Methadone - Pain Management Message Board

Bill17724 · 11-09-2004, 01:56 PM

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

kisa · 11-09-2004, 09:39 PM

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

Shoreline · 11-10-2004, 09:04 AM

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

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
[url]http://www.ampainsoc.org/pub/bulletin/sep00/upda1.htm[/url]

[url]http://www.mainehospicecouncil.org/MaineLink/vol2no2/methadone_rediscovered.htm[/url]

[url]http://medications.com/go/drug/Dolophine[/url]

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.

Rach18 · 11-15-2004, 10:20 PM

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.

Shoreline · 11-16-2004, 07:26 AM

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