My doctor prescribe methadone for me for the first time after we had tried several other meds that I did not handle all that well. I never hear anyone mention methadone as just a pain reliever by itself. I only hear of it in terms of withdrawal from heroin. Why is this? Is it not that good of pain reliever? Is it just too highly addictive? Or is it just as addictive as all the other narcotics? It is working very well for me at just 15mg a day. I would appreciate any response on this medication. Thanks

Bill

Hi Bill, there is a lot of stigma with methadone in both the medical & recovery field, but yes, it is a great pain management form for some. You seem to have a Dr. that is working with you, that is a wonderful thing. Just make sure that you are always aware of your refills & take extra cautions. You are on a low dose, & if it works for you why not?. Let me know how you are doing. Yes, is is addicting, but pretty much all pain medications are. Remember that thre are pros & cons to all meds. I do not know the extent of your pain, but I do know it has had great resuslts.
Kisa :)

Hey Bill, You just haven't done a search up in the rght hand corner for topics or threads concerning methadone, just type in methadone into the search feature, keep it from searching all forums, just stick with this furum and it comes up every week from someone new to the med. Don't use the big google search at the top at first, use the search this forum clickable drop down just a the top of each thread just under wear it says welcopme Bill 77725, you ast visited /x/x.

Lots of us have taken it or still use it. It's the only affordable med if you don't have script insurance. When I lost my insurance, 1400 dollars worth of kadian was replaced by 60 bucks a month for meth.

It's very forgiving becvause of the half life, 20-30 hours, so it's not like you wake up every morning and need to lay catch up because it's been 12 hours since you last dose of OxyC or 24 hours since your last dose of avinza, or 8 hours from your last dose of generic LA morphine or MSContin. All those meds have normal half lives of about 2 hours but have been extended to about half of their duration, the 8 hour meds have 4 hour , the 12 have "OxyC" which doesn't klast 12 for many only has a sightlu longer, like 4.6 hours and Avinza time release forumula, when it wears of it wears off.

I've had to go till %PM to find enough to fill a coomplete meth scripot. My dose was higher, I was at 120mgs for about 18 months, swithced to LA morphine for about a year and then back to the same dose of meth. Only in the last 3 months I used meth did I have an ncreazse following breaking more hardware in my fusion. I went to 150, the side effects really got to be too much and because I did well on morphine and my head was clear, and I mean my head, it's not the same for everyone, I had an Intrathecal pump implanted in june that delivers morphine.

It takes about 5 days for your serum level to build up and smooth out, But it's a good pain med and one of the beter for nerve pain due to some specific actions.

BEfore i started taking meth I researched it greatly, and you do have to dig past the tons of articles on meth detox to find POM info, But I would think wth it's rise in the PM comunity there might be some more recent articles I haven't read.

These are good ones, you just ned to cut and paste them into an IE browser or whateverone you use, I have just found IF I found it using a specific browser Ican get back easier using the same. I'm not a computer whiz by anymeans, they may be a great technical reason for this.LOL :confused:
But here are a few artciles and use the search at the top of the page to find more recent discusions and you can click right on them. You will find other discusions searching for "NMDA receptor" . It's one of meth's unique advantages in PM.

Welcome and god luck, Dave
http://www.ampainsoc.org/pub/bulletin/sep00/upda1.htm

http://www.mainehospicecouncil.org/MaineLink/vol2no2/methadone_rediscovered.htm

http://medications.com/go/drug/Dolophine

PS , To be careful at night whiletakinng meth, Driving is a bit riskier, with meth's potential to cause sponatanious nodding out "falling asleep". It really only happened to me if it was late and I was watching TV and pretty much flat lining my brain with TV info. BUt falling asleep when your not expecting it untill you get used to it or when you just not involved in anything to keep you awake isn't uncommon.

At home alone, watching TV, I could see it being a problem, but with a wife and kid it really wasn't untill late at night watching TV so I just went to bed. But it's worrysome enough to keep me from driving at night.

You did not say what pain you are having ???So I can honestly say to you that if your pain is not SEVERE than I would NOT take methadone. I would have your doctor switch you right away to a weaker pill. Such as Vicodin,Lortab, Lorcet or percocet something like that. If your pain is unbearable than methadone may be exactly what you need to deal with your ailment. I was addicted to methadone for about 2 1/2 years. I was taking between 10-20 mg per day(1-2tablets). When I weaned myself down to a piece of a pill, I still had Horrible withdrawl symptoms that lasted a very long time and it was a living HELL. So I am not saying this to scare you but I know some doctor's are so eager to write a script for methadone and they have NO CLUE how to successfully wean you down and give you med's to help with the painful withdrawl's. I had a doctor not too long ago try and write me a script for it and I was like no thanks. There is no amount of pills/money that could take me down that road again. I have been clean from Methadone and did manage to take myself off without any detox program but it was very hard and a very long process. I hope you have researched all your options and I am sorry if I am just being brutally honest about my own experience with Methadone. It may work for you just fine, like I said I have no clue what pain you are dealing with and I know methadone is a great pill for people with chronic pain as it has a long life line and is very strong.

Hey Bill, I wouldn't let meth withrawal stories scare you. Again, the difference is between use and abuse and addiction and physical dependence. Coming off meth cold turkey or simply discontinung it without replacing it with another strong med is very different than meth not workingout and switching to another med.

You can experience differential withdrawal from switching away from meth to another med but I have done it 3 times and it is nothing like the living hell addicts claim when going from meth to nothing, It wouldn't be any worse than going from heroin to nothing, Using meth maint just prolongs your dependence on opiates but allows you to to function without fixing every 4 hours with short actng meds.

If you have chronic pain and opiates are the last option, than switching to Vicodin isn't actually an option. Going from one of the stronger Long acting meds to a short avcting med isn't a common practice with PM, The whole idea of Using the LA meds for pain management is to improve the quality of life and ability to function. If it takes someone 2 years to realize it's not improving their quality of life and they can get by with a couple Vicodin, then likely they never should have been put on meth in the first place.

When you get advice not to take it unless in severe pain, that's pretty much a given, Just like you shouldn't take morphine, oxycontin or Duragesic unless your in severe pain and need round the clock pain managemnt.

Sorry you had a tough time Ratch but switching from meth to nothing is very different from swithcing to meth to another LA opiate. EAch time I did a cold switch, I experienced some mild withdrawal for a week or two and then you work on adjusting and acomadating to the new med. I get the feeling that because some folks have gone straight to I hurt, to long acting meds. This creates major problems like Ratch described. Why would a CP patient that can't function without opiates go from meth to nothing. Unless they didn;t need meth in the first place or were unable to comply or simply wanted to try life without meds, which is fine, but if you know everything else has been tried prior to long acting meds, you pretty much know what your options are.

Because of misinformation about meth, The belief you can't get high on meth and the whole meth maint stigma of switching from heroin or other abused opiates to meth as a way to detox. Obviously a line has been crossed somewhere. either from simple abuse and addiction or perhaps somethng that started as a pain issue turns into an addiction issue, which statistaclly the odds are quite low.

I went cold from 150mgs of meth to the pump and felt little to nothing during the transiton.

IF you went to the addiction board you would get horror stories or stories of how it prevents people from returning to their opiate of choice and a destructive lifestyle, but that really has nothing to do with pain management. There is so much misinformation about meth out there because there are so many people still on meth maint 10 years later without an attempt to lower the dose or discontinue, you can't compare meth maint for addiction to methadone used for chronic or acute pain.

It's used reposnably by most legit CP patents, It's used for hospice care and doesn't convert into harmful metabolites. Anytime you add a psych component to the use of opiates when treating chronic pain, your bound to exerience problems at some point. If meth was the only option because a patient abused their meds, it's not a good option.Meth can be abused too. If you can't find relief from other meds or don't have insurance it's a god send.

This is a PM forum, not an addiction forum and the purpose of you posting here was to learn about meth used for PM not addiction, the addiction info is easy to find. Acurate info and safe info about the use of meth for CP that is harder to find.

LIke I said, 150mgs taken for pain and swithced to another med or the pump is not coaparable to folks that use meth for maint of addiction. IMO it's simply trading one addiction for another. Finding a legit PM doc willing to go against all principles of pain manageement and use only short acting meds is a pretty good indicator that meds could likely be done without. However with the booming PM industry and the ability for any doc to hang a sign that says Advanced pain management outside there office. There are docs that don't understand the med noe knowhow to taper a patient or do a comfortable transition from one drug to another. A PM sign out front doesn't mean they know what they are doing or have tried and failed to manage pain using other modalities.

Short acting meds are used for acute pain and pain not expected to last beyond a surgical recovery, not as a staple for manageing chronic pain, you also see more abuse of SA meds. Hydro products are the most abused opiates of all.

If you hurt bad enough that you can't function, the name of the med has little to do with anything, If it works it works. You have to ask why can I DC meth in a week with no problem and another calls it living hell? Likely because another opiate used for PM wasn't used to replace the meth or some other reasons to discontinuing opiates was found. I'll still stand by my statements that if yur taking meth and your pain is relieved by surgery, the meth can be tapered offf and replaced with SA meds and then the SA meds Discontinued.

You can worry yoursef to death if meth isn't your only alternative, but if it is, and it's being prescribed correctly, for intractable pain. It's perfectly safe and no harder than DCing any other opiate. If meth is so hard why not DC heroin completely and avoid years on another opiaite, caling it meth maint doesn't remove the addiction. The addiction isn't being treated, they are simply preventng withdrawal, which has nothing to do with the reasons meth is used in PM.

No offense Ratch but if meth was used for something other than intractable pain that responded to no other med or treatment than your experience would be very different from someone living with intractable pain. A decent PM doc would have gotten you off the meth and onto another med, not make you experince meth withdrawal by not providing another med to replace it simply because of side effects?

All opiates cause dependence, whether you quit OxyContin or morphine or meth or heroin cold turkey, It's pretty much the same ride. The difference is the reason a person is using these meds. Without the addiction component and being replaced by another opiate, switching from meth is not what Ratch described. It's simply a med change with the normal side effects from starting low with the new med and some differencial withdrawal caused by receptors meth binds to that other opates don't.

People have the same problem switching away from Durageisc, some differential withdrawal, due to Fentanyls unique qualities and the large steps down with the few sizes to choose from with the patch. 50ugh to 25 ugh is a 50% reduction in opiates and bound to cause problems, switching from 25 to another med causes some differential withdrawal because fentanyl is unique and other opiates don't bind to every site fenatanyl does.

I don't go to the addiction board and sing the praises of meth to peple trying to DC it, but for some reason folks on meth maint feel the need to come to the PM forum and warn patients that have no other choice that they are traveling down the same horriable road they traveled.

The difference is the reason why you use meth, have you abused opiates or heroin and gone to the doc to discontinue your IV med use? That's meth maint. Meth used for PM has completely different effects, you don't live with the same psychological problems that drew you to opiate addiction and then live with the fact you really are no closer to being clean after years on meth than you were when abusing other opiates.

So take advice with a grain of salt and remeber there are two reasons people use meth and often people want to confuse proper use prescribed by a PM doc, with addiction maint to prevent withdrawal. Hardly the same reason, and that's what seperates improper use of opiates from proper use.

Meth carries a stigma, just like Oxycontin is becoming stigmatic because of abuse of this med, it still restores quality fo life to thousands of PM patients. But folks tend to focus on the negative. If you told someone you take OxyContin you would get the same looks, same treatment by pharamcies and same treatment by ER docs if they believe OxyC has no medical value and simply leads to addiction.
How is it going, as far as relef and side effects?
Good luck, Dave

Excellent post Shoreline. I was hoping you would come along and give him better info on meth as I know nothing about it.

Shoreline-Dave,

I agree with many things you talked about in your post but I think you should read what the original post said.He asked if it was highly addictive? He wondered if it was a good pain reliever?He also wanted ANY responses from those who knew something about Methadone. I was just stating my opinion and if you read my post I wasn't saying I was totally against it or that it wasn't for him. I wasn't saying I was for it either.You spoke a lot about your experience from switching from Meth to something else and having little withdrawl symptoms, which is possible but the original post did not say he was switching from meth to something else. I believe a lot of what you said is very true. I was ONLY trying to give him some advice since he knew nothing about what he was putting into his body or the effects it would oneday have on his body should his pain get better and he wanted to get off meth altogether or if he's doctor oneday decides he isn't going to write any more meth scripts and sends him home with clonodine. I have seen that happen one to many times as it did with me. I had a great PM doctor so I thought but he had no idea what methadone was all about as most doctor's don't unless they have experienced it themselves. I was just trying to be helpful. Read my post again and you will understand that I was not saying it wasn't for him or that it would not help his pain. I just wanted him to know that sometimes doctor's write meth even though the pain is NOT chronic and the patients who know nothing about it start taking it and have no idea what they are in for when the time comes to switch or stop it altogether!Heck, he didn't even post what he's injury was or why a doctor would even write it for him. All i know is I have had doctor's try and write Methadone for headaches,back pian that (was bearable) and other NON-CHRONIC problems just not realizing what they are prescribing or the effects it can have on people's lives. Methadone is a painful withdrawl even with a taper and that is fact. Unless like you mentioned you are switching from meth to another opiate just as strong or stronger.than it may or may not be so bad. I am not trying to sing any praises for methadone nor am I trying to spare people from traveling down the same road I traveled. Just trying to give hiom some insight on what he is taking since he didn't seem to know anything about it. I was taking it for over 2 years and I know a little about meth myself. You didn't have to hang on everything I said and write a novel trying to under-mind what I wrote in my post. we are all entitled to our own opinions and he asked for any responses he could get so I gave it to him. I am sure he apprecitated your expert advice but there was no need to mention my name in your post several times.

Hey Rach, I'm sorry you took offense, But when you phrase your use as being addicted, There are two ways to take, One for what you are exactly saying, addicted, whch is very different from dependent, or 2 you simply don't understand the dfference between addiction and physical dependnece. But starting a post with I was addicted to meth for 2 years, It instantly seperates yourself from the folks that know they have to trade physical dependence to have some quality of life and folks that abuse and become addicted. We don't know if you abused or not, but when you used the term addcicted, It implies abuse, not simple physical dependnece.

It's something many people don't understand and think that a med that causes withdrawal means you are addicted. In PM addiction isn't a term used lightly, adicction means the end of pain management for many people. It's destructive and has all kinds of psychological motives for using the meds. Simple physical dependence is enevatable. If you take paxil for 2 years and try to discontinue it cold turkey, You will can end up in the ER, same problem with any benzo. There are many meds when discontinued abruptly cause abstinence syndrome. However withdrawal is used solely for drugs of abuse where abstinence syndrome is used for medications like antidepressants although the problem is virtually the same. There isn't a difference between abstinence syndrome and withdrawal, other than what people think when you use one or the other word.

There is a good article by a PM doc a that explains the difference between addiction and dependence. Basically adiction is destructive, Perhaps you misused the term, But many folks from the addiction forum either believe meth is a lifesaver because now they haven't shot up in 10 years and are content with replacing one opiate for another or the other opinions sound reminiscent of your post.

Folks that have have no choice and the only med that allows them to walk or restores some quality of life tend to get upset by posts from addicts proclaiming the evils of the only med that has restored quality of life for someone in intractable pain. Restoring quality of life is hardly destructive , addictive behavior

You took it for two years and experienced withdrawal. If you had taken an equal amount of oxycontn, MSContin, Kadian, Duragesic or any long acting med it would have been just as unpleaseant to discontinue abruptly or taper incorectly.

Docs actually think meth is easier to withdrawal from due to the long half life and slow ellimination. I don't agree. It just takes longer for meth withdrawal to start and longer to complete, But whether it gets bad after 3 days of no use and last longer or it starts within hours of missing a dose and is a few days or wekes shorter. It's still withdrawal with every single symptom.

When it comes to longevity of withdrawal, that depends on how long you take any med and how much change you have created in your bio-chemistry. Whether you have completely shut down endorphin and enkephlin producton for years or for weeks makes a difference. Whether it's morphine, Heroin or methadone, the longer you take it the longer it takes for your body to reset itself.

If your body could reset tolerance and all the changes that occur in a couple weeks, medication holidays would work. But they don't. If you took a month off from any opiate or benzo, within weeks of reintroduction your med requirements would be right back to what they were previously.

After 2 years of use, I would expect you to go through 3 phases of withdrawal. The initial, barfing, chills, shakes, bowel problems, skin crawling, restless legs etc can last 2-4 weeks. Once you get passed that there is a second phase that lasts from 3-4 weeks out to 3 months. Then a third phase that can take up to 6-9 months to completely reset your biochemistry and for sleep patterns to return.

I just think, Had you taken a long acting morphine product, OxyC or used Duragesic you would have experienced pretty much the same thing., Onset is slightly delayed because of half life and duration, the initial phase is a few days longer. But once you get past the intial sickness, you still have months of fun ahead once you have taken any potent opiate for years. I've done the rehab thing myself 20 years ago and I know from experience it can take 6 months to a year for your hands to stop shaking and to be able to simply lay down and go to sleep.

Opiates may be the most notorious for withdrawal, but benzo's withdrawal can cause seizures and death. The only deaths occuring from Opiate withdrawal are from suicide due to the depression that goes hand in hand whith going through withdrawal.

You are right if you have seen GP"s through Meth at someone with low back pain or a headache, It's the most absurd thing I have heard and haven't experienced or seen it myself. In fact what I have seen is quite opposite, I've yet to meet any doc with a heavy hand prescribing meds. I went threw 7 years, 3 fusions, broke 2 sets of hardware and didn't recieve a vicodin from a dozen PM docs that didn't believe in using opiates. After 3 failed surgeries and more modalities than I care to name and months in PT, work hardening and 3 pain clinics where a tylenol 3 wouldn't be prescribed for anyone. Opiates were offered to me as last resort

No surgical solution and no interventional or procedurural modality or relaxation therapy touched the level of pain I live with. I absolutely agree folks are going to opiates way too fast, without trying other methods . People are aware of what is available now that wasn't just a few years ago, Folks want instant relief and I see advice all the time to seek a PM doc because someone has pain 3 months post op. If the PM doc can do something other than prescribe long acting opiates that's great advice, But I also see posts where the PM doc was a jerk and wouldn't give me meds on the first visit.

When folks sugest keep looking for a doc with a different attitude about opiates rather than try something that doesn't have a gaurentee like opiates, You end up with folks on opiates that never should have in the first place.

Why use methadone or Oxycontin if Elevill and skelaxin works, but because of public knowledge of these potent opiates that gaurentee relief, having to go through a PM clinic that doesn't believe in opiates becomes something to refuse, as if there could be no useful tool or knowledge gained from a doc that doesn't believe in meth, oxy or morphine. All the stuff I went through, I still learned something and was able to take at least one tool away from the experience to manage pain.

I somehow lived through 3 surgerries and the withdrawal when docs decided I didn't need pain medicine anymore. It pissed me off when one PM doc said nobody has every died from pain, But the fact is, he was right. If you arive at a PM docs office in pain, you will not die if you leave that apt without a prescription for opiates that gaurentees imediate relief.

The last surgery I had was a 6 level fusion that failed and left me bed ridden for 9 months. I was miserable, but I didn't die. Even the clinic that first initiated opiates in 2000 used opiates selectively, and didn't use opiates on everyone. It was obvious to me and the docs which patients were willing to try anythng to relieve their pain and which patients wanted nothing but a script for opiates.

Just as you can't expect relief for everyone with a bad disc from an ESI, you can't expect a positve outcome from giving everyone with pain, long acting opiates. We really don't disagree. I explain physical dependence, dependence on the doc to keep prescribing, and dependence on the pharmacy to have your meds when you need them is a huge trade and needs to be justified all the time. It's something the patient needs to be aware of and understand the difference between dependence and addiction but not be frieghtened by horrer stories of addiction and withdrawal.

Better PM docs use contratcs to explain this and yet there are people that feel contracts are rediclous and one sided. What's rediclous about knowing up front your not going to get an early refill, 30 days means 30 days, you will be disharged if arrested for diversion or DUI and that explains what physical dependence is.

It protects the docs from frivilous law suites from patients that say I didn't know I would become dependent on LA morphine. Contracts also inform the patient what the rules are, like don't bother telling me the dog ate your month supply or they fell in the sink. Class 11 meds aren't normally replaced. If a doc is foolish enough to allow early refills and replace lost meds, eventually some pharamcist is going to report him for overprescribing.

Sorry to be long winded, But if you read my posts they can get long and I have a sticky keyboard from my daughter, so you may see some odd words with 12 e's in a row. LOL Here is the article about CP , opiates and explains the difference between simple dependence and addiction.
http://www.hosppract.com/issues/2000/09/brook.htm
Good luck, Dave