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maximum dosage of methadone for chronic pain
Hi Walker, I am one who takes Methadone without any other narcotic. I have been on Methadone for just under 20 yrs and can't begin to remember what my dosage was way back in 1993. In addition to chronic pain resulting from a severe neck injury which I sustained as a result of working as a nurse in a detox unit. (Kind of funny but totally true). Then about 9 mos after the injury I gave birth to (in the beginning) a tolerable case of fibromyalgia which at that time I was assured was not progressive. The big lie. Mine has progressed over 19 yrs to a severely debilitating case. In any event, over the years add several more serious pain conditions, a hip replacement, some kind of bone related surgery on one foot and a severely broken wrist (in 3 places) and the chronic pain involves far more than just my neck. For your complete edification, I am a 70 yr old woman and i also suffer from quite severe fibromyalgia. I currently get monthly scrips for 240 tablets of 10 mg Methadone which, of course, works out to 80 mg per day although I take less some days and more on others depending on pain levels. At this point I need to convince my pain mgmt physician to allow me more like 100 mg per day. I do also take Cymbalta which was primarily developed for some depressive disorders but it has been approved for use in chronic pain and fibromyalgia. It is not an opioid. When I can afford it, I also take Lyrica. I am not convinced of its efficacy. Neither is Lyrica an opioid. Pain is so, soooo subjective and each individual experiences pain SO differently that it is very difficult for any of us to fairly compare circumstances. I am going to tell a story about pain comparison immediately after I post this. Good luck with your situation and trust YOUR gut and the pain YOU are feeling and the degree of relief YOU are experiencing from the particular medication you are using; be it Methadone or something else. My good wishes are with you and Happy New Year to all. Ellie
2 Identical surgeries and 2 very different pain experiences.
Walker and others. Before I worked detox, I worked in a regular hospital and one day was caring for 2 post surgical patients (amongst other patients). Both a 16 yr old 275 lb high school football player and a 79 yr old tiny little lady had exactly the same surgeries on their left knees done by the same surgeon and one right after the other. I would have expected (early in my nursing career) that they would require similar amounts of pain meds and would experience a similar degree of pain. The 16 yr old was back to my floor and in my care first. Right from the get-go he was screaming with pain. I was called every variety of nasty curse words imaginable. I had given him everything he could have and even called his surgeon to see if I could increase his dosage. Just once, by a slight amount tho I don't recall amounts now, or the particular narcotic either for that matter. He still kept yelling about his pain and his parents weren't very happy with me either. I suggested they call the surgeon if they wished. About an hour later, up came the little 79 yo lady. I inquired about her pain and asked if she needed medication. Her answer was "No thank you, deary. I don't like taking medication". For the remainder of my 12 hr shift the 275 lb 16 yr old football player screamed and cried unmercifully about his pain while the 79 yo lady never requested nor would she accept ANY medication for pain relief; not even Ibuprofen!! Remember, same surgery, same surgeon. But this is a perfect example of how different people experience exactly the same PAINFUL procedure (in this case surgery) in such extremely differing ways.
New member today, but I just started taking methadone about 4 months ago but previous to that I as taking or prescribed 4 750mg of vicodin a day then doc switched me to Norco's. I was so concerned about my liver and neither was really helping my pain as much as I needed it to so I could actually work. Have many different issues with my lower back for the past 20 years. I've been taking the above meds for approx. 9 years now and now with Methadone it seems to help my pain a great deal more although I still want Norco's as well. I actually take them sometimes as well along with methadone. My doseage is 5mg 3x a day but I really need more I think as my pain is still there. Doc states their goal is to help with 50% of you pain. Well that's not that great of percentage when you have the pain like I do. It really freaks me out seeing how many mg's some people take on this site of methadone, I always hear rumors that methadone can put you 6 feet under very quick if you take too much. I actually took a total of 35mg's today as I have been hurting pretty bad today and doesn't really seem to help much. Doesn't give me the energy that Norco's gave me but I feel methadone is safer and won't kill my liver like vicodin or Norco. I do feel a little different on Methadone, not sure how I feel but different. My mouth is very dehydrated in the morning too. Also heard methadone with wreck you teeth? Sorry for misspelled words, didn't proof this msg. Any comments on above would be appreciated. Thanks.
Ellielouwho and others w questions,
Please be cautious when reducing on some days and increasing on others, although you are probably a pro by now and aware of your body and how you react. I recently found these graphs which explain the effects of initial dozing, "lining out" and missing a dose. And I thought others might find it helpful as it explains a lot of questions that were asked in this thread esp person who said their Dr's relative died after restarting on methadone...these charts show why.
I've been on methadone for 4 yrs for severe back/neck problems - 5 surgeries, failed back syndrome, perm nerve damage, additional ruptured disks (no more surgery!), spinal stenosis, severe osteoarthritis in my vertebrae and other small joints for my age (45)...no fybromalgia thank goodness. I had 3 neck surgeries ('99,'02,'03) w complete success. I struggled for at least 5 years ('02-'08) w pain running down my leg before they found the problem and "fixed" it but it was too late and I have perm nerve damage.
I'm on a lower dose than most at 10mg 3x a day and oxcycodone 10mg 3x a day. I hope my Dr will increase methadone at next visit as I can't stay comfortable unless I do nothing but lay around all the time. I would like to reduce or eliminate oxy all together due to apap and it jus really doesn't work that well for me. My conditions are degenerative in nature and I'm sure are just getting worse.
Long story to get to my point about effectiveness of methadone, but after neurosurgeon couldn't help anymore I went to pain management Dr. I was only on 5mg percocet 4x a day and was pretty miserable. After 2 days on methadone I was finally getting relief. I didn't realize how much pain I was really in until the methadone. It was literally the first time in over 6yrs (10 counting neck problems) where I had relief from the pain. It's too bad it gets such a bad wrap as it was originally developed as a pain med, not to conquer opiate addiction!!
I also agree w comments about low liver damage w methadone. If you go to the website the charts were copied from (access by the link above) it explains risks to peripheral organs and its low...no apap with it.
Thanks for reading, Jade
This is also a good reference about calculating dosage when changing narcotic pain meds to methadone and explains why calculations from multiple sites don't give the same result. I think understanding the differences of methadone and its half-life is key to preventing accidental overdose. I've been on it for 4yrs and am jus now getting this info so don't rely on your Dr for it, esp if they don't prescribe it regularly.
Last edited by ddcmod; 12-01-2014 at 04:32 PM.
Originally Posted by Sarge69
Please see the links and my experience in my other two posts as I think it will help you. Your story w pain meds being ineffective is a lot like mine so I think the methadone will help considerably, jus be aware of the accumulative effect when starting or increasing dosage. In my opinion, it sounds like your Dr was being cautious and you just need to titrate to a higher dose.
Hope this helps. Jade
There is NO WAY you were ever prescribed 650 MSG of methadone . EVER. Geez folks, be careful who you listen to on here. I just found a moron dressed in a dip>>>>s clothing. Hey man, I think a village somewhere is missing its idiot. You better hurry home, dum dum.
Originally Posted by mpvt
I have been on 160mg of methadone for over 12 years and my liver tests are normal too....hmmm.
Mike, You Should Work As A Greeter At Disneyland !!!
Originally Posted by Sutmik1
Mike, I'm sorry, but this segment of your comment: "So, according to that study, the only maximum dose is the dose required to relieve the pain.", sounds like something somebody who believes in the Easter Bunny would say! Since when does "a study" allow a physician to circumvent state or federal law when it comes to daily maximum dose regulations or restricted medicinal usage for some Rx drugs?
Case in point...you go in to your GP's office and say "Doc, I hurt my back last night will you please prescribe me some Methadone for pain?" Can he? Most certainly! Now, you go into your GP's office and say "Doc, I'm currently addicted to opiates. Will you write me an Rx for Methadone for addiction?" Can he? NO !!! Not legally! If he states on the script that the methadone is for addiction, the pharmacist will not fill it and if he does, he's breaking the law.
Case in point...you go into your GP's office and say "Doc, I have Narcolepsy, will you write me an Rx for Benzedrine (an amphetamine)?" Can he? Most certainly! Now, you go into your GP's office and say, "Doc, I've gained 50 pounds in the last 3 months, can you write me an Rx for Benzedrine? Can he? NO WAY JOSE !!!
Also, and this is very, very, relevant...while federal law may allow authorized physicians to prescribe a high level of Methadone for addiction, it does NOT necessarily mean that any MD can prescribe a similar quantity of Methadone for pain. Believe me, it's ALLLLLLLLLL regulated! KIP (knowledge is power).
Well, I may be wrong, but to me Tomlacovera sounds like a wanna be!
Notice how he states "I have a degree of medical training", not a degree IN "medical training" (typical wanna be statement). Which taken literally, could mean he once took a first aid course with the Red Cross!
But even before that, he JUST has to mention that "my brother is a doctor" !!!
Well, whoopee dotta doo!
His brother being a doctor is about as reassuring when he starts spouting medical advice, as I would be telling 300 passengers aboard an inflight Boeing 747, whose LONE pilot has just died of cardiac arrest, that everything is AOK as I announce " Ladies and gentlemen, rejoice, rejoice and please don't fear, you have absolutely nothing to worry about...my brother is a pilot!". KIP (knowledge is power).
I've been taking methadone for 10 years. I switched pain management doctors in May and they reduced my dose from 50 mg per day to 40 and took away my Soma, Norco, Valium and Ambien. After being educated, I now know I was completely over-medicated. Now I am in constant excruciating pain from a herniated disc in my lumbar area. I'm going to see another pain doctor next Friday. I've read through the other comments and my first question in coming here was if I asked to be increased to 60 mg per day was too much since I'm not taking any other pain meds and because I'm not an addict since I stopped all those meds on my own with no problem. Has anyone had a radio frequency ablation and did it help? I had it done on both side at the end of June and it brought no relief but I think it's because my disc is too messed up. I cannot take this pain any longer - I'm ready to eat a bullet
Originally Posted by marshall1955
Why call someone a fool?
You do realize this thread IS OVER 9 YEARS OLD RIGHT???
Hi I'm not a user of any kind.. but I am looking for answers of anyone has any.. My brother last week decided that he no longer wanted to be addicted to Morphine so he went to the doctors and they gave methadone 110mls. my brother died on the 10th January 2015 I don't understand why the doctors would give him that dose ?? My family are falling apart..
I think you are right on with the village idiot quote. I take 40 mg, of methadone divided into 4 doses each day, and I certainly believe that 650 mgs will "cool" you quickly!
Originally Posted by Williamlemons42
I am not a health care professional but I have an opinion. If your brother was a morphine addict perhaps he had abused his body so badly that he was on the "edge" of dying and perhaps he was going to die regardless. Again, this is only a guess and a lay person's opinion (although I was a peace officer for over 30 years. Also I am sorry for your loss. Ed
Hi everyone, I am new to this forum. I am in pain management for 14 years now,, been on the same dose of Methadone , 20 mg three times a day, for 10 years, and I function fine. However, my pain doctor told me yesterday that due to the FDA cracking down on Opiate usage, they would be starting to decrease the dosage for all patients that are on High Dosage of opiates, and I asked my doc if that included me,and she said yes. So after reading many posts here, it appears I am not really in that range, and for those that are on 60mg a day or more, I am wondering what region of the Universe you are located, as my doc told me I would not be able to ever find another clinic to take me due to my high dosage of medication...(which had me in tears, because my spine is so messed up and I am in a LOT of pain). Thanks for any input you may have :-)
The reason is methadone is a powerful analgesic opiote .that sleepy feeling will go away after a few weeks.
Be careful till your body adjusts if your working,driving a cad or a forklift till the a adjustment period is over.
Then you will not even know your taking anything besides pain relief
Initial methadone doses ranged from 2.5 to 80 mg per day and the maximum doses varied from 20 to 930 mg per day. but if you want increase your dose you should consult your doctor first..
Methadone dosage is different when taken for chronic pain than it is for opiod dependency. For example, one may get 10-20mgs poq 4 x a day totaling between 40-60mgs per day sometimes with a medication like oxycodone or hydromorphone for breakthrough pain prescribed usually by a pain management physician.
For opiod dependency, the patient goes to a clinic (usually) and receives the entire dosage (25mg - I've seen patients at doses upwards of 200mgs. I personally think there's a "ceiling effect* after 120mgs...I've been on Methadone for chronic pain for a LONG TIME and my dose at the moment is 20mg at 6am and 20mg at 6pm w/oxycodone every 6 hrs or so for BT pain. I also take 2mgs of Xanax at night which helps my muscles and anxiety. Yes,I know about the dangers of mixing benzos w Methadone but my dr has had me on this regimen for about a decade so I have a tolerance to it. With no tolerance, YES,VERY UNSAFE!
STAY SAFE AND PAIN FREE!
I believe and I have proof
Hi my name is Sarah,
Originally Posted by tomlacovara
I have been on methadone for 2 years and I am on 330. I have full carries so if you had an e-mail I would send you the pic of my bottle, hell I give you my pharmacist number at my clinic. Some people have a very high metabolism, and for me it goes right through. I dont think you should be giving out advice, especially if your not 100% certain. I would also appreciate it if you wouldn't put down health practitioners. Every body is made different, and responds different to medication. Also I just had my liver tested and I have a VERY HEALTHY liver thank you very much! I also have never done the nod on Methadone.
Last edited by Sarwhip; 08-23-2016 at 04:20 PM.
All of you on methadone need to get an EKG at least once a year. I developed qt elongation on only 30 MG of methadone a day. It can kill you if it gets bad. Tell your doctor you want your heart checked yearly. I had to get off of methadone because of it and get on morphine. It doesn't work as well, but at least I am alive.
Hi i am on 10 mg at 12 tabs per day and 280 percosets 5mg per month. I use to get 640 10mg methadone a month and 380 percosets but the problem is that my doc is trying her best to take me off my methadone, before i started taking meds.i Hadnt even taken an aspirin inmy life and i hated pills ,drugs etc to making an extremely long story short i was in an auto accident so i have a botched surgery wich caused severe chronic nerve damage on my entire left side , front and back I have chronic nerve pain in my legs, rhuematoid arthritis in my knees and hands ,I have 2 bad shoulders and 2 herniated disc in my back .
Originally Posted by mpvt
I hate to say this because i use to b the one who thought people whom thought this were stupid but i dont know if i can live with this pain and no pain meds.
My doc says i get more methadone than anyone else in the clinic and the drug store refused to fill my script because of all the people overdosing on methadone, I do live in a small town but im scared to death that i wont be able to find a doctor that will give me my meds so lol my qusetion to u is do you live in a big city? Because i think you have more options in a bigger city versus one that only has 7000 people. I have to go out of town to see any type of specialist.
If they were high it was benzos doing it. My counselor, along with a pamphlet I've read, says that to be therapuetic one must be on at least 75 - 80 mg!! For addiction I was fine on 115 mg... And that dosage helped my arthritis pain very well.
I take methadone for opiate addiction. My counselor , as well as a pamphlet I've read, states that its not therapeutic until at 75-80 mgs! It seems most people at my clinic take about 125 mgs. I've heard as high as 250 mg. The only time I've heard of under 80 is if its a new client or someone detoxing out of the program. Also, they tell us do not worry about our dosage amount. They say we must be on enough to last 24 hours without feeling withdrawals. That can vary greatly between people. There are occasions that some people do not metabolize correct and clinic will give them a split dose... Meaning instead of expecting our dose to last 24 hours they have us take 1\2 in the morning and the rest at night. If course for pain this entire plan would be different since they have you take several doses throughout the day. I guess I'm talking this because of the fear I heard about ovrdosing.