Methadone for Pain Management - Some Questions

[DemonFairy]

Hi, I've been reading this board for a couple of weeks now. It's the only place I've found with so much good information about Methadone. Since I'm sure you know more than my pain management doctor, and I have an appointment in four days, I wanted to ask a couple of questions here first, so I was armed with the proper information. He's a good doctor, he's mostly very helpful, but sometimes he's a bit arrogant (or insecure) about things he doesn't know. For instance, my partner and I both have fibromyalgia and have been doing tons of research, and the one thing we definitely haven't tried that we think might work is Xyrem. He's never heard of it (how is that possible!?), and thinks that if a drug rep hasn't come by pushing it, then it isn't worth trying. Never mind that the Fibromyalgia Network, that he's a part of, has had several in-depth articles about how Xyrem is helping patients get restorative sleep that is making it so they no longer need their other meds. Anyway, that's the background of what I'm working with.

I started taking Methadone almost a month ago, and except for the nasty nausea side effect in the beginning, it's done a really great job relieving my general all over pain. It lasts longer than OxyContin for me, and is SO MUCH cheaper (I maxed out my pharmacy coverage for the year at the end of March, so I have to pay cash for everything now :mad:)and I'm mostly happy with it. However, a couple of weeks ago, I noticed that my breakthrough pain meds weren't working at all. I read here that you need to be taking at least 80mg/day for the oxycodone to stop working. I'm only taking 30mg/day (10 mg every 8 hours) - is it possible that such a low dose could keep my oxycodone from working? I don't think it's my imagination. Yesterday, I took a really high dose for me (ugh, have extra pain from doing some simple work on the pool), a dose which would've made me nauseous last month (40mg), but I didn't feel it at all. No pain relief, no nausea, no buzzy feeling, nothing. I really need my breakthough meds to work, because even though the Methadone is working really well on my general pain, it isn't able to wipe out the specific pinpointed pain. Has anyone had this trouble on such a lose dose? And, if my oxycodone won't work, is there another med you could suggest that would work?

That said, I'm also having trouble with the Methadone affecting my bladder. I've had weird bladder problems that were finally fixed in March with a new med called Enablex. It's been my wonder drug, and two weeks ago, it quit working. It's a problem that makes it so I can't sit comfortably at my desk and work, and I work online from home, so that's bad. It only affects me when I sit too. I'm not sure if the Methadone is blocking the Enablex from working, or if the side effects from the Methadone are making my bladder worse. Regardless, if it doesn't improve, I'm going to need to quit taking the Methadone and go back to oxycodone and/or OxyContin, or whatever else might work to get rid of the pain. My question is about withdrawal. You guys have absolutely terrified me about quitting the drug. Ugh. So, if someone could tell me how to taper in the easiest, most painless way possible, I'd appreciate it. I have access to whatever other meds I might need to make it easier. I've been taking 30mg/day for a month, so how long would it take me to taper if I'm switching back to oxycodone? Would I need to take lower and lower doses until I was completely off it and then switch over? Could I take lower doses for a week and then quit and switch over?

Any help you could give me would be greatly appreciated. Sorry to be so wordy in my first post here, but I needed to try to explain some of the reasons for my questions. I'll try not to be so boring in my future posts. :)

[Synack]

Hi, I've been reading this board for a couple of weeks now. It's the only place I've found with so much good information about Methadone. Since I'm sure you know more than my pain management doctor, and I have an appointment in four days, I wanted to ask a couple of questions here first, so I was armed with the proper information. He's a good doctor, he's mostly very helpful, but sometimes he's a bit arrogant (or insecure) about things he doesn't know. For instance, my partner and I both have fibromyalgia and have been doing tons of research, and the one thing we definitely haven't tried that we think might work is Xyrem. He's never heard of it (how is that possible!?), and thinks that if a drug rep hasn't come by pushing it, then it isn't worth trying. Never mind that the Fibromyalgia Network, that he's a part of, has had several in-depth articles about how Xyrem is helping patients get restorative sleep that is making it so they no longer need their other meds. Anyway, that's the background of what I'm working with.

I started taking Methadone almost a month ago, and except for the nasty nausea side effect in the beginning, it's done a really great job relieving my general all over pain. It lasts longer than OxyContin for me, and is SO MUCH cheaper (I maxed out my pharmacy coverage for the year at the end of March, so I have to pay cash for everything now :mad:)and I'm mostly happy with it. However, a couple of weeks ago, I noticed that my breakthrough pain meds weren't working at all. I read here that you need to be taking at least 80mg/day for the oxycodone to stop working. I'm only taking 30mg/day (10 mg every 8 hours) - is it possible that such a low dose could keep my oxycodone from working? I don't think it's my imagination. Yesterday, I took a really high dose for me (ugh, have extra pain from doing some simple work on the pool), a dose which would've made me nauseous last month (40mg), but I didn't feel it at all. No pain relief, no nausea, no buzzy feeling, nothing. I really need my breakthough meds to work, because even though the Methadone is working really well on my general pain, it isn't able to wipe out the specific pinpointed pain. Has anyone had this trouble on such a lose dose? And, if my oxycodone won't work, is there another med you could suggest that would work?

That said, I'm also having trouble with the Methadone affecting my bladder. I've had weird bladder problems that were finally fixed in March with a new med called Enablex. It's been my wonder drug, and two weeks ago, it quit working. It's a problem that makes it so I can't sit comfortably at my desk and work, and I work online from home, so that's bad. It only affects me when I sit too. I'm not sure if the Methadone is blocking the Enablex from working, or if the side effects from the Methadone are making my bladder worse. Regardless, if it doesn't improve, I'm going to need to quit taking the Methadone and go back to oxycodone and/or OxyContin, or whatever else might work to get rid of the pain. My question is about withdrawal. You guys have absolutely terrified me about quitting the drug. Ugh. So, if someone could tell me how to taper in the easiest, most painless way possible, I'd appreciate it. I have access to whatever other meds I might need to make it easier. I've been taking 30mg/day for a month, so how long would it take me to taper if I'm switching back to oxycodone? Would I need to take lower and lower doses until I was completely off it and then switch over? Could I take lower doses for a week and then quit and switch over?

Any help you could give me would be greatly appreciated. Sorry to be so wordy in my first post here, but I needed to try to explain some of the reasons for my questions. I'll try not to be so boring in my future posts. :)


My friend, I don't know what to tell you but if you switch back to the oxy you should be okay. I didn't catch how long you've been on the done but a few days might be hell in between the switch..

Good luck.

[youwonhundred]

I notice you're in Vegas. Who's your doc?

[DemonFairy]

My friend, I don't know what to tell you but if you switch back to the oxy you should be okay. I didn't catch how long you've been on the done but a few days might be hell in between the switch..

Good luck.

I've only been on it for a month. So, you think I should be able to switch back over to oxy quickly? This forum has terrified me about withdrawal. I've never had any w/d experiences, although I did have a relative stay with me for a couple of days detoxing from alcohol. We fed her Ativan, 7-Up, toast, and a whole lot of sleep with kittens to pet when she woke up. Seemed to not be too bad physically.

I would love it if I could get back to the oxy within a few days, because this bladder problems sucks. It's so sad though, I loved how cheap methadone was, and how long it lasted.

[DemonFairy]

I notice you're in Vegas. Who's your doc?

I'll send you a PM with his name. I don't want my posts associated with his information publicly, although except for the Xyrem issue, I have nothing but good things to say about him. It's gotten kind of expensive seeing him, because I've had to go every month at $95 each (my co-pays ran out in January), but he's been trying to help. I had oxycodone from my back surgeon when I started seeing him, so oxy was what I started with, but the pain kept getting worse, so I wanted to try something new. My partner tried Fentanyl patches and wasn't thrilled with them, so I didn't even bother. Methadone was recommended by an RN friend who did hospice work, so I figured she knew her pain management.

ETA - Alas, I can't send PMs yet, so if you'll send me an email to MrsCrump AT gmail, I'll let you know his name.

[Hammilton]

There's no fucking way in hell you're going to be prescribed Xyrem for fibro. You'd be fucking retarded to even ask for it. I wish I could give negative points for that post.

I'm not trying to be mean here, but guess that was the result, but holy christ- how quickly do you want to be labeled a drug seeker? Asking for pharmaceutical GHB is moronic beyond belief. It's approved for one thing- and is considered a C1 (that's moronic, too). How about asking for LSD and Heroin while you're at it? Maybe he'll script you some shrooms.

A doctor not knowing about Xyrem isn't a big surprize. It's not a pain med. It's a narcolepsy treatment for fucks sake. I can't believe no one else commented on this before I did. I bet you could ask him for the triple cocktail or some other meds completely erroneous to the treatment of pain and he won't know shit about them.

Did you actually thing before you posted this? We're a bunch of dope heads here, but we're not stupid enough to believe that docs should know about every med on the market- no matter how erroneous to their specialty- and be willing to prescribe schedule 1 meds. It's simply not how things work. If you want to scam a doctor, you sure as fuck should know better than asking for C1 meds not remotely associated with pain relief.




shit, now I know I'm taking a noob-bashing vacation, but trust me, I'd say the same to anyone who posted the same, whether it was one of you cool 10K Pointers, a 25 pointer or an aspiring opionomo.

[paper skeletons]

There's no fucking way in hell you're going to be prescribed Xyrem for fibro. You'd be fucking retarded to even ask for it. I wish I could give negative points for that post.

I'm not trying to be mean here, but guess that was the result, but holy christ- how quickly do you want to be labeled a drug seeker? Asking for pharmaceutical GHB is moronic beyond belief. It's approved for one thing- and is considered a C1 (that's moronic, too). How about asking for LSD and Heroin while you're at it? Maybe he'll script you some shrooms.

A doctor not knowing about Xyrem isn't a big surprize. It's not a pain med. It's a narcolepsy treatment for fucks sake. I can't believe no one else commented on this before I did. I bet you could ask him for the triple cocktail or some other meds completely erroneous to the treatment of pain and he won't know shit about them.

Did you actually thing before you posted this? We're a bunch of dope heads here, but we're not stupid enough to believe that docs should know about every med on the market- no matter how erroneous to their specialty- and be willing to prescribe schedule 1 meds. It's simply not how things work. If you want to scam a doctor, you sure as fuck should know better than asking for C1 meds not remotely associated with pain relief.




shit, now I know I'm taking a noob-bashing vacation, but trust me, I'd say the same to anyone who posted the same, whether it was one of you cool 10K Pointers, a 25 pointer or an aspiring opionomo.


Actually, there are studies linking it to fibromyalgia, but only to the chronic fatigue portion of it. If someone asks a doctor for xyrem to treat PAIN, they're up a creek.

[DemonFairy]

There's no fucking way in hell you're going to be prescribed Xyrem for fibro. You'd be fucking retarded to even ask for it. I wish I could give negative points for that post.

I'm not trying to be mean here, but guess that was the result, but holy christ- how quickly do you want to be labeled a drug seeker? Asking for pharmaceutical GHB is moronic beyond belief. It's approved for one thing- and is considered a C1 (that's moronic, too). How about asking for LSD and Heroin while you're at it? Maybe he'll script you some shrooms.

A doctor not knowing about Xyrem isn't a big surprize. It's not a pain med. It's a narcolepsy treatment for fucks sake. I can't believe no one else commented on this before I did. I bet you could ask him for the triple cocktail or some other meds completely erroneous to the treatment of pain and he won't know shit about them.

Did you actually thing before you posted this? We're a bunch of dope heads here, but we're not stupid enough to believe that docs should know about every med on the market- no matter how erroneous to their specialty- and be willing to prescribe schedule 1 meds. It's simply not how things work. If you want to scam a doctor, you sure as fuck should know better than asking for C1 meds not remotely associated with pain relief.

shit, now I know I'm taking a noob-bashing vacation, but trust me, I'd say the same to anyone who posted the same, whether it was one of you cool 10K Pointers, a 25 pointer or an aspiring opionomo.

Ugh, don't be a jerk. Xyrem has been in trials for years for the treatment of fibromyalgia because it's thought that fibromyalgia is a sleep disorder versus a pain disorder. LOTS of people take Xyrem for fibro. http://www.jazzpharmaceuticals.com/news.php?id=17 This study was two years old, so I'm not even cutting edge on this treatment. If you do a search, there are sites all over the place discussing Xyrem and fibromyalgia. The reason I discussed it with my doctor (who is in the Fibromyalgia Network), is because in the April 2007 issue of the Fibromyalgia Network Newsletter (which means my doctor SHOULD be reading it), there's a detailed story by a woman who took Xyrem, and is now able to function well and pain-free, and no longer needs her other meds. Because my sleep is non-restorative, meaning no matter how much or how little sleep I get, I still feel exhausted, I wanted to explore trying something that's been proven to help fibromyalgia. I'm sorry that you're not smart enough to do a simple search for Xyrem & Fibromyalgia, before you wasted your time attacking me, and oooh, wanted to give me negative points. Oh so scawwy.

I'm not trying to scam any doctors. I'm not a drug seeker. If I was a drug seeker, I wouldn't have chosen Methadone over OxyContin, oxycodone, fentanyl patches, etc. I'm not looking to get high, I'm looking to get rid of the constant pain I'm living with. I don't care how you get your jollies, I'm here on this board because I wanted advice from people who have experience with methadone. I'm not here to learn how many pills of whatever, combined with whatever else, will get me the most high. Honestly, if you guys want to get high, that's fine by me. I think drugs should be legal and money should be spent on education & rehab versus prison.

You know what surprises me? It's not that you attacked me out of sheer ignorance, it's that you didn't even bother to do five seconds of research to see if you were right. Because if you had, you wouldn't have had to waste your time posting at all. Or hell, maybe you could've posted something helpful.

Here's someone from the National Fibromyalgia Association looking for success stories - perhaps you ought to write him an email or call him, you need to let him know that anyone taking Xyrem is just looking to get high, because you're on a message board about opiates, so you know everything.

------- Do You Have a Story? -------
The NFA is currently seeking patients who are successfully taking Xyrem (sodium oxybate) for sleep. The FDA currently acknowledges its use in a select group of patients with narcolepsy (a disorder characterized by spontaneous, sudden episodes of falling asleep without warning) in order to reduce the number of attacks of cataplexy (weakened or paralyzed muscles). However, recently, some clinicians have prescribed its “off-label” use for their fibromyalgia patients with some very promising results. We are planning an upcoming article for the magazine on sleep and we would like to share your success stories with our readers. If you would like to share your story, please contact edeffner@fmaware.org (edeffner@fmaware.org) or call (714) 921-0150 .

[DemonFairy]

Actually, there are studies linking it to fibromyalgia, but only to the chronic fatigue portion of it. If someone asks a doctor for xyrem to treat PAIN, they're up a creek.

Closer, but still not true. Hey Admins, I know this is veering off-topic (I own & admin several forums, so I know it can be annoying), but if there isn't any more advice for me about my original questions, at least this can turn into an educational thread about fibromyalgia. I know there are people here who are dealing with chronic pain, perhaps some of them are FMS patients.

02/23/2006 | Press Release

STUDY FINDS THAT XYREM® (SODIUM OXYBATE) RELIEVES PAIN
San Diego, California - February 23, 2006 - Patients with fibromyalgia syndrome taking Xyrem® (sodium oxybate) in a Phase II clinical trial experienced significant pain relief, according to data presented today at the annual meeting of the American Academy of Pain Medicine in San Diego.

“The pain of fibromyalgia is notoriously difficult to treat,” said Patrick B. Wood, MD, of the Louisiana State University Health Sciences Center in Shreveport, Louisiana. “The results from this trial are quite encouraging, and further study is warranted."

The 8-week randomized, double-blind, placebo-controlled study examined two dosages of Xyrem (4.5g per day or 6g per day) taken in two equally divided doses (the first at bedtime and the second 2.5 to 4 hours later). The intent-to-treat population included 188 patients [randomized to Xyrem 4.5g, n=58; Xyrem 6g, n=66 or placebo, n=64], of whom 147 [78%] completed the trial.

The primary outcome variable [POV] was a composite of changes from baseline in three co-primary, self-reported measures: Pain Visual Analog Scale [PVAS], captured with electronic diaries; Fibromyalgia Impact Questionnaire total score [FIQ]; and Patient Global Impression of Change [PGIC].

In the intent-to-treat analysis, a statistically significant benefit in the POV was seen in both doses of Xyrem compared with placebo [4.5g, p=0.005 and 6g, p=0.048]. Patient response rates in the POV were 34.5% [4.5g] and 27.3% [6g] compared to 12.5% in the placebo group. In the PVAS, both doses of Xyrem resulted in significantly greater improvement than placebo [4.5g, p=0.04 and 6g, p=0.03].

In this study, Xyrem was generally well tolerated and no treatment-related serious adverse events were reported.

The most commonly reported adverse events included nausea and dizziness and were dose-related [4.5g, 15% and 6.7% respectively; 6g, 28.4% and 13.4% respectively; placebo, 9.2% and 1.5% respectively]. Most adverse events were mild to moderate in severity and transient in duration.

[DemonFairy]

So, Hammilton, no interest in apologizing after your accusations were proven erroneous? You sure did feel really great while you were attacking me, it sure would be nice if you'd slink back here and apologize. I understand that I'm new here and probably wouldn't be trusted immediatel, but I don't think that excuses your behavior.

My doctor's appointment is later today, so I'll be asking to wean off of methadone, to go back to oxycodone, which makes me sad. I'll also be taking in those studies about Xyrem for my doctor, because they're something he should know about. He's in a practice of four fibromyalgia doctors, including one doctor who's is considered an expert, so if none of them know about the Xyrem studies, it's something they need to start looking into.

[Southern_Belle]

Hi, I've been reading this board for a couple of weeks now. It's the only place I've found with so much good information about Methadone. Since I'm sure you know more than my pain management doctor, and I have an appointment in four days, I wanted to ask a couple of questions here first, so I was armed with the proper information. He's a good doctor, he's mostly very helpful, but sometimes he's a bit arrogant (or insecure) about things he doesn't know. For instance, my partner and I both have fibromyalgia and have been doing tons of research, and the one thing we definitely haven't tried that we think might work is Xyrem. He's never heard of it (how is that possible!?), and thinks that if a drug rep hasn't come by pushing it, then it isn't worth trying. Never mind that the Fibromyalgia Network, that he's a part of, has had several in-depth articles about how Xyrem is helping patients get restorative sleep that is making it so they no longer need their other meds. Anyway, that's the background of what I'm working with.

I started taking Methadone almost a month ago, and except for the nasty nausea side effect in the beginning, it's done a really great job relieving my general all over pain. It lasts longer than OxyContin for me, and is SO MUCH cheaper (I maxed out my pharmacy coverage for the year at the end of March, so I have to pay cash for everything now :mad:)and I'm mostly happy with it. However, a couple of weeks ago, I noticed that my breakthrough pain meds weren't working at all. I read here that you need to be taking at least 80mg/day for the oxycodone to stop working. I'm only taking 30mg/day (10 mg every 8 hours) - is it possible that such a low dose could keep my oxycodone from working? I don't think it's my imagination. Yesterday, I took a really high dose for me (ugh, have extra pain from doing some simple work on the pool), a dose which would've made me nauseous last month (40mg), but I didn't feel it at all. No pain relief, no nausea, no buzzy feeling, nothing. I really need my breakthough meds to work, because even though the Methadone is working really well on my general pain, it isn't able to wipe out the specific pinpointed pain. Has anyone had this trouble on such a lose dose? And, if my oxycodone won't work, is there another med you could suggest that would work?

That said, I'm also having trouble with the Methadone affecting my bladder. I've had weird bladder problems that were finally fixed in March with a new med called Enablex. It's been my wonder drug, and two weeks ago, it quit working. It's a problem that makes it so I can't sit comfortably at my desk and work, and I work online from home, so that's bad. It only affects me when I sit too. I'm not sure if the Methadone is blocking the Enablex from working, or if the side effects from the Methadone are making my bladder worse. Regardless, if it doesn't improve, I'm going to need to quit taking the Methadone and go back to oxycodone and/or OxyContin, or whatever else might work to get rid of the pain. My question is about withdrawal. You guys have absolutely terrified me about quitting the drug. Ugh. So, if someone could tell me how to taper in the easiest, most painless way possible, I'd appreciate it. I have access to whatever other meds I might need to make it easier. I've been taking 30mg/day for a month, so how long would it take me to taper if I'm switching back to oxycodone? Would I need to take lower and lower doses until I was completely off it and then switch over? Could I take lower doses for a week and then quit and switch over?

Any help you could give me would be greatly appreciated. Sorry to be so wordy in my first post here, but I needed to try to explain some of the reasons for my questions. I'll try not to be so boring in my future posts. :)

Hello!

My name is Deborah and you have asked a very complicated question. You didn't say how long you had been taking methadone but it is not an easy medication to detox from. It is easier to detox from heroin than methadone but you are not on a very high dose but it is evident your Pain Management Doctor isn't up to date nor understands methadone.

Methadone usually only works for pain anywhere from 3-6 hours depending on your tolerance . Personally, I have pain similar to yours and I have tried everything and nothing worked for me but methadone but in much higher doses but methadone is a drug I would not take unless I knew I was going to be suffering from the pain the remainder of my life and my guess is that you are. I would not worry about how addictive it is and the nausea will go away after you take it awhile.

You should always take methadone after you have eaten and never on a empty stomach. You can buy a medicine called Prilosec that will help you taking the methadone and for nausea - the best prescription is free. If you begin to feel nauseated after taking methadone, then lie down on your left side on the bed for about an hour or until it passes and it will pass. I know -I am an expert at it for I have been on methadone for thirteen years and believe me it works better for your kind of pain than any other medication except for some of the N'SAIDS and they will eat your stomach up.

I would highly recommend that your Doctor increases your dose of methadone very slowly and gives you a lower dose for break-through pain because methadone as I was saying above works for pain anywhere between 3-6 hours but it works for heroin addicts 24 hours to stop withdrawal symptoms and craving unless your dose is not high enough. Usually other opioids doesn't work with methadone because methadone usually fills the opiate receptors for a period of 24 hours or close to it. This is probably why you are not receiving any relief from your Oxycontin.

If Oxycontin was working for you then you should never have went to methadone. Believe me, there are many people who are not aware of it but methadone is 3x more potent than morphine. It is under a lot of scrutiny now because many people on the street have come to this realization but they believe it is in the same category as Percocet, Vicodin ES and Loratab 10mg- but it is not!!! It has a slower onset of action and there are many medications that react with it. You need to check these medications out if you should decide to stay on the medication. Many deaths occur from methadone because of the ignorance off people about the medication. It is a very long-acting drug with a half-life of 15-55 hours. Oxycontin's half -life is only 4-6 hours and the ones named above are less than 4 hours. This should give you a clue to why so many people are dying from the medication because it hangs around a long time and if you mix it with benzodiazepines and/or alcohol it will kill you. If you are taking any other medications, even antidepressants, antihistamines or even NyQuil with it then it poteniates the action of the methadone and acts in synergy with it and it can kill you. :confused:

I am sharing this fact for all the others who may not possess the knowledge that I have concerning methadone. I am a Pharmacist but I was never taught about the medication but when I started taking it - I began to research it in depth and I even started a website to educate people about it for I found people had so many questions concerning the medication that wasn't being answered by the medical profession. Compare the half-life of the different medications and you will notice even though Oxycontin is Extended-Release, it's half-life is only 4-6 hours. I am telling you as long as Methadone with a half-life of 15-55 hours is active in your body then it is occupying the opiate receptors and as long as it is occupying them then the Oxycontin can't even lock on to them. You are really taking it for nothing and throwing your money away. I hope you can understand what I am trying to explain to all of you.

You asked about a taper from methadone and I am going to recommend exactly what the majority of Doctors educated about the drug recommend below:

If you really must withdraw from methadone, it is best to do so very slowly. You should not withdraw from more than 10% of your dose per week at doses over 100 mg. That is, if you are on 150 mg, you could probably safely lower your dose to 135 mg. Once you get down to doses under 100 mg, you probably won't want to drop more than 2 mg per week until you get down to 50 mg. Then I would say you should drop only 1 mg per week or 2 mg every other week. Of course, not everyone is the same, and some people can drop more quickly. Others might not be able to drop this fast.

And by all means, if you put yourself on a schedule but find that you don't feel well, stop dropping and stabilize until you feel better. You may even want to go up a few milligrams until your body adjusts. Don't decide that you want to be completely off methadone by the next season coming up because your body might not listen to you. It might tell you that you shouldn't be completely off until next year--or the year after.

Before you even attempt to withdraw, ask yourself why you want to do so. If it is because your counselor or your parents or your significant other wants you to, forget it. You won't be successful. You must be the one who wants it, and you need to have all your affairs in order. That means you need to be working or doing something that you like to do, your finances should be in order, and you shouldn't have any issues you haven't dealt with. If you are ill or under stress, you absolutely do not want to try to withdraw at this time.

You are not on a very high dose therefore it should not be too difficult for you. You may be able to switch back to Oxycontin depending on your dose without too many ill effects from the methadone but my guess is that it will affect you some. If you are having bladder problems then you may not have a choice but to return back to Oxycontin or another medication if it is affecting your bladder. If your bladder is not eliminating the medication properly then it is a factor you should consider with all of the opioids. I am truly concerned about your dilemna and I know what it is to need pain relief and to deal with all the side-effects arising from the use of medications.

I can only share my opinion and it is only mine. Methadone is one of the very best pain relievers there is but it is also very addicting and hard to withdraw from. I would not recommend it for anyone unless they are dealing with chronic pain and have tried all else and unless the pain is ongoing the remainder of their life. Your Pain Management Doctor showed his/her ignorance when they prescribed Oxycontin for breakthrough pain. It cannot lock onto the opiate receptors if methadone is blocking it, therefore it cannot work. The half-life of the medications explain this if your Doctor does not understand. You may not have any ill effects or withdrawal symptoms from switching back to Oxycontin, but if you do, then you should be slowly withdrawn from methadone.

It has to be your decision of which medication but if it is affecting your bladder then you could have your Doctor check into the reaction between the two drugs but I am asking you to check out the medication that you are taking for your bladder because it has some serious warnings that come along with it. As long as you are taking it and taking Oxycontin then please make sure they check your liver and kidneys frequently. I am more concerned with the medication they have given you for your bladder. It can affect your liver so please make sure they run tests every six months to see how your liver is. (Enablex)

I hope this helps you and some of the rest and I think this is a very good forum and I would like for all you to visit my website for methadone information if you can't find the answers here but I highly recommend this Forum. It is one of the very best I have seen.
My website is: http://www.MedicalAssistedTreatment.org

I hope this answers your question as to why your break-through medication is not working.
The half-life of methadone is 15-55 hours and it is attached to your opiate receptors like a lock and key and until the half-life is reached and it beomes an inactive metabolite -the Oxycontin cannot bind to the opiate receptors to relieve your pain.

Thank You.
Southern_Belle

[panthrax]

I, too, take methadone for pain management and have been for the past 5 years.

I need oxycodone for breakthrough pain, since the methadone doesn't take care of everything.

Here is a guide than can help you with methadone withdrawal: http://panthrax.host.sk/methadonewd.html

I, too, am considering new medications to help my pain. I wish you the best.

[doctor diesel]

Hey Demon Fairy, don't mind Hammilton, he tends to talk like that to lots of people. We're kind of used to it around here. Pay no heed, dear fellow.
By the way I am the principal carer for my wife, who has fibroymyalgia, and it's this that brought me to this board back in 2005. It would be interesting to compare notes and exchange ideas on the subject in future, so maybe we could do so by PM?

As I understand it new opiophile members can't PM until a certain amount of time has passed, or a particular number of posts have been made, but if that's not the case then please PM me and we'll take it from there.

Welcome aboard!


Doctor Diesel

[Ganjacake]

I suffer from pain from previoius back surgery 20 yrs ago. my back is fu---d .but I know the methadone got rid of my terrible sciatica.guaranteeded.I'm now on oxy's,but when sciatica comes back ,I do a couple of weeks of done and the leg pain is gone .Anyone who suffers,ask dr!

[DemonFairy]

Wow, Deborah, that was mighty impressive. I greatly appreciate you taking the time to answer all of my questions, and then some. I went to the doctor today, and he seems to feel that I can withdraw within a week. He's having me cut my dose in half, while adding my new med, MS Contin to it. I was taking 30mg/day of Methadone for 4 weeks total. I figured after reading here, the Methadone was why my Oxycodone wasn't working, but for certain things, I'm better read than my doctors. I guess when it comes to doing research for just me, it's easier than knowing everything about everything for everybody.

The reason I switched from OxyContin to Methadone was that the dosage he had me on 20mg 3x/day wasn't relieving the pain especially when I got the Teva generic, and more importantly, I was in a financial bind. My partner also has fibromyalgia, so we're generally doubling the cost of the doctor's visits ($95/each), the OxyContin (together over $500), the Vistaril (cheap, but it adds up), my Protonix (Prilosec stopped working when my opiate doses got higher), and my Enablex. Plus her thyroid, anti-anxiety, and anti-depressant meds. We were hitting close to $1k/mo just in meds. Blech. I have insurance, but I maxed out the pharmacy benefits in March and everything is out of pocket now. I'm now using those great free prescription drug cards online, like freedrugcard.us and rxdrugcard.com - those little pieces of paper can save A LOT of money, especially on generics. For instance 90 30mg Oxycodones are only $55 at Target or Costco with freedrugcard.us - sadly the Oxycodone ERs are cheaper, but the savings aren't as great for them. It's still worth using the cards though.

The Methadone really did work well for me. The nausea went away about a week ago, and my only problem was with my bladder. However, since I've had that problem for about 7 years, and it caused as much trouble, if not more than my pain issues (I've only been in serious pain since October '05, when I herniated a disk, then had surgery for it April '06, then resulting from financial & physical stress, seemed to end up with fibromyalgia after the surgery), and Enablex finally gave me my life back in March of this year. Until I got that med working on my bladder, I couldn't sit comfortably at my desk to work, couldn't sit on the couch to watch a 30 minute tv show, couldn't drive more than a few miles from home (I'm the only driver in my household), because I always needed to go! It was awful. I was pretty much tied to my home, unless I wanted to risk the stress of trying to drive somewhere. Oddly enough, my bladder is perfectly fine if I'm standing, so when I drove somewhere and started to have weird urgency issues, if I could pull over and stand up...whooosh, fixed. Then, I'd sit down and it would start again. So, if I had to choose Enablex or pain meds, I'd choose the Enablex. I'd be miserable, but at least I'd be miserable and be able to sit down. :) I guess the way to describe it to someone, since I've never been able to find anyone with the exact same problem in years of searching online and talking to several doctors, is that it feels just like a bladder infection, except without the pain. It never was a bladder infection, and one of my friends thought maybe it was just a super antibiotic resistant one, but no, I had a really horrible sinus infection last year, and I went through four different courses of antibiotics to get rid of it, but my bladder remained the same.

Since I went to the I Be New Here forum, I'll try to be good and keep as many responses as I can in this response. I'm not trying to run up my post total, as I can't think of a reason that I would need to. I can handle being without PMs for a bit. If I'm desperate, I'll find some money to fork over to buy 'em.

panthrax - is your oxycodone actually working for your breakthrough pain? After about a week of being on Methadone, no matter how much I took (well, up to 40mg once), it didn't work. It was like I was taking sugar pills. I discovered, however, that my body hadn't forgotten that I'd taken that many extra Oxycodones though. Ugh. I discovered 10 on my pain scale a couple of days ago. Let's just say, I'm going to be more careful, and dutiful about taking my Colace or MiraLAX. Damn, I thought herniated disk pain was bad. Heh. Hey, Deborah, if you're still reading this part down here, what pain med would be good for breakthrough pain if someone, like panthrax, is taking Methadone? After reading all of the scary Methadone stories, I'm not sure that I ever want to go back to Methadone once I'm done with my w/d. But damn, I'm sure going to miss a really good $13/month long-acting pain med. It did work really well for me once it got into my system.

doctor diesel - no, I still don't have PMs. However, I posted my email address in my third post. Count down 3 Domo-kuns. ;) We've tried some interesting things for fibromyalgia in our household. My partner has had it for many years. It's probably viral, and she gave it to me. Hrumph. There's one treatment I want to try, but it requires plane travel. I live in NV, and my brother is a chiropractor in Northern CA. He's using a new technique called bio cranial and having fabulous results with it. Until I sent him my very own guinea pig, I was super skeptical. Maybe even beyond super skeptical. However, I sent him a friend who lives in his area, who has been in incredible pain. Multiple herniated disks, and not enough pain meds to keep it under control. She's even been spending time in a wheelchair, it was just that bad. So, I ask my brother for a favor, and he's giving her a big discount on her treatment. I'm going to give you some quotes from one of her emails, and then maybe your wife could find someone where you live who does bio cranial.

"Well, I have concluded that your brother is amazing. I can't really explain a whole lot, it's weird what he does, very brief, seems just like all he's doing is stretching my neck. However, when I leave there I honestly feel taller, my shoulders are in a more correct postition, and my posture is better." "
After all these years, it feels so incredibly weird that such a simple treatment is helping. I see a huge light at the end of a very long tunnel. I might actually get some of my life back." "I went to Target on Monday and walked all over the entire store. The amazing thing about that is that I had the energy to do it, sciatica never kicked in, nothing hurt. When I got in the car I realized I'd been walking for 45 min and I felt fine. It has been years since I've been able to do that. When I went in to Target, I wasn't really thinking about my back, I just had my list, and just lost track of time. Normally, Target is hell for me...I have to use a cart to lean on, I stop and sit on the floor, I only grab what is on the list and avoid every unneccessary aisle." So, when you read about bio cranial, and it sounds weird, just know that for some reason, it works. He's had all kinds of success stories. My problem is having enough money to go up there and stay for a couple of weeks of treatment. I really wish I could get my chiropractor to get the training, so I could drive 8 minutes to his office, get treated, and go home. If you send me an email, I'll give you more information, so if it's a possiblity for your wife, maybe you could look into it. Because, believe me, I would LOVE to get rid of all these meds. I'll be honest, I don't mind the buzz every now and again with a stray Lortab or Percocet for a toothache, but I'd give it all up for the pain to be gone. I've also been working on getting a medical marijuana card here. My pain management doctor says he'll still treat me, so I've already spent $50 getting the application. I know that marijuana can take care of some of the pain without any of the horrible side effects that the pills have. I'll just have to suffer through the damned euphoria and munchies. ;) Oh, and thanks for letting me know about Hammilton - I figured that he was probably like that a lot, but frankly, I wanted him to think about it before he did it again. In fact, today, my doctor called Jazz Pharmaceuticals with me in the exam room, to get more information about Xyrem for fibro. He said that he wasn't at all comfortable about prescribing it, but that he could refer me to his associate (who is really the bigwig fibro expert whose office it is), and he's much more likely to be in favor of trying something like that. So, except for the astronomical cost of Xyrem, I'm that much closer to another treatment that might cure me. Although, bio cranial is definitely something I should try first. For one, except for the flight to Sacramento, the treatment for me is free.

Ganjacake - Ugh, I had the most incredibly horrible sciatica about a year before my disk herniated. It was like needles jabbing directly into each side of my butt. It was awful. Then, after the herniation, it was similar, but more like dull needles jabbing into my butt versus the sharp needles from the year before. By the way, I'm assuming from your name that you've used marijuana for your pain? I hope that it helps. I wish I didn't have drug tests as a possibility for my pm doctor, but since I do, I'm clean. I don't want my meds taken away from me because of pot, when I can work on getting it legally here.

Whoo, this is a long post, but hey, I did it all in one. Bonus points, no? I'm pretty sure there are some typos in here, but I'm exhausted. Running a few errands in a day generally wipes me out for the rest of the day. That's one thing that was definitely better with the Oxy than the Methadone. I had more energy. The Methadone was weird - I'd eat a meal, and then a few minutes later just want to fall asleep at the table. I can't even count the number of times in the past month where I've been so utterly exhausted that I've just gone to bed for a few hours. Luckily, I work online, so I can work whatever hours I want.

So, anyone who wants to write, I'm more than happy to get mail at my MrsCrump email address until I have PMs available.

Now, go get yourself a treat. You deserve it after reading all of this.

[DemonFairy]

I just wanted to post a final ending to my Methadone story, in case someone out there ends up in the same boat as I was. I was only on Methadone for a month, but due to some unforeseen side effects, had to stop taking it. I halved my 30mg/day (10mg/3x/day) dosage for a few days, then took that amount every other day for a couple of days, then quit completely. I didn't suffer a single withdrawal symptom. I assume that it was because of my low dose and being on it for only a month, and because I was transitioning to another opioid at the same time.

I still miss the pain relief that I got from Methadone and would go back to it in a minute if it didn't bother my bladder. My next med was MS Contin, and it did absolutely nothing for my pain, even when I doubled my dose to see if it was a dosage issue. So, I quit it after two weeks. My pain is eating me up and I wish I could use the Methadone for it, but I go back to the doctor next week. I'm going to ask for Oxycodone and Lyrica, and then I'm going to try to get other kinds of treatments, because I'm clearly resistant to a lot of meds that help other people. I read up about morphine and that it was supposed to be stronger than Oxycodone and other stuff, blah, blah, blah, and my 15mg ER tablets may as well be water for all the good that they do. I once even took 3 (I feel safe admitting that here ;)), and still...nothing. Ugh. Since I figured all it was doing was pushing my tolerance up and not relieving any pain, I thought the best thing to do was quit taking it.

Good luck to the rest of you who are either starting Methadone or stopping it. For pain relief, I've found nothing better, not OxyContin nor MS Contin, and I lament my inability to take it almost every day.