Replacement of Methadone with Opium Tincture
2/7/2018 12:00:00 AM

Replacement of Methadone with Opium Tincture

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Some of the members who have been liberated from addiction since one year and half ago were randomly summoned to be tested to report their liberation durability. It is unbelievable that there were no signs of addiction anymore in 80% of the members.


What do we do in order to replace methadone with opium tincture? There are three cornerstones which should be considered when prescribing the medicine, whether in Congress 60 or other clinics: appropriate medicine, amount and time. These three factors should be taken into account.  

 Suppose that we want to stick two things together. Since there are different kinds of glue, we should choose the proper one. This is the same as choosing the appropriate medicine. We should know if the medicine includes all the necessary factors.

 For example, Tramadol has been derived from Narceine, an opium alkaloid, which performs a special job in certain area. Or Methadone derived from Thebaine, another opium alkaloid, has a limited scope of performance, or buprenorphine and morphine which are exhilarating.

 It is necessary to know what features the medicine has and gives us.

When someone uses OT, they don’t tend to commit suicide any more, they are not even depressed. Other medicines might not have the same results as OT. Opium Tincture contains Papaverine, which has an important role in erection. Those who problems in their spinal cord have papaverine injection to improve their sexual problems. There are some derivations, like Codeine and Morphine, in Opium which delay orgasm. There is a substance in opium called Protopine which regulate the heartbeat.

Thus we should research into all the functions of 25-50 alkaloids and then give our ideas. A physician can recognize that you won’t need to take fluoxetine, lorazepam and amitriptyline if you use opium.

We should consider this fact and decide on the proper medicine, without prejudice but with reason, to improve sexual, sleep and depression issues.

 I have experienced that those who have heart problem face no difficulties. I’m sure that methadone can be harmful for those who have kidney and liver insufficiency while using opium, opium extract, heroine and different pills; because methadone doesn’t contain all the necessary substances while opium does.

 Opium even includes alkaloids which regulate the heartbeat, the blood pressure, the amount of blood sugar, sleep and sexual issues. It is not possible to prescribe a large amount of pills for the sick. There are some people who refer to Congress 60 as they are using 35-40 pills per day.

Another factor to pay attention to is the proper amount of medicine. Do you know how much is 70 cc of methadone? Once a man who had drunk was taken to the judge. He ordered to give him 1000 lashes him. The man said to the judge, “Either you haven’t been lashed or you don’t know how much is 1000 lashes.” 150-200 mg methadone, 70 cc methadone or 60 cc opium tincture are not proper amount of medicine and has destructive effects on the sick.

 It is not correct to say: use your medicine for now and we will wait for the results. We are not to increase the dosage of the medicine perfunctorily.

The third principle refers to the proper time. When to take the medicine? How to use it? After the meal or before it? How long can its effect last? When it lasts longer it means that the medicine still exists in the blood flow and gradually decreases. The efficient life span of heroine is 6-7 hours, but it decreases during 12 hours. Therefore, we considered TDS as the best and proper time of taking the medicine.

 Some of the members who have been liberated from addiction since one year and half ago were randomly summoned to be tested to report their liberation durability. It is unbelievable that  there were no signs of addiction anymore in 80% of the members. This is because we use proper medicine, proper amount of medicine and proper time of using it.

The addicts should take the medicine TDS in 8-hour intervals in a day, that is more difficult than taking it once a day. I have told since the time the method was piloted in INCAS (Iranian National Center for Addiction Study) that the medicine have to be prescribed TDS and it has done. They said, “If they take the medicine with themselves, they may sell it.” I answered: “because you didn’t teach them.”

I told Dr. Mokri, “You may have a gun at your home by which your children kill each other whereas there are a lot of ammunition in a garrison and nobody is killed because they have been taught. We should teach those who receive Opium Tincture how to use it.

 When someone comes to Congress 60 and says: “I take 40-50 cc methadone per day or I use methadone with meth, hashish, opium or other substances, the first action we take is to cut using other substances because methadone is used predominantly.  

As meth is opposite to methadone, the consumption of methadone decreases when we cut using meth.

The second step is using methadone TDS. For example, when the addict uses 35 cc methadone, we divide the amount of methadone into 3 and round it. So we prescribe three dosages of 7 cc; one in the morning, one in the afternoon and one at night.

Thereafter it is not necessary to prescribe OT, but to continue with methadone for one week more in order to be adapted with methadone.  After a week we cannot immediately replace methadone with Opium Tincture because their body do not accept it completely.

What should we do? First, we replace the afternoon dosage with OT, after one week OT is replaced with the morning methadone, and finally after the third week we omit the dosage of night and replace the methadone with OT.

 This replacement is done in one month. Now how much OT is replaced with methadone? What follows below includes our experience which has had acceptable and good results.

 As you know 1 cc methadone equals to 5 mg methadone. Therefore, we give the same amount of OT if they use less that 10 cc methadone. If they use more than 10 cc methadone to 20 cc, we need to give OT to them as much as half of the amount of methadone they use. For instance, when the individual uses 20 cc methadone, we give him 10 cc OT for his 10 cc methadone, and for the next 10 cc methadone we need to give 5 cc OT which totally becomes 15 cc OT.

And if the person uses 30 cc methadone, for the third 10 cc we will give him 1 cc OT, which totall becomes 16 cc.

Anyway we should calculate the proportion so that it doesn’t exceed 16.5 cc OT. This is true for opium extract, too.

We have recently been changing the protocol of opium extract. We don’t omit opium extract right away.

Next week I will give you a pattern and ask you to calculate the amount of OT should be given to the sick.

Translated by: Marjan


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