Opioids Methadone and Codeine letting me down

[closeau]

Hello to everyone. Im bout to fall asleep and am getting lazy searching all these threads for an answer to a probably dumb question. So, forgive me if I started a thread thats already covered. I find the search engine on Bluelight to be fantastic. Very long story short, Im in pain management due to enormaous blood clots that start under my heart and go down to both knees. Almost blocked in my groin and thats where all the pain is. Im on 40mg of methadone a day. I take 10mg every 4 hrs. I wont see my pain doc till April. Ive tried all the methadone potentiation tricks. Some work, some dont. Im on a lot of medication so Im tired a lot. Just looking for something to increase pain control. And...if it improves my energy and I get a buzz....whatever, haha. Point is, not lookinmg for just a high. I really do have constant pain that the methadone doesnt touch. Dr will not give me anything else but methadone...so far. Well, I got some Cheretussin AC today. 10mg codeine and 200mg og guaffisen, or whatever that bronchilator is. I took 40mg of the codeine, 4 tbsp. I didnt feel anything!! I know Cod is a weak...weak opiate. The weakest there is, right? Well, darn, I didnt feel a thing. I cant CWE liquid, can I? Will the brocilator hurt me at high doses? Is the methadone blocking it? Thought any dose under 60-70mg of methadone a day you should not build an opiate wall. Im getting codiene and ibruprofin pills this week too and was gonna cwe those. How much Codeine shoud I take to feel something is my question. Ant potentiators or otc tricks for getting the most out of the Codeine or Methadone? Hopefully Ill get some breakthru meds in April. I got my fingers crossed cause constant pain really sucks!! Sorry for my spelling and good evening!!

P.S: I go for Codeine now cause I can get it otc. Thats what the codeine thing is all about. Cheap too!

 

[Ohayou]

Well if you've got a tolerance to that much methadone, i imagine you would need several hundred MG of codeine to have any meaningful effect. I don't recommend this because methadone DOES NOT play well with other CNS depressants at all.

 

[closeau]

Gotcha. I have read up on some of that. I would rather be in pain then risk ANYTHING interacting with all of my meds. I cant use DXM cause I'm on Zoloft. I cant use blah, blah, blah with whatever cause of my blood thinners. I hold my life as a gift and dont want to mess with that CNS stuff. Thanks for the very important tip Ohayou!!

 

[Ohayou]

No problem friend, I'm glad you are using my advice! Talk to your doctor and maybe he can change your dose or switch you to something else to make you more comfortable.

 

[Znegative]

Yeah, I would not even bother with the codeine.
I've found gabapentin works really well with long acting opiates, and greatly increases analgesic properties. Gabapentin is a CNS depressant though so you would not want to overdue it. Gabapentin is prescribed as a pain medication (for nerve pain I'm fairly certain that when you do wind up seeing your doctor, he would not mind trying that out.

The problem with most true potentiators, is that while they might intensify the effects of an opiate (methadone in this case) for a few days, you will soon find yourself back at the point you were at before using potentiators. True potentiatpion of an opiate usually means that the metabolism has been slowed, or more of the drug is absorbed, which would give you the same result as if you had actually taken more opiates (to state this more clearly, youll be raising your tolerance). There are a few that are said to actually decrease tolerance, like DXM, but as you mentioned, you can't take that.

 

[closeau]

Thanks Znegative. I'm actually on Gabapentin 600mg a day. My Dr said I can go up to 900mg and it should not affect my breathing or anything. I just dont think methadone is it for me but my pain dr thinks its like....gold and b/c its cheap too. Im not made of money but thats really not an issue if it helps my chronic pain. Some days, I cannot walk (when its 8 or 9 out of 10.) when I'm a 5 Im ok. It still hurts but I can tolerate it. Its just, the methadone my body gets used to. Then, it loses its painkilling effectivness, I think. Im not sure bout matienince cause I have no experience there. I just wish there was SOMETHING. Some sort of combination of extended release and immediate relief meds. No history of addiction...I did have to quit drinking which was more health reasons. Just dont get it. Going for second opinion and maybe another pain Dr. I know I can onlt have one pain Dr at a time, haha!! Who know? But...for now Im stuck on the methadone, whaich still keeps me about a 6 out of 10. Just trying to eek a little more out of the done. Thanks for the tips and keep them coming!!

 

[Ohayou]

I think methadone is great for pain management because it is so potent and has such a long half-life. The problems with it are that tolerance builds fast and it makes you pretty lethargic. Maybe fentanyl might work better for you, or maybe oxycodone/morphone. Methadone seems to lose its painkilling efficacy pretty fast, so maybe a different opioid would do better.

 

[ganeal]

Yes I have to agree Gabapentin or Lyrica is great comboned with opiates..I take 90 mg's methadone a day with 900 mg's lyrica and it works great,although I dont' take my lyrica(pregabalin) everyday because of tolorance issues,I wait and take it like 2 days a week and it gives a great buzz,I find if I take it everyday I quickly get accustomed to it...

 

[Znegative]

I actually think that opioids like methadone lose there magic slower than short acting ones, or rather, you can receive more of a consistent effect once you stabalize on a dose of methadone, then on a drug like oxycodone. The problem is the blockade effect that methadone has. If your taking it for pain only, raising your tolerance to the point where it becomes a blocker is not something you want to do.

 

[flyonth3wall]

Some good advice here man. My advice will repeat something that Ohayou said - I tried Methadone for a little while before switching to Fentanyl Duragesic Patches - I find them very effective for pain though your tolerance does rise quite quick, though the same could be said for Methadone. If you could manage to stabilise on Fentanyl Patches though, I'm sure you would find that they do the job very well, and I suffer with a lot of legit pain too, but with the patches can usually manage to live as normal a life as possible. The only problem I have with them is that they make me feel tired and sleepy quite a lot, but other than that they are great. Good luck dude.

 

[closeau]

Thanks to all who replied to my thread. Tried again today. Dosed 30mg methadone and 60mg codeine. I know the codeine dosage should be higher but I had to go thru some crap and searching till I found this small bottle of Cheratussin AC. Mom and Pop pharmacy had it. Cant go back there soon. It aint even worth the money for the codeine. Im not expecting this super buzz and although I didnt sleep well last night I had a lot of "buzzed" energy all day. Took my codeine with my 3rd dase of the day. I went over today and took 60mg instead of 40mg of methadone. Ill just catch up tomorrow. No worries. I will talk to my Dr about other choices. I know asking to be put on a specific med will look sketchy. How would yall go about getting to Fentanal with him. He seems pretty dead set with the methadone, which is A LOT better than nothing. I just need like Dilaudid pills(Hydromorphone?) to ease the terrible breakthru pain. But...he says breakthru medication is what starts addiction. Thats what he said last time I saw him. Crazy though considering hes got me physically addicted to a drug that dependence and withdrawl is terrible. I know...whenever the day comes, we will taper down SLOWLY!! Dont want any part of methadone withdrawel. Infamous pain and discomfort. Well, any other suggestions are welcome. Thanks to all for the help. Later!!