I have a very high tolerance because I was in hospice on an extreme amount of narcotics you wouldn't believe me if i told you and after reviewing all my history several doctors concur i will have to be on methadone for the rest of my life. This is unfortunate, but they were just trying to make me more comfortable as i was told i had 12 to 18 months left and was confined to a hospital bed 24/7 at home. I've been on almost every single legal opioid in the US and i can definitely say that suboxone/subutex never worked for pain for me, it was only effective for managing withdrawal and slowly coming off opioids, that was before hospice, afterwards, the max dose of 8mg 3x per day did next to nothing and I was in acute withdrawal. Now, I'm on 60mg of methadone 4x a day and 8mg of dilaudid 6x a day which is about 5% of the narcotics I was on in hospice, it was very difficult to do as my hospice dr retired and I had to go down very fast. But as far as the analgesia of buprenorphine to methadone, it doesnt compare at all...they are using methadone to treat cancer pain now, and they used to make a 40mg wafers and patients used to be on 700-800mg per day, like 20 years ago anyway. (Stopped making the 40mg ones like 6 or 7 years go) But methadone is the best medication for me in so many ways....as a painkiller (despite its half life it only works for pain for 6 to 8 hours, which is what the dr at a methadone clinic told me years ago and said I needed to be in pain management, I just moved back to California a week ago, I was in Arizona for a couple months then Laughlin Nevada for a couple months then las vegas for over a year, and it was as complete nightmare, i had to be hospitalized about 25 times because no doctor would manage my tolerance and I would have grand mal and tonic clonic seizures, I had one right in front of a nurse practitioner in a pain drs office once just before I was about to get my prescriptions and they called an ambulance & sent me back to the hospital.....like no one prescribes methadone there & they had me on 200mg of mscontin twice a day and that sucked compared to the methadone.....anyway, those are my 2 cents, I dont come on here often I was looking up something but couldn't find it oh well, but if anyone has any questions about anything, I've been prescribed everything except onsolis, kadian, and exalgo...well I was prescribed kadian and exalgo but my insurance wouldn't cover it and it was in the 4 digits lol, kadian is a 24 hr time release morphine, exalgo is a 24 hr time release dilaudid, and onsolis is one of the instant release fentanyl medications, the only one I was never put on because it needs a special delivery company paperwork filled out and a bunch of xtra stuff that the other instant release fentanyl products (lazanda, fentora, actiq, abstral, subsys, etc didnt need) u gotta be really sick to get your insurance to pay for those too, otherwise they are ridiculously expensive, lazanda is the most effective painkiller I've ever had, but it costs like 50 grand a month if you're not sick enough to warrant your insurance prescribing it)
The pain relief is similar, although because I have so many extra pills, I can easily take one near bedtime, which I never ever had the luxury of doing with methadone, due to doctor being so goddamned stingy with the script.
