switching from hydrocodone to methadone (question)

Rrector

Jayboy...Can you give some specifics to the meds? How much Hydro were you taking per day and what dose did your Doc switch you to. Is the 10 mg of Methadone per day? I can answer your question, if you can give me the doses.

jayboy557

director, i was prescribed 10/325 norco's at 6 aday. i was taking more than that though. more like 15 or so a day. i'm having surgery in a month and wanted to stop taking so much hydro. no excuse but i take that much to be out of pain. anyway, doc switched me to 10mg of methadone. do you think i will have withdrawals from the hydro since i was taking so much. thanks for responding. oh by the way, fyi i am sheduled to have an artificial disc replacement on my l4-l5.

Rrector

Jayboy,
You may have some mild withdrawal making the switch. If you were taking 150 mg of Hydrocodone a day, you also were taking almost 5,000 mg of apap a day, way over the 4,000 mg limit. If your doctor knows how much Hydro you were taking and will work with you, if would really make things easier for you if you could continue to take the Hydro, while starting on the Methadone. Decrease the Hydro while increasing the Meth. It takes about five days for the Meth to build up in your system with it's long half life. If you can continue to take some Hydro with it, it will make the transistion a lot smoother for you. You'll most likely need to be higher on the Methadone. I'm at 180 mg. a day and you'll have to be higher too, but that will be a level you'll have to figure out where it covers the pain for you. Also, switching to Meth, will get you away from the high apap level. Let me know if I can answer anything else for you.

Shoreline

Hey jason, Something to consider is that pain meds aren't given so that people won't experience any pain, they are given to take the edge off and still remain functional. If the meds become more impairing than the injury, how are you benefiting from the meds? Your simply driving your tolerance through the roof and setting yourself up for a real problem manageing post op pain and some nasty withdrawal when the meds come to an end.. After the AD is placed, they will likely discontinue meds at some point to see how well things work.

You may very well need more opiates, but with surgery scheduled and a drug such as meth if you complain untill you have it adjusted to the point where it's relievng all your pain, post op pain control will be very difficult and the end of meth will come and it will be very ugly. The goal after surgery will be to get you off the meds and functonal again and docs tend to do that very fast and furious. People don't die from opiate withdrawal and surgeons aren't well known for their compassion when it comes to pain meds.

I wouldn't attempt to adjust your dose to the point your not feeling pain, reducing it from unbearable to tolerable is what a responsable doc shoots for and should explain to each of his patients. If you crank your dose of meth up on your own, even to prevent withdrawal you could be risking your life, because your unaware of how much from previous doses is still in your system. You will still have meth from day 1 in your system on day 5.

After surgery the switch back to short acting meds or the taper off of meth will be very unpleaseant if your doc doesn't know what he is doing and you shoot for total relief with meth prior to surgery. Meth is not something you can just taper off in a few days.

If you adjust your dose on your own like the hydro, you can kill yourself. Meth is the most dangerus drug there is for patients that won't/can't follow directions. I'm not suggesting you have to suffer immensely but get every dose change aproved by your doc and go very slowly and shoot for tolerable, not pain free.

You are now taking a class of meds that docs and pharmacist won't refill early. So adjusting your own dose, if it dosn't kill you will only cause you to run out early. Best case sceanario if you don't OD from taking more meth than prescribed is you run out early and experience the worst withdrawal you can imagine.

It took Director many years to get to that dose safely and each increase was aproved by his doc. It took many trials of other meds much more potent than hydro and at best it may only relieve half his pain.

If you expect 100% pain relief, it's much like abuseing meds where it will take more and more each day to maintain 100% relief or the same buzz the first dose created. Tolerance to the buzz ocrs very rapidly and long before tolerance to the anelgesic effects.People stay on the same dose for years with chronic pain without needing an increase.
I wouldn't adjust your dose too high because the more you take the harder the withdrawal will be when the doc discontinues the meds or switches you back to hydro post op. Just try to get by untill surgery and give the surgery a chance to relieve your pain.
Good luck, Dave