Split dosing is something you may have heard about, but really don’t understand. Actually, it’s very simple. At its most basic, instead of taking your daily methadone dose once in the morning, you split it in to, taking half in the morning and the other half (ideally) 12 hours later. “Fast metabolizers” of methadone are generally advised to split their doses. Methadone is supposed to last 24 hours. However, there are a group of people – the so called “fast metabolizers” – for whom this does not apply. These people tend to really “feel” their dose in the morning, and then by the end of the day or the next morning, they are in withdrawal. Split dosing evens this out, so they don’t feel their dose, and aren’t in withdrawals by the next morning.
I decided to try split dosing for myself. I have never considered myself a fast metabolizer, although by the time morning rolls around, I can definitely tell my body is ready for my next dose. My problem has always been the drowsiness associated with methadone. I certainly don’t get high off it. However, about 4 hours after I take it (when the blood levels are peaking), I feel like a truck hit me. For the life of me, I can’t stay awake. And if I’m driving – well, forget it. I can’t.
Split dosing has worked really well for me. The first few days I suffered a tiny bit of withdrawal until the afternoon, since you initially take only half of your dose in the morning. After less than a week, my body had adapted. This really changed the way my body felt. I don’t get walloped with that wall of fatigue any more. The one trade off is that it has been a little bit harder to wake up the next morning, since there is more methadone in my body the next morning than there was before I split dosed.
All in all, if you’ve got any of the problems I listed above, you might want to try split dosing. Instead of, say, taking your full dose at 6 a.m., you simply take half at 6 and the other half at 6 p.m. Now, generally, this will only work for people who have many take home doses. Your clinic may not want to work with you split dosing if you come in every day and, besides, who wants to go to the clinic twice a day?
If you decide to try this, let me know what you think!