BrittleBones
05-20-2007, 12:46 PM
I've been reading through some of the latest threads and there have been some that talk about going from one med to another. This is sort of a technical question but I am curious: I was on Methadone for almost 2 years before the doc switched me to the Duragesic Patch (100) last month. I know that duragesic (fentanyl) is not an opiode antagonist like suboxine/subutex (sp?). My understanding though is that the methadone that I was on was an opiode antagonist. If I were to take a methadone dose while on Duragesic, (not that i'm going to..I promise!!) would the methadone then throw me into withdrawals? I hope my question is clearer to you, the reader, than it is to me...the writer! Thanks for any input. KathyMac
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whosit
05-20-2007, 07:24 PM
OK...I understand what you are talking about. I am not 100% sure about this but I have an idea. If you were to take a methadone dose then it would not put you into withdrawl. The methadone itself would prevent you from going into withdrawls and you will have duragesic on top of that. The opiod antagonist keeps the user from getting "high" from the the effects of the opiod. It does not prevent the opiod from acting on your body and relieving pain or preventing you from going into withdrawls. My guess is that if you add methadone to the mix you will prob have to much opiates in your system and will become sick to your stomach or something. I hope this helps you but dont take anything I said to seriously because i am not sure about any of this. Just putting alot of this together from differnet posts on this forum.
Wvrecon432
Wvrecon432
forginon
05-21-2007, 01:36 PM
I've been reading through some of the latest threads and there have been some that talk about going from one med to another. This is sort of a technical question but I am curious: I was on Methadone for almost 2 years before the doc switched me to the Duragesic Patch (100) last month. I know that duragesic (fentanyl) is not an opiode antagonist like suboxine/subutex (sp?). My understanding though is that the methadone that I was on was an opiode antagonist. If I were to take a methadone dose while on Duragesic, (not that i'm going to..I promise!!) would the methadone then throw me into withdrawals? I hope my question is clearer to you, the reader, than it is to me...the writer! Thanks for any input. KathyMac
KathyMac,
I'm really glad you promised you weren't going to do this because IMHO it's a real bad idea. Methadone is not an antagonist. It is a full opioid agonist, with properties that tend to negate the high other opioids bring and also tends to mitigate tolerance better than other opioids.
But methadone is a beast unto itself and based on my limited knowledge, I would never attempt such a thing. Once one has been on another opioid and gets switched to methadone it's not surprising to learn that the starting dose of methadone is much, much smaller than the dose of the previous opioid because of incomplete cross tolerance. In English, it takes much less (in mg dosage) methadone to manage chronic pain in one being switched from another opioid. It would also take much less methadone in mg to overdose.
I expect it would be a real dangerous thing to try.
steve
KathyMac,
I'm really glad you promised you weren't going to do this because IMHO it's a real bad idea. Methadone is not an antagonist. It is a full opioid agonist, with properties that tend to negate the high other opioids bring and also tends to mitigate tolerance better than other opioids.
But methadone is a beast unto itself and based on my limited knowledge, I would never attempt such a thing. Once one has been on another opioid and gets switched to methadone it's not surprising to learn that the starting dose of methadone is much, much smaller than the dose of the previous opioid because of incomplete cross tolerance. In English, it takes much less (in mg dosage) methadone to manage chronic pain in one being switched from another opioid. It would also take much less methadone in mg to overdose.
I expect it would be a real dangerous thing to try.
steve
BrittleBones
05-22-2007, 09:56 AM
Thanks for the responses! No, I wouldn't take methadone while on another opioid. I was just trying to figure out the difference between agonist and antagonist. I was under the impression that taking them together would negate the pain-relieving effects of both drugs...now I know that isn't the case. KathyMac
forginon
05-23-2007, 01:10 PM
Thanks for the responses! No, I wouldn't take methadone while on another opioid. I was just trying to figure out the difference between agonist and antagonist. I was under the impression that taking them together would negate the pain-relieving effects of both drugs...now I know that isn't the case. KathyMac
Sorry KathyMac - I took your comment totally wrong.
The one thing I do know about methadone is that it comes with no kind of rush, and if being taken theraputically, and then another opioid is used, there will be no high from the second opioid, regardless of dose, as I understand it.
steve
Sorry KathyMac - I took your comment totally wrong.
The one thing I do know about methadone is that it comes with no kind of rush, and if being taken theraputically, and then another opioid is used, there will be no high from the second opioid, regardless of dose, as I understand it.
steve
conductor
05-23-2007, 04:56 PM
Hello all,
This thread is still a good idea! My knowledge of anything (Methadone included) is limited. However, many people think that Methadone has various properties because it is usually compared to Heroin.
Also, the idea of agonists vs antagonists is worth a mention. Doctors, often, don't always pay attention. For instance, I went to the ER approximately 10 years ago because of a tremendous migraine headache. I was on the Duragesic Patch and under the care of a Pain Management doctor. This PM doctor ran the Pain Unit at the hospital and instructed me to go to the ER for an injection. Seriously, you can see the Pain Unit from the ER.
Naturally--as these types of things go in these stories--the ER physician (you know...a colleague of my PM doc since they both worked in the hospital and IN THE SAME PHYSICIAN GROUP) would not follow the order called in by my PM doctor. "Why," you may ask? The ER doctor assumed I was a drug-seeker in spite of my PM doc vouching for me. He said that the only thing he could offer me was an injection of Stadol.
HERE'S WHERE THE "ANTAGONIST" THING COMES INTO PLAY. Stadol (and Nubain...and maybe a couple of other medications) is a mixed agonist-antagonist. My pain doctor told me to never use Stadol because the "antagonist" portion of it would reverse some of the relief I was already receiving from the Duragesic.
Well...When I said this to the ER doctor, he became very IRKED. I, at this point, called my PM's answering service (again) and eventually explained this all to my PM doc. Mildly stated, he was unhappy with this friendly, cooperative colleague.
Do I even have to say it? I did not receive headache relief that day.
So...to return to the point (whatever that may be by now). It is important to know our medication types because we don't want to use medicine that reverses the relief we are already receiving!!
Jon (Conductor)
This thread is still a good idea! My knowledge of anything (Methadone included) is limited. However, many people think that Methadone has various properties because it is usually compared to Heroin.
Also, the idea of agonists vs antagonists is worth a mention. Doctors, often, don't always pay attention. For instance, I went to the ER approximately 10 years ago because of a tremendous migraine headache. I was on the Duragesic Patch and under the care of a Pain Management doctor. This PM doctor ran the Pain Unit at the hospital and instructed me to go to the ER for an injection. Seriously, you can see the Pain Unit from the ER.
Naturally--as these types of things go in these stories--the ER physician (you know...a colleague of my PM doc since they both worked in the hospital and IN THE SAME PHYSICIAN GROUP) would not follow the order called in by my PM doctor. "Why," you may ask? The ER doctor assumed I was a drug-seeker in spite of my PM doc vouching for me. He said that the only thing he could offer me was an injection of Stadol.
HERE'S WHERE THE "ANTAGONIST" THING COMES INTO PLAY. Stadol (and Nubain...and maybe a couple of other medications) is a mixed agonist-antagonist. My pain doctor told me to never use Stadol because the "antagonist" portion of it would reverse some of the relief I was already receiving from the Duragesic.
Well...When I said this to the ER doctor, he became very IRKED. I, at this point, called my PM's answering service (again) and eventually explained this all to my PM doc. Mildly stated, he was unhappy with this friendly, cooperative colleague.
Do I even have to say it? I did not receive headache relief that day.
So...to return to the point (whatever that may be by now). It is important to know our medication types because we don't want to use medicine that reverses the relief we are already receiving!!
Jon (Conductor)
BrittleBones
05-24-2007, 02:21 PM
Thanks for that story Jon - that is pretty much what I was trying to find out. I think I remember you posting something about your visit to the ER and being offered the Stadol. And thanks to you also Steve! Take care - KathyMac
pattihabs
06-03-2007, 09:36 PM
hey hitler. i was on methadone for about a month. i was taking 5mg 3x a day. i got immediate pain relief for the 1st time after trying many other meds. the only problem was the high. i would vomit for 24 hours and get a migrane for 2 days. i took zofran to prevent the vomiting to no advail. i will never firgure why someone would want to take this as a recreational drug. getting sick to my stomach and a migraine is not fun to me... patti. ps, i am going to give meth another try but this time not mix it with the other meds my doc was giving me with it. only meth and hopefully it will work and i will get this wonderful high you mentioned...:blob_fire