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Is Oxycodone a good alternative to Methadone??
  1. #1
    Lilylizi is offline New Member
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    Default Is Oxycodone a good alternative to Methadone??

    Need some expert advice....

    I've taken 290mgs of Methadone for the past 4 years and have been hearing from the medical profession and reading on the net about the incidence of sudden cardiac death from Methadone, even when taken at the prescribed dose. I also don't like the sound of the month-long utterly hideous detox (that is assuming I EVER get to the point where medical science can solve my medical condition which is pretty unlikely) All this information has freaked me and my pain specialist out...a lot so I am researching my options regarding alternative medications. I have narrowed it down to three:
    Morphine, Oxycodone and Fentanyl
    The Fentanyl is already out as it is not funded in my country so it is too expensive. That leaves the other two and I have tried Morphine briefly before but they gave me too little and I started to go into withdrawl and couldn't handle so went straight back to Methadone.
    Need some advice...is Oxycodone a good alternative to Methadone??
    Liz

    PS. Please don't do the whole preach-to-me-about-how-addictive-these-drugs-are...I have an incurable condition so I have no option but to take these kind of drugs.

  2. #2
    abs1962 is offline New Member
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    Hi Lilylizi,
    I am not an expert but I can give you my recent experience involving Methadone. I don't want to bore you too much with my history, but just so you understand my condition, I was diagnosed with DDD of lumbrosacral spine in Dec. 07 after several months of "hip joint" pain leading to numerous diagnostic procedures to pinpoint the cause. I had always been active throughout my life up until my mid-forties, when my back pain began to worsen. At first, I experienced aching & mild discomfort, especially during and after gardening & softball, my two favorites recreational activities. I was actually diagnosed with a minimally bulging disc by MRI around 10 years ago, and at the time the orthopaedic md said that the condition could "resolve itself". The MRI that I had in '07 did not show a bulging disc, but did show mild DDD of L4-L5-S1 & on flexion view some mild spondylolysthesis. A nuclear bone scan confirmed arthritic changes. Anyway, the hip pain led to extreme trigger point pain in legs & back, and severe & sharp pain in lumbar area along with sciatica. At that point I was taking Lortab 5mg & Flexeril up to 6x daily with no relief, so I contacted my primary md who referred me to a pain management md. She diagnosed piriformis syndrome in addition to DDD & increased Lortab to 10mg, replaced Flexeril with Zanaflex. I continued monthly appointments until this md left the practice 6 months later, even though it was very difficult traveling 100 miles for each appointment. I then I began going to a local md who also handles pain management patients. By last October, I was back to the unending pain/max medication dosage cycle. My md suggested that I try Methadone to alternate with Lortab. I agreed & began therapy with 5mg. I never took more than 5mg at a time & during the next 3 months I had horrible hot flashes, felt like my heart was going to beat out of my chest at times, low blood pressure, extreme drowsiness, & difficulty with my vision at times. I decided to discontinue Methadone therapy when a routine morning visit to the nursing home where my mother resides ended abruptly with chest pain. Needless to say I ended up in the local ER (the hospital was next door) with dangerously elevated blood pressure & angina that took 3 sprays of Nitro, an injection of a beta blocker & ACE inhibitor to resolve. After I was stabilized, my primary md made the decision to send me to a cardiologist via ambulance for a complete cardiac workup. I was admitted to a larger, more advanced hospital 100 miles away & had numerous diagnostic tests the next day. I knew that I was in danger of a stroke or possibly heart attack, but did not realize how close until I was later told that I was "on the verge of a massive heart attack". Fortunately, all tests were negative for any heart damage. I don't know for certain that the Methadone caused all these problems, but I will never take it again because of all the risks & documented cardiac deaths. Also, heart disease, CHF, and stroke run in my family--parents & grandparents. Just for the record though, it was a wonderful pain reliever! I just made the decision to try Oxycodone even though I am really nervous about some of the documented side effects, but after an epidural last week which has not helped at all, & my current uninsured status as of May 1st, I do not have many other alternatives. I will let you know how the Oxycodone works if you are interested. Also, I would appreciate any advice you might have on pain management options.
    P.S. I have never used the Fentanyl but I have seen too many warnings about problems with it also. My dad was on the patch due to chronic pain in 2003-04 and had a heart attack, which ultimately lead to his death due to heart damage. Again, this cannot be proven as causing his life-ending cardiac problems due to his other health conditions: diabetic, high-blood pressure (controlled with medication), bedridden following stroke in 2002 and chronic back/hip pain.

  3. #3
    Robert_325 is offline Retired
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    Quote Originally Posted by Lilylizi View Post
    Need some expert advice....

    I've taken 290mgs of Methadone for the past 4 years and have been hearing from the medical profession and reading on the net about the incidence of sudden cardiac death from Methadone, even when taken at the prescribed dose. I also don't like the sound of the month-long utterly hideous detox (that is assuming I EVER get to the point where medical science can solve my medical condition which is pretty unlikely) All this information has freaked me and my pain specialist out...a lot so I am researching my options regarding alternative medications. I have narrowed it down to three:
    Morphine, Oxycodone and Fentanyl
    The Fentanyl is already out as it is not funded in my country so it is too expensive. That leaves the other two and I have tried Morphine briefly before but they gave me too little and I started to go into withdrawl and couldn't handle so went straight back to Methadone.
    Need some advice...is Oxycodone a good alternative to Methadone??
    Liz

    PS. Please don't do the whole preach-to-me-about-how-addictive-these-drugs-are...I have an incurable condition so I have no option but to take these kind of drugs.



    You're on entirely too high a dose of methadone to switch over to oxycodone. It's an instant release medication which wears off quickly. You would have to take way too much oxycodone to achieve the same results you receive from 290mg methadone for pain relief.

    If you are dead set on getting off methadone you will need to be on an extended release medication with something like oxycodone for breakthrough pain. Perhaps oxycontin, opana, ms contin, etc as an extended release with codones for breakthrough.

    My suggestion would be that if you really want to make the switch to another medication you should titrate down on the methadone to a much more reasonable dose prior to making a switch. This will help insure you don't have to take such a high dose of something else. You're going to have a rough time making the switch from almost 300 mg of methadone and still keep the new medication at a reasonable level.

    Is your pain dr really that uninformed about methadone that he/she doesn't know what to do? I have to question the dr's knowledge about pain management if that is the case. Methadone is a good medication, possibly the best, for pain management where a patient is going to be on meds for life. If you look around the net you'll find just as much bad press about any of the other pain meds as well. It becomes a quality-of-life issue at a certain point. All RX meds have potential consequences for using them. Good luck and God bless.
    Last edited by Robert_325; 05-02-2009 at 01:32 PM.
    MartyWalker likes this.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  4. #4
    Bobbi1969 is offline Junior Member
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    Default switching over

    I agree with robert about the high dose and trying to switch over. And a time release with some thing for breakthrough pain will most likely be suggested.

    Oxycontin is a very good drug for chronic pain issues, however.... be very careful with it. If there is a history of abuse ,etc. this drug will get you by the balls quickly.The acute withdrawl of this drug (when you run out) topped by the pain condition is pure hell. Talk it over with your doc, and go low and slow.

  5. #5
    nemesis is offline New Member
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    I to agree with robert. WAY to high of mg of methodone. with saying that, it's not like ur trying to kick an opiate habit, like i did, and i did it with methadone, and it worked. But it really sounds like ( sad to say but,,,,) the time release oxycontin is what ur going to be dealing with, just have to find out what mg is right, and will work for you. Good Luck.

  6. #6
    00donald is offline New Member
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    Default methadone

    I was on 300mg of methadone for 4yrs and am now taking 56mg on a continuing decreassing program to rid myself of methadone. It's hard now and I'm slowing to 2-3 mg decreassing weekly as I get lower it's harder and I find myself going through withdrawells being hot and cold a lot. Try not to stay on a high dose for long as it's the worse medication I've ever had to get off and believe me I've done it all. Now I don't do anything thank God not even pot as I find life better and it's nice to have money and go on vacation. I've been addicted for over 40 yrs so I know. Don
    P.S. try not to use anything as an alternitive.
    Last edited by 00donald; 05-23-2009 at 11:06 AM.

  7. #7
    jloops is offline New Member
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    Quote Originally Posted by Lilylizi View Post
    Need some expert advice....

    I've taken 290mgs of Methadone for the past 4 years and have been hearing from the medical profession and reading on the net about the incidence of sudden cardiac death from Methadone, even when taken at the prescribed dose. I also don't like the sound of the month-long utterly hideous detox (that is assuming I EVER get to the point where medical science can solve my medical condition which is pretty unlikely) All this information has freaked me and my pain specialist out...a lot so I am researching my options regarding alternative medications. I have narrowed it down to three:
    Morphine, Oxycodone and Fentanyl
    The Fentanyl is already out as it is not funded in my country so it is too expensive. That leaves the other two and I have tried Morphine briefly before but they gave me too little and I started to go into withdrawl and couldn't handle so went straight back to Methadone.
    Need some advice...is Oxycodone a good alternative to Methadone??
    Liz

    PS. Please don't do the whole preach-to-me-about-how-addictive-these-drugs-are...I have an incurable condition so I have no option but to take these kind of drugs.
    I think you can switch to morphine or oxycodone. They are similar, the oxycodone will be more expensive. You will likely be more comfortable with a time release medication (MS Contin or Oxycontin) than taking it several times a day since you are accustomed to methadone, which stays in your body for a long period of time in steady amounts, especially if dosed several times a day.

    The best way to switch is NOT suddenly. Don't expect to calculate the equivalent morphing/oxycodone dose, and just stop taking methadone one day. Instead, you need to start taking the oxycodone or morphine and start reducing your methadone dose. Every time you take the methadone down, increase the new drug.

    You're going to need quite large amounts of oxycodone or morphine to match 200 mg+ of methadone. I would start taking one of the -Contin preparations 3 times a day, and immediately reduce your methadone dose by some amount.

    Let your doctor fill in the exact details, but I would accomplish the switch over several weeks, moving methadone down and the other drug up every few days as long as you feel comfortable.

    Encourage your doctor to do it this way -- any other way is unlikely to be satisfactory, at least during the transition period.

  8. #8
    jloops is offline New Member
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    Quote Originally Posted by Lilylizi View Post
    Need some expert advice....

    I've taken 290mgs of Methadone for the past 4 years and have been hearing from the medical profession and reading on the net about the incidence of sudden cardiac death from Methadone, even when taken at the prescribed dose. I also don't like the sound of the month-long utterly hideous detox (that is assuming I EVER get to the point where medical science can solve my medical condition which is pretty unlikely) All this information has freaked me and my pain specialist out...a lot so I am researching my options regarding alternative medications. I have narrowed it down to three:
    Morphine, Oxycodone and Fentanyl
    The Fentanyl is already out as it is not funded in my country so it is too expensive. That leaves the other two and I have tried Morphine briefly before but they gave me too little and I started to go into withdrawl and couldn't handle so went straight back to Methadone.
    Need some advice...is Oxycodone a good alternative to Methadone??
    Liz

    PS. Please don't do the whole preach-to-me-about-how-addictive-these-drugs-are...I have an incurable condition so I have no option but to take these kind of drugs.
    I also strongly suggest you get an EKG done immediately to determine if the methadone is causing the QT prolongation which methadone is associated with.

    I agree with you that high dose methadone is not advisable when other drugs which do not share this effect are available.

    Do not panic, however, since you've been on it for several years, apparently without incident. I would, though, get the EKG done PRONTO. If it shows anything nasty, I'd go into the hospital and ask that they swiftly convert you from methadone to another drug as an inpatient...

  9. #9
    mpvt is offline Platinum Member
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    Oxycodone is pretty weak compared to methadone and to get the same effect from 290mgs of methadone you would need 725mgs of oxycodone a day. No doctor would order that.
    After 4 years at 290mgs you can start to come down to 120 mgs were you would be safe from the effect of heart problems. Only doses over 150mgs a day are consider a watch area for heart problems. Try and come down 10% a month until you reach 120mgs. I can almost garuntee you that you won't have a problem doing this....Good luck...Dave

  10. #10
    Robert_325 is offline Retired
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    Quote Originally Posted by mpvt View Post
    Oxycodone is pretty weak compared to methadone and to get the same effect from 290mgs of methadone you would need 725mgs of oxycodone a day. No doctor would order that.
    After 4 years at 290mgs you can start to come down to 120 mgs were you would be safe from the effect of heart problems. Only doses over 150mgs a day are consider a watch area for heart problems. Try and come down 10% a month until you reach 120mgs. I can almost garuntee you that you won't have a problem doing this....Good luck...Dave




    Thanks for that Dave. I don't have the conversions handy being on the road on someone else's computer. I will tell you though, believe it or not, my stupid pain dr back in 2002 when I got clean was prescribing me 900mg of roxicodone per day. Was taking thirty 30mg pills by script a day and this was supposed to be a great pain dr.

    When I checked myself into rehab I saved the last script label as a souvenir just to prove that the dr was doing that to me. What an idiot. Of course that's why my heart stopped twice, I had a stroke, multiple seizures, I freakin almost died trying to get clean. It almost did my heart in. In addition to the roxies I was buying 30 or so 10/650 lorcets on the street. That was awfully stupid and I still can hardly believe I survived as that went on a pretty good while.

    I know that you did insane stuff too for years but you're right that NO dr in his/her right mind would prescribe that kind of dose of oxy for anyone. It's amazing that we're still alive and able to communicate in complete sentences today. I give thanks to be alive every day. Take care and have a good weekend dude. God bless.
    I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.

  11. #11
    ChristianHuff is offline New Member
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    Talking Methadone Issues

    Quote Originally Posted by Lilylizi View Post
    Need some expert advice....

    I've taken 290mgs of Methadone for the past 4 years and have been hearing from the medical profession and reading on the net about the incidence of sudden cardiac death from Methadone, even when taken at the prescribed dose. I also don't like the sound of the month-long utterly hideous detox (that is assuming I EVER get to the point where medical science can solve my medical condition which is pretty unlikely) All this information has freaked me and my pain specialist out...a lot so I am researching my options regarding alternative medications. I have narrowed it down to three:
    Morphine, Oxycodone and Fentanyl
    The Fentanyl is already out as it is not funded in my country so it is too expensive. That leaves the other two and I have tried Morphine briefly before but they gave me too little and I started to go into withdrawl and couldn't handle so went straight back to Methadone.
    Need some advice...is Oxycodone a good alternative to Methadone??
    Liz

    PS. Please don't do the whole preach-to-me-about-how-addictive-these-drugs-are...I have an incurable condition so I have no option but to take these kind of drugs.
    ----- Reply Below-------
    I was on Methadone for over a year. That alone was scary. I was on 90mgs of liquid and had to travel over 50 miles one way everyday to the clinic that I got it from. After doing major research, my wife and I decided to bite the bullet and attempt to get off the Methadone. I went through 4 days of extreme sickness, and it was not something that I reccomend to anyone. PLEASE do not stop taking the Methadone unless you substitute it with something else. Opiates can KILL YOU if you just stop. I was taking 180mgs Morphine, my dad died and I went to a clinic that I was given 'a safe alternative' to Morphine. LIES LIES LIES. Nothing can be so far from the truth. To make a long story short, I now take 20mgs (2 X 10mg) Oxycodone, 2 Somas and one Zanaflex daily. I still have very slight pain but nothing like I had while on the Methadone. If I can help, please let me know, I am always willing to help those that need it. I hope this helps you!! =))
    MartyWalker likes this.

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