Opioids What was my pain management doctor thinking?

[Opiofile89]

I am just about to turn 21, I have a chronic pain condition and have been on opiates since I was 15. I've had OxyContin, Fentanyl patches, MS-Contin, Percocet, you name it, I've had it at one time.

So, I work my way up to 50mg of Methadone per day + 40mg oxycodone a day. My PM doctor had a bright idea to switch me from Methadone to Kadian my last visit. I want to know if I'm just stupid and this is right or if there was some kind of mistake here. I've been taking the 50mg of 'done for 2 years now. I get the script for Kadian (Morphine CR) and it's 10MG Capsules TWICE a day for a total of 20mg every 24 HOURS. From EVERY conversion I've learned to do, known to do, put in on the internet, this is wayyyyy below the dose. And believe me, my body knows it. I have been in withdrawal ever since I started. I have increased the dose every day on my own because I have been on vacation for Labor Day and NO way to get in touch with her or ask questions. I've been doing this long enough I think to know what I'm doing anyway. I got up to 80mg of the Kadian in the morning and that was just enough to sort of ease WD symptoms. I think it would take at LEAST 120mg for pain control. Does anyone else think it was an idiot move starting me at the lowest possible dose of Kadian??? And is it just me or is Kadian pure shit anyway? Especially compared to the methadone I was taking....sigh. It has been hell that I didn't even know could exist.

Just wanted an opinion to know if it was me who was crazy or if I'm in the right here.

Thanks.

 

[Deleted member 137730]

you def got screwed. 20 mg of oral morphine is NOTHING and could be given to a opiate naive patient safely.

I would start dosing heavy with what you have and call your doctor and let him have it. Maybe print out a conversion for him and make him feel like an idiot.


50mg methadone plus the fact because of its half life it builds up the most .... hmm yeah thats hundreds of mgs of morphine.

 

[Opiofile89]

I have been dosing heavy already, to the point I'm already out. It was taking 10 of them just to get out of WD. That still did nothing for the pain. I'm gonna go in Friday and let them have it. Totally ruined my vacation. I think she is willing to give me fentanyl again and if so, I'm going to request that. Tired of taking 8-12 pills every day...

 

[dokomo]

Yeah you need to let her know all of your symptoms, just how awful its been, etc and asking WHY this happened.

That is just ignorant.

 

[HdoubleODeezy]

i would go in there sick as possible and show her what she did to you.. and that's WITH taking the whole script.

 

[hedon]

u shouldnt have switched doctors....

 

[MemphisX3]

You didn't get screwed you have a doctor that doesn't think someone your age should be on that much pain medication. It's not a conspiracy. And if you switched doctors it'd pretty standard for a new doctor to start you out at the lowest dose. She is protecting her liscence. Either call her and explain and be 100% honest or go in there and explain and be 100% honest. What is your condition?

 

[MemphisX3]

This whole "you should let her see what she did to you" talk and "she screwed you" is bullshit. If you go in with that attitude you are sure to fuck things up even worse, having said all this I'm quite positive there is a PM megathread.....

 

[dhopeless]

Wow...equivalant dose of morphine from 50mg methadone is 187.50 mg at 0% cross tolerance...your doctor must be retarded or read your chart wrong. Tell him or her what hell you have been through, and everything else you told us. Damn you must be dope sick as hell!

 

[T. Calderone]

I think this new doctor is trying to cover her ass, given your age and possibly not a clear understanding of your condition. I'm in Florida and there are several in my area that will not treat a person under age 25. What you can do is bring all your prescription receipts to show what you have previously been prescribed. I hope you have saved them. But tread lightly because some doctors may get a bit humpty if you come across as confrontational. ~theresa

 

[homeydontplaythat]

i would inject the morphine if you use needles at all. the BA is WAAAAAAAAY higher that way, this way you will not run out as quickly. oral morphine is horrible and that dose is incredibly low. i have had the kadian capsules before with the beads inside. as long as you filter properly you should be fine. however, you wouldnt have a long actiing opiate if you injected.

what a stupid cunt. i would call her right now and tell her what time it is, ie time to put a 0 at the end of the dose 10mg BID. should be 100mg BID, she may have actually made a typo on the script, or the pharmacy fucked it up, SO CALL her, thats the only way you will find out.

 

[T. Calderone]

Actually, I think you would get a better result if you go to the office in person but that's just my two cents. If she won't give you the proper dose, hope you still have the receipts from the pharmacy to show "this is what you need" Otherwise, I hope you can go back to your previous doctor.

 

[PureLife]

i would inject the morphine if you use needles at all. the BA is WAAAAAAAAY higher that way

Don't take this advice( this is a harm reduction website, why would you tell someone to inject their medication?especially medication they actually need for a condition they actually have ) Go see your doctor again and explain to her the situation

 

[hale]

don't sound right.

doc may not be a fan of methadone or he is trying to get you off of opiates

 

[raver2008]

wow thats fucked up. the advice of show her how sick she made u isnt wrong, but if u go in there all pissed off blaming her it wont get u anywhere, stay calm and explain how thats succh a low dose conpared to what u were on and how sick you are now will prove it

 

[cj]

dont inject kadian for gods sake those beads would do a number on your veins. And yes kadian is one of the shittiest pain meds out there IME. I agree with what somebody else said she doesnt think you are old enough to be in that much pain and or she thinks your flipping scripts or whatever. Im stoned and matbe paranoid but she may be testing you to see if your selling your scripts as she knows if you were taking that much before you would be in terrible withdrawls. I think you screwed yourself by not calling her as you probably violated your pain managment contract by taking more then prescribed tread lightly or you may really fuck yourself.

 

[Opiofile89]

I know she's not trying to get me off of anything, and she has been very willing to write whatever I've asked. I just told her I was having some heart effects and it was guessed that it might be from my Methadone. I am terminally ill so this is pallative care here. I've been seeing her for 2 years. She's the one that increased my methadone up to 50mg over the past few months. I AM going to go in there dopesick because really I don't have any other choice. She mentioned before Kadian that we might try Fentanyl so I'm going to see if she'll still be willing to do that again. I've already had 75mcg/hr Duragesic before back when I was 16 but had to come off them for a chance to go into a transplant which never happened, so now I'm just being kept comfortable. I've just been trying to work my tolerance back up to where I can be back on the patches, they were the most effective along with my 4 percocets a day.

I'll let you guys know how things go tomorrow, that's my appointment with her.

 

[Opiofile89]

dont inject kadian for gods sake those beads would do a number on your veins. And yes kadian is one of the shittiest pain meds out there IME. I agree with what somebody else said she doesnt think you are old enough to be in that much pain and or she thinks your flipping scripts or whatever. Im stoned and matbe paranoid but she may be testing you to see if your selling your scripts as she knows if you were taking that much before you would be in terrible withdrawls. I think you screwed yourself by not calling her as you probably violated your pain managment contract by taking more then prescribed tread lightly or you may really fuck yourself.

I tried calling her while on vacation through Labor Day and couldn't get in touch with her. I told her receptionist when I made the appointment (this appointment will be 8 days from the time she gave me the Kadian) that I was in horrible withdrawals and only surviving on Percocet...so I go in tomorrow. We have a very good relationship so I know she doesn't think I'm doing anything wrong here. I was just in the hospital last month taking these high doses of Methadone and Oxy and needing increases so she knows that it's *me* who has the tolerance and taking the pills. She even told me when I got the script "We'll probably have to titrate this" but to hell with titrating it I don't even WANT Kadian again. I'll go to methadone or (her other choice was Opana ER or like I said Fentanyl). Anyone here have any comments about Opana ER? Is it just as shitty? Should I just see what she thinks about giving me Duragesic again?

I talked to my pharmacist yesterday and even she couldn't believe I was only given 20mg a day so she let me have my Percocet 2 days early just to stave off WDs as much as possible.

 

[RedRum OG]

i get high off 20mg oxy. i take 120mg kadian XR. that should put your dose in perspective.

 

[Opiofile89]

i get high off 20mg oxy. i take 120mg kadian XR. that should put your dose in perspective.

While I don't usually use my meds to get high from, I do feel a slight opiate buzz from 40mg oxy (at one time). I've noticed that the past couple of days that I've been taking big amounts to keep myself from being dopesick.