Seeking Advice on Methadone Dose and Alternatives.....thank you

Number of posts : 4 Location : Canton,GA Registration date : 2010-02-14

This is my 3rd or 4th post and I cannot thank you guys enough for you thoughtful and timely responses. It means a lot to know I am not alone in my struggles. I hope you can help me out, yet again..ha I have been on Methadone now for 2 weeks. I am on a very low dose (30mg a day) At the worst point of my addiction to opiates I was taking 12 to 14 Percocets(10mg ea) everyday. So a total of 120mg to 140mg. Thank God I felt comfortable enough with my doctor to tell him the truth about what was going on in my life and he was caring enough to offer me alternatives. We both concluded that due to my chronic health issues and deteriorating physical condition I would need to receive on going pain management while still focus on living free of opiate addiction. That is no easy feat to achieve, I assure you.. whewwww...

Well anyway, I am so happy to report that the Methadone has been sufficient for me in stopping my withdrawals and eliminating any cravings for the high I had enjoyed in the past. By the 3rd day on Methadone I felt like I did 2 or 3 years ago. Before I EVER took an opiate. And it was such a miraculous feeling for me, to go from feeling like I was in my own living hell to being NORMAL again. I am unsure about what issues I need to address with the doctor on my next visit. Although emotionally and mentally I am healing and I am so thankful for that, physically my pain is very much an issue for me. I don't sleep well due to joint pain and cramping in my back legs and sides. When I get up in the morning my lower back and hips hurt so badly I can barely climb out of the bed.

I know that I was not this uncomfortable a couple of years ago, and I suppose the reason for some of the increased pain is the process of my illness. But I am also sure that some of it directly relates to my body's attempt to adjust to the demands and changes I have put it thru. When you stay heavily medicated about 20 hours out of every 24 you don't feel very much of anything, and now the low dose of Methadone has provided a disturbing wake up call me. I know I am doing a lot of talking here but I hope you will bear with me a bit longer..

My uncertainty stems from the discrepancy between my physical condition and my mental condition. I believe that the road is straight ahead for me as long as I remember where I have been and knowing I never want to be there again. But at the same time, I would like to believe that this is not the best I can feel physically. I am a single mom and I have 6 yr old twins and a 5 yr old and right now my pain is interferring with pursuing the life they deserve. I have spent too much of their lives looking for meds to waste even another minute now.

Ok, anyway, I don't want to increase my Methadone to a higher dose if that means increased side effect..ie: lethargy, nausea, drowsiness..in other words i dont want to be "doped" up. been there done that...ya know? So is there a way to find a happy medium for mind and body on Methadone?? If I have to accept the pain issues at this point to insure there is less chance of falling under the spell of medication again, I will manage the pain the best I can, I hope Seeking Advice on Methadone Dose and Alternatives.....thank you Icon_rolleyes

So are there alternatives for me? I am allergic to steroids and cannot tolerate anti inflammatories(NSAIDS to) My only option, as far as I can find, are these. More methadone, leaving well enough alone and hoping for a balance I can live with, or changing to something else. My doc did offer me MS Contin when I met with him initially but that seemed to be no improvement to me. And i REALLY hate the way Morphine makes me feel. What would you do??

Also, as stange as this sounds, part of my pain and discomfort also comes from me having little or no energy to get me thru the day.. I was diagnosed with CFS a few years ago and my GP told me then that due to my FibroMyalgia and the CFS I would notice a gradual loss of energy, increasing weakness and loss of muscle/strength overall. Of course when i was eating Perocets I was pumped up and ready to go so i never got the realistic view of what was happening to me physically. It just seems that now since I am not masking all of my issues with excessive meds I have a lot to face and I need to make the right choices.

AND I am so so so sorry I have rambled on forever, but I wanted to give you the full picture of my problem.

So, in closing, the last point is this... In researching Methadone, optimum dosing, tolerance, side effects etc. i found some sites dealing with CFS as well as FM. And several people who had issues very similar to mine, including being on Methadone, expressed that the best thing they ever did was ask the doctor to add a stimulant to their long term care plan.

About 65% were on Adderall and that was relieving some of the pain while giving the boost they needed physically to build up their strength and stamina. The remainder of the people posting about their experiences had success when Phentermine was prescribed to them, and the added result was some weight loss which alleviated some pain in their kness, feet, back etc. I have heard of Adderall but I thought it was for kids... Phentermine I remember from the Phen Phen Redux diet craze. And the other they mentioned is something I have never heard of and can find little about on line..it is called Dexedrine Desoxyn as one medication and then it is listed as two meds.. Dexedrine and Desoxyn I have NO idea what they are at all... so I have completed my million word post.

Again I am sorry it is so long. I would love any advice you can offer..that is if we can even remember what my question was ha ha ha also I would like to know if you have ever heard of the use of stimulants in conjunction with Methadone to improve over all results and would you think that is potentially good or bad? God bless you all and have a great day.... Honored to know you all... Marva

HI Marva,

Do not feel bad for asking questions and PLEASE do not think you are rambling. That is what we are here for and I don't feel like you rambled at all. You had to give all the info to gve us a clearer picture of what's going on with you.

The doc that is treating you w/the methadone, what is/was he "originally" treating you for? The FM or the CFS or something else?

Because I would recommend you share these issues and concerns with him. One thing to keep in mind, it may take several more weeks for you body to adjust to the methadone and allow it to "build up" a bit in your system before you notice a difference in your pain levels. Also, remember what I told you before about pain from opiate addiction. It may take a while for your body to "settle down" from all of that.

Main thing is, I would definately speak with your doctor. Tell him the things you have been telling us, start keeping a diary of your symptoms so that when you go back in to see him, you can show him these things. He sounds like a very understanding person who is willing to listen to you and work with you to manage your pain and your addiction. Consider yourself VERY lucky because so often as soon as you mention addiction to a pain mgt doc, he will boot you out on your behind right then! NO weaning and certainly no methadone!

I know you said you are "healing" both mentally and physically, but one thing I did want to mention since you are not going to a methadone clinic for your addiction treatment, is the importance of working some type of "treatment" program like a 12 step program or get some type of counseling. While your physical addiction problems are in a type of "remission" right now, you need to work on the mental aspect of your addiction and find out what things led you to this in the first place.

This is my PERSONAL opinion only, but I feel like methadone treatment alone for your addiction without some type of counseling is totally useless. If you don't work on the real problems behind your addiction and the feelings and/or things that led you to abuse the pain meds in the first place, you never will TRUELY heal. I also feel that if you EVER had a hope of being medication free at any point in your future, you will fail if you don't fix whatever it was that brought you to this point in the first place. Again, that is my personal opinion, I am not a doctor or therapist, I am only speaking from personal experience on that.

Anyway, I know I don't "answer" you question probably like you had hoped, but in this situation with you still being so new to methadone and unsure of how to handle your previous medical conditions in addition to your addiction, only you and your doc can really say for sure what may or may not work for you.

Again, I firmly believe after what you have said about your doctor that he is a kind and considerate doctor who will do whatever he can to help you. So please open up to him and tell him what is going on with you and your concerns. Share with him how you are feeling, the symptoms you are having and even the info you found online about the amphetamines and see what he thinks about that. Honesty and open communication with the doctor I think is going to be what you need the most at this time.

Good luck!
RuthAnn

Subject: Hello, Marva Wed Feb 17, 2010 10:05 pm

Seeking Advice on Methadone Dose and Alternatives.....thank you Donnat10

My name is Deborah Shrira and I am the Creator of http://www.MedicalAssistedTreatment.org

and of this forum. I rarely have time to socialize with all of you here but I happened to read your post and was quite interested in what you had to say. I have really bad back problems and I can barely get out of bed in the morning without methadone except I don't have your problems; it doesn't make me drowsy but then I have been on it for seventeen years. I really could use a dose increase again but they are difficult to obtain once you get up to a high milligram dose/320mg. I was blessed to even find a MMT Program to even supply the dosage. It isn't even holding me now for twenty-four hours therefore, I must try and get most of my work done before it wears off.

I didn't read all your posts but if you are going to need pain medication for the remainder of your life then I would go up slowly but you seem to be having a problem with the dose of methadone you are on. I really can't believe your physician put you on methadone when you were only using Percocet because it is possible Oxycontin or even Morphine may have worked for you. I am not sure because, personally, I believe methadone should be the last medication you should be put on. If the methadone is not stopping your pain totally then the other drugs may not have worked for you. If the methadone is stopping your withdrawal symptoms and cravings for twenty-four hours then it is doing what it is supposed to do for addiction. If you are using it for pain issues, too (it is not working for you, am I right?)

First, it must be given every 4-6 hours for pain. If you dose just once daily then there is no way if you have really bad chronic pain it is going to stop it. I have the same chronic pain issues as you have, similar ones, and I have nerve damage and there is not many medications which will completely stop pain stemming from nerve damage and I believe it is the same for your pain. If you have only been on methadone for two weeks then unless you are in a state which will allow you to split dose, then you have no choice but to take your dose all at once. Once you receive doses to take home with you then you can split dose and it should help you some. You may then have to increase your dose and once you are taking them home you can split them or even third them and it may help reduce the lethargy from the methadone.

It is possible, too, your physician can write you something for break-through pain which may help your pain for the remainder of the day but I am curious once you take the 30mg in the morning, does it completely stop your pain? You haven't been on it long (two weeks) and if it makes you feel drowsy and tired (lethargic) some of this will pass the longer you take it and I am assuming you drink coffee and you can buy Vivarin and it will help keep you alert instead of consuming too much coffee. If you still have the pain once you take the methadone then you have a problem and need to be looking for a way to deal with it, as you are.

I can share this with you if you take methadone for very long, you will require more and more and will build up a resistance and the other opiates will not phase you if your physician prescribes them for you for break-through pain. It is possible and I am not even sure they will help your pain now (but I am trying to distinguish which is your major problem,here) Is is the pain so you can live a quality life? Is it the methadone making you feel drowsy and tired and is it affecting your ability to be a Mother to your children the way you would like ? I don't claim to have all the answers, by no means, but I feel like I can share my experience with you. Methadone saved my life but when I first started taking it I felt drowsy and lethargic but I am telling you, it will soon pass and you may want to increase your dose and once you start taking home doses, then you can split them and it will help you. What worried me is the seriousness of your pain and how you are going to handle it?

Now, you said your friends suggested stimulants. They probably would help decrease the drowsiness and lethargy but they are just as addicting as opiates, if not more and I don't think it would be a wise decision to start on them even if you could find a physician to dispense them. Dexedrine is dextroamphetamine and Desoxyn is is methamphetamine hcl and they are very addicting and please consider this before you start taking either of them because methadone is addicting and you will become physically dependent on it and anyone can tell you it is much more difficult to withdraw from methadone than heroin or any other opiate. I can tell you this, it will decrease the effect of your methadone and it will not last as long. It will cause the methadone to be metabolised much faster and you will probably require a larger dose. You can check out the interaction between the two medications at http://www.drugs.com

If you prefer you can send me an e-mail and I will provide you the information on the interaction of the two drugs. You do need to keep this in mind when you make the decision. If it wasn't so addicting and wouldn't increase the metabolism of methadone, then I would say ,"Go for it!" It is still your decision and it may increase your strength and improve the quality of your life temporarily and then you would need more and more to produce the same effect.

There is no easy answer to your question and I know how important the quality of your life is and I do understand you don't want to be doped all up around your children and my main concern is your pain. I assume you are attending a MMTP or are you seeing a Pain Management Doctor? You may have said in one of your earlier posts but I missed it...I was seeing a Pain Management Doctor and attending a MMTP but I couldn't handle all the medication. I was receiving 280mg methadone from my MMTP but I had been on this dose for about seven years and needed an increase and my MMTP would not give me one. When my pain became worse, my pain management physician tried me on other drugs for break-through pain (like morphine, Dilaudid, Oxycontin, Fentanyl and others) and none of them worked for I had been on methadone too long and it is so much more potent than any of these. The ratio is 40 mg methadone = 440 mg morphine (think about it?)

He finally gave me methadone and started out at 40 mg and I would take my 280 mg dose in the morning and about 1200 PM I would take 10mg and every four hours after to help with the pain. It did help much more than any of the other drugs but all the methadone was giving me really bad Acid Reflux. It is very difficult to reach a happy median if your pain is very severe and I don't have much strength either but without the methadone, I would not be able to even get out of bed and move around. Then last year they stopped Pain Management Clinics from dispensing the 40mg diskettes which many of the patients had to transfer to the MMTP's because some of them were on higher doses than I was and could not handle taking so many 10 mg tablets. I eventually ended up at a new MMTP and they would not allow me to receive the medication from my Pain Mangement Doctor. Seeking Advice on Methadone Dose and Alternatives.....thank you Affraid

Seeking Advice on Methadone Dose and Alternatives.....thank you Affraid

It wasn't easy having to return back to the way I was on just the 280mg. It did help my stomach but my pain became worse and it affected the quality of my life. Let's just say I had ongoing problems with the Management at the MMTP. They made my life a living H---on earth. I eventually was able to locate another one and transfer and they did increase my dose to 320mg and it has helped me.

I don't know much about CFM but I do know some about Fibromyalgia but I am going to read up on it but I just wanted to let you know I am concerned about you because I understand how important the "quality of life is" and how a sickness can almost destroy your life and I wanted to let you know I do care but I did want to share with you about the dexedrine and DESOXYN. pLEASE GIVE IT ADEQUATE CONSIDERATION BEFORE DECIDING ON TAKING ANY FORM OF AMPHETAMINE because they can drain the energy you do have and will cause methadone to be metabolized much faster.

I am happy to have you as a member and we have some wonderful people on this forum and a great Moderator, RuthAnn. I am in the process of building a new website on methadone therefore, I am busy most of the time between it and e-mails and we receive calls twenty-fours a day. I just wanted to share my thoughts with you and I am sure there will be others who may have some advice to share but we all will be here to support you. Once again, welcome aboard!

Subject: Hi Marva, Ruth, Deb Wed Jun 30, 2010 8:51 am

Hi I just want you to know I read all your post, I'm so gratful I can read about other's Expereances, etc. and I can share mine as well, Anyway's I believe in Baby step's Like doing Stretches, just for 2 mins, or 5, I know after I do a few stretches I feel better, and I take my lil dog for walk's everyday, That help's, Has anyone Ever heard of Coral Calcium, you can buy it in the drug store, but it's better to get it at a Vitamin store because the price is very good. That help's your body, it's not addicting, It's a fantastic Vitamin to take You feel great, You know as we get older with our Pains n such, I heard it's because our body losses Oxagin, as time go's by, BUT I know there is something in that Vitamin store that can help, Not sure if it's coral Calcium, But all I know is I take it and I feel great, I need to check out the Vitamin store what help's with the Oxagin etc, I hope this help's. I just remembered it being talked about on TV a few time's, Also There's book's you can borrow at the Library "Kevin Trudeau" " Natrual Cures" Plus he has alot other's, Have a great day, and Write back anytime, I'm just so glad to be a part of this wonderful Family, HUG'S Sammy. Seeking Advice on Methadone Dose and Alternatives.....thank you Icon_wink

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