Transfer from Methadone to Pain Meds?

[blues1580]

I have been on a high dose of Methadone for a number of years for Chronic pain. I go to a clinic but recently asked my doctor if he would take over my care and switch me from going to the clinic, over to a time released morphine pill I can take once or twice a day. He won't write me Methadone and is reluctant to do it at all because he's never had a patient that he's had to transfer from methadone to a morphine pill before . Has this ever happened to anybody and what amount of timed released morphine would it take to transfer from 170mg methadone over to the other?

[opus88]

sorry to jump in on your thread Blues with a question for Marge.
Does your Dr. wean you when you go from one to the other and back? and if so aren't you in alot of pain while doing so?
And each time you go from one to the other than back again are you than able to start at a lower dose than where you were at before stopping each one?
I guess you'd need to be if tolerance was the reasoning?...sounds like an interesting concept.

[Mage1970]

I've gone in both directions - pain meds ( Oxy/Fent ) to Methadone/Physeptone and back . It really does depend on what your PMdoc is willing to try . If your taking Methadone liquid I found going onto the PhyseptoneSR tablets not too bad , but switching back to an opiate based tablet was problematic . As Tuck stated theres no conversion chart as there is with opiate to opiate . Both myself an my management clinic believe in changing up every 9 to 12 months to lessen the chance of of building tolerance to any particular , but thats me and mine , some people stay on the one drug for years without problems .

[Tuckamore]

Hello Blues,

Welcome to the Pain Mangement Forum. You've asked a good question. One that I have not seen on the forum before.

I am sorry but I do not have any personal knowledge that can assist you. I assume that the methadone has been for Pain Mangement but is no longer effective.

Most of what I read says that methadone is more effective than morphine at treating pain and typically causes less adverse effects. That may be the reason your physician is reluctant to RX morphine. The use of methadone has gained renewed interest due to its low cost and potential activity in neuropathic pain syndromes.

I have also read that it is the difficult to convert methadone dosage to another strong opioid. It has varying absorption rates from person to person. There are no accurate charts that tell you if you take 50mg of Methadone that will equal 60 mgs of Morphine. Conversion is usually done by trial and error.

You might want to consult a PMP or discuss this with a pharmacist that you know and trust. Good luck to you. Maybe one of our members will more information for you. Please keep in touch and let us know how you are doing. I will look forward to your updates. We all learn from one another.

Take Care,
Tuck