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  • changing from methadone to ms contin

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    Old 02-06-2008, 07:29 PM   #1
    lisagirl1965
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    changing from methadone to ms contin

    I have had 3 major back surgeries and my surgeon and now pain management dr. have put me on every type of narcotic know to man. But today when i went to see my pm dr. he told me that the methadone that i have been taking for the past 3 yrs was not going to be continuing. He said that only certain patients would be able to be prescribed it and pm drs are no longer able to prescribe it. It sounded as if only heroin addicts were going to be able to get it. Anyway, i was on ms contin 60 mg 3 times a day prior to taking methadone and he put me back on it today. Will i get the same pain relief i did with my methadone??? I also take percocets 10/650 3 times a day as needed.... Just wondering if anyone had gone thru this.... I have tried all of these medications in the past... vicodin, percocets, duragesic patches, ms contin ER & IR,& oxycontin and none seemed to work as well as the methadone. Any comment would be helpful. Thanks so much.

    Last edited by lisagirl1965; 02-06-2008 at 07:39 PM. Reason: adding info

     
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    Old 02-06-2008, 07:32 PM   #2
    brianpain33
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    Re: changing from methadone to ms contin

    Can you give us a little more information. Are you in Pain Management? Is this something that your doctor wants you to do? We can help you alot more if you give us some background on why your on methadone and why you want to switch?

    Brian

     
    Old 02-06-2008, 07:52 PM   #3
    lisagirl1965
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    Re: changing from methadone to ms contin

    sorry...newbie here to the boards. i edited my question with a little background...not much or it might take all night to type.. just some basics.

    Lisa

     
    Old 02-06-2008, 09:15 PM   #4
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    Re: changing from methadone to ms contin

    Hi Lisa, It would help to know what your dose of meth was but regardless, methadone is such a unique med, your going to have to give it time. No other drug has every quality meth has so even when converted at exceptable and even high rates people can experience some edifferencial withdrawal. Thi scan take weeks to pass and although the first instinct is to think it's just too low a dose, an increase won't make up for a quality that just isn't there. Your doc could add something like nemanda and give morphine NMDA antagonist action or you may simply do fine. I was always sensetive to change but knew it was just something I had to put up with.

    I thhought morphine worked great at the right dose, it just wasn't something i could afford at the time, so most of the time I used meth. I havene't heard about a change in methadone laws, but I haven't looked. If you don't mind , what state are you in. Could be state , could be federal. It could be your own docs discomfort, pressure from DEA or an increase in meth overdoses in your area.

    Few docs will put their livelyhood on the line if a med they have alternatives for puts them under the magnifying glass even further. My group of docs don't prescribe LA oxy. I live in VA where the first tracking system and the first few hot spots of abuse occured so I can except the logic in not using it. I can hardly blame them. I'm sure being a clinic and doing nothing but treating CP puts them in DEA sights anyway, I know they have one employee that is strictly the Liason that supplies them with info on any patient they want, whether it's your dose or your last UA results.

    Good luck and welcome, although the ride might be bumpy at first, the goal is to get you on a med and dose he isn't going to loose his practice and your only source of PM over. Take care, Dave

     
    Old 02-06-2008, 10:23 PM   #5
    forginon
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    Re: changing from methadone to ms contin

    Just last spring I was switched from methadone to MS Contin because of a heart problem I developed. At the time I was taking 80mg of meth daily (20mg) four times per day. On the day I switched they gave me instructions to work up to 5 60mg MS Contin tabs per day. So I started at 3 tabs every 8 hours and slowly worked my way to 5 per day. I seem to have settled at 8 tabs daily, 3 upon rising, the 3 at mid day and 2 at bedtime.

    I experienced no withdrawals whatsoever. I have to agree that the methadone was the best pain med I've ever used. But I'm doing well on the morphine. And I'm sure you will also.

    Try not to worry unnecessarily. Chances are you'll sail right through this adjustment.

    Best of Luck!

    steve

     
    Old 02-07-2008, 05:16 AM   #6
    lisagirl1965
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    Re: changing from methadone to ms contin

    I was taking methadone 40mg twice daily and i live in Florida. From what my PM dr explained to me yesterday was it was mandated that PM drs are no longer able to prescribe methadone...only the clinics because so many patients have been dying. When i asked if it was abuse from the patients he said no it was the PM dr's prescribing it didnt know what they were doing. I have been seeing my PM for about 6 yrs now and it hasnt been until this past year or so that he has started doing random drug screens..... I think i have only had 2 since i have been seeing him....Not sure about other patients though. .. ...Last yr my PM sent me to my internist to have an EKG done because he had just attended a seminar that told him about heart problems that were associated with methadone. It is called long QT syndrome. I already have a heart murmur...not treated... but my EKG was normal so he let me continue on with the methadone. As far as the prices are concerned..I just couldnt afford the ms contin in the past and that is why i was switched to methadone. I am just lucky now because i am on ssd and have the medicare prescription plan that pays for most of it.... Anyway, thanks for the advice but would rather be on methadone because it works for up to 36 hrs..... Guess i will sit back and wait and see.

    Lisa

     
    Old 02-07-2008, 07:24 AM   #7
    forginon
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    Re: changing from methadone to ms contin

    I developed heart failure after a very bad bout with the flu last year. So my GP, who now does my prescribing, called my PM doc to get her input, and she suggested the tie in with prolonged QT interval and methadone. My cardiologist said that there was no evidence of that on any of my tests but my GP wanted to switch me anyway. This was unfortunate as I really preferred the methadone. I also feel badly for other patients on methadone in my GP's practice, because I have to believe this over-reaction will extend to them as well.

    But, like I wrote, I am doing pretty well on the MS Contin so c'est la vie.

    steve

     
    Old 02-07-2008, 12:35 PM   #8
    medusa23
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    Re: changing from methadone to ms contin

    sorry i messed up while posting! (very new here)
    anyway, regarding the new methadone law...retail pharms can't sell the 40mg size anymore. they told me that my dr. can prescribe it until their supply runs out (i'm their only customer on it) & then i have to start taking the 10 mg, which means to get my 60 mg daily i have to now take 6 pills! this makes no sense to me b/c there's always some way around everything.
    by the way, i also switched from OxyContin to MS Contin several yrs ago (b/c of insurance & $$ issues) & it did nothing for my pain. i like methadone b/c one's tolerance doesn't develop like it does w/OxyContin & others. the sellers of OxyContin are in some deep trouble b/c they didn't disclose how highly addictive it truly is. it did work well but i had to keep upping the dose + it lost it's effectiveness pretty darn quick.

     
    Old 02-07-2008, 01:29 PM   #9
    badoldback
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    Re: changing from methadone to ms contin

    Hey lisagirl,
    It sounds like your doctor just misunderstood the DEA rule change. As was just stated above, the only difference is that only addiction rehab clinics are going to be able to prescribe the 40mg tablets. Pm clinics can still prescribe Methadone, but it will have to be in multiples of 10mg tablets. (I think this is to make the DEA look good on TV, they can say " See, he prescribed hundreds of pills a week, he must be a bad doctor")

     
    Old 02-07-2008, 02:27 PM   #10
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    Re: changing from methadone to ms contin

    The last two posts have been right on about the DEA rules on prescribing Methadone. The 40 mg wafers that some people were taking for pain control are no longer available from your PCP or PM doctor. They can however, prescribe Methadone in the 5 mg and 10 mg tabs. You can still be on Methadone Lisagirl, you just have to take more pills. I would recommend you ask the pharmacist when you fill a Methadone script for the Roxane brand.

    I'm on 180 mg per day (60 mg TID), so I take 18, 10 mg pills a day, in addition to my other medication. It sounds like a lot, but really, it's not that big of a deal.

    You might mention to your PM doctor you have learned that physicians can still write for Methadone for pain control, but it has to be the 10 mg tabs. The 40 mg wafers are used by the clinics for maintenance or detox only. I hope this makes you able to understand the fact that the Feds have not taken the prescribing for pain control away from the doctors.

     
    Old 02-07-2008, 06:40 PM   #11
    lisagirl1965
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    Re: changing from methadone to ms contin

    Thank you!!!!!!!!!!! I am very pleased to hear that its possible to get back on the methadone...My PM dr said he had only 2 patients on the 40mg tabs and i actually showed him what it looked like at one visit. I had my monthly appt yesterday and started on the ms contin 60 mg tid with percocet 10/650 tid prn breakthru immediately after the appt. I have started having more pain today than when i was on the methadone. I figured it was about time that the methadone was getting out of my system but it doesnt seem like the ms contin is working. I also take valium 10mg tid and elavil 100mg at bedtime to sleep. The ms contin doesnt make me as tired but the pain relief difference is definitely worth it!!!!!!!!!!!!

    So, i guess i will have to wait til my next appt to see if he will return me to methadone....hope he knows what you guys are telling me. Where can i get this information so i can take it to him just in case he doesnt believe me? Any ideas?

    Thanks again for all of your help.

    Lisa

     
    Old 02-08-2008, 02:51 PM   #12
    Rrector
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    Re: changing from methadone to ms contin

    You could always call and try to move your appointment up and go to see your doctor asap. Take the other meds with you and ask him to write a script and put you back on the Methadone. Here is an advisory from the DEA that explains the the 40 mg wafers being pulled from the pharmacies, but the 5 and 10 mg are still available and may be prescribed by physicians for pain.

    [url]http://www.usdoj.gov/dea/pubs/scheduling.html[/url]

    This should take you to the DEA website. Type "40 mg Methadone" in the search and when the page opens, what you need is the first item listed. Print for your doctor and good luck.

    Last edited by Rrector; 02-08-2008 at 03:08 PM.

     
    Old 02-08-2008, 06:22 PM   #13
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    Re: changing from methadone to ms contin

    Just venting here.....I really think the DEA just doesn't get it sometimes. What's the difference between taking 18 10mg pills per day or 4.5 40mgs?? If anything, you'd think the DEA would be worried about the QTY of pills rather than the strength. From a diversion standpoint, I'd be more concerned about scripting 100s of 10mg pills vs much less qty of the 40s. Just my .02. Maybe I'm the dumb one!

     
    Old 02-08-2008, 06:43 PM   #14
    lisagirl1965
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    Re: changing from methadone to ms contin

    The funny thing about the 40 mg methadone was it was suggested to me by my pharmacist when he was having problems obtaining the amount of 10mg tablets that i was dispensed each month. I spoke to my PM and he changed me over to the 40's without hesitation and now i am having to go thru all this crap. I thought it was so much easier to get the 40mg tablets than having to make sure my pharmacy had the large amount of pills i needed when i was on 10mg. Oh well, i am a RN and what the heck do i know.....if its simple they have to change things to make them harder on the patients..

     
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