Since there is so much controversy regarding whether or not someone can use heroin successfully on top of being on methadone and in a program, I went to an expert. Someone who has been a heroin addict for years, talks openly about all of it, and uses both methadone and heroin. Here is his response: (my warning: Parents who's children are on methadone and tell you they are clean. BEWARE. They actually MIGHT be clean, but then again.....my daughter used on top of methadone and still does. You CAN in fact get high. )
From Gledwood, with his permission.
Gledwood has left a new comment on your post "Parents Helpline":
Hi I left a rambling response at mine but here's the answer to your question. I just read this back and it's just as rambling but different. I hope I answer your question. In short yes they do use on top. I can't prove this, but maybe American patients "behave" themselves more in the more restrictive system you have... I don't know and could never prove this, but maybe...
Over here methadone is drunk under supervision in a local pharmacy for a few weeks, then it's taken home (so people like me can drink it in bed!) eventually people go into shared care where their GP prescribes it and they might pick it up twice or even once a week. It's not necessary to have a job to get this treatment (or to be drug clean) ~ just relatively "stable".
In my experience people on methadone generally stopped "working" to support their habit but continued to use on top of the methadone, just at a much lower rate.
If crack is being used (we don't really have crystal meth here) that prolem really has to be addressed first, otherwise the person is just going to stay off the rails and methadone will be pretty much a waste of time.
A methadone dose of 80 to 120mg is said to blockade a lot of heroin's effects. This belief seems to be more prevelant in America than here. Everybody is different and 2 people using the exactly the same amount of heroin might need different methadone doses to feel equally OK.
I'm adding all this info because I do get the suspicion things are perhaps slightly different here than in the USA.
Here everything is free, so people don't appreciate it as much. Heroin is very easy to get here. I don't believe the figures (surely they can't be true!) but the official figures say that 20 tonnes of heroin is abused annually in the US. While the British goverment estimate that 30 tonnes is used here! Opiate addiction here pretty much means heroin addiction. Nobody I know ever uses pain pills. Maybe heroin really is a LOT more prevelant here, I don't know. But that might account for a difference. Otherwise I just don't know.
But no. I'm sorry to say that being on methadone does NOT mean their babies are behaving themselves or safe :-(
I would guess there's probably a better chance that somebody new to it all would stick to a script without using on top.
Years ago I used a LOT more heroin, and yet relatively tiny doses of methadone kept me feeling OK. As the years went by my tolerance to opiates seemed to mean methadone was less and less effective, while heroin seemed to feel pretty much the same. I don't know why this is and it happened just as much when I was just on heroin as on heroin+methadone. But I feel this point needs to be researched, as it means people with long habits are being underprescribed.
I'm trying to work out WHY people use on top of methadone. In my case I felt noticably more depressed on methadone than on heroin. Also I was very badly addicted and knocking back a couple of swigs of gloop just didn't compensate for not hitting up. Injectable methadoen is sometimes prescribed in this country and I know I would have done FAR better on that... if only, if only. Knowing other variations of treatment are given to other people makes me feel sad as I feel I wasn't really given a chance when I was i desperate need of help. Nowadays I feel much more resolute. I'm genuinely fed up of drugs of all descriptions. I am sure I would have done well on a programme a LOT earlier on ~ but only if that programme had been tailored to suit me personally. I had a lot of problems that just weren't being addressed. Ho hum!!
Posted by Gledwood to DHAM !! DaughterHeroinAddict Moms -The Other Side of Addiction at July 1, 2011 9:49 AM