Methadone: A Flicker Of Light In The Dark

Methadone: A Flicker Of Light In The Dark

To provide a better understanding of the very important role methadone plays in the treatment of addiction.
 
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 Methadone for both pain and maitenance?

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methadonian



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Number of posts: 4
Location: Jacksonville, Florida
Registration date: 2009-12-11

PostSubject: Methadone for both pain and maitenance?   Tue Dec 29, 2009 9:28 pm

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?
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PostSubject: Re: Methadone for both pain and maitenance?   Thu Jan 14, 2010 12:28 am

Hi! my name is Cat. maybe I can help to answer your question. I live in GA. here in GA pharmacies are no longer allowed to dispense anything besides the 5 or 10 mg pills. this makes it hard for pain clinics to prescribe large doses of methadone now that pharmacies can't carry anthing else. maybe something like that is going on in FL? i know here alot of pain clinics were trying to lower patients doses & even take them off methadone all together. they are also scared of the high dose patients dying or of people selling the methadone illegally. most of methadone deaths are attributed to people from pain clinics selling their meds. it probably has nothing to do w/ you personally & it's not fair! I guess they probably think that if they put you off onto a methadone clinic again, they don't have to worry about you. I am sorry that you will be forced to either lower your dose or have to get off of it all together. it was brave of you to be upfront w/ your doctor in the first place. alot of methadone patients aren't b/c of the stigmas placed on us. I wish you luck & please let us know how its going.
Cat
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PostSubject: Re: Methadone for both pain and maitenance?   Sat Jan 16, 2010 8:58 pm

If you were going to your doctor strictly for the purpose of receiving Methadone to help you manage your addiction that would be one thing.
But you are currently seeing your doctor and receiving Methadone for pain reasons am I right? He is writing "for pain" on the prescription. Have you tried talking to the doctor to see if he will at least leave you on current dose until after you are able to have surgery?
I think the key word here is Methadone. If it were Oxycontin I would imagine there wouldn't be a problem. I agree with you, it isn't right.
I can sympathize with you and your pain. I have had three back surgeries for ruptured disks and each time the pain before surgery was the most horrible pain I ever experienced. Do you already have the surgeon picked out who will preform the surgery? Is it possible for you to see him/her for your pain management until the surgery? It may be worth a shot to ask if you haven't already.
Good luck and as Cat said please keep us posted on how you are doing.
Dee


"I will let yesterday end so that today can begin"



Never take any online advice over that of a qualified healthcare provider
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Location: Vermont
Registration date: 2009-03-05

PostSubject: Better Late Than Never   Wed Feb 17, 2010 9:25 pm


Dear Methadonian:

My name is Deborah Shrira and I am the Creator of http://www.MedicalAssistedTreatment.org and this forum is part of it even though I don't have much time to interact with all of you. I really miss being a part of it but they are some great people who are members and they all have information and are only happy to share with with you and offer support.
I am a pharmacist by profession but once I started taking methadone and it worked for me, I had to open a website to let others know about what a wonderful medication it was. I became addicted to pain medication because of the numerous surgeries I had and spent many months in Residential Inpatient Treatment which didn't work for me because I still had pain. Finally, a patient told me about methadone and I showed up for treatment and it stopped my pain, withdrawal symptoms and my craving. I couldn't believe it! I was on it for years before I developed serious back problems and now I draw Disability because I can no longer work standing on my feet all day and I have the same kind of pain you have plus nerve damage and I know just how agonizing your pain is, believe me?


Have you thought about filing for Disability? It was very difficult for me to admit I could no longer work even though I have spent many long hours constructing the websites and answering emails. I am able to stop and rest if the pain becomes too unbearable without worrying about losing my position. I know it can't be easy to come up with the money if you are not working and it is much better to be able to see a Pain Management physicain if it is possible. As I said, I started out on a MMTP for addiction and my back problems developed later. I am sure you know Pain Management physicians can only write for pain and not for addiction.


You are living in Florida and it probably is one of the worse states you could be in now. If there is limit imposed on what they can prescribe, it would have to be a State law because there is no Federal Regulation imposing a limit on the methadone He can prescribe. He can't prescribe any for addiction to any person but if He is prescribing it for pain there is no limit unless a new law has been passed by Florida. I can share this with you, the DEA has just put quite a number of Pain Management physicians in jail for over-prescribing and Florida is one of the states with the highest death toll from methadone (it is #1 or #2 for deaths) Florida and North Carolina are the two states with the highest deaths from methadone. Of course, they have proved most all of the deaths are coming from the Pain Management physicians prescribing and not from the MMTPs. I don't know but I am checking into it but it is possible because of all the physicians they found over prescribing and because of the many deaths the state of Florida has, they possibly did pass a law lowering the amount which could be prescribed. It is not a law in Georgia and other states I checked on. It is not a Federal law ..therefore it has been passed by Florida or otherwise your physician is giving you the run-around.


Many Pain Management physicians will not dispense over 50mg and some will possibly go up to 100mg in Georgia but most won't. I did go to one temporarily after I was first diagnosed but I was attending the MMTP too. Methadone doesn't work too well for pain if it is given once daily therefore, I was given methadone for breakthrough pain by my Pain Management physician. When I first started seeing him He told me He would not go over 50mg on any patient. I was receiving 280mg from my methadone clinic but I had been on it for 13 years and been on the same dose of 280mg for seven of those years. It was not stopping my pain and the quality of my life had been compromised. We did a Peak and Trough to see what my serum level was and it showed I wasn't receiving enough methadone even for my daily dose and so my Doctor did go up to I believe 95 mg. He didn't usually do this but He could tell how it was affecting my life and He did make an exception which later I had to stop taking because my MMTP did not like me receiving it. They made alot of trouble for me and I decided to stop. I eventually did transfer to another MMTP but in the state of Georgia we have about 43 MMTPs and I called all of them and I could not find but one who would take me on the dose I was on (280mg). I had been on this dose for seven long years. Most of the clinics didn't care and told me they would not accept anyone on a dose over than 120mg.


I think you will find out if you call some of them that they have lowered their dose of methadone also because of all the deaths which have occurred and the DEA is putting heat on all of them. You will no longer find too many people on high doses and I am sure there are patients which are members of this forum which will share with you just how difficult it is now to obtain an increase in your dose at MMTPs. I have personally tried to help quite a few obtain an increase in their doses.


It is hard to know whether your physician is giving you the run around because He is scared because of all the heat on the Pain Management physicians because Florida has one of the highest death toll rates from methadone and maybe your doctor heard of all the arrests made in the state of Florida and has become cautious. I am checking up on it for you to see of they passed a State law limiting the amount of methadone and I will get back to you. How about checking in and letting us know just how you are holding up because we are concerned about how you are doing and I should have some news for you soon.


Welcome, and I am sorry it took me so long to answer but I seen your post and it reminded me of what I heard last week about the round up and arrest of x # of physicians from Florida which was over prescribing methadone. There is no limit on the amount to be prescribed unless Florida has just passed one...so I would ask the Doctor for more information because I think it is his decision because He is running scared. I could be totally wrong and I am checking it out for you.


I will be in touch and I hope to hear from you.
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methadonian



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Location: Jacksonville, Florida
Registration date: 2009-12-11

PostSubject: Re: Methadone for both pain and maitenance?   Fri Feb 19, 2010 5:14 pm

I was told by another doctor that there was a memorandum out from the state medical board. I think it was advisory only but I am not sure. I am currently at 70mg of methadone daily and my pain doctor has even offered me breakthrough pain meds which I have declined. I've had too much experience playing around with my tolerance to mess with something that seems to be working just fine.......ya know what I mean? When I was on 90mg I could get a little euphoria from my dose and I equated that with pain relief.

Actually the euphoria you feel from any opiod medication is only a side effect and has nothing to do with analgesia.
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MrsPenguin2005



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Number of posts: 15
Age: 57
Location: Beverly Hills, FL
Humor: If plan A doesn't work out...don't worry...there are 25 more letters in the alphabet...nobody can drive you crazy unless you give them the keys...
Registration date: 2012-04-05

PostSubject: Re: Methadone for both pain and maitenance?   Sat May 19, 2012 12:10 am

Hi Methadonian...that's why I love it that I have found these forums for people with these types of problems...I never fail to read something that pertains directly to me Smile...I also live in Florida but not where the clinics are plentiful but in Central Florida in the stix...I had a car accident in 2007 but have been an opiate addict since I was 12 or 13 and I am 55 now...I, too, have been on methadone off and on since the 80's and am also comfortable at a dose of 100-110...it just so happens that I am on disability and although I tried going to our local clinic (funny, I really mean the one 37 miles away from us), the 2 or 3 weeks I went nearly wiped out our savings...the clinic did not take any kind of insurance and I was unaware that any clinic did...between the $420 for the methadone per month and the extra $240 a week in gas (we were driving a very old jeep and I would be surprised if we got 20 miles to the gallon), the cost was astronomical and simply out of the question...I went to my pain management doctor and I can't really say that he took mercy on me as I never told him I was also an addict because I had been forewarned that this type of doctor would not treat me for addiction but only pain...he prescribed me 40mg methadone a day and 40mg percocet a day...this amount and this combo is NOT working for me...my husband and I talked about asking him to up the methadone and down the percocet but somewhere deep in my gut I know this will not happen...he will either keep it the way it is or he will terminate me completely...I don't exactly know how I know this but I just know...I can almost tell by his attitude towrds addicts...he has only had me on this combo (at one point he had me on 6 or 7 30mg oxycodone a day)for 2 months and he is already talking about taking me down or off or whatever...today I dug in my heels and did some serious research and finally found what I believe is a clinic that should meet almost all my needs...it says on the website that they take medicaid and medicare and also have a sliding scale that goes on your income...BUT they are an hour and a half a way from me but I am intending to go this Tuesday for intake...my husband and I will work out the travel details whenever but right now we know this is one of the things that is severely affecting our marriage and if I do not get into a clinic soon (being as even if I could find a doctor, I really feel I also need whatever counseling they would have to offer while my doctor and I'm sure no pain management doctors would offer any addiction counseling...they would go broke to admit they were treating addicts...anyway, we finally sold our jeep and picked up a little honda that seems to be getting about 35 miles to the gallon and between that and my medicare/medicaid, I should be able to join this clinic and at least stick it out until I am eligible for take outs...then my life might get even better as I intend to floow all the rules and earn every take out they will give me...and so, I guess my whole point is that I so sympathize with those of us who cannot either afford the methadone clinics or cannot get to them or whose doctor will not cooperate even in the smallest way...I realize that I am very fortunate compared to some because I have insurance and may have found my solution so I am in no way complaining...I am simply saying that sometimes there are solutions out there but I had to work at finding mine and it will not be the most convenient solution but at least it is a solution in many ways...I do not know if it is a state law that pain management doctors cannot give you more than 40mg a day of methadone or if it is the pharmacies because they can't carry larger mg pills or what the hell it is but imagine if there were doctors who were sympathetic to our plight and were willing to help...God forbid the gov't (and I am not saying this is open season on the gov't by no means)try to help people on methadone instead of looking at us with the stigma attached to it...so many are afraid and just want to be rid of it...Good luck to you in your search for help...where in Florida do you live...I don't know if I am allowed to give you my e-mail in any way but if I can help you, please don't hesitate to ask...I know certain info can't be given on this forum but like I said, maybe I have some info you could use...all the best...Barbara *Mrs. Penguin*
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