Methadone maintenance and pain medication

[Mymy]

I am currently on methadone maintenance and need
extensive dental work done including oral surgery.

What would you recommend for pain relief after surgery?
My dose is 60 mg. of methadone which I am taking for opiate
addition. I am stable on my dose and do not abuse opiates.

Is there one pain mediction (medication) that is better then the other for
patients who are on methadone? I was wondering if the clinic
should just raise my dose of methadone while I am in pain.

Thanks for taking the time to read my question

Sincerly Anne

[Michael97]

I don't think raising the methadone would be a good thing if you are stable on your current dose.  There are plenty of other shorter acting opioids that are more suitable for short term use.....if you can use them responsibly.  It would take too long to bring you back down to your current dose of methadone.  Maybe a duragesic 25.  The patch is prescribed q 3days....a lot harder to abuse than a bottle of pills!  The patch contains fentanyl, and at 25 ug/h, is a relatively low dose.  It can be taken concurrently with the methadone.  After using the patch, just continue on your current methadone dose.

ps  the patches come in boxes of 5, but the pharmacy can break open a box...meaning the doctor can prescribe 1 at a time.

[Thomas]

doc dan can confirm this: you'll probably get Vicodin (hydrocodone) for breakthrough pain because the effgectiveness of Vicodin doesn't seem to be neutralized by methadone, the way heroin would be. I seriously doubt if they will bump up your methadone, especially since you're not on it for pain reief to begin with. You'll probably find that the Vics work quite well and feel pretty good. I wouldn't be too worried.

[niccee]

Please be careful. I have been on methadone maintenance for a couple of years. It has worked great. I am now down to 20 mgs from 80 mgs with plans to be totally off soon.( The lord willing.) I have never posted here, but come for the knowledge and support. I was given a drug for a kidney stone that made me go into immediate withdrawl. It was the worst 4 hours of my life. I thought I was going to die. There are certain pain medicines that don't mix with methadone. Please be very certain of everything they give you. The ones that I know of that you are not suppose to take are Talwin, Stadol, Nubain, and Talacen. This is the list my counselor gave me. I have taken Lorcet and did not have a problem with it and it worked pretty good. If you don't mind I would like to thank everyone here for all the good advice I have been reading. Good Luck.

[Thomas]

Niccee is totally right about checking out any painkiller you try to use on top of Methadone. The drugs niccee mentioned, Talwin. Stadol and Talacin (another form of Talwin) are classified as partial opiate agonists/antagonists. All the classic pain killers (opiates, that is) are opiate agonists. Any pain killer that is classified as even a partial opiate antagonist means it will at least partially neutralize or try to neutralize the effects of opiates like morphine, codeine, methadone, Vicodin.

I know from many different correspondences with people who know, that, if you're on methadone as a maintenance drug, any form of hydrocodone (like Vicodin, Lorcet, Damson-P, Norco, Zydone -- there's a bunch of them) seem to be very successful for treating pain without causing complications. If that doesn't do it for you, as far as I know, Percodan, Percocet or OxyContin are definate opiate agonists that pack quite a punch. I suspect your doc might not be too thrilled to give you Percodan, Percocet or especially OxyContin because of their pronounced addiction potential. But, used right, any of those forms of hydrocodone, like Vicodin or, even stronger, VicodinES, will work quite well and wont "antagonize" your methadone.

As always, check with your doc and the pharmacist. But I think, following this road map, will get you where you want to go. Good luck. To check, by the way, use www.rxlist.com. That site will tell you under "description" and "clinical pharmacology" if there are any antagonist properties to the painkiller. When in doubt, use the Vicodin. It's tried and true, battle tested by many methadone patients, including doc dan (***@****), who will be only too glad to tell you about his experience dealing with intense pain while maintaining his methadone schedule. He's highly educated in his field as a substance abuse councilor, highly motivated to be of help, and won't let you down if you contact him.

The only reason I can imagine him not answering a message addressed as I have indicated is that he's changed the address. If that happens, come back to the forum and we will help you anyway. There is a core of forum participants that have a combined time as junkies of one kind or another of several hundred years. My own story accounts for more than thirty of those years. So, you're in good, non-judgmental, knowledgeable and oh-so experienced company. You couldn't shock or repel us if you tried, my friend!

This experience of ours has made us brothers and sisters in a deeply meaningful way. I know that part of the reason I'm still alive is the help I've gotten and been able to give to my brothers and sisters on this forum. Brighty, Rachel, Ambrosia, Dave, PokeBry, Wizard, Doc Dan, the redoubtable J.B., CJ1Naro, Angelica, (a few people here are the same with different handles) - I'm forgetting so many people I will want to kill myself when I realize who I've forgotten - please forgive me in advance. But, listed or not, they are the salt of earth and will help as much or more than I can.

One rule we have is that you have to post back to let us know how things worked out or how your doing, in general. God bless you. I hope this message has helped.

Thomas

[Deja]

I'm sorry to butt in on this thread and I wish Mymy good luck during her upcoming surgery.

I wanted to post an update since I haven't been around since last week.  I saw my doctor on Friday and told her that I discontinued all my pain meds.  She was concerned about the withdrawal, but at that point I had made it through.  

We talked at length about my level of pain and quality of life and I was adament about not taking oxy anymore.

I agreed to a script for vicodin- 5's and she said if I use them as prescribed - up to 4 a day I should be fine.  I really do need pain relief! That is the bottom line.  

I don't want anyone to think I caved in and failed at my attempt to stay clean!  Since I filled the script I really have only taken 3 a day and I am now getting adequate pain relief on that dose.  

Can I stick to that routine and not start increasing again?  I am praying that I can.  I don't want to start that cycle again!

I've said this in prior posts-  I have never gotten high off these meds!  

To Wizard, JennyFla- everyone-  I have been thinking about you guys and praying for you!  How are you doing?

Love,
Deja

[Wizard]

Thank you for asking about me :-) Deja, I'm doing wonderful! Had a little rough one yesterday but with the support of my family here on the forum and my family at home, with the grace of God, I got through another day of LIFE. As far as you, I glad to see you are talking to a Doctor who seems to have a concern about your wellbeing. YOU got off the oxy's and that is no easy task. I KNOW...If it's determined that you need pain relief then so be it it . That is no cop out or crime. If the Hydro as perscribed works for you then that's all you can ask for. If you start worrying about the next refill or how many you have left, (remember those days people?) Use that as a sign to re-evaluate your usuage. doesn't mean I'm right. Just my opinion, those were my classic signs of abuse. If it was time to worry about my next med, it was time to reflect on my actions.  You deserve to be pain free. That should be a human right of natural law! I'll keep praying for you Deja, thanks for thinking of me during your own time of tribulation.
Power & Magick 2 U,
Peace  & Light on us all,
God Bless,
Wizard

[Thomas]

I apparently f-ed up here, too, by giving out doc dan's hotmail address. I publicly apologize to him for violating his privacy. It won't happen again. In fact, whoever reads this please direct any requests for help or questions of any kind to one of the more humanitarian-minded posters on the board like maximus. I'm sure he'd love to donate his time and wisdom to help. Consider me gone.

Thomas

[Pillpoppa]

Hi Mymy,

Check out my postings to niccee about methadone withdrawl so I don't have to repeat myself here. Your teeth are bad as mine were because zinc is an essential ingredient in hair/teeth/nails etc.

[Vai]

I'm 70 yrs old, have multiple severe pain producing disorders, and have been on high dosages of narcotic prescription meds for over 3 yrs.  I have managed to wean myself off of oxycodone and trazedone.  I am still taking 320 mg of methadone every day. My daughter has moved me to where she lives, and she and my son in law have set me up in a very nice apt of my own, and are doing all they can to help me.  She wants me off of any opiates at all, and is trying very hard to find medical help for me to get off the methadoone. I am on Medicare, and cannot find drs or clinics or anyone to help, as my dosage is so high.  One Dr.gave me a scrip for enogh methadone to last one month, and a referral for help to get detoxed.  We have found  one psychiatric hospital who says they take medicare, and will take me as a patient.  I am so frightened, I am almost suicidal.  Yet I really, really, don't want to die.  I am afraid to go into a hospital, afraid of facing life without strong pain meds, and just don't know what to do.  I feel so obligated to my precious kids for all they've done to help me, that I feel I must go into that hospital she found for me, yet I'm scared to death.  If I had stayed in Hawaii where I lived for most of my life, I would still be on the high doses of meds, living a miserable life. Yet I am here now, and I am glad to be close to my family.  I am just so scared.  Does anyone know of a reputable pain Dr. here in or close to Broward County in South Florida who takes Medicare?  The only ones my daughter has been able to locate won't take me, because they say I'm on too high a dosage, and they won't touch me. Of course, I know she had  been looking for someone to get me off the medication, and not for someone who will continue this course of treating my pain.  Personally, I don't mind taking it, as if works for me.  But I want to please her.  Can anyone help?  Vai

[Cipher]

I was in a car accident 9 months ago and was ejected from my seatbelt while we rolled into a large rock cut. I have incredible back pain.I have been prescribed 120 Percocet a month for pain. However, I usually go through them in about 2 weeks. After that I have to buy at least one 80 MG oxycontin a day or I want to commit suicide so as not to be in pain anymore, or go through the withdrawals. I function very well on one 80MG Oxy a day. Any less and I am a very hatefull person. I don't mind having to live my life on this medication but I spend all of my time thinking of how i am going to get more. I have seen so many doctors that just pass the buck and don't want to prescribe me a dose that works. I am addicted to pain relief.  Not getting high. So I have decided to try and get on Methadone for withdrawal and pain relief. But guess what... 2 doctors from two different meth clinics refused and said i need to be on painkillers... not meth. So I got a referral to a pain specialist from one of them. And guess what... He said I should be on meth. I AM GOING NUTS. This isn't fair. I am so close to ending it all it isn't funny. I don't know WTF to do. I have been teaching college for 10 years now and am not about to let my career go into the toilet over this accident. Anyone have any ideas? I live north of Toronto, Ontario, Canada

[Cipher]

I know exactly how you feel Vai.

[marcatj]

Hi buddy... listen, you posted this post on the end of a VERY old post, so it look like you may have gotten overlooked today.

I don't know how many people are still up tonight.  I also am afraid I personally am at a loss for advice... usually people come on here wanting to get off pills, so that is all I know about...

PLEASE though, do not give up hope.  Post your question again in the morning, however, post it on a new thread (if you go to the beginning of the Addiction Forum, it says "Ask A New Question."  Repost this, and I think you will get more feedback in the a.m.

I would also suggest posting on the Pain Managment forum too, here on Medhelp.  Perhaps there may be info there too, since you are looking for more relief.

I wish I knew what to tell you.. I just don't. :-/  I'm sorry.  But there will be many more on in the a.m., and hopefully (and I'm pretty darn sure) you will get some feedback.  And again, post on a new thread. As well as the Pain Mangmt site.

Hang on buddy... there's an answer out there somewhere....

warmly,
mj

[marcatj]

I just saw your post too.. as well, at the end of this very old thread.

I hope you are still around to post again.  Please do so on a new thread so people will see it - there are many wonderful people here just waiting to help each other out.  I promise you...

Please take care...
mj

[mrshthoward]

I take 10 Miligrams, maybe 4 a night for RLS, Restless Legs Syndrome.  The problem I have is having a severe hot flash at night.  I don't know if it is the Methadone. or meds I am taking for low thythroid condition.  Has anyone experienced similar symptions?  If so please let me hear from you. Thanks.  ***@****

[smokeyjo81755]

have been on methadone for 2 yrs and have had hot flashes for 2 yrs i think it comes with the terratory

[bubbaganoosh]

i found my dose great for dental work no need for additional opiods.

[paulieg66]

I am on methadone and am having hernia surgery. What  will work for pain after the surgery?

[KiaKaha]

Speak to your anaethnetist at your pre operation check up. They are the ones who suss out your post op pain meds.  They'll sort it for you with the least amount of interference with your methadone.

[paulieg66]

I am on methadone and am having hernia surgery. What  will work for pain after the surgery?