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  • Methadone - please put my mind at ease

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    Old 06-19-2014, 10:16 AM   #1
    GodHand
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    Methadone - please put my mind at ease

    I was diagnosed with Ulcerative Colitis six years ago. Two years ago my symptoms got so bad I was in constant pain and had to have the 3-step j-pouch surgery at the Cleveland Clinic. Overall it was a fantastic set of surgeries, and I am very happy I had them done. That said, since my diagnosis, I have been struck with very annoying spasms in my abdomen with no underlying cause, other than it's just a symptom from the Ulcerative Colitis. The problem still persists today.

    I recently got referred to a Pain Management doctor, and he's a great guy. At first he put me on the Butrans patch, but my skin reacted to it and I had to come off. On Tuesday, he put me on Methadone. I am to take 10MG once per day for seven days, then, if tolerated, one pill twice per day (morning and evening).

    He has assured me it's safe, as have the nurses, but I am scared. I have taken it and it has really helped. I do NOT abuse any sort of prescription medication! That said, I still get very nervous taking it. People have told me it's perfectly safe when taken as prescribed, and I would never, ever take it recreationally or the like. It is stored in a locked safe, and I take it exactly how it's written, and I take nothing else with it.

    Can someone put my mind at ease a little bit more about this possibly? Like I said, I will only take it as prescribed but the entire name has such a stigma around it I can only find like one positive article for every five written. Both my Pain Management and Internal Medicine doctors have said this medication is perfectly safe for someone like me, with no history of abuse (I also do not consume ANY alcohol) or addiction. Can anyone share with me some success stories on this? I was surprised he went way off to Methadone, but from what others have told me who also see Pain Management doctors, this drug has become quite popular due to its long halflife in the body. Thank you.

    Last edited by GodHand; 06-19-2014 at 10:18 AM.

     
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    Old 06-19-2014, 07:47 PM   #2
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    Re: Methadone - please put my mind at ease

    I am on Methadone and doing very well. In fact, I've been on most other opiate pain meds and circled back to the Methadone because nothing worked even close to as well for me. It was the first long acting pain med I was tried on. Due to my high dose I do get quite a few side effects, but the benefits outweigh them for me. Its very individual as to if any med will work well for you and if it will be tolerated. Hopefully you do well on it. I think you have nothing to worry about from what you said.

    Most of the bad press about Methadone is with overdoses. The most typical scenario is someone takes it, feels nothing, then takes more, and so on, and it builds up in the system. This is especially bad when combined with benzos and/or alcohol. When started at a low dose, the dose is raised very slowly, and it is not combined with other meds, that risk is pretty much negated to be no worse than any other opiate pain med.

    If you are completely freaked out about it you could even start at 5mg a day for the first few days (or split the 10mg pill and take 5mg 12 hours apart), to start even slower. The most typical side effect, especially when starting, is sedation. Often it can come on unexpected, like you feel fine one minute and start nodding off the next, so be on the look out for it and be careful especially when driving.

    Also of note is that the half life is very long, but it has a relatively short time of action...it is typically dosed three times a day. I actually take it four times a day. So a bit less convenient than some other meds. It is also very inexpensive, which can be good for folks who don't have insurance or who have high deductible plans and such (many long acting pain meds can literally cost a thousand dollars a month if someone was paying cash, although it is very dose dependent).

    The only other potential problems Methadone has that other opiate pain meds don't have is the higher risks of respiratory depression (not typically an issue with low doses in healthy patients), central sleep apnea (typically more of an issue with high doses), and prolonged qt interval (often doctors order an ECG after you've been on it for a bit just as a precaution). The third is unique to Methadone but the first two are for all opiates but higher for Methadone as far as I know.

    Methadone is especially known for people being able to remain more clear-headed than some other opiates while on it, although most folks on meds for chronic pain don't feel any "high" from them, at least not after awhile. Tolerance may also increase slower than with other opiates.

    Doctors either tend to use it a lot or not at all. I think why it and Butrans and such are popular with many PM docs is due to the lower abuse potential as well as the potential to build opiate tolerance slower. It is actually the shortest acting of the long acting pain meds in terms of dosing frequency (there are other pills that last 12 or 24 hours, or patches that last 2-3 or 5-7 days). I think its great you are seeing a pain management doctor, as they are best suited to prescribe long acting pain meds. Seeing a pain specialist has finally got my pain under good control. I wish I had done it much sooner. Good luck! Best wishes.
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    Old 06-20-2014, 08:56 AM   #3
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    Re: Methadone - please put my mind at ease

    I have been taking methadone for around 2 years and have had no problems at all with it.I take it 3x a day at 20mg per dose.I also take oxycodone for breakthrough pain and Somas for my back for muscle spasms.I am pretty sure if you can tolerate methadone than it would be the drug for you as i have heard and know that it is easier on a stomach.It is not any more dangerous or even as dangerous as some pain medicines.I know a lot of patients where i go to the pain doctor who take methadone and in much higher doses than what you are taking,and they have never had any problems with it.If you stay on that small dose i dont think you will ever have too worry and if you can make it on that dose id never try to get it raised.The less you take of any pain pill is for the best.Good Luck with your pain issues!
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    Old 06-20-2014, 09:39 AM   #4
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    Re: Methadone - please put my mind at ease

    I just wanted to say that if i knew what i knew now about pain medications i would have never let the doctors raise mine.After they raise them then it isnt long they need raised again.I should have only allowed a very small raise every now and then.If even that-So that is why i said to you that id stay at the dose you are at.Its much better for your overall health,but i think you know a lot more about pain meds than i did and are very careful already with them so thats great.
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    Old 06-20-2014, 03:50 PM   #5
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    Re: Methadone - please put my mind at ease

    I have been on methadone now for almost 5 years and other than the initial sedation I have had no problems with this med. Also I am on a much, much higher dose than you. However that being said once the initial tweaking of my dose I haven't needed an increase in those 5 years and honestly don't forsee the need for an increase any time soon. I also take 20 mg oxycodone for breakthrough pain and I almost never need them.
    I can honestly say that when I went on methadone I was at my wits end. Since then my pain levels rarely go above a 5 and for me that's a miracle. It gave me back a huge part of my life.
    Of course these are my experiences and everyone is different. Don't let the bad press scare you. You sound like you have a great head on your shoulders and as long as you follow the rules and dose properly you should be perfectly fine.
    Good luck to you. I hope that this medication gives you the relief you deserve.

     
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    Old 07-21-2014, 04:11 PM   #6
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    Re: Methadone - please put my mind at ease

    Hey, guys, I just wanted to give an update. I have continued with Methadone since making this thread and am so far very happy on it. It has successfully basically eliminated the pain I have, though I do have some peak times of pain, it's nothing too dramatic.

    Am am currently taking 10MG of it in the AM, then another 10MG in the PM.

    I brought up some of my concerns with my pain doc that echo what I initially mentioned and he put my mind at ease - telling me that I'm on a very low dose, am not an abuser of medications nor am I a large consumer of alcohol. He said the horror stories I find are usually due to careless prescription writing practices from those unfamiliar with Methadone, people whom it was not prescribed for taking it, and in settings where higher doses are used for the management of other opioid addictions. With that, I felt more at ease.

    Overall the only annoying symptom is nighttime anxiety and sleep issues, and for this he prescribed me Temazepam. 15mg to be taken at night. This has also been a huge help to me in combating the anxiety from Methadone.

    He said I may need a dosage increase down the road, but for now he's very happy my pain is very minimal at the small dose I'm at now, which is good. Really Methadone and the morphone medications (hydrophorphone / Dilaudid) have been the only two that have helped significantly. I had absolutely NO relief from morphine, and oxycodone was helpful though in very short bursts, and I don't want to walk around with narcotics on me during the day just so I can get pain relief.

    Thanks for the responses!

    Last edited by GodHand; 07-21-2014 at 04:12 PM. Reason: Typos

     
    Old 07-21-2014, 06:34 PM   #7
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    Re: Methadone - please put my mind at ease

    So glad this is helping you. Thanks for the update! Agreed about the causes of the scary stories about Methadone.

    As a side note, definitely let your doctor know if you get a pain increase at the end of the dose. It is more common to take Methadone three times a day. You could probably stay at the same daily dose but split it up more if needed.

    Also, I'd ask your doctor about the long term use of Temazepam. It is a benzo, which isn't ideal. Was anything else tried first? Best wishes.
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