Originally Posted by acaptainn
honesty w/ your PM its so hard. i was and got cutoff,,it really shocked me,Ive since started w/ a new PM an did not aproach the addiction issue, but did tell them both that im now resistant to opiates ( 10rs worth)
i askd both for methadone they both said absolutly not w/ no explantion why, i cant understand why
i wanted to trade in oxy an percs for meth. WHY NOT, my mind asks
I think lots of docs don't really understand methadone, or how to prescribe it. Rather than admit it they probably just refuse to work with it. It is very complex to prescribe, especially when the patient is coming from another narcotic - the conversion ratios seem like advanced math. First you have to convert the present narcotic into an equinalgesic dose of morphine. Then calculate an equivalent dose of methadone using a conversion ratio that can range from 2:1 to 12:1 depending on how high the dose of the previous narcotic was. Then they calculate how to divide the daily dose into 3 or 4 per day, then divide by half for the starting dose. I think I'm remembering this correctly. At any rate, I think many of these docs just don't want to deal with methadone. It's too bad because to date the best pain med I've ever used was methadone. I think it could help many chronic pain patients.