Remove this ad
avatar

reviewsatisfaction

Senior Member

Posts: 331 Member Since: 02/14/12

Lead

Nov 11 14 1:15 PM

Tags : : , , , , , , , , , , ,

I read this article study, along with other research and information from my own DR's saying that pain medicine will not work for me or anyone else in my position the same way.
Seems in this study below,Those who pursue heroin's fleeting pleasures suffer long-term damage that goes well beyond deteriorating mood and stability. As if the excruciating addictive effects weren't bad enough, heroin also profoundly disrupts essential physiologic systems regulated by the brain—including response to stress and pain, gastrointestinal and immune function and control of reproductive hormones.
Heroin addicts had little hope of escaping these agonizing rhythms until the advent of methadone maintenance therapy.
AS I read it, methadone does not cover every receptor. For my pain though I am still shit out of luck as the opiod binding receptor is still covered with methadone treatment....which is why I have a hard time controling acute pain.
So why do some doctors feel like because I am maintained by my methadone I have my pain covered?? Also give tic for tac that I am not a heroin user anymore...seems they have it even worse.
So, after breaking both my legs and having 2 surgeries THJR and you know what? I definately felt pain. So if these opiod binding receptors are indeed covered by the BIG M and my MMT does not cover as many as when I shot heroin...It still covers the ones for pain they say...there for the stigma, and the poor medical science for us all...to find something to help .
So because I did feel the terrible acute pain after my surgeries and when I broke my legs, yet at the same time I did receive opiates that could help me deal with that pain, even if it was a truckload.
Doesn't this call for further studies to do something???
MY question I had 120 mgs of methadone in my body when I broke my legs and yet I hurt just as bad as if I was not taking anything...So when my doctor that treats me for my pain with broken legs thinks I am covered for pain because of the 120 mgs of methadone in my body?....Yet they never seem to see through the stigma (after my suffering) even with my BP and body language and me cussing crazy hurt, that I am in pain...When they do, I receive opiates every 2 hours and still the pain returns This is where a new science needs to begin, IMO for us all in MMT... I would be interested in finding why it has taken so long to get this through any kind of research studies to date.
Before posting please read this study done in 2000..I know it is awhile back, but it does help simplify things for those of you that may have not been in the position of some very REAL ACUTE pain.
Along with a understanding just how good MMT is for us but how we do need further studies done to help those of us that may have a accident, disease, or any kind of acute pain. God forbid....
http://www.rockefeller.edu/pubinfo/news_notes/121500e.html

Thanksimage
Review

Last Edited By: reviewsatisfaction Nov 12 14 6:35 AM. Edited 3 times

Quote    Reply   
Remove this ad
Remove this ad
avatar

sapphire76

Posts: 3,678 Member Since:02/22/10

FORUM ADMINISTRATOR

#1 [url]

Nov 12 14 8:03 AM

Methadone will kill some pain, but obviously it's not going to kill 100% of it, and the analgesic effects only last for 4-6 hours at most, they certainly will not last anywhere near the full 24 hours.

The sad fact is that most Dr's are uneducated, and think that the methadone will kill all the pain, when in fact because of tolerance and other issues, we often need more pain relief than an opiate naïve person.

Nice to see you @Review!! :)

Quote    Reply   
avatar

reviewsatisfaction

Senior Member

Posts: 331 Member Since:02/14/12

#2 [url]

Nov 18 14 8:17 AM

A tad repetitous

but I must say until any one of us that may share in any physical pain,  Surely will wonder Why???
Doctors keep finding other ways to keep treatments available for addicts that are in need of recovery, but never think about INJURY OR ACCIDENTS ETC...
Believe me though, the day any one else may need this answered will remain as dumbfounded in the doctors that do not understand it either

Nice to see you again too, Sapphire
I still hurt but am trying to get through the spill

image
Review

Quote    Reply   
avatar

sapphire76

Posts: 3,678 Member Since:02/22/10

FORUM ADMINISTRATOR

#3 [url]

Nov 21 14 5:36 AM

I know that when I had surgery to remove my gallbladder, it went very badly as the bladder was all infected and swollen and had 'stuck' to the walls of some of my other organs and was very difficult to remove as a result, it also split when they were removing it, meaning that the infected stuff burnt some of my organs and meant that I had a massive internal infection.

It was a bit of a nightmare trying to get an optimal dose when they put me on a pain pump after the op, even though I had told them I was on methadone.

Next month I am having a nerve and muscle conduction test as part of my treatment for my neurological problems. I'm getting loss of feeling in my arms and legs, and when the feeling comes back, it leaves burning and painful tingling sensations. The methadone does help the pain for the firsst 8 hours after dosing, but after that, I am in complete agony. I'm just hoping that this nerve conduction test will mean that they have a proper diagnosis and can medicate me to relive the pain.

Quote    Reply   
avatar

reviewsatisfaction

Senior Member

Posts: 331 Member Since:02/14/12

#4 [url]

Nov 29 14 11:58 AM

By George..I think I got it...

First though @Sapphire I remember when you were cutting back (tapering) off your dosage of methadone..I think that you did the best thing for your body before this operation that in turn,what was happening, showed your doctord that your internal organs actually stuck and then found a terrible infection within your organs. So if it was your idea... or the dr's idea it was best for you to slack on how much methadone was in yours or anyones body when you are about to have surgery. Everyone just kept telling me to stop smoking cigs...  so  I might have felt they had some idea about "methadone and surgery" if my doctors did for me what your doctors did for you.

So after all is said I have developed a constant pain all over my body over the past 12 years..(my last car accident) and now even worse, on the body parts I feel from my surgeries...I was recently given Gabapentin, 300gs it is for pain and sleep both which I was having problems with... Why I have pain all over my body, my guess is that I have something like Firomyalgia, now this medicine was given to me along with oxycodone for BTP. After taking it I feel so much better as far as the all around pain. I was in 16 car accidents and totaled 12 mostly out of commission with the whiplash through most but had a herniated disk with my last few...This is why people need to drive without double vision.
Before this I was given muscle relaxers, along with a break through pain med which starngely enough did not help as much or really at all as i would of thought seeing how the fibroidmyalgia affects muscle and joint pain.
I do think that there is another longer acting medicine that one can take, with this all over suck ass pain BUT whether or not it is safe with Methadone, is the question????
The relief I get with this Gabapentin  medicine is just marvalous...almost to the extent, that I feel I have returned from a dark journey....I  just hope it will last as in long acting relief...

Hope to see you all later...wishing you well
 image
Review
        

Last Edited By: reviewsatisfaction Nov 29 14 12:05 PM. Edited 1 time.

Quote    Reply   
avatar

sapphire76

Posts: 3,678 Member Since:02/22/10

FORUM ADMINISTRATOR

#5 [url]

Dec 1 14 6:01 AM

I'm glad the Gabapentin is working! I believe that you're not at anything like the max dosage yet, so you've still got room for manoeuvre if you develop tolerance.

Quote    Reply   
avatar

wayovermyhead

Posts: 4,350 Member Since:07/16/11

FORUM ADMINISTRATOR

#6 [url]

Dec 1 14 3:34 PM

what about split dosing?

The methadone does help the pain for the firsst 8 hours after dosing, but after that, I am in complete agony. I'm just hoping that this nerve conduction test will mean that they have a proper diagnosis and can medicate me to relive the pain.


FORUM ADMINISTRATOR
Wishing You Best In Love & Life 
wayovermyhead

Quote    Reply   
Remove this ad
avatar

sapphire76

Posts: 3,678 Member Since:02/22/10

FORUM ADMINISTRATOR

#7 [url]

Dec 2 14 5:59 AM

I think that would not have a good affect on the taper. I'm down to 40mg now, and I don't think that I would be able to manage with the addiction side of things just taking 20mg in the morning.

Quote    Reply   
avatar

wayovermyhead

Posts: 4,350 Member Since:07/16/11

FORUM ADMINISTRATOR

#8 [url]

Dec 3 14 12:25 PM

I know what you're saying....and the first couple of weeks I went to split dose

 I struggled with my morning dose being so less than usual...but when you take a dose 12 hours later instead of 24 hours later that eventually becomes the norm because you still have more than half of your morning dose still in you when you take the afternoon dose.  So legitimately you are taking the same amount every day it seems to just not ever let you bottom out like the 24 hour method did me.  

FORUM ADMINISTRATOR
Wishing You Best In Love & Life 
wayovermyhead

Quote    Reply   
avatar

wayovermyhead

Posts: 4,350 Member Since:07/16/11

FORUM ADMINISTRATOR

#9 [url]

Dec 3 14 1:14 PM

@review

Per @review Seems in this study below,Those who pursue heroin's fleeting pleasures suffer long-term damage that goes well beyond deteriorating mood and stability. As if the excruciating addictive effects weren't bad enough, heroin also profoundly disrupts essential physiologic systems regulated by the brain—including response to stress and pain, gastrointestinal and immune function and control of reproductive hormones.

Yes as you state above ...they or should I say some do recognize we have residual effects from our past addictions...especially since it was opiates.....We as past addicts and now MMT/MAT patients experience some pitfalls and/or strikes against us that unless we find doctors that can understand, sympathize and relate to our additional considerations and needs WE ARE SCREWED...We are at their mercy and more likely than not they have no idea that the methadone we take for maintenance no matter how high the dose IS NOT GOING TO HELP THE PAIN....Maybe during the "Peak Period" we might feel some slight relief. 

Of course we can take a chance in hopes not to piss the doctor off by printing off material and/or "The Dear Doctor Letter", trying to suggest they be open and/or responsive to newer more relevant information/facts than what might have been taught to them in their 4 to 6 hours of Substance Abuse Continuing Education Credit Classes (CEU's).....But unfortunately, "The Dear Doctor" Written by Dr. Payne...only states our need for additional pain medication and stronger medications due to the tolerance we have developed from being on maintenance therapy etc....it fails to mention the consideration that we might be susceptible to and/or suffer from "Hyperalgesia".... It probably fails to mention this because when it was written "Hyperalgesia" was not known to be a residual pitfall/downfall of long term heroin/opiate abuse.    

This by no means excuses the doctor's failure to be responsive to learning or adopting something new such as these facts and it is downright negligent to fail or oppose taking them into consideration if offered and/or approached with evidence and facts that do exist in our favor regarding why we need special consideration and possible stronger and/or larger amounts of narcotic analgesic relief, but since they usually have the GOD-Syndrome themselves they see the patient that tries too bring this to the light as "drug seeking and/or a return to drug seeking behaviors.

Opioid-induced hyperalgesia (OIH) is defined as a state of nociceptive sensitization
caused by exposure to opioids. The condition is characterized by a paradoxical response
whereby a patient receiving opioids for the treatment of pain could actually become
more sensitive to certain painful stimuli. The type of pain experienced might be the
same as the underlying pain or might be different from the original underlying pain. OIH
appears to be a distinct, definable, and characteristic phenomenon that could explain
loss of opioid efficacy in some patients.

Please see the link regarding why we suffer "Hyperalgesia" after long term opiate exposure and abuse...

FORUM ADMINISTRATOR
Wishing You Best In Love & Life 
wayovermyhead

Quote    Reply   
avatar

wayovermyhead

Posts: 4,350 Member Since:07/16/11

FORUM ADMINISTRATOR

#10 [url]

Dec 3 14 1:31 PM

THE DEAR DOCTOR LETTER

Dear Doctor:

The bearer of this letter is a patient in a methadone maintenance treatment program.
Methadone patients frequently need treatment for other medical, surgical, and dental conditions.
At times the health professional is not familiar with addictive disease and the various forms of
treatment, including maintenance pharmacotherapy using methadone or LAAM. The reaction to
being informed about the addictive disease/methadone treatment often includes fear, anger,
prejudice, disgust, and other negative subjective responses, none of which contribute to the
objective delivery of quality health care. Many patients are very reluctant to provide information
to the other health professional about their addiction and treatment with methadone or LAAM
because of previous unpleasant experiences. The most common reaction is based on fear and
disgust which is inversely proportional to the professional's level of familiarity with addiction
medicine and patients with addictive diseases. The purpose of this brief letter is to touch on the
most common problems encountered and to offer any assistance I might be able to provide.
It is widely accepted that addictions are diseases and that their treatment is a legitimate part of
medical practice. Addictive disease can be characterized as a chronic, relapsing, progressive,
probably incurable, and often fatal (if untreated) disorder. The principle diagnostic features are
obsession, compulsion, and continued use despite adverse consequences (loss of control).
Methadone has been used in the treatment of opioid dependence for over 30 years. It has been
found to be both effective and safe in long term administration. An adequate individualized daily
dose of methadone eliminates drug craving, prevents the onset of withdrawal, blocks (through
opiate cross-tolerance) the effects typical of other opiates, such as heroin or morphine. Efficacy
of treatment is based on elimination of or reductions in illicit/inappropriate drug use, elimination
or marked reduction in illegal activities, improved employment, pro-social behavior and
improved general health. Such treatment has been shown to be effective in reduction of the
spread of HIV and other infections. Dramatic reductions in mortality rates are seen in
methadone maintained patients in comparison to untreated addicted populations.
The methadone maintained patient develops complete tolerance to the analgesic, sedative,
and euphoric effects of the maintenance dose of methadone. Tolerance does not develop to
the effects of reducing drug hunger and preventing the onset of withdrawal syndrome.
Methadone has a half-life in excess of 24 hours which makes single daily dosing possible.
Methadone has a relatively flat blood plasma level curve that will prevent the onset of abstinence
syndrome for over 24 hours without causing any sedation, euphoria or impairment of function.
Along with discrimination, and related to the same stigma, the failure to provide adequate
treatment of pain methadone maintained patients is a common and very serious problem..
Since the patient is fully tolerant to the maintenance dose of methadone No analgesia is
realized from the regular daily dose of methadone. Relief of pain depends on maintaining
the established tolerance level with methadone and then providing additional analgesia. Studies
have shown that exposure to adequate doses of narcotics for the relief of acute severe pain does
not compromise treatment of the addiction.
Non-narcotic analgesics should be used when pain is not severe. In the event of more severe
pain the use of opioid agonist drugs is quite appropriate. The dose of opioid agonist drugs, such
as morphine, is usually increased to compensate for the opioid cross tolerance established by
the methadone. Also, the duration of analgesia may be less than usual. Doses must be individually titrated to ensure adequate analgesia. 
Best results are obtained with a scheduled dosing as opposed to PRN. Morphine may be required q 2-3 hours at whatever dose that
provides relief.
There is no justification for subjecting a maintenance patient to unnecessary pain and suffering
because of their disease or its treatment. Adequate treatment of pain will ensure a more
pleasant hospital stay as well as enhance healing and recuperation.
Opioid partial agonist and agonist/antagonist drugs such as Buprenex, Talwin, Stadol,
and Nubaine should never be used in the methadone tolerant individual. Severe opiate
withdrawal syndrome can be precipitated by drugs of this type.
Both propoxyphene and meperidine are known to produce CNS excitatory metabolites. Due to
the cross tolerance the higher doses required to achieve analgesia can increase the risk of
seizures. For this reason propoxyphene and meperidine should be avoided in the maintenance
patient.
The administration of opioid agonist drugs should be closely supervised in terms of quantities
and duration. Prescribing for self-administration by the patient should be carefully monitored. If
it is necessary to prescribe for self administration, caution should be exercised in the amounts
prescribed and refills carefully supervised.
Similar precautions are indicated in the prescribing of sedative/hypnotic and CNS stimulant
drugs. The abuse potential of ALL benzodiazepines is quite high.
At times the attending physician is tempted to treat the opioid dependence itself. This is usually
attempted by tapering the methadone dose to zero. If successful, the graded reduction may
result in a reduction or elimination of the physical dependence but has no effect on the disease
itself. Even after the methadone is discontinued significant signs and symptoms of abstinence
may persist for several weeks and even months. The relapse rate associated with detoxification
alone approaches 100%. A relapse to street/illicit drugs increases risk of overdose, hepatitis,
AIDS, and a host of other biomedical, psycho-social, legal, and other complications.
Under some circumstances some form of intervention can be accomplished during a hospital
stay for other conditions when desired by the patient and in consultation with the methadone
program physician. Such a process should involve experienced addiction professionals with a
strong emphasis on continuity of care upon discharge.
If you have any questions or concerns about our mutual patient in relation to methadone or drug
dependency please call me. I would be delighted to hear from you.
Sincerely,
Your name and special instructions

FORUM ADMINISTRATOR
Wishing You Best In Love & Life 
wayovermyhead

Quote    Reply   
avatar

sapphire76

Posts: 3,678 Member Since:02/22/10

FORUM ADMINISTRATOR

#12 [url]

Dec 5 14 5:17 AM

That's very true Henry!

Quote    Reply   
Remove this ad
Add Reply

Quick Reply

bbcode help