Opioids First Time Methadone Use--Any Dangers?

[Eva 33]

I've been prescribed long-acting opiates like Avinza (morphine) and Exalgo (dilaudid) by my pain doctor for over 5 years, so I do have a tolerance to opiates. I need to take fairly high amounts to get my pain under control.

Methadone is the cheapest opiate, and I may have to switch to it for financial reasons. Avinza and Exalgo are both super expensive. 5 thousand dollars a month without insurance! I do have insurance now, otherwise I'd never be able to afford that.

As an "experiment", my pain doc prescribed methadone for me. His directions are: "Take one tab every 8 hours for 5 days, then 2 tabs every 8 hours if tolerated".

My pain doc emphasized that methadone can take a while to work, and to be careful not to dose too quickly if it's not working on my pain. (I've also heard stories of people on methadone maintenance who got impatient and dosed too quickly, who ended up overdosing on methadone).

A few years ago some of the news shows were doing stories like, "Methadone---one pill can kill". They highlighted cases of chronic pain patients who apparently had DIED due to just ONE methadone pill! Is this just stupid anti-drug propaganda? Or is this real? (I have read up on the QT interval heart issue. My doc didn't do any tests to see whether or not I have that, so I'm a bit scared. I wonder if methadone clinics test for the QT heart interval? Probably not. I'm sure it's an expensive test).

For the record, I do also take benzos at night to sleep. I also take some other short-acting opiates. Yes, my pain doc knows about everything that I take. He prescribes everything.

I think I heard once that mixing benzos with methadone is a bad idea? But I mix benzos with other opiates (like morphine or dilaudid) every single day, and I've never had an adverse reaction. I'm sure I have a huge tolerance. Is methadone really so different from other opiates?

I've never before taken methadone, though, so I wouldn't have a tolerance to it. Even though I've taken many, many different pain meds for chronic pain (including Fentanyl patch, in the past), I guess there's something about methadone that scares me. Probably all of the bad press.

Is a 5 mg. methadone pill a pretty light dose? My pain doc said there's no reliable way of converting from morphine or dilaudid to methadone. I do need to try this "experiment" but I am kind of scared.

Are there any regular users (or past users) of methadone who can reassure me? What are the side effects of methadone? (I've looked them up online, but I'd like to read some real life experiences). Thanks for any advice!

 

[Thomas29]

I just Personally started Experiencing with Methadone myself and Acute Dosing meaning not taking it everyday Methadone is Twice as Strong as Oxy so 5mg of Methadone should feel Similar to the Potency of 10mg Oxycodone. If you take it everyday though it builds up in your System and each Dose gets Stronger and Harder to Predict the Potency that is when you need to be Careful my Friend.

 

[aifre]

youll be fine, methadone is just pretty strong and there are some pretty high dosed pills of them made for heroin maintenance, so i can see how someone with no tolerance to opiates not knowing shit, taking one, and kicking the bucket. sounds like you have a fairly high tolerance, and of course it was prescribed by your doctor.

 

[clubcard]

If you have any known heart problems, you need to be VERY careful. Methadone causes long-QT which can lead to sudden cardiac death.

 

[ComfortablyNumb95]

if you have a tolerance 5 may not even be enough (I took 7mg my first time with 0 opiate tolerance) anyways don't take more then that if you're mixing with benzos. methadone is some dangerous shit!
also consider than it can take up to 3 hours to come up so absolitely don't redose if you don't feel shit after 1/2 hours. just wait and see

 

[Mr.Scagnattie]

If you're used to taking high doses of hydromorphone and morphine.. trust me, 5mg's of methadone most likely wont do anything. That's a tiny dose and doesn't really make much sense for somebody with an opiate tolerance.

You are definitely panicking and giving in to the propaganda about methadone. While it's a dangerous drug, it isn't anymore dangerous than any other opiate. As far as mixing it with benzos, it is not recommended, and many clinics wont even give you methadone if you're on benzos. But if your doctor is giving you benzos while on other opiates, than switching to methadone isn't going to change anything.

 

[Eva 33]

Thanks for the replies and info.

I think my biggest concern is the prolonged QT interval heart issue. I don't know if most methadone patients are given electrocardiograms prior to treatment? I'm guessing that for MMT in the USA, probably not.

I don't know if my pain doctor should have ordered an electrocardiogram first? I've heard of other pain docs doing this prior to prescribing methadone. I think my heart is okay, but I do remember that I have a bit of an "irregular heartbeat". (I was told this by a cardiologist years ago, whom I was seeing NOT for heart problems, but just because he was also a General Practitioner).

Maybe I am worrying a bit too much, but that black box warning for methadone about possible heart attacks is scary stuff. The news stories I referred to above (One Pill Can Kill) were actually of chronic pain patients taking one methadone pill prescribed by their doctor, and then dying of heart failure in their sleep due to undiagnosed heart problems.

 

[Mr.Scagnattie]

^^

No clinic is going to give you an ekg. They just do standard blood tests and a physical.

 

[Lady Codone]

The biggest immediate risk would be overdose, followed by addiction as a possible long-term outcome. Since you already have some tolerance and are using it legitimately for medicinal reasons, you should be fine. Start with a half-dose just to be sure. Nausea/dizziness can be more severe with some opiates.

As for the QT interval thing, I'd avoid any other drugs with similar effects, such as cocaine/Darvocet/Levaquin/Paxil/etc. Here's a more complete list of QT prolonging drugs: http://www.atforum.com/SiteRoot/pages/addiction_resources/QTDrugs 9-03-02.PDF

Have regular checkups and it shouldn't be much of an issue unless you have a serious underlying heart condition. Many people take methadone for years or even decades without problems.

 

[FractalOmniverse]

This is not really a great answer to your question, but I would honestly tell you methadone isn't worth the risk. If you have no opiate tolerance or experience, the high might feel nice for an hour or two but the overall health risk is higher. If you have any opiate tolerance, although the risk of an overdose is much slimmer, a methadone buzz will not compare to those previous opiate experiences. Having abused methadone a few times myself, I'd say that as an opiate (even a synthetic opiate) it's pretty disappointing, and barely measures up to being stoned or popping a couple oxys.

Methadone is a dangerous one, because of its extremely long half-life. I'd say just take it as prescribed (if you really want to, double up on a single dosage for a cheap thrill and just skip the next dosage), and just pack yourself a bowl if you want to veg out. The only instance I could see someone wholly appreciating the effects of methadone despite the lasting toxicity of it in your system, is if they were going through a nasty morphine/H withdrawal. That's all I got for ya.

EDIT: My bad, I'm too used to drug abuse threads.