The total dose of methadone on the first day of treatment should not exceed 30 mg as this can be dangerous to a patient.
Standard doses for narcotic addiction is 15-30mg in the beginning. The dose can be increased after 5-7 days. Typical dose increases are between 5-10mg. It typically takes about 2-3 weeks to get to the dose that is right for you. Some patients feel that the starting dose is too low for them. In most cases this is true. However, because each person metabolizes methadone differently, we need to go slowly in the beginning to avoid any dangerous side effects.
Doctors and their fellow clinical staff must be extremely careful when making adjustments to a patient’s treatment. In extreme cases, deaths have occurred during early treatment due to the effects of those first few days of dosing. For patients whose tolerance for methadone is expected to be rather low, the initial doses should be low as well. A patient who has not been on opiates for five or more days will have a much lower tolerance for methadone.
The first few days
Methadone binds to cells in the liver, lungs and fat before moving back into the bloodstream to have an effect on you. This process is harmless and doesn’t damage the cells at all.
This means that you won’t get the full benefit of your dose during the first few days of treatment. It takes three or four days for these ‘tissue reservoirs’ to fill up and for the methadone to take full effect.
As you can see from the graph below, you have much more methadone in your system four days into treatment than you do on day one or two. People often feel they haven’t enough methadone to hold them in the early days of treatment. If this happens to you, keep taking the methadone as prescribed and talk to your drug worker or prescribing doctor. The risks of overdose are very high if you use other drugs in the early days of treatment.
Call the clinic to set up your first appointment. This first appointment will consist of an assessment only. You will not receive methadone on your first visit. The reason being is that the doctor must get an approval to prescribe you methadone from the college of physician and surgeons. They typically provide this approval within 24 hours.
Once you have been approved for methadone, the doctor will go over the side effects and will remind you to not combine it with certain other medications and alcohol. You will be asked which pharmacy you will be using and the prescription will be faxed to them. Try to choose a pharmacy that is convenient to you and one that provides methadone.
Your follow-up appointment will be within 5-7 days.