As you can tell from my name, I have fibromylgia, plus ankylosing spondylitis. I have been seeing a rheumatologist for about 6 months. He has given me every NSAID know to man, sulfathalazine, and wanted to try methotrexate-which I absolutely refused. He finally put me on methadone with ultram for breakthrough. IT is not enought. I am not opiate naieve, I have had TMD problems for years and was on hydrocodone for a couple of years before this, so I have a tolerance. I have mentioned that I need either a better breakthrough med or more methadone. He responded by sending me back to my PCP. She said she will continue to give me the methadone, but won't increase the dose either. I also go through the OP's to get the Hydrocodone, since what I have is'nt working and no one will beleive me or do anything about it. I know its probably illegal, double dipping, and my docs would ban me forever if they found out, but I don't know what else to do. I want to go to a pain clinc and see what they say. Can I just ask for a referral? Will my doctor think Im going over her head? I see my rheum for my last visit tommorrow. I run out of methadone that day too. I hope he'll at least give me enough until my PCP can take over. Im scared to say the least. But for those of you who take methadone, and are pretty tolerant of opiates, what is your normal dosage. I have taken 20mgs and that worked. I dare not tell the doc I took more than prescribed, but how do I tell them I need more. I have asked time and again for a better breakthorough med, and all I get is Ultram and antidepressants.
I really can't afford internet medicine anymore, and I'd rather get it from my doc. What should I do and how should I go about asking them for something better?
I take 10mg in am and 10mg in pm. I am on a very low dose. I think it varies from person to person and illness to illness. There is no set answer. It is important for you to work together with your dr. and make them see this dose isn't working for you. Good luck!
I take methadone as well. I'm currently on 30mgs in the morning 10mgs at lunch and 30mgs in the evening. I know that it is a high dose. But My pain is quite severe. I also take OxyIR for BT pain. I was titrated up to this dose tho over a long period of time. I really don't think that there is a normal dose per se. It just varies from person to person and doctor to doctor. My advise would be to be honest with your PM doc. It is not good to double dip as you would say. Doctors and Pharmacys can catch on to that pretty quickly. Just be vigilant with your PM doc. Keep a Pain diary and breing it with you. Such as when the pain is worse, when you take your meds and so on.. I hope this helps. Never give up on yourself. And by all means keep trying to get the best pain relief possible. We all deserve it.
Methadone is one of the most potent opiates you can get.It just sounds,like you said,the doc ain,t givin you enough.I been on the same dose for 18 months and never felt a need to go any higher.One reason is that Meth has such a long half-lfe that it stays in your body and keeps building up so you can take 20mg one day ,20 the next day,and 20 the third day,but you,d still have about 20 still left in you from the previuos 2 days worth,so it would be like 40mg.That,s one big reason a bunch of docs are afraid to Rx this drug cause of the uncertainties that exist in the blood serum levels of the drug.A lot of folks have got messed up from doc,s giving them too much,too quick.I started on 30-40mg,4 times a day.Within 3-4 days,I could,nt even function,I was so dopey.I cut back to 20mgx4,and been there since.Talk to the doc and tell him how it is.They know when people are just wanting to get more for a "Buzz".Methadone don,t really give you a buzz,the doc,s know that.Good-Luck,FS!Jack B.
Well, I visited my rheumatologist last week, and he gave me my last script for methadone from him. He says that since my pain is getting better, that I should stop taking the methadone! Well he must be a moron, because the methadone is the reason the pain is going away! While I am not completley pain free, it helps. I just feel that I am more tolerant than my docs realize, and I can handle more. I also need a better breakthrough med.
He has me tapering off this month. Im supposed to go from 4 pills a day to 2, then after two weeks 1 pill, then use them PRN. That is the stupidest thing I have ever heard of, and even the pharmacist who filled it said so. If it is working, and not causing bad side effects, then why stop? He is turning me over to my PCP, and she said she would continue the methadone. I am going to see her next week. I want to tell her why I don't want to stop. I have started cuttting down, and surprise! The pain is coming back! He said to take Tylenol in between. Please! If my PCP won't continue the meth, then I don't know what to do. Find another doctor I guess, but what do I do in the meantime. And although my rheum said that I wouldnt feel withdrawl symptoms, I am. Runny nose, diarrhea, chills and goose bumps. I know withdrawl. Im not going through this. Do you think a PCP will overrule a specialists suggestion? I am following his orders, and I am going right back to where I started when I was not on the methadone. I don't know what to do.
Yes hopefully your PCP wil do what she said and continue you on the methadone. And if your PCP is a good doc. htey will adress the BT pain as well. That is the most moronic statement I've heard yet. Well your pain is better so lets stop the pain meds. DUH. I'm so sorry that you are going thru this. Whats wrong with some of are idiotic docs anyway.
Yes it sounds as if your in to withdrawals. I can only say if your PCP does'nt help you then keep goijng until you find the right Doc. I may suggest before you go to your PCP start keeping a pain diary if you already aren't. this might help convince her that you are taking control of your pain and that you really need to stay on the meds. Again you will be in our prayers and by all means keep us informed as to how you are doing and what the PCP has done....
I think the rheumy doc is an Opiodphobic and just told you that crap to get rid of you.He sounds afraid to Rx C-2,s,anyway.All you got left,right now,is the PCP,so do like Grizz said,keep a diary where it says that "At 2:00PM my pain level was 6-7,I took a Methadone pill,an hour later my pain was at a 3 or 4,so I was able to cook my dinner and wash my laundry and do my dishes and fold the clothes!I was so happy!"
When you put it down on paper like that,it shows them doofus doctors how good it is for a Chronic Pain person just to be able to FUNCTION,even doing household chores that have to be done,while not crying in pain!I understand your situation cause I,ve"been there,done,that".Those docs can,t understand,cause they have,nt any idea what it,s like.They just cannot fathom pain they cannot see.(Unless,like few do,they actually believe the patient hurts as much as they say they do.How much Methadone are you taking?Above all,you MUST stop the "double-dipping"NOW!You WILL get caught,then you,ll be screwed.Good-Luck,jack beanstalk
i had a pain managment doctor prescribe me to take 2.5 mg of methadone every 12 hours. i suffered incredibly. i called and told his nurse that 2.5 mg was not having any effect. she told me he said to give it time. i gave it two more days and it was still not helping. i called again and his nurse told me to increase the dose to 2.5 mg every 8 hours. i did that for a few days and was still not getting any relief and let them know. the pain manager told me that he could not do any better than 7.5 mg in a 24 hour period.
i asked him if he could give me a referral to a doctor who may be able to do more. he referred me to a pm clinic that told me they could not provide more than nsaids and an anti inflammatory (both of which is detrimental to me due to a compromised liver). they began biofeedback and asked me for my mothers telephone number and my 9 year old daughters telephone number so they could discuss my situation with them. i refused to supply my daughters telephone number and was told that i was not being compliant with their program. there is no way in hell that i will give a stranger my 9 year old daughter's telephone number to discuss my medical conditions.
i think the pharmaceutical company's reccommended minimum effective dose is 2.5 mg every 3-4 hours.
7.5 mg of methadone every 24 hours did nothing for me.
[This message has been edited by Wes1212 (edited 05-19-2003).]
Yes you are right! I know that it is wrong to "supplement" the methadone with meds off the internet. I don't think I would get caught, since it is done online, with no in state pharmacy to deal with, but it is not cool. I don't have a pain contract though, and was never asked to sign one. I figured that It was OK. But I would much rather obtain meds legitimately. Don't worry, I can't afford the 200$ for the Vicoden off the internet. I just want my PCP to continue the methadone. All I can do is pray and start a pain diary. I am having a bad flare day, so I'll go now. Thanks for the advice.
Sarah, I am so sorry your going through all this and I know deep down it doesnít really help to know your not alone. But your not and life really can suck. Ask your doctor about Opana immediate release for brake threw pain and Opana ER for round the clock. You take it every 12 hours. Opana has quite literally saved my life. Don't give up, and keep fighting the good fight sweetie. And she said "smile it could be worse" and sure enough she smiled and things got worse!
First, I am not a Doctor, just a patient. I take methadone for chronic pain going on 6 years now and that is mixed with percocet. I take 60 mgs of methadone and 60 mgs of percocet on a daily basis. I know that methadone dosage can be increased much further if needed. What happens with most of you is that you don't go to pain Dr's. PAIN DOCTOR is what you need as they deal in nothing but pain. The know how to tell if you are just searching for drugs or really need help. I have had the same Docs for over six years. They have tried the Duragesic Patch, Ultram, and several others before we ended with Methadone and Percocet. At this time I am actually debating having a morphing pump installed inside me so that I can get away from the side effects of the pills. Constipation, itching, tirdness and breakthru pain are just irritating after this amount of time. My Chronic Illness is ideopathic and thus its cause is unknown. Please, Please go to a Doctor who deals in pain and away from those who are afraid of the followup paperwork it takes to dispense powerful pain killers. Do not suffer, get help. Methadon with insurance is 5 bucks a month..
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I have suffered with severe neuropathy for 13 years. At first, the Neuro used Oxycontin, which I hated because it kept me in a fog. After a couple years, he tried Fentanyl patches. They worked fairly well, but were very expensive and not without risk. They also left me feeling a bit foggy. I got to the point that I felt like just ending it all. Neurontin and other stuff did nothing.
Then one Neuro suggested trying Methadone. That was six years ago. I started with 20 mg every 4 hours. After a couple years, we increased to 30 mg in the am, and 20 mg the rest of the time. That has been a big help to me. I have been able to resume photography and do some limited travel. It does NOT leave me in a fog, or cause other problems. It seems to work for me very well. It is cheap, it works, it does require caution.
Good luck though. I know how pain solutions can be so different for each individual, and how tough it can be to find what works for you.