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Hey ya'll SWIM has been on the Methadone program for aprx, 3months now, and just 24hours ago his dose of methadone has been increased from 45mg to 50mg oral liquid in mixed drink, daily dose at local clinic.
Also, SWIM has a bottle of Ativan, (Lorazepam) 1mg, prescribed for anxiety,Also Hydroxyzine (atarax) 25mgx2 tablets once a day as needed.
NOTE: SWIM HAS zero Benzo tolerance. (its been 2years sense a benzo)
SWIM was wondering, What time would be the best to take the ativan to get full effects of the methadone in conbination with the benzo Ativan.? Before SWIM consumes the methadone, or after?
Also, would taking 2-3 teaspoons of baking soda with water before, and 2-3 teaspoon fulls baking soda after the methadone was consumed, have a greater effect on SWIMs high that he is looking for?
Will the baking soda interact with the lorazepam and the methadone in a good way? (making the high last longer,more euphoric, faster onset?)
One more thing !, to boost the high of this conbination " 50mg methadone 1mg ativan,baking soda" would say.. 50 mg Atarax (hydroxyzine) add to the effect? or ruin the benzo high?
I thank you in advance for all your suggestions and comments.
Baking soda won't do anything. Taking benzos with your methadone is a great way to kill yourself. The hydroxyzine will potentiate the methadone. Try taking 50 mg atarax right after your methadone. See how you feel in about an hour.
They just increased your methadone. There's no reason for you to need to get even higher by throwing a benzo into the mix. Benzos on their own are near impossible to fatally overdose on but when combined with opiates, even in small amounts, they can easily kill. You just go to sleep and never wake up.
If you are going to take the lorazepam, which I suggest you don't do but you probably will anyway, take no more than .5 mg to begin with. Wait at least a couple hours before taking anymore and only take another .5mg
Further, if you're on the clinic, shouldn't you be trying to get your life in order and trying to get over your addiction? Why are you adding more addictive drugs to the methadone (that you just had upped)?
Now it is clear for me baking soda do nothing. From common sense all this magic moves around baking soda is to turn methadone hydrcloride into methadone freebase. SWIM took 2 equal amounts og methadone hydrochloride, one of those turned into freebase using baking soda. Bio test 1: 300 mg methadone hydrochloride injected IV... "khhmmm....not bad....". Bio test 2 on next day: methdone freebase 29& mg divided with a little help from medical ethanol and warter injected IV "khmmmmm.... not bad...." But is there any difference? Not counting ethanol aftertaste in mouth and a little more burring felling while injecting --- nothing. Maybe placebo effect... but haven't found any difference to be honest.
Nooo...the point of the baking soda is to mix it in water & drink it; by changing the pH of the stomach (I forget if it goes up or down), it allows more/better absorption of various active ingredients, which results in either getting high on a lower amount of active ingredient, or longer duration of the peak of the active ingredient. That's the idea, anyway.
Agree with MP - mixing in the benzo when one just upped their methadone dose is asking for trouble. Hydroxyzine does a fabulous job of potentiating methadone - we can't even be prescribed it any more at my methadone clinic if you want to continue to receive take home doses - it's abused that much to potentiate methadone.
In regards to the lorazepam...I'd take what the doctor prescribed & no more than that. I pray that the doc who 'scripted the lorazepam knows the patient is also taking methadone. But if one doesn't have a benzo tolerance, they should be more than good on the prescribed dose, esp mixed with methadone & hydroxyzine.
Eating baking soda will make it neutralize HCl in stomach (3 spoons before).
NaHCO3 + HCl --> NaCl + CO2^+H20
same effect with methadone hydrochloride (addition spoons after):
medon.HCl + NaHCO3 --> medon (freebase) + NaCl + CO2^+H2O
Other speaking about solubility depends on pH is magic that ppl accept as is cos they don't understands why this happens or some1 don't want to tell to them why is it happen thinking it is too hard to understand for them.
Changing pH means adding into mixture compound with higher or lower pH and that compound react with other parts of solution, reacting with some of them, ionizing some of them, and so on, instead of explaining what happen ppl prefer to talk about some magic dependence between pH and solubility.
That is 100% false. Baking soda most definitely potentiates both methadone and other orally taken opioids.
The most obvious reason is that the baking soda is very basic, and will raise the ph in your stomach, therefore neutralizing the lower ph acids used for digestion. This is good because instead of being destroyed and absorbed rapidly in the stomach from acidity, it is able to pass into the intestine where bioavailability is much higher and more methadone is able to pass into the bloodstream. This is the same reason a lot of people take Tums and other antacids before dosing, but baking soda is much more effective.
The other, more important reason for using baking soda is the alkalinity. Baking soda is a decent urinary alkalinizer, so it decreases the amount of methadone that your kidneys excrete, therefore making your dose last much longer.
However, just taking a teaspoon or two mixed in with water (as directed on the back of Arm&Hammer boxes for use as an antacid) will not be of much use. You have to take a full tablespoon ~45 minutes prior to dosing for it to be as effective as described above. Baking soda is VERY salty, so its hard to get down and is not to be used for people with high blood pressure. SWIM's suggestion is to stir 1/2 tablespoon into a glass of water, chug it down, and then repeat with another 1/2 tablespoon.
This is SWIM's guide to potentiate methadone and other oral opioids:
Step one: take 400mg cimetidine with 1 Tablespoon Baking Soda mixed in water.
Step two: wait 45-60 minutes (can sometimes be difficult)
Step three: take another 200mg cimetidine along with your opioid of choice and 50mg hydroxyzine
Cimetidine can be substituted with grapefruit juice, baking soda can be substituted with Tums, and hydroxyzine can be substituted with promethazine or other H1 antihistamines. However, SWIM has spent a LOT of time coming up with this specific combo, and the substances and doses above will give the best effect.
I guarantee SWIY will have GREAT results if you follow all three steps. If you are a very tolerant and experienced swimmer, you can also add in benzos to step three. If you do that you will want to only take half of your normal methadone and benzo dose for obvious reasons.
WARNING: Do not use this method of potentiation if acetaminophen (Tylenol) is mixed in with your opioid (Vicodin, etc.)
Cimetidine is a CYP3A4 inhibitor just like grapefruit juice, so it will increase the chance of liver failure if acetaminophen is added in the mix in high doses. Do not use this method if more than 1g of acetaminophen is included with your opioid and do not do it often!
Ataraxia Is there any researches about links between CYP3A4 inhibitors and metabolism of methadone? The latest that I found is clinical research made in 2004 (attachment) thats clearly shows inhibitors not working. CYP3A4 inductors increase rate of methadone's metabolism (from same research), but inhibitors doesn't have opposite effect. Beside, there are some opioids that doesn't have nitrogen or oxygen and I doubt CYP3A4 can do anything with those opioids.
And, by the way, HCl, acid in stomach, does not destroy methadone.HCl.
and 50mg hydroxyzine
Antihistamine, also acts like a moderate m-сholine blocking agent... Effect from this should be a way stronger that any juice/inhibitors/soda's effects which are somewhere between placebo and nothing, at least for SWIM and methadone.
I have most definitely had potentiating effects from using DXM and/or Tagamet and/or Prilosec with my methadone doses over the years. I personally think the effect is most noticeable with lower doses of methadone (20mg + potentiation subjectively felt like 40mg, but 90mg + potentiation certainly doesn't approach 180mg subjectively - thank goodness, or I'd either be dead or sleep all day *LOL*), and I don't think it's placebo, as other people have noticed these effects too, even when they didn't know what was up. (Meaning, I knew someone was sick & they only had 10mg of methadone & I gave him 45mg of DXM & he came back up to me the next day asking what the hell I'd given him, because he felt really good, waaaay better than he should have on just 10mg of methadone). Anyway...
All these methods affect the CYP-hoosiey-whatsit enzyme, and thus the metabolism of methadone. Does it work much better with other opioids? I think so, but that doesn't mean the effects from potentiating methadone with those methods are worthless.
You've mentioned CYP3A4 and CYP2D6 inhibitors, inhibiting only CYP3A4 not works what i meant.
Wonder if meds you've mentioned have that "moderate m-сholineblocker effect". Seems like manufacturers usual 'forgetting' to write it in instructions like with hydroxyzine while this effect playing not last role in potentiation of opioids/ates.
I don't know about any current research articles out there, I can only speak from personal experience and taking a VERY long time to do trial and error experiments on myself.
I have tried almost all of the substances/remedies mentioned in the opiate potentiation thread in varying combinations, doses, and time intervals. I have been doing this on and off for the better part of a year.
Having said that, I have just recently added hydroxyzine to the mix. Just the baking soda and cimetidine ALONE have great potentiation for methadone. I am on 90mg of methadone daily, and I totally agree with everything in kailey elise's comment, especially where she noted that this method works better with other opioids, which I can also confirm. Lower doses of methadone have much more noticeable potentiation, but there is still quite a bit of potentiation on higher doses. It is not doubled like on a lower dosage, but both intensity and length is definitely noticeable. I have takeout doses from my clinic, and if I do the method I described above I usually don't take my next dose until about 36-48 hours later. If I don't take cimetidine and baking soda, within 24 hours I have noticeable withdrawal symptoms in varying degrees. The cimetidine and baking soda seem to greatly lengthen the experience, and the cimetidine plus hydroxyzine seem to greatly intensify the experience.
Just as any other substance, every person has a unique reaction. The substances, dosages, and time intervals above work best for me. I admit I haven't read any specific studies to back up my claims, I can only speak from a LOT of personal experience. I can say with a 100% fact that it is not placebo, and I can also say that no other combinations of substances/dosage/time intervals work as well as the method I described above for me personally. Just because you took baking soda in the past and took cimetidine once before with no results, does not mean the exact method I wrote above will have the same results. But my best advice would be to try as many different combos and find out what is best for you personally. For me and quite a few others that have tried it, the combo of cimetidine, baking soda, and hydroxyzine is second to none.
was on lorazepam for panic for 20 years. Tried to get off and it was impossible. Had 2 gran mal seizures, first in the hospital rehab and second after discharged and went home. Fractured and completely dislocated my arm during the second. So, benzos should not be taken lightly, particularly if you have no tolerance. I started on 1 mg and it knocked me on my ass all by itself. I would recommend taking the benzo by itself to begin with to see how you react. Everyone is different. This was prescribed to you so unless you doc is a complete idiot he wouldn't give you something that is going to kill you but be really careful if you have no tolerance to benzos.
Man, sorry to here that jplaw. I recently (about 7 months) started taking 1mg clonazepam twice daily for panic attacks and general anxiety. If i keep on this script for a long time, could I in turn start having seizures after I want to quit? How long does it take to reach this point? (I have never had a seizure in my life)
Isn't Ativan and Atarax enough to potentiate the methadone. I've been on it 6 times, no longer than 2 years at a time. Plus taking that much baking soda every day is putting a lot of sodium in your body. I think the mixture you have is fine, delete the baking soda and maybe eat a grapefruit for breakfast and tell the clinic to raise your dose if it's not holding you all day.
Experiment for yourself. Take your methadone, Ativan and Atarax and drink some grapefruit juice. The next day don't drink the grapefruit juice, and tell us if you really felt a difference. If you do, it will be a very small difference. Of course, it all depends on your liver, because it is your liver and is unique, no liver is exactly the same, just like fingerprints.
Definitely be careful with Methadone and Benzo's. I know 6 people who died taking large quantities of benzo's with methadone. That doesn't include the people I don't know. 50mg of Methadone, max of 2mg of Ativan, and a Atarax should do you fine. I know I wouldn't take that much sodium every day. Yuck.
Are you stuck at 50mg and it's not holding you or what. Tell your doctor to raise your dose or the clinic. All that other crap doesn't really increase the effects of methadone to the point that your really gonna feel it that much. I think it's all hogwash, personally. I'm very aware of the science behind it, but am talking as a ex-methadone addict. Just take you M-done and prescriptions, you should be fine. The more drugs you put in your body the better chance of an adverse reaction. Tums have a pH of around 8 (Calcium Carbonate), and really are just gonna neutralize your stomach acid. Taking cimetidine may help the methadone hold you longer by not metabolizing the methadone as fast. The longer one is on methadone, the faster the body will metabolize it. At first the liver metabolizes it slower because it's new to the system, then after you take it everyday, the liver knows exactly what to do with it and metabolizes it faster. I used to take my dose at 7 AM and by 10 PM, I was going through it somewhat. Enough to cause me to be unable to sleep, and I was on 140mg and on Xanax and Restoril. I got tolerant to everything. Then when you try and get off, it is hell on earth. Off course, you had to have had an opiate addiction, because you are on a clinic in Canada. You can always ask for a dose increase. Why are you asking these questions anyway? What's the problem? Why isn't Ativan and Atarax enough to increase methadone's effects? You haven't been posting, so I'm assuming you just got off this site, so I'm probably writing all this in vain. Oh well, shit happens.
Last edited by salgoud; 08-09-2011 at 17:11.
Reason: because I'm an idiot