Methadone for chronic pain as well as maintenance

I am new to this forum but am having a problem that I could use a little advice on. I have been on methadone off and on for the better part of 15 years now. I have always taken it as a means to abstain from heroin use. I don't feel like I've ever really abused the system at my clinic by going up to unusually high doses like some people I know who come into the clinic with a vicodin or loracet habit and decide they want to get on methadone and as much of it as they can get. I am a 280lb man with a fairly high tolerance, (2 grams a day), when I was actively using and have never had to take more than 100mg of methadone a day to get by comfortably.

Anyhow I give you that little bit of background on my history to help explain a little problem I'me begining to have. Last September I ruptured a disc in my back which began to put pressure on my sciatic nerve running from my back down my left leg and, in the begining, the pain from it was almost unbearable. I had to stop working and could no longer afford the 14.00 dollars a day at my clinic. That was the bad news. The good news is that I was already taking a medication ,(methadone), that is very effective in treating chronic pain. So now instead of taking methadone for 1 reason I am now taking it for 2 reasons, maintenance as well as pain. I went to a pain management doctor who took mercy on me and continued my presciption of 90mg a day. Now not only was my methadone more affordable by going through a doctor for it as opposed to going to a clinic I no longer had to get up every morning and make that drive to the clinic to dose.

Things were going well for the first couple of months but then this doctor told me he was gonna have to start taking me down on my dose. He said it had to do with the regulations regarding the dispensing of methadone and the fact that I was an addict. I have been up front from the get go with every doctor I have seen so far about my past problems with heroin. I even turned down other opiates the doctor said he could prescibe me for breakthrough pain. I just want to stay at my normal 90mg at least until I've had my back surgery. Then once I am able to go back to work I could go the clinic route if I wanted to stay on methadone for maintenance.

Methadone has literally been a life saver for me when it comes to my drug problem. Without it I fear I would of either been dead or in prison a long time ago without it. It just does'nt make any sense to me that if a person is in chronic pain they are limited to the amount of methadone they can take for it but if a person states that they are a drug addict "the sky's the limit" as far as how high they want their dose to be. That just seems bass ackward to me. Anyone else out there had this type of experience with methadone when it comes to getting it for pain?

Hi there. My name is RuthAnn and I am one of the moderators for the group. I also have been on methadone for addiction over 9 yrs now.

I am sorry to hear about the trouble you have encountered, but unfortunately, this doctor is absolutely right. Current regulations enforced by the DEA do not permit DEA Registered Doctors to prescribe narcotic drugs, including methadone and LAAM, for the treatment of opiate addiction. But any Doctor with a narcotics license can prescribe methadone for pain. This is a very fine line and if you ask me, a very messed up system. Please see this page from our website
http://www.medicalassistedtreatment.org/35901/index.html it will go into more details about this.

So the fact that this doctor was actually prescribing it to you for your addiction (even though he was also prescribing it for pain) can very well get him into trouble and he could lose his license.

I was first introduced to methadone by a doctor that had pity on me. I went to an ER and laid it all out to them what I was doing and the problem I was having. The ER doc on call also specialized in internal medicine so he had no certification for addiction treatment. However, he put me on methadone and kept me in the hospital for a few days to get me on a stable dose. After I was released from the hospital, the doc still prescribed it for me but he told me up front that he would have to start tapering me off within a few weeks.

Long story short, he was detoxing me fast (to try and protect himself) and once I got down to a certain dose, I realized I was not going to be able to detox that fast so I contacted a methadone clinic and I have been going to one ever since.

The drawback is the cost! When I was given the script from the doc for methadone it would cost me $50 for the doc visit and only $17 for a MONTH's worth of methadone! Course, I had trouble finding a pharmacy that carried it and it had to be special ordered, but it was CHEAP CHEAP CHEAP! Also, the doc would only require me to come in like once every 3-4 weeks, he would give me a UA and check on my progress but that was it.

What a BIG difference a clinic was in not jus the cost but everything else!

I won't ramble on all of that, but unfortunately, there isn't anything you are going to be able to do about it. To get methadone for the treatment of addiction it will have to be done through a methadone clinic.

I am sure there are others on the forum who do take it for pain as well (the owner of the site and the forum is one of those pts) so maybe they can give you a little more insight about their experience with it but again, there isn't going to be much you are going to be able to do about it and that is what you will run into with other doctors as well.

Hang in there! I am glad you felt comfortable enough to reached out to us and if we can help you out in any way, please let us know.