You're using liquid methadone to control your taper? I'm so glad I saw your warning about the rapid detox because I have been saving money and planning that, thinking it would be the answer to my prayers.
55mg.
It's recommended to get to 30mg of methadone before switching. But, if decreasing becomes really hard then you can switch over at higher doses. My doctor is going to have me wait 3 days from my last dose of methadone and then start me on the subutex. Basically, i'll dose on Friday morning and then on Monday morning he will begin the induction of subutex. Waiting two weeks is way to long and you will be in real agony. I know that waiting the 3 days is going to be hard enough.
Today I had to wait in line again for some 30mins. Its good that I dislike the drive, wait in line, the ua's, and all the things about the clinic! I think if they just gave me the medication once a month I'd never get off. It would be just to easy to stay on. I mean I want off for so many other reasons also. One reason is when I workout I sweat so much I can actually wring my shirt out. I quit a good job because of the sweating. Also, the sexual side effects are horrible. I mean you can still have sex, but it's nothing like being clean. When I did the rapid detox, apart from being completely horrible, my sex life became great right away. This stuff I realize robs you of so much of life and your not really aware of it. The clouds are just more blue and the sun shine a bit more wonderful when your not doped up on methadone. The mental part of the dependence I don't like. Just the fact that I have to have this stuff or i'm going to be completely in misery. The reasons I want off far out weigh any reason to stay on. I do admit it's helped me and that it's been postitive in many different ways. I believe it's let my brain do a lot of healing. It's allowed me to separate myself from the old lifestyle of using.
I go down again on Friday. This last drop was nothing so I figure this next week will be easy also. I know that before when I got clean things weren't right. I often used again to relieve myself from the way I was feeling. Many times it had to do with anxiety, restlessness, overthinking, sadness, and moods that were out of control. I know that now that I'm on Zoloft that those feelings are going to be different. I'm going to work with my medical doctor and therapy and work through the way I feel once i'm totally clean this time. Rather than running for instant relief i'm going to work it out through professionals. Before I refused to take any medication like Zoloft. I just didn't think I had a mental health issue. I also didn't want to have a mental health issue that required something like Zoloft. But, I didn't care anymore because I can't take using drugs anymore it's no fun and it's total misery for me now.
It's recommended to get to 30mg of methadone before switching. But, if decreasing becomes really hard then you can switch over at higher doses. My doctor is going to have me wait 3 days from my last dose of methadone and then start me on the subutex. Basically, i'll dose on Friday morning and then on Monday morning he will begin the induction of subutex. Waiting two weeks is way to long and you will be in real agony. I know that waiting the 3 days is going to be hard enough.
Today I had to wait in line again for some 30mins. Its good that I dislike the drive, wait in line, the ua's, and all the things about the clinic! I think if they just gave me the medication once a month I'd never get off. It would be just to easy to stay on. I mean I want off for so many other reasons also. One reason is when I workout I sweat so much I can actually wring my shirt out. I quit a good job because of the sweating. Also, the sexual side effects are horrible. I mean you can still have sex, but it's nothing like being clean. When I did the rapid detox, apart from being completely horrible, my sex life became great right away. This stuff I realize robs you of so much of life and your not really aware of it. The clouds are just more blue and the sun shine a bit more wonderful when your not doped up on methadone. The mental part of the dependence I don't like. Just the fact that I have to have this stuff or i'm going to be completely in misery. The reasons I want off far out weigh any reason to stay on. I do admit it's helped me and that it's been postitive in many different ways. I believe it's let my brain do a lot of healing. It's allowed me to separate myself from the old lifestyle of using.
I go down again on Friday. This last drop was nothing so I figure this next week will be easy also. I know that before when I got clean things weren't right. I often used again to relieve myself from the way I was feeling. Many times it had to do with anxiety, restlessness, overthinking, sadness, and moods that were out of control. I know that now that I'm on Zoloft that those feelings are going to be different. I'm going to work with my medical doctor and therapy and work through the way I feel once i'm totally clean this time. Rather than running for instant relief i'm going to work it out through professionals. Before I refused to take any medication like Zoloft. I just didn't think I had a mental health issue. I also didn't want to have a mental health issue that required something like Zoloft. But, I didn't care anymore because I can't take using drugs anymore it's no fun and it's total misery for me now.
55mg
Holly, yes i'm at a clinic and on liquid methadone. Im doing 2mg a week taper. DO NOT waste your money!!! I spent 8,300 dollars at the colman institute in seattle. His name was doctor Rosenfeild and it was a waste of money. They doped me up so good for the week while they did it. Your so doped up and each day you go in and they inject you with a little bit of naloxone or whatever the name of it is that takes the opioids out of your system. They use a little bit each day and then the last day once you pee clean they cut a small opening and put in a naltrexone pellet. That pellet lasts for 2 months and makes it so you can't use or if you do you don't feel the opioid. At any rate it was the worst experience I have ever had in my entire life. I've gone through many detoxes in my life. I've actually had detoxed myself with nothing at all before from my herion habit. Most times I went to the free detox center downtown, which is closed now. I actually was on suboxone before and took myself down and got off that drug and stayed clean a year afterwards. NOTHING was so painful and miserable than what happened after I started waking up from all the drugs they give you while you are going through the rapid detox. I think it should be illegal! I would bet my life that the success rate is 0% and I mean that literally. Of course, they don't do any follow up because the doctors that do it know it's a failure. They are taking advantage of people that want off and are scared of the long drawn out process of tapering. Tapering is the only way to do it. You cant short cut the process I know because I tried to. Also, i'm a strong man and I can take a lot of pain and this was the worst I have ever had. Not to get to personal, but I had a huge hemroid coming out of my anus. It was so big that just laying down and moving hurt!!!! I have never had a hemroid ever in my life before! It was from my body being so stressed. It's not humane to put people through that process. If it worked and was legit it would be done all over the place. I hope that you don't fall into the lies from their site! I read that site over and over and listened over and over to the testimonies they had posted. I debated about doing it for quite sometime. Then one day I decided I was going to do it and what a mistake it was. I don't regret it because I had it in my mind it was the way to go. The propaganda on the site convinced me that it was the best way and I was blessed to have the money to do it. I hope you don't make the mistake and do it. I know two other people personally from my clinic that tried it. Both of them had the same experience as me! They both are back on methadone and doing it the right way and that is real slow and controlled.
Holly, yes i'm at a clinic and on liquid methadone. Im doing 2mg a week taper. DO NOT waste your money!!! I spent 8,300 dollars at the colman institute in seattle. His name was doctor Rosenfeild and it was a waste of money. They doped me up so good for the week while they did it. Your so doped up and each day you go in and they inject you with a little bit of naloxone or whatever the name of it is that takes the opioids out of your system. They use a little bit each day and then the last day once you pee clean they cut a small opening and put in a naltrexone pellet. That pellet lasts for 2 months and makes it so you can't use or if you do you don't feel the opioid. At any rate it was the worst experience I have ever had in my entire life. I've gone through many detoxes in my life. I've actually had detoxed myself with nothing at all before from my herion habit. Most times I went to the free detox center downtown, which is closed now. I actually was on suboxone before and took myself down and got off that drug and stayed clean a year afterwards. NOTHING was so painful and miserable than what happened after I started waking up from all the drugs they give you while you are going through the rapid detox. I think it should be illegal! I would bet my life that the success rate is 0% and I mean that literally. Of course, they don't do any follow up because the doctors that do it know it's a failure. They are taking advantage of people that want off and are scared of the long drawn out process of tapering. Tapering is the only way to do it. You cant short cut the process I know because I tried to. Also, i'm a strong man and I can take a lot of pain and this was the worst I have ever had. Not to get to personal, but I had a huge hemroid coming out of my anus. It was so big that just laying down and moving hurt!!!! I have never had a hemroid ever in my life before! It was from my body being so stressed. It's not humane to put people through that process. If it worked and was legit it would be done all over the place. I hope that you don't fall into the lies from their site! I read that site over and over and listened over and over to the testimonies they had posted. I debated about doing it for quite sometime. Then one day I decided I was going to do it and what a mistake it was. I don't regret it because I had it in my mind it was the way to go. The propaganda on the site convinced me that it was the best way and I was blessed to have the money to do it. I hope you don't make the mistake and do it. I know two other people personally from my clinic that tried it. Both of them had the same experience as me! They both are back on methadone and doing it the right way and that is real slow and controlled.
Jason & Holly
Methadone is hard to get off but it can be done I am living proof 86 days since my last dose. I went through all the WD and my sleep is he only thing I have problems with but I can tell you what helped me through all the withdrawls.
Methadone is hard to get off but it can be done I am living proof 86 days since my last dose. I went through all the WD and my sleep is he only thing I have problems with but I can tell you what helped me through all the withdrawls.
Jason thank you for your reply. I have so many thoughts and questions, but limited time to get it all out.
Please heed my warning about starting the Subutex so soon after your last dose of methadone. I did it, and I ended up in an ambulance having severe convulsions and the worst emotional and physical torment I have ever experienced. I'm no doctor, but I know methadone gets into your tissue and bones, which seems to be why it takes so long to get it out of your system. Please consider this very carefully so you don't have another nightmare experience that prevents you from achieving your goal.
I completely agree with you about the misery of being tied down by a methadone clinic. All of the regulations and the time involved in getting your daily meditation makes it impossible to live a normal life. I've missed a number of family camping trips and reunions because I couldn't be approved for takeouts and there was no methadone clinic close enough to the mountains of Colorado to arrange a courtesy dose during my travel. It's like a prison, except you live on the outside. The daily visits, UAs, rushing to get there on time, etc. It keeps you enmeshed in the drug world because you inevitably become acquainted with other folks, some of whom are like you and me, while others are con artists and thieves. I've had several terrible experiences in the clinic itself, not to mention all of the related side effects of methadone. It has destroyed my life, yet I'm terrified of living without it. I hate it. Just like you, I had never used til I was 38 years old! Once a person starts, their life will never be the same.
Anyway, I am so glad I found your warning about the rapid detox scam.
Thank you again for sharing so much detailed information about your experience. It is truly helpful.
Please heed my warning about starting the Subutex so soon after your last dose of methadone. I did it, and I ended up in an ambulance having severe convulsions and the worst emotional and physical torment I have ever experienced. I'm no doctor, but I know methadone gets into your tissue and bones, which seems to be why it takes so long to get it out of your system. Please consider this very carefully so you don't have another nightmare experience that prevents you from achieving your goal.
I completely agree with you about the misery of being tied down by a methadone clinic. All of the regulations and the time involved in getting your daily meditation makes it impossible to live a normal life. I've missed a number of family camping trips and reunions because I couldn't be approved for takeouts and there was no methadone clinic close enough to the mountains of Colorado to arrange a courtesy dose during my travel. It's like a prison, except you live on the outside. The daily visits, UAs, rushing to get there on time, etc. It keeps you enmeshed in the drug world because you inevitably become acquainted with other folks, some of whom are like you and me, while others are con artists and thieves. I've had several terrible experiences in the clinic itself, not to mention all of the related side effects of methadone. It has destroyed my life, yet I'm terrified of living without it. I hate it. Just like you, I had never used til I was 38 years old! Once a person starts, their life will never be the same.
Anyway, I am so glad I found your warning about the rapid detox scam.
Thank you again for sharing so much detailed information about your experience. It is truly helpful.
Hi Mojo. Congrats on 86 days! Please do tell us what helped you withdrawal and how you feel about your ability to stay off methadone. How high was your dose of methadone, and how long were you on it?
55mg go down tomorrow again to 53mg
Mojo - Don't forget how horrible he clinic is. Don't forget all the hassle, the money, and the prison you are locked into. It's going to get better and better for you I know it. Also, if you are experiencing sleep problems or whatever that are truly hurting your life it would be best to get some help from your GP. I really believe in getting that help rather than resorting back to street drugs or methadone...
Holly - I will keep that in mind and be sure I'm really into withdrawl before I do the induction. I have read and heard of those stories. I'm going to do the transfer because I've gotten off of suboxone before so I know I can do it. The mental part is harder than the physical I think and knowing I've done it before is going to help me get through it. I'm going to post here and share my experience and it's coming up pretty soon. I'm thinking of doing the transfer at 49mg, which my doctor said he has done many times with success. I haven't decided yet, but i'm considering it.
I feel good today and am excited to go down again tomorrow. I'm really grateful i'm on the path to getting off the methadone. The success rate of getting off is so low that it makes me excited to be one of the success stories. I feel like i'm finally old enough, wise enough, tired enough, and overall motivated enough to be done with everything completely. I have to be wise with HALT and all the things I've learned about relapse. I know that Im going to be successful and just hearing mojo's story amplifies that. I know other guys that were on for as long as me and have 7 years clean now. It's really doable. There should be a site dedicated to success stories to reinforce the mental state of those in the process of getting off.
Ok, thanks both of you for the comments!
Mojo - Don't forget how horrible he clinic is. Don't forget all the hassle, the money, and the prison you are locked into. It's going to get better and better for you I know it. Also, if you are experiencing sleep problems or whatever that are truly hurting your life it would be best to get some help from your GP. I really believe in getting that help rather than resorting back to street drugs or methadone...
Holly - I will keep that in mind and be sure I'm really into withdrawl before I do the induction. I have read and heard of those stories. I'm going to do the transfer because I've gotten off of suboxone before so I know I can do it. The mental part is harder than the physical I think and knowing I've done it before is going to help me get through it. I'm going to post here and share my experience and it's coming up pretty soon. I'm thinking of doing the transfer at 49mg, which my doctor said he has done many times with success. I haven't decided yet, but i'm considering it.
I feel good today and am excited to go down again tomorrow. I'm really grateful i'm on the path to getting off the methadone. The success rate of getting off is so low that it makes me excited to be one of the success stories. I feel like i'm finally old enough, wise enough, tired enough, and overall motivated enough to be done with everything completely. I have to be wise with HALT and all the things I've learned about relapse. I know that Im going to be successful and just hearing mojo's story amplifies that. I know other guys that were on for as long as me and have 7 years clean now. It's really doable. There should be a site dedicated to success stories to reinforce the mental state of those in the process of getting off.
Ok, thanks both of you for the comments!
53MG!
Down to 53mg today and it felt good to watch it drop. Gosh I'm so excited about this I can't believe it. Not trying to get to gross or anything, but i'm waking up with erections on a regular basis again. It just shows that my body is getting back to normal again. It's really scary and disheartening when that stops all together! I read in mens health that during the evening this is very normal and important for men. It's a time that keeps that vein and that part of the mans body healthy.
I've been hitting the gym and eating healthy and both feel wonderful. Yesterday, I walked out of the gym after working out and just felt good. The air was cool and the sun was peaking through the clouds a bit. I mean I just had a good feeling that I haven't experienced in awhile. This happened again after going to see the movie Everest. When walking out of the movie I just felt good inside. It wasn't from getting high, getting something new it was just a good feeling to be. I know that methadone steals this type of life experience from me. Your not aware that it's absent until you begin to have these good feelings again. Methadone really numbed me out in so many ways. Getting lower like this has already has had some really positive results.
Thanks again for all the replies and all the support. I hope that all this documentation is useful to someone sometime. I'm grateful I shared my rapid detox experience and it helped holly!! Ok, piece to all and God bless!
Down to 53mg today and it felt good to watch it drop. Gosh I'm so excited about this I can't believe it. Not trying to get to gross or anything, but i'm waking up with erections on a regular basis again. It just shows that my body is getting back to normal again. It's really scary and disheartening when that stops all together! I read in mens health that during the evening this is very normal and important for men. It's a time that keeps that vein and that part of the mans body healthy.
I've been hitting the gym and eating healthy and both feel wonderful. Yesterday, I walked out of the gym after working out and just felt good. The air was cool and the sun was peaking through the clouds a bit. I mean I just had a good feeling that I haven't experienced in awhile. This happened again after going to see the movie Everest. When walking out of the movie I just felt good inside. It wasn't from getting high, getting something new it was just a good feeling to be. I know that methadone steals this type of life experience from me. Your not aware that it's absent until you begin to have these good feelings again. Methadone really numbed me out in so many ways. Getting lower like this has already has had some really positive results.
Thanks again for all the replies and all the support. I hope that all this documentation is useful to someone sometime. I'm grateful I shared my rapid detox experience and it helped holly!! Ok, piece to all and God bless!
Holly I was on methadone for 4 1/2 years first year 60 mg then moved down to 20 mg for 3 years then 15mg the last year. WD were not intolerable the lack of sleep were the worst. Didn't start feeling wd until about 6 mg then after I go off I got restless leg syndrome for about 2 weeks but then that went away then a cold for about a week and sneezing a lot. Aches in my body for about 2 weeks but if you take hot bathes that helps a lot. Lack of energy for about 6 weeks but I have been exercising for about a year before I tapered so just pushed through it and now I have even more energy than I did before.
Jason yes the clinic was the reason I got off the methadone and I won't ever get on that stuff again. Yes my dr gave me some abien for sleep and it works great they say sleep is the last to return.
I am here for you both just ask me anything.
Jason yes the clinic was the reason I got off the methadone and I won't ever get on that stuff again. Yes my dr gave me some abien for sleep and it works great they say sleep is the last to return.
I am here for you both just ask me anything.
53mg
Thanks Mojo! That is great and I know I'm going to make it through all the suffering from the WD's. If I reflect back on all the suffering throughout my addiction I know I can do this.
I feel great today. I went down again yesterday 2mg's. I'm going to do the transfer to suboxone because I believe the WD's are a bit easier. Like I mentioned before I was on suboxone and got off of it before so I know I can do it. I've heard that getting off methadone is a lot harder with regards to the WD's.
I'm finally old enough and wise enough to make this work. Im making an early morning meeting my home group and going 4 days a week. I'm going to start attending a group at the clinic for people getting off methadone that are below 50mg. I'll have to wait a few weeks until i'm under 50, but that will be another line of support. The working out has been really great for me also.
I'm diving into my faith with all I have going forward. Through my faith I was able to get off the suboxone. I remember going through the WD's and I used prayer and the promises of God to pull me through. I drew so much courage and power from my faith it was amazing. I know for me that's going to be critical in both getting off methadone and never going back to using.
Thanks Mojo! That is great and I know I'm going to make it through all the suffering from the WD's. If I reflect back on all the suffering throughout my addiction I know I can do this.
I feel great today. I went down again yesterday 2mg's. I'm going to do the transfer to suboxone because I believe the WD's are a bit easier. Like I mentioned before I was on suboxone and got off of it before so I know I can do it. I've heard that getting off methadone is a lot harder with regards to the WD's.
I'm finally old enough and wise enough to make this work. Im making an early morning meeting my home group and going 4 days a week. I'm going to start attending a group at the clinic for people getting off methadone that are below 50mg. I'll have to wait a few weeks until i'm under 50, but that will be another line of support. The working out has been really great for me also.
I'm diving into my faith with all I have going forward. Through my faith I was able to get off the suboxone. I remember going through the WD's and I used prayer and the promises of God to pull me through. I drew so much courage and power from my faith it was amazing. I know for me that's going to be critical in both getting off methadone and never going back to using.
53mg
I feel great this morning. I'm heading out to church and then to the book store. I'm going to get a copy of a book called, Mind Power. I'm going to really focus now on my thinking. I know, for me, that my thought life is critical in how my life is going. When I got off suboxone before I was very focus in my mind on my faith. I'm going read this book and see what he has to say. But, the mind game when going through taper and detox is huge. It can be so powerful and I believe can be a tipping point to success or failure. If you read discussions and studies about placebo's it's amazing. I mean people get huge results from taking a sugar pill for serious things that are effecting them. This in itself shows how powerful our thoughts are and how shaping our thinking is so important. This is going to be another way to prepare for my complete success of tapering and then staying clean!
I feel great this morning. I'm heading out to church and then to the book store. I'm going to get a copy of a book called, Mind Power. I'm going to really focus now on my thinking. I know, for me, that my thought life is critical in how my life is going. When I got off suboxone before I was very focus in my mind on my faith. I'm going read this book and see what he has to say. But, the mind game when going through taper and detox is huge. It can be so powerful and I believe can be a tipping point to success or failure. If you read discussions and studies about placebo's it's amazing. I mean people get huge results from taking a sugar pill for serious things that are effecting them. This in itself shows how powerful our thoughts are and how shaping our thinking is so important. This is going to be another way to prepare for my complete success of tapering and then staying clean!
Jason,
It is really cool that you are documenting your detox for others. Every person will have different reactions in both time and severity, but all in all the same symptoms show up. You are doing the detox in the correct way, slowly and with the help of a doctor and having a plan.
I have been on methadone for many years and have a very full, busy life. As an advocate I also volunteer at my clinic and write a newsletter for patients and/or their families to help them understand that methadone can be a great tool to use in the fight against opiate addiction.
Since the methadone board was added here in 2011 it has really been helpful. The idea was to have people be able to come to ONE site and have access to all things addiction related. As far as I know this is the only site that does that.
Keep up your good work and congratulations on your success so far. I am sure your experiences will be helpful to those who are thinking about detoxing. In your case it seems that methadone did what it was supposed to, it helped you to free yourself from an opiate addiction, get a good firm hold on your life after addiction and allowed you to make a informed decision on detoxing when you were really ready.
granny
It is really cool that you are documenting your detox for others. Every person will have different reactions in both time and severity, but all in all the same symptoms show up. You are doing the detox in the correct way, slowly and with the help of a doctor and having a plan.
I have been on methadone for many years and have a very full, busy life. As an advocate I also volunteer at my clinic and write a newsletter for patients and/or their families to help them understand that methadone can be a great tool to use in the fight against opiate addiction.
Since the methadone board was added here in 2011 it has really been helpful. The idea was to have people be able to come to ONE site and have access to all things addiction related. As far as I know this is the only site that does that.
Keep up your good work and congratulations on your success so far. I am sure your experiences will be helpful to those who are thinking about detoxing. In your case it seems that methadone did what it was supposed to, it helped you to free yourself from an opiate addiction, get a good firm hold on your life after addiction and allowed you to make a informed decision on detoxing when you were really ready.
granny
53MG
Yes, methadone helped me. I was a heavy IV heroin user and had overdosed 3 times in the year that I decided to get on methadone. The overdoses were one of the reasons for the decision. I was a cronic relapser to heroin. I personally believe that a person should try getting clean at least 10 times before going on methadone. Also, if they have had a short lived pill habit they should really really try other options first.
I was up this morning at 2am and then 3:30 and then had to get up at 4am with that anxiety in my body. It's a weird uncomfortable feeling. I decided to go ahead and document it here. I'm up now and I'm not going nuts or anything. I'm just feel a slight tinge of uncomfortable feeling. Before I as on Zoloft, this feeling was heightened to about 6 times the amount. So, it's progress for me. What's strange is last weeks drop these feelings didn't show up as much. I know it's nothing compaired to how it's going to get at the end. But, it's ok and I'm going to work all week on my thinking habits and what I know to be true...
Methadone is serious business getting off of. I had actually detoxed from herion so many times it's not even countable. I had been in the public detox well over ten times and had detoxed on my own multiple times also. Getting off methadone take a lot more patience and strength than getting off heroin. Staying off is going another story, but I know once I complete this it's going to strengthen my resistence to use again exponentially.
I Pray that this little journal ends up with a beautiful outcome! I am aware that even if you take the best candidates the success outcome of getting to 0mg's is in the twenty percentile. I read that from a long PDF that discusses the process, gives recommendations, and outcome stat's. The sat's aren't exact of course like all stat's, but it gave me a ballpark to be aware of.
Yes, methadone helped me. I was a heavy IV heroin user and had overdosed 3 times in the year that I decided to get on methadone. The overdoses were one of the reasons for the decision. I was a cronic relapser to heroin. I personally believe that a person should try getting clean at least 10 times before going on methadone. Also, if they have had a short lived pill habit they should really really try other options first.
I was up this morning at 2am and then 3:30 and then had to get up at 4am with that anxiety in my body. It's a weird uncomfortable feeling. I decided to go ahead and document it here. I'm up now and I'm not going nuts or anything. I'm just feel a slight tinge of uncomfortable feeling. Before I as on Zoloft, this feeling was heightened to about 6 times the amount. So, it's progress for me. What's strange is last weeks drop these feelings didn't show up as much. I know it's nothing compaired to how it's going to get at the end. But, it's ok and I'm going to work all week on my thinking habits and what I know to be true...
Methadone is serious business getting off of. I had actually detoxed from herion so many times it's not even countable. I had been in the public detox well over ten times and had detoxed on my own multiple times also. Getting off methadone take a lot more patience and strength than getting off heroin. Staying off is going another story, but I know once I complete this it's going to strengthen my resistence to use again exponentially.
I Pray that this little journal ends up with a beautiful outcome! I am aware that even if you take the best candidates the success outcome of getting to 0mg's is in the twenty percentile. I read that from a long PDF that discusses the process, gives recommendations, and outcome stat's. The sat's aren't exact of course like all stat's, but it gave me a ballpark to be aware of.
53mg
Well I'm up again this morning at 3:30am... I went to bed at 10pm, so that's not to bad. It's just when my body is waking me up now. Saturday I woke up at 5am. I realized how my mind tries to start psyching itself out. I know that I'm going to have to rain that in as I get further along in this process. I'm still been eating well and exercising and taking vitamin each morning. I've fought addition my entire life. Its hard to believe I'm still fighting with this much courage. I was a functioning addict/alk for most of my life. The needle and spoon took everything away the last 5 years.
Well I'm up again this morning at 3:30am... I went to bed at 10pm, so that's not to bad. It's just when my body is waking me up now. Saturday I woke up at 5am. I realized how my mind tries to start psyching itself out. I know that I'm going to have to rain that in as I get further along in this process. I'm still been eating well and exercising and taking vitamin each morning. I've fought addition my entire life. Its hard to believe I'm still fighting with this much courage. I was a functioning addict/alk for most of my life. The needle and spoon took everything away the last 5 years.
Jason:
Fight the good fight, try to figure it out and change it. Do your best as you have been doing.
If, in the end, you find yourself overwhelmed and helpless like millions of us do then simply surrender and join us at the AA/NA meetings.
I found that in surrendering that my recovery could begin ... not end.
All the best.
Bob R
Fight the good fight, try to figure it out and change it. Do your best as you have been doing.
If, in the end, you find yourself overwhelmed and helpless like millions of us do then simply surrender and join us at the AA/NA meetings.
I found that in surrendering that my recovery could begin ... not end.
All the best.
Bob R
53mg
Thanks papa bear, i'm going to a 7am meeting this morning. I have to surrender to everything that I don't like because I'm to much of a fighter.
Yesterday I napped for like 4 hours and then went to bed at 9pm and woke at 12 and then 2am and laid there until 3am and got up. Good I happen to get that message because i'm just going to surrender to it and not fight being up so early. Good things are happening in my life. My family relationships are really solid. I'm following through with things I plan with my son always now.
Thanks papa bear, i'm going to a 7am meeting this morning. I have to surrender to everything that I don't like because I'm to much of a fighter.
Yesterday I napped for like 4 hours and then went to bed at 9pm and woke at 12 and then 2am and laid there until 3am and got up. Good I happen to get that message because i'm just going to surrender to it and not fight being up so early. Good things are happening in my life. My family relationships are really solid. I'm following through with things I plan with my son always now.
53mg
I happen to come across this this morning. It's what i'm going to use because I feel like this methadone taper and recovery is the same sort of situation for me.
World War 1 soldiers of the 91st Brigade agreed to recite the 91st Psalm daily. The 91st Brigade was engaged in three of the bloodiest battles of WW1 ; Chateau Thierry, Belle Wood, and the Argonne. While other units similarly engaged had up to 90% casulaties; The 91st Brigade Did Not Suffer A Single Combat Related Casualty!!!
The 91st Psalm
"He that dwelleth in the secret place of the most High shall abide under the shadow of the Almighty.
I will say of YAHWEH, He is my refuge and my fortress: my God; in Him will I trust. Surely He shall deliver thee from the snare of the fowler, and from the noisome pestilence.
He shall cover thee with his feathers, and under His wings shalt thou trust: His truth shall be thy shield and buckler.
Thou shalt not be afraid for the terror by night; nor for the arrow that flieth by day; Nor for the pestilence that walketh in darkness; nor for the destruction that wasteth at noonday.
A thousand shall fall at thy side, and ten thousand at thy right hand; but it shall not come nigh thee.
Only with thine eyes shalt thou behold and see the reward of the wicked.
Because thou hast made YAHWEH, which is my refuge, even the most High, thy habitation; There shall no evil befall thee, neither shall any plague come nigh thy dwelling.
For He shall give his angels charge over thee, to keep thee in all thy ways.
They shall bear thee up in their hands, lest thou dash thy foot against a stone.
Thou shalt tread upon the lion and adder: the young lion and the dragon shalt thou trample under feet.
Because He hath set His love upon me, therefore will I deliver Him: I will set Him on high, because He hath known my name.
He shall call upon me, and I will answer Him: I will be with him in trouble; I will deliver Him, and honour Him.
With long life will I satisfy Him, and show Him my salvation"
53mg
Man I'm up at 3:30am now every morning. Waking with body uncomfortable, dreaming, and then have to get up... I have recently added an extra healthy diet and extra cardio to my day's. I go down on my dose again tomorrow. After two more weeks my doctor said he would transfer me to sub's at 49mg. I'm thinking of making the cut. I have a GP appointment and am going to see if he will prescribe me like 5 days of valium to start taking when I start going into withdraw and then take a few days into the actual switch. I'm going to ask my methadone doctor if he will approve it if my GP will do it. I mean I could easily get them myself, but I don't want a dirty ua and I also want to see if the medical community will support me through this transition with some compassion...
I read so many stories about not feeling anything until getting down to 30mg. I wonder why it's effecting me these little tiny 2mg drops? I can't understand it... Maybe because I've been on methadone 6 years and was at 140mg's for so long. Not judging anyone, but I refuse to be on methadone when i'm 50... It will be to depressing for me to be 50 waiting in line at the clinic.
Man I'm up at 3:30am now every morning. Waking with body uncomfortable, dreaming, and then have to get up... I have recently added an extra healthy diet and extra cardio to my day's. I go down on my dose again tomorrow. After two more weeks my doctor said he would transfer me to sub's at 49mg. I'm thinking of making the cut. I have a GP appointment and am going to see if he will prescribe me like 5 days of valium to start taking when I start going into withdraw and then take a few days into the actual switch. I'm going to ask my methadone doctor if he will approve it if my GP will do it. I mean I could easily get them myself, but I don't want a dirty ua and I also want to see if the medical community will support me through this transition with some compassion...
I read so many stories about not feeling anything until getting down to 30mg. I wonder why it's effecting me these little tiny 2mg drops? I can't understand it... Maybe because I've been on methadone 6 years and was at 140mg's for so long. Not judging anyone, but I refuse to be on methadone when i'm 50... It will be to depressing for me to be 50 waiting in line at the clinic.
53mg
I just found a document supporting my last post of having some medical assistance for the transfer. This doctor clearly sees that using a benzo for the transfer is legit.
PCSS Guidance
Topic: Transfer from Methadone to Buprenorphine
Author: Paul P. Casadonte MD
Last Updated: 08/09/06
Guideline coverage
TIP #40, Treatment Protocols: Patients dependent on long-acting opioids (pgs. 52-54).
Clinical questions
Which patients receiving methadone should be considered good candidates for transfer to buprenorphine?
How should I transfer a patient from methadone to buprenorphine?
Background
Patients receiving methadone may seek transfer to buprenorphine treatment. There are a large number of clinical scenarios that would cause a patient receiving methadone to seek a transfer to buprenorphine. It is incumbent upon the physician to weigh the clinical issues carefully prior to agreeing to assist in the transfer. If a patient is stable on methadone, it is generally not advisable to agree to transfer to buprenorphine without a careful evaluation of the factors motivating the desire to transfer. However, if in the physicians medical judgment, buprenorphine treatment is appropriate and the patient is well-informed of the risks and benefits, transfer may be a reasonable option.
Among the potential benefits of transfer to buprenorphine include lower risk of overdose or sedation, less severe withdrawal if a dose is missed, the capacity to obtain medication at a local pharmacy and the option of treatment in a doctors office.
A number of factors might motivate a patients request to transfer from methadone. These include; a desire to no longer receive their treatment from an opioid treatment program, perceived stigma associated with receiving methadone, concern about having methadone in the house, a desire to travel frequently for work, concern about having a large numbers of methadone bottles in their possession when traveling, concern about losing methadone bottles without the possibility of replacement, less need for the required counseling/medication dispensing/urine collection in regulated opioid treatment programs, and/or living a long distance from a treatment program.
Alternatively, the patient may not be doing well on methadone, continuing to use opiates, stimulants (cocaine or methamphetamines) or benzodiazepines and wishing to leave the
structure of an opioid treatment program. Finally, it is possible that a patient may be buying methadone on the street and is now seeking legitimate treatment.
Patient education
When a patient is seeking transfer from methadone to buprenorphine, it is advisable to determine if the request is based on realistic expectations. It is important for the prospective patient to know that, in an effort to lower the patients level of opioid physical dependence, it is advised that most patients taper their dose of methadone prior to transferring to buprenorphine. Unfortunately, for some patients, the transfer process may be associated with a period of discomfort, both from tapering methadone and from starting buprenorphine. Individuals on moderate to high-doses of methadone, over 60-100 mg, may not be able to taper without discomfort and a risk of relapse. As the methadone dose is lowered, if the patient begins to experience withdrawal that interferes with their functioning or leads to relapse, he/she can be advised that transfer at a later time may be advisable.
Coordination
If the buprenorphine practitioner is not associated with the patients methadone clinic, it will be important to work with the methadone physician and treatment team to coordinate the taper and the timing of the transfer. One should work with the methadone clinic staff to insure continuity of care and a smooth transition, and know that if the transfer fails, that the patient may return to methadone treatment. In some cases, the methadone clinic staff may oppose the patients transfer. The buprenorphine prescriber should be cautious about being perceived as forcing the transfer, yet encourage the patient to advocate on their own behalf if needed and appropriate.
Recommendations
Level of evidence: Low observational studies and a limited number of randomized studies
Transfer Process
Studies of transfer from methadone to buprenorphine are limited (Levin, Fishman, et al 1997; Breen, Harris et al 2003; Law, FD et al. 1997; Clark, Lintzeris et al, CPDD 2006) but offer helpful insights into the transfer process on both inpatient and outpatient settings. It is advisable for the patient to arrange a few days off from work, to go through the transfer.
As with any induction, the patient must be essentially free of opioid full agonists before taking the first dose of buprenorphine. It is not necessary to start with buprenorphine mono then transfer to buprenorphine/naloxone a few days later. The minimal absorbtion of naloxone is not likely to cause a precipitated withdrawal if the patient is in adequate withdrawal when they receive their first dose of buprenorphine.
With the long-acting agonist methadone, the timing of the first dose of buprenorphine may be perhaps more difficult to determine than when starting someone who is using a short acting-opiate. Methadone undergoes significant storage in body tissue, especially the liver, so the length of time until withdrawal is experienced is dependent upon factors
such as hepatic function, dose of methadone, duration of methadone, etc. While a patient may know how long it takes for them to go into withdrawal while using heroin, they may not have ever missed a methadone dose and so be unaware of the timing of withdrawal symptoms.
Higher methadone doses and a shorter timeframe between last methadone dose, are clinical concerns in the methadone to buprenorphine transfer process. Generally it is advisable to taper a patient to 2030 mg methadone, and maintain that dose for a week or more. Buprenorphine may be started 36-72 hours after the last methadone dose, but it is advisable to observe for objective signs of withdrawal (Clinical Opiate Withdrawal Scale of 13-15) and not rely only on time lapsed since the last methadone dose. The key to a smooth transition is not the length of time since the last methadone dose, but rather how much objective withdrawal the patient is in when they come for their first buprenorphine dose. Both the doctor and the patient may be surprised to learn that it may take much longer than 36 hours to begin methadone withdrawal. Clonidine, anxiolytics, including benzodiazepines, non-steroidal anti-inflammatory agents may be used judiciously to assist the withdrawal process, and continued during the induction as well. Withdrawal anxiety will be one of the more common concerns.
Alternatively a patient may taper to the dose at which they report discomfort, and if withdrawal signs are observed by the practitioner, the patient can then be stated on buprenorphine with results similar to a taper to 30 mg methadone. (Breen, Harris, Lintzeris 2003)
A recent study from Australia, conducted on an inpatient unit with doses of buprenorphine that are not available in the U.S., presented at the College on the Problems of Drug Dependence (2006 Clark, Lintzeris) evaluated 3 induction schedules-low (0.8 mg qid on day 1 increasing to 32 mg by day 5; standard (4 mg day1, increasing to 32 mg at day 5) or high (32 mg day 1 and maintain through day 5). The authors conclude that the high and low dose induction proved more tolerable than the standard induction. In addition, it was advised to wait as long as possible after the last dose of methadone to perform the buprenorphine induction. Because of the difficulties in tapering a stably maintained patient's methadone dose, several studies have tried to induce patients at higher doses, such as 60mg, or 70mg. The results suggest that although it is uncomfortable, it may be possible, and not completely contraindicated (2005 Glasper, 2003 Greenwald).
It may not be possible to admit a patient on high-dose methadone (over 40 mg) to an inpatient service, nor to taper methadone to 30 mg. After obtaining a COWS of 15, it appears advisable to start at 2 mg, and continue to dose until the patient is comfortable up to 32 mg on day 1. If withdrawal is precipitated, management with ancillary medications is advisable. Discomfort may persist for up to 96 hours.
Post-transfer Management
It may be helpful to maintain contact with the patient and provide reassurance and telephone consultation up to 3 times daily for the first few days. This can be an intensive process for the physician as well as the patient so it may be inadvisable to start the transfer late in the week. After 3-5 days, the patient will be stable and comfortable, but it may be necessary to add medications to assist with some of the discomforts associated with the withdrawal/transfer process. The patient may lose patience with the discomfort
and want to return to methadone. The clinician will need to work with the patient either to accomplish this, or to encourage them to wait a bit longer, provide additional therapeutic support and/or increase ancillary medications.
References
Lintzeris, N., Clark, N., Muhleisen, P. & Ritter, A. Australian National Clinical Guidelines and Procedures for the use of Buprenorphine in the treatment of Heroin Dependence. (2001).
Law, F.D. et al. The feasibility of abrupt methadone-buprenorphine transfer in British opiate addicts in an outpatient setting. Addiction Biology 2, 191200 (1997).
Breen, C.L. et al. Cessation of methadone maintenance treatment using buprenorphine: transfer from methadone to buprenorphine and subsequent buprenorphine reductions. Drug Alcohol Depend 71, 49-55. (2003).
Levin,F.,Fischman, M et al. A Protocol to Switch High-Dose Methadone-Maintained Subjects to Buprenorphine: American Journal on Addictions V.6, Number 2, Spring 1997
Johnson, R.E., Strain, E.C. & Amass, L. Buprenorphine: how to use it right. Drug Alcohol Depend 70, S59-77. (2003).
Clark, N, Lintzeris, N et al. Transferring from high doses of methadone to buprenorphine: a randomized trial of three different buprenorphine schedules. Presented at College on the Problems of Drug Dependence, Scottsdale, June 2006
Glasper, A., L. Reed, et al. (2005). "Induction of patient with moderately severe methadone dependence onto buprenorphine." Addict Biol 10(2): 149-55.
Greenwald, M., K. Schuh, et al. (2003). "Transferring methadone-maintained outpatient to the buprenorphine sublingual tablet: a preliminary study." Am J Addict 12(4): 365-74.
Provided by: Physician Clinical Support System (PCSS)
877-630-8812 | PCSSproject@asam.org | www.PCSSmentor.org
PCSS Guidances use the following levels of evidence*:
High = Further research is very unlikely to change our confidence in the estimate of effect.
Moderate = Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low = Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.\
Very low = Any estimate of effect is very uncertain.
Type of evidence:
Randomized trial = high
Observational study = low
Any other evidence = very low
* Grading quality of evidence and strength of recommendations
British Medical Journal, 2004;328;1490-
I just found a document supporting my last post of having some medical assistance for the transfer. This doctor clearly sees that using a benzo for the transfer is legit.
PCSS Guidance
Topic: Transfer from Methadone to Buprenorphine
Author: Paul P. Casadonte MD
Last Updated: 08/09/06
Guideline coverage
TIP #40, Treatment Protocols: Patients dependent on long-acting opioids (pgs. 52-54).
Clinical questions
Which patients receiving methadone should be considered good candidates for transfer to buprenorphine?
How should I transfer a patient from methadone to buprenorphine?
Background
Patients receiving methadone may seek transfer to buprenorphine treatment. There are a large number of clinical scenarios that would cause a patient receiving methadone to seek a transfer to buprenorphine. It is incumbent upon the physician to weigh the clinical issues carefully prior to agreeing to assist in the transfer. If a patient is stable on methadone, it is generally not advisable to agree to transfer to buprenorphine without a careful evaluation of the factors motivating the desire to transfer. However, if in the physicians medical judgment, buprenorphine treatment is appropriate and the patient is well-informed of the risks and benefits, transfer may be a reasonable option.
Among the potential benefits of transfer to buprenorphine include lower risk of overdose or sedation, less severe withdrawal if a dose is missed, the capacity to obtain medication at a local pharmacy and the option of treatment in a doctors office.
A number of factors might motivate a patients request to transfer from methadone. These include; a desire to no longer receive their treatment from an opioid treatment program, perceived stigma associated with receiving methadone, concern about having methadone in the house, a desire to travel frequently for work, concern about having a large numbers of methadone bottles in their possession when traveling, concern about losing methadone bottles without the possibility of replacement, less need for the required counseling/medication dispensing/urine collection in regulated opioid treatment programs, and/or living a long distance from a treatment program.
Alternatively, the patient may not be doing well on methadone, continuing to use opiates, stimulants (cocaine or methamphetamines) or benzodiazepines and wishing to leave the
structure of an opioid treatment program. Finally, it is possible that a patient may be buying methadone on the street and is now seeking legitimate treatment.
Patient education
When a patient is seeking transfer from methadone to buprenorphine, it is advisable to determine if the request is based on realistic expectations. It is important for the prospective patient to know that, in an effort to lower the patients level of opioid physical dependence, it is advised that most patients taper their dose of methadone prior to transferring to buprenorphine. Unfortunately, for some patients, the transfer process may be associated with a period of discomfort, both from tapering methadone and from starting buprenorphine. Individuals on moderate to high-doses of methadone, over 60-100 mg, may not be able to taper without discomfort and a risk of relapse. As the methadone dose is lowered, if the patient begins to experience withdrawal that interferes with their functioning or leads to relapse, he/she can be advised that transfer at a later time may be advisable.
Coordination
If the buprenorphine practitioner is not associated with the patients methadone clinic, it will be important to work with the methadone physician and treatment team to coordinate the taper and the timing of the transfer. One should work with the methadone clinic staff to insure continuity of care and a smooth transition, and know that if the transfer fails, that the patient may return to methadone treatment. In some cases, the methadone clinic staff may oppose the patients transfer. The buprenorphine prescriber should be cautious about being perceived as forcing the transfer, yet encourage the patient to advocate on their own behalf if needed and appropriate.
Recommendations
Level of evidence: Low observational studies and a limited number of randomized studies
Transfer Process
Studies of transfer from methadone to buprenorphine are limited (Levin, Fishman, et al 1997; Breen, Harris et al 2003; Law, FD et al. 1997; Clark, Lintzeris et al, CPDD 2006) but offer helpful insights into the transfer process on both inpatient and outpatient settings. It is advisable for the patient to arrange a few days off from work, to go through the transfer.
As with any induction, the patient must be essentially free of opioid full agonists before taking the first dose of buprenorphine. It is not necessary to start with buprenorphine mono then transfer to buprenorphine/naloxone a few days later. The minimal absorbtion of naloxone is not likely to cause a precipitated withdrawal if the patient is in adequate withdrawal when they receive their first dose of buprenorphine.
With the long-acting agonist methadone, the timing of the first dose of buprenorphine may be perhaps more difficult to determine than when starting someone who is using a short acting-opiate. Methadone undergoes significant storage in body tissue, especially the liver, so the length of time until withdrawal is experienced is dependent upon factors
such as hepatic function, dose of methadone, duration of methadone, etc. While a patient may know how long it takes for them to go into withdrawal while using heroin, they may not have ever missed a methadone dose and so be unaware of the timing of withdrawal symptoms.
Higher methadone doses and a shorter timeframe between last methadone dose, are clinical concerns in the methadone to buprenorphine transfer process. Generally it is advisable to taper a patient to 2030 mg methadone, and maintain that dose for a week or more. Buprenorphine may be started 36-72 hours after the last methadone dose, but it is advisable to observe for objective signs of withdrawal (Clinical Opiate Withdrawal Scale of 13-15) and not rely only on time lapsed since the last methadone dose. The key to a smooth transition is not the length of time since the last methadone dose, but rather how much objective withdrawal the patient is in when they come for their first buprenorphine dose. Both the doctor and the patient may be surprised to learn that it may take much longer than 36 hours to begin methadone withdrawal. Clonidine, anxiolytics, including benzodiazepines, non-steroidal anti-inflammatory agents may be used judiciously to assist the withdrawal process, and continued during the induction as well. Withdrawal anxiety will be one of the more common concerns.
Alternatively a patient may taper to the dose at which they report discomfort, and if withdrawal signs are observed by the practitioner, the patient can then be stated on buprenorphine with results similar to a taper to 30 mg methadone. (Breen, Harris, Lintzeris 2003)
A recent study from Australia, conducted on an inpatient unit with doses of buprenorphine that are not available in the U.S., presented at the College on the Problems of Drug Dependence (2006 Clark, Lintzeris) evaluated 3 induction schedules-low (0.8 mg qid on day 1 increasing to 32 mg by day 5; standard (4 mg day1, increasing to 32 mg at day 5) or high (32 mg day 1 and maintain through day 5). The authors conclude that the high and low dose induction proved more tolerable than the standard induction. In addition, it was advised to wait as long as possible after the last dose of methadone to perform the buprenorphine induction. Because of the difficulties in tapering a stably maintained patient's methadone dose, several studies have tried to induce patients at higher doses, such as 60mg, or 70mg. The results suggest that although it is uncomfortable, it may be possible, and not completely contraindicated (2005 Glasper, 2003 Greenwald).
It may not be possible to admit a patient on high-dose methadone (over 40 mg) to an inpatient service, nor to taper methadone to 30 mg. After obtaining a COWS of 15, it appears advisable to start at 2 mg, and continue to dose until the patient is comfortable up to 32 mg on day 1. If withdrawal is precipitated, management with ancillary medications is advisable. Discomfort may persist for up to 96 hours.
Post-transfer Management
It may be helpful to maintain contact with the patient and provide reassurance and telephone consultation up to 3 times daily for the first few days. This can be an intensive process for the physician as well as the patient so it may be inadvisable to start the transfer late in the week. After 3-5 days, the patient will be stable and comfortable, but it may be necessary to add medications to assist with some of the discomforts associated with the withdrawal/transfer process. The patient may lose patience with the discomfort
and want to return to methadone. The clinician will need to work with the patient either to accomplish this, or to encourage them to wait a bit longer, provide additional therapeutic support and/or increase ancillary medications.
References
Lintzeris, N., Clark, N., Muhleisen, P. & Ritter, A. Australian National Clinical Guidelines and Procedures for the use of Buprenorphine in the treatment of Heroin Dependence. (2001).
Law, F.D. et al. The feasibility of abrupt methadone-buprenorphine transfer in British opiate addicts in an outpatient setting. Addiction Biology 2, 191200 (1997).
Breen, C.L. et al. Cessation of methadone maintenance treatment using buprenorphine: transfer from methadone to buprenorphine and subsequent buprenorphine reductions. Drug Alcohol Depend 71, 49-55. (2003).
Levin,F.,Fischman, M et al. A Protocol to Switch High-Dose Methadone-Maintained Subjects to Buprenorphine: American Journal on Addictions V.6, Number 2, Spring 1997
Johnson, R.E., Strain, E.C. & Amass, L. Buprenorphine: how to use it right. Drug Alcohol Depend 70, S59-77. (2003).
Clark, N, Lintzeris, N et al. Transferring from high doses of methadone to buprenorphine: a randomized trial of three different buprenorphine schedules. Presented at College on the Problems of Drug Dependence, Scottsdale, June 2006
Glasper, A., L. Reed, et al. (2005). "Induction of patient with moderately severe methadone dependence onto buprenorphine." Addict Biol 10(2): 149-55.
Greenwald, M., K. Schuh, et al. (2003). "Transferring methadone-maintained outpatient to the buprenorphine sublingual tablet: a preliminary study." Am J Addict 12(4): 365-74.
Provided by: Physician Clinical Support System (PCSS)
877-630-8812 | PCSSproject@asam.org | www.PCSSmentor.org
PCSS Guidances use the following levels of evidence*:
High = Further research is very unlikely to change our confidence in the estimate of effect.
Moderate = Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low = Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.\
Very low = Any estimate of effect is very uncertain.
Type of evidence:
Randomized trial = high
Observational study = low
Any other evidence = very low
* Grading quality of evidence and strength of recommendations
British Medical Journal, 2004;328;1490-
I found that going from booze/drugs to off booze/drugs was:
"Don't drink/use and go to meetings"
All the best.
Bob R
"Don't drink/use and go to meetings"
All the best.
Bob R
