Opioids Methadone vs oxy, hydro etc. for pain

[LucidSDreamr]

I just got switched to methadone and am finding 5 mg to not be anywhere near as effective as 10 mg hydrocodone for pain.

I have noticed pain relief like 6 hrs after taking the methadone though but still not that great.

This is my first time trying methadone. I thought it was supposed to be this great pain killer too but it seems to suck. Is this your experience? How would you contrast it's analgesic effects with hydrocodone or oxy and what would you say is an equal analgesic dose?

Also it makes me feel nauseous and loopy not a clean euphoric feeling like hydro.

I'm thinking of asking to get switched back to hydrocodone. Any feedback? Thanks

 

[MsDiz]

May I ask what dose of hydro you were on that the Dr decided to switch you to methadone?

 

[LucidSDreamr]

10 mg. Up to 3 times a day if needed. Usually just took 10 to 15 mg per day

 

[MsDiz]

10 mg. Up to 3 times a day if needed. Usually just took 10 to 15 mg per day

So it’s madness for you to be switched to methadone. Look, I’m no expert on methadone because it’s probably one of the only opioids I haven’t had but I would ask your dr to switch you back.

Hydrocodone is strong stuff and if you’ve not even got near to maxing it out dose wise then you’ve really had no need to be switching.

If 10-15mg per day worked for you then great. Stick to it.

 

[Jabberwocky]

As MsDiz wrote, it is really bad to substitute low dose off hydrocodone (or any other short acting opioid) with methadone. I was using methadone for pain and it is an effective pain killer. Problem is that pain killing property of methadone, at least for me, lasted for at most 8 hours. But the methadone stacks in the body and you accumulate lots of it if you use it every 6-8 hours for pain. With bad profile regarding interactions and propensity to cause very bad withdrawal it is really not the best solution for somebody who can get by with 20mg of oral morphine equivalent. As I am not a doctor and you are not my patient I can't give medical advice. But I will suggest that, if you can, stay off of methadone if not truly necessary. Leave it for the future to have a wildcard if things get worse. If I had to choose between 3 x 10mg oxycodone or 3 x 5mg methadone I would choose oxycodone (for the pain) every time. Not because it is better for pain and not because it is less adictive, but because it is more predictable, it doesn't accumulate and withdrawal can, for my taste, be better handled. I would compare 5mg of methadone with 10mg of oxycodone pain wise. That is my subjective feeling based on type of pain I was (am) suffering. It is up to you and your doctor, but be very careful with mixing any medication with methadone. There is a big list of interactions for methadone in both ways - upping the effects and lowering. I would be very careful with the ones that potentiate methadone effect on breathing, like benzodiazepines and other gabaerics (gabapentin, pregabalin/Lyrica, carisoprodol/Soma). I don't want to frighten you and can not know what is best for you, but beware of methadone. It is not for no reason that people use it as a last resort. I hope you will be able to manage the pain successfully. In the end it is about what works for you.

Take care!

 

[MsDiz]

Absolutely madness that any Dr switched someone who was managing on 10-15mg of hydrocodone to methadone.

 

[ChinaGroove]

I've been in Methadone for the last four years for addiction/dependence. I have no experience using it for pain. However, the fact that any doxtor would switch from a low dose of Hydrocodone to Methadone is, odd.
Methadone is a long acting opioid that stores in your body tissue, hence it's effectiveness for treating addiction. Those qualities also make it a potentially dangerous drug and one of the worst to withdraw from.
All of those qualities, plus the fact that Methadone isn't commonly used for pain, just strikes me as odd.

 

[Larimar]

Yeah doctors want to take people off the “good” stuff . My oxy connect lost his script and was offered methadone or subs or tapendol. He had to try out the tapendol for 6 months and it didn’t work so then his insurance let him go back to the oxy. And this is a older man who had a oxy script for 20 years , never failed a drug test , never failed a pill count etc. Insurance companies and doctors are being told to stop or limit their opiate scripts .

 

[MsDiz]

Yeah doctors want to take people off the “good” stuff . My oxy connect lost his script and was offered methadone or subs or tapendol. He had to try out the tapendol for 6 months and it didn’t work so then his insurance let him go back to the oxy. And this is a older man who had a oxy script for 20 years , never failed a drug test , never failed a pill count etc. Insurance companies and doctors are being told to stop or limit their opiate scripts .

Tapentadol is amazing for me tbh, much better than oxy. But yeah, it’s a joke to take someone off a med they’ve been on a long time and which is still affective.

 

[LucidSDreamr]

My doctor told me that methadone was not an opioid. I almost laughed in his face. I'm a scientist with a PhD in chemistry and he knows that so he trusts my opinion. I didn't say anything though other than I will give it a try. Some sales rep in a tight skirt got to him. He's like 90 and not all there.

It is so hard to get opioids these days and stay on your doctors good side that I didn't want to rock the boat and argue without trying what he says.

I plan to ask him to switch me back but I just want this current bottle of methadone to work. It does...just not as well as I expected.

I also suspect he switched me to get me permanently hooked because he has seen how easily I go on and off hydro without getting dependent permanently. I hope that isn't why he did it.

 

[MsDiz]

My doctor told me that methadone was not an opioid. I almost laughed in his face. I'm a scientist with a PhD in chemistry and he knows that so he trusts my opinion. I didn't say anything though other than I will give it a try. Some sales rep in a tight skirt got to him. He's like 90 and not all there.

It is so hard to get opioids these days and stay on your doctors good side that I didn't want to rock the boat and argue without trying what he says.

I plan to ask him to switch me back but I just want this current bottle of methadone to work. It does...just not as well as I expected.

I also suspect he switched me to get me permanently hooked because he has seen how easily I go on and off hydro without getting dependent permanently. I hope that isn't why he did it.

Man, seriously get off that methadone. If you have chronic pain and will need opioids for life you’re fucking yourself up. You’ve jumped up 3 levels or so? That’s pointless. Hydro was working for you in small enough doses.

That Dr is incompetent.

I’d also say you’re gonna feel it coming off that too but I’m sure you know this.

 

[Jabberwocky]

I also suspect he switched me to get me permanently hooked because he has seen how easily I go on and off hydro without getting dependent permanently. I hope that isn't why he did it.

I wouldn't be surprised if that was the case, but I believe that something much less sinister could be in play here. As methadone is (along with buprenorphine now days) go to opioid for opioid replacement therapy for managing addiction, your doctor could be just doing a calculation regarding FDA and his licence. If he puts you on small dose of methadone he is solving 2 problems (from his perspective) at the same time. First one being your actual pain problems and second being covering his ass. If you are on methadone he can easily justify prescribing you opioid medication at all circumstances. He can say that it was purely for pain but he can also say that he was being cautious as "he saw the first signs of addiction, so he scripted you the medicine that treats addiction and pain at the same time".

I don't believe that sales reps are pushing methadone as it is dirt cheap and basically every other opioid will yield a bigger profit. From where I sit (far, far away) it looks that he is just playing safe.

Or, if you have neuropathic pain, he actually believes in your self restraint and is giving you an opioid that is also NMDA receptor antagonist that could be more suited to your needs (pain type)...and thus having a trifecta of benefits - treats your pain, treats your pain better than opioid with no NMDA receptors antagonism and his ass is covered regarding prescribing practices.

But having wrote all that I still don't believe that methadone is answer in any case. Especially if it is not working extremely well when compared with the dose of hydro/oxycodone that you were getting before. From your opening post it is clear that it is not working that way for you.

I have met a fair share of uneducated doctors in my life and I have also met doctors that would like having a patient sicker so they can prescribe more medications. Everything is on the table and I am just speculating.

I don't know how long do you plan to take methadone on a daily basis, but as you already know (PhD in chemistry) methadone in acute dosing and methadone long term are not the same thing. You could raise your tolerance to hydrocodone (opioids in general) after just one month on methadone. That is also something to calculate into the equation.

You are a bright person and you obviously know what you are doing so I will not "preach". I am just stunned that somebody who is doing well on maximum 30mg hydrocodone is put on methadone. I hope it all turns out well and that you get the best med possible for your condition.

 

[Dextro .45]

Hydrocodone is a weaker opioid than Oxycodone / oral Morphine, but still better than Tramadol...

if Hydros are working at low dose stay on it....it’s a short acting moderate potent opioid as needed for pain.

Methadone is a long acting potent opioid that needs to build in your system over a week of daily usage to reach its full potency potential. For chronic long term pain, Methadone is a good option. I am on 80mg daily and is great for chronic pain.

Methadone 5mg for first time is still ok, but if you took that daily for a week plus, it’s analgesic properties would be more pronounced, longer, effective.

for short term as needed pain relief Hydrocodone is a safer better option. Would much rather have OxyIR 5mg tablets though, 5 a day as needed, for a low-moderate tolerance person.

 

[LucidSDreamr]

Man, seriously get off that methadone. If you have chronic pain and will need opioids for life you’re fucking yourself up. You’ve jumped up 3 levels or so? That’s pointless. Hydro was working for you in small enough doses.

That Dr is incompetent.

I’d also say you’re gonna feel it coming off that too but I’m sure you know this.

I've only been on methadone for a week so it shouldn't be too bad if I get switched back soon

 

[LucidSDreamr]

Hydrocodone is a weaker opioid than Oxycodone / oral Morphine, but still better than Tramadol...

if Hydros are working at low dose stay on it....it’s a short acting moderate potent opioid as needed for pain.

Methadone is a long acting potent opioid that needs to build in your system over a week of daily usage to reach its full potency potential. For chronic long term pain, Methadone is a good option. I am on 80mg daily and is great for chronic pain.

Methadone 5mg for first time is still ok, but if you took that daily for a week plus, it’s analgesic properties would be more pronounced, longer, effective.

for short term as needed pain relief Hydrocodone is a safer better option. Would much rather have OxyIR 5mg tablets though, 5 a day as needed, for a low-moderate tolerance person.

I took it for about a week so far. This drug fucks me up majorly. Nodding hard, nauseous etc (but not in a euphoric way like dope). But I'm surprised I'm so intoxicated and the analgesia is like nothing for me.

I've always heard good things about methadone for pain and always taken comfort in the fact that it can be given to me if opiates became impossible to get...the comfort is gone now. Heroin is the only safety net left for when Iose my prescription and that is a scary reality

 

[MsDiz]

I took it for about a week so far. This drug fucks me up majorly. Nodding hard, nauseous etc (but not in a euphoric way like dope). But I'm surprised I'm so intoxicated and the analgesia is like nothing for me.

I've always heard good things about methadone for pain and always taken comfort in the fact that it can be given to me if opiates became impossible to get...the comfort is gone now. Heroin is the only safety net left for when Iose my prescription and that is a scary reality

There are so many options before methadone. I’m a chronic pain patient also.

 

[LucidSDreamr]

There are so many options before methadone. I’m a chronic pain patient also.

...I was speaking only in terms of opioid painkillers. I'm definitely pouring lots of money and time into non opioid treatments as well.

If they are taking away things like hydro and Tramadol which is happening to a lot of pain patients...I don't know what else we will be left with besides done or subs

 

[MsDiz]

...I was speaking only in terms of opioid painkillers. I'm definitely pouring lots of money and time into non opioid treatments as well.

If they are taking away things like hydro and Tramadol which is happening to a lot of pain patients...I don't know what else we will be left with besides done or subs

I’m speaking in terms of opioids. Being on hydro at 30mg max is a good level to be on. You’ve loads of room left. Taking tolerance breaks helps also. Seriously, there are a lot of choices. I’m on tapentadol and I find the analgesic effects are great.

 

[LucidSDreamr]

I’m speaking in terms of opioids. Being on hydro at 30mg max is a good level to be on. You’ve loads of room left. Taking tolerance breaks helps also. Seriously, there are a lot of choices. I’m on tapentadol and I find the analgesic effects are great.

Yes tapentadol is effective I've tried it. It has a bit of a dirty feel to it imo opinion but the analgesia is great.

I know there is plenty of room medically speaking for me to be treated...but just the bureaucracy that exists these days in the USA with doctors being targeted and prosecuted for writing legitimate prescriptions has resulted in limited access to oipioids for pain patients.

They failed miserably at addressing the heroin epidemic so they have turned to punishing doctors and patients so they can look like they are doing something. They blame heroin epidemic on the treatment of chronic pain patients rather than the systemic failures of the legal system, lack of drug rehabilitation opting for life destroying penal system for addicts, and obliteration of the middle class giving rise to disease of despair such suicide and drug abuse.

Easier to ignore the real cause and blame chronic pain patients.

 

[Dextro .45]

Oxycodone blows all that other trash outta the water any day...analgesic properties and it’s VERY euphoric to boot (probably it’s downfall) ....no other opioid touched Oxy for me..... illicit I.V. heroin, prescribed oral & I.V. Hydromorphone, Methadone, Tramadol, etc.

In chronic pain winter time, hands cold sore and painful, a green CDN 80 Perdue Pharma Oxy and a hot tea would melt me in euphoric warmth I’d kill for lol. Started banging it after I knew I could get 2 nice times outta one oral 80

I wish I could go to the factory floor in Pickering Ontario and take 10,000 grams of pure Oxycodone hcl powder before excipients added and pressed into tablets ha ha.