Shoreline

Hi Molly, Having switched away from meth 3 times , what you are experiencing is fairly normal. What you experience is either differencial withdrawal, which just means meth binds to receptors that oxycontin doesn't, or you dose is simply too low. But meth doesn't impede other opiates from their anelgesic ability. It impedes the high they may produce, But I've always used BT meds succesfully with meth, the impedeing of all effects of opiates isn't true. The receptors that give pain relief are different from the receptors that cause typical opiate euphoria.

So someone looking to get high while taking meth would basically be wasting their monmey but somebody needing additional anelgesia while on meth would get the additional pain relief if you used oxycodone as a BT med with meth, you just wouldn't get high from the oxy but you would still get the pain relief.

Your conversion is a bit on the low side but increasing the dose won't necesarrily stop differential withdrawal.

Part of any type of withdrawal is added pain. Meth blocks a receptor that that controls rapid tolrance to opiates, that sets our pain threshold and helps with neuro pain, along with blocking the NMDA receptor it stops the production of the NK-1 nueroceptor and the production of substance P which is a neuro inflamatory agent.
Without that NMDA blocking ability you loose alot of what meth has to offfer aside from simple pain relief.

It takes a about 3 weeks to feel normal after stopping meth and converting to another opiate. IF you can tolerate the increase in pain for another week, you would likely need to adjust your dose of oxyC upwards but to do it strictly for the point of stopping withdrawal it would not be effective. Meds like Clonodine can certainly make the transition easier and once you feel the withdrawal has deminished and if you still need added pain relief than absolutely talk about increasing your dose for the purpose of aditional pain relief.

But to simply increase to stop withdrawal wouldn't be effective and you would end up on a higher dose of OxyC then you would if you just rode out the differential withdrawal and then worked on adjusting the dose to obtian max relief from the oxyC without terrible side effects from rapid increasing solely to decrease the withdrawal.

Peope have said they have swithced from meth to oxyC without any problem, but they tend to fail to mention how long they took meth prior to switching which makes huge difference. If they simply tried it for 3-4 weeks and switched I wouldn't exepect them to experience differential withdrawal.

The same things happens when you switch from Duragesc to one of the more traditional opiate slike oxy or morphine because Fentanyl binds to receptors that those meds don't bind to.

If your not feeling better monday, get in to see your doc. Someone asking for an increase over the phone doesn't have the same impact as seeng your patient's BP 200/100 and sweating and shaking. Your doc will either treat the withdrawal with Clonidine and other adjunct meds or increase the oxyC.

Of the 3 times I swithced, the first was to oral morphine which was a bear and to Duragesic which was a bear. I had been taking 120 mgs for over 2 years.

When I swithced from meth to the pump wtith morphine I was at 150 mgs a day and had taken meth for another 2 years. That did go smoother simply because of the strength of IT meds VS the strength of oral meds, 100-300X stronger when delivered by pump vs oral meds. I still had some mild withdrawal symptoms for the first few weeks but it can be done , your doc can make it easier and your dose of oxyC is probably a bit on the low side but docs tend to convert on the low side to be safe rather than sorry.

If they ever had to experience withdrawal from a lousy conversion they might be a little more compasionate about the process. It would have been better to taper off the meth while slowly adding in the oxy but docs that aren't interested in the pharmokenetics of opiates and simply look at the end result don't have a complete understanding of all the opiates and meth is the least understood opiate for all docs in general. There are still docs that think meth is only for heroin detox or maint and aren't aware of it's use for CP.

Call the doc on monday and get into t see him, but the withdrawal ill lkely end by the end of the third week and you will still likely need tobe seen for an adjutment. You have gone through thehard part, day 5-10 where the meth has completely left your symptoms so the improvement will be uphill other than adjusting your dose of oxy to match the relief you got from meth, and hopefully without the meth side effects that likely had you switch in the first place.

Hang in there and as much as people talk about the physical symptoms of withdrawal, depressoion and feeling like your brain is fried is something really not spoken of. But large changes in the neurochemistry are occuring from the transition and you need to understand it's normal and not act on any implulses you may feel or any feelings of desperation , or the idea you will never find relief again, You will, It just takes time to adjust any meds dose and when the docs does cold switches he sets his pateient up for feeling the way you are now.

It will pass in about another week and you can focus on finding the right dose of Oxy in the same manner you found the right dose of meth, by slowly adjusting upward untill you find relief or the side effect become to bothersome. If Oxy just doesn't do it for you, switching from Oxy to morphine is a breeze if the conversion is in the right ballpark. Oxy and morphine bind to generally the same receptors the MU and Kappa, where meth aslo binds to the delta receptor, blocks the NMDA rceptor and all the neurochemical changes involved from blocking the NMDA receptor.

Fentanyl also has delta receptor activity which isn't replaced when switching to morphine or oxy either. Just part of the joys of being a guinea pig in the PM areana and if you don't report the problems your havng, yuor doc will continue to do the same thing to other patients.

Hang in there, it will improve over the next week and make an apt to let your doc know what's gojing on and what you have been experiencing.
Stay in touch and let us know how your doing.

I remeber at one point when switching from meth to morphine I couldn't focus my eyes on the bouncing keyboard well enough to even type.

He didn't start you rediculously low but you will likely need increases as any drug needs to be titrated properly. There is no absolute table that gaurentees X amount of meth will give the same relief as X amount of Oxy.

The converson tables are simply to get you in the right ballpark without OD and hopefuly without withdrawal, however Meth is so different from oxy that the withdrawal was just something you were not prepaired for and many docs don't explain and are not aware of differential withdrawal when swithcing from one class of opiate to another.

You don't still have meth in you after 2 weeks to be blocking the effects of Oxy so that's not the problem. I would guess you probably felt OK the first few days and the withdrawal really kicked in on the 4th or 5th day because of ther long half life and the amount of time your took meth.

Anyways, It will end soon, you have gone through the toughest part and you simply need to adjust the oxy to a level that is effective and ride out the remainng ill feelings from the switch, over the next week or so.

Take care Dave