Nerve Pain- Daily 100mg Methadone(not enough relief!) Pain patients or experts wanted

[Stato]

TL;DR short version in below post by me, I know this is long and detailed but I am in pain and off my head slightl.... nah off my head a fair bit


As per title, I am on 100mg methadone daily as opiate therapy, was 80mg but pain forced 100mg - this is (20ml syrup) and this will be a long post as I am awake (chemically assisted stimulation atm, but after I slept well after using more methadone than I should have due to pain. fuck. INCLUDING DHC on top.

Remember I am chemically awake . sorry if i rambled here ......

Info Re Me

I am a Male in my 20's, "Opiate Addict in MMT treatment" - Started using /w "soft" opiates, never have I IV'd heroin but (would) consider it if not treated properly with proper painkillers as i feel I am a little under medicated now, and no I wouldn't take it to just get high, I'd take whatever I could to get PAIN RELIEF right now. It's an Option right now for me unfortunately -- though 100mg methadone sorta kills it as it would be too expensive to use (Id expect) and ILLEGAL even as a painkiller I'd think, even if for breakthrough and IV'd! which id rather stay away from. So I am looking at my options via the legal proper route - I have no desire to further ruin my life, I need to do things the right way, but deserve proper medication to live day to day.

My Opiates Past Use - Were mostly All of 2012 on off as needed (3-4x weekly) , and Daily during late 2011. - Then Opiate replacement therapy started late 2012 afaik (suboxone first then methadone worked better for me at the time, probably because it's a full agonist and I was still chasing anxiety relief, I wanted to start getting OFF now, but this issue happened. No way Will I be on something for no reason other than to keep well, if it helps me with pain it has a purpose , if it does nothing but keep me from being sick. I want OFF. So for now it has a purpose, after my foot heals I'm getting OFF. I dont want to be on 15 years like some junkies i've seen in a short stint In a bad place (government run, guess it.... mmmm, )

Tonight: Took earlier - 200mg - 2 days dose of m'done(sun,mon) and 200mg DHC liquid(100ml rikodeine) tonight for pain, whilst stupid to take doses I cant afford to be without, I was badly in pain - these were also taken 12+hrs after 100mg m'done (so 300mg mdone downed in 24hrs, just for pain relief as needed.,+ 200mg DHC if it even does anything i am yet to notice due to using done on top unsure there.) with 100mg being normal my daily dose for this foot pain + opiate treatment. This extra 200mg + DHC was taken as my daily dose had worn off as pain relief and I was in agony! Burning and pins and needles all up to my ankle, unbareable, Yes, I probably overdid the dose (I did nod off 1.5hrs after), but clearly It's not enough pain relief at 100mg methadone a day (usually 1pm or 3.20PM) for me in the first place or the takeaway would have happily sat on my shelf like It used to some sundays when I had takeaways I forgot to use not being in pain.

SOLUTION for my breakthrough pain??
Now I don't want to keep upping methadone It does not help breakthrough pain I experience after it's worn off as primary painkiller. I feel a short supply of other pain relief until my foot gets better (4-8 weeks from now) using another opioid for breakthrough pain Thoughts on short term : (Oxycontin 30mg / 40mg / 80mg(?) bottle(28) of 40mg or 80mg (Probably 40mg x28 bottle, 2 daily, that's 2 weeks from now which is when I see my methadone dr) OR perhaps - Kapanol IR Morphine 100mg? Is this going to work? Or MS Contin Morphine Time Release 200mg (Appropriate?) if not, even Dilaudid IR Hydromorphone 8mg x 20 - Perhaps Dilaudid 8mg tablets x20 (bottle) might be an option (not the best I see but something) -- so that this pain isnt unbareable - this is replies I need from bluelighters, what would you do? Any Chronic pain patients?
I consider my methadone your norspan or durogesic patch so that covers my general pain at least, but not breakthru (unlike the pain patients patches heh), what do we all think I should do??.

So I was looking to step off the done, but I can't for reasons mentioned above -- as even 100mg is not enough pain relief LONG enough, it's fine for 6 hours it works well for that time, just not after. (I upped 20mg to100mg from 80mg daily prior to this illness) and it doesn't provide enough pain relief for a whole 24hours as I am expected to wait until next dose leaving me in significant pain starting 6 hours after dose (usually about 6pm). Wondering how do I cope....

THE ACTUAL PAIN PROBLEM AND MY CURRENT ISSUE! BELOW
Pain Cause: I damaged nerves (called neuropraxia) in my left foot after a suicide attempt left my leg hanging half off the bed for 12+hrs (idiot no lectures please), leaving me with temporary (6-8 weeks, we hope, if I am able to do proper exercise on it which again I am limited due to pain unless well medicated so I can step as best as expected, instead of limping and no pressure on the foot) the pain is called neuropraxia/neuropathic pain due to compression of nerves apparently.

I was forced to up my methadone to 100mg from 80mg rather than decrease as I was planning. This higher does does not cover "breakthrough" pain (6+hrs after dose, i want to chop my foot off sometimes due to the pain,after the done wears off other days if i've layed around in bed it's bareable and OK enough, just feels like It's in a bucket of ice water and slight pain but I'm a man I can bare most things... with no extra painkillers needed except my done, and I usually take my methadone after 1PM as late as i can bare so i can have a functional afternoon and SLEEP OK.... so I'm usually OK until 6.30PM, this is the longest I can manage and Ideally I'd prefer to take it at 8AM so i can but I cant! Or I'll be stuffed at 1PM or earlier) so sometimes I'm in agony ( like now as I write this) as the 'done for me only provides 6hrs useful relief of pain. If I had something to take for breakthrough pain after the done wears off or isn't enough, I'd be taking it, I think the MS contin or oxycontin is enough at a bottle of 28 40mg oxy, should last 2 weeks with the pain i'm in, or even 30mg as we expect it to get better. If not, 200mg ms contin's would help me.. Unfortunately I'm not the doctor and since I'm on methadone therapy, can I even be prescribed these meds even if in dire need? My MMT doctor just offered to give me takeaways (thanks doc, at least I dont have to try and crawl the 20min walk there, because I can't... I CAN organise a lift or a bus or taxi for the 2 weeks of takeaways to pick them up though, that's fine.) but I wonder if I can receive anything else to help me day-to day.

I'm lucky I'm not employed at the moment Or I'dve lost my job for sick days.

Sorry if this thread is jumbled mess, I'll do a small tl;dr below because i've done lots of cut-n-paste and at the same time been going afk often to put hot compress's on my foot to help hopefully. I am told it works.

 

[poledriver]

Have you tried Lyrica? A couple of people I know have been prescribed it for nerve pain of varying sorts.

 

[Stato]

Lyrica no, I haven't tried it at all, is it something applicable for short term use for neuropathic pain (specifically neuropraxia of my left foot/half up my leg) with the pain hopefully lasting only 4-8 weeks - Normal opiates do wonders, I just feel undermedicated even though I'm on methadone I need something else to help control it. I will put Lyrica on a list and perhaps ask my doctor next time I see him (maybe this week if i can!!) and see what he says, My foot feels like it's in an ice bucket right now. I'll post a photo of how my leg was which caused the issue, maybe if anyone see's a friend like this you will remember the photo and think to move his leg a bit. cause it's fucked my foot .

Oh BTW, I cleaned up my original post a bit, it's still a bit rambly, I'll make a TL;DR soon. It's hard when you're typing in pain, as well as being chemically awake.

 

[Stato]

tl;dr

Opiate Addict on 80mg methadone
Hurts foot in suicide attempt, left with Neuropathic pain (Neuropraxia of left foot, cant walk)
Given 4x takeaways (the limit) a week, cant walk to the pharmacy to dose. - Also Upped methadone to 100mg for pain relief.

Pain Relief only lasts 6hrs. Need something for breakthrough pain as I'm in agony.

What are my options, as above Lyrica has been suggested as a non opiate, I wonder if it's something effective in short term treatment, I know opiates are at least I can walk ALMOST normally when dosed up, otherwise I'm gritting my teeth and hugging walls to move around.

I was thinking I have 2 weeks until I see my Methadone doc, Is it appropriate to see my GP and ask for a single script of pain relief for brakethrough pain, I can't even sleep sometimes. 100mg methadone is FINE, from the time i take it to aboiut 6 - 6.5 hours after.

I was thinking a short term 40mg oxycontin 28 tablet prescription may be appropriate, one at night. One in morning. Hell, even the 30mg tablets if I need to take 2 I will do so.

I know my doctor will be careful re addiction but I'm past that crap, my MMT doctor actually listens to me, but it looks like I'm really going to have to whinge to get short term pain relief, and wondered what you guys thought the best is for my situation. Perhaps Kapanol 100mg bottle of 28 (Instant release morphine) that way its not building up and slow release. Or Dilaudid 8mg bottle of 28 to take as they are IR and probably well suited?


ugh, options. I just need proper pain relief i dont care what it is. Just short term.

 

[poledriver]

Yeah I'm not too sure, I've only taken it recreationally to help me get a bit more tipsy on the piss. I know 3 people who take or have taken it for their nerve pain tho, and 2 of them swore it was the best thing for their pain. Definitely ask your doctor about it, it used to cost alot apparently, but I think it's on the pbs and decently priced now.

I think it comes in capsules of 25, 50, 75, 100, 150, 200, 225, and 300 mg. You'd probably want the 300mg ones. Hopefully atleast 200 or 225's depending if your doctor thinks it will be a good idea, I'm not sure at all about the reactions with your other medication, but I do know the people who I know who take it also use oxy.

Also i dont know about whether its good for short term use or not, all things to take up with your doc. There's loads online about lyrica and nerve pain, do some googling when you get a chance.

http://www.freemd.com/neurapraxia/treatment.htm

 

[poledriver]

Is Neuropraxia = Neurapraxia ?

 

[Stato]

I know a friend of my fathers takes something like this for back pain, he said it made him feel out of it. although one new to opiates could say the same thing so...

And yes, Neuropraxia = Neurapraxia same thing.

I started off not being able to move any toes on my left foot. it will take time to heal but it hurts really badly.

If I can't get relief and it's still bad in 2 weeks next pay, I'll probably end up doing something stupid and scoring smack Or I'll end up trading my methadone for heroin, and i don't want that. I don't want to break the law.

 

[oldirtybizza]

I think it comes in capsules of 25, 50, 75, 100, 150, 200, 225, and 300 mg. You'd probably want the 300mg ones. Hopefully atleast 200 or 225's depending if your doctor thinks it will be a good idea, I'm not sure at all about the reactions with your other medication, but I do know the people who I know who take it also use oxy.

not really the best HR giving such high dosage indications since like you said you have no idea about possible contraindications or the drugs effect on the individual. docs will almost always start patients on the lower dose and titrate up, Considering the cocktail of other meds this dude is on a 300mg lyrica could be quite dangerous.

I've personally been on lyrica and was started out at 75mg's, in my nearly 2 decades of drug use and over a decade of opiate use, I wasn't really expecting much out of them. first dose took 350mg felt nothing for 3 hours and then totally passed out, woke up 2 hours later and could hardly walk, was experiencing closed eye visuals. slept for 10 hours after that and was still wobbly at work the next day. at it's peak felt like a ket/g combo.
Moral of the story is everyone's mileage my vary .

Bear in mind that this drug is supposed to be taken twice a day for chronic pain,it's not use as needed. it has similarities to benzos so tolerance and addiction along those lines will naturally develop so that's something you might want to take into consideration OP as you already have an opiate addiction adding another one might create other problems down the line.

I stopped taking the med as I didn't like the mental sides and the annoying WD whenever I stopped taking them, It was however very useful for neuralgic and radiating pain. the burning type sensation you mentioned virtually disappearing.

Perhaps Kapanol 100mg bottle of 28 (Instant release morphine) that way its not building up and slow release. Or Dilaudid 8mg bottle of 28 to take as they are IR and probably well suited?

Strato, what's with the junkies xmas list of drugs? you can throw around all the names of the strongest opiate meds you think might help but the reality is your going to get what your doc thinks is appropriate, and TBH you have temporary nerve pain in your foot you'd be LUCKY to get panadeine fortes.
The recommended treatment for your injury is rest and NSAIDs and it's actually a bit funny you think 80mg oxys and 100mg IR MS are suitable.

I don't want to give you a hard time but you're dreaming mate. I'm not going to go into my medical situ but I can tell you I've previously suffered from true debilitating pain with all the scans and shit to back it up and I've never been prescribed anything even close to what you're recommending been given.

Pain is 50% physical and 50% mental bro, if you want pain relief from opiates you're going to have to sort out your tolerance and addiction first rather than just piling more drugs on top.

 

[poledriver]

not really the best HR giving such high dosage indications since like you said you have no idea about possible contraindications or the drugs effect on the individual. docs will almost always start patients on the lower dose and titrate up, Considering the cocktail of other meds this dude is on a 300mg lyrica could be quite dangerous.

Yeah you're right, as I said in the next paragraph, all things to take up with your (his) doctor.

 

[opi8]

Lyrica works for a lot of people, make sure you speak to your doctor about dosages because I believe that 75mg is the starter dose, and it can be dangerous to mix with other substances due to the side effects.

If I offended anybody with this, or other posts, forgive me. I have not been in a great mood, have taken way too many benzos and booze and I mean no harm my mental motor starts dribbling shit. It's usually due to unrelated anger that I hold at the world for its current state, not at any particular poster.

 

[oldirtybizza]

^Seems like your referring to my "kill me twice over" comment in the smack thread,and bringing it up here, if so you need to build a bridge, Whats the problem you showed a nearly half g piece and I mention that for myself personally 1/4g would be a lethal dose. I've got no interest in dissing your tolerance or your gear so don't take it personal.

No ignorance in my post just realism, OPs a self confessed ex addict on MMT and he's asking about getting cancer strength opiates for his sore ankle. good luck bro

 

[Stato]

Stato, what's with the junkies xmas list of drugs? you can throw around all the names of the strongest opiate meds you think might help but the reality is your going to get what your doc thinks is appropriate EDIT by Stato: Correct, Unlikely to get anything, perhaps the lyrica if i can i will get it., and TBH you have temporary nerve pain in your foot EDIT by stato: And half way up leg, inability to move my toes etc you'd be LUCKY to get panadeine fortes. EDIT by stato: I agree, most patients would get a box of fortes, a box of endone, and get told take 2 forte and 1 endone as needed. This doesn't help an opiate tolerant individual on the edge in severe pain
The recommended treatment for your injury is rest and NSAIDs and it's actually a bit funny you think 80mg oxys and 100mg IR MS are suitable.
EDIT BY STATO:I Don't know what's suitable, I keep a tight sock on my foot for 3hrs a day (until it becomes unbareable) -- I take my done at 1PM, I can thenwalk until 6.30PM. If the done helps immensely with pain, why wouldn't morphine, hydromorphone or oxycodone (I prefer not to take oxy if i can help it... anyway)

I don't want to give you a hard time but you're dreaming mate. I'm not going to go into my medical situ but I can tell you I've previously suffered from true debilitating pain with all the scans and shit to back it up and I've never been prescribed anything even close to what you're recommending been given.

EDIT BY Stato: Funny that I have a friend with a debilitating lower back issue in his mid 20's and he's on 80mg oxycontin for it, perhaps you're undermedicated and should kick a fuss up until you feel you have the relief you need, like I will.


Pain is 50% physical and 50% mental bro, if you want pain relief from opiates you're going to have to sort out your tolerance and addiction first rather than just piling more drugs on top.

I am so keen to get off methadone it's not funny, but neuropathic pain is not 50 physical 50 mental as you state. Not for me it isn't!

 

[mister]

I had a quick search on the net and acupuncture kept coming up as offering relief.

Have you tried, or would you consider acupuncture?

 

[poledriver]

I tried it once for something, I cant even recall what was wrong, but damn i hated all those needles, I also had some glass jar sucker things on me, quite a weird experience in all, cant recall if it helped or not either. lol..

Dont know if this is any help op -

http://www.suffernomore.com/Pain/Peripheralnervepain.htm

 

[Stato]

I agree, I've had 300mg a heap of times and it doesn't really do much for me either, just makes me feel a bit wobbly and drunk. I guess drugs effect different people differently though.

I'd sure want something stronger than 75's or 100's if I had the type of nerve pain OP was talking about, but whatever, talk to your doctor.

^ Agreed. - on 100mg methadone DOES relief the pain just not for long enough to call my life functional now, I need other relief. 200mg Ms Contin perhps (I'm a big wary of time release benzos on top of methadone, I don't want to OD and be naloxone'd again).

I had a quick search on the net and acupuncture kept coming up as offering relief.

The best thing is walking on it, keeping a sock on it (warm/bloodflow) and positioning I've personally noticed.... But If it helps my painI would consider it yes, hell... I'd sudk your dick for relief or a shot of H 200mg+ -- it's been 12+urs since last done dose, I have just finished a week long intense hypnotherapy sessions 7x 45mins apparently to help with my need to pop benzos when the anxiety gets too much...and other personal issues..

I wish I hadn't acid base extracted the Rikodeine I had left, then i'd have SOMETHING to use for pain right now.

I'm off to evap the DHC HCL containing solvent. as quickylu as poossibe

Statos

(Can't say this hypnotherapy causing drug/benzo abstinence is successful though. I take what i want when i want as needed for medical purposes only (though sometimes in higher than recommended doses due to tolerance from past abuse), I don't use anything daily, EXCEPT methdone because i'm forced to for mmt and need to even moreso for pain)

 

[oldirtybizza]

^Poledrivers quote refers to lyrica not methadone, so I don't know what you're agreeing to

Actually it's highly unlikely that a doctor would prescribe two different opiates concurrently for a patient in common acute pain, an nsaid or other cox2 analgesic with the addition of an opiate in cases of stronger pain is standard.

You asked for advice from chronic pain BL'ers so I'm just telling you from my exp and how a doctor would most likely see it.

I would say that your friend and most people in the west are over-medicated. I could get prescribed more meds than I do but I choose not to, because I've been down that road and in the case of nerve pain more painkillers often result in decreased tolerance to pain and rebound pain. I don't think anybody here could honestly say that being on opiates 24/7 is overall beneficial to ones well being.
Nobody needs opiates it's a preference not a necessity.
It's funny how acute pain can turn into chronic pain when people become addicted to their pain meds, the mind is a powerful thing capable of limiting and increasing the awareness of pain.

Being on MMT you should be primarily considering other analgesics and lastly opiates , not the other way round. If you really are both in pain and also serious about kicking .

Never ask a doc for meds directly or mention opiates it will backfire and rouse suspicion. Lyrica is a good option for neuropathic pain but your doc will consider its abuse potential before rxing it also takes nearly a week to establish plasma levels and obtain proper analgesia.

Have you tried taking NSAIDS yet, I know it seems like a joke to people used to strong opiates but It does work well for some.
If your in OZ you can get the 15mg 500 mg panadeines and the 12.8mg 200mg Ibuprofen+, taking 2 of each 3 times a day this would give you decent analgesia + a bit of extra opiate pain relief to supplement the 100mg methadone you are taking which is the equianalgesic dose of over 1gram of oral morphine, you've already bumped your own dose up by 20mg which is equivalent to adding an extra roughly 150mg of oral morphine.

 

[poledriver]

I deleted that post, as I think it is a bit risky talking about 300's in that way, what I take and stuff might effect someone else totally differently, especially when they are on many other drugs/meds.

Old dirty has offered some good advice I think, I', not a doctor and have no personal experience with much pain at all except snapping an acl along time ago and a few broken bones here and there. So my suggestion of lyrica was only based on the friends and family I have been around a fair bit who I know take it (or did) fore their nerve pain.

All the best with it mate.

 

[Azron]

Have you tried Lyrica? A couple of people I know have been prescribed it for nerve pain of varying sorts.

This.

 

[opi8]

Final thought, both stato and olddirty seem to be throwing around the word junkie in a derogatory way, hey, that's fine. But please remember we are on a board that's filled with all types. No offense intended as usual, but it's just the fact that I personally don't see the difference between a pain (physical) patient and a pain (physical, mental) who's self medicating as a black and white area. I see drugs that help people live their lives, some can get prescribed a junkies xmas list without even wanting them, others resort to the street because they can't, end up in jail and having their entire lives ruined. I don't understand or agree with it, but putting people down, using derogatory terms for people just doesn't seem right on this board, to me personally.

 

[oldirtybizza]

Didn't mean it to be derogatory in any way, since when was the term junky wrong, no worse than smakie IMO.
The meds the OP is requesting would be pretty high on most opiate fans list of pharmas (hence junkies xmas list), they're also highly regulated and the least likely to be prescribed to someone with a history of opiate abuse.
I was just giving the dude solid advice for obtaining relief, anyone that has pain and requests opiod analgesics by name is considered suspect by doctors. especially when they may not even be the best treatment for a particular type of pain.

However I do have a problem with people who abuse and get prescribed RX meds under false pretenses, because they make it so much harder for people with valid medical complaints to acquire proper pain relief.