Thinking about getting on methadone

[dopemaster]

So heres the deal with me. I got hurt pretty bad 6 or 7 years ago and I have been a chronic pain patient for almost 4 years now. My pain is legit. The thing is I have ended up injecting my meds and buying more as well. I get alot of medicine as it is 60 mgs oxycodone instant, about 200 morphine time release. I cannot picture my life off of pain meds or with no opiate substitute. I called the local clinics and first off I cannot get more than 60 mgs of methadone being on benzos, which I am and I need due to panic attacks which I have had my whole life. The other problem is Im finacially challeneged and my prescriptions cost about 6 bucks and well these assholes want 300 plus dollars a month. Id be willing to move if I could get methadone for free with medicaid/medicare. Id like to ask my pain doctor to switch me to methadone but I dont think that would go over well even though they treat pain with methadone. My clinic is kinda get in, get out, dont talk, pee in a cup, take your scrip, dont talk, type of place. So I got legitamate pain which fucking hurts and now I am opiate dependent as fuck. I should probly also add I was taking about 100 mg of oxy a day long before I got on pain management and had scrips for tramadol and lorcet, so I have been addicted to opiates for ten years. So would 60 mgs hold me? Am I better off on the meds?

 

[Crashing]

In my opinion, 60mg of methadone is an appropriate medical dosage for you at your usage levels, assuming you're IVing 60mg oxycodone + 200mg morphine daily.

 

[dopemaster]

I iv the morphine too. I also spend about 500 dollars a month on opana, oxy, dillies, etc.

thanks for the reply btw.

 

[Deadhead420]

I iv the morphine too. I also spend about 500 dollars a month on opana, oxy, dillies, etc.

Do you IV all 200mg in a day? And do other unperscribed opiates on top of that? Because that changes things. I doubt 60mg methadone would hold you if you're doing all that.

And are you talking about going to a methadone clinic? Like for heroin addicts? Because I doubt those types of places would be the best thing for a pain patient when you're already in a pain clinic. I would try talking to your current doctor at the pain clinic and see if they'll let you switch. Probably wouldn't be the best idea to tell them you IV and buy pills on the side though.

 

[ugly]

hi dopemaster

i am not sure if this will be helpful or not. my mom has been on methadone for several years for back pain. she has recently quit because she was misusing it. she ran out before the end of the month. always.

she always had to do a drug test to see if she had methadone in her system, i suppose to be sure she wasn't selling her drugs on the street. my mom is very naive and didn't even know people on the street wanted methadone.

i also think the drug test was to be sure she wasn't on anything else.

she used to get so fucked up on alcohol and pills that she would stumble around the house butt naked and leaking waste. it was brutal. so if you get on methadone... just be careful. it can be combined with other substances to turn you into a person that NOBODY wants to deal with.

 

[Swimmingdancer]

Methadone is really strong, 60mg might be enough. However, there are some problems. Methadone maintenance generally only gives you one dose every 24 hrs. This is not very effective for pain, it's effective for many (not all) people in alleviating withdrawals for 24 hours, but tends not to alleviate pain for that long, so when prescribed for pain methadone is normally given in lower doses 2-4 times a day. The other problem is that if you start out titrating up to 60mg right away and aren't allowed to go any higher than that, you will have no room for dose increases when you develop tolerance. In my experience tolerance to the pain relief of methadone still builds fairly quickly, once I'd been on it for a while it did nothing to relieve my pain aside from relieving the pain associated with withdrawal. A big disadvantage to methadone is that it has worse and far longer-lasting withdrawals than morphine or oxy should you ever decide you want to get off of it. Getting methadone from an addiction maintenance clinic means you have to go to the clinic every day for a very long time if you live in the US, eventually if you abide by all their rules (like having drug tests that are clean for all unprescribed drugs) you may get the occasional take-home dose, so you have to consider the limitations it will put on your life. Personally I think if you are not wanting to quit opioids or sacrifice pain relief, better ideas would be to make an effort to discuss things with your current PM doctor or find a new PM doctor. Maybe if you could switch to some kind of regimen that was effectively reducing your pain you could make an effort to stop injecting your meds or getting extra drugs illicitly. I'm assuming that you got mentally addicted to opioids and now your tolerance is too high for just taking your meds as prescribed to hold off withdrawals, let alone pain? You might want to consider getting some form of help for the mental aspects of addiction. It can be very hard to stop injecting, go back to taking your meds orally and only using them for physical pain once you have been addicted. Perhaps switching to a less tempting med or meds might help you to do that. But going on methadone maintenance is a big decision.

 

[pasha]

After all, methadone is an opioid similar to the ones you were on to manage your pain, only with a much longer half-life. You have to dictate whether or not it's effective for your pain, and whether your willing to deal with the lifestyle limitations mentioned in Swimmingdancer's post. Give it a shot, weigh the pros and cons, and make your decision from there.

I personally don't like methadone. Being on it for 30 days was more than enough to convince me that I never want to touch it again. It made me depressed, it didn't resolve much of the pain I had, and I found it very difficult to sleep on it.

 

[bmoreharfordroad]

Methadone actually really helped me, it is very hard to come off and is a process. If you use it for a 30 day detox that is okay, but if you don't think can stop using and you want to stop, I guarantee your life will be better than when you were using.

 

[Swimmingdancer]

Methadone actually really helped me, it is very hard to come off and is a process. If you use it for a 30 day detox that is okay, but if you don't think can stop using and you want to stop, I guarantee your life will be better than when you were using.

My life was no better than when I was using heroin, partly because I continued to do so while on methadone. Very quickly the methadone did not make me feel high, improve my mood or relieve my pain, and so for a very long time I just used IV street drugs on top of the methadone and had 2 ball and chains instead of 1. Methadone doesn't magically make you not have any desire to use other opioids. Especially in the OP's situation where they would have a dosage cap and they have legit pain. Maybe you meant if someone stops all other opioids, only takes methadone (orally and as prescribed), has an average metabolism for methadone so isn't getting withdrawals between doses and is not in need of pain relief their life would be better, simply because they are not using IV drugs anymore and not in a constant state of sick/high/sick?

Methadone doesn't make anyone's life better, it can be a tool if you are motivated to use it in the right way and do other things in your life. Everyone is different, you can't guarantee that someone's life will be better simply because they go on methadone maintenance.

 

[dopemaster]

Swimming hit the nail on the head. Basically it took forever to get to a dose that even touched my pain and by then I was fucking with the needle and buying strong from people I know. Ive been using over half my lif,e but never like this. I wake up in the middle of the night wanting a shot and it doesnt even get me high. Whenever I ask for more meds its like here have more morphine which well only works good if you shoot it. I absolutly dont want to get off pain medicine. I would like my doctor to RX done for me for pain, cuz once a day 60 mgs just doest sound like it would do it. I know they do rx methadone but Im not sure how to steer the conversation that way as there is no conversation at my clinic. Its just like "does that hurt" "yes" "ok see you in a month or two and pee in a cup on the way out". To be honest you get punished in some way for asking questions, but this place writes the strongest scrips in town. My injury was severe and I have over 15 bone shards in one joint. I have tried methadone before and taken well over 100 mgs in a day and I thought it was ok nothing great, but no side effects. The dosage cap as well as losing the pain clinic for good seems to outweigh any possible benifit. When I try to take my meds orally its dificult to say the least and if I inject em I run out and end up very dope sick and in pain or calling the dope man. My pain is fucking horrid, Im not gonna lie about that in an online forum. If it was as simple as just straight up addiction Id be on the juice or clean already. So its either really bad pain or really nasty drug habit. I appreciate your responses much. I dont have many friends anymore as I choose not to hang round drug users cuz most tend to steal and my family is small and really all they say is why dont you just swallow your pills. I dunno what Im gonna do, I dont think done is right for me( at least with the cap), so I will probly try to take my pills orally. Id probly never stop shooting if I did not have to deal with shit like track marks and all that other stuff that comes with the territory.

 

[Swimmingdancer]

So its either really bad pain or really nasty drug habit.

It sounds like both. Chronic use of opioids increases your sensitivity to pain and cause pain of their own when you don't have enough. It sounds to me like you started out using them for pain and developed a mental and physical addiction, and now your tolerance is through the roof and they aren't very effective for pain anymore, plus you still have the addiction aspects.

In order to get your pain in check and your opioid use under control I think you are going to have to either:

A) learn how to mentally cope with a degree of pain, while you transition to a pattern of use or regime of meds that is less harmful to your life or even taper off opioids completely (this is what I did, and I found my pain is actually starting to improve compared to when I was taking opioids); or
B) switch to a med regime that completely alleviates withdrawal and pain and is not as easy/tempting to for you to abuse (and be aware that your tolerance will still go up - although less quickly if you use only the minimum needed - and you will eventually have to keep increasing your dose or switch to option A)

Plus work on the psychological reasons behind your drug use and work on ways to prevent yourself from using your meds in ways other than prescribed or buying illicit drugs.

Would it be possible for you to get a second opinion from another doctor without having to leave your current doctor?

Could you initiate a conversation with your current doctor about how your meds are not reducing your pain enough and what options you might have for something stronger and longer-acting (for example fentanyl patches, ER hydromorphone, methadone, etc) - even if you didn't feel comfortable making any suggestions about what you might be prescribed surely you could try harder to get a dialogue going about different options and make it clearer to your doctor that your current meds are not enough?

Could you see a therapist confidentially?

And have you considered adding in non-opioid treatments (including non-drug treatments) for your pain to at least reduce the pain aspect of why you use opioids?

 

[dopemaster]

I had actually asked for the fent patch and big lecture from the doctor, hes not really a cool guy. I might just ask to go all on morphine cuz it wasnt until I got the oxy that shit hit the fan. Im feeling a bit more optimistic. I have switched back to oral morphine about a week ago and when I get my refills I will try to keep the oxy out of the needle or take it less even. Maybe kinda taper off. I did that before with psych meds. Taper that is. Also there are two docs and one does not take my insurance so he has to get aproved for that. The one I cannot see right now is the one to talk to so I might have to wait a bit before talking to my doctor.