Hello, I was just put on Methadone and Oxycodone for pain releif. I am on Oxycodone 10mg six times a day and on Methadone 5mg 4 times a day. Is anyone else on a similar combination?
It makes me a little sleepy..will this go away when I become a bit more acclimated?
Is it true that the Metahdone will only block the effects of the Oxycodone if I take 80mg and upwards a day? Thanks

Methadone doesn't block the effects of other opioids any more than high doses of other opioids do. In other words, if you were to take 80mg oxycodone daily, you would probably not notice an additional 10mg. Methadone is very potent, so users often do not notice relatively small doses of other opioids if they are taken during methadone use. It certainly does not have antagonistic actions, and raises tolerance rapidly like typical strong opioids.

There is certainly no magic number for how much drug you would need to drown the effects of other drugs. It must vary considerably. Where did you get the 80mg figure from?

Hey Nephro, I did some reasearch and I consitently saw between 80mg and 120mg listed.

I've seen the same, but many of the sites discussing it are rather ghastly. Whatever you decide, be very, very careful.

Hmmm, that's odd. I've never heard of a doctor giving two long acting pain meds. Are the oxy Percocet 10/325???

Bruin7

Sounds like he's probably on percocet. When I was at my last pain clinic, I was on Methadone 10mg 3x a day, with 4 percocets a day for breakthrough pain. I was told to never go above 30 mg of Methadone a day.

I've read that people who go to Methadone clinics and take 100mg or 120 mgs or 200 mgs can't 'feel' any other opiates, which is the point. They are trying to get them to get off of other drugs like herion, oxycontin, etc.

But putting Methadone and percoets together was a common usage at my pain clinic. (with Flexeril and something to sleep). They did have to write "for chronic pain" on my Methadone scripts so my insurance would fill it.

Percocet, sorry for the confusion. lynx, thanks for the info

Seattle, I would trust your doc. Not that docs always have the correct answers, but your pain must be legit and he/she must have some experience with these meds.

The Methadone is undoubtedly for sustained pain control and the Oxys for breakthrough (pain always seems to breakthrough in my experience.)

Methadone can be a real bear to get off of, should that occur, but I have heard (read) good things about pain control. I sincerely hope that is true for you.

Follow your doc's orders, manage your meds well and consider yourself fortunate. I have a feeling your quality of life is better.

Take care.

Just keep breathing my friend. Methadone can be dangerous when mixed with other meds.

Hi,

if the methadone is holding the pain ya know ya don't HAVE to take to instant release oxycodone and nod off.

Thanks for your guy's info, its much appreciated. Prior to this I had little to no experince with Methadone for chronic pain. The tricky thing about the methadone is that its sometimes hard to guage the correct amount, you sometimes end up being too sedated - sometimes you dont feel a thing, but at the same time you dont want overdose because of methadones slow onset..Its not like anyother painkiller ( maybe the fentanyl patch).

I've also heard reports that methadone is only reliable for 6-8 hours of pain releif. So I always have to keep that in mind and try to plan accordingly.

So far I really like the effects of the combination but one thing that bugs me is that when I awake in the morning and am 10-12 hours past my lase dose I often am in ton of pain. And sometimes the pain is in places that I havent experinced it before (I havenet experinced this before with other pian med's).

Otherwise, positive feedback for anyone else considering this combination.

You can't expect to be pain free 100% of the time, while alive. Mrthadone is very strong. It may be affecting other things in your body or you may have arthritis.

Despite methadone's longer half-life, some patients can wake up in partial withdrawals if it has been 10-12 hours since last dosing. This can manifest in body pain unrelated to the underlying painful condition.
If this side-effect is a serious problem, it can be avoided by adding a dose 5-6 hours after initially falling asleep.

how long you been on it it will be a week or two befor the
methadone will work all night it has a long 1/2 life
but takes a while to get to theraputic dose level

It is often given every 6-8 hours during the early stages of dose titration, but on prolonged use not more often than every 12 hours, as the drug can accumulate over a period of time.

Thanks for the info. Its only been a week and a half. and as a precaution the doctor only had me taking 10mg total the first 5 days, now im on 10mg in the morning and 10mg in the evening. Im thinking that once it accumaltes in my body, like someone else mentioned things will be better. My pain m. doctor also said that methadone can actually deaden the nerve's in my hand ( thats where the injury is )over-time. Whos knows, I'll reamin optimistic... the only medication that I havent tried in my pursuit of being pain free is oxymorphone.

I dont know why they would give u oxy and methadone.. Methadone blocks Opi's... Thats why they have Methadone Clinics, to get people of of Opiads.. The Methadone is basically cancelling the Oxy's out..

Methadone does not cancel out any other medication. You're thinking of an opiate blocker, which Methadone is not. It's a legal replacement for Heroin, and a wonderful long term pain medication.

Suboxone blocks the Mu(?)opiate receptor in your brain, making oxycodone, hydrocodone, or even something like Dilaudid have little if any effect. That & its ceiling dosage make it preferred over methadone for opiate dependence nowadays.

In low-medium (i.e. analgesic) doses, buprenorphine doesn't block anything, and, in fact, behaves as a pure mu-opioid agonist. Naloxone (in Suboxone but not Subutex, Buprenex, Temgesic, Transtec or BuTrans)is a different matter altogether, of course, although I don't know what blocking effect (if any) it has in Suboxone. There was a long thread on this just a week or so ago, with lots of valuable info.

Sorry, I tried to edit my last post but the time limit was up. I just wanted to add that if the Suboxone in question was a high dose tablet (say, 16mg or 32mg) then it might indeed interfere with other mu agonists like hydrocodone or oxycodone, especially if the user were already dependent on high doses of these. I was thinking of the analgesic range (I always think of that automatically when buprenorphine is mentioned, given that I'm prescribed Temgesic for pain - I keep forgetting it's used mostly for opioid dependence in the US).

copied & pasted from another thread..

I just know that, in my experience, I have taken 32 mg Suboxone (the supposed "ceiling dosage") and felt nothing. That, and when I was in the ER being administered Dilaudid at least 48 hours after my last dose of Suboxone (aprox 8 mg at that point), I didn't feel a thing. The doctor, in his words, gave me "enough narcotics to kill three grown men," yet I was still coherent and completely sober.

That sounds about right. Doses at the 16mg to 32mg level for a person previously opioid dependent typically result in them feeling "nothing" although at times transient euphoria might be present. I guess that was what the person who made this quote was saying was lacking.
Using enough Dilaudid within 48 hours of 8mg of Suboxone would be a challenge to reach an effective painkilling dosage. If the ER physician was completely aware of the Suboxone situation, he should have titrated the dose accordingly or switched to a stronger narcotic such as IV Fentanyl.
Suboxone can be over-ridden for acute pain treatment but the doctor has to be fully informed about what he is dealing with.

It's sounds messy.
Knowing how many times I have seen dr's screw simple things up,I wouldn't want to make things any more complicated for them.

I know a number of people who took Naltrexone for months and they said they felt sick the whole time until they stopped.
(These were previously opiate dependant people).

It is somewhat different with Naltrexone but it can also be over-ridden much like Suboxone can.
And complaints about nausea being a side effect from Naltrexone are common.
I've often wondered, however, whether it was the drug causing the nausea or it was because of the effects of the post-acute withdrawal syndrome itself.

I too wondered about the nausea being part of the PAWS.I only know one of them that stopped and started again which showed the nausea only when taking the Naltrexone.This was also many months after tapering of opiates.

I've never taken Naltrexone so I don't know personally, but as you said, nausea is known as a side-effect.
On the otherside is the fact that some people report Naltrexone has helped them stop smoking and drinking among numerous other "addictions".

While I was on methadone for pain (I have MS) I hurt my back. My doctor prescribed me 60 percacet 10mg/325mg tabs for Break-through pain.

And it wourked too. Depending on the dose that you're taking of methadone it probably will BLOCK all the other opiates that yu would take for pain unless it's a large dose or your last dose of methadone has been over 24-36 hours and is not as prevalent in your body.

BUT Doctors DO prescribe this combination of drugs. Infact he also prescribed to me at the same time valium 2.5mgs which you would assume that NO Doctor would prescribe an opiate along with a Benzo. But is was a very small dose and I never had any adverse reactions thankfully.

Hmm, that's odd. Wouldn't taking the methadone block the oxycontin??? They should have given you a continuous medication like methadone and then oxycodone/APAP (percocet) as breakthrough pain.

Bruin7

That is absolutely not true that after awhile you only take Methadone every 12 hours. I have been on Methadone 50mg 4x a day for 4 1/2 years with absolutely NO problems. After 12 years of battling, trying to find someone who would not treat me as a criminal or a junkie -I finally found something that managed my pain like nothing ever had. I wasn't high - I just was not in pain anymore. Well when I say not in pain - I mean the pain I still had was very manageable. I was living in AZ then and going to a pain clinic in Phoenix. I came home to PA for Christmas and had to stay because I didn't have a home to go back to in AZ. So I had no refills or anything as I had no idea I would have to stay here. I went into horrific withdrawal in Feb and was hospitalized for 4 days. I had told docs and nurses in the ER when I was being treated for a urinary tract infection that I was scared of going through withdrawal. They just basically said 'Oh well too bad'. 2 weeks later I woke up vomiting uncontrollably. I called an ambulance and they took me to the hospital that had said 'oh well'. I didn't have insurance so the ER personnel cost the hospital thousands of dollars by ignoring me. Inpatient was wonderful. They found a clinic for me to go where I could get Methadone again. This clinic ONLY took patients with no insurance. I didn't understand that. I went and saw this doctor from Feb til May. I still had AZ Medicaid, but it covered NOTHING but a couple of prescriptions - not even the Methadone - no hospitalizations, no doctors' offices. I even told her this as well as another woman in the office who had called me once when she got a call from the pharmacy. Well the doctor found out and accused me of going to other doctors violating my pain contract. I had gone to the ER because the clinic didn't have on call drs. or evening hours. She made many false accusations and just dropped me. She had given me 3 prescriptions the last time I saw her before she discharged me. I went to fill one of them and the pharmacist this doctor had called and said that the prescriptions were NOT to be filled!!! What happened to the Hippocratic Oath - First Do No Harm. So I am in withdrawal again - just starting and I have NOWHERE to go. I am on PA Medicaid again, but nobody will treat me that I have called so far. I went to the ER last night and the P.A. that treated me talked to me like a junkie. He said they don't prescribe Methadone - why is that? He gave me a shot of morphine after me begging for it instead of taking the prescription for 10 tabs of Percocet which would be like taking an aspirin at this point. I told him all of the symptoms I was having of the withdrawal and he sarcastically said "Yep that's the withdrawal' like "Too bad - live with it'. I am in so much pain, so anxiety ridden, can't sleep, can't eat and I have NOBODY to help me find someone to treat me. I have to use Medicaid because I have no money. Does anyone know of a pain doctor/pain clinic that prescribes narcotics without making you go through the run around of injections, etc. I did all that for 12+ years. I cannot function with this pain. It is degenerative disc disease in my cervical and lumbar spine and the head and neck pain I get are indescribable. Does anyone have any suggestions? Please. I have been crying every day for 2 weeks. I went to a doctor last week and she was so mean - again treating me like a criminal and a junkie. I know this is typical - I went through it for 12 years.

What I was referring to in saying that Methadone could only be taken every 12 hours after a certain period of time was this post:

It is often given every 6-8 hours during the early stages of dose titration, but on prolonged use not more often than every 12 hours, as the drug can accumulate over a period of time

You're going to struggle getting prescribed methadone 50mg, 4 times a day. You can say that it's what you take, but that doesn't make it normal, or indeed safe. If you had overdosed by accumulation, the prescribing doctor would be in deep trouble.

50mg is quite a bit for a doctor to prescribe. Mine is 10mg methadone 3 times a day and 4 10/325 Norco 4 times a day. My Doc does not like to prescribe methadone and has taken most of his patients off of it and switvhed them over to Fentenyl patch. (I know I spelled that wrong). He told me on my last visit that this is what he is wanting to do with me.

I've been on methadone for pain for over 10 years now without any problems what so ever and my doctor also give me percacets for breakthrough pain.

I've never had a problem with methadone or percacets but you have to USE th emedicine in the way that it's written for. Never too much or more than prescribed.

when you say you never knwo how much to take, that you take too little or too much tells me that you're not using methadone properly. Not preaching but please be careful.

I'm sure you probably know this but Methadoen due to it's long half life accumulates in the body so that after 5 days of dosing at the "same" dose it has an accumulative aspect to it which makes the dose in your blood level almost double. that is why it is SO improtant NOT to juggle your dose and maintain a normal dose. so a dose of 20 mg a day at the end of 5 days would probably be closer to a dose of 35mgs in your blood serum.

If you're nodding off you're probably at a higher dose than you probably need knowing that you'll NEVER get 100% pain relief. Just try to closely manage it.

I've had to take all this myself because of my MS. Hope this helps you out some.

good Luck.

Individual responses vary greatly with methadone, and the normal starting dose is 5-10mg, possibly 4 times a day. Is is usual for the dosing interval to be increased after analgesic titration, and 8-hourly dosing is needed for some patients, but I've never seen it given more often that that with chronic use.

This is why those on MMT can be given the dose once daily; even then the usual dose range is 60-120mg daily.

Having said that, 200mg per day may have to be divided more due to the sheer amount.

A treatment regimen of 200mg/day of methadone for four and a half years is much more like a methadone maintenance program than one for chronic pain. You may have found a very unusual doctor where you lived previously but trying to replace that prescription level at a pain management facility will be extremely difficult regardless of your insurance situation.
I've never heard of that daily dosage of methadone tabs taken for pain at intervals during the day. If you are trying to find 200mg/day, I suggest you find a local methadone clinic that might accomodate your financial situation.

The sad story RIA refers, just convinces me once more that the ethical distinction between "good" patients (suffering from pains in the body) and "bad" junkies suffering from pain in their self is a barbarian, middle aged belief our descendants will be horrified from...

But, in the meanwhile and being pragmatic, since Dubya is an awful memory of the USA past and in Italy the not inject-able form of Morphine (the Sulphate caps and the other preparations) will be available with a normal prescription without any ID cross-check (as it already is for Oxycontin 10 since November 2008), my trust for a radical, but silent change is much more stronger now than yesterday.

Even if the speculations of media's piranhas (CNN or FOX is the same, being prohibition a poisonous crosswind) on Michael Jackson's death due to a supposed abuse of prescription products, don't help the cause.

In these days, Europe seems much milder and supportive to people surrounded by "pain"....

While I have no idea what you think "Dubya" had to do with your chronic pain treatment, I do know without a doubt that Fox News and CNN are not the same.
And when the facts about Michael Jackson's death are confirmed, I doubt that you are going to like the resulting publicity. He likely abused prescription drugs and it cost him his life. How would reporting about that be a poisonous crosswind?

That much methadone is never giver for pain because it causes cardiac arythmias. the ONLY reason that its given in 200mg/day doses is for heroin treatment.

They are not the same, be excepted for the attitude to attack the freedom to decide how and through what one may cure itself.
And last night on CNN International, there was a "red-hot" journalist (on Jackson' case) invoking jail, punishments and (my God) a "Social Reaction" against this nth "evil" (prescription drugs) and its witch Docs...
I don't think this is properly what US (therefore the entire world) need.
I was disappointed being a CNNer...
BBC starts to sound different, here and there.... but still hesitant...

Poor George has nothing to do with my diseases, of course ;-)
They have (probably) an etiology similar to Michael's one.

For some reason, GWB represent to me the neverending legacy of one aspect of the anglo-saxon "vision" of the world that embarrass me a bit: the resolution of geo-political and economic question, through "religious" war against various "evils".
Maybe the first Chapter of this history is the War of Opium in 1850 and the novel keeps on today with prohibition (a total, full of side effect defeat that's under our eyes) and west Africa transformed in a giant "hub" for south American products (kindly brought to Europe inside warm bellies, lent for the job).




I don't like at all.
There are many ways, as you know, to introduce a news to the public.
Criminalize all the physicians that do their best to help a part of suffering humanity to dampen the impact of prohibition, is like invoking the close-down of the pastry stores because of the death of an imprudent diabetic.
I'm ready to get this from Fox, not from CNN...

Ciao

It sounds funny to me to hear an original colonialist, a European (an Italian, no less) invoke the USA in such terms. Pretty PC, funny in an infantile way. Chiunque si ricorda di Il Duce?

No need to criminalize all doctors but there is definitely a need to criminalize the fool who provided this patient with IV propofol as a sleeping medication. That will appropriately be well-covered by the news media.
And I hope you are not holding up President Berlusconi as an example of a politician who is not "embarrassing." Instead of a presidential history, his CV reads more like a rap sheet.
I'm not even going to inquire about how your diseases are similar to Michael Jackson's.

Guilty for the off-topic diversion I imprinted to this thread...



Totally agree. The problem is that me and you and the readers here we do know the difference among demerol, oxy and surgical IV anesthetics. I hope Media will strongly point out this difference (once the case is cold) and stop putting everything in the same basket.



Why you figured out that my critics on a small part of the USA approach to foreign policies and individual freedoms, automatically mean that Europe, and my country in particular, is a sort of "graceland"?
In Italy, a part from the Health Services Coverage, we adopt the worst (most conservative) positions of any west democracy trying to lock any improve/change and killing social promotion to protect lobbies interests.

Without USA support (Marshall plan and NATO), my country would still be a land of an-alphabet slaves, manipulated by the Catholic fist and a bunch of modest, weak and ridiculous dictators (Banana Republic style).

So, I'm terribly aware of the dramatic similarities between the "Dux" of yesterday and our actual one.
Therefore I watch with extreme gratefulness and genuine curiosity at your politics, your choices, your national debates. Don't want to be misunderstood.
I'm freely talking on sensitive matters in a board its life is possible thanks to the 1st Amendment.

So said, let me say I consider death sentences and prohibition perspectives as unreasonable stains on an evening dress.




My narcissism is insane, probably... anyway is something related to "father's role" and to family as a psy-concentration camp.... with related needs to escape from "adultness" and a disphoric state about body, masculinity etc...

Hi,

actually methadone is a dandy pain reliever and the oxycodone (instant release) is for breakthrough pain.

the reason it's used to "detox" heroin addicts is it's such a LONG acting opiate they can ramp your dose up high enough it takes a MOUNTAIN of heroin to feel it over the methadone dose... and you give up trying to "get high" shooting smack... and you don't get sick if you do your methadone... and all is good while they SLOWLY drop you down.

does anyone know how much oxycodone 80 would be with prescription/without insurance at pharmacy?

http://www.drugstore.com/pharmacy/prices/drugprice.asp?ndc=60951071070&trx=1Z5006

then add 10% for your local pharmacy's overhead.

Your quite correct. I am prescribed 10/600 Lorcets, and 10mg of methadone. The Lorcets are for the breakthrough meds. Thet work well together.

Oh BTW, before I was taking 10/325 Norco and since last week the Doc upped it to 10/650 Lorcets. Does work much better. Just hope my liver can take it. It doesnt seem to bother my stomach like it does some people.

I'd think I'd rather have the Norco...

even the FDA is on to the toxicity of apap and had a press release a while back about it.

and I can't imagine a little more tylenol would improve much in the way of pain relief considering you're doing methadone AND 10mg of oxycodone...

Actally bumping up the tylenol is helping out a little, not much,but anything is better. I havent been on that strength for long. Well see. Could be from taking the Norco's for a long time. Thet really dont do much for me anymore. Thats why he did it. It works different ways for different people. I will see him in 3 months and no telling what he has planned.

much easier to add APAP that take it away... i would ask to go back down to norco, and on the days that are bad and you feel you need 650 APAP buy a bottle of 325 mg tylenol and take one with it... or break an extra strength in half and you will have 575mgs of APAP with the norco. better yet, if you are on methadone, he should be giving you 15 milligram oxycodone IR for breakthrough, will work much better than the norco or lortab and cut out all the APAP (your liver will thank you!) i cant believe you get any relief at all from hydrocodone while being on methadone. that is a good thing though i guess... most after making the switch to meth for pain mgmt do not feel hydrocodone at all in regards to pain relief.

Thank you. You are correct on the apap. I thought the doc would aslo put me on oxycodone IR with the methadone too. All I can say is, if I attemp to question anything with him about my meds, he tends to get upset.

The Norco's were not working for me well, that was his resolution to the problem. It took me a long time to get a PM doc. The MRI's a had were covering my nerve damage due to my big mass of authritis covering it. He ended doing some kind of nerve test that hurt like h*ll. Shocking me from my feet all the way up to my back and then found out I have a cut nerve in my back. I went through severe pain for almost a year until he found it.

My situation is I cant ask for anything from him. It's either his way or no way. I'm sure you know what I mean.

Too bad you werent my PM doc, I know I would feel a lot better. LOL
Taz

I'veread this whole thread and so appreciate your very informedd reples. I just heard about methadone for pain 3 days ago from one of my kids, no less.

Over the weekend I got dumped (along with everyone by this eclinic doctor and was in shock...what was II going to do??

I went to a methadone clinic on tuesday, and had my 2nd dose today. I can't feelanything else and I want my norcos, but I am going to hang in there and will report how it goes. I got desperate, I thought the clinic was only for heroine addicts. I am unhappily off pain pills, but I had run out and the freaking doctor left. I'm curius, are any of you getting these drug combinations from any
f2
f docors with the OCS companies? If you don't want to say here you could pm me...

Thanks,

Boogie

Yea, at breakfast my kids and I talk about the latest in pain meds. My little one really likes the oxy IR and my older ones are all into the Dils.

OMG....Your one sick puppy Q&W.

Taz

Qui moi ?

I just spent $570.00 today for 60tabs of 60mg oxycontin without insurance and just a discount card.

Hi I read your info about Norco and if you dont mind me asking what state do you live in? I live in Mi and my dr is not giving me the right dose of Norco(generic) and I also think I have a high tolerance of the meds it is making me have to take more. I asked where you live because I need a new dr in Michigan suburb of Detriot to re-evaluate me and give me the right dose for my pain. I am on Norco generic q 6 and I need q 4 which means I am out of my meds after 17 days an have to wait 7-10 days in order to get my refill. I am looking on this site to order more meds while I have to wait to get my refill. So
1) are you in MI, if yes what is the name of your dr? so i I can be re-evaluated for the rigth Rx. ALso do you get Norco online or local pharmacy? I need to order online without Rx more norco or something stronger, maybe oxy to have me covered until I can get my refill. I have looked all over this site and can not find where to get hydro or oxy without Rx and shipped farily fast and not costs me 300.00 or more. Do you have any places you can direct me. thanks JOBLESS

That is a lot of money for a small amount. did you get online. if yes can you give me the site??

No I get my meds from a real PM Doc and it took a lot to get there. If I ever lose insurance, I will have to go to a F2F. Good Luck.
Taz

I get 400mg per day find a real pain dr

for real pain especially the neck,just get methadone its ckeap and lasts

Question: Are you saying a pain management doctor is prescribing you 400mg/day of methadone?
Or have you found a clinic that will dose you at this level daily?
If either of these is true, you might be breaking some kind of world record.

What was your process to get to this point?? I ask, because my doc has increased my dose of oxycontin with not much pain relief and I asked him to change to Opana and he has increased the dose to where he says he is "uncomfortable" and thought that I might just ask him for methadone to see if that would help or at least lower my tolerence so I can be on a affordable level..(I have no insurance)..I think you might have some info for me to help with this...can you share your experience?

I'm afraid that lowering your tolerance usually involves increasing pain. Non-narcotic analgesia may have to be used in the process in the highest doses.

Hi,

if you don't have insurance and have a chronic pain situation then Methadone is a good choice.

long lasting pain relief... to me it's more... relaxing pain relief.

and it's DIRT cheap.

a heavy dose for a month is like 10$

Same for me and it works great. I take hydro for breakthru.

I also take methadone for my chronic back pain. 10mgs x3 daily. Nothing for breakthrough pain. 30mgs daily doesnt do diddly squat but better than nothing. I asked for something for breakthrough pain. A very firm NO. Gonna talk to my caridologist or get a referral cuz it suck being in pain every minute of the day. Im sure I can get Tramadol at the IOPs but they dont work for me. Not sure about any IOPs that are cheap for codes, or perds. Afraid of LL's too. In otherwords its a lose lose situation LOL .

They should have given you something for breakthrough. Doesn't make any sense. No wonder your in pain most of the time. The hydro's help in between. Maybe you should talk to him. Tell him it isn't lasting long enough or something or something is missing in between.

Thanks Taz.....Ive tried and she wont budge. (PCA) not an MD gonna ask my cardio to talk to her on thurs when i get my tests results back.

About 2 years ago, I was on methadone 10mg x 3/day + Percocet 10/325 x 2/day for breakthrough. To be honest, I would take the methadone in the morning, then take one at lunch, then when I got home I'd treat myself to a couple Percocets and it did create an eurphoria. So much that I didn't need the 3rd methadone.

Bruin7

When I was on the mscontin and percs I had no issues till the new dr took me off everything. With the methadone thats all I get. Sure would be nice to have those percs but there are some new developments with my health so Im hoping she will have mercy on me!! LOL yah right

I believe a serious pain dose would be at least 100 mg methadone. But one would probably need to take a NMDA antagonist to archieve the full pain relief without high tolerance buildup. It's the only thing that in practice can dampen tolerance.

I don't get it that doctors underprescribe the doses so often. I mean either you are on opiates or you are not. There is no practical middle way so they may just as well prescribe a serious dosage. Does it come as a surprise to them that patients experience rapid tolerance buildup? Then they shouldn't have prescribed in the first place.

400 mg of methadone is not exceptional. Besides opiate tolerance is very flexible you know. It will continue rising until it the reaches a ceiling where it's balanced between the time you take them and time you sleep. If you take extended release 24/7 then there is no ceiling unfortunately.

PS: What will you high dosers do if you run out of meds for one reason or the other, for instance say civil unrest. The WDs from a +100 mg methadone dose is capable of inducing seizures/heart attacks and killing you. The reaction will be the equivalent of getting a massive shot of adrenaline. Deaths from high dose methadone WDs is not unusual. Maybe it would be good to have some clonidine at hand...

I don't know for sure where you live but the advice you are suggesting is off the charts.
You seem to be confusing methadone treatment for pain with methadone treatment for substance abuse. Using early treatment doses of anywhere near 100mg of methadone for pain treatment is insane and could be deadly. And likely would not work anywhere close to the effectiveness of 10mg at intervals during the day.
And 400mg is not exceptional? Is this some fact found in drug treatment in Denmark?
The opportunity for fatalities when discussing methadone should be focused on the potential for overdoses rather than from withdrawals. Advocating the use of much larger doses of this medication being used in chronic pain treatment is just irresponsible and could be dangerous for someone to believe who is not familiar with how incredibly easy it is to overdose with methadone.
People read this discussion board for advice. Can you understand how the advice you are giving could have very negative consequences if anyone actually acted on it?

Im on Methadone for pain managment I get 10mgs x3 daily. I also have other issues (kidney failure) etc. I am not allowed to take any ibuprofin and very little tylenol. Im not trying to advise anyone on how much to take. I was just talking about my experience and yes I wouldnt ever want to receive more than 100mg per day. Many years ago I was on high a higher dose of methadone I made my dr ween me down cuz of all the deaths that were happened from dr's overprecribing. However now this new pcp is underperscribing by not giving anything for my breakthrough pain. Many of the issues I have are dengerative but I dont dare ask her for more.

Rose

99, Where do you come from. I take 10mg of methadone 2x daily, but that is why they give you breakthrough meds between.

In fact, severe pain can be treated with 5-10mg every 6-8 hours. Only when tolerance rises is the dose cautiously increased. If you are talking about the terminally ill, then that is different, but a "serious pain dose", as you put it, would NOT normally be "at least 100mg methadone".

When I was on the higher dose of Methadone I was taking the 40mgs (the large Wafers) I was taking 2 3x daily which equaled to 240mgs per day! I was so drugged up I couldnt function! I wanted my pain releived but not like that. My disabled daughter required 100% care back then and I couldnt give it to her. After a few weeks that was it for me. And yes nephro when you are in severe pain the dosage you said will work, my problem though is nothing for breakthrough pain. Ive been on pain managment for many yrs and have had to switch out meds due to my tolerence level. And even worse is when the dr says "drug holiday" Oh that was brutal!! 1 month of nothing! (switched dr's after that) No reputable dr will put anyone on meds that will make them comatose unless cancer (at least in my state)

There are times and places for 'drug holidays', and doctors often get those times and places wrong. May I ask if you started on a lower dose of methadone, or were you switched to it from something else?

I was on the Phentynl patch and I was having allegic reaction of rashes etc and my urologist told my pcp to put me on the methadone. Im ok with the dose of methadone I have the only problem is nothing for breakthrough pain. Im gonna talk to her tomorrow and see what she can do. I doubt it tho.

Good luck talking with her tomorrow...always a dicey proposition. Sad, but true, no?

I don't understand why your doctor doesn't give you a breakthrough med. What do you do between times? I get hydro, but I think they should have given me Oxy or perks.

Hey Taz...well I had my appt today but too many other things going on so I didnt bring it up. I needed to discuss other issues regarding my admition to the hospital for almost 2 days so tests to be done was the subject.

As for breakthrough meds, she is a hard-nosed pcp. Quote from her "i give you more than I do other pts" sheesh 10mgs of methadone x3 a day is a lot? LOL not compared to what I used to get. The DEA is cracking down on ALL dr's now. They get us addicted in the 1st place and then take it away. Oh well just have to deal with it till the time is right with her......depends on her mood LOL

Nice to know that she treats all her "individual" patients as individual cases needing specific care. This just makes me angry...

But the methadone does not work well by itself. That means you are hurting the in between times. You may have been better off with taking hydro. That way you get more in the day at least.
Do you crash down in between? Must be unbearable. At least my hydro takes the sting out of it until I take the methadone. I only get it twice a day 10mg. I get 4 10/500 hydro for the break through. I hate doctor.

My dr isnt even a MD she is a PAC!! And up until Feb I always had perc's for breakthrough pain See where Im from there is soooo much drug activity going on that they dont trust ANYBODY and thats whats increasing the crime rate here. I get so frustrated for those that really really need the pain relief (not even referring to myself) but everyone has to suffer and pay the price. There are so many pharacies that dont carry Oxycontin anymore cuz of the increased robberies at the 24hr ones....ex walgreens.

They need to go by the individual instead of catagorizing everybody as a drug addict! Thats probably why so many people order from online. Dr's arent treating pain managment pts needs. Makes me peeved too!!

Rose

I'm surprised your getting that from a PAC. I get mine from my PM Doctor. No other doctors would even touch giving me that. I have so many doctors. They all are in their own fields. Actually I have 2 PM docs. One for surgery and the other for meds. I still have to see them all. Going up a ladder and paying for all of them really sucks. Good thing I have Ins. Even with that it gets expensive. Tomorrow I get another MRI done.
Does it ever end???????????

Nope it doesnt end. Im afraid its gonna get worse. I have a few different dr's as well for different meds etc...I feel sorry for the eldery that have to pay $500 plus for the necessary meds!!!! As far as pain management goes I dont understand why 1x a month they have a pt do a UA and if they fail they get no meds instead of making us suffer. How hard can it be to do a UA 1x per month!!!!!!

Rose

I have yet to asked to do a UA test yet. But I'm also not counting it put especially now a days.

LOL yikes my dr hasnt done one either. In fact I havent had one from my previous dr either. I hope I didnt Jinx it! I was just making a genereralized comment for those that really need them and dr's wont give them anything this would be a good solution for the DR's rather than thinking EVERYONE is a drug addict. But you would think a dr could tell just by looking at the pt. Eyes, personal hygeine, how they dress etc. Its not fair that we are at a dr's mercy. Plus the DEA.

I know someone who's daughter was had cerebal Palsy and the dr's re-connected her legs and had extensive surgery's over the years. This person was ON pain meds PRN And the DEA board said she couldnt get pain meds anymore (after 20yrs) no taperin of meds.....just cut her off. She had 10 dr's vouching for her in a court they still denied! She told me about it yesterday. I was flagergasted. Those Dr's QUIT cuz they couldnt do it. Also, she had friends who also had CP and their dr's and to cut them off too. The pain was sooo bad they commited suicide!! 7 of them. I was horrified. Its like human neglet. I cant imaigine how much pain people have with CP. I about cried when she told me this. And we think we have it bad?? no comparison to leading 7 people to take their own life cuz they couldnt deal with the pain. So her daughter started drinking beer and smoking pot. Basically the DEA more than likely are turning her into a alki. I personally do not drink or use street drugs but given this poor woman's condition I dont blame her.

Rose

You know, there was a British solicitor/lawyer - Clive Stafford-Smith - who was appalled at the death penalty system in the US, and how the criminal justice system seemed weighted unfairly towards the poor. Now I haven't a clue about the innocence or guilt of the condemned, but I do know that he went over to the US and represented a number of those facing execution, and to my knowledge is still fighting their cause.

Perhaps it would take a doctor from outside the US, who won't face losing his licence, to go and do a similar thing for chronic pain patients?

The cases mentioned above are just terrible.

Im pretty sure that they are teaching ALL med students to not give any pain meds for chronic pain. I know cuz my daughter's neurologist is really young and her reg dr is really young. I couldnt believe they took my child off of hydro's that she was on since she was 11 and now she is 22. She literally has NO concept about pain meds, W/D's etc...when she gets her migraines she calls the hydro's
"headache medicne" LOL....same with the neurologist. She'd say am I going to the headache dr ....but when he retired and they just stopped cold turkey even though she doesnt know how to describe what she's feeling I know cuz she acts up, doesnt behave etc. Its very confusing not having her usual routine not to mention 2 new dr's who dont know diddly squat about her condition.

For crying out loud they are not much older than she is!! They should have just kept her on the regiment she was on from a very well known dr. Not to mention screwing up her ADHD meds and giving her dextroasmphentime CAPS instead of tabs. I told them look in her CHART and do your JOB right. Next month they still did it wrong. I was so peeved. 1st new dr's then different meds....not good for a child with special needs who need routine! Stinkin DEAAAA!!!!!!!!!! stepping of the soapbox now before I really start steaming.
Rose

Morning Rose, boy those are horrible stories about pain and neglect. Criminal really.

One of my sister's friends committed suicide yesterday. He had stomach cancer which is very painful.

I hope I don't find out that he was not getting the pain meds he needed to live out his life.

I happened to see the news yesterday, which I don't normally watch. A UK hospital turned a woman away SEVEN (7) times when she complained about her pain and swelling. Eventually, they diagnosed her with ovarian cancer, and she died a week later in agony, after they removed a gallon of fluid from her abdomen.

They have offered an apology, and will apparently investigate. No mention of compensation.

There aren't enough apologies to bring her back. Whenever I hear about this stuff just makes my skin crawl.
What's this world coming to?


I keep thinking, this could be me one day. I've had bad days of pain and makes you depressed. You want to just grab a bottle of Jack and drink it.

You are so right Taz! I hear these stories and it just makes me so mad and sad at the same time. In the back of my mind, I also think - this could be me or one of my loved ones.

GoogleRose, I'm so sorry this happened to you and your daughter. That is just so wrong!!!

Thanks guys for your support. When I complain about my pain not being managed, I stop and think wow this is so mundane compared to these other people who are much worse than me. It humbles me when I hear these horror stories about people commiting suicide cuz they cant handle the pain or feeling like there is no hope left. It reminds me of these people who are in a hospital knowing they are dying and asking a family member to pull the plug but its not politically moral so they get charged with murder when all the pt wanted was to be out of misery.

There is no telling whats gonna happen. Already the crime rate has increased cuz people in pain arent getting any pain relief. Dr's dont give a rats you know what. Im thinking thats why my dr and those other 2 dr's for my daughter couldnt do what the DEA wanted so they quit. I dont blame them. Like those 10 doctors going to court for my friends daughter's friend all 10 dr's were going to bat for these people. NO sympathy from the DEA. NONE. These people killings themselves (the one's who had ceribal Palsy) is an outrage. IMO the DEA contributed to manslaughter. Even tho it wasnt them directly who did so but the denial for any type of pain meds is horrific.

I think dr's who really care about people should go on strike to the DEA!! But wishful thinking as they know it wouldnt do any good. Ive noticed that there are more "clinics" and less private practice. At least where I live. So, whats left is litterly nada!!!! Online dr's and then we fear the good ole customs sending LL's. Ive never ordered pain meds online cuz I cant afford $500 plus. Thats like half my income!!

Thank god for 1 of my dr' prescribing me valuim for panic attacks, and ambien for sleep!

Methadone has a very long half life, so don't worry if you don't feel it working at first. It takes me sometimes about an hour to feel the first effects of it. But it is the best pain medication I have ever used. You are lucky to have been prescribed it.

I would like to add that while some may feel it in the first hour, DO NOT re-dose until like 5 hours into it! the medicine will reach its peak performance probably around the 3-4 hour mark.

I haven't been on the boards in awhile but I've been keeping up with what's going on. I have had chronic pain for many years and my Doc and I go round and round about my meds. Now my son has chronic pain at 32 years old and it's congenital colation in both feet which causes leg pain and back pain because he can't walk right. He can't work and has no insurance. Our Doc has just changed him from hydro 10/325 to 2 10mg methadone 2 times a day. He is on day 2 and is having bad side effects. This can't be DEA pressure! I take 75mcg fentanyl patches every 48 hrs, 10/325 hydro up to five a day, and actiq 400mcgs 4 times a day plus Soma for muscle cramps. Now I'm 55 and have too many problems to list except spinal ddd, and dystonia and osteo. Why is my son suddenly switched? I feel like I need to go with him and suggest the patch at a lower dose and a breakthru med. Why are people treated this way!

Peace and less pain for all,
Deb

The doctor probably wanted him on something long acting to control his pain. Hydro is not recomended for long term, chronic pain treatment. It is good for breakthrough, as I'm sure you know. If he tried him on methadone, he would probably switch him to another, long acting medication like the patch. I don't think it was a bad thing he was switched to methadone. Many on this board wishes they could get that kind of pain treatment. I would just tell his doctor about the side effects and try something else.

Perhaps the side effects diminish after a while? I think I have seen that posted.

I agree w/TJ and would call his doctor to discuss side effects and alternatives.

I am on hydro 5/500s for chronic pain and have been on it for about 6 years, so docs do script it for chronic pain, although it is not recommended.

Thanks guys, I am still looking at him as my baby boy so I can't see the flowers for the trees. He has complaned to me and his big sister about the side affects. He loves to read and he feels that his eyes can't focus. We will give it a try. But we will go back in 20 days if his side effects don't settle down.

Peace and less pain,
Deb

it sounds like to me if his eyes can't focues, he's actually getting too high of a dose. does he take them both in the morning? or one in the morning and a second about halfway through the day?

anyawy, if its because he's got a "buzz" from his methadone, that will go away rather quickly actually and he should level out. as long as he's not taking any benzo's. because that is very dangerous with methaodne. especially xanax.

When they first put me on Methadone, they first had me take halves first, then after a while, they moved me up to the full 10mg. That is a strong dose for using it the first time. Even with my first time taking in in halves which would be 5 mg made me dizzy for a while. I couldn't imagine what 10mg to start out would be. I get hydro's for b/t but it is also because of my age. If I was younger, I would be on a less dosage. I still don't get enough pain relief, but they had just told me yesterday that I will need more later in life since my chronic pain is here to stay.Methadone can be split in half. Why not give him halves in half the time and the other half later until he can cope with it. This is JMO, but I am familiar with Methadone and how they got me to take them with no problems.

DeeRock is right about the high. Too much too soon. This is a type of med that needs to be weened on.

Methadone can really mess with you. I found it great for pain, but the side effects were so bad it was not worth it. My worst effect was sweating. I'm not talking about a bead or two on my forehead, I mean SWEATING. I would soak through my clothes sitting still in A/C. I would get out of an ice cold shower, towel off and be sweating before I could get dressed. I went to an outdoor concert and brought 3 pair of clothes and two towel. I did more costume changes than the band . Seriously, it was so bad that I would almost prefer pain. At least pain wasn't overly visable and disgusting. Hopefully a lower dose will help. If not, there are many long acting opiods. Good luck.

I thought I would add my two cents, which happens to be based on years of research. This is in response to earlier comments that kind of made me mad about Methadone and "blocking dose" and heroin and etc. First of all the lady starting this thread that took 2omg of Methadone and 60mg of Oxy a day is most likely not going to have any blocking effect from the methadone at the dose they are on.

This is the deal with blocking doses. Methadone CAN and WILL block other opiates. BUT it must be in levels higher then 400ng/per Ml which fluctuates do to liver function and person to person. But generally 80MG is a blocking dose. I know this for a fact a friend has had many blood tests and is on Methadone, and his levels after being on 100mg of methadone were still not blocking other opiates.

After an examination of his blood concentrations it was found he had 300NG/Ml and thus no blocking effects.

So unless you are on a large or fairly large dose you probably will not feel full blocking. Some folks do though, at 30mg I know a person who has full blocking? So go figure.

Methadone is NOT ONLY for Heroin. This has been a stigma attatched to Methadone for years. And it is too bad. Because the drug is very good when used correctly. When not, it can be evil. Along with MISEDUCATION it is the second biggest hangup doctors face with methadone.

Mis education sometimes works for the patient and sometimes not/. I know a person who is on Methadone for Chronic pain and there doctor thinks Methadone blocks all Opiates and therefore is the safest of all. This is scary, he freely prescribes it.How can a college educated person be this dumb in there field of expertise? Most doctors however think HEROIN and JUNKY and do not know it is very cheap and works a long time very well.

Well there is my two cents and I just wanted to comment on "blocking dose" due to miseducations by many.

Whooo! I might have said his dosage wrong. My son is on 20mg twice a day. and I think it stinks! But he is taking it for chronic pain and not as a blocking agent. I have gone round and round with him about it. He thinks the fam doc is treating him like a drug adict and I told him the drug is a good long acting med for those without insurance like him. Now, I hate it because of side effects too. All I did was sweat and want to crawl the walls. We are all different. But he seems to not be able to take the same meds as me, so let's say it's genetic. We are going in to the Doc on the 30th. He doesn't think he can take it that long. And I did suggest that he break it up into 4 doses a day at 10mg and see how it goes. I was flat out refused as he says he has to take it as prescribed. He is stuborn. He has so much pain he quit his job 3 yrs ago. He should be on disability but won't apply. Still working on him though. Stuborness is genetic too!

Peace and less pain,
Deb

P.S. He is also on Soma. He has really bad muscle spasms like me.

Deb,
He still will be taking it as prescribed per day, just not all at once until his body gets use to it. That is way too much for just starting out. The sweating part is that the heart is racing and working harder and makes you sweat. I now take mine 10mg every 12 hours, but I took it slowly as my doc prescribed first because of what it does. Maybe you need to talk to him and tell him why it is making him sweat. I have a heart condition and I take Lanoxin to regulate my heart. My problem is it races and then I sweat. I have that under control. I still don't know why a doctor would give someone that much to start with. It just blows my mind. Not trying to scare you, but with the heart racing and the sweating can cause a heart attack. He is young, his heart is taking it, but it is still wearing it out in the long run. Baby steps is all I'm saying. methadones can be broken and when he is dealing with them, then up it. I bet when you go to the doctor after he takes one that both the blood pressure and heart rate will be sky high. The blood pressure can vary with different people, but it will either be up or low.

Hi,

I get a SMALL script for roxicodone for BAD BAD days.

while my condition is chronic I'm not literally in serious pain 24/7... sustained release Tramadol and an nsaid is EVERY DAY... and usually something at sleep (or I see the dawn)

depending on the nature of your pain something non-schedule like Soma (carisopradol) may help... it's a muscle relaxer and it really helps me.

My sister died of breast cancer.

Watch the John Wayne movie The Shootist... Jimmy Stewart plays a doctor... and like he says "I would not die the death I just described to you"... and if I ever get to that point I won't.

Hi,

not to second guess the doc....

but instead of 2 twice a day try 1 4 times a day... same dose... but fewer peaks and valleys.

of course the idea with methadone may have just been to get him pain free quickly with 2 at a time... it takes a lot of people a few days to get level.

but a lot of apap (tylenol... that's the 325 in the 10/325 hydros) isn't good for the liver and there was an FDA warning about it... and it really isn't good for you... that's not government BS.