starting methadone and have a question

bluemonkey · Sep 15, 2014

know people don't typically switch from hyrocodone to methadone but, I have other medical issues and the Tylenol in norco plus the loperamide ( yep was on that too for a yr has made my feet swell and my right side hurt like crazy. I have tried to cold turkey quit twice and relapsed because of real pain.the last 3rd time i tried I as in the regular hospital for a month with "an infection" they never actually found. I was admitted through ER with a pulse rate of 140.
Because my feet and legs are swollen the pain there is astronomical at the moment. Any time my wheelchair hits a bump it takes a lot not to cry. And to top everything off my dad, who means the world to me got pissed off at me for the 3rd time this week.I had an appointment with GP about legs but, she keeps canceling . I swear I have the only GP who is off more than she works lol which makes it hard to get refills. So i'm done i'm headed to the clinic tomorrow AM.

Hopefully the 'done will take the edge off all this pain while my other drs figure out whats causing it. Also I hope it will allow me to stop focusing on meds so much and repair things with dad before its too late. So i do have a question, what happens if I am allergic to the methadone? I can take dialuadid but, not morphine. Only mention that to say how weird my body is. So if it turns out i'm allergic to this can i just go back to my meds? the clinic said yes but, im not sure i believe them. they said with my history i would probably only be on 'done for 9 months at most.

I know this seems like a last resort step but, state insurance that comes with disability checks does not cover subs. if I did not have other medical issues playing in i would not consider switching but, I have quite a list. So please don't preach at me saying the switch is silly if you have other ideas i'm open but, not to just "its silly to switch..." The state insurance is also why I am a huge waiting list just to switch GPs ( all from dr Vacation's office id bet lol). In fairness she's old and should probably be retired like century a ago. vacation is not her real name just feel like it should be... anyway thanks for reading and any feedback

tattfacehobo · Sep 19, 2014

Honestly, I would not switch from hydrocodone to methadone. IMO, That would be moving backwards. Getting on methadone is far worse than being addicted to hydrocodone. The withdrawals are a living hell. I know it's tough not having opiates with having chronic pain, but you should really consider a life without any form of substances. I'm just chiming my two sense, through personal experience, moving to methadone or dilaudid (hydromorphone) would not be helping at all. Words of advice - Go to detox then maybe a long term inpatient treatment and once you finish that start going to NA. I'm fighting to get off heroin and it's hell, but getting off methadone was a thousand times worse. I hope everything works out for you OP. Easy does it, one step at a time.
Regards.

BlueSaffron · Sep 19, 2014

Seconded. Methadone does help people sometimes, but so does radiation. Both are something to be used as a last resort IMO.

neversickanymore · Sep 19, 2014

If you share a little more about your condition then we might be able to give you stronger advice.

rhun · Sep 20, 2014

While normally switching to methadone if you're only dependent on hydrocodone isn't a good idea, the fact that the OP has pain management issues and may have legitimate, chronic pain changes the situation completely. Sober Living may not be the right forum for this. When used for pain, methadone is used in much smaller doses and is just like any other pain medication. It can be a good option for someone who needs a long acting medication.

OP, what exactly is causing your pain? If they don't know what it is and there's a chance it can be resolved, I would not switch to methadone. It can be hard to get off once you're on and unless you're going to have pain issues for the long haul, it's not a good idea.

Another thing is, once you go to a methadone clinic doctors will always think you're an addict and you may never be able to get another narcotic prescription again. That's why many chronic pain patients end up at methadone clinics only as a last resort.

Doctors, however, can prescribe methadone for pain if they feel it's needed in your case. As for the allergy question, methadone is an opioid like hydromorphone so it's likely you won't be allergic (morphine is an opiate and a definite of the poppy plant while opioids are synthetic) but it's really something you would need to bring up with a healthcare professional.

Honestly, it really sounds like you need to find a new doctor. Not just up and switch to methadone just cause you don't want to deal with it. Switching to methadone should only be considered after exhausting all other options. Because once you're on it, there's usually no going back.

bluemonkey · Sep 30, 2014

I have a hip out of place and now have liver problem because of all the loperamide and tynol.I also get chronic migraines. I use a wheelchar becauseI have Cerebral Palsy and theortho doctors say the only way to re-align my hip is to breakall thebones in my leg and put it bk which would take a yr to recoverfrom for normal people. my body takes much longer to heal than most. So that surgery is just not an option. atm, they've swithed me to precocet which is barely working for pain or w/ds for that matter

neversickanymore · Sep 30, 2014

Thanks.. I feal that methadone is a great painkiller. I received more benefit for pain from methadone than anything else. Most of my pain was neuralgic pain.

Methadone has many advantages, but also comes with some areas that need to be watched.

A big benefit is that you will no longer be on the roller coaster of short acting opiates. The brain wants its homeostasis and short acting opiates really end up creating allot more pain than they prevent in the long run. This also should allow you to get much better sleep.

Here is some very solid information on what methadone is and areas you need to make sure your physicians are aware of and actively dealing with, remember its your body, health, and quality of life.. so please don't let a physician continue if thier heads up their own ass. Some can tend to have big heads, so we may need to help them extract it

Although the effects of methadone are very long lasting the analgesic effect is around six to eight hours. This fact may come in handy as you will be able to explore what pain effect was from the condition and how much it may have been exacerbated through prolonged use of short acting opiates. I think you may find that your pain may be reduced much better for longer periods and you may not receive such a strong rebound as the medication is removed by the body.

If you are a male then I you will need to have your testosterone levels checked twice a year if you are on a dose of over 40mgpd. Doses above this are quite likely to cause decreases testosterone levels and these can have unpleasant and negative effects.

I would also include a vitamine D supplement daily and have your levels for this checked at least once a year.

Methadone is really unpleasant to come off and this unpleasantness last a long time. Two weeks in acute withdrawal and usually many months in paws. I know I have kicked it and it was a BITCH to say the least. Just something that you need to take into your descion.

Im sorry you are suffering and i hope you find the relief you want and deserve

Methadone side effects, separating fact and fiction.
Low vitamin d status of patients in methadone maintenance treatment.

I will link one more, just have to track it down.
If you do undergo this approach I would be interested in hearing any changes it has on your CP symptoms, if you want to share of course.

rhun · Sep 30, 2014

^ that's all good information and all, but the biggest issue he needs to look at is whether as a pain patient he wants to risk never getting scripted pain medication again. Because that is the reality for many CPPs once they go on buprenorphine or methadone.

OP, if you still have pain that isn't being managed I would look at getting a new doctor first before making the jump to methadone. Better to exhaust all options before going to a methadone clinic because otherwise you could likely be stuck on methadone for pain permanently even if it doesn't work for you. This also means you will be treated like you have an addiction and won't get short acting opioid for breakthrough pain.

If you need a longer acting opioid, the right doctor will script it. And a doctor can script both buprenorphine and methadone for pain, not addiction. Which means you won't be limiting future options. With your tolerance level, I think low dose bupe will be a better option. Still very effective for pain but less potential for addiction and way less side effects.

I've tapered off both methadone and buprenorphine. It was a long process but I had a solid taper plan and took it slow and there was no major discomfort. Other medication really helped too.

neversickanymore · Sep 30, 2014

but the biggest issue he needs to look at is whether as a pain patient he wants to risk never getting scripted pain medication again.

OP are you going to get the methadone from a pain doctor or are you going to get it from a clinic. Getting it from a clinic is not a good idea as you are going to need to dose at least every eight hours.

If he gets the methadone for pain management from a doctor this would in no way prevent him from getting other pain medication at some point. I was on methadone and oxy for break through at the same time.

neversickanymore · Sep 30, 2014

Here are some more good links.

Neuropathic Pain: Causes, Management and Understanding

Hypogonadism and Low Testosterone Levels as a Side Effect of Methadone and Buprenorphine

rhun · Sep 30, 2014

neversickanymore said:
OP are you going to get the methadone from a pain doctor or are you going to get it from a clinic. Getting it from a clinic is not a good idea as you are going to need to dose at least every eight hours.

If he gets the methadone for pain management from a doctor this would in no way prevent him from getting other pain medication at some point. I was on methadone and oxy for break through at the same time.

He said in his very first post that it would be a clinic, which is why I said that. I also included in my last post that doctors can script buprenorphine and methadone for pain as well as a short acting opioid for breakthrough pain.

I think buprenorphine would be much more appropriate for someone whose tolerance is very low. He's only been on hydrocodone and just recently low dose oxycodone in the form of Percocet.

neversickanymore · Sep 30, 2014

Sorry I must have been distracted some how and missed that.

Yeah I agree I would not go to a clinic, esp since the OP will have to make their way to the clinic everyday. That sucks enough, let alone trying to do this while having to use a wheelchair. Combining that with with the eight hour window for relief.

Given that they are going to be on pain medication for a long time I do not think methadone is a bad route to take.

I have no experience with bupe pain control.

rhun · Oct 1, 2014

Hey my bad, I've been posting from work on my breaks and I've been sick for coming up on 2 weeks now. Reading back over my last couple posts, it's a little muddled.

As far as the buprenorphine for pain, I should have put that it would only be an option if the OP went ahead and went to an addiction clinic. Of course there's Butrans and Buprenex, but as of right now doctors can not script buprenorphine SL for pain even if they're certified to prescribe it for addiction.

This is really too bad, because there's been some study done into its use for pain and it was very effective. I'll post the links later if I can find them again, I researched it awhile back. But I will say I'm more recommending it due to my own experience. I've met a lot of pain patients in treatment who it worked well for and many buprenorphine doctors who have a lot of experience with this medication say it's effective for pain while generally having less side effects.

Is methadone good for pain? Yes, absolutely. But it's also a heavy duty opioid with a lot of side effects. Multiple male methadone patients I know personally had to do testosterone injections as a result of being on MMT. I didn't get my period for the entire year I was on it. Sugar cravings and weight gain are an issue as well as lethargy and sedation.

I think it has its place, but not until other options are at least attempted. My impression from the OP is that he's frustrated, partly because he doesn't feel his pain needs are being addressed but also because of family issues. Going on methadone shouldn't be a snap decision. And his current doctor isn't going to script it anyway.

He's only tried hydrocodone and just this week oxycodone. He needs to get his father involved if the doctor isn't adequately addressing his pain. Maybe they can try other medication in addition to opioids... muscle relaxers or pregabalin if it's appropriate. Also, physical therapy, massage, chiropractic, etc.

If none of this helps or is appropriate for his situation then he needs to try a new doctor. And keep trying till he finds a good fit. There's so many opioids he can try before going to methadone. I think he needs a longer acting opioid for daily use and maybe a short acting one for breakthrough pain. But his doctor may have very specific reasons for only scripting oxycodone, we don't know the situation. On the other hand, I know in this country doctors are afraid to prescribe medications and legitimate pain patients suffer.

Hope that was more succinct

rhun · Oct 1, 2014

Also, I wanted to add that I know I suggest buprenorphine a lot. But it's not just because I've had a good experience with it and I will say its not a magic pill or going to be the right medication for every person. I was on methadone for one year and tapered off and I'm coming up on a year on buprenorphine now. I did taper off buprenophine earlier this year but had to go back on almost immediately when I found out I was pregnant. I've been on both high and low doses of both medication and I really can't say I had an awful experience with methadone by any means.

My father and I, both being opiate addicts and both having been on methadone and bupe maintenance, have researched both medications pretty extensively in the past. I've also been around and seen both the successes and failures of these medications during my own recovery journey, which has included inpatient treatment, intensive outpatient, group therapy, sober living environments, 12 step meetings, LifeRing, buprenorphine doctors and addiction specialists, drug and alcohol counseling, psychiatry, and methadone/buprenorphine clinics. I'm surrounded by addicts and addiction and while treatment is by no means one size fits all, I've found that buprenorphine in general is more conducive to recovery and leading a stable, healthy life.

I typically suggest buprenorphine in cases where an individual has had no success with cold turkey detox and treatment, the individual needs to be on maintenance due to pain or other issues (and has a low to moderate tolerance), a rapid or 30 day taper is being utilized in treatment, or an opiate addict requires long term maintenance for whatever reason. I strongly feel that bupe should be tried BEFORE methadone, but unfortunately where I am insurance won't cover it unless methadone has been tried unsuccessfully first. It's pretty backwards, but methadone is an old standby and bupe is relatively new.

That being said, methadone definitely has its place in treatment. Hard-core opiate addicts with high tolerance and/or a long duration of use and addiction may require methadone. I made the choice to try buprenorphine this time around but it wasn't easy... My tolerance was absolutely ridiculous and there was definitely some discomfort adjusting to being on bupe even at the max 32mg dose. For similar cases like myself (IV user, used cocaine and benzodiazepines with the heroin, multiple failed attempts at getting clean, dying from addiction) and worse, methadone is just the easier route. But there's a lot of side effects and many of us end up stuck on it for life.

Methadone is also appropriate for chronic pain patients who have been on opioid pain management for some time and have already tried multiple medications, including the stronger ones like morphine, hydromorphone, oxymorphone, etc. Getting off isn't an issue because they require medication indefinitely and have exhausted other options. The benefits to the patient outweigh any potential side effects or consequences.

I advocate buprenorphine because it has all the benefits of opiate replacement therapy (whether used for detox or maintenance) without a lot of the side effects of full agonists, has less potential for abuse, and doesn't require daily dosing. Because it's a partial agonist, it's a great transition drug because it allows the patient to feel normal without the discomfort of withdrawal and PAWS. It's an adjustment, as you feel sober on it and need active recovery to deal that and there is physical dependence. But it's not replacing one addiction for another, which ultimately I felt methadone was doing. Bupe allowed me and many others a shot at active recovery we wouldn't have had otherwise.

Anyway, just wanted to shed some light on why I'm such a supporter of buprenorphine treatment.

bluemonkey · Oct 5, 2014

thanks for replies everyone. I am a girl btw. Since I am allergic to morphine most drs say that a lot of other opiates are not doable for me. I'm also allergic to tramadol. I broke out in a rash and saw giant smurfs ( very freaky so never again). My tolerance is actually high atm because of the loperamide. After a shot of diluadid in the er a few days ago, I was awake enough to ride my wheelchair home safely ( after 1mg in iv to be exact).

I would do anything for my dad even CT w/d again although I would rather avoid it. So I think the hardest part of all this emotionally is that i'm slowly pushing dad away. How would drs I have in future know if I would to a methadone clinic in the past? I ask because i'm planning to move across country when I am down with school in a yr or so. So, if I have tapered by then wouldn't it be my choice to reveal that or not? The clinic said with my history I would probably be off in 6-9 months.

I am also concerned that pain management drs might not accept me because I am already dependent. i have heard that you have to drop clean urine one first visit. Anyone know if that is true. I am in the USA btw.

neversickanymore · Oct 5, 2014

No you do not need to drop a clean urine test. You just need to provide them with the records of your current medications and not have any illegitimate chemicals flagged.

I was under the impression that you would be continuing the methadone because of the pain for awhile. If you are planning to get off of it very soon. like the "6-9 months" then I would not go the methadone rough. It is really is a very rough detox. You could detox cold turkey from the hydro four times in a row compaired to what the methadone detox lasts. Also since the methadone is also a nmda agonist and a rebuke inhibitor for serotonin and noradrenalin.

This means that your brain will adjust all these systems to include the methadone being on board and when you tapper and take the methadone away all these systems are left temporarily disturbed. This combines with methadones generally very long half life. which varies quite a bit from person to person with an average of right around 30 hours, to produce acutes that usually last two weeks and often very strong paws for around a half of a year.

Here is some information on very helpful medications for detox as well as information on PAWS.

NSFW:

So if you are under the impression that a getting on methadone and tapering off will be easier and more comfortable then detoxing the hydro, i think you will not find this to be the case at all if you decide to go that route. As was stated before if your ultimate goal is to get off the medications and want to use a tapper then I would go the suboxone rout. I would only consider the methadone if you feal you are going to be on long term therapy for your pain.

I hope you find this information helpful and come to a great descion that benefits you and your life

BlueSaffron · Oct 5, 2014

neversickanymore said:
Also since the methadone is also a nmda agonist and a rebuke inhibitor for serotonin and noradrenalin.

This means that your brain will adjust all these systems to include the methadone being on board and when you tapper and take the methadone away all these systems are left temporarily disturbed.

I didn't know that... I wonder if that's why I was so depressed coming off methadone....

bluemonkey · Oct 5, 2014

if i can work with a pain dr then yes I would rather stay on because even with meds at the moment I hardly sleep however if it comes to be at a clinic i just cant imagine doing that long term ideally, my career will involve international travel after school. which would be hard if not impossible going to a clinic everyday

donetherebeenthat · Oct 5, 2014

Bluemonky, you have gotten some very good factual information from these posts. I just want to reinforce 3 points that I've experienced myself. Coming of methadone is shear misery. I would rather come of hydrocodone 4 times over than go through the methadone hell. And suboxone would be my choice over methadone. This has been my 1st hand experience with these 3 meds. Wishing the best for you I know you have a lot on your plate.

D.T.B.T.

straightrazor · Oct 5, 2014

BlueSaffron said:
I didn't know that... I wonder if that's why I was so depressed coming off methadone....

I guess it is possible but I don't know how likely. Depression is an aspect of withdrawal from pretty much every opiate.

starting methadone and have a question

Bluelighter

Greenlighter

Bluelighter

Moderator: DS

Bluelight Crew

Bluelighter

Moderator: DS

Bluelight Crew

Moderator: DS

Moderator: DS

Bluelight Crew

Moderator: DS

Bluelight Crew

Bluelight Crew

Bluelighter

Moderator: DS

Bluelighter

Bluelighter

Bluelighter

Bluelighter