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  • methadone vs morphine

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    Old 12-25-2014, 07:34 PM   #1
    syl1207
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    methadone vs morphine

    I suffer from COPD & CHF. Sometimes it is painful to breathe. I have been told that methadone is used primarily to control the pain and morphine to relax the airways so breathing is easier. Methadone only contends with pain. Is this true?

     
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    Old 12-25-2014, 09:05 PM   #2
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    Re: methadone vs morphine

    It is a little more complicated than that.

    Both are respiratory depressants, which is why morphine is prescribed for COPD, but methadone's peak respiratory depressant effect typically occur later after dosing and persist longer than its peak analgesic effect. This makes it a poor choice for pulmonary treatment.

     
    Old 12-26-2014, 10:50 AM   #3
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    Re: methadone vs morphine

    Its difficult to compare Methadone to any of the other pain meds as the conversion is more variable. Many folks have better pain control with it than their previous meds. However, it may have slightly more risk; its often recommended to get an ECG to check the heart for prolonged QT interval, and a sleep study to check for central sleep apnea.

    For me, Methadone has been the only pain med to significantly help long term (about 5 years). I seem to get much more bang for my buck (better pain relief for a supposedly equivalent dose). Agreed that Morphine however would likely be a better choice for COPD, and it should help pain like any pain med.

    By the way, both Morphine & Methadone can be more sedating than some of the other pain meds, Methadone more so (vs. Oxycodone which is more likely to cause more energy than sedation). Also, Morphine could be used as needed (in the short acting form), while Methadone is only used as a long acting med (although it is quite short acting). Best wishes.
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    Old 12-26-2014, 09:00 PM   #4
    syl1207
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    Smile Re: methadone vs morphine

    Like most medical questions, you end up with more questions. The 2 answers received gave me more information so that I can make a better thought out decision regarding which to use.
    I thank both of you for the information. Will most likely end up using morphine rather than methadone.
    Luckily, I don't have too much pain at this time - just shortness of breath.

     
    Old 12-29-2014, 09:51 PM   #5
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    Re: methadone vs morphine

    Quote:
    Originally Posted by syl1207 View Post
    I suffer from COPD & CHF. Sometimes it is painful to breathe. I have been told that methadone is used primarily to control the pain and morphine to relax the airways so breathing is easier. Methadone only contends with pain. Is this true?
    These descriptions are a bit lax. Methadone is a good pain medicine for a couple of reasons. It's generally used on back and neck issues. It also has an incredibly long half-life and stays in your system for a very long time, thus providing greater pain coverage with less medication.

    Morphine is used off-label to control Shortness of Breath for COPD/CHF patients and it does that by relaxing your bronchial muscles and Breathing Tubes. But morphine can also effect your respiratory system if given too much and stop your breathing. Your Dr. would have to be very diligent in making sure your dosage was correct since using it off-label. They would probably start you at a small dose and titrate it up to your therapeutic level.

     
    Old 12-30-2014, 05:28 PM   #6
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    Re: methadone vs morphine

    Thanks for the clear explanation. The MDs and nurses never tell you anything and when I ask, the MD is vague and the nurses skirt the issue and finally I get the I don't really know response. I guess most hospice patients are at the point that they don't really care. Even tho I am on the way out, I still want quality of life and knowledge and how to cope with shortness of breath and pain management fills the bill.

     
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    Old 12-30-2014, 09:40 PM   #7
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    Re: methadone vs morphine

    Regardless of where your at in your pain journey or stage of your health you deserve to be well informed about your treatment; what it is, what it does, why, etc. Some Docs get a little lazy, they figure patients will just look it up on the Internet...but that's not the way it should be. They're the one your putting your trust in, don't let them run over you or ignore you, be firm and get the answers and information you need.

    Take care,
    KK

     
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