Methadone with Duragesic?

[dopesick]

Currently on Duragesic patch 100mcg q48hrs, Doc wants to add 10mg x3 daily p.o. Methadone to extend the patches. Any thoughts on whether one would cancel out the effectiveness of the other? In other words, would the methadone in any way block the Duragesic? Would I be better off taking them together or using up the patches and then switching to the meth each month?

thanks
dopesick

[Shotalotofdopeamus]

I would get your doc to put you on 30mg x 3 p.o. roxicet rather than methadone. Fent has a very short half life and so does oxy compared to methadone but with a fent patch and roxi when you need it you should be able to function. Methadone is one hell of a gorilla to have on your back. You have not been sick till you've kicked methadone. It lasts forever. But to answer your question mixing the two should be quite nice. You might still feel some pain but you wont give a fuck. Adding in methadone on top of fent will increase the analgesic effect the patches have on you already. Good luck...IMHO try to get the Roxicet before you get on methadone.

[Canis aureus]

I don't know about fenttanyll's affinity. Methadone has strong affinity and may hold your receptors too well, meaning that fentanyl could not break trough...

[rachamim18]

Your MD is correct. It is amild dosage and even when considering the grand total, 30 mgs. per 24 hours, it is not enough to flood your receptors. Instead it will boost both analgesia and psyoactive effect. I would surely go for it if I were drug seeking OR in need of heavy analgesia.

[Hammilton]

rachamin is right, methadone at that dose is neither enough to block your receptors or to cause much of a dependence.

Halflife isn't much of a concern when you're taking a fent patch, since it lasts about 3 days, in theory anyway.

I don't think that adding the methadone is going to extend the analgesia from the patch, but it might feel like it.

Methadone isn't as good at providing analgesia as many people think, but your 3x daily is a good way to do it.

[dopesick]

Shotalot, the Doc for some reason won't go for roxi's or oxycontin, but he suggested the 'done. To Hammilton, Rachamim18 and Canis aeuris, thanks for the replies. Since it seems the only way he will go, I will give it a try. While we're at it, what kind of dose of methadone do you think would be good to completely replace the patches? It would be a cheaper way to go, since I have no insurance. Would I be giving up the euphoria from "off-label" use of fentanyl or does methadone give a similar buzz at high enough doses?

thanks
dopesick

[Ghost666]

Methadone can definitely get you buzzed pretty good and I don't think it takes a whole lot either, depending the person pf course.

I started MMT treatment today. For the last 6 or 7 months I've been using pretty high amounts of OC's and hydros. If I'm scripted 150 Lortab 10's I take 7-8 of them 3-4 times a day. On OC script time I go through 80mg's 3 times a day easily, chewed. Been doing that much for a while now, give or take a few days here and there while I'm budgeting them to not get sick. Oh, and budget my ass...lol. As you sit there only going to eat 2 20's, do so, then quickly grab 2 more and start chewing, telling yourself, "Ill be alright. I'll just only take 2 per day the last 3 days." Of which, the next day later you are now down to 2 to last you the next 2 days, of which you gobble them both up together, leaving you a day or two without.

Well, today I took my initial dose of methadone which is always 30mg. I drove home and crawled back into bed and started to feel a tad better in half an hour and fell asleep. Woke up 45 minutes later and was actually pretty lit. I felt quite groovy and had this little smirk on my face. Dozed back off for another hour then got up for work and felt it even stronger yet. I was ready to attack my day, I felt great. I have a back up bottle of 60 Lortab 7.5's just in case I felt like crap today but I didn't touch them. Tomorrow is my day off so I may munch a few to curb my curiosity of if I'll feel anything or not. My back pain is also a little high still so that's primarily why I may munch a handful. If they do no help and I don't feel them, urge to take them will be gone and I'll save them for a rainy day. My dose tomorrow will be 35mg methadone at 5am, won't try the lortab until early afternoon. I'll tell you the results....

[rachamim18]

On the last post. Yeah, that is pretty much all you do for the first few years on methadone, sleep all day. I hated it at first but got used to it after a while.

As for how much methadone to replace your patches? There is a complicated equigesic formula for the two, do not know about tables for the 2 but I am sure they exist.

Subjectively, in Florida I was on 100 mgs. of methadone, (limit there) and was given a couple of boxes of Duragesic among other things. OF course I wanted to gain beenift buyt do you know , even with 5 patches that I tampered with to defeat the time release matrix, I only was able to gain the tingling palate (subdermal administration,. IV might have been a whole lot better). It is a strange interaction. The receptor values for Fen are pretty good , nothing is ever comprable to methadone but these numbers are pretty nice and yet methdone, the monster, ate it up post haste.

Your doctor will be able to caluclate just how much you will need.

Methadone is actually now believed to be pretty good for analgesia. Latest work backs it up and of course Pain Relief specialists are now turning towards it Interesting to see how America deal with the shift. I would hope it would have a positive effect in terms of accessibility,etc. but am afraid that the govt. will use it as an excuse to limit it even more to addicts.

[reddragon3668]

Methadone isn't as good at providing analgesia as many people think, but your 3x daily is a good way to do it.

That is a very subjective statement. I just recently changed meds, but was on methadone for over six years for chronic pain. In my opinion, it is one of the best analgesics out there. Unfortunately, however, tolerance became a big issue for me and at higher doses, the side effects can start out weighing the benefits.



While we're at it, what kind of dose of methadone do you think would be good to completely replace the patches? It would be a cheaper way to go, since I have no insurance. Would I be giving up the euphoria from "off-label" use of fentanyl or does methadone give a similar buzz at high enough doses?

I've read here that allot of people get a nice "buzz" off off methadone. For me though, I never really experienced this except maybe in the very beginning. My highest dose was 240mg a day and there was absolutely no euphoria. But, there were other things... my emotions were very level, I had more energy (as opposed to the morphine I am taking now), and while I did nod from time to time, methadone caused allot of insomnia in me. For me, it really was a mixed bag.

Personally, for years I praised the virtues of methadone in pain mgmt... much for the same reason you suggested: the cost/benefit analysis. I did not have insurance either and it was cheap. But in retrospect, I don't think I would have ever went on it knowing what I know now. From what I understand, fent sucks to kick, but methadone is an absolute bitch! Just that alone, for me, was enough to make me want off of it.

Supplementing your fentanyl with methadone will likely be a nice combination. But try and keep it as low as possible. If you do need to switch to methadone due to financial constraints, then I am sure it will do you well. The conversion amounts are not an exact science, but I think it will be allot easier to switch from fent to methadone than the other way around. Methadone's blocking effect makes it difficult and an arduous process to get regulated on something else.

Good luck and let us know how it goes!

[Paregoric Kid]

methadone and fentanyl can be a very powerful combination.

[OpiatedSoul]

I need to update my profile, I'm not on either Fentanyl or Methadone anymore, however when I was on them together I didn't get anything from either except hard core nodding all the time! I don't know if they effected each other or not since I have never just taken Methadone alone without the Fentanyl, but when I was on the Fentanyl alone I still had some considerable nodding.

[oxydose]

I didn't get anything from either except hard core nodding all the time!


what fucking more do you want? jeeez you mofos are hardcore!


lol jk i know what you meant

[rachamim18]

On the La Guardia quote...Fine except most Americans DO want this form of prohibition to be retained just so. Ignorance is truly bliss.

[OpiatedSoul]

what fucking more do you want? jeeez you mofos are hardcore!


lol jk i know what you meant

Ha ha! Some hardcore nodding would be nice right about now. Wish I still had those patches!

[dopesick]

Thanks for all the good posts guys. I appreciate all the opinions and ideas.