Opioids Methadone prescribed with other Opiates, why?

[DeadheadChemistry]

I have always been told that Methadone blocks all other opiates, yet I constantly see it being prescribed along with other painkillers including Norco, Lortab, Oxycontin, Darvocet, etc.

My question is this... I am on Methadone maintenance and I happened to come across quite a few Lortabs and Darvocets. Would I be wasting them by taking them on top of my Methadone or would I actually feel them? I'm on 100mg methadone a day which does absolutely nothing to me because I've been on that dose for a year. I've heard Darvocet is similar to Methadone, maybe I would feel those a little bit?

Just looking basically to understand why Methadone is prescribed with other painkillers and since they are prescribed together so often (including when I had surgery) will I feel the lortabs and darvocets I have?

 

[jackie jones]

No, methadone does not block opiates. It is essentially used to stop cravings for heroin.

When used in pain management, it is often combined with other opiates, since the duration of methadone is very long.

I am not sure if you would feel lortabs or darcocet on top of methadone, since they are rather weak opioids. Probably to some degree.

 

[pallidamors]

The simple answer is that methadone doesn't block other opiates. The people who say so are probably thinking of buprenorphine, which as an opiate agonist/antagonist. Methadone is a full mu agonist, however, so it doesn't block other opiates, it would have an additive effect.

However, 100 mg methadone a day is a fairly high amount, so while you you'd still feel the lortabs and darvocets, you might have to take a bit to overcome your tolerance. But start with a safe dose to start with since it will stack on top of the methadone, as I mentioned earlier. You can always dose up, but ya can't dose down.

 

[DeadheadChemistry]

Exactly the answers I was looking for, thank you very much guys. Very helpful. I'll probably start with 20-30mg Hydrocodone and maybe a couple darvocets at night after the methadone has begun to wear off a little and maybe I will feel the effects a little better?

 

[smackem]

There has been some literature that claims that the methadone has a stronger affinity therefore blocks out most other opioids. However; I think the idea is more like 'Lets get this junky on such a high dose of daily methadone that his tolerence keeps normal opioid doses from working on him'. Which is auctually not that bad of a method... Kicking methdone blows dick.. But unless you get sent to jail, you hardly ever have to cold kick it.

 

[djsim]

^ it was initially brought in mainly due to the long half-life, minimal euphoria, and rapidly achieved steady plasma states (~5hrs according to MIMS).

 

[PinK~cloud]

continuing along with djsim, methadone is also used because unlike suboxone, some addicts need a very slight, and i mean very mellow high to keep from using.

 

[TheDankaholic]

Methadpne does not block other opiates like suboxone does. It's just when you are on a high dose of methadone/100mg+ your tolerance is so high that it would take a large dose of any other opiate to achieve any kind of recreational effect.

I can personally attest to the fact that methadone is great in conjunction with other opiates for pain management. My Dr. actually had me on Methadone for around the clock pain and Hydromorphone(Dilaudid) & it was a good combination for analgesia. They keep the methadone dose rather low so it doesn't counter against your break through meds. My dose of methadone was only 30mg a day with 4 Hydromorphone 4mg tablets for breakthrough. I then switched to Fentanyl because I was having problems with constipation & headaches with the methadone plus I was very afraid of the withdrawals if I had stayed on the methadone longterm.

Since then I've actually managed to drop my Fentanyl dose down from 100mcg to 50mcg's and increased my Hydromorphone to 4mg's, 6 times daily (180 tablets a month) and I've found this to be the best combination so far for analgesia.

In short though methadone is a great painkiller for CP patients and in no ways blocks any opiate effects. You only start to experience diminished effects when you start taking doses upwards of 100+ mg's which I hardly see for CP patients. They will more likely then not switch the methadone to something else before they will let the dose get to the point of canceling out the other opiates in your pain regime.

 

[Eagleman]

Methadone can shoot your tolerance through the roof. Some people refer to methadone as the "great barrier reef" or other clever names like that. So be extremely careful taking other opiates on top of the 'dones. Try taking maybe two Lortabs on top of the 'done and potentiating with an antihistamine (to start).

 

[Tchort]

Methadone does not block other opioids. It is a regular mu agonist, just like Morphine, Heroin, Oxycodone, etc. The only difference is Methadone has a longer half-life, and greater volume of distribution + a higher oral bioavailibility.

Methadone maintenance results in other opioids, at normal recreational doses, not producing euphoria by cross-tolerance. When a person enters MMT, first their dose is titrated up to the point where they no longer feel physical withdrawals for 24 hours. Then the dose if further titrated up to the point where they feel no cravings for 24 hours.

This second process raises your tolerance to opioids to a high level (i.e. 80mg-120mg on average for MMT).

Other opioids can still work, but the dose would need to be huge, and is out of reach for the average addict (most people are not willing to spend several hundred dollars on a single high). Plus, trying to go over the top of the Methadone cross-tolerance could result in accidental overdose easily.

Methadone is often prescribed with other opioids for chronic pain patients because Methadone's stable plasma levels and long half-life without being in an extended release form mean it can provide round the clock pain relief for a sizeable percentage of pain patients. The NMDA antagonism of Methadone is a benefit for certain kinds of pain as well. Other opioids are prescribed with Methadone for chronic pain patients because breakthrough pain is still a factor, since Methadone is not extended release, it still requires 2-4 doses a day; which can be dangerous because of the long half-life.

 

[DeadheadChemistry]

Ok, well I took 40mg of Lortabs (Hydrocodone) late at night, I take my Methadone early in the morning. Didn't feel a thing. I didn't think I would honestly, I have shot a large amount of heroin before on methadone and felt nothing but a little itchy. So I think I'm just wasting money, I would kill my liver with acetaminophen before I could get high off Lortabs anymore it appears.... -sigh-

I've been on Methadone way too long and I miss that opiate high... I've been thinking about it a lot lately. I know if I come off Methadone I am just going to go straight back to pills and heroin but I really want that feeling again. I want that euphoria that comes when you shoot up heroin. I can't get it on Methadone, and I know that's basically the whole point but I know I'm not ready to quit drugs. If I decided to just stop Methadone cold turkey without even lowering my dose from 100mg and started shooting heroin as soon as I feel withdrawals would I feel the heroin? Like how long does it take for that "Methadone barrier" to break down and for me to be able to get high again?

 

[bfisher]

As far as blocking opiate receptors, yes, thats bullshit, methadone does not do this. BUT, i was just thinking, and the 'methadone blocks out other opiates' theory makes some sense, IN the sense that its such a Long Lasting, Very Potent Opiate, that the methadone user has been probably taking for a long time(since the dose is Every single day).
I know for a fact that its hard to catch a buzz with opiates while on methadone... the way to do it would obviously be by taking a larger dose of some Stronger opiate...

But i think using any opiates while on mmt is completely retarded.

 

[wowzers]

Wow, ur on 100mg of methadone a day? I pray to god I can get that one day.....Methadone is my absolute favorite thing ever......Once in awhile when I come across it, I take 40mg(4 x 10mg tabs) in a day and I will be high for 2 days....
How do u even go about getting methadone in that amount everyday?

 

[oxyhydro]

Im not 100% sure but I think methadone is a long acting drug that mimics the effect of opiates for people trying to get clean, as a painkiller I don't think its very effective, can anyone verify this?

 

[wowzers]

I have taken them off and on for a year...about 4 days out of the month probably at least and from what I can tell...they are just like a painkiller...but better - they last sooooooooooo long ..the next day I still feel mine (usually about 50% strength still the next day) so I just love them. I dont care that people say "no head buzz" and "just take it to not get sick" for me it is a very very good drug.

 

[Tchort]

Im not 100% sure but I think methadone is a long acting drug that mimics the effect of opiates for people trying to get clean, as a painkiller I don't think its very effective, can anyone verify this?

It doesn't mimic the effects of opioids; it is an opioid, and a potent one. It is an excellent painkiller. Its particular profile makes is well suited for treating opioid addiction through maintenance or taper.

 

[potatodaddyHater2]

what about the APAP in most pills(tylenol or otherwise) mixed with methadone? Would that be dangerous, i i understand its highly dangerous to mix meth-adone lol with xanax and understand the effects other opiates have on it, but im not sure about the APAP part, i know what methadone is so please dont explain that to me, ik what opiates are as well, so please spare me that as well. CAN METHADONE BE MIXED WITH LARGE AMOUNTS OF APAP(AROUND 5 GRAMS) WITH SAY, 20 MG OF DONE? thats all i need to know. thanks\

p.s. poison control are bunch of fucking idiots, "you cannot live without your liver" no shit!? lol but still, that idiots has me paranoid because i tend to analyze every little detail about drugs before i take them as to not DIE, actually, fuck it. I may have just talked myself out of taking the pills. take it easy, feel free to answer the question above, not as important anymore.

 

[potatodaddyHater2]

No, methadone does not block opiates. It is essentially used to stop cravings for heroin.

When used in pain management, it is often combined with other opiates, since the duration of methadone is very long.

I am not sure if you would feel lortabs or darcocet on top of methadone, since they are rather weak opioids. Probably to some degree.

thank u guy, sorry for asking the same question twice. I prefer to read books over "bluelighers"...lol sorry. Mostly because i know my shit, wow that was arrogant. take it easy.

 

[stuckinaloop]

what about the APAP in most pills(tylenol or otherwise) mixed with methadone? Would that be dangerous, i i understand its highly dangerous to mix meth-adone lol with xanax and understand the effects other opiates have on it, but im not sure about the APAP part, i know what methadone is so please dont explain that to me, ik what opiates are as well, so please spare me that as well. CAN METHADONE BE MIXED WITH LARGE AMOUNTS OF APAP(AROUND 5 GRAMS) WITH SAY, 20 MG OF DONE? thats all i need to know. thanks\

p.s. poison control are bunch of fucking idiots, "you cannot live without your liver" no shit!? lol but still, that idiots has me paranoid because i tend to analyze every little detail about drugs before i take them as to not DIE, actually, fuck it. I may have just talked myself out of taking the pills. take it easy, feel free to answer the question above, not as important anymore.

taking 5 grams of apap is extremely dangerous

you cant live without your liver

if you do tha ta lot, youll wake up with yellow eyes man

the fact that your combining apap with done doesnt mean shit...just th efact that you are taking SO much more apap then the safe single dose limit is what makes it dangerous

 

[Atlien3]

ok, so im on 80mg methadone daily and i came across 65mg of oxy this morning and i have not dosed since yesterday (34 hours ago) and i just ate the oxy and guess what? to my suprise, i feel it, i actually feel it, its not blowing me away, but i do feel it