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Simonv
Stranger
Reged: 04/17/03
Posts: 16
Loc: Northwest, USA
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I have a wonderful understanding Private Dr. who doesn't have a problem prescribing me meds. I am currently recieving methadone 10mg. 10-12 per day for pain and valium 10mg. 3 times a day for muscle spasms. The methadone isn't working as well has it used to and when I take an extra one it only makes me tired and doesn't do anything for my pain. My question is what do you people believe would be a good breakthrough pain killer for me. I don't know what would work with the methadone, it seems to keep other pain meds. from working when I take them. I would appreciate your input, Thank you.
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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I am trying to get off the methadone for this exact reason. Few narcotics will punch through that much methadone. What people forget is that while methadone is great for heroin addicts as it hogs up the opiate receptors and prevents other opiates from getting through, it really sucks for pain patients due to this same effect.
I've had multiple drugs prescribed for surgical and break through pain while on 100mgs total daily dose of methadone. MSContin, morphine IV, Demerol IM, Percocet, Darvocet, Vicodin, etc. The demerol definitely helped, but made me so tired all I could do was sleep. Darvocet actually helped (as it never did pre-methadone...weird!) Morphine was useless. Oxy worked for a VERY short time (maybe a day or two) and Vicodin also worked for a day or two.
BE CAREFUL of drugs that are opiate agonist antagonists such as Nubain, Stadol, etc. These may cause acute withdrawal syndrome in patients on methadone.
I've written tons of posts on this topic, of my experience with this very issue, FYI.
Whatever you decide, best of luck to you. Always available if you wish to talk further by PM.
Regards-
night_shade
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Never underestimate the predictability of stupidity.
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quincy
Board Addict
Reged: 11/07/02
Posts: 333
Loc: pacific northwest
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I also take methadone and I am also having problems with my breakthrough meds working. I take Norco- about 3 or 4 three times a day. Yes 30mgs of hydro is a lot, but I need that much now to feel any relief at all. I never thought it may be the methadone though. I wonder If I should ask for something else.
And yes, I was at 100mgs of methadone for awhile and all it did was make me sleepy, which I never had before. That seems to be the only side effect of that drug, but from what I am reading, it is blocking out the effects of the other narcotics? Could you please explain this in more detail? I might be better off with oxycontin or something else.
Sarah
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Sarah-
Methadone reduces or eliminates the effectiveness of other opiates because it is long acting. If I remember right, you take your methadone in 3 doses throughout the day. A single dose of methadone has a half-life of about 12-24 hours. Essentially, think of your opiate receptors as a sponge, on methadone they get saturated for a long time, so when you attempt to use a different narcotic, there is simply no place for it to get absorbed. On a three-times-a-day dosing regimen, you wouldn't get much relief at all from, say, Oxycodone. If you were on a once daily dosing regimen, you may get relief towards the end of the day from oxy if you took the methadone early in the morning.
The higher your methadone dose, the less effective other narcotics (including heroin for those on MMT) will be. In fact, even though the breakthrough med may not FEEL like it is doing any good, it's CNS depressive qualities are still adding to those of the methadone and people can overdose without ever achieving a "high" or analgesia.
Hope that explains it a bit better.
All the best---
night_shade
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Never underestimate the predictability of stupidity.
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