Chronic Pain Support Group
Physicians and professionalsdefine pain as chronic if it lasts longer than three to six months and is persistent. It's distinct from acute pain that is a direct result of injury or trauma. This support group is dedicated to those suffering from chronic pain. Discuss treatments that have worked for you, find advice for your specific experience, and find support. You're not...
Ok, as for my advice to you- this is REALLY important- I don't want to scare you away from methadone (it's a great med for pain), and you shouldn't be scared- as long as you start taking the methadone very slowly, everything should be fine. HOWEVER- there have been quite a few pain patients who have died from methadone overdoses when they first started taking the medication because their pain docs didn't understand how methadone works and how to properly prescribe it. For example, some docs might say "ok, take 30mgs every eight hours" like they would with any other pain med. That might be fine even with long-acting, time release meds because they usually last like 8-12 hours. Methadone, however, is a MUCH longer acting drug. So long-acting that I, as I said, take in only once a day (some people I know can even skip days and feel fine)- it's pain-relieving abilities don't last for 24-36 hours, but the DRUG ITSELF does stay in your system for that long. You might feel fine for the first day or so, but the methadone builds up in your system with each dose... so if you take a significant amount multiple times a day for a few days without a decent tolerance for opiates, you could end up a few days in with a large amount of methadone in your system at one time- even though the doctor never intended for you to have more than 30mgs at one time in your body. Did that make sense? If not, please message me privately and we can talk more about this. Methadone is a great medication for pain... it works great just for pain relief and I think you will find that it makes you feel less high than other narcotics do. That's why it is so successful when used in addiction treatment- it blocks cravings and withdrawal symptoms without creating a high. You might feel a little bit out of it at first, but you should adjust quickly and that will go away. I don't want to scare you away from methadone at all, I just want you to know the risks and if you feel something isn't right with the dosage you've been prescribed or if you feel too out of it, go with your gut and err on the side of caution. I think if you're worried about how you'll function at work, then it would be a good idea to start any med over the weekend. Would you be willing to tell us what dosage your have been prescribed- I think most commonly they prescribe 10mg tabs now- and how often you're supposed to take it? Also, what kind of tolerance would you say that you have for opiates? I'm NOT a doctor, of course, but I have spent YEARS educating myself about methadone so I hope I can offer some educated advice about it to you.
Oh, another positive I have seen with methadone is that tolerance to it seems to build much slower than with other narcotics so you should be able to stay at the same dose for a longer period of time. I have only increased my dose twice in seven years (after the first six months of gradual increases to get me to a comfortable dose)... and then by a TINY amount compared to my dose- like a 2% increase. That is always a plus because even though pain docs are fully aware that tolerance happens naturally, when it does happen they can act like you've been abusing your meds.
Again, methadone is great medicine for pain and for addiction- it has absolutely SAVED my life- I have stayed off of heroin since the second day I was one methadone. And it works very well for my pain- even if it's only for a few hours after my dose. I had a much more negative experience with every other pain med that I've tried, and there have been many. Increasing my methadone dose to manage my pain was the best option for me (as opposed to staying at a lower dose and using that just for addiction and then adding other meds on top to deal with my pain)... I wish they hadn't increased it quite so much, my dose is rather high, but hopefully I will be able to change that soon.
Ok, please give us more info about what you have been prescribed. I just want to make sure you're safe. :)
~Jennifer
I do think any medication is a totally individual thing...you may not do well on it where others can't live without it. It's just got a "scary" reputation but you may find it to be your lifesaver too!! I hope you do get some relief.
FYI-I also take it with Norco so it will be ok to take with your percocet too...in case you were worried about that.
It sounds like you were WAY over-dosed when you tried methadone. It sounds, really, like it got you extremely high.. lol. From my own experience with abusing opiates, everything you described is what it was like when I first started using heroin and could still get REALLY high. I would get tons of energy and want to talk to everyone and clean the house and just do everything! And then five minutes later I'd pass out where I was standing. All of that was punctuated by frequent bouts of vomiting. That's kinda what I was talking about in my previous post- people being started on too high a dose or too frequent a dose of methadone. That may be what happened to you. Or maybe you were just particularly sensitive to that particular med for some reason- we're definitely all very different in how we respond to meds. My grandmother swears Tylenol knocks her out- I feel like that's physically impossible, but maybe she just is that sensitive to it. Lol.
I agree with Jennifer. Although I have never taken methadone, I'm concerned.
You are right to be concerned about taking the methadone at any dose, especially if your doctor has not discussed all of the ramifications of the medications, dosing, side effects, and complications associated with the medication as a whole and your dose in particular. From your profile it does not appear that you are an opiate tolerant patient, as you only take an oxycodone preparation (presumably Percocet) at night. I'm concerned too about a doctor who is sending you out into the world with methadone, first use, with no expectation of seeing you for 6 months. That's simply unreasonable. A good doctor will want to at least hear from you on Monday and then find out how you're doing and follow up in a month, at least by phone if not in person. This isn't candy we're dealing with, this is heavy duty prescription medication with a very high rate of physical dependence and very serious, life-threatening side effects.
While I understand cost is an issue and methadone is one of the least expensive of the long-acting opiates, it's also the strongest. Are you on or have you been on any sustained-release opiate or do you take the the strongest Percocet in high doses around the clock at all? Are you actually opiate tolerant or do you only take it at night? Opiate tolerant means taking opiates at a relatively high doses (more than just a 5/325 Percocet every 4-6 hours) around the clock for an extended period of time, not just as needed or a few tablets but for a number of years. Being opiate tolerant to a minimum level equivalent to at least 100 mg morphine per day is what's needed to be able to transition to methadone; it's not a first crack out of the barrel pain management treatment, despite it's low cost.
Here is a link to the FDA Methadone consumer warning label page based on postmarketing information (information you need to know and should get with every script, but probably don't):
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm142841.htm
And here's the link to the manufacturer's prescribing instructions (including changes mandated by the FDA): http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM142842.pdf
I know there's a lot of "medicalese" in both, but please read through them; they both have important information that you need to know about this medication you're about to take.
I highly, highly recommend you have someone with you, someone alert and awake, when you take your first dose (take it during the day on a weekend first, not at night). This alert individual needs to monitor you for breathing, cognition, alertness and any other side effects (without ticking you off by staring at you all the time...my husband did that recently when I had to increase a dose of immediate release medication and I was ready to find a 2x4 and hit him over the head!). If you fall asleep, they need to stay awake and be vigilant, checking your breathing every few minutes and be ready to call 911 if you stop for any reason (then attempt CPR).
I don't mean to scare you unduly, but this is a very heavy duty medication for someone who is not opiate tolerant (i.e. has not been on some other long-term, sustained-release narcotic medication in increasing doses for an extended period of time). I also don't mean to scare you into pain, but I do mean to scare you into doing the right thing and being very, very careful when you take it. The half life of methadone, the time it takes for half of the medication to leave your system, is 8 to 59 hours. That's 8 hours to nearly 3 days! And the effect on the breathing center of your brain is delayed in methadone, unlike it is in the other opiates such as oxycodone and morphine. No one can predict how you'll respond and when that effect on your breathing center will kick in.
I guess the bottom line is please be very, very careful. I know the desperation for pain relief. I also know the impact of an overdose. I was fortunate enough to live through the experience . I had a doctor prescribe too much IV dilaudid in my PCA pump at a basal rate (steady rate that didn't require me to push the button) assuming I was more opiate tolerant than I was. As a result, I coded, stopped breathing and they couldn't find a heartbeat (thankfully the heartbeat issue was only briefly). Fortunately I was already in the hospital and found by a corpsman and revived with Narcan and CPR. Yet I survived because I was already in a hospital with the needed medications and expert staff only seconds away from my room. I would not have lived had a comparable overdose happened at home, alone.
I just want you to be very very careful. We all want you to be around for a very long time. Please, use caution.
I will be checking in by phone) after the 1st and second wk) and have to go to clinic every month to get script, this is a pain clinic and i feel they are very knowlegable.
thanks for all the advice, but im scared now.