Need help with this one

[andiLC]

I have been on methadone for opiate addiction for ten years I am so tired of going to a clinic every single day but I have seizures so rapid detox would not be safe. The problem is I herniated 3 disc in my lower back and sometimes it hurts just to turn over in bed. I'm honest doctors about my methadone use and tell them my mg I do the little back exercises and NOTHING it seems to get worse!! I feel like I am being denied necessary medication because I chose to go to a methadone clinic. I know there is a such thing as breakthrough pain so why doesn't this apply to me? If anyone has advice I WOULD LOVE TO HEAR IT!!!! Thanks guys

[philnoir]

Methadone, for some, is the most effective semi-synthetic opioid analgesic available. Invented in the 1930s, it is inexpensive, naturally long-acting, and also has NMDA-antagonist properties that help reduce opioid tolerance.

For those of us with chronic pain that respond well to chronic opioid therapy (COT), methadone is a god send.

However, in the last decade, methadone was introduced to primary care physicians as the perfect pain medication, without proper training in the use of this medication.

Because of methadone's extraordinarily long half-life (anywhere from 24 to 100 hours), the drug can build up in one's system, and in the opiate naive, present considerable danger of opioid induced respiratory depression. In fact, over 1/3 of deaths caused by opioid prescription overdose during the period 1999-2008 were caused by improper use of methadone.

So, state medical boards, state regulatory agencies, addictionologists, and the federal agencies responsible for "protecting" the public against medication have all come down hard on doctors who prescribe this excellent pain medication -- even if the prescribing doctor has the experience and training to safely use this medication.

Because of the mistakes of a few, millions of chronic pain patients who respond well to COT and methadone are now being denied treatment, unless they sign up as "drug addicts" and receive their medthadone at addiction clinics.

This is a tremendous disservice to the people in pain who need this medication, and as a result, we suffer needlessly.

My advice is for every chronic painer on COT who have had success with methadone, which has been taken away from their choice of medications should write their local and federal representatives, as well as state medical boards regarding the needless suffering we undergo because of their sweeping bias against one of our most effective pain medications.

Its one thing to keep opiate naive people away from methadone. We certainly don't want untrained doctors killing people in acute pain with inappropriate opioid medication choices. But denying methadone to long-time opiate tolerant people who have years of positive response to methadone allowing them to live productive lives, condemning them to a life of suffering to cover the ignorance of inexperienced prescribers is tantamount to malpractice.

We need to recognize that there are three classes of opioid users -- the opiate naive, the opiate tolerant who require opioids for a year or two, and the chronic intractable pain patient who will require strong opioids for rest of their life in order to live functional lives.

[mandi66]

Hi andiLC,

You mentioned getting your methadone everyday at a clinic.  That is liquid methadone.  The rules at the clinic you go to have to be followed to a T or.  your contract will be broken.  Read the contract that you signed when you decided to become a patient there.

The rules at a methadone clinic are very strict, very different than if you were a patient at a primary care doctors' office or pain management doctor.  You would be able to take break-threw meds if you were not a patient at a clinic (liquid methadone).

If you have maintained well at the clinic-no dirty ua's, and compliant, then you could switch over to reg dr. or pm dr.  They could give you methadone in pill form and a bt med like percoset. lortab, oxycodone etc.  The doctor could slowly wean you off your methadone and put you on something entirely different.  Or you could opt for no meds after he slowly weans you off the methadone.

Only you know what road you choose to take.  It is your decision alone.  But it does help to get some help regarding which road you wish to take.  This forum is here to help support you.  These are big decisions, not to be taken lightly.

Good luck to you.  We will be here to support you.  I know firsthand how good it feels to know someone cares and will be here to listen when you need to talk.               mandi

[remar]

I'm not sure how much help I can be but I do have a couple of questions.
Are you in pain management or do you get your Methadone prescription from your primary Dr? Are you saying you're ready to get off of this medication? If so, it can be done but with you it has to be done very slowly. I'm not sure what pain medications you can take along with Methadone.
If I were you and did want to get off of this medication and be able to take pain medication I would find a highly trained pain specialist to work with.
No, I don't think it's fair for you to be denied pain treatment because you're on Methadone. Like I said though, I'm not sure if it's even safe to take any pain meds with Methadone. Another reason you might be denied is because you have a history of opiate abuse and Drs don't want to see that happen again. Have you actually worked with a physical therapist before? For some people it do wonders for their pain.
We have many wonderful and very knowledgeable members here on the pain forum. I think they will read your post and hopefully give you some answers.