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Opioids The dangers of methadone before surgery (HELP!)

yoboy

yoboy

Bluelighter
Joined
Apr 30, 2010
Messages
333
Location
maryland usa
I need to ask you all a quick question..... hopefully someone can shine some light on this because I think I fear that I have made a huge mistake that may end up costing me a lot of money.

To make a long story short, I am scheduled to have surgery done on December 2nd. (approximately 113 hours from now/4 and a half days) The procedure will general anaesthesia. I took 95 mg of methadone at 1 pm today. (November 27th) I am not on methadone with a doctors permission. A friend just gave me his bottle so I took it like the dumbass that I am. Prior to this afternoon I had not taken any methadone for approximately 6 weeks.

What I want to know is...... What are my chances of dieing on the goddamn operating table? Do you think that when I tell the anaesthesiologist this information they will advise me to reschedule the procedure? How badly have I fucked this one up?

Rescheduling might end up costing a lot of money so I'm really freaking out right about now. I've made a horrible mistake.... please, if anyone has been in a similar situation, lay some knowledge on me.
 
Well you could look up the half-life and do the math to see if there is gonna be any left in your system. (relatively simple math) If you can't figure that out you should probably tell the doc/surgeon. Better off losing money than your life right?

It might be hard to get an answer on here. I'd be reluctant to do the math for you and tell you its gonna be ok, then have you die on the table because I figured wrong. SERIOUSLY DON'T take my advice OK.


edit more info
The mean half life of Methadone is 22hrs. With that you'd have around 3-4mgs left in you at the time of surgery. But that is just the mean half life. It can be up to 60 hours and if thats the case you'd have quite a bit left in you. I have no idea what they will use for anesthesia and no one else here does either, so consider that.
 
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macbrown, trust me man, I'm not taking anyones word as gospel (though I do appreciate the input and thank you) and I never lie to my doctors. I can't stop thinking about how bad I fucked up so I just need to sit here and read about it till I go insane then gradually settle down. SHIIIIIIIIIIIIIIIIIIIIIIIT

I just read somewhere that methadone has a half life of 190 hours.... I think I just lost 500 dollars. Holy jesus this is the biggest dopefiend fuckup I've ever pulled off. I've been puking for the last hour constantly. I don't even like methadone. WHAT the FUCK is wrong with my head? 500 dollats down the fucking toilet along with a mcdonalds medium fries and a sprite. MOTHER FUCKER
 
Pretty much you coulda got high on anything besides methadone and had no worries. But you took what was handy, a lot of us would do the same thing. I wouldn't beat yourself up over it anymore. What's done is done. (No pun intended). I don't think 190 hours is correct, but it can definitely be up to 60hrs and that could cause some problems. Just gonna have to ask them if its ok that you could possible have up to 60mgs of Methadone (or more but I doubt it) in your system at the time of surgery. And see what they say.

Or you could just make up some huge lie and tell them your brother/wife/dad/whomever died and you have to postpone the surgery. Maybe a free bereavement rescheduling? j/k

Hope you feel better.

Well my internet is sucking and this isn't posting at all. We'll see if this will show up. I used to live in Silver Spring for about a year. Glad to be gone from that place. Can't stand the traffic, drives me nutz(pun intended)
 
exactly..... I can never resist the free shit. And I guess that few amongst us do when the opprutunity arises. But I hate methadone and I've puked 3 times in the last hour and a half. Jesus Christ...... I've officially lost my fucking mind. Five hundred dollars. This makes no sense.
 
listen mate, as a methadone addict i can tell you that after 2 let alone 3 days you are easily ready for surgery without any dangers. methadone has a long half life that is about 24 hours after you took it. it would be a different situation if youd been on meth for a long time as it builds up in your system if using regulaly. if you took it once even 2 days before surgery you shouldnt worry as it will be well on its way out of your system by now. i put my life on that statement. put it this way, it would be more dangerous to drink 3 shots of vodka 3 days before surgery. tell the docs and they will tell you the same. hope this answers your question.
 
^^^ thank you for the reply. I am a cheap motherfucker who works 2 jobs as it is and the prospect of pissing away 500 fuckin doll hairs is bothering me a lil bit.

Do you think that all this vomiting is helping clear my system or is that just fantasy?
 
^
Unlikely that the vomiting is helping at all unless you started immediately after you took the methadone. Once it gets into your system, it's there for the duration - similar to alcohol. If you're drunk, puking won't make your blood alcohol level go down.
 
5hours after taking almost any drug wont help. try swallowing acid then try puking an hour later, see how far that gets you. at most 3 days after methadone you are safe to do anything[within reason, dont jump off a cliff]. meaning the meth wont influence anything else you take.
 
^^^ I hope you're right about that. I'm already nervous about the general anaethesia and the surgery and all of that and this new development has me geekin

try swallowing acid then try puking an hour later, see how far that gets you.
Click to expand...
lol, aint that the truth!
 
bump.... can't stop creepin out over this. Does anyone have any experience of methadone use before surgery?

still can't hold water without puking and it's been almost 24 hours since I drank the bottle. I've taken bottles off people at least 10 times and felt perfectly fine so I don't know what the hell is going on
 
honestly i skipped threw the thread and only read the first post by the OP..
This is kida wierd as i am going on methadone and have chronic ulcerative cholitis,,,
So when talking to the lady at the clinic i happend to bring up the same questions..
Fist question i asked is if i go on methadone will it stop the effects of demeral when imm in the hospital ,also i asked if i had to get anethesia would it effect that ,,and to both questions the lady said no ,,she said that niether would be effected by the methadone ,,,so i think youd be alright specialy since its days away..
hope this helps ,,,BTW this appointment i had was only 2 days ago when i asked the questions if this helps any...
And i know some will dissagree but i got the answers rite from the horses mouth,,even to my dissbeliefe,,cause i was sure that being on the done would definatly screw with my demeral shots and my anathesia..but she said no so who am i to argue i dont know shit about done cept what ive read...
also i will add you realy should tell the anathesiolagist cause they like to know everything,,,even though i have lied before to them,,,but they wont tell on you in confidential...
 
i go to the clinic u will b fine no worries. its days away but even if it was the day bfore u would still b fine. I would not say one word to the doctor AT ALL. if u do then u will b treated way differently they will automatically think u will abuse any medication they give u so they will give u something shitty like darvicet or something. trust me i know. u will b absolutley fine. and like i said bfore there is absolutley no reason u need to tell the doctor
 
hey dude my mate is on 60ml meth a day he still had an op...a major one too....if i was you and worried drink plenty water...???? it may speed things up
 
I had kidney stone surgery while on MMT and the surgeon was biased and told me she wouldn't allow a general anesthesia. However, I complained to the hospital ombudsman and was allowed to speak with the anesthesiologist before the surgery. She assurred me I would not be aware of what was going on during the surgery or remember anything afterwards and she was right.

I also had dental surgery and DIDN'T tell my dentist ahead of time that I was on MMT and he used NUBAIN which put me in violent and horrible WD's. He rescheduled and gave me IV valium mixed with demerol which worked just fine ontop of the methadone.

I think you're fine with the time frame but would suggest you tell your dr anyway. This following really doesn't apply but is good for informational purposes for you....

Here is a copy of a letter which "We Speak Methadone" advises all MMT patients give to surgeons, pain mgt dr's...etc

=======================

Dear Doctor:

This is a general letter in reference to our mutual patient(s) maintained on methadone in our Opioid agonist Treatment Program (OTP).

Methadone maintenance has been used in the treatment of opioid dependence since the 1960's. The methadone maintained patient develops complete tolerance to the analgesic, sedative, and euphoric effects of methadone. The stabilized patient also avoids the opioid abstinence (withdrawal) syndrome and opioid-drug craving. Sedation in the stabilized methadone maintained patient is usually attributable to the interaction of other drugs or medical conditions.

The best policy is to coordinate your medical treatment of the patient with his/her OTP. Confidentiality regulations that apply to substance abuse treatment are unique and restrictive; a signed release of information is required before our staff can acknowledge a person is a patient, much less discuss specific issues about his/her treatment. However, even without a release of information, our medical personnel can direct you to appropriate resources or answer questions regarding major drug-drug interactions, cardiac considerations, safety of breastfeeding, pregnancy issue, or other issues related to methadone-maintained patients.

Pain management in the methadone maintained patient is frequently misunderstood. Patients are fully tolerant to their maintenance dose of methadone and no significant analgesia is realized. Relief of pain depends upon prescription of additional medication that is appropriate for the nature of the pain, including long and short acting opioids. Methadone can be an excellent analgesic; however, to be effective for this purpose, it must be administered in divided doses, 2 to 4 times a day, and in a total dose that exceeds the patient’s maintenance dose. A single methadone dose exerts analgesic effects lasting 4 to 8 hours.

For the medical provider treating a methadone maintained patient for pain, coordinating and documenting treatment with the OTP is best from both medical and legal perspectives. Getting written recommendations from the OTP, making written notes of verbal recommendations, using a standard pain-treatment contract with the patient, and documenting the source of pain and treatment history will avoid problems and misunderstandings.

When considering analgesia, some methadone-maintained patients can be managed the same as those without an addiction history; however, others must be monitored closely regarding medications associated with neurobiological reward mechanisms, such as opioids, stimulants, or benzodiazepines. If opioid medication is required, the required dose will be at least 10% to 50% greater than usual. This is due both to high opioid tolerance and reduced pain thresholds of methadone maintained patients. Also, administration of opioid analgesics may need to be more frequent than usual (q 3-4 Hr versus q 4-6 Hr for non opioid tolerant individuals).

If it is necessary to prescribe opioids for self-administration, long-acting drugs are preferred for chronic pain treatment, including methadone. When short-acting opioids are indicated, a week's supply or less of medication with a small number of prescription refills, if any, serve the needs of most methadone maintained patients. Talwin, Stadol, Nubain, and buprenorphine can precipitate severe opioid withdrawal (abstinence syndrome). Many patients experience discomfort with tramadol. Darvon (propoxyphene) and Demerol (meperidine) provide negligible analgesia and, in higher doses, accumulation of metabolites can cause seizures in methadone maintained patients. Naltrexone and naloxone precipitate severe withdrawal.

Some anticonvulsants, tricyclic antidepressants, SSRIs, etc., can be used adjunctively for the treatment of pain. However, NSAIDs, (ibuprofen, rofecoxib, etc.) might promote cirrhosis in patients with Hepatitis C, and should be used only when HCV is known to be absent. Dilantin, phenobarbital, and Tegretol should be avoided because they strongly induce CYP 3A4 metabolism of methadone. If necessary, use of these drugs without causing undue suffering can be accomplished if the methadone dose is increased, even doubled, to balance the rapidly increased metabolism. Caution must then be used when such agents are discontinued to avoid overdose or intoxication when such metabolism rapidly diminishes. Valproic acid, divalproex, and gabapentin are useful alternatives (as of 2/2004).

Methadone maintenance treatment is NOT a contraindication for the appropriated use of psychotropic medication in the 60% of patients, or more, with addictive disorders having Axis I psychiatric comorbidity. While most psychotropic medications have interactions with methadone, which can be consequential, and some have the potential for abuse, most can be used with proper monitoring and awareness. Making individual determinations in each patient regarding the use of benzodiazepines or stimulants is preferable to precluding their use entirely in methadone-maintained patients. Our OTP clinical staff can help you assess risks of diversion, drug abuse, or medication interactions. For problematic patients our clinic might assist with monitoring or administering medications, if appropriate.

Regarding the dually-diagnosed patient, discontinuation of methadone maintenance treatment is contraindicated when stabilization of psychiatric symptoms or pain can be attributed to methadone. Substantial evidence exists that methadone itself may engender potent psychotropic benefits as an antidepressant, antipsychotic, and stabilizer of labile affective states. Finally, there are no contraindications for stabilized OTP patients regarding treatment of hepatic disease, HIV- related illness, or organ transplantation.

Useful information about methadone’s significant interactions with other medications and its metabolic differences from other opiates (such as its metabolism by CYP450 enzymes, propensity for accumulation, etc.) is readily available on the Internet or upon request from our clinic. Please see the following resources from the www.atforum.com web site concerning methadone-drug interactions, cardiac considerations, and dosing and safety issues:

http://www.atforum.com/methadonedruginteractions.shtml

http://www.atforum.com/cardiacmmt.shtml

http://www.atforum.com/dosingandsafety.shtml

Additional information on methadone metabolism and dose ranges required for effective treatment appear on the “Articles” or “Links” pages at www.capqualitycare.com. If discussions of clinical issues or a transfer of records regarding our mutual patient is required, please have the appropriate release of information requests signed and contact us.

Sincerely,
==================

http://www.indro-online.de/letter.htm
 
As an RN, let me tell you that while you are under anesthesia you will be fine because you will be intubated, so any respiratory depression is basically nullified during your procedure. once you are extubated, if you had methadone in your system on top of whatever else you are given, then you might have a problem, but I think it will be far enough out by that time. If it happens that you aren't breathing enough, a post-op RN will give you narcan, which will correct the problem (but likely lead to you being in a lot of pain!). I would call that your worst care scenario. An RN won't let you stop breathing. But I think you have enough time if you don't take anything else.
 
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