Opioids Methadone saturation ?

[come_unity]

Hi, I would love to hear back from some very knowledgable people concerning methadone and pain mngt. My understanding as personal exp is that at around 60-80mg, you're receptors are saturated. My question I'm very curious to know is, is there any opiate/opiod that can essentially provide pain relief? Say if someone was in acute pain? Are their any options, or are methadone patients shit out of luck? Or is more mthadone the only thing that would help, I've noticed doubling my dose doesn't give any profound effect, like one would expect from a shot of diladid, someone opiate naive to it. Is there any thing like that for mmt patients in need of acute pain relief?

 

[come_unity]

Is this in the right forum or should it be moved to Chen and pharm forum. Any help would b incredibly apppreciated, thanks in advance.

 

[jamesBrown]

60-80mgs of methadone is already a high dose of what is essentially a painkiller, even if it's not being prescribed for pain. So if you are still in enough pain after taking your methadone I recommend speaking to your doctor about how you should approach the situation.
The doctor MIGHT suggest switching you to oxy, or fentanyl....but I'm assuming you are on MMT for addiction because otherwise whoever is prescribing your methadone would have already switched you to another medication since the methadone isn't taking care of your pain. It's hard to say. But given the fact you are prob on MMT, I imagine it will be very difficult to get a script for anything that will help you with your pain unless you have a documented, proven, undeniable condition that is causing a high level of pain.
Also...are you just trying to get high?...or even trying to just get rid of all of your pain? Because if either of those are true, I think you are out of luck. Treatment for pain is NOT supposed to get you high(like the feeling an opiate naive person gets from IV Dilaudid), nor is it supposed to take away ALL of your pain.

I don't know your medical history, so again, I think speaking to your doctor is your best option.

 

[crzydiamond]

Sometimes, when MMT patients require pain medicine, the doctors can give meds such as fentanyl that have a higher binding affinity for the opioid receptors and thus can get past the methadone saturation.

This is like hospital Level care for serious surgical type pain. It isn't something you're going to get for a minor issue

I personally had IV dilaudid when I was in the hospital on MMT; however, I was only on 20 mg of
methadone so I didn't have the saturation effect. But from when I was on 90+ mg, that's what the dr told me they do for
severe pain while on maintenance

You have to make sure they are aware of your tolerance or else they start you at "opioid naive" doses. And do your best to have a doctor who understands pain treatment with MMT

 

[come_unity]

That's for both replies, I had a feeling it was gonna be fent (if anything) to break through methadone saturation. Thanks crazy diamond that's what I was looking for though, I'd love to see some other folks weigh in with possible studies, possibly rachimim would know? Or I wonder if calling a prominent pain mngt doc may get me my answer(I usually get to talk to doctors on the phone who aren't my pcp, it's sad, mine in in and out after 2 min if that, after a 3 plus hour weight. Thanks all, hope to hear from more!

 

[jamesBrown]

Can you tell us whether you are prescribed the methadone for MMT or for pain?

Because I believe it will make a HUGE difference depending on which situation your in.

 

[Methacodone]

Most likely it's for MMT... Pain management patients who have a script for Methadone are usually at the 20-40mg range.. often times with a breakthrough opiate as well such as Oxy IR, Morphine, Dilaudid, etc.

 

[come_unity]

Yeah methacodone I'm mmt. I'm starting to wonder in the pain mgmt option might not be a better idea at this point. Dr around here generally rx like you said 20-50mg done, and either fent IR whether it's actin or fentora, or Roxie 30's.

 

[Methacodone]

Yeah I'd rather be a pain management pt than a MMT pt anyday though.

For a couple reasons,

1. You get the Methadone in pill/tablet form.
in MMT most clinics carry the liquid form of 'done, which I fucking hate.
The clinic I used to go at had the best form of Methadone, brand name 10mg DOLOPHINE and 40mg METHADONE DISKETTS.
Holy SHIT the 40mg wafers were SO euphoric. They were so good the clinic actually banned them, and forced everyone on pills back to the liquid form.
I was one of those patients. I was SO fucking pissed at the time.

2. Like stated above, more likely than not you also get a breakthrough IR opiate..
I would kill for a script of 10mg Methadone and 30mg Oxy IR