Tuesday, June 03, 2008

Methadone for pain relief can be permanent

I was reading an article entitled “The Methadone Poisoning Epidemic” in The Forensic Examiner magazine (sorry no link, it was paper) and I wanted to share a few points with you.

Using information from a National Center for Health Statistics report the author relates that in 2003 methadone-related deaths rose 29%, while drug related deaths as a whole only increased 6%. In addition, methadone was responsible for more deaths than any single prescription painkiller listed (that doesn’t reflect our experience while we see these sorts of methadone overdose deaths, those with hydrocodone and oxycodone are in higher numbers here). The number of unique patient prescriptions for methadone increased 80% through 2005 and 2006 (in most cases prescribed for pain management).

The real key and the point the author really stresses is that methadone overdoses occur by in large in folks using methadone as a pain medicine, not in folks on methadone as maintenance therapy for opiate addiction. This is primarily because while the drug half life in the body is 24 to 36 hours, the pain relief effect lasts 4-6 hours. While the intent is to reach steady state for pain modulation, folks start chasing their pain with additional doses. Those additional doses build over time because of the long “real” half life with lethal consequences.

This lethality is compounded by concomitant use of other medications and certain underlying medical conditions, like sleep apnea and prolonged QT interval heart conduction problems.

Methadone is a dangerous drug for pain management and many don’t realize that (patients and doctors alike). It should be used with caution and only with a physician very familiar with the drug and with highly motivated and conscientious patients.


Anonymous said...

I am still alive thankfully, but I appreciate the warning. I was put on this stuff (methadone) 7-8 years ago after several very long surgeries.I was told that I would be in pain for the rest of my life. So far they are right. But as the dose of methadone would eventually not do the trick anymore they increased my dose. And they have done this over the years till now.I am at the point where I need more for the pain again, however I don't want anymore because I can hardly think straight anymore as it is from this drug.I am tired and can fall asleep in seconds when I want to, my memory is now real bad. I don't doubt some people think I'm gettingaltzheimer's !(did I spell that right?). I also feel very shaky and sweat profusely when sitting and start dosing off. I mean drops falling like tears from my head!I don't like thia at all. Also , I recently went in for another surgery and after I was awake again after surgery I was in horrible pain and they would give me shots of everything, all of them and nothing worked!Nobody knew what was going on. Again recently I went to the dentist to have some teeth removed (this was due to radiation of the teeth and then if you get an infection in your teeth or gums your jawbone no longer has the ability to heal anymore so they had to take out these teeth so they could scrape my jawbone of the infection or else I could loose my whloe jawbone)so they gave me gas and then some topical ointment to dull the pain for the shots of novacaine and I thought there is know way I'll feel anything with all this but WHAM!!!!I have never screamed as loud!! I yelled at the dentist and accused him of not putting on the gas and just charging me for it! But he showed me it was turned up all the way! It turns out that I have been on the methadone for so long and on a high dose now that no pain reliever pills shots anything would work on me!!! So what happens if I get in car crash and lose an arm or something????? Nobody can do anything for the pain!!!!!! Now I try to get off it and I'm told I will go thru months, yes MONTHS of withdrawal pains!!!! And one of the withdrawal symptoms is you can not sleep!!!!!! I will nwver getaway from all this pain plus feeling sick like you want to die on top of it!?!? What ami gonna do??? Anyone know or have a suggestion??????

Anonymous said...

Same happened to me.I was given Methadone for a degenerative disc disease five years ago. I had a car accident and was treated like a drug dealer. I had to go to rehab. I was there about a week. I was given Gabapentin and Clonidine. I did not go thru withdrawals or have any pain.

My body pain tolerance increased and ALEVE and Tylenol actually work again.