methadone for pain

[Grammy]

Has anyone tried taking methadone for pain. March 24th marked year number twenty for me --I am the lady that underwent six pelvic reconstruction surgeries since 1994. Not one of them helped in any way. Just last week I underwent a five day stim trial that was a disaster because the doctor put one lead directly in the central of the sacrum and a second wire to the right of the spine. All stimulation was right sided regardless of the programs that were tried. I am currently taking a small dose of Percocet and subutex to try to control my pain and I might as well be eating M & M's. I am going to ask my pain doctor to prescribe methadone again to see if it will help me once again as it did in the past. I never needed to go higher than 10mg --three times a day. My problem is I have apnea and methadone is not a good med for anyone with apnea. However I do not have the ability right now to enjoy anything so I guess I need to figure out what to do. I am wondering if apnea would be better if you sleep in a bed where the head of the bed could be lifted. To wrap this up--if you have had good luck with methadone I would like for you to post about your experiences. Thanks Grammy

[Positivepoppy]

Sorry have not had experience of methadone, just felt compelled to post you best wishes as you sound as though you've had a rough ride to say the least! I had a ketamine infused drip for 23hrs after decompression surgery but 4 months on and still in chronic pain.
I hope someone is able to help you and things improve. Take care

[ezer]

I did not tolerate it -I had trouble breathing on it- but I think it works well. It is really hard to get out of it though. You need to face the fact that you may have to stay on it forever or switch to Suboxone. The relapse rate from Methadone is horrendous (95% of people that were on Methadone relapse).
Have you considered something like the new Butrans patches? Also for intractable pain, a pain pump seems to be a valid choice.

[Cora]

I did a very short trial of Methadone and it was disastrous for me. Terrible side effects. I have now been on Buprenorphine 3 mg ( generic of Subutex) and that has been great for me. Likely the Butrans patch which is the patch form of Subutex will be too low of a dose for you if you have been on oral meds for any amount of time. I have also not needed any escalating doses of the Subutex and it has held my pain in check now for a couple of years at the same dose. Initially, I was having a hard time accepting that I would have to stay on this drug, and now I'm just happy that it is allowing me a very good level of functioning with very low amounts of pain.

Hope this helps,
Cora

[Grammy]

How much subutex do you take a day. You said that you use 3mg but is that under the tongue medication and how often do you use the med. I currently am trying the patch at 5 mg but it does not seem to be strong enough for my pain. My worse feeling is one of extreme vaginal pressure that is always there.

[ezer]

Grammy,
For me the 10 microgram/hour patch was magic. 5 microgram/hour did nothing. You need to up the dosage. You are still far from the 20 microgram max (in the US, in Europe it is much higher 70 microgram/hour).

The Butrans patches are in microgram per hour (not mg) and the Suboxone in milligram (mg). You have to convert the units to do a proper comparison.I have included the calculation below.

The conversion taking in consideration sublingual bioavailabilty is 5 microgram/hour Butrans patch is roughly equivalent to 0.5 mg/day of Suboxone/Subutex.
If you convert Cora's 3mg/day, it would be like a 30 microgram/hour patch (not available in the US).

A 5 microgram/hour Butrans patch like you have is equivalent to 5 to 10mg/day of Methadone.
I am surprised that you got converted from 30mg/day of Methadone to only 5 microgram/hour patch. For you, 10 to 20 microgram/hour Butrans would be the correct equivalence. Doctors should really pay more attention to conversion charts that are readily available.

Conversion between sublingual and Buprenorphine patch:
5 microgram/hr (patch) X 24 hours = 0.12mg/day
Assuming 25% sublingual bioavailability of Suboxone/Subutex compared to a patch:
0.12mg / 0.25 = 0.5mg Subutex/Suboxone.

Conversion between Buprenorphine (oral) and Methadone (oral)
http://healthquestions.medhelp.org/buprenorphine-oral