I have been in pain management for many years now and should know the answer to this question. Unfortunately it is the amount of time that is creating the problem. I am quite tolerant to doses of opiates/oids that would kill an opiate naive person.
I looked at the conversion tables through google and globalarph is now very user unfriendly so I do not understand the results it spewed out. There was another table for equianalgesic properties and that is not what I am looking for either. The result was incorrect in my experience.
Changing from one full agonist to another is generally not difficult but methadone is a tricky beast. It is long acting and I swear it hides out in places that we have yet to discover. Very difficult to come off of for me but this time I am doing the reverse.
I am going from 200mg/day of oxy and switching to methadone PO. First, what is the real equivalent because the 19mg/day that the conversion table lists cannot be correct. It may be due to the term 'equianalgesic' but anyone that has taken 200 mg/ day of oxy -160 oxycontin+ 40 hcl, knows that 19mg of methadone is not going to overcome the oxy withdrawal which is very fast in onset.
That is where the problem lies, I believe. Methadone is probably the strongest PO analgesic I have ever taken but it needs time to build up and that creates a large variable considering the many different populations of cpp's. Dosing time becomes an issue because of MD's long half life in comparison to oxy.
Given all that, is there anyone who has a good idea of how much MD to take in place of the oxy when converting from a 200mg/day oxy to zero oxy? I am simply looking for the most comfortable approach. Aren't we all? That's like asking what the most comfortable form of electric shock would be but it is what it is and I have to be able to perform my job without too many sick days while I convert. This voluntary but hopefully temporary. My tolerance to the oxy built up and the prescribed amount was no longer working.
I looked at the conversion tables through google and globalarph is now very user unfriendly so I do not understand the results it spewed out. There was another table for equianalgesic properties and that is not what I am looking for either. The result was incorrect in my experience.
Changing from one full agonist to another is generally not difficult but methadone is a tricky beast. It is long acting and I swear it hides out in places that we have yet to discover. Very difficult to come off of for me but this time I am doing the reverse.
I am going from 200mg/day of oxy and switching to methadone PO. First, what is the real equivalent because the 19mg/day that the conversion table lists cannot be correct. It may be due to the term 'equianalgesic' but anyone that has taken 200 mg/ day of oxy -160 oxycontin+ 40 hcl, knows that 19mg of methadone is not going to overcome the oxy withdrawal which is very fast in onset.
That is where the problem lies, I believe. Methadone is probably the strongest PO analgesic I have ever taken but it needs time to build up and that creates a large variable considering the many different populations of cpp's. Dosing time becomes an issue because of MD's long half life in comparison to oxy.
Given all that, is there anyone who has a good idea of how much MD to take in place of the oxy when converting from a 200mg/day oxy to zero oxy? I am simply looking for the most comfortable approach. Aren't we all? That's like asking what the most comfortable form of electric shock would be but it is what it is and I have to be able to perform my job without too many sick days while I convert. This voluntary but hopefully temporary. My tolerance to the oxy built up and the prescribed amount was no longer working.
