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maximum dosage of methadone for chronic pain
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    ironhorse is offline New Member
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    Default maximum dosage of methadone for chronic pain

    I was just recently taken off 60 mg per day of methadone for chronic knee pain. I had built up a tolorance to the drug, and this so called pain specialist told me that 60 mg was the maximum dose for pain relief that had been tested, and I have a hard time believing that because I know that addicts take extremely large doses of methadone and it seems that there would have been studies to determine the effectiveness of methadone at higher levels for pain relief. Can anyone tell me just what the maximum dose is for pain control of methadone? The doctor had me withdraw from the methadone before he put me on morphine s04 at 200 mg per day and it isn't nearly as effective as the methadone.

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    mpvt is offline Platinum Member
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    There is no limit for pain control.I'm on 400mgs a day of methadone and have taken 650 mgs a day at times.Your doctor has cold feet and may suspect that your addicted.Can you go to a pain clinic???If you can't then a methadone clinic will have to do but don't tell them your there for pain.Your going to have to tell them your addicted to methadone.The one good thing is you will get a much larger dose than 60mgs.Good luck....Dave

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    kyhomegirl is offline Member
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    Hello mpvt, I was just wondering something. Are you able to function on that much methadone? I watched that methadonia on HBO and they all seemed to be zombies! But I think they were also on benzos or something too. Also, do you take it all at once, or throughout the day? Sorry for all the questions just curious!

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    mpvt is offline Platinum Member
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    Methadonia was a poor documentry on methadone.Those bozo's were abusing benzo's along with their methadone.They certainly don't represent the majority of people in MMT.I was actively addicted for 22 years,in that time I never went a day without opiates,never.I also could take massive amounts of opiates.I was taking 3 000mgs of morphine just before I got on methadone and I could have taken more if I was able to get my hands on it.So needless to say I have a very high tolerance to opiates.400mgs of methadone makes me feel normal,I have never nodded on methadone and to be truthful I have difficulty sleeping.I hope this answers your questions.If you have any more don't hesitate to ask that's one of the reasons I come here.......Dave
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    LovlyM is offline Junior Member
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    Im on the Methadone clininc and was up to 135mgs...I am not on 68 and going down 1 mg a day for detox. Your best bet might just be to say your addicted and go to a methadone maintenance. Its not just for herion addicts but anybody with any dependance to any opiod or pain killer (like me). Good luck

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    kyhomegirl is offline Member
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    I thought it was the benzos that made them act like that. Now my husband is even more against it. So do you take it all at once? I guess you probably would huh?

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    LovlyM is offline Junior Member
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    Yes, I get dosed once a day...they call it liquid cuff.

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    tomlacovara is offline New Member
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    Quote Originally Posted by mpvt View Post
    There is no limit for pain control.I'm on 400mgs a day of methadone and have taken 650 mgs a day at times.Your doctor has cold feet and may suspect that your addicted.Can you go to a pain clinic???If you can't then a methadone clinic will have to do but don't tell them your there for pain.Your going to have to tell them your addicted to methadone.The one good thing is you will get a much larger dose than 60mgs.Good luck....Dave
    My friend....I have been on Methadone for years and my brother is a doctor and I have a degree of medical training as well. Whatever doctor has you on that much methadone is seriously misguided and commiting a crime against you. By switching to another opioid when your tolerance raises and then some time after switching yuou back is a very effective way of combatting the tolerance issue. The amount of damage that you are being subjected to to your liver is criminal . You need to go get a second opinion and then get yourself a lawyer ....more importantly , you need to have your liver tested immediately. And if you are a chronic opiate user and you do sustain liver damage you will be an unlikely canidate for transplkant as non-opioid dependant persons will be before you on the recipient list. Your doctor is endangering your life on so many levels.....that I pray for your safety that you are not being truthful.....not an accusation but a real wish placed in defference to your well being

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    tomlacovara is offline New Member
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    Hello ....actually 60 mgs. is the lower dose in the chronic pain spectrum. All of my rersearch to date shows that the average dose for chronic pain treatment is between 60 to 80 mgs. I went back and tried to find 2 seperate articles quickly to send to you,I couldnt find them that fast but if you want them contact me and I will make sure I find them.

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    tomlacovara is offline New Member
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    Default heylo

    Quote Originally Posted by kyhomegirl View Post
    Hello mpvt, I was just wondering something. Are you able to function on that much methadone? I watched that methadonia on HBO and they all seemed to be zombies! But I think they were also on benzos or something too. Also, do you take it all at once, or throughout the day? Sorry for all the questions just curious!
    Using that much methadone is dangerous to the potential liver damage it can cause over a period of repeated use. In my opinion it is criminal for a doctor to do that to a patient when there are effective alternatives such as switching to a different opioid with a different chemical signature that you can in a way tolerance shift....kind of like if you have a high tolerance to 1 switching to the other is like starting all over fresh.....then when your tolerance raises to that you switch back thus not bombarding your liver and subjecting it to permanant damage and also if that happens you will be highly unlikely to be eligable for a transplant.....Play in traffic with nitroglycerin at night wearing black with a blindfold..... same thing.

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    lennylou is offline New Member
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    Quote Originally Posted by tomlacovara View Post
    My friend....I have been on Methadone for years and my brother is a doctor and I have a degree of medical training as well. Whatever doctor has you on that much methadone is seriously misguided and commiting a crime against you. By switching to another opioid when your tolerance raises and then some time after switching yuou back is a very effective way of combatting the tolerance issue. The amount of damage that you are being subjected to to your liver is criminal . You need to go get a second opinion and then get yourself a lawyer ....more importantly , you need to have your liver tested immediately. And if you are a chronic opiate user and you do sustain liver damage you will be an unlikely canidate for transplkant as non-opioid dependant persons will be before you on the recipient list. Your doctor is endangering your life on so many levels.....that I pray for your safety that you are not being truthful.....not an accusation but a real wish placed in defference to your well being
    Just to be clear, a way of combatting tolerance is switching opiates\/

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    gene546 is offline New Member
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    Default student

    Quote Originally Posted by ironhorse View Post
    I was just recently taken off 60 mg per day of methadone for chronic knee pain. I had built up a tolorance to the drug, and this so called pain specialist told me that 60 mg was the maximum dose for pain relief that had been tested, and I have a hard time believing that because I know that addicts take extremely large doses of methadone and it seems that there would have been studies to determine the effectiveness of methadone at higher levels for pain relief. Can anyone tell me just what the maximum dose is for pain control of methadone? The doctor had me withdraw from the methadone before he put me on morphine s04 at 200 mg per day and it isn't nearly as effective as the methadone.
    I’m taking 90 MG of methadone a day. 30 MG three times a day, and it has been very effective for my cervical spine, right knee and sciatica nerve pain. My MD started me with 30 MG the first month, 60 MG the second month, and finally 90 MG; the latter dosage is very effective, and I feel like finally, the pain is under control. Side effects: none so far, I’m pretty sure that 90 MG is the adequate dosage… at least for me. I couldn’t perform my sexual duties with my wife, nor many things that now I can do it; at least to feel productive and less depressive.
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    sheri1612 is offline New Member
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    Hey there....I know you posted back last year so I hope you get a chance to read this. I have been on Methadone for over 12 years now and it is for chronic pain. Currently, I am on a dose of 12 10mg tablets per day and have been for over 4 years. We have had the same doctor, same insurance and same pharmacy for the same 4 years. I pick up my prescription every 2 weeks without fail. When I went to pick it up today, the pharmacist informed me that he was having a very difficult time getting it to go thru insurance. He finally was able to do it, but really had to go about it in a difficult manner. I immediately called my insurance provider and asked them what the problem was and I was told that the manufacturer of methadone will only allow a maximum daily dose of 8 10mg tablets per day! I wanted to scream and yell at this lady, but I knew that it wasnt her fault so I maintained my composure... Anyway, I then asked why the sudden change and she then said that this went into effect Jan. 1st 2010!!! I said they were about 8 months behind (since its now Sep 2010) and that I still didnt understand how the insurance company or the manufacturer can determine how much of any drug I take when my doctor has prescribed it for me and again has not changed the dose or mg in 4 years!!! Have you heard of anything such as this? I am also tempted to just pay cash instead of going thru insurance since I think methadone is relatively cheap. Anyway, I just wanted to get another point of view. Thanks so much and have a great day!

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    pamh123 is offline New Member
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    Post in pain also

    Quote Originally Posted by ironhorse View Post
    I was just recently taken off 60 mg per day of methadone for chronic knee pain. I had built up a tolorance to the drug, and this so called pain specialist told me that 60 mg was the maximum dose for pain relief that had been tested, and I have a hard time believing that because I know that addicts take extremely large doses of methadone and it seems that there would have been studies to determine the effectiveness of methadone at higher levels for pain relief. Can anyone tell me just what the maximum dose is for pain control of methadone? The doctor had me withdraw from the methadone before he put me on morphine s04 at 200 mg per day and it isn't nearly as effective as the methadone.
    I have been on methadone for 4 years for chronic pain and it also has maxed out but as to your question your doctor needs to do some checking and I am on 100mgs a day plus take 3 percocet 7.5mg 3 timesw aday and today am seeing my pain doctor for my regular appt. and going to be asking for him to increase my methadone dose at least 20 mgs and I know others that take 150 mgs daily so please if you are having pain either find a new doctor or ask your doctor nicley to please call and talk to a pharmacist and they can even tell him ya dont want to just bam jump up a bunch but 10 or 20 mgs a week should not hurt you I wouldnt think as that is how they raised mine. I hope this helps you.
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    Sutmik1 is offline New Member
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    Post Methadone and Liver or Kidney Damage

    I am sorry to say, but the comment made about large doses of Opioids or other Narcotics being harmful to the liver or Kidneys is wrong. The only time that Narcotic or Opioids are harmful to the liver or kidneys is when they are combined with any of the NSAID family, acetomeniphen, or aspirin. Narcotics and opioids are only dangerous when high doses are used in people without severe chronic pain when the dose is raised too fast. Chronic pain is a respitory stimulator, keeping people from stopping breathing, as noted in the treatment of Chronic pain with Narcotics and maximum doses on The WebMD website. So, according to that study, the only maximum dose is the dose required to relieve the pain. If it takes 2000 mgs of Methadone to control the pain level and it was done over a period of time, then that would be the maximum dose of Methadone for that pain level. Narcotics being harmful to the Liver and Kidneys are commonly misconstrued, so long as, the drugs are pharmaceutical and not >>>>>>e or some other street drug.
    My knowledge in this matter comes from being a Chronic Pain Patient on a large dose of Oxycontin for Many Spinal Fusion surgeries, for many years, and my concern for my health on the high dose plus long term dosing and speaking to Anesthesia Docs and several Pharmacists. Hope that helped.



    Thanks,
    Mike
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  16. #16
    Sutmik1 is offline New Member
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    Talking The use of Roxicodone for break through instead of Percocet

    Hey pamh123, I noticed that you said you took Percocets for your break through pain control. You may want to consider asking your doc to switch you to a drug called Roxicodone and get you away from the Acetomeniphen that is in the Percocet. Percocet is highly dangeropus and toxic to your kidneys. Long term and especially High doses of Percocet could cause severe endstaged renal disease. That could potentially cause you a life threatening condition with a kidney transplant being needed to save your life. Roxicodone is a drug that is an immediate release drug containing 5 mg, 10 mg, 15 mg, or 30 mg tablets of oxycodone only. The same drug that is in Percocet, but without the CET and it is more efficient. It gets more of the oxycodone into your system the the instant release component. It can also be delivered via Sublinguinal or under the tongue, getting even more of the drug into your system and making it a better Break Through Pain Drug.

    Just a thought. Save those kidneys and your liver if you are using anything with Ibuprofen in it.

    Good Luck,
    Mike
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  17. #17
    Karlin is offline New Member
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    Quote Originally Posted by tomlacovara View Post
    My friend....I have been on Methadone for years and my brother is a doctor and I have a degree of medical training as well. Whatever doctor has you on that much methadone is seriously misguided and commiting a crime against you. By switching to another opioid when your tolerance raises and then some time after switching yuou back is a very effective way of combatting the tolerance issue. The amount of damage that you are being subjected to to your liver is criminal . You need to go get a second opinion and then get yourself a lawyer ....more importantly , you need to have your liver tested immediately. And if you are a chronic opiate user and you do sustain liver damage you will be an unlikely canidate for transplkant as non-opioid dependant persons will be before you on the recipient list. Your doctor is endangering your life on so many levels.....that I pray for your safety that you are not being truthful.....not an accusation but a real wish placed in defference to your well being
    It sounds like, in your professional opinion, you are saying opiates cause liver damage.
    IMHO, unprofessional but personally experienced, I disagree. I have been taking 300mgs to 500 mgs per day for over 20 years - YEARS I say! - and my liver tests normal.

    Liver damage comes from other drugs -

    Acetominophen damages liver... eg Tylenol. {leading cause of liver damage deaths in USA?}

    Vioxx , Celebrex {cox2 inhibs] damages livers - {i.e. Dr. Reuben found guilty of fraud for report the FDA based approvals on. It was not widely reported, my own doctor never heard the story, so I can understand why professionals are wrong at times}

    ---

    The theory is that "plant based drugs" such as opiates are compatible with the human body because we - the poppy plant and humans - evolved together.
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  18. #18
    Arche is offline New Member
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    Default Wow

    Quote Originally Posted by sheri1612 View Post
    Hey there....I know you posted back last year so I hope you get a chance to read this. I have been on Methadone for over 12 years now and it is for chronic pain. Currently, I am on a dose of 12 10mg tablets per day and have been for over 4 years. We have had the same doctor, same insurance and same pharmacy for the same 4 years. I pick up my prescription every 2 weeks without fail. When I went to pick it up today, the pharmacist informed me that he was having a very difficult time getting it to go thru insurance. He finally was able to do it, but really had to go about it in a difficult manner. I immediately called my insurance provider and asked them what the problem was and I was told that the manufacturer of methadone will only allow a maximum daily dose of 8 10mg tablets per day! I wanted to scream and yell at this lady, but I knew that it wasnt her fault so I maintained my composure... Anyway, I then asked why the sudden change and she then said that this went into effect Jan. 1st 2010!!! I said they were about 8 months behind (since its now Sep 2010) and that I still didnt understand how the insurance company or the manufacturer can determine how much of any drug I take when my doctor has prescribed it for me and again has not changed the dose or mg in 4 years!!! Have you heard of anything such as this? I am also tempted to just pay cash instead of going thru insurance since I think methadone is relatively cheap. Anyway, I just wanted to get another point of view. Thanks so much and have a great day!
    My doctor just switched me from 60 mg of MScontin 3x's aday to 10 MG's of methadone 2 X's aday and it puts me to sleep with just the 10 mg's . Now i can eat like 15 roxies aday and never get the effect from methadone i cant believe how you all can function on the doses your describing ,thats just incredible . I hope you all are ok and not having adverse effects . why does so little have such a large effect on me even though i can take other opiates at much higher levels? thanx for the time

  19. #19
    bobbyjack is offline New Member
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    Default re: 60 mgs methadone for pain control

    Quote Originally Posted by tomlacovara View Post
    Hello ....actually 60 mgs. is the lower dose in the chronic pain spectrum. All of my rersearch to date shows that the average dose for chronic pain treatment is between 60 to 80 mgs. I went back and tried to find 2 seperate articles quickly to send to you,I couldnt find them that fast but if you want them contact me and I will make sure I find them.
    Hello and thank you for this comment; been trying to find legitimate or Medical journal-type articles I can take to my physician as she has a problem dosing me correctly primarily due to her family member who was an addict and overdosed/died from methadone after he had been on it then stopped and went back. I know that after being on it and stopping then going back your tolerance is different then just starting out. Has something to do with memory? Which our cells all have.. anyway I hope you can still locate those 2 articles and would greatly appreciate them.
    I currently take 40 mgs per day, but when she first prescribed them I knew I would need at least 60, but it was difficult getting this dose; also understand it has to be done slowly. I also live in a small..town.

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    bobbyjack is offline New Member
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    I think I replied to your post incorrectly so in case you did not get my reply (I'm new) here is:
    Hello and thanks for your comment regarding how much is enough or too much methadone for pain.
    Ihave chronic and acute pain flare-ups and would really like to see those articles re: 60-80 mgs is normal.
    My physician had a family member (an addict) who was o methadone then went off. When he went back on he "overdosed" I did not ask about other medications because, a) did not want to be insensitive b) did not want to seem challenging because I was new patient, I like this doctor but I'm concerned that I may never be treated with the appropriate dose, and I live in a relatively small town where finding doctors is a rare commodity. The doctor I saw in the Bay Area 300miles r/t, had me on much higher dose. They are not afraid of it, I suppose.
    Thank you for your help.

  21. #21
    bobbyjack is offline New Member
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    methadone does not cause liver damage; you should check this out yourself/

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    lifetimeofpain is offline New Member
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    I too am an MP veteran from the '80's at fort McClellan AL. My doc I have seen for close to 15 years said that the typical pain treatment amount he uses is < 100 mg. of methadone.

  23. #23
    lifetimeofpain is offline New Member
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    Unfortunately that is to common of a story. They need to realize that the body resets itself after a while and you once again become a zero tolerance person so what you use to take regularly without any effect is now lethal!

  24. #24
    lscagle is offline New Member
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    FWIW: I am a physician and I have been on methadone for +12 years. Just to let you know, I have a chronic pain physicain that manages my care. I take 40mg q 6hrs for chronic low back pain from falling down a staircse in 1993. I also use 30mg oxycodone q 4 to 6 hrs prn breathrough pain. I have used just about every type of narcotic analgesic and I have to say that methadone is my prefered medication. It is one of the "more" safer medications in reguards to hepatic or renal insult.

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    troopbd is offline New Member
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    I seriously question if you are truely a physician. The way you wrote the frequency of what you take isn't exactly correct, although would pass on an RX at the pharmacy. The other things are the ""more" safer" comment and the misspelling of the word regards. People on here are truely looking for guidance and/or advice. It is unethical to misrepresent yourself as a physician if that's not what your profession is. If you are in fact a physician, then I humbly apologize.

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    zoltron is offline New Member
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    I'm currently taking 100 mgs daily & have been for 6 yrs now (spinal-stenosis). My pain management doctor (who's 1 of the nicest docs I've dealt with) started me at 40 mgs in 2000, then went to 80 mgs in 2004 & then 100 mgs in 2006. 1 nice thing about the State I live in (USA), is the pain clinic gives me 3 prescriptions at a time, post-dated every 28 days. That way I only need to see them 4 times a year.
    I go back the end of Jan. 2013 & I think doc is going to increase my dosage. Does anyone know of a better pain killer than methadone? I'd try something else, but if it's not as effective, forget it.

  27. #27
    timbotimmyjim is offline New Member
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    I have been on Methadone for chronic neck pain for approx 10 years as a result of a car accident. I currently take approx 150mg a day. I have tried all kinds of different pain meds, and by far Methadone has been the most effective while not causing me any of the " doped up" side affects. My pain management Dr told me before that Methadone gets a bad rap because of its use for herion dependancy and I have come to agree. This medicine has allowed me to support my family - before, I was on ice all day....

  28. #28
    Bobofet is offline New Member
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    Quote Originally Posted by Arche View Post
    My doctor just switched me from 60 mg of MScontin 3x's aday to 10 MG's of methadone 2 X's aday and it puts me to sleep with just the 10 mg's . Now i can eat like 15 roxies aday and never get the effect from methadone i cant believe how you all can function on the doses your describing ,thats just incredible . I hope you all are ok and not having adverse effects . why does so little have such a large effect on me even though i can take other opiates at much higher levels? thanx for the time
    I had the same problem when I started on methadone, as well as wIth any dose increases. I am now on 100 mg a day and have no issues. It just takes a little time to become adjusted.

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    TheGateKeeper is offline New Member
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    [deleted - swearing]
    Last edited by ddcmod; 12-21-2012 at 11:15 PM.

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    TheGateKeeper is offline New Member
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    Default Newbie to Methadone & Drugs.com

    I'm new here as a poster and I just started on Methadone this week, which is why I came here looking for proper dosages for Methadone for pain control. I suffer from a diagnosis of serious osteoarthritis of the spine & spinal stenosis for which I've been taking opiods for three years now. I've taken everything from Oxycontin to Fentanyl in countless dosages & forms (pills, patches & injections) and I've been on Dilaudid for the past year now.

    It seems my system has built up a tolerance to Dilaudid so, my doctor prescribed Methadone on Monday which I'm currently taking 5mg tablets three times a day. That sure doesn't sound like much when I read the comments on here however, I'm still taking the Dilaudid along with the Methadone & my doctor wants to be sure I can tolerate the Methadone before increasing the dosage & eliminating the Dilaudid all together? I'm really hoping the Methadone works for me so I can get off the Dilaudid simply because it messes with my breathing & I don't care for that at all.

    The pharmacist says I will really like the Methadone & it should have me off the Dilaudid pretty quickly with excellent results for pain control using the Methadone only? Does anyone take just Methadone for pain without using other opiods as well? Thanks in advance, Walker.

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