Methadone -vs- Morphine, Study Results

Nurse-k-99 · Feb 6, 2004

Yes but there is not much you can do sometimes not all have a good out look on pain managment. This area is the worst so a person dose what they have too. It is to bad. We had a doctor that was great with P-M but he retired and went to Texas because the NH medical board was giving him such a hard time. Now there is one left and there is a waiting list for him. Sad:o

akamom9041 · Feb 7, 2004

speaking from experience, pain managment is good in texas....lousy in florida! So I can totally understand where nurse-k-99 is coming from.....sometimes you gotta deal with the hand you are dealt....sending you best wishes"K-99".

VvFreckles · Feb 8, 2004

freckles freckles freckles

hi ~

i am not sure if this message will reach anyone, but will try.

at another time i will explain all the disorders and diseases that have led to methadone pain mangement, but for now, i have a serious concern.....

i am a nurse, who has been unable to work for at least 15 years, as a nurse, and have worked as a receptionist off and on since then, because of my health.

i have been on methadone for about10 years, and beofre that varying meds, codiene, percocet, ( caus9ing liver problems, sending me to methadone), and oxycontin. i had a doc that apparently on too much meds, according to my current doc, as well as a couple others i consulted. ok, now, i have been maintained on 80 mgs of methadone, down from 210mgs about ayear and a half ago. back then, i was also taking oxycontin 80mgs, 2/tid, plus, roxycodone for b/t meds.

as i said, i have ben at 80mgs, with morphine 15mgs, no more than 6/day, for a year and a half. my last visit to my pain doc resulted in his taking me off methadone, and putting me on kadian, 100mgs. although i had some meth left over, (from not taking it) i filled the kadian right away, in case of withdrawal, or other problems, allowing me to have something to take until i saw my doc again. that all sounds fine, but i have been in a withdrawal state since starting, 5 days ago. i have used my meth to help abate this, but the kicker is, my pain doc insists i am "oversensitized, and must be brought back at least 50% of what i was taking.(making it 40 mgs of meth a day). first, i think coming off all the stuff i was on was good, but enough. i was just making it without suicide thoughts with the 80 mgs and pulse radio frequency lesioning", and "prolo therapy" i told him that, but he insisted that i either cut back to 40 mgs, or go to the kadian 100mg, and be brought down that way. he insisted the dosage was a lateral move, telling me the dose actually equalled 100mgs of meth. i am in withdrawal, and i know he will not believe me. is there some place i can go online to see a conversion chart? i was hoping perhaps "dave" could answer that, for me, and tell me if he thought this withdrawal feeling is in my head? i have been in w/d many times, so i know the feeling. i wasn't planning on it. i am over 50 years old, and feel that if it's working, don't fix it, and now he has. i also feel powerless at this point. what can i say, or do? i xcaqnnot write prescriptions, and don't know, and don't want to know, how to get them on the street. i just want to have my pain be at a level where i can enjoy life to some degree. i had just gotten there with my last injection,(radio freq...), and told him it helped and with that and my meds, i thought i could live ok at this stage. but, he decided that it was now time to take me down, if not off all meds. i havew spent well over 22 years in pain, with many surgeries. i know that 8 pills a day may seem like a lot, but it's what was keeping me comfortalbe for almost 2 years without an increase. i am lost, now, as far as what to actually ask this forum. perhaps just support? another pain doc, since this one is now not trusting what i tell him what my pain level is? ok, what is the conversion of 80 mgs of meth, to long avting morphine, (kadian)? i also know that he will tell me i am not in w/d, coz i asked him if i would be, and he said no.

sorry for the length, thanks for listening,

freckles

Nurse-k-99 · Feb 8, 2004

Thank you akamom so far all is well except a sm amount of depresion.

Freckles I am so sorry that this ia all happening to you. I would like to say that I have hasd kind of the same thing. I am now in a methadone clinic I get 190mg of methadone QD. I do not feel bad at all it took awhile to get to a stable dose but I have been there for 20 months. That might be away for you to go. I have a friend that was on 80mg of oxycontin TID and also kaiden 100mg TID. with valuim PRN (?) anyway I talked her into going to the methadone clinic(please do not think that these clinics are full of heroin addicts because mine is 95% oxycontin users from all walks of life) she is doing wonderful her dose is 125mg QD at the mometnt but she went off all of her med's ALL OF THEM with very little W/D. her pain is at a min now. At first she was scared but now she is thankful. The reason for having to go to the clinic and tell them you are addicted or dependeant and want off all narcotic's is because they do not treat for pain only addiction(wich go hand in hand sometimes) I have to say that it is nice not being in pain and living normal after so long. If there is anything i can help you with please feel free to e-mail me. God bless Kelly:cool:

VvFreckles · Feb 8, 2004

all all

reply

Thank you kelly, for your reply. It seems I am in the right place, although it is different than other boards I have seen. Now I have to figure out how to make my font bigger. Do I need to write then "enter text you want to change"?

Anyway, I can read it OK for now.

I Did go to a meth clinic when I was forst put on methadone, years ago. Your right, they do not treat pain, and there are some good people there, but I had such a hard time getting there. I did go, since that was my only alternative, but they did also tell me that my dose was getting over 100mgs, and if that happend, I would NOT be elegible to take it home at all! I wonder sometimes at what the universe has in store for us, since around that time, I had a siezure as I was just starting off to go to the clinic, and ended up crashing into a car about three houses up from me. Then not too long after, I had another one at the meth clinic! They think it may be because I stopped my clonipin, but I had tapered down, as I was running out, and didn't want/need it at the time. Personally, I think it was the stress. At any rate, I was given my scripts for meth by my doc,(primary care) including putting me back on clonipin, at a lower dose, as well as a couple other siezure control drugs. I have since stopped the others, but remain on the clonipin, which is a great help for the sleep problems I have had.

Problem is, she,(my pc at the time) left medicine, so I did find a pain doc. (the one that had me on too much). She left medicine, but referred me to my current pain doc. If I have to, I will go again to the meth clinic, but it is quite far and difficult to get to every day, especiually if they are Never gonna let me bring any home. The daily runs down there took most of my day.

After sleeping on the message I wrote, I think I may have to find another pain doc. The trust is obviously broken, maybe beyond repair. There are several in my neck of the woods, but I wonder what I will say when I go? "My last doc didn't do what *I* wanted?" I don't think I would mind Kadian as much if it was a truley paralell dose, but it just doesn't seem to be. I also checked out the sites someone posted for a question about conversions, and saw that, according to the 2 I saw, I am NOT on a paralell,(sp) dose! I guess I should admit right here and now, that the 80 mgs/day, wasn't really enough, but I was willing to make it work, or, rather "live with it", and still am, since I doubt a pain doc would increase it further. I don't miss the oxycontin either, since, like you, I wasn't getting much relief, and I was feeling also, that I needed increasing doses.

My pharmacist told me he had a bunch of people on more meth than I, but that doesn't really help, except to be grateful that I can get it without going to a clinic,. But, I need a dockor to not just order it for me, but work WITH me, in treating my ongoing pain! Of course this means new referrals, geting charts, etc, just to see if a doc woll work with me, instead of riding roughshod over me. Please excuse errors, as I am not a good typist, and for some reason my spellcheck wont work on these replys. I already spend far too much time re-reading posts and e maills to make sure they make sense, etc.! Thanks again, mel

all text :confused:

Nurse-k-99 · Feb 8, 2004

I do not know when the last time was that you went to a meth clinic but things have changed and are changing all the time. There are doctor who will RX methadone for a month at a time but the requirments are hard to meet. I take 190mg QD and I am going for takehome # 5. Where do you live? I could get you some info. There are more and more clinic's popping up every where it is a big problem now all over the country. Oxycontin use or over use. Kelly

fab4fan · Feb 8, 2004

Post deleted by writer

fab4fan · Feb 8, 2004

Here's a conversion chart

Hope this helps you.

Dave ARNP · Feb 8, 2004

Methadone is the primary pain drug I write, and I always write for a month at a time.

Also, Methadone sometimes provides greater pain releif than Morphine will. No matter how equal the dose is.

Dave

rnmom3153 · Jul 21, 2004

Hi Dave & all...I am new to all this so please excuse any mistakes I make. I have been treated for chronic pain for 8 years..I have run the gamut and for the last 10 monthes have been on methadone. I am now up to 80 mg TID and since starting on that dose I am having a life I could only dream about!! Iam able to function, work (with many restrictions) have somewhat of a social life. I feel great, have no signs of adverse effects or toxicity. But now my doctor is uncomfortable with that dosage. He sent me to a friend of his who was appalled that I was on so much and he is recommending a medication holiday! I have never heard of this, but when I have been of meds I have gone through withdrawal as well as being in unbearable pain. I would honestly rather be dead than go back to where I 've been!!I really respect your opinion so please help me. I see my doctor tommorrow. Carol

Theresa Ann · Aug 2, 2004

Dave,

I need to comment and ask a question. I just found this board and am extremely excited to see all the info on it! Now, my question to you is this. I am speaking from experience. I have a myriad of health problems in addition to being legally blind since the age of nine (now 47) due to Histoplasmosis. I have been diagnosed with severe steroid induced Osteoporosis (due to being put on massive quantities of cortisone at the age of nine for the Histo for a period of one year) in hopes it would clear up the Histo. Well, needless to say I was not fixed but experimented on at Emory University. That is okay though because lots of others have been helped as a result of my parents allowing me to be a "lab rat" for lack of a better term. Also, the laser for the eyes was just coming out and I also helped pioner it for future use on the eyes. It was a very powerful laser they used on me that over time has taken all but a total of one percent of my total vision over the years. Of course I don't drive and have not for the past ten years as scar tissue spreads. Well, to get to my point. I was put on Oxycontin 80 mgs a day for FMS/MPS as well as Osteoarthritis, migraines, etc. Then when I wanted off of them they put me on Methadone for about three years. Well, I just had enough of the Methadone, like the Oxy, because at a certain point it does not keep on working as in the beginning. I was up to 100 mgs a day of the Meth. Now, my question and comment to you is this. Do you truly believe Meth is a "good" pain med? Also, I almost died coming off of it and I went into a private hospital, by choice, to detox from it. It has been the worst physical event in my life! I am just not one to want to take opiates if I can get by with other meds. However, I am allergic to aspirin, NSAIDS, etc. so I feel certain my choices are limited. I have worked with my new doctor, and with my limited knowledge of the medical field, but we are still trying to find something out there that will work on the many many pains. What is your opinion on this as I would greatly appreciate a fresh approach? BTW, the doc who detoxed me was not a good doc in my opinion and believe you me, I've seen hundreds of them in my lifetime. My mistake was just picking him from a commercial because I was desperate to get off the Meth and my pain clinic docs would not help. Can you believe that?! Anyway, not trying to discourage anyone from taking Meth or Oxy but I NEVER would ever put one of those meds in my system again unless I were literally dying of a fatal disease. Thanks for reading my post.

timewood · Aug 3, 2004

this is a subject that i know about too well. i am very glad that there are compassionate practitioners who do not feel that pain builds character/seperates the weak from the strong etc etc.

having said that...pain management is just that...management .

My father was on so many pain meds over a period of years (he had a terrible spinal chord injury) and none of them helped him regain the degree of function that he was seeking. The doc that finally put him on methadone was very brave. We live in a small, very uptight, traditional town. The doc took quite a risk in prescribing it for my father. My father was treated like the scum of the Earth by other doctors he saw and by all but one of the pharmacists in town. Not only was he in physical agony...he was treated like an unclean leper.

For the first year or so methadone helped my father immensely. Then, it began to kill him slowly. His legs became so full of edema (due to the methadone) that he could no longer walk. He chose a wheelchair over getting off methadone. He was so terrrified of being in pain that he completely denied being addicted to methadone. Methadone did give him about a year of freedom but it came with a tragic price. He regularly (throughout the day) had "the nods" but claimed he was "just thinking". It was easy to see that he was an addict. Easy for everyone except my mother and his doctor and of course, himself. He stopped leaving the house. He stopped laughing. He stopped loving. He stopped living. He stopped caring about doing anything but being high. And the methadone only worsened every one of the physical problems that he already had. I saw him so many times...too stoned to even remember if he had taken his meds...so he would take more and more. I had read about overdosing on methadone that had been taken as much as 36 hours previously and begged my mother to dole it out to him. Everytime the methadone took something away...he and my mother would blame it on his spinal chord injury...an injury that was not progressive and did not "become progressive" until after he began his love affair with methadone. When he died he had several vertebral fractures from falling while stoned (they had healed without his ever getting medical help) including a crushed tail bone. He also had lung cancer. He also had a large tumor growing in his parathyroid gland. He was completely numb to all of these health problems because he was "overmedicated". :stone

I think in the long run, my father was a poor psychological/physiological candidate for methadone. My father was an addictive personality. He smoked, compulsively overate, had been a sex addict and a gambling addict. I used to say he was a symphony of addictions. He was even addicted to nasal spray. I wish that there had been a way for him to take a medication without getting addicted but I truly see that my father could not help but become an addict. I am all for methadone when necessary but I think it must come with comprehensive counseling. At his core, my father was a sensitive, brilliant, passionate man who really never learned/mastered the life skills that could have helped him to go on to learn pain management skills that could have added years to his life. He had low to no tolerance for frustration or emotional discomfort. He had a high tolerance for drugs. I wish that the doc could have seen that my father's personality and his injury and methadone were a deadly combination. My father died last year at the age of 53..a broken-down, isolated ghost of the man I once knew. I had grieved him long before he died. :stone

I do not share this story with anyone...partly because I do not want to perpetuate a culture of insensitivity that belongs in the dark ages with insane asylums and snake pits. But, I have wanted to share my father's story on this particular board for some time. Methadone must be used wisely...it can be a wonderful drug but only for the right patient.