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-   -   Is anyone taking methadone for pain? (http://www.healthboards.com/boards/pain-management/547501-anyone-taking-methadone-pain.html)

chip51 10-27-2007 02:55 PM

Is anyone taking methadone for pain?
 
Hi All

A few months ago, after having abuse problems with oxycodone & hydrocodone, my pain doctor prescribed methadone in low dose and it has worked great for pain relief.
I still have to be very vigilant and take meds as prescribed since I have the addiction history.
Due to ulcerated esophagus anti-inflammatory meds are not an option for me. I have disk material that has fallen into spinal canal and need surgery but have used up all sick time and money so cannot consider surgery till next summer. The surgeon says my only recourse is meds or surgery and I trust his opinion. He is top notch.
My problem, as I see it, is that the dose of methadone is enough to make life bearable and for me to work but it would make me more comfortable at a slightly higher dose.
I mentioned this to my doctor after the first month and he was adamant about not increasing the dosage even though the informatin I have studied states that the protocol is to raise the dose over time until it brings adequate relief to the patient.
I feel that by being honest about abusing the other meds I have made the doctor nervous and sabatoged myself in regards to getting effective treatment.
Now I am afraid to bring it up again for fear he will refuse to treat me.
Has anyone had any experience with this kind of thing? And if so were you able to communicate to doctors in an effective way?
Also, I am seeing a counselor weekly to make sure I stay on track with the meds because without them I cannot function.
Thanks to any input.
chip51

butrfligirl28 10-27-2007 04:26 PM

Re: Is anyone taking methadone for pain?
 
I would discuss what your pain levels are keeping you from doing. Be specific and say, "while I am feeling better, I still cannot play with my kids, and mow the lawn." "These things are important to me and my #1 goals as far as pain management." Talk about what you want/need to do, and how the pain levels you are experiencing are keeping you from them.

Also, tell him what you told us....that he is nervous now because you disclosed your addiction. Let him know that you will continue to be honest, and will alert him immediately to any of the same thoughts, actions, ect. Let him know however, that this problem is different, and not about chasing a high. It is about gaining the quality of life you deserve. Good luck!

forginon 10-27-2007 06:59 PM

Re: Is anyone taking methadone for pain?
 
I communicate to my pain doc using the 0-10 pain scale, with 10 being the worst pain imaginable. I told my doc early on that my goal was to be able to remain steady at a 5, that I could live with that. At the time my level was around 7.5. At 7.5 I was unable to increase my level of functionality as I wanted. So the doc raised my dose until we got to 5. By using this pain scale I gave my doc the opportunity to have the decision be as objective as possible. Then I was able to return to exercising, more involvement with the family, etc. This is what pain docs want to see, that if they prescribe these meds that it brings more functionality with it. What they don't want to see is us becoming couch potatoes on our meds.

steve

acaptainn 10-28-2007 12:46 PM

Re: Is anyone taking methadone for pain?
 
honesty w/ your PM its so hard. i was and got cutoff,,it really shocked me,Ive since started w/ a new PM an did not aproach the addiction issue, but did tell them both that im now resistant to opiates ( 10rs worth)

i askd both for methadone they both said absolutly not w/ no explantion why, i cant understand why
i wanted to trade in oxy an percs for meth. WHY NOT, my mind asks

forginon 10-28-2007 12:56 PM

Re: Is anyone taking methadone for pain?
 
[QUOTE=acaptainn;3279840]honesty w/ your PM its so hard. i was and got cutoff,,it really shocked me,Ive since started w/ a new PM an did not aproach the addiction issue, but did tell them both that im now resistant to opiates ( 10rs worth)

i askd both for methadone they both said absolutly not w/ no explantion why, i cant understand why
i wanted to trade in oxy an percs for meth. WHY NOT, my mind asks[/QUOTE]

I think lots of docs don't really understand methadone, or how to prescribe it. Rather than admit it they probably just refuse to work with it. It is very complex to prescribe, especially when the patient is coming from another narcotic - the conversion ratios seem like advanced math. First you have to convert the present narcotic into an equinalgesic dose of morphine. Then calculate an equivalent dose of methadone using a conversion ratio that can range from 2:1 to 12:1 depending on how high the dose of the previous narcotic was. Then they calculate how to divide the daily dose into 3 or 4 per day, then divide by half for the starting dose. I think I'm remembering this correctly. At any rate, I think many of these docs just don't want to deal with methadone. It's too bad because to date the best pain med I've ever used was methadone. I think it could help many chronic pain patients.

steve

acaptainn 10-28-2007 02:46 PM

Re: Is anyone taking methadone for pain?
 
thnks Just, ive decided im going tp print some things ive learned on the board
and present them to my Dr.
i hope he doesnt take it as an insult,
or i could just stay on opiates , grrrrrrrrrrrrrrrrrrr,, i dont want them any more,grrrrrr


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