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Pain killer's and methadone
I have someone very close to me that can't get off methadone despite numerous attempts... They have tried everything from loritabs to quitting cold turkey and the withdrawals are horendous... My question is if one is on methadone for reasons other than substance abuse or addictions and seeing that methadone is an opiate blocker is there any kind of pain killer such as Oxy's, (that a doctor will actually write a script for) or any other forms of medications or just ways in general other than weaning off or quitting cold turkey that will make the withdrawals bearable?????
As a subscriber to both the pain management and the substance abuse forums, I often see widely different views of the same drug. In this forum, people are looking for pain relief, and in the other, they are trying to recover from the pain relievers they are using.
In the case of methadone, it almost looks like this is the perfect drug. According to my late son, it is one of the better pain relievers, and has a mellowing side effect on the personality that enables a moderate user to feel more socially confident without being physically or mentally impaired in the process -- somewhat like the fictional "soma" in Huxley's Brave New World. Everything is great until you decide it's time to quit, and then everything goes to hell in a hurry. It seems to have taken my son several years to get to this point, and then he spent two years of misery, involving out-patient and resident treatment with suboxone and subutex, and four OD's (the result of decreased tolerance), the last of which was fatal.
Since the person you describe is already addicted to methadone, if the pain problem is chronic and permanent, and the dosage is effective without being high enough to affect function, it might be better to just stay on it. If he/she gets off it, there will be misery from the withdrawals, in addition to the pre-existing pain, which will not be relieved by any other opiate as long as the methadone stays active. Drugs such as suboxone or subutex will help with the withdrawals, but are themselves addictive, and they are not effective with pain. There's a lot of good information about this kind of problem on the substance abuse forum.
In the case of methadone, it almost looks like this is the perfect drug. According to my late son, it is one of the better pain relievers, and has a mellowing side effect on the personality that enables a moderate user to feel more socially confident without being physically or mentally impaired in the process -- somewhat like the fictional "soma" in Huxley's Brave New World. Everything is great until you decide it's time to quit, and then everything goes to hell in a hurry. It seems to have taken my son several years to get to this point, and then he spent two years of misery, involving out-patient and resident treatment with suboxone and subutex, and four OD's (the result of decreased tolerance), the last of which was fatal.
Since the person you describe is already addicted to methadone, if the pain problem is chronic and permanent, and the dosage is effective without being high enough to affect function, it might be better to just stay on it. If he/she gets off it, there will be misery from the withdrawals, in addition to the pre-existing pain, which will not be relieved by any other opiate as long as the methadone stays active. Drugs such as suboxone or subutex will help with the withdrawals, but are themselves addictive, and they are not effective with pain. There's a lot of good information about this kind of problem on the substance abuse forum.
Tuck is right in everything she is saying. I have a lot of exeperience with Methadone as I was on it for over 2 years to treat my chronic pain.
It is a 'VERY' difficult drug to get off of as I know from experience. Tried 3 times and the third time was a charm for me I guess, but it 'CAN' be done and I am living proof of that.
They key is a good MD, a 'VERY' long and 'SLOW' taper, the slower the easier it will be. There are meds out there to help with PAWS and the Dr can discuss those with this individual. The slower the taper, the milder the W/Ds. I also recommend using the liquid form to taper, as then the doses can be even reduced even smaller and smaller and this is much more convenient than trying to cut pills.
Also wanted to tell you than when taking Methadone, other opiates such as Oxy,Vic's,Perc's etc etc do not work the same way as the Methadone blocks those opiate receptors in the brain where those meds are attempting to bind to. It is tough to find a decent med for B/T pain while on Methadone because of this.
Tuck is 100% correct about Methadone half-life, much longer than most other meds usually starting at 72 hours and being as long as twice that.
Check out some of my journals for more info if you like. Also feel free to send me a PM if you'd like further info.
The substance abuse forum has many people there who have experience with Methadone. In the chronic pain realm, it's not as popular amongst MD's who like to prescribe it but some certainly do.
Let us know how your friend is doing and what he/she decides.
Wish you both the best of luck. :-)
Brian.
It is a 'VERY' difficult drug to get off of as I know from experience. Tried 3 times and the third time was a charm for me I guess, but it 'CAN' be done and I am living proof of that.
They key is a good MD, a 'VERY' long and 'SLOW' taper, the slower the easier it will be. There are meds out there to help with PAWS and the Dr can discuss those with this individual. The slower the taper, the milder the W/Ds. I also recommend using the liquid form to taper, as then the doses can be even reduced even smaller and smaller and this is much more convenient than trying to cut pills.
Also wanted to tell you than when taking Methadone, other opiates such as Oxy,Vic's,Perc's etc etc do not work the same way as the Methadone blocks those opiate receptors in the brain where those meds are attempting to bind to. It is tough to find a decent med for B/T pain while on Methadone because of this.
Tuck is 100% correct about Methadone half-life, much longer than most other meds usually starting at 72 hours and being as long as twice that.
Check out some of my journals for more info if you like. Also feel free to send me a PM if you'd like further info.
The substance abuse forum has many people there who have experience with Methadone. In the chronic pain realm, it's not as popular amongst MD's who like to prescribe it but some certainly do.
Let us know how your friend is doing and what he/she decides.
Wish you both the best of luck. :-)
Brian.
Hell Pumpkin,
Welcome to the Pain Management Forum. I am sorry that your friend is having problems.
Methadone has a very long half life. It actually deposits in the tissues of your body and withdrawal can be a long process. My best advice to your friend is to withdrawal with the help of a good physician that is knowledgeable in the area of withdrawal. PMP may be an option.
It is unclear why your friend would want to get off methadone if they are in chronic pain and this medication is helping them. There are other medications that can ease the withdrawal symptoms. I am not real familiar with them. The substance abuse forum may have better answers on those medications but you are always welcome here.
Good luck to your friend,
Tuck
Welcome to the Pain Management Forum. I am sorry that your friend is having problems.
Methadone has a very long half life. It actually deposits in the tissues of your body and withdrawal can be a long process. My best advice to your friend is to withdrawal with the help of a good physician that is knowledgeable in the area of withdrawal. PMP may be an option.
It is unclear why your friend would want to get off methadone if they are in chronic pain and this medication is helping them. There are other medications that can ease the withdrawal symptoms. I am not real familiar with them. The substance abuse forum may have better answers on those medications but you are always welcome here.
Good luck to your friend,
Tuck
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