been in pain management for 4 years i'm taking 45mg methadone 3 times a day and 16mg dilaudid 5 times a day, doc is insisting on weening me off the dilaudid and increasing my methadone. to be honest it scares the hell out of me. i've hated methadone from the beginning. sure it works to control my pain level but i always felt the dilaudid was working pretty good. prior to methadone i was taking dilaudid only for 5 years , i was feeling great, doc thought methadone to be better, i noticed a problem from the first week on methadone, doc said the problem was i was'nt taking enough methadone! i can miss a day of dilaudid, i miss a day of methadone, i get sick. my girlfriend thinks my doctor is going to kill me, what do you think? should i get off the dilaudid and up the methadone or are there other meds, safer meds that can work well enough to control pain level? everyone says methadone is something i may be on for life. i have small children at home i dont notice but others say i became a different person since starting methadone.
In most PM offices these days, they try to get a patient onto an extended release or other long acting base medication, with a few breakthrough meds as needed on occassion. It sounds like you are taking the methadone and the dilaudid every day. If that is the case, I can understand why the PM doctor would want to increase the methadone and reduce the dilaudid.
The breakthrough meds are only supposed to be used when you have a sudden, unexpected increase in pain levels, not as an adjunct to your base pain medication.
If the base medication isn't covering your pain, then increasing that medication, makes sense.
If you are taking the dilaudid as you posted you are, then all you have really done is increase your base medication and have nothing to available to cover any sudden increase in pain levels.
There is no harm in trying to do as the doctor suggests. You may find that you get better, more consistent pain relief by following his lead.
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Hi I also am taking methadone and dilaudid i do not like the methadone because it makes me so tired my dr has suggested the same thing as yours but he also want me to take nuerontin but i can see trying to up methadone as it is a good pain killer my dr said dilaidid should only be used for emergency pain not a everyday thing which is the way i have used mine in the past. I wish you luck as it sounds we are both in the same boat Please let me know how it goes for you.
Break thru meds are short acting meds such as Dilaudid, Vicodin, Percocet, and they are for Break Thru pain, which is exactly what it says it is, pain that gets so bad it breaks thru the coverage that your long acting med provides. Long Acting meds are for managing everyday pain, longer term, usually 12 hours at a time, these are Oxycontin, Morphine, Opana, Methadone.
Your Dr. is correct you should not be using your Dilaudid (BT med) all day every day to help control your pain, your Methadone (LA med) should be covering most of your pain management. If you don't like the methadone, you could always talk to your doc about switching to a different LA med.