December 3, 2006 - 10:14am
We have several posts discussing methadone for the treatment of pain. In the past methadone was used for the treatment of narcotic dependency. Now the drug is also prescribed for chronic pain when other opioids fail to give proper pain relief or when the patient develops a tolerance to his current treatment.
Methadone has many advantages like longer dosing intervals, inexpensive cost and effective pain relief according to some posters. Since methadone is being prescribed more often for the treatment of pain, more problems with the drug are becoming apparent.
Last week the FDA issued an Advisory regarding methadone. We quote verbatim and include the FDA links for your convenience in reading all the material included with the Advisory.
FDA Public Health Advisory
Methadone Use for Pain Control May Result in Death and Life-Threatening Changes in Breathing and Heart Beat
FDA has received reports of death and life-threatening side effects in patients taking methadone. These deaths and life-threatening side effects have occurred in patients newly starting methadone for pain control and in patients who have switched to methadone after being treated for pain with other strong narcotic pain relievers. Methadone can cause slow or shallow breathing and dangerous changes in heart beat that may not be felt by the patient.
Prescribing methadone is complex. Methadone should only be prescribed for patients with moderate to severe pain when their pain is not improved with other non-narcotic pain relievers. Pain relief from a dose of methadone lasts about 4 to 8 hours. However methadone stays in the body much longer—from 8 to 59 hours after it is taken. As a result, patients may feel the need for more pain relief before methadone is gone from the body. Methadone may build up in the body to a toxic level if it is taken too often, if the amount taken is too high, or if it is taken with certain other medicines or supplements.
To prevent serious complications from methadone, health care professionals who prescribe methadone should read and carefully follow the methadone (Dolophine) prescribing information
FDA is issuing this public health advisory to alert patients and their caregivers and health care professionals to the following important safety information:
- Patients should take methadone exactly as prescribed. Taking more methadone than prescribed can cause breathing to slow or stop and can cause death. A patient who does not experience good pain relief with the prescribed dose of methadone, should talk to his or her doctor.
- Patients taking methadone should not start or stop taking other medicines or dietary supplements without talking to their health care provider. Taking other medicines or dietary supplements may cause less pain relief. They may also cause a toxic buildup of methadone in the body leading to dangerous changes in breathing or heart beat that may cause death.
- Health care professionals and patients should be aware of the signs of methadone overdose. Signs of methadone overdose include trouble breathing or shallow breathing; extreme tiredness or sleepiness; blurred vision; inability to think, talk or walk normally; and feeling faint, dizzy or confused. If these signs occur, patients should get medical attention right away.
FDA recently approved new prescribing information for methadone products approved for pain control. The information in the new prescribing information is based on a review of the scientific literature completed by FDA. A Medication Guide for patients is planned.
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Date created: November 27, 2006
December 3, 2006 - 12:59pm
#2
Methadone Info
Thanks TP~
I think this is a very good topic to have in this forum. Methadone IS a very difficult thing to understand. I'm glad you posted this!
I agree with GTplayer. It shouldnt get swept away.
December 3, 2006 - 2:22pm
#3
Just bumping it up. Maybe
Just bumping it up. Maybe davidm could help us out in keeping this on the Active Threads? I would have sent a PM, but I assume your inbox is full anyhow.
gtrplayer
December 3, 2006 - 2:57pm
#4
Methadone
Thank you for your comments, gtrplayer and justneedtoknow.
Per your requests, the excerpt for the FDA methadone Advisory is now on the Pharmer.org Welcome page.
TeamPharmer
December 5, 2006 - 12:11pm
#5
A lot of people and maybe
A lot of people and maybe even the doctors prescibing this drug don't really know the in and outs of this drug. The half life is quite long for some people and I feel bad for anyone who has lost a loved one due to this. However methadone is a wonderful painkiller and just like all the rest people are going to overdose, but hopefully can be revived. Methadone is one of the most complex drugs around. Thanks for the info TeamPharmer.
December 5, 2006 - 10:00pm
#6
new to methadone treatment
hello i am glad you had that warning up. i am just starting to use methadone 10mg right now,after years of 80mg of oxycodone plus norco"s to go inbetween doses. i am afraid of it after reading this about the fda report. i wanted a change in my pain mangement and started going to a real doctor for pain not just my regular doc i have been going to for years. i went from 2 80"s oxy 2x a day to 1 in the am and i cut out all the hydros. the pain is tuff but i wanted to try something new and not be to hard to get like my others are or were. i have 5 blown discs 11 cracks from advanced degenerative disc diease. some from accidents from years ago and the others just collapsed from bending, found out all the women on my mothers side plus 1 of my daughters has it too. i am 47 years old, single,moved to the country better for my nerves i thought. i go back to my pain doc thursday to tell him what i think of this new drug and to be honest i dont like it. i cant drive and living in the country i have to travel if i go anywhere. but i dont want to go back to the oxys or hydros. i did read in one of the other forums about kadians but i dont know if my insurance will cover it as i am on medicare and humana. man i am glad i found this site, i am sorry i have written to long but this site has given me information i was looking for and new friends i havent met yet.
peace to all and a good nights rest
susantex98
chronic back pain
December 7, 2006 - 7:00pm
#7
just curious but how many
just curious but how many times a day are you taking 10mg's
from my personal experience you are probably not taking enough because 2 80's daily plus breakthru med is a lot of stuff to take.
you would probably need close to 60-80mg daily at first to equal the same analgesia. Like the warning says and like I will tell you Methadone is very very complex, but at the same time is a good painkiller, one of the best and it lasts longer than most. You may feel tired at first when taking methadone but it goes away. again I don't know your dosages and my suggestion is just a guess but If you don't like it due to insufficient analgesia I would give it a chance and the dose may need to be titrated.
As you probably noticed it is a lot cheaper than oxy. Again, at first it will sedate you but eventually after a few weeks this will go away, at least for me it did, but everyone is different.
December 7, 2006 - 8:43pm
#8
methadone is some serious
methadone is some serious stuff my neighbor was givin that and ended up in the hospital b/c she couldent breathe
December 23, 2006 - 6:40am
#9
Some info about Methadone
I visited my pain specialist yesterday and had not known about this before the visit. I have been on and off methadone for 2 years now. My pain specialist is good about changing meds so that there isn't a tolerance so then you don't have to keep bumping up the amount taken....but anyhow I digress... We had a hour long discussion on this basically because methadone is the most effective of my pain meds that I take and most effective of all the ones that I have been on in 9 years. It controls my pain the most for the longest time. With the least side effects. The way he explained it to me ...the biggest problem is people not taking methadone as prescribed. Upping their dosage on their own. Also those that are drinking while taking methadone (which is also not taking it as prescribed) is also a problem. He suggested that since I had been on methadone and had no side effects at all that as long as it was working then no need to change. He also pointed out that there has been this problem in the past with Oxycontin, Viox, and a list of like 8 to 10 other medicines that I had been on. So if you are on Methadone call your Dr. and schedule a appt and see what His/Her take is on it. I am sure some Dr's are going to remove their patients immediately just for malpractice issues. My doctor is giving his patients the choice he did mention to me though that a lot of the ones that are choosing to go off of it are calling back in a week later begging to go back on it because the alternatives aren't controlling the pain as well.
It was a interesting Dr. visit to say the least we discussed Insurance practices and how a lot of insurance companies were trying to make doctors to prescribe methadone because it is cheaper than its alternatives. The only bad part he said was methadone is a tricky drug and a lot of Dr. who are not specialists in this field do not know the proper way to prescribe it. It stays in the system for up to 59 hours or something like that (he and I spoke of so much the information is all rambling in my mind) so a lot of Drs that aren't specialist but that the insurance companies has got them to prescribe methadone instead has prescribed methadone wrong or at least not in the proper dosage.
Then the illegal form of meth made in meth labs give the prescribed form of methadone a bad name when people die from it. Especially for the ones where you have some people selling prescriptions (another soapbox)
Anyhow it was a very interesting visit...and a lot of interesting information...luckily there was no one after me in the office since I was the last patient of the day at 12 noon because of a Staff Christmas Party so I didn't feel guilty for keeping him talking for so long because I did enjoy all the information he gave. In the end I am staying on methadone till something changes...it works and if it was going to hurt me I think it would have done so before now (I hope)
intent
December 23, 2006 - 3:16pm
#10
Quote:Then the illegal
Quote:
Then the illegal form of meth made in meth labs give the prescribed form of methadone a bad name when people die from it.
Methadone and the 'meth made in labs' are two completely different drugs.
A meth lab produces crystal methamphetamine, a stimulant, that in no way resembles Methadone.
I find it hard to believe that people actually confuse the two, but anything is possible.
December 23, 2006 - 3:26pm
#11
i wasnt going to say it but
i wasnt going to say it but was thinking the exact same thing.
all thoughts and opinions expressed are those of my own and should not be mistaken for medical advice. i am not a doctor nor a pharmacist. all medical questions should be answered by a licensed pharmacist, doctor, or primary care manager.
December 25, 2006 - 11:10pm
#12
The Deadliest Methadone Synergy.
Methadone often kills alone, but possibly the most prevalent way methadone kills is in conjunction with benzodiazepines. Benzodiazepines include commonly used drugs such as valium,xanax,klonopin,dalmane and their generic equivalents. Of the dozens of "benzos" however, Xanax or its generic moniker,alprazolam presents the greatest dangers. Methadone and Xanax depress respiratory function and when used together the synergistic effect is exponentially greater than that produced by either drug alone.
I spent 7 years on methadone maintenance. During that time 12 fellow patients died. Of these deaths, 11 were the result of the toxic combo mentioned earlier, the other was hepatitis c related liver failure. My experience alone does not constitute proof, but do a superficial search and you will find similar evidence.
If you use Methadone for pain relief or maintenance please be intensely cautious when using any drug that has the potential to sedate. Particularly "Xanax" or its generic equivalent alprazolam.
(edited by TeamPharmer)
January 4, 2007 - 12:55pm
#13
back pain
back pain is tough,i`m having to deal with it all the time also.I`m taking darvocet,loratab,and soma.
January 9, 2007 - 1:43pm
#14
Methadone and Benzo's
ntezbnggreen, We have eerily similiar stories. I was on methadone maintenance for almost 4 years(side note: in the end it did not work for for me, suboxone finally did the trick for me.) but while I was on the clinic we has several deaths also because of people mixing benzos with their methadone. I even had a few freinds of my own die this way. Most of these people died mixing xanex with their medication, that seems to be the benzo of choice for most people at the methadone clinics, and I'm not goin to lie, I did it too. Klonopin is a close 2nd. Once in a while you might see valuim or ativan. But in closing... ntezbnggreen warning is a great warning and should be taking very seriously.
January 10, 2007 - 6:57pm
#15
http://www.thepetitionsite.co
http://www.thepetitionsite.com/takeaction/472711451
http://www.thepetitionsite.com/takeaction/472711451
On June 24th 2006 I lost my fiancé (Ron) to t hi s deadly drug prescribed by a physician with a combination of other medications that acted as additives to the Methadone. He had knee surgery and became addicted to the percocet he was prescribed. He checked hi mself into Greenleaf in Valdosta , GA for detoxification. Upon entering the facility he was drug tested and did not come up positive for opiates (he had stopped taking the percocet 4 days before entering the facility). On the fourth day in detox he died sometime between 2am and 1pm in the afternoon (he was never checked on in all of those hours). The night before he died he was complaining of migraines and vomiting, apparently the staff thought he was still experiencing withdrawals and was not concerned about these symptoms. The symptoms of methadone toxicity mimic withdrawal symptoms physicians and staff must be very cognizant of the complex properties and metabolization of methadone. There were many errors made in my fiancé’s death including the fact that he was given numerous amounts of additive medications such as benzodiazepines. He had only been taking percocet for about 4 months and according to the DSM IV he wouldn’t be an appropriate candidate methadone maintenance treatment.
It doesn't matter specific reasons for taking methadone but what does matter is that t hi s medication is deadly and physicians need to more prudent in prescribing it as well as monitoring their patients w hi le beginning treatment of any kind using Methadone. I'm not sure if Ron was given methadone for the sole purpose for detoxification from opiates or if it was a combination of pain relief associated with numerous surgeries and opiate addiction. Methadone is difficult to properly dose no matter what reason it's being used for and primarily relies on the patient’s indications of how they feel (assumedly they are being monitored). There are ways to make the administration of methadone safer, it's just a matter of putting the focus on t hi s drug and the deadly consequences when administered incorrectly or not monitored.
Many people are dying unnecessarily at the hands of the physicians they turn to for help. Methadone deaths are rising throughout the country. Ron was 32 years old and has 2 children from a previous marriage that now do not have a father.
Current statistics show that nearly 4000 people a year die from methadone. These deaths are mostly happening to pain management and detoxification patients wit hi n the first 10 days of taking initial dose. Most of these deaths are related to methadone prescribed with other medications that react as additives with methadone. Diversion of methadone is a serious problem because it lands t hi s most deadly drug on streets. Statistics also state that methadone is contributing to more deaths nationwide then heroine and cocaine.
January 11, 2007 - 6:14pm
#16
get away from the methadone
Ok this might be a long story but im going to tell you about my experance.I was on 2 80 mg oxys,180 hydrocodone every 2 weeks,360 ir perks,120 soma,120 xanax.anyways to make a long story short.i got off all that and i told the doctor i wanted to be put on methadone well i started off taking 5mg a day for like three months then it went up to 10 mg and before i new it i was up to 120 mg a day.they worked great for the pain for about a year then it was down hill from there.i actually started to hurt worse in the mornings i could hardly pick my feet up.i could feel the methadone in my bones and all i wanted to do was eat sweets.i craved sweets like a drug.the withdraw off methadone is the worst thing i had to ever come off of.they make it sound like methadone is this micarle drug.it isn't at all.i would not recomind methadone to anyone.unless your doing a 28 day program.and in your case you are going to be on meds. for the rest of your life,just like me.well i went in to my doctor and told him i wanted off the methadone and i wanted to be put on oxys and perks for a break threw.so he put me on two 80's a day and three perkoct a day for break threw.but the oxys only lasted about 8 hours so they increased me to three a day.i feel so much better now.see i have fybromiliga and there are days when it takes everything i have in me to get out of the bed.im sorry for rambling on but if i was you i would get off the methadone and try to find something else.is durregsic patches a option for you??they are a 3 day patch and in the patch is fentnyol.it is supposed to be a good pain med.i also tryed them but i had no relief from them at all.every body is different when it comes to pain meds.what works good for one may not work at all for another.well i will quit boring you with this long story.i just wanted to share with you what i went threw.and it wasn't a pleasant experance at all.i would be up for any suggestion as long as it kept you away from methadone.methadone is awful.it does int take long to build up a tollarance to it either.but thats with any drug.methadone was just allot quicker.sorry for boring you.P.S sorry im a bad speller
January 13, 2007 - 6:52pm
#17
First I want to say that I
First I want to say that I am very sorry for your loss. That must have been horrible for you and his family.
I have to say though, that I have been taking Methadone for over 6 months and have had no ill effects at all. I do take it as it is prescribed and even though I have had very hard days where it just isn't doing all it could for me I never take more than I should because I know (as should everyone) that it could be very costly mistake. I have since spoke to my doctor about the fact that it has built up a tolerance and now I also have the patches that I use as well.
I do realize that there are lots of cases we see on the news and in the media that say how it kills and may be unsafe but as I said in another post if the media would focus on the good that Methadone has done for many people it may just sway some opinions. Not to say that it won't cause allergic reactions or any other side effects in some people IF used correctly it can be managed well with great results. In my case with out this I wouldn't be able to function well enough to be mom & a wife and have a job. Even though I can only do half of what I had been able to do before my back began to hurt and before my surgery with out this med I would be bed bound.
Thanks again for letting me air my &*&?!!! Love to you all and wishing you all ONE pain free day!!
Danielle ~~~ in the lovely state of Florida
*** All replies to questions/comments are of my own opinion. I do not and have not ever worked in the medical field.
March 16, 2007 - 4:39pm
#18
HELP!! Mother n law on too much painkillers
I have some concern and questions. MY mother n law has been on hydrocodone and oxycodone (80 mg aday) for a year now and they switched her to methadone 40 mg about 4 months ago for chronic pain. Personally i dont think anything is wrong with her she's just a pill head. She's prescribed 200 40 mg methadones every month but she is also prescribed 280 .5 mg xanax a month as well. She runs out of her methadone after 2 1/2 weeks and buys hydrocodone or oxycodone and takes them til she gets her script refilled of methadone. Im thinking this is going to kill her...am i right? Does anyone have any suggestions of what I can do to change her mind because im scared shes going to die. I found some articles on deaths of methadone mixed with xanax and she said she would stop taking xanax and she did for bout 3 days. she gets so mest up you cant even understand her when she talks and shes taking care of her 4 & 6 year old grandchildren, and shes a RN on top of that taking care of ICU patients. Help me because she is endangering herself and others by doing this i think so anyways. so let me know if im right and what i can do.
thankyou
March 20, 2007 - 10:33am
#19
Methadone/Xanax
I have been around the Methadone clinic for many years.In the last few years the Xanax/Methadone thing has really taken off.Many of the deaths I have sen are a result of younger people who don't have much tolerance taking LARGE doses and falling asleep not to awaken.You are exactly on the mark with your thoughts that your mother in law is endangering herself as well as others.When someone gets so out of it that they cant speak or act clearly they are way over-doing it!!also if she is prescribed 40ml and runs out quickly then she is trying to get high,otherwise her Dr. would give her a stronger dose.The addition of Xanax just makes it stronger.Many people take the combination and it is necessary for them(seizure,etc.).Your relative needs help not draconian intervention but don't be surprised if you meet with much resistance this is normal for an addict you need the assistance of professionals,not a clinic but an addictionoligist,she will still need pain meds but never in the strengths that will cause incoherence.
May 14, 2007 - 12:18am
#20
Detoxification...
It's funny I just stumbled across this board.
I just turned 21 years old. I've been off of methadone (daily liquid doses, from a clinic) for one week and a day. (Not really a success story yet) Before that I attended that clinic for a YEAR and a HALF. over eighteen months, plus a few years of addiction before that, from everything from hydro to heroin. The agony of withdrawal would probably be too much without the ativan i managed to acquire for this awful past week.
But there's plenty they don't tell you about these clincs and this med.
It does slow your breathing. I'm a healthy kid... and my girlfriend would wake me up crying, because i had stopped breathing for so long in my sleep.
But the worst part, for me, was the effects it had on my digestive system. I would be constipated for days, uncomfortable bordering on dangerous. I survived on prunes, laxatives, mineral oil and changing my diet completely... but my skin was still yellow. and I feared eating, just because of how ridiculously long the "food" would get dried out and stuck in my intestines. I felt toxic, even after reducing my dose to 25mgs a day (I was up over 100mg, with the counselors' full support)
The clinics don't care. The counselors don't care. The one I went to was privately funded by clients and they NEVER tried to help you get off. Its their main source of income! It costs a dollar for a dose of liquid, any size, they charge us 13 any size. That's a better market than selling crack.
This drug is awful. Avoid it at all costs, unless your pain is so bad you've just resigned yourself to death... Cause this is a fast route.
May 14, 2007 - 4:24am
#21
have you looked through some
have you looked through some of the other posts about stronger pain medicines? there are stronger meds out there other than methadone that are also alot different. these may be of interest for you to speak with your doc about. diludid (is it spelled right) is one, or patches, or suboxone (?), morphine, and many others. there are some others that may work better for you as a long-term pain med that are worth looking into. good luck
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
May 14, 2007 - 4:33am
#22
sorry
this is to melis11577, first, I am truly sorry for your loss, that is something extremely hard to deal with, even w/out the circumstances behind it.
have you considered though, that it was not solely the methadone, but perhaps more the xanax, or another med? you said other meds acted as additives, therefore the methadone alone may have been just fine, and otherwise would not have caused a problem. so many people think bad about methadone and are afraid of it, and its for reasons such as these. really, the medicine by itself is not what is so harmful for people, its what they take along with it. ALOT of pain meds say on the warning labels not to take with other meds as it may have an adverse effect. it was really the benzos that slowed down his breathing so much, so have you blamed those meds as well?
it also is the responsiblity of the staff as well. the staff at the facility are to blame for what happened to him b/c any legal, licensed facility should have staff on hand to detect these sort of situations. it may be a thin line b/w regular w/draw and what your fiance was going through, but with the risk and potency of the meds that were dispensed at a facility like that, they should have had more knowledgeable staff and proccedures put into place just in case of sad situations as your fiances. I hope you were able to put some repercussions upon the facility that allowed such a dreadful thing to happen under their watch. again, i am sorry for your loss, and hope you are recovering well
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
May 14, 2007 - 4:36am
#23
it is sad to see that a
it is sad to see that a medicine that stands to be extremely helpful for so many people get such a bad rep, more so b/c so many people are using it the wrong way, or not paying attention to correct usage
I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience.
May 14, 2007 - 10:42am
#24
People die from
People die from their IRRESPONSIBLE DRUG USE and the physicians who try to treat them with the best technology we have catch the blame. If Ron wasn't using his medication IRRESPONSIBLY, he would not have ended up in detox or rehab. You state that you do not even know why Ron was taking methadone, so why are you assuming he was treated incorrectly? Do you even have the autopsy and toxicology report yet. If you do, please post it.
May 14, 2007 - 10:45am
#25
The only thing that is going
The only thing that is going to help her at this point is to report her to the state board of medicine, and have them investigate her. The patients she cares for in the ICU deserve at least that much.
May 14, 2007 - 10:50am
#26
I have to say that i agree.
I have to say that i agree. it is completely irresponsible to say that he wasnt properly treated.
i do agree that methadone can be a tricky med to prescribe, however to simply lay the blame on the physician isnt acceptable.
there are far too many cases of malpractice that should have never surfaced. while it is true that malpractice does sometimes occur, more often than not people feel that they were mis-diagnosed or mis-treated when in all reality it is usually something which they have done to cause the problems in the first place. being in compliance and being truthful with your physician is extremely important. when people are not compliant or truthful then it can oftentimes lead to more serious problems and other-times death.
that being said, i am sorry for your loss.
all thoughts and opinions expressed are those of my own and should not be mistaken for medical advice. i am not a doctor nor a pharmacist. all medical questions should be answered by a licensed pharmacist, doctor, or primary care manager.
May 15, 2007 - 2:40pm
#27
Yeah,Be carefull with that
Yeah,
Be carefull with that methadone! I took a much larger dose for a long time and my inbetweeners were msir (MORPHINE). This was a change from ms contin 100mg x 4 /day + 80 msir at my descretion. I also took kadian for about 6 mos through the kadian patiant assistance program. They require only that you show an inability to pay for good meds even if u are insured. UNFORTUNATELY, they take a great amount of time to turn around the script, and doctors don't double up. If he gave you a script, and you send it off to be filled, you had better pray the medicine gets there before you need it urgently. This was my first and worst experience with acute withdrawl. EEEEEEEEEEEHHHHHHHHH! It seems I have alot in common with you injury wise, and I hope I helped you a little, ask me anything, I have no shame, have been in pain management for nearly ten years and am extremely physically dependent in a large way to morphine. I often wish I were dead. Too much to see as my children grow up. But I have been rite where you are now, and I know it is hard.
Thanks for posting this. Is there anyway to keep this at the Welcome screen so that it does not get looked at for a few hours and then is swept away?
gtrplayer