Opioids Being FORCED to switch from DILAUDID to METHADONE. What do I need to know?

[VaderisBaddAss]

I wish I could say the methadone worked for me, I didn't really get the chance to finish it. They got me on methadone, and I was on just that for like a month, and then they sent me to a pain specialist, he immediately put me right back on Dilauded (hence why I went from IV Dilauded, to IV methadone, to pill form methadone, and back to pill form Dilauded. That as probably march 2010..and I'm still on Dilauded. Tho still thru the legal prescriptions of drs for a valid condition.

But IMO, if the pain dr had not switched me back to Dilauded because I was having real legit pain, and I was just using the methadone to get off Dilauded from surgery, and didn't need any more pain meds, the methadone would have def worked to get me not using anymore. Course, assuming I had no more pain.. That was a little confusing.. Sorry.

 

[John_Burrows]

Well as you guys predicted, the side effects I was experiencing from the methadone have subsided. It's almost a week now.

Meanwhile, the methadone is keeping the withdrawls at bay quite well. And it lasts a loooong time. I've been plugging it for the most part, and if I cram (heh heh) 30 or 40mg in the morning, I don't need more until the evening (it seems like I might be able to go 24 hours, but I haven't had the guts to go that long between doses).

I've been using about 60mg a day, although the doc prescribed only 40, so now that I'm comfortable with the fact that methadone will indeed prevent WD for me, I'm going to try and reign it in a little and lower my intake to the prescribed dosage and see what happens.

Next week I'll call the doc and decide if I want to go back to dilaudid. Now that I know how I feel on methadone, I'll probably go back to dillies at least temporarily so I can really judge the difference.

Is it possible/desirable to use both drugs at the same time? Because my pain fluctuates, I like the idea of using methadone (perhaps a lower dosage) to keep my WD away, but use dilaudid to manage pain. I was using six 8mg pills a day, but I have a feeling I could cut that in half if I was able to also use methadone. At the very least, I wouldn't have to take the dillies at night just to keep WD away while I sleep.

 

[Tommyboy]

Is it possible/desirable to use both drugs at the same time? Because my pain fluctuates, I like the idea of using methadone (perhaps a lower dosage) to keep my WD away, but use dilaudid to manage pain. I was using six 8mg pills a day, but I have a feeling I could cut that in half if I was able to also use methadone. At the very least, I wouldn't have to take the dillies at night just to keep WD away while I sleep.

Some people don't feel the effects of other opiate while on methadone. This is more common for people on doses of 80mg and above, but it certainly happens to people on lower doses. Basically, since methadone lasts so long, you opiate receptors always have opiates on them, so adding something else (like dilaudid) doesn't produce a noticeable change.

Everybody is different though, and I know there are people prescribed methadone for pain, and an IR med for breakthrough pain. It depends on the person and the dosage to the extent of its efficiency.

 

[VaderisBaddAss]

I mixed them. And when I was on the Methadone, I would take the Dillies and feel it. The Methadone would not mask the rush, but then again, the methadone only worked for like 3 or 4 hours (IV) for me. Once I was on methadone pills, I still only lasted 4 hours with them, but I didn't need the Dillies. As long as you keep taking the methadone you shouldn't go back to the Dillies. But if you are just using them for pain control, definitely try to cut them in half like you said.

If the methadone really helps your pain, and the WD symptoms, AND you can tolerate a little breakthrough pain, don't bother with the Dilaudids bc if I had the choice, I wouldn't have gone back to them. If you want to get off them, don't bother going back.. again, if you can tolerate it..try it for more than a week.

 

[ptrsnake13]

I've been on methadone 24 years. It's no drug to fool with and is very strong. The first time it may take 2 hours to hit so don't take more before that. It's a totally different drug than other opioids so don't listen to the guy who said it's no good and especially the guy that takes 360 mgs. He's on a program like me and our tolerance has built up over time so again, take as directed for a few days until you get used to it. It stays in your system a long time.
ptrsnake13
Pete

 

[Swimmingdancer]

How's the methadone doing as far as helping with your non-WD pain? You should be able to get an effect from the Dilaudid while on methadone at the dose you're on, but as Tommyboy said it's different for everyone and methadone does have some opiate-blocking effects, especially in higher doses. Just be careful with the Dilaudid, cuz the Dilaudid and the methadone could also intensify each other in that you could overdose at a lower dose than if you were only taking one and not the other. (It's the same with things like alcohol - you may get drunk much more easily while on methadone). You may need to use more Dilaudid than usual in order to get the same effects that you would get while not taking methadone, but start with a small dose the first couple times to see how it affects you. It's always better to take not enough than too much, you can always take more later. Personally I found that other opiates still worked well for me while on methadone, especially at the 50mg per day and under range. But it's important to bear in mind that if you use methadone combined with Dilaudid or any other opiate with any frequency they will create a cross-tolerance and your tolerance will go up, so you won't be able to go back to using the same dose of methadone in order to prevent withdrawals. What I would do if you are going to take both is to lower your methadone dose and take the Dilaudid a long time after your last dose of methadone. This way you will get the most effect from the Dilaudid and still have some extra methadone left over for when you don't/can't take the Dilaudid and are in need of a higher dose of methadone.

 

[Tommyboy]

You should be able to get an effect from the Dilaudid while on methadone at the dose you're on, but as Tommyboy said it's different for everyone and methadone does have some opiate-blocking effects, especially in higher doses.

The blockade effect may be more pronounced for people taking a single high dose, as opposed to several lower doses throughout the day. I know that his dose is below the accepted "blockade dose" but as said before, it effects people differently, and taking it 4x a day may make less likely to block other opiates.

 

[smackem]

just so you have both sides of the story:

Methadone is GREAT for me. It doesn't just handle withdrawals, it ANNIHILATES them. It gives you a warm wonderful glow that last so very long. You will be totally and completely taken care of from a physical addiction perspective. Also you don't have to clock watch as it is very long lasting. It is one of my favorite opiates for a lot of reasons, not least of which is it cuts down on addictive behavoir. However; lets be real, this is a STRONG opiate.

 

[Swimmingdancer]

just so you have both sides of the story:

Methadone is GREAT for me. It doesn't just handle withdrawals, it ANNIHILATES them. It gives you a warm wonderful glow that last so very long. You will be totally and completely taken care of from a physical addiction perspective. Also you don't have to clock watch as it is very long lasting. It is one of my favorite opiates for a lot of reasons, not least of which is it cuts down on addictive behavoir. However; lets be real, this is a STRONG opiate.

Yeah what kind of dose are you on though, for how long, and what was your tolerance like before you started taking it?

 

[IndustrialStrength]

I've had great success with lowering dosages john. If 60 has you feeling at least decent you can likely cut.
I recommend cutting every 3 days by 5 or 10mg. Can lower your dosages with little to no pain.
As with the half-life it eases the dosage drop by doing it every 3 days.
At least for me it was relatively painless everyone is different so your mileage may vary.
For me doses of 40-60mg a day where not blockade dosages. As such I could do dillies, etc. on top for breakthrough.
You may be able to do the same.

Regardless glad to hear the methadone is working for you. I had believed it would.
Especially considering your doses & my personal experience.
Since 40mg of Methadone would hold me when I was IV'ing higher doses than yourself I figured you'd be golden.

I'd consider methadone or another long lasting medication & using the Dillies for breakthrough.
I find it odd that you would be on just dillies to begin with. As usually an ER & IR med are both prescribed.
I know in your shoes I'd be fucked. I slam 24-32mg for a good rush but still barely feel anything past 10 minutes.
Well pain relief wise I don't get much beyond the initial relief.
No idea how anyone could maintain or prevent pain long term using just dilaudid.

I digress, getting slightly off topic. However I'm glad that your having success so far.
I also enjoyed the not being a slave to the needle aspect that methadone gives.
So I agree with you there john. Hopefully everything continues to work out for you.

 

[John_Burrows]

Hi guys

Well "working" is relative - the methadone works for keeping withdrawals away, but it's not doing anything for pain. Also, I've been having a strange side effect - sleep. I've been on methadone for 8 days now and twice I've slept for 18 hours. I've never done that before in my life. It's not 18 hours straight - I get up to pee a few times - but I have no problem going back to bed and snoozing again.

I'm not sure if it's the drug or the pain; when I get up I ache and when I lay back down there is no pain, so I wonder if my mind and body would just rather lay there and be pain free. But it sure is weird to sleep that much. Usually I'd toss and turn until I'm like "ok enough i have to get the fuck out of bed" but during the last week, no problem.

I really don't want to go back to dillies, but while I was on them for three years pain was not an issue.

Anyway, I'm going back to the pain doc right now to see if he'll script me again for dilaudid. After that I'll have to decide if I'm actuslly going to fill the script or tough it out with the methadone...

 

[IndustrialStrength]

The sleep thing is relatively normal I believe John. At least in my experience I can sleep for hours on end on Methadone.
I actually just switched back to it for a quick re-taper as I'd been creeping up not down recently.
I dozed off in a chair at like 10pm last night. Didn't get up till 11AM today. So that's 13 hours right there.
Anyways just wanted to help alleviate your concerns & let you know that as far as I know that's pretty normal.

Of course I tend to be chronically fatigued regardless of meds & to sleep a lot.
Oh & if your dreams tend to occur more often & more vividly don't be surprised.
I find I have shit tons of crazy dreams when I first switch to methadone.
Usually the first week or so.

Hell last night I woke up twice crying my eyes out.
I woke up a third time when my girl woke me as I was trying to scream help she said.
The help thing is a mechanism I've learned to do where if I realize I'm in a shit dream I can scream help in my dreams.
The help translates to reality as I start whispering/saying/screaming help & my GF wakes me, comes in handy.
But I digress, I just wanted to warn you about the dream thing in case you have had some crazy ones & were wondering about it.

I hope your pain issues work out better for you John. I know in my case Methadone worked ok for pain.
With IV Opiates I (& perhaps others) find that I go for complete pain relief.
I find with regular opiate dosing & non IV; complete pain relief is usually not feasible.
Just partial relief as the dosages for full relief tend to raise tolerance & other bullshit at least in my case.
Perhaps your running into a case of IV relief vs non IV relief? Perhaps not just figured I'd mention it either way.

For me the fact that methadone kept w/d's away made it a winner.
I'd rather have some pain & no w/d's, than major w/d's that I can cure along with my pain with a shot.
As the w/d's come back again within hours & it's repeat, repeat.
The partial pain relief combined with lack of withdrawals is more appealing to me than full pain relief & dealing with withdrawals.
Again everyone is different & as such you may feel differently.