Opioids oxycodone to methadone advice/help?

[milagro]

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.

 

[electric moon]

At the clinic here in my town they start you off at a 30mg dose. Liquid. If you don't feel its enough you can go up on your does, you just have to fill out paperwork. I believe you can go 5mgs at a time. I was at 120mgs a day when I went on methadone, and the 30 mg dose was enough to curb withdrawls, but everyones different.

 

[SS373dOH]

Like you stated, methadone is hard to convert, and also depends on how you're taking it. 50-100mg of methadone= 200mg oxycodone (oral) source: http://www.bluelight.org/vb/threads/564885-Opioid-Conversion-Chart


- Hopeless Soul

 

[milagro]

Thank you-

I will not go to a MD clinic because this a temporary setback and is for managing my pain. I spoke to a clinician at one nearby and she said if you have methadone tabs from your pain clinic, use those. She could not convert as well because a dose PO (by mouth is very different from a 10mg tab. I have worked up to 50mg and now that it has had time to build up in my system the pain is nearly gone. It is a remarkable pain killer but the side effects are horrible for me. Sweating attacks that make my body feel like it is on fire, it can be so intense that my hair becomes soaking wet. After 5 minutes of this hell I am freezing cold. Then there is the tinnitus and constipation that are unrelenting.

I do not know how people are able to function on the massive amounts that are given at these clinics. Also, my doc would never prescribe for me again if I went outside of the pain clinic. He simply will not increase my dose of oxy and it just does not work at the level I am at. I take it with methadone and have no idea if the oxy is working because I believe it has a greater binding affinity and saturates the receptors that the oxy uses.

One thing is certain. I miss the old oxycontin. It was the most unbelievable pain killer outside of IV morphine I have ever used.

 

[SS373dOH]

IMO the side effects from methadone, outweigh it's benefits.. people look like zombies after being on it for a while.


-HS