Should I worry? - Pain Management Message Board

forginon · 05-23-2007, 10:16 AM

Now that I've been changed from methadone to MSContin should I worry about tolerance?

Due to fears about the methadone possibly contributing to my heart failure (no evidence whatsoever), I was switched from methadone to MSContin. I was taking 80mg of methadone daily and am now taking 300mg MSContin daily (target dose).

I was so happy on the methadone, and one of the warm fuzzies was how long I had been stable on 80mg per day, and the knowledge of how much less tolerance methadone causes.

Am I now back (I had experienced tolerance with other opioids) under the possibility of escalating doses due to tolerance?

steve

Bad_Spellr · 06-07-2007, 03:09 PM

There are as many contraindications for Methadone as for MScontin. Methadone blocks other opiods and takes a very, very long time to completely detox from. This is most likely why your MS dose is 300mg.

Once your methadone dose has reached a certain pinnacle you'l most likely never have pain releif again without surpassing that point.

My advice to any and all for long term pain care is Fentynal. The Duragesic Patch is the best I've ever used, although the problem is you can only shower every two days. I don't care what anyone says, if they get wet they fall off.

Wren9 · 06-07-2007, 05:56 PM

Bad_speller, why is the Duragesic patch the best you've used? I have tried lots of pain meds, but never the patch. I hate having to take pills all the time...I think I would like the patch...but I am worried about side effects. Methadone worked great for me due to its long-halflife -- but it caused too many side effects -- weight gain was a biggie. Now, I'm on Oxycontin, and it affects my moods...it's too uneven. Up and down. Does the patch provide even relief? I know we are all different. I guess I need to broach the subject with my pain management doctor. There is something very appealing to me about putting on the patch and then forgetting about it for 2 days.

-Wren

BrittleBones · 06-07-2007, 08:31 PM

Hey Wren....not to change the subject but can you tell me what you mean when you say that the Methadone made you put on weight? Did it just make you hungrier for foods like sweets and carbs, or did it literally put extra weight on you without you changing your diet. I just got off of Methadone. I had taken it for 2 years and during the past 1 1/2 I've gained 60 pounds!!! Now I'm on the Duragesic Patch 100, with Oxycodone 30mg. for breakthrough. I've heard others talk about the weight gain with the methadone, but wanted to know if you could clarify. Thanks!! KathyMac

Wren9 · 06-08-2007, 11:23 AM

Hi Kathy,

My understanding is that methadone can lead to increased insulin-resistance in some individuals, which leads to increased sweet cravings and also makes fat storage more efficient. This is similar to a diabetic or pre-diabetic state. Eating a lot of sugary foods and other simple carbs (flour, rice, etc.) sets up a cycle in that the more you eat them, the more you crave them. It is important to break the cycle by eating a "low/good carb" diet and also exercising if possible.

I gained about 30 lbs in six months on methadone. Some of the weight I gained (about 10 lbs) was weight I had lost due to severe pain and not having an appetite. But I went over and beyond my normal weight. Since stopping methadone, and switching to a different pain med (first Kadian and now Oxycontin), I have lost most of the extra weight.

I am very interested in the patch; it is one of the only things I have not tried. I hope it will give me the same steady blood level as methadone without so many side effects.

How do you feel since switching to the patch?

-Wren