dangers of methadone w/d with AVM in brain

[haley726]

I am almost a month out of the methadone w/d's. I went to my bi-annual MRI and neuro appointment yesterday and didn't get the news I wsnted to hear. He said because of the w/d my blood pressure was dangerously high and can put extra pressure on the AVM. He put me on blood pressure meds and a loe dose of vicodin to stop w/d's until we get the MRI results in next week. He said then we could discuss an "appropriate" way to get off the narcotics so he could monitor me. Basically, a long term taper. He also reminded me that I have severe migraines from the AVM. Thanks doc... I remember. That's what started me on narcotics in the first place. I guess my question is... Is the neurologist full of it or is it dangerous in my case to quit CT?

[J T Junig, MD PhD]

Please understand that I can't give advice counter to your neurologist in the case of an AVM-- which as you know is a very dangerous situation.

But.. opioid withdrawal is NOT necessarily associated with increases in blood pressure.  I suppose it may be in some people.  But in my case, my blood pressure was very low during withdrawal.  In fact, the doc in my detox wrote to 'hold clonidine if BP less than 90'-- and I could not get a dose for the 4 days I was there, as my systolic BP never broke 90!  Of course, I was dehydrated from diarrhea and sweating buckets...

AVMs can be complicated in how they respond to blood pressure;  some may be more affected by higher pressure on the venous side, and others by high systolic arterial pressure.  But arguing with one's doc about hemorrhoids is one thing--- and arguing about managing and AVM is entirely different.  I think you need to take your docs advice-- and if you really don't trust it, go to an academic med center and have an expert in the field provide an opinion.  I would NOT stop opioids CT if I had an AVM that was possibly expanding.

Best wishes to you-- take care of yourself.

[haley726]

where can I go to find the academic med center? I have just fought so hard for 30 days to get to this point, and just want a second opinion. What are the differences between methadone w/d and vicodin w/d? How would vicodin be more "appropriate" to taper off of than methadone?