thanks for that explanation - methadone is so far left of my world I'm missing the dynamics of its' addiction. If anna had detoxed for two weeks in May, then was not taking excessively until sometime in September, would she have had any less of a hard time, by Feb, do you think, than if she'd never detoxed at all?
“If anna had detoxed for two weeks in May, then was not taking excessively until sometime in September, would she have had any less of a hard time, by Feb, do you think, than if she’d never detoxed at all?”
From what I understand “maintenance dose” can be a shifting level. Some people are maintained on 20mg and some are maintained on 100mg. Hospitals and clinics have more standard definitions but probably HKS and KE were just calling it “maintenance” depending on who they were talking to. Point being, there’s no “Standard” for what defines a maintenance dose outside a particular hospital or clinic’s own definition for themselves.
In any case, whenever ANS had to complete the detox, whether Sept or Oct or Feb. it would have been the last 20-30mg that step would have been the hardest for her to have come down from. So the short response to your question would be, “it probably wouldn’t have mattered much.”
I think this is a link to a british site that tries to talk about it and how HARD the last few milligrams are. http://www.drugtext.org/library/books/methadone/section9.html#detox
They even have a recipe for how to do that last step over a 6 month period. They consider one month fast. They have several different scenarios so you can get an idea of how difficult it is to get someone off the stuff. They describe the last step as the hardest and the cravings and miserable anxieties, paranoias, rages are supposed to be supported by a number of environmental things in addition to medications that were probably not there for ANS. They list things like a strong desire to detox, group therapy and individual therapy (no again) and say that successful detox is majorly inhibited by a pre-existing depression.
I think ANS was a very very hard case to have detoxed, even if she had wanted to. And after Sept ‘06, after Daniel died, even at the risk of losing her baby to LB, I’m not sure she wanted to detox. Her use probably climbed. I think it was likely as an addict that she was just angry that LB’s threat to take DL was forcing HKS and KE to try to take her narcotics away. I think narcotics and other meds had become her only comforts after Daniel’s death.
I think HKS and KE had a real tiger by the tail.