Opioids Switched to ... Methadone????

[Janemcc13]

So, I've been taking oxy at 1st on and off and then just on for about 6 years. Official dose is high as it is: 100mg/day. Unofficially, it's more like 400. I can get by ok though, as low as 60. For a couple days, I can manage. I'm very lucky in that withdrawal for me isn't terrible illness. It's terrible fucking pain though. I didn't get put on this shit for no reason. I'm beyond injured. Birth defect started it all. I've also been told by a few doctors that I have some enzyme in my liver that just burns through this shit, which I very much believe. These people had no interest in telling me that...it would be right after surgery #7 or whatever. That would explain why, at 5 feand tiny, I can drink more than any man I've ever met. I don't drink anymore though, so slight digression there.

I moved to a new state and soon learned regulation is about double or quadruple where it was where I came from. Saw doctor today and got bumped from start of day to end. Official start of withdrawal, but I hide it too well. He had no clue....prescribed methadone, effexor, and a muscle relaxant. I expressed huge reservation at methadone. I've partied plenty but never done heroin. I won't lie - recently considered to save some damn money. Never did though.

It's been 3 hours. I'm still in horrible pain. Did some homework and think I've been put on far too low a dose, and am also scared shitless. I got 5mg pills, 3xday. I've not come across anything like that yet in 3 hours of looking. Closest I've seen is 30. Another thing is this is apparently the worst thing to kick, ever, hands down.

I literally don't even smoke, don't drink and hate myself for the oxy habit I've developed. I have held out hope someone can "fix" my pain but no such luck yet. If I'm a lifer, I know this is best but.....fuck!

Dose thoughts??? I already took 15mg. Figured safe for day, safe now, and did wait full hour between each. I'm at about 10% relief at best. I can't do this shit if that's the best it gets. I have a toddler,a business, and so much more. Any info, thoughts, advice, etc is much appreciated. TIA.

 

[I B Profane]

If you were taking 100-400mg Oxy per day, then 15mg is not enough Methadone IMO.

You should talk to your doc about this, see about getting on a higher dose, but be careful to titrate up. Methadone is very slow acting and lasts an extremely long time, so there have been ODs where people take some Methadone, don't think it's working, take some more, and don't wake up. Be careful and good luck.

 

[CfZrx]

I'm on the same dose. That's too low for you! But, man methadone is the bomb for pain! Take cimetidine 600 mgs an hour b4 your pills for max effect

 

[willy33]

Methadone is good for pain but tolerance will develop relatively quick. I B Profane is right about the dose being completely inadequate. Methadone has a long half-life, hence it's use for opiate-maintenance therapy. Your doc may suggest morphine, but one of the problems with that particular drug is it has a very low bio-availability profile. This means when taken orally only 20 to 40 percent of the dose is actually absorbed into the bloodstream and you will NOT be getting the dose which the doctor has written. Naturally the way around this is intravenous or intramuscular injection, but this is a route of administration I would not ever recommend on account of the potentially numerous complications which can arise. I know it's easier said than done, but perhaps asking for a referral to a pain-specialist may be the way to go. Drugs like fentanyl have worked for friends and associates of mine who struggle with chronic pain. I wish you the best of luck and hope you find a way to deal with what sounds like a very frustrating situation.

 

[Janemcc13]

So, further questions of course. Dr is pain specialist and orthopedist. Knows his shit. He'd said he'd write for a little oxy for breakthrough pain, but then either changed his mind or forgot. You all know 400, but he only knows 100. Still terrible pain and given last 2 days spent with 2 30s each only, I should have been fine. So this is low for proper me who'd never think of taking extra. My instincts based on worst headache imaginable with a side of burning back and arms says this isn't shit. Let's talk 50.....right? If I am going on that which I will never be off, I don't want a second of discomfort in my pinky finger. If my dose calls for more, l will call crying until either I get there or feel better. Given how fucked I am on oxy, while bad genetally, I think good for me.

 

[manboychef]

Just be honest with your doctor. Doctor patient privelege prevents them from getting law enforcement involved that you may or may not have been abusing your prescription. there may be some stern talking too and maybe a little finger wagging going on, but generally doctors are understand about such things. Honesty is the best policy...if its all out in the open then he may actually be able to treat the pain you have.....rather than the perception of the pain you had due to your amount of prescribed mediction.

 

[Bropiace]

I want to agree with manboychef but I can't. I am all for honnesty but I am also for risk vs reward. I do think the solution will come from your doctor but I would never even consider if I was in your shoe to talk about taking 4 times the amount prescribed.

I will only tell you what I would do if I were you after disclaiming I have no pain, am an addict and might be talking out of my ass. There might be a better option. Still this is what I would do :

I would talk to the doc about the meds not really doing it for you. I would also talk about physical incomfort (mild withdrawal symptoms). If your history allows, you can play dumb and say that it started when you tried the new med so you think it is a side effect. Also describe some breakthrough pain and the constant pain both (shows you are on too low a dose and might get him to remember the Oxy). It will be a long process but each time I see him I would talk about feeling a bit better each time he raised your script but far from ideal.

In the meantime I would score Oxy or Dilaudid off the street. And I would keep my usage minimal and try to taper. By slowly reducing your daily habit and by having your doctor slowly increase your prescription you will eventually hit a balance point. Personnaly, I would also go on with the tapering. Once you hit the point where you do not need to get some meds off the street (stick to pharmaceutical, you cannot taper what you don't know the concentration of) you can take it more easy on the taper. Still I would go on. If you do it very slowly, you won't suffer too much from both your pain and the withdrawal. That way you can increase a stash if some bad luck happens. Also aiming for a taper with at the very least keep you steady on your dose instead of raising your tolerance.

Whatever you end up doing, always be careful if you mix opiate, when you try something new and as other said keep in mind the high half-life of methadone. It builds up for a few days to hit peak plasma at a steady dose. It is even worse if you inscrease it.

Good luck.

 

[Janemcc13]

I'm so honest it's kinda pathetic. Except here, in State of arrested doctors. I am, well....a professional. I've read the actual laws, medical board guidelines, and then found a documentary explaining everything. A few asshole, and that's putting it kindly, doctors were prescribing shit like oxycontin and opana (tried it. .. nothing, but if I were 15?) to teens and early 20s. The kids would take ridiculous amounts at parties and die. A few were dumped and help didn't come for hours out of fear. So, parents banded together and got the dirtiest doctors on earth but then Johnny law wasn't satisfied. Something like 30 doctors were arrested. If someone had OD'd on heroin with a smidge of vicodin in his system, poor dr got attempted murder. This was only a year ago. While the laws and even Board guidelines allow for treatment, doctors are scared shitless here. That's my only reservation in telling full truth. No one person is the same and I just don't fit any medical mould anyway. Drug A should knock me out but I'm wired. Vice versa with drug B. Benzos do NOTHING and I mean that. I have taken up to 10 10mg Valium just to see what the fuck all the fuss was about. Nada. So, I'm telling truth and leaving recreational use out. Honestly,hasn't gotten me high in at least a year. It's legit pain control and the occasional high chase effort. I downed 12 30s last week and realized that high is forever gone. Now, if I'm asked a direct question, I am indeed a terrible liar but I'm also smart in only answering what was asked. My husband, the poor dear, has been calling them all morning. Yes, they did forget that oxy script. His intent was to trade one for the other slowly. So, as long as hubby doesn't come back with something less than 30mg per day, this should work. I've read wonderful things for people who have no hope of getting off of pain meds. I guess that's me unless medicalmiracle,at which time I'm fucking strong si will fight the battle then. Until that mythical time, the idea of living without pain has me so excited I can't stand it,even as I sit here in withdrawal.

 

[manboychef]

I can't stress being honest enough. My only concern with getting pills on the blackmarket is the threat of johnny law getting involved. They no longer save lives. In fact, they can take your life and make it not worth anything especially when it comes to prescription drugs.

Bropiece is right. Just tell your doctor the truth about your pain, and that what you are taking is not scratching the surface, however if your doctors around your area are indeed that jumpy, definitly leave out the part about abusing your scripts. All doctors have a moral obligation to ease pain, and cure sickness. It is part of the hippocratic oath. Hold them to it. If he does not, try to find another doctor. It is a free market, you dont need to stay with someone that is not intune to your needs as a patient/customer.

 

[willy33]

Don't you just love the irony (read: hypocrisy) of doctors? "Here's a script for an addictive, legal and pleasant chemical. Take them. But don't you dare come back telling me you need more, even though essentially I got you started on them."

Doctors will convince themselves it's some form of moral weakness on the part of the patient. They will turn their backs so quickly....most doctors are great, when it comes to objective treatment (you have a suspicious mole on your back, doc takes it out), but when it comes to psychoactive compounds, especially one's with abuse potential, their bias and subjectivity overrides all systems.

Instead of trying to help constructively, they make their patient question their activities, not the other way around. My advice: try find a good psychiatrist with some humility.

Good luck

 

[manboychef]

^^^^absolutely right. There are so many xanax prescriptions out there...but god help you if you are in pain.

I think that most doctors experiencing the kind of pain they are being biased and subjective about would look at alleviating said pain in a different manner. We already have created another boom in the heroin market because the people they prescribed pills to can no longer get them. Personally, if I were a doctor, I would much rather have a patient take medically prescribed opiates that are legal for the patient to own and carry, over the stuff passing for heroin these days.....straw man argument over.

 

[Raki]

Methadone is one of the worst opiates/opioids for analgesia. The OP believes his physician "knows his stuff" but I am afraid his physician is an ignorant moron. With a short duration for analgesia and a 36 hour halflife a Chronic Pain patiemt will accumulate toxic serum levels VERY quickly. Even on 100mg of Oxycodone daily- the dosage that the physician is aware of, 5mg three times a day is terribly inadequate. If he has a physician who doesnt use equigesic charting when switching the primary form of analgesia the physician is deadly dangerous.

As for switching from Oxycodone to methadone as the primary analgesic, I will offer myself as an example. I was maintained on 220mg of methadone daily for almost a year and half, and am now in a nation that has no methadone but has Oxycodone over the counter. I have taken 420mgs and cannot even get a nod without boosting with 1200mgs of DHC and 50mgs Promethazine. So, that 5 milligrams of methadone three times a day? Let's just say he will not feel a thing, as well as not obtaining analgesia.