Cost of methadone vs sub for chronic pain

[4afriend]

If a person has a chronic condition (reverse lordosis of the cervical spine) and needs pain control despite a history of opiate addiction, which would you recommend...methadone or sub?

When she was diagnosised they placed her on vicodin's for the pain.  She took them as prescribed but with the opiate addiction only a few months behind her, she hated feeling drugged and having to rely on them for her pain so she had the dr. prescribe her sub for it instead.

She said that this condition is irreversible, therefore will need the pain control for the rest of her life.  She doesn't have insurance at this time, so she is paying out of pocket for the sub and honestly doesn't have the finances for that.  With no insurance, would methodone be cheaper for her to use? I don't know the cost for methadone.

Am I right on thinking that it shouldn't really matter which one she is taking since she will have to be on them forever anyways?  Would going with the best affordability be the best way to go for her?  If she were to switch from sub to meth, will it be hard for her Physically/emotionally?

Any input would be greatly appreciated...

[iloveny630]

I just wanted to say that I think you are a great person for being so concerend about your ex and his girlfriend.  I know that you have a right to be concerned since your children are around these people but it seems that you genuinely care about them.

[4afriend]

Thanks for all the info and input in regards to my post.  However since my post I've learned that the sub treatment she is receiving is for addiction only.  The pain I was informed of was just to keep from having to say that there was a relapse.  She is my ex's girlfriend.  I knew last summer she went into detox for a bad oxy addiction, however they had split up before she was released.(due to other issues).  They reconciled this past spring, so I had asked if she was still using or had followed up with after care.  He had told me that she was fine and that the problem that she had had wasn't that bad.  It was later when he wasn't having any money that I had learned of the "back problem" and the need for sub for pain control.  I think they just didn't want me to know about the problem.  Which honestly, I care about the problem (I have dealt with my own demons) but I don't believe any addiction makes for a bad person...it makes that person be human.  The only hopes that I have had is since she is aware of her problem and she is around my kids, is that she take it seriously and maintain the care that she needs.  Flash forward from spring to now...I, within the last couple of weeks, have learned that my ex also has an oppiate addiction.  Very bad for him, because he will always be around and have easy access to them due to his work.  So his treatment is imperative.  Their plan for his tx is for her to continue the sub treatment since it is in place and he shares hers..because he can only afford to pay for one person.  She hasn't worked in awhile and just started a new job.  My concern is/was that he needs to have his own personal treatment for this illness too. Pills will be in his face everyday.  He says he's going to use it for 6 months and then be done with it because he just needs to get used to not taking them and then he will be fine.  They both refuse any encouragement for counseling/after care because they say they don't need that with the sub.  When I had thought she was using for pain control, I thought I had the perfect solution...Meth for her since she would always need it and it is cheaper and job stability for insurance isn't her thing.  And since that would be cheaper, he could do the sub plan but with his own dr. to help supervise/monitor him and his progress....But anyways...thanks for all the info, I had really thought I was finally onto something good there for awhile...

[wildwoodone]

Posters are correct that Sub is not approved for chronic pain use mainly because it is only an opiate partial agonist.  Methadone is your best bet for chronic pain and I think cheaper.

[4afriend]

Thank you so much for sharing your experiences btn the meth and sub.  That was exactly what I was wondering.  Although, I'm sure that getting off of either differs for everyone...personal experiences/knowledge was exactly what I was looking for.

I have tried to encourage her to add other additional non medicinal things to her pain control effort, however she is resistant to try any because she says the sub helps it already so there is no other need to.   She been on it since April and I think she's just found comfort in knowing she doesn't need the opitates while she has the sub and that her pain is in control.  The only problem is the fact of the cost for long term use/control.  Job stability hasn't been one of her things so insurance coverage could be an ongoing issue.  At this time she has us helping paying for her treatment, however I don't know how long this can go on either...it's so expensive.  She just recently started a new job, however it is one that I personally wish she didn't take, because it will take a big toll on her back without a doubt.  But she said it's the only thing that could possibly pay enough to help get her treatment.  I'm afraid were fixing one thing and then hurting the other...

Thank you for your well wishes and may I pass some along to you as well.  I hope you continued success with your recovery and hope that your symptoms will subside further for you in the near future so that you may truly be able to enjoy all your efforts and hard work

[TysonRed]

In my own humble opinion if the person is looking for pain control, methadone is a far better option. In most instances I think methadone would almost always be the cheaper alternative. The one bad thing about methadone usage for long periods, the doses for pain always increase over time leading to very high dosages and severe dependence. In my experience with suboxone, it had no noticeable pain relieving benefits. From what I understand the best pain relief that buprenorphine can provide comes from Buprenex which I believe only comes as injections. I can tell you that Ive gone thru both methadone and suboxone withdrawals and to me suboxone is no easier if not harder than methadone to get off. I tapered off of methadone very slowly from 80mgs to 2.5mgs and had some bad w/d's. Years later after getting myself wrapped up in opiates again, I started a suboxone treatment. After 18wks of using sub, tapering down to a crumb .25mg, Ive experienced the worst set of w/d's in my life. Im not exactly sure if I did something wrong, besides take it too long, but 20days later and Im still suffering. Now Im not familiar with your friends condition and have no idea what her pain is like, but I can tell you there is always alternative pain relief besides opiates. I wish you and your friend all the best, take care and good luck!

[4afriend]

I will make sure she understands the "ball and chain" concept of meth.  From my understanding, sub can be the same with long term use.  Although, I couldn't tell you if one is worse than the other...I only know what I have read on here.

All of this should be better once she has health insurance..however if she is able to keep the job she is just starting, it will be at least another three months before she is eligible.  I would imagine once she gets coverage, she could still do the sub if she chose to due to her history with addiction...it should be covered that way wouldn't it?

From what she says its an irreversible condition...although she may be saying it's irreversible right now due to no insurance for any other possible treatments/fixs.  I guess I should and will ask her that.  If she can get some sort of medical treatment for the condition once her insurance gets in place, it would probably be best just to continue what she is doing and bid her time waiting these few months.  As long as they don't give her the "pre existing" clause...Ugh I hate insurance companies!!!

Thanks for you input!

[cattalina]

Suboxone is not FDA approved for use with chronic pain, and it generally only used to help addicts get off of other opiates. Switching from sub to methadone shouldn't be too difficult physically, emotionally it depends on her state of mind regarding her illness/addiction.  If she absolutely has to take pain meds, it makes more sense to go with something that will work and isn't as expensive. Methadone is a ball and chain - make sure she knows that.