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  • Methadone Users: Advice Please?

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    Old 11-13-2003, 05:29 PM   #1
    lindao1
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    Methadone Users: Advice Please?

    Hello everyone.

    As some of you may know, after three years on Oxycontin I built up a hugh tolerance to it so the dr. tried me on the patch which didn't work, the morphine pump which I had complications, Avinza which didn't work and so today he has put me on Methadone. My dose is 10 mg four times per day.

    I am completely ignorant when it comes to knowledge of the Methadone. The only thing I know is it is given to heroin addicts to ease their withdrawal. I have heard it is used for severe chronic pain but this is my first time of dealing with it.

    Can someone please enlighten me about this med? How it works (if it works), pain levels achieved, side effects, do you have to adjust to it at first, usual dosages, etc. Any info that you can provide me with will be very much appreciated. It seems I remember several posters being on the Methadone and I would be grateful for any input.

    Thanks so much for caring. Linda

     
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    Old 11-13-2003, 11:24 PM   #2
    BadBackToo
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    The very first thing I will say about the methadone vs the OxyContin is that you no longer will notice the clock watching for your next dose. the methadone keeps a more stable serum level. Also you won't get a "bang" from the methadone, if you currently get one from your OxyContin, which is a good thing, you don't need to become acustomed to clock watching and up and down oxycodone syndrome.

    The badpart for me was that it took care of my pain so well, that I could sit much longer that I was able to tolerate. This caused my feet and ankles to sweel terribly by the end of the day. It then would take the next three days of not taking any methadone, and wearing pressure stockings and laying in bed to reduce the massive swelling in my feet and ankles. At first the doctors thought it was a clocked artery in me, but both legs?!? Well, the third time this happened on methadone, the doctor said " thats it, were not giving this stuff to you ever again, you can consider yourself allergic and tell any doctor that in the future.

    A very weird story indeed.

    But you did ask.

    I still think its a great alternative. I would rather take it over the oxycontin, or the MS Contin, because of how little medicinal effect I feel from the methadone. But everyone will react differently.
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    Old 11-14-2003, 07:27 AM   #3
    inyo
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    methadone...

    lindao1,

    badbacktoo "hit it right on the nose". i was on methadone for about 3yrs, and one of the first things i noticed (aside from the very effective pain relief), was that there was no more "clock watching", (as the pain relief was more constant).
    i had been thru pretty much every med out there, and methadone worked better for me than anything else ever did.

    from the research ive done...methadone acts on the NMDA receptors in the brain, which other opiates do not (except Ketamine and dextromethoriphen). methadone also acts on the mu receptors, as do the other narcotics.
    but apparently the fact that it acts on the NMDA receptors, makes it more effective on chronic/nerve pain.

    my only problem was, that after about 3yrs...the methadone became toxic in my system. at that time i was taking 80-100mg a day...everyones doseage is different to answer your other question, but you have to raise the dose slowly (if needed) because it takes awhile for it to build up to its maintenance level in your system. the only side effect you should experience (which should subside), would be drowsiness. i found that if i was up doing something i was ok, but if i was sitting down, i would maybe nod off, or become very sleepy...but that feeling soon went away.

    but make sure your dr does regular blood checks to check the methadone level in your system, as it can build up to toxic levels, if your body isnt metabolizing it properly...as mine apparently wasnt.
    it was found that i had hypothyroidism, so i guess its quite possible that had something to do with it. but just to be safe, id get it checked...as it can cause heart problems.

    ive now weened down on my methadone dosage to where its no longer in the toxic range, and supplemented it with MSContin (not nearly as effective), and MSIR.
    its not as effective as before...but its doing ok i guess...at least i can still take it, even though its at lower doses.

    hope this answers some of your questions, and good luck, hope the methadone is effective for you.

    take care
    inyo

     
    Old 11-17-2003, 09:58 AM   #4
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    Hi Linda, Everyone is right about meth being very forgiving as far as being late or missing one dose. It has such a long half life your not shaking like a chiwawa waiting for your next dose of OxyC.

    It does take 4-5 days to reach a steady serum level because of the very long half life. 24+hours. The long half life is why Heoin addicts can control their withdrawal symproms with once a day dosing, however it does not control pain for 24 hours with once a day dosing. For CP TID or QID is recommended and for severe pain it can be dosed every 4 hours.

    The long half life means that if you take 40mgs today and then take 40 mgs tomorrow, Half of yesterdays dose is still in your system. So day two given the same dose your serum level goes up 50%. On day 3 your still going to have some of day 1, half of day 2 and all of day 3 so lets say by day 3 you have the equivalent of taking 70mgs that day. This is why it takes so long to attain a steady serum level. After the 4th or 5th day, Day one is actually wearing completely off and your serum level evens out.

    I had never heard of a story like Inyo's, where you did fine for years and developed toxic levels, this just means you are never too old to learn.

    I was talking to my shrink and we talked about meth and dextromathorphan and somehow got talking about antiD's. He told me that 10% of Caucasian patients are not able to metabolize meth especially when you combine other meds that require the same liver enzyme to metabolize and take the same route of elimination through the liver. I don't know if Inyo is Caucasian or not, it really doesn't matter, we talked about this population because it's the one I'm in. There may be other statistics for different ethnic backgrounds.

    He said Paxil, Dextromathorphan, Ultram and meth all take the same route of elimination requiring the same enzymes to break it down. Meth doesn't actually break down, it passes through unchanged but still takes a route of elimination and requires specific enzymes to eliminate it properly. This may be why Inyo ran into trouble 3 years down the line. 1 out of 10 in a specific population really is a very small statistic. If Inyo wants to mention her ethnic background I can look for statistics reflecting that factor.

    As far as feet swelling, That's a side effect that's part of every class of opiates profile. I've seen my wifes ankles swell to the point of pitted edema from MSC. Read about others with problems with OxyContin and Duragesic. Edema is not an allergic reaction and is easy to manage with HCTZ or any of the "water" pills. It can be managed medicinally or through change of habit.

    If you know you have to get up and walk around every hour it's not a difficult way to manage a side effect. Neither is wearing a compression stocking if your getting better relief from a particular med. Side effects are something we all have to deal with and it's up to us how big a deal we make out of them.

    IF all the meds were so effective you could sit so long you get edema, managing the edema would be my choice but were all different. Some people can't handle any side effects, or don't expect to have to handle them thinking there is a better med out there.

    If they all cause edema when you sit for hours in a computer chair, it's up to you if you would prefer to be in pain rather than taking a Diuretic or move around a little more often. Being bed ridden certainly isn't good for edema and is more likely going to cause a severe clotting problem. So everyone has to balance their side effects with the benefit of each med.


    Unfortunately you do have to dig passed all the Methadone maint crud to find information on methadone used for pain. Treatment of pain is why it was initially invented and the addiction thing was just an off label use for meth in the beginning. IT became the most prevalent use of the med so it's not really considered an off label use anymore but it's still isn't methadone's original intended use.

    The long half life, a coincidental characteristic is why it became used so prevalently for opiate addiction. The lack of Tolerance build up because of the NMDA blocking ability is just another characteristic that makes it well suited for pain and for meth maint.

    Unfortunately there is a stigma associated with methadone. It's not one you should really worry to much about. The pharmacist knows your not a meth maint patient when he fills a one months supply. Addicts aren't given a month supply at a time. They are given liquid so they have to swallow it when they receive it from the clinic so they can't build up a stash.

    You don't have to tell everyone you know what you take. If you have to tell someone what meds you are on, tell them Dolophine. That was also it's original name and has nothing to do with Adolph for those that think it does. It's Greek, for Pain-end. The brand name is still called Dolophine and comes in 40mg diskettes meant to be dissolved in water or juice.

    It is a safe med but should be used cautiously when combined with Paxil or Ultram. IF you take these meds you do need to have blood levels checked periodically. IT takes longer to adjust the dose because of the half life but if you find a working dose most likely you can stabilize on that dose for some time. God luck, Shore

     
    Old 11-17-2003, 10:38 AM   #5
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    Hello everyone!

    Thank you SO much for providing such great detailed info on the Meth. Knowing of it's history in treating addicts, I was rather apprehensive about agreeing to this med therapy; however, now that you've given me insight into the mechanics of this med and what to expect, I feel much more comfortable. For that, I thank you very much.

    I take the Meth 4 times per day. The only side effects I'm experiencing at the moment is slight nausea and drowsiness. I've only been on the Meth for 4 days, and since you said you do have to get used to it, I'm willing to be a bit more patient for these effects to level out. It does seem to be controlling my pain much better than the Oxy did - thank God for that.

    Is 10 mg qid a low or moderate dose to start out with? I know I've read some people are started out with 5 mg. so I guess my tolerance is such that the dr. felt 10 mg would be more appropriate for me. And can he go up on the dose as time goes by if needed?

    Shore, I agree with you - there is not any real info regarding Meth as a pain medication. Everything I've found on the internet relates to Meth and the heroin addicts. It would be nice to find some informative material that specifically addresses it's use in treating chronic pain. That's why I'm so grateful to you all for giving me first hand knowledge of it's ability to control pain.

    Thanks again everyone for being so kind in answering my questions. I think I was suffering from "fear of the unknown" when initially starting this therapy. You words of wisdom have most definitely eased my mind and now I can look forward to finally obtaining much needed pain relief. Your bud, Linda

     
    Old 11-17-2003, 09:00 PM   #6
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    Hi Linda,

    The only thing I'd like to add here for you is, if this option is even applicable to you, make sure you get MethaDONE, and NOT MethaDOSE. If you hand in a doc's RX for methadone, unless he's noted that it needs to be brand specific, the pharmacy is allowed to give you methadose. It's kind of like a generic, but not in the traditional sense (at least that's how I understand it, and still don't know it all). And I believe in most pharmacies both will be about the same $$. The methadose simply isn't as strong. Though I'd heard a lot of people talk about this before, it's not something I ever had to worry about, becuase the first time I was ever RX'd methadone earlier this year I automatically got "done" from the pharmacy. But now that I'm back on this med, and for my first new RX was given "dose", I'm here to say everyone was right! I know the FDA allows for all generic meds to be as much as 20% weaker than the brand name, but in all the other generics I've ever gotten (hydrocodone for Vicodin, oxycodone for Percocet, etc) I'd never really noticed a difference. Boy did I here. I think it's like what most others say, the "dose" is actually a bigger pill, and I think the company throws in some filler stuff that makes it weaker. But now I just got my first refill last week and I made sure I was given "done". I 100% notice a difference. The "done" is without a doubt stronger. I'm RXd for 3/day, and whereas before I had to take 4/day some with the "dose", I've now only taken 2/day a couple times with the "done". My pharmacist just asks me to let her know a few days before my next appt, so they can order the methadone from Roxanne and it'll arrive by the time I need my refill. Good luck

     
    Old 11-18-2003, 07:32 AM   #7
    Webron69
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    [QUOTE=lindao 1]Hello to you as well!!!!!

    [SIZE=4][FONT=Franklin Gothic Medium][QUOTE=lindao1]Hello everyone.

    As some of you may know, after three years on Oxycontin I built up a hugh tolerance to it so the dr. tried me on the patch which didn't work, the morphine pump which I had complications, Avinza which didn't work and so today he has put me on Methadone. My dose is 10 mg four times per day.

    I am completely ignorant when it comes to knowledge of the Methadone. The only thing I know is it is given to heroin addicts to ease their withdrawal. I have heard it is used for severe chronic pain but this is my first time of dealing with it.

    Can someone please enlighten me about this med? How it works (if it works), pain levels achieved, side effects, do you have to adjust to it at firssubject matter at hand

    Last edited by Webron69; 01-11-2004 at 07:02 AM.

     
    Old 11-18-2003, 10:32 AM   #8
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    Hey Linda, 10mg QID is a healthy starting dose but it's all relative to what your previous dose of Oxy was
    I have some good articles but I'm not sure if I can post them. Let me ask a mod first.
    Take care, David

     
    Old 11-18-2003, 10:57 AM   #9
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    Tyler,

    My, you read my mind!! How did you know? It seems I read somewhere about there being a difference between the Methadone and Methadose. But I did not think about it until after I filled my first rx which was prescribed as "done" but which the pharmacy filled as "dose". I wish I had remembered about the difference before getting the rx filled but now I'm stuck with the "dose".

    My concern is whether my insurance co. (HMO) will allow me to have a choice of the brand vs. generic. I know if my dr. writes on the script that it's medically necessary, that they would pay for it. But if he doesn't, I'm not sure whether I can request the "done" even if I'm willing to pay more for it. Do you know by chance? On my next refill, should I ask the dr. to request brand for me? It seems to me that a 20% difference is quite a bit when trying to control intractable pain. I need all the help I can get at this point.

    Anyway, thanks so much for the info. You've given me a great deal of insight as to the difference between the brand and generic. I really would prefer the brand and if you think it's worth it to me, I will ask the dr. to specifically request it. Shore, what do you think about this? Thanks so much for your help! Your pal, Linda

     
    Old 11-18-2003, 11:04 AM   #10
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    Hey Shore

    I really, really appreciate you going thru the trouble of requesting approval from the mod to provide me with additional info. I always look so forward to your replies as you are such a wealth of accurate info.

    I hope the mods will understand and allow you to post the material. Like I said, the info on the internet is geared to one side of the Meth story and I would like to know more about the other part that particularly pertains to me.

    As always, thanks so much, Shore! You are a Godsend. Your pal, Linda

     
    Old 12-05-2003, 06:40 AM   #11
    Webron69
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    Re: Methadone Users: Advice Please?

    Hello everyone!
    Is there anyone out there who does go to a methadone clinic?I go for pain management as well as for addiction problems.I am a chronic pain sufferer that does require meds.......

     
    Old 12-20-2003, 02:29 PM   #12
    Camellia Vernon
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    Re: Methadone Users: Advice Please?

    Quote:
    Originally Posted by lindao1
    Hello everyone.

    As some of you may know, after three years on Oxycontin I built up a hugh tolerance to it so the dr. tried me on the patch which didn't work, the morphine pump which I had complications, Avinza which didn't work and so today he has put me on Methadone. My dose is 10 mg four times per day.

    I am completely ignorant when it comes to knowledge of the Methadone. The only thing I know is it is given to heroin addicts to ease their withdrawal. I have heard it is used for severe chronic pain but this is my first time of dealing with it.

    Can someone please enlighten me about this med? How it works (if it works), pain levels achieved, side effects, do you have to adjust to it at first, usual dosages, etc. Any info that you can provide me with will be very much appreciated. It seems I remember several posters being on the Methadone and I would be grateful for any input.

    Thanks so much for caring. Linda
    Dear Linda,
    I have a posting on here about aking oxycontin and methadone for chronic back pain. Coming off the methadone has been nothing short of a long nightmare...and I was tapered over a two month period, taking only 5 mg. four times a day. My last day of taking methadone was Nov 6. I am much better now, but still have nausea and diarrhea every single day. At first I was very sick, migraine headaches, 3 ER visits, couldn't move physically I was so sick, then went into a big depression. I have to say that yes, it worked for my pain, but over the course of two years I gained 55 pounds, sweat all the time, cried all the time, slept all the time. Finally I changed pain centers and am on the mend. I have heard that heroin users say it is easier coming off of heroin than methadone...the ER doctors told me that. I now have a muscle disease caused from the mixture of opiates and anti-depressants. Be really careful. My withdrawal I guess was more severe than many, but you still go through withdrawal. Not a picnic. Good luck to you. Camellia

     
    Old 12-20-2003, 04:14 PM   #13
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    Re: Methadone Users: Advice Please?

    Camellia,

    I want to thank you for your honesty in dealing with the Meth. Because of all the negative comments I've heard about withdrawing from it, I was very hesitant to even go on it in the first place. But unfortunately, I had exhausted all other options according to my dr.

    I really dread ever having to come off this stuff. In fact, I've been thinking I would rather get off of it now instead of further down the road in the hope that maybe the withdrawals won't be as bad. But it is working well for my pain. Right now I'm in such a conflict over this stuff. I wish I never agreed to it in the first place, but it's too late for that.

    Everything I've heard about withdrawing from the Meth is as you have described - a nightmare. I haven't heard of anyone having an easy time of it.

    I've already put on some weight which I hate and certainly don't need, but I had no idea it was from the Meth. Is it normal to gain weight being on it? And yes, the sweating is unbelievable! It's a constant annoyance.

    Camellia, thanks for laying it on the line and being truthful about what I suspected all along. I guess I really have a hard decision to make as to whether or not to continue on the Meth. I just don't know right now what to do. Please take care and keep me posted as to how you're doing. Linda

     
    Old 12-21-2003, 06:10 AM   #14
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    Unhappy Re: Methadone Users: Advice Please?

    Hello to the other pain sufferers out there, I am hoping that someone out there can give me some info on the possibility of treating central pain syndrome with methadone. You all sound like very caring people so I thought that someone just might be able to help me in my quest for relief from this torturous pain. Let me give you just a little history. I am currently recovering from surgery to remove a cavernous hemangioma from inside of my spinal cord.This was the third surgery that I have had to endure just in the last two years. Surgery # 1 was to repair a herniated C-6&7 disc.It was also after my first MRI at this time that the CA was first discovered inside the cord at the C-7,T-1 level.Finding that info out was a whole other nightmare that I wont get into at this point.I had alot of problems after surgery # 1,my neck kept crunching ,had alot of pain and numbness(by the way, it took me 6months to convince my neuro that something was even wrong,"your just healing").When he actually thought "hey maybe something is wrong here"Duh.He scheduled another surgery to place a plate and screws at the C-6&7.It was after this surgery that my pain level started to go through the roof.After going through the usual epidural injections and trigger points with no actual relief that I asked my primary(really great Dr, he believed me when i said something wasn't right, and kept me well supplied with the pain meds that I needed just to get through my day)to refer me to a different neurosurgeon as I was in absolute agony from the last surgery and didn't want the man to go anywhere near my neck again.When I went to see this other neuro at our local university,I was told that this CA in my cord had actually bled(something my last neuro had failed to mention,even though it was in the last MRI report that he had)and the lesion needed to come out. I was also told that this lesion was also most likely the cause of this non stop absolutely horrid gnawing pain that i had had for over two years.I was scared to death.My other two surgeries were pretty much a walk in the park (in one day and out the next)compared to what i would face with this one(two weeks in the hospital, first two days in ICU,followed by a almost two week stint in the local rehab hospital to try and deal with the damage that would be caused by the surgery.I really didn't have a choice here as my Dr told me that the chances of a more profound bleed after having one were quite high and could be devistating with paralyzation being the biggie here.So i could go into the surgery under more controlled circumstances or wait until the 'big one" happened and kind of crumble to the floor. Anyway, I had the surgery a few months ago,and oh my, what a wild ride this has been! While in rehab, I started having this horrible burning/stinging,skin tearing pain in my L forearm on up the back side of the upper arm,also the same pain from one shoulder blade across to the other,and also in and towards the back of the armpit.I was being given two percs every four hours with ms injections for breakthrough.No help there.Also was given Doxipin cream and lido patches(they seemed to help a little with the surface stinging in the blades.)They were also increasing my Neurontin almost daily.I was also dealing with Brown-sequard syndrome which caused my left leg to become really weak(could hardly walk up until like four days into rehab) this syndrome also caused my right leg to lose the ability to feel hot/cold or surface pain.As a result of the surgery, I suffered alot of neuro damage to my left hand and forearm.as time has been going by,i am getting more burning and numbness which starts to turn into the same ripping pain that is in those other areas.I have been on oxycontin with lortab for breakthrough,and they have increased my neurontin up to 3000mgs a day.I also take two 750mgs of Robaxin four times a day to try and lessen the pain of these horrible knots of muscle in my neck and shoulders caused mostly by the inability to move my neck hardly at all for over two years.My PT has worked out these knots over and over again but they keep coming back.my insurance co stopped my PT as i was not making any progress(there goes the really great upper shoulder massages that i used to look forward to as they did offer at least some relief for a day or two before things got all tight again)My neurosurgeon is not one that really likes his patients to stay on narcotics for very long.At my last appt he said something like "while I know that you are dealing with some rather severe pain, we don't want you to stay on them for very long as they really cause alot of cognitive issues"and then he said something about narcotics scrambling the pain signals but they also scramble other signals in the brain that we don't want scrambled,or something like that.So he is telling me that "hey I know that you are in agony but we can't give you anything to make it better"Wonderful!He did mention elavil, but I had a reaction to that many years ago while taking it for depression,so that one was out the window.His other idea was to implant a dorsal column stimulator in my neck(has anyone had one of these?)I have read about this thing at the medtronics site and see alot of contraindications for me not to have this, plus the overall success rate is like only 30-50%,and most people still have to take pain meds anyway.unfortunetly for the people who suffer with central pain syndrome, narcotics really are not effective.the only drug that I have heard of that some people say has offered at least a little relief from this type of pain is Methadone.so i am sitting here with a totally messed up L hand, excruciating pain that rips through certain areas of my body,ongoing significant degeneration in my entire C-spine, tons of scar tissue formation and many, many bone spurs, upper shoulder knots from hell and now this burning pain is starting to progress into other areas of my body.I need help!If anyone out there has had some success with methadone for central pain or has found anything that helps relieve this type of pain i would so greatly appreciate ANY suggestions.Thank you for listening to this long drawn out story.I am really sorry that i rambled on so long. feelbad
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    Old 12-21-2003, 10:38 AM   #15
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    Wink Re: Methadone Users: Advice Please?

    Do allow time for this drug to work. When it works, it can be wonderful relief for you. I was on it and was really happy with the results. It does take a bit of time, a week or so, to start feeling relief, but once you do, you will find it much more steady than the ups and downs of the short acting meds. Good luck, be patient, and Happy Holidays.
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