage compared to methadone when it comes to treating anything but the most extreme depression and anxiety. And benzodiazepines for anxiety—don’t even bother, unless you like withdrawal and dependency-induced anxiety so much you want to experience it every day with symptoms that rival methadone withdrawal in life’s constant contest of miseries.

You will feel like you possess a powerful secret when you quit methadone. You will wonder how people get by without opiates. If you’re free from withdrawal but now a prisoner of any of the potential side effects of quitting methadone, you may refuse to go back to the drug because you’ve been through months or years of agony just to get off it. Even if you want to get back on methadone, you may refuse to go back to the kind of places or people (greedy clinics, rip-off treatment programs, corrupt doctors, etc.) that you were forced to deal with to acquire the medication. It’s harder to subject yourself to being treated like a subhuman when you have the stubborn will to avoid it, and by now your willpower will be very strong.

If you decide to go back, you will wonder why you can’t just go to a normal, decent doctor. You will certainly feel frustrated if you feel that you need to go back to the medication for health reasons, and not because of addiction. After all, if you made it this far, you’re no longer physically dependent, and the terrible months of withdrawal have probably conditioned you to hate methadone. You are supposedly no longer a junky, and they only give this stuff to junkies. Where does that put you? If you didn’t know that methadone could alleviate your symptoms, it would put you with everyone else who has whatever you have. But you know a secret, and with wisdom comes the terrible frustration of knowing when everyone else is wrong.

Regardless of what you do, you will continue to live in an age that treats opiate addiction with hysterical fear and inexcusable ignorance. There are deep historical reasons for this. Public health is not among them. Due to cultural beliefs, the medical community thinks it’s appropriate that you suffer because you are an “addict”.

The insanity of the age means that surviving quitting can be harder than surviving using. the_ludovico_technique_by_biscutbuu-d52inxcIdiots at the FDA who have never ingested Tylenol 3 argue about how much naloxone cut is needed in your buprenorphine to induce the desired punitive effect if you fail to put it your mouth properly. Big Pharma scientists are busy to distraction with their insane quest for the oxymoronic holy grail of “non-euphoric” opiates. Apparently, the foremost thing they need to figure out in order to help you is how to make sure you never accidentally feel good. This is being taken to even greater extremes by the medical foot soldiers of the Drug War, so-called “addiction specialists”, the people who pass for doctors and are supposed to be treating you though they usually know very little about medicine let alone addiction. If they ever knew what the Hippocratic Oath was, they long ago traded it in for a paperback copy of A Clockwork Orange. Nowadays, their “new” idea is to force you to take naltrexone to ensure you never feel good again. Maybe implant it in you. It was done in the 1990s by shady rapid detox clinics. Assorted quacks are “very excited!” to try it again. It only killed a few people and it had no success to speak of, but it has the punishment element.

So, if you do this, if you quit methadone, then at some point you are going to be all alone with your existential angst, and it will be severe. If you don’t know what that means, don’t worry, you’ll soon be able to lecture Kierkegaard about his incomplete understanding of the subject.

This is not medical advice. I am not a doctor of medicine.