[gerstner23]

i would like to know if the fentanyl lollipops would work for acute pain. i am on 120 mg of methadone a day and i have tried vicodin, percocet and other drugs for acute pain and they do not work because of the methadone. just would like to know if the fentanyl would work, because they are rather expensive and i dont have insurance so if they are not going to work i will tell my doctor to not even prescribe them. also if you could tell me if the fentanyl wont work what will for acute pain, it seems like the methadone has put my tolerance through the roof. can take 10 to 15 percocets or vicodins and only feel that stupid tylenol effect and not the opiate. so anybody with suggestions let me know thanx brad

[SiestaKeys]

I do believe that methadone is a partial antagonist, which blocks some of the opaite receptors in your brain...this is why it is given for heroin addicts, and why you cant get pain relief. Why did your Dr. Rx methadone in the first place? Why not fenanyl patches which last 3 days? And yes fentanyl lolipops are for acute pain but usually only in severe cases, ie cancer patients because they can kill VERY easily from OD'ing. Oxy or morhpine is usually Rx'd for breakthru pain with the patches.
This is a problem with most Dr's-- they dont know what meds for breakthru pain are and they dont know that hydro, oxycontin and morphine contin are good at "preventing" pain but not for when pain does set in. This is where a short-lasting, instant release opiates help.

[mpvt]

Methadone is a synthetic opioid agonist and at a certain blood serum level will block pretty much any other opioid you take.My suggestion is to increase your methadone dose.The fentanyl lollipops will likely be useless.Save your money and try increasing your methadone...Good luck.....Dave

[SiestaKeys]

Sorry I forgot that you dont have insurance because fentanyl is very expensive. If you dont mind, how much do you spend on methadone per month? Have you tried morphine b/c there should be some generic time-release pills available. Generic Oxycontin is also available and the 40mg costs around $3/pill.
And you should get yourself a new Dr. Your current Dr obviously has no clue about opiates otherwise he wouldnt have Rx'd other opiates in addition to methadone.

[gerstner23]

i spend 30 a month on methadone. i have no idea why he prescribed me other opiates on top of methadone. i did call the pharmacy about the generic oxycontin, and he told me that for 60 of the 40 mg it would be 330 dollars. mvpt if i get a higher dose of methadone will that help for the acute pain? just wondering because overall i think methadone is the best painkiller around just dont know how it will work for acute pain. also morphine pills are very expensive too. which might be the reason my doctor prescribed me vicidin and percocet he knows i do not have insurance and those two drugs are very cheap same as methadone which is why i started that also thanx brad

[mpvt]

Hi Gerstner23: Yes, if you raise your methadone dose then it should help your pain.Methadone is extremely potent and blocks all other opiates when you get to a blocking dose of 80-120mgs.Some people are able to get a blocking effect at a lower dose.
You shouldn't need any other pain killer except maybe a anti-inflamatory for swelling.
Methadone is one of the most studied drugs out there and you can take it forever and it doesn't hurt organs or cause brittle bones(some of the stupid things I hear make me laugh).So if taken properly methadone is a great pain killer.Good luck.....Dave

[SiestaKeys]

Only $30 per month for methadone is great but you should still look into trying a new Dr unless this one is affordable because many Dr's have exhorbitant intial consult fees. Also, I would research higher doses of methadone because suboxone/subutex, at high doses, can completely block all the opiate receptors and thus cause withdrawal and pain, and methadone acts similar to sub. I think this is why subutex is not used to treat pain.
If you want to alleviate the acute pain, the only way to go is either oxy or morphine without spending far too much. The oxy at that pharm you called is far too high. I know because I picked up 60 80s for my bro and those were just over $300 at Walgreens. Also, smaller pharms can be cheaper. For example, generic 10mg hydrocodone runs 80-90 cents per pill, and special compound 10mg/80mg apap is only $.95 per pill and those cost far more to make because they are made at the pharm which are always smaller ones. Good Luck.

[mpvt]

Methadone is a full agonist while buprenorphene (suboxone,subutex) is a partial antagonist.
Being a apartial antagonist make's buprenorphene espcially good for addiction as it has a ceiling effect.Buprenorphene has the highest affinity to the opiate receptors so once your on a stable dose nothing else (as far as an opiate goes) is going to work.
Buprenorphene is 40 times stronger than morphine and has been used as a I.V. pain killer for years.I think the usual dose is .2mgs I.V. .
Buprenorphene also has an extremely long half life (36-72 hrs) which also makes it a good choice for addiction recovery.

Methadone is a full agonist just like morphine but many many times stronger.Methadone has a half life of 24-36hrs making it a good pain killer and a good choice for a heavily addicted patient.
Methadone acts differently then say oxycodone or morphine in that it doesn't hit you fast.It gradually comes up and I believe the peak values are around 6 hours.
Oxycodone and\or morphine are used early in a chronic pain patients case's but eventually due to tolerance these drugs become almost useless after some time.
This is when methadone should be used or duragesic patch and even the morphine pump.

I can tell you that if you are a chronic pain patient to learn as much as you can about the drugs and the overall class of drugs you're going to be taking for the rest of your life.There is alot of misinformed people out there with good intentions but they really don't know what they are talking about and that can be dangerous.So good luck and I hope you are able to control your chronic pain and have a good quality life......Dave

[circa9870]

Methadone is a very strong agonist as others have said and at a certain dose, which varies from person to person, it blocks other opioids. I do believe,hoewever, that it is possible for some opioids to 'breakthrough' that wall that methadone produces. However these can only be other very strong agonist, the one I have heard most is fentanyl, though there is some dispute about it. Another one is hydromorphone, again some dispute about how well this works. Oxymorphone may also, but like the others some say it works while some say it is blocked. What the ones who say it does work say is that you have to take larger doses than normal to make it work, of course your doctor will decide what works and what doesnt becasue, obviously, trying this on your own is playing with fire.

Good luck finding something that works and I hope everybody has a pain free day,
Circa