I know a lot of people dealing with pain management, and most are on Methadone. I have been on the Norcos for almost 3 years now and it is no longer working, but occasionally my doctor acts weird about refilling my prescription. Anyway, I want to get on the methodone so I'm not taking so many pills a day. How do I go about asking him?
Personally, I would never ask for a med by brand name. I think it sends up alot of red flags but you know your doctor better than us.
You might say that the meds are not currently working and if there is anything else that we could do to help relieve the pain whether it be a different medication, tens unit, therapy, accupuncture, etc.
I would say something like 'I would like to try a long acting med, after so many years of taking daily pain meds that last 4 hours or less, I want off that rollercoaster of pain, to only take a few pills a day and get hours of relief has to be better for me physically and spiritually, if it isnt, doctor, can you please explain to me why not?' He should at that point either offer you a LA med, of which methadone is the cheapest and probably most 'popular' LA med being used these days, or explain why he wont.
If he says he wont and why, ask him at what point he would consider it, if the answer is never, its time to look for a new doctor, but at least you know where you stand.
It is much better for you in every way to be on an LA med than the daily use of a SA one, I wish you luck, dont give up until you are happy with your care! I think if someone needs a daily dose of a short acting pain med for more than 3 months straight, their doctors owe them an explianation as to why they shouldnt be on a long acting med.
First let me say that I'm sorry you are dealing with chronic pain. It is truly difficult for those who don't have it to understand, and there is always this nagging suspicion that you are faking it for the drugs. I've been dealing w/it for almost 10 years after a brain injury left me with a multitude of symptoms, including pain so severe that I couldn't stand the weight of a sheet on my skin. I couldn't pet a cat, or stroke my daughters hair. I might have committed suicide had it not been for friends and family (especially my kids).
But to my point, I truly have methadone to thank for my life and my sanity and it may be what you need to keep a steady control of your pain. The thing about different opioids is that they have different half-lives. That is, the time it takes for half of the drug to be broken down and/or cleared from your system. One of the good things about methadone is that it has a long half-life and therefor can keep your pain under more steady control (although you may still need something short-acting to deal with "break-through" pain)
The down side of methadone is that the half-life is extremely variable in different people and it doesn't work for everyone. So, if it works for you, it may take awhile to reach a steady blood level that is also effective in controlling your pain. With the long half-life, there is the danger that if you start on too high a dose, it could build up in your system to the point of becoming toxic. So if you get it scripted, BE PATIENT. Let the doc slowly build you to an effective dose, even if it means an extended period of pain or discomfort.
As to getting it prescribed, I wouldn't ask for it by name until it's obvious your doc isn't going to bring it up. Just say you'd like something that lasts longer, than what you take presently, and doesn't bounce your pain levels all over the place. You might also want to look into what rights you have as a pain patient. Your state might even have a "Bill of Rights" for pain patients. These exist in some states and are the result of advocacy groups whose members have had to deal with the prejudice and resistance of doctors to prescribe adequate pain meds.
If all else fails, seek out a reputable pain specialist in or near where you live.
Good luck to you, may you find relief and peace.
p.s. methadone isn't without its dark side; the usual opiate problems mostly, but somewhat magnified over time. If you get on it remember to drink lots of fluids and take tons of fiber (powdered psyllium husk works well).