Don't ya think Methadone should be one of the first time, med for pain??? Instead of Hospitals giving out Percocet, they should pass out Methadone, don't you agree???
In certain situations I could agree. If you were already opioid tolerant and your pain was chronic. But many hospitals are treating people with acute pain, surgeries, broken legs, etc. So I wouldn't consider methadone a good choice for short term pain. Also, the majority of people who leave the hospital take their meds responsibly and don't need long term pain management. But it does work well for long term pain control and you rarely need dose adjustments unlike perc's or hydro's ... short acting meds. But as a first line defense, I would have to disagree.
Methadone is one of the strangest opioids out there (at least as far as I'm concerned), along with Ultram (for totally different reasons). Anyways, Methadone's initial strength is twice as strong as Morphine initially. Within a few week, this is not true, as Methadone sits in the system for a long, long, long time. While the pain killing abilities only last for 4 to 7 hours, depending on age and weight and source that you look at, the CNS depression lasts much longer.
according to ( http://en.wikipedia.org/wiki/Methadone )
"Methadone has a slow metabolism and very high fat solubility, making it longer lasting than morphine-based drugs. Methadone has a typical elimination half-life of 15 to 60 hours with a mean of around 22. However, metabolism rates vary greatly between individuals, up to a factor of 100, ranging from as few as 4 hours to as many as 130 hours, or even 190 hours. according to another source"
So, if you take a does of lets say 20mg the first day, and that's not cutting it, and you decide to go up to 40mg the next day, if you're not opioid tolerant, it has the possibility to kill you. The CNS is still completely depressed from the previous day, and taking the 40 on top of that would be like taking not 40mg, but a bit less than 60mg. As the days progress, it continues to build and build to the point where it has a ratio to morphine according to several studies (and just about every study says something different) to be 1mg of Methadone to 10 to 20mg of Morphine. Even over the course of a year, the methadone collects in the liver, and your levels continue to increase over the course of time, thus the most probable reason as to why there is so little to no tolerance build up.
Methadone takes a long time to build up in your system, and is the reason why it doesn't have the "rush" that you'd get from other very strong opioids. However, it is very addictive, and while you can lead a more productive life on methadone vs. heroin and several other prescription narcotics, it is actually comparatively hard to discontinue. The withdrawals aren't quite as bad, but they last twice as long, so really, it's a matter of opinion. Methadone also has it's own host of risks involved. One of the risks include sudden heart arrhythmia that is more problematic at doses above 30mg, as well as central sleep apnea, lack of oxygen during sleep, not due to blockage such as what often happens during snoring, but due to the brain not regulating that overall function as well as it should. Over a course of years, this places a burden on the right side of the heart, making it work harder to get oxygen into the system. This eventually can lead to a cardiac problem with the heart, on the side that there is little medication or treatments available for, as alpha blockers, beta blockers, and heart medications in general work only on the left side (working on clogged arteries, reducing stress on the pump out, but not so much on the pump in, what brings the oxygen to you). The only reason why I know this is cause this is something that I'm currently struggling with.
Regardless of the risks involved, Methadone nonetheless is rated by many to be one of the best medications for long term chronic pain, however, is not well suited for short term use due to the slow build up that should happen when starting the med, the cardiographs that will be needed at certain stages of the increase (if your doctor is informed on the details of this medication), and overall investment of time, and time that it takes to act at the level that you need it to act.
I hope that you don't mind my lengthy response, and you need to note that I do not have numbers of the actual percentage of methadone users who are prescribed the medication, who die from heart failure - can't find the data. I can find tons "about it", or... 10 people died from... but never says exactly the frequency. Something to keep in mind that I may be just relaying tainted info. Also, the sleep apnea is something that is never discussed, and is very hard to find hard data as to what percentage of users are affected by some of these things. I was also on a cocktail of meds that I've recently stopped half of, as well as taken pro-active measures to fight the disorder, such as exercise, vitamin B6 at night is suppose to help, as does cutting out certain unhealthy dietary habits :(
This medication is not well understood by many doctors, and the more in depth that you go into the facts that are stated, the less substance they actually hold, and may be a simple result of all of the deaths that have occurred due to abuse of this very potent medication, not realizing the half life of the pain killing effects, vs. the CNS depression.
I am not a doctor, and don't claim to be, just a guy who has chronic pain, as well as a few mental issues, so please double check my statements, as it seems like the info regarding this med changes depending on what study you look at, and I have yet to find the exact percentages. If anyone knows, I hope that you share, cause I really wonder how much of it is a scare tactic used my doctors, vs. reality, much like the benzo scare of the 1970's, truly useful medication that so many doctors don't like to use, only due to its image, but… are more than willing to give out Tramadol cause it's not scheduled.
Good luck, and I sincerely hope that this has been of some help!!
You can get addicted to Methadone - it is an opiate, same as Percocet (Oxycodone). Also, it takes time to build up in your system, so it wouldn't be good for acute pain (which is what you have after surgeries, or an injury). Because of the nature in which it builds up in your body, it also takes a very long time to withdraw from, and can be very hard to get off of. That is one of the reasons doctors don't prescribe it first thing.
I am glad it is working so well for you - best of luck to you!
Let me give you some numbers. I have had 4 friends die in the last 6 years from methadone use (most were first time uses) . Then another died this year from a fent. patch. These drugs are serious and very dangerous. They shouldn't be handed out like candy. The whole country would be opiate addicts.
I starting taking opiates because a doctor prescribed them to me for chronic pain when I was 17. I always had a prescription and it said "Take every 4 hrs for pain" so I did and thats how I ended up addicted. Im in withdrawals now from suboxone (which sucks) that I got on so I could taper off. So just everyone be careful. I was doing it for the right reasons only when I had pain and now 7 years later with extended times of sobriety (yrs) I'm having to detox from something much stronger. So just know that if you take it every day even if its because you just can't function with out which I definately get you are most likely already dependent on them.
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