I'm going to direct this mostly at you as you seem to just about know everything. Here is the background. Been taking 325-500 Vicodans for a long time. Upgraded due to lack of pain control to Lortabs 10- 500. Then up to Lortabs and 1 Oxycontin 40 twice a day. That didn't last that long before the doctor thought that that wasn't working and put me on Methadone (10mg) 1 to2 X 3 times a day as needed. I've only taken 1 or 2 in a day. The Lortabs are 1 x 4 times a day. I feel so much better just taking the Lortabs and I wonder if I'm not taking enough of the Methadone to work or if I'm used to the Lortab feeling. I do get headaches when I take the Methadone and I'm not sure about that either. I think I'd rather take Oxycontin 80's 2 x Day and the Lortabs. Am I way off here. I know I'm kinda rambling but I need to know... Your thoughts ?????
There is definitely a huge difference in the way Oxy feels and the way meth feels. Hnnestly you haven't given the meth a fair shake yet and your mainly relying on the BT meds. It's a bad habit because when you do need BT mees you will be very use to the dose you presently take.
Most Long acting med literature suggests that if you need BT meds more than twice a day the base dose should be adjusted, But since you haven't taken enough methadone to manage your base pain, you still rely heavily on the BT meds. My docs office just made a clinic policyy change and won't write for more than 60 unit doses per month. I talked my way into being grandfathered because I take 2 30mg MSIR at a time and have no other otpion.
But if you gave the Meth an honest shot, I would bet you wouldn't need as much BT and could actually save it for flairs and the unpleaseant side effects will deminish. The idea of BT meds, is that he's giving you the means to manage your own flares so you can stay out of the ER. IF you take the same dose Of BT med every day at the same time, You really don't have BT meds to help unless your going to suddenly double your meth which is dangerous.
IT would really be best to try to increase the meth and stabalize and see what your neeed for BT meds are. PLain old tylenol works for the opiate headaches I get. Yes, headaches are a side effect of opiates as strange as that sounds.
You need to maintain the same dose for at least 4-5 days to really know what the serum level is going to level out at and allow yourself to become accomadated to any unpleaseant side effects. You doc gave you alot of lee-way so use it. If 10mgs QID, I would suggest 4 times a day, every 5 hours is fine, You don't need to set an alarm with meth..
If your presently taking 2 a day, take 3 a day for 5 days and see how you feel before adding the 4th dose. If you need to increase you do that once you become used to any unpleaseant side effects. You could then add 10 mgs in the evening or morning for a week or so and then add the other 10 mgs In the opposite spot. If you add the 50th mg in the morning add the 60th in the evening. I bet you would become used to the med after about a month and actually find you get better relief without rapid tolerance. The Extra BT meds may only be available during titration and this is your chance to get your base dose correct.
Good luck and if you have questions ask away. Been on this stuff way too long,.LOL
Take care, Shore
I have taken 10mg of methadone in am and pm daily for migraines and chronic cluster headaches. It has done a wonderful job stopping the pain and letting me get back to a normal life. I would recomend it highly. I did not need any meds for breakthrough pain. It was wonderful. It took about a week to kick in.
Hey K, Karla is right, It takes about a week to stabakize your serum level before you actually know how effective the dose is going to be. Since you have been stable on 10mgs twice a day, add a third dose for a week, then re-evaluate the need to continue increasing, If your still needing BT meds 4 times a day, Add a 4th dose for a week, see how you feel and if neccesaary add another 10 mgs to one of your QID doses, Keep doing this each week untill the side effects stop you from increasing or untill you have the relief you need not to depend on the norco for pain relief. . Give it a chance and keep us posted,
Take care, Shore
I am still quite confused about all of this. What should I be feeling when taking the 10Mg of Methadone. Truthfully I'm a little scared with the different things I've been reading about Methadone. Should I try to take as little as possible? What if I want to get away from it. What can I expect? I have yet to take 2 in the same day although I think I will today. I really don't have any Lortab left so I have to depend on the Methadone to do the job. Can I expect to be drowsy or sleepy? or not feel anything at all? At one of the addiction boards I was reading they said that Metadone was the hardest to get away from... Well If you can rest my troubled mind I wouldn't mind whatever input that you have.
I have had 4 back surgerys in the past year and have been on all kinds of pain meds including oxycontin 40mg twice a day with two percs. I was just released from the hospital and I am going to a new pain managment doctor, but before I left the hospital my ortho doc put me on methadone 10mg 4 times a day and I have to say it works better than any pain med I have ever tried. I just hope I dont have to stop taking it any time soon. I have degenerative discs and alot of scar tissue from the 4 back surgerys with rods and screws put in. I am 33 yr. old male and right now can hardley stand up without having MAJOR pain. I just want to get back to some kind of normal life with less pain as possiable, just hope they let me keep taking this methadone from here on to help manage my pain?
Hey K, Don't worry about what folks on the addiction boards have to say about meth, They have taken it for a completely different reason. Analgesia was never even a concern of folks that use meth to detox off of heroin or other potent opiates. Meth is very safe even at high doses as long as you get to the high dose slowly.That's why you don't really want to add more than 10 mgs a week.
This way you allow your body to become accustomed to the side effects. Yes Meth will make you drowsy, where oxy and Hydro tend to cause a histamine release which feels energizing. However, meth offers something other opiates don't, meth binds to the NMDA receptor which increases you tolerance to pain and slows your tolerance to opiates. Did the addicts mention this ?
I don't really understand the concern about when you discontinue the med. If it's being prescribed for pain, using it is usually your last resort, so why worry about discontinuing it.People that abuse Oxycontin and Morphine go through withdrawal, people that abuse meth and benzo's go through withdrawal, mainly because it's all self medicating with no medical professional overseeing or suggesting the proper way to use these meds. They think they are clever because they have figured out how to abuse an oral med, so cleaver that they ignore every health risk from abscess to aids. That really doesn't sound to clever to me.
If there was hope you will recover and not need opiates then you were never really a great candidate to use long acting meds in the first place. Long acting meds are for people that need long term pain intervention, Not short term for a sprained ankle. I know my spine will continue to deteriorate as one screw breaks after another. So having to discontinue opiates at some point isn't even an expectation. No surgeon will touch me after 3 fusion's have failed. I have tried every non opiate method to manage pain there is. So why worry about some addict saying it's harder to discontinue than Heroin.
If that was the case, why didn't they just keep shooting up Heroin. It must have some medical value even for addicts. But addicts don't see things the same way normal people do. There thought process is very different. When you got your meth filled was your first thought, " I wonder if I can inject this and get really F$%$# up?"
That's why addicts get their meth in liquid form, once a day, at a meth clinic. Because if you gave them 90 pills for a month, they would inject them all the first week and brag about how clever they are to have figured out how to inject methadone.
Then start looking for the next med to abuse so they won't experience withdrawal because they are addicted. Addiction and dependence are two totally different things. The articles by Dr Brookoff, part one and two explain the difference very well. mainly addiction is destructive, Use of opiates can actually improve a chronic pain patients quality of life. The addict doesn't care how destructive it is, he will continue the same behavior until they are jailed, hospitalized and seek treatment or OD. A heroin addict has about a 10% chance of returning to a normal life. 90% will go right back to the same destructive behavior that makes them feel so intelligent because they know how to cook heroin or shoot dilaudid , things normal folks wouldn't give a second thought too. Stay away from the addiction forums, There is little to be gained unless your a recovering addict and struggling with your need to use meds.
But a hardcore addict in recovery will tell you that there is no safe amount of opiate, no proper use of prescription meds because everyone will become addicted just like they did. I'm not just like they are, I can actually make 30 pills last 30 days and won't start doc shopping after I take all 30 the first week.
If some surgery could relieve your pain you could comfortably taper off meth at about 5% a week and go back to the land of normal people that don't live with intractable pain.
Personally, I don't have a problem with taking it, I have switched back and forth between meth and morphine and Duragesic. There is some unpleasantness when switching but I have learned and so has my doc about the need to slow tapers down when using methadone. My alternative is to live the rest of my life in bed and that's not expectable. methadone has retored my ability to walk and function and I don't worry about the what if's.
You can't just do a cold switch from meth to Oxy but you can do a cold switch from oxy to meth. The folks on the addiction board have probably never even dug passed all the addiction info to learn about it's analgesic properties, since analgesia was never the reason they took it to begin with.
It amazes me that an addict will give advice about a med he thinks he knows about when all his amazing knowledge didn't prevent them from injecting Black tar heroin or OxyContin into their veins, They are just so clever. Where was their brain when they were injecting that crap into their arm. And the med that freed them from having to shoot up every 4-6 hours is now a bad thing because when it was discontinued it wasn't pleasant.
Well, there is no pleasant way to discontinue IV use of opiates. meth is about the best they can do and unless they plan on staying on meth forever, they will likely have to discontinue the meth at a pace set by a methadone clinic. Trust me, the clinic isn't as concerned about a meth maint patients comfort as your PM doc is, who prescribes meth for an entirely different reason.
So an addict figured out how to inject oxycontin and only develop minimal abscesses from doing so.That doesn't put them at the top of my list as a person to receive accurate clinical information from.Particularly information about analgesics, when pain relief was never even a concern. The buzz is why they inject and abuse drugs.They are so cleaver that they took years to figure out it was destroying their life, so clever they didn't realize no matter how big a dose they injected it wouldn't be like the first time, but kept trying to recapture that first rush for years.
You can either let an addict scare you by their ridiculous behavior that makes them think they are so clever because they can bypass a time release mechanism or know how to cook cocaine into crack.Or you can rely on information from doctors and medical journals.
The info an addict gives isn't quite the same as medical information you have read and researched. If I wanted to learn how to make crank, I would ask an addict, If I wanted to learn about methadone's use for analgesia I would do some medical research. Ask a doc and ask other CP patients what their experience was. I have done The research and I"m happy to share the information I have gathered. You don't have to take my word. Read these articles and educate yourself and if you didn't understand something, I or someone else that has used meth correctly to treat CP will be happy to help.
I can Guarantee you that there are thousands of patients using meth for pain relief that don't become the sick addicts that have given you twisted advice. No prescription drug is evil, only the people that use it and choose the drug over their life, family, health and put obtaining more drugs at the top of their daily To-do list.
Links to more medical info on pain management
Good luck and go slowly even though your out of hydro. You may be in a little more pain this week but 30mgs of meth is a whole lot stronger than 4 10mg Norco or Lortab.
Take care, Shore
Well said my friend, as always! If you remember, I went from the oxy to meth for a short time. Lately I've been back on the oxy (i've been on mostly oxy for 4 years now). And I can honestly say the meth provided much better pain relief for me than the oxy. In fact, at my next visit to the PM dr., I'm gonna request to go back on the meth. The only reason I went off the meth in the first place was because of the side-effect of profuse sweating while on the meth. Well, wouldn't you know, I'm now having that problem with the oxy so I would rather deal with the sweating as a side effect and get good pain relief with the meth, than deal with the same side effect and not have great pain relief from the oxy.
I remember when I first was given the meth, I could not find a whole lot of info about it being used for analgesia; it was all about addicts. And of course, it scared me. But Shore you were so kind to look up and provide me with a wealth of info on meth as a true pain reliever. That instantly made me feel comfortable with taking the meth for chronic pain. And I thank you for that.
So to the original poster and others, please don't disregard meth as an excellent pain med for chronic pain. As Shore stated, you need to concentrate on it's pain-relieving abilities and not let the history of it's use for addictions cloud your judgement. I would not be willing to go back on the meth now if I hadn't educated myself as to its benefits for pain patients (thanks to Shore!). Another added bonus I think is that my dr. appears much more willing to rx the meth rather than the oxy because of the tight restraints imposed on dr. who prescribe oxy due to the bad press and negativity. Again as Shore stated, I can't go the the addiction board and feel comfortable with the meth because of the unfortunate experiences of addictive personalities. So I give the addiction board my sincere sympathies, but for my own good I can't take their advice to heart or relate it to my particular situation. Good luck with whatever you decide. Linda
I just wanted to say thank you for all the useful information you've gathered for meth being used to control pain. When I first started on it, if I'd told someone, they thought I was a herion user, so I don't tell too many people I'm on it (plus had have bad experience of having medication stolen by someone I thought was a good friend) to avoid that negative reaction. Now I can print this information and have my family at least read it so they'll know that I'm on it not to withdraw from another drug, but to help control my pain.
Quick question, is meth really used by most pm docs as a last resort? My pm doc never did put me on Oxy or MsCotin (are those the same thing?). Not quite sure why. I had been seen my a ns who told my previous gp that I was "overweight, under exercised and addicted to vicodin". My gp then switched me from vic's to darvocet 100/650 which was like taking tic-tacs. Once I got back into pm, the pm doc switched me from the darvo's to the meth, 5 mgs morning & 5 mgs nighttime, so my dose is very light. Helped at lot at first but am noticing now that I've been on it 6 months, the pain is coming back again. Think it might be time for a bump? Something I'll have to ask about my next appointment I guess.
Anyway, I did want you to know I think it's wonderful of you to share the information you've worked very hard to get and to make sure you get the thanks you deserve for that work. It can't be easy given everything you've been though.