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Chronic Pain  (Expert Forum)
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Med help for chronic pain
Questions in the Chronic Pain forum are answered by a medical expert

Med help for chronic pain

by 4eversittin, Feb 02, 2009 04:07PM
I am in severe chronic pain due to a Spinal chord Injury.  I know that I will need to be on some form of narcotic pain killer for the rest of my life.  My goal is and this is what I stated to my doc; to be on a low enough dose to cut enough of the pain and still be able to function normally in society.  I do not want to be doped up, high, nodding, or any of that.  I just want to have a better quality of life by reducing constant pain to a tolerable level.  Hence; I was on 20mg OxyContin ER- 1 in the A.M., 2 in the afternoon, and 2 in the evening.  This was a little too much because I was a little drowsy and euphoric sometimes and with the Oxy I had really bad urinary retention that made it difficult for me to sleep.  So I moved to Methadone 10mg every 8 hours.  I like the pain relief from this but like I stated today (which is day 3 of being on Methadone) I was very drowsy and slightly confused all day.  Also one of the major issues with me is worrying about taking too large a dose of narcotic and making breathing even more difficult than it already is.  So, do u think that Methadone is a viable long term solution or should I get off of it ASAP and try something else?
Member Comments (3)

by Amphitrite, Feb 02, 2009 11:37PM
I'm not the expert but I do have an opinion on this subject as more and more pain docs turn to methadone as an alternative to meds like oxycontin.
And the reasons are that unlike meds like oxycontin tolerance doesn't built the same way so the doctor isn;t having to raise the dose to meet th epain need of their patient. And also methadone has shown to be a good pain med used for long term chronic pain relief becauuse of the above reason (and it's much cheaper).

I do have to say you were on a heavy dose of oxy if i understand correctly..20mg 1 in the am, 2 in the afternoon and 2 in the evening. Thats 100mg not to mention taking them they way means they were running into eachother and overlaping which is why you probably felt euphoric at times.
But many pain docs do prefer to pace the meds out three times a day as oxycontin isn't truely known to work the full 12 hours. And being on it myself, it really doesn't. But my doc, well my ex pain doc prefered teh two a day approach.

So my advice to you is that you make sure your comfortable on your meds. If you feel very drowsy see about taking it down a bit and see if the pain is well supported and you feel more alert. But remember also every med has an adjustment period where you may feel more side effects at fist which will disapear as your body adjusts.
But that's def something to mention to your doctor.

I am guessing that your pain doc is the one prescribing the methadone as meth clinics don't treat chronic pain but many have been forced to go out of nessesity for pain support.
They most likely equaled your dose of oxy with methadone to make sure you not only transitioned more easily but that you would recieve enough pain support..or have you a bit of a lower dose(just guesses as I'm not your doc..or close to an MD).

Have you had trouble breathing? Or is it just a fear your experiencing?
If you feel your having trouble breathing I advice that you call your doc asap and have the dose lowered. But if it's just a fear and you feel your breathing is okay, I still suggest you call your doc and talk to them about what your concerns are and what the side effects your feeling are and they will probably do their best to make sure your comfortable.

I hate to hear you say that you will have to be on pain meds for the rest of your life. As another Chronic Pain patient with a disease with no known cure yet, I'm still looking for other options to help like interstisms9I think that's what they're called), non0narcotic options, accupuncture and meditation.

Is there no other option available such as surgery to help correct or improve things or any of the new devices being used for many different kinds of pain that break up the pain signal from your nerves to your brain?

I jusy hate to see another CP patient say this is it for the rest of your life. I've been there of course saying this is how it will always be..meds, meds and more meds...a room filled with pills for the rest of my life. But I realized as sson as I thought that way I was giving up on any other options there may be somewhere.

No judgement of course as I'm in a similiar position and my disease can't be cured and it serious. But I just wish theer was something else available for you or maybe try some things you haven't yet. Like a Tens machine(have to you tried one), accuptincture, water therapy...
Please don't just give up. People like us have few options it's true but as soon as you think this is it for the rest of your life, you tend to just throow in the towel to any other options(and of course I don't know you and am speaking for myself and the others I know who've felt the same way).

Anyway, that's all.

But as for your origional question methadone has actually become quite popular for CP treatment as it has alot of benefits. The one downside is that it has a ceiling effect for other short acting meds if you ever need breakthrough medication like percocet or lortab. Short acting meds don't work as well with methadone. But I've heard many say that not only was it the best decision they made for their pain treatment, but that the amount of money they saved was well worth the switch also.

I've babbled long anough. I wish you all the best in treating your pain. I know how devestating it can be when it's not treated sufficiauntly.
And see what the expert says. He may have a whole other take on Methadone for pain treatment.

Best wishes, amph

by Amphitrite, Feb 02, 2009 11:43PM
Oh I also forgot, methadone has a longer half life which means you need to take it fewer times a day as you would have to take something like oxycontin

by bev62, Feb 06, 2009 03:48AM
Have you tried Duragesic patches?  
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