Well this makes no drug sense

Discussion in 'The Watercooler' started by Star*, Dec 4, 2009.

  1. Star*

    Star* call 911........call 911

    DF is on methadone for chronic pain management.

    Last month his pain management doctor told him that this would be his last months prescription of methadone. When asked why, he was told that methadone has been causing heart attacks and he can't risk being sued for malpractice.

    So he gave him a list of alternative medications to check out and select from this list. This is where it makes no sense to us because he's been managing his pain on two to four tablets of methadone, now they want to put him on morphine.

    They are offering him synthetic morphine, morphine, and other forms of morphine. The side effects of all of these have as a #1 problem breathing problems, lowered blood pressure. We also suspect this will be MORE of an addictive opiate than methadone. Another side effect of it is "the dumb".

    Anyone else take any morphine-type pills or manage pain with any of these drugs?

    They also offered Duragesic patches but they don't work for him. (They do for me, but not him at all)

    Just too weird....I haven't been able to find anything on the internet about people dying from heart attacks from methadone related deaths either.

  2. mstang67chic

    mstang67chic Going Green

    I called Mom who is a heart patient and on Methadone. Her doctor asked her about it the last time she was in the hospital thinking she was having issues. But, they did a complete workup and her heart was fine so he agreed to leaver her on the methadone. She hasn't had any problems with it at all.

    My step-dad is on morphine sulfate and on very large doses of it (200MG 3 X DAY). He sleeps a LOT but has gotten adujsted and doesn't have the "dumb" nearly as bad as when he first started on it. However, he also takes a fast acting low dose (about 15 mg) PRN to carry him through till his next regular dose instead of upping his normal dose. For him though....his pain is unimaginable. He had prostate cancer, did the radiation and was over radiated. His colon was basically fried. He had a colostomy done but the lesions in his colon and rectum are still there and are what causes his pain.

    I would talk to the doctor again and see if there is ANY way to leave Df's medications alone. If they are working and he's having no problems...why mess with things. It's just going to, in my opinion, cause more problems than it's worth between readjusting to a new medication and dealing with the probable DT's from going off the methadone.

    If you have any more questions, call/text me, I'll call mom and see if I can arrange it so you can talk directly to her.

    Also, she said that Dad's pain doctor said that methadone is stronger than morphine. I would think that would mean Df would have to take a larger dose of the morphine, assuming it works for him. I got morphine after a surgery once and it didn't do a thing for me.
  3. Hound dog

    Hound dog Nana's are Beautiful

    Star I've taken those synthetic morphine medications on occassion. I avoid them honestly at all cost if I can. To be bluntly honest, they make you sick as a frimpin' dog. You can't drive on them, heck you've got all you can do to navigate across the room while taking them. Saying you're "out of it" is an understatement.

    I would imagine the addictive aspect would/will be sky high. But if SO is being treated for chronic pain that they see no future resolution for then they're aren't the least bit worried about that aspect.

    I was no risk of becoming addicted since I just could not tolerate they horrid way they made me feel. And I'm used to mega doses of morphine (both synthetic and otherwise) via IV. I swear they didn't make me feel as bad as the pill form. And thankfully the doctor had warned me about how it makes people feel so I took it when I knew I had others around me and I was safe.

    Any opiate pain medication is going to have the side effects of decreased breathing and low blood pressure. Actually, that's not too big a deal as long as he always takes them per order. And I doubt with SO's pain level anything less than an opiate type medication will be enough to keep his pain tolerable.

    This is from my own experience. I'm not getting pharm until next quarter. So I don't know what new medications are available. But if that is his option, I'm guessing it hasn't changed much.

  4. Lothlorien

    Lothlorien Active Member Staff Member

    I don't know anything about the morphine, but if you go that route, be prepared for the pharmacy to need time to order it.

    I'm probably wrong, but once you go on Methadone, isn't it something that you have to stay on?

    Perhaps you can tell the doctor you are willing to sign a waiver that he's told you of these side effects and are willing to give up the right to sue?

    Maybe doctor is being investigated for Methadone prescription abuse? There was a doctor up here that lost his license for prescribing medications.....basically a legal drug dealer, including oxycontin and methadone.
  5. Star*

    Star* call 911........call 911

    Thanks for all the info.

    Being that it's a class 5 narcotic there were a lot of adjustments with the doctor, and our pharmacy. They do not keep in "in stock" and when they originally got the prescription we all struggled to get the dosage right, had to switch pharmacies because if you get shorted you are SOL. We did several times or they couldnt figure out the dosage (someone else with a counting case of the dumbs) and it was a huge disaster. FInally we found a CVS that double counted and would allow us to stand there with a tray and count ourselves in front of a tech. Okay that was fine.

    I like the idea of a waiver. I will suggest that. I like the idea of getting a new pain management doctor all together better. This guy is a nitwhit. He's the one that I had to call on Labor Day to come look at the botched surgery on DF's back when it was oozing green fluid onto the bed I had to replace. He came in the ER, threw his coat in the corner, huffed, exhaled, and then made some comment about how HIS weekend on the lake was just ruined and this better be serious....looked at DF's back, then stuck on a mask, visor, and 2 pair of purple gloves and a paper gown. I just sat smartly and I mean SMARTLY across from a howling DF and said "So how was the lake today? I would have loved (said like Mrs. Doubfire) to have had 1/2 a day there." then just chuckled and said ha ha ha but I was cleaning up SERIOUS oozy green stuff from a mattress I'll have to throw away now.." JERK.

    I'm not sure about this doctor being investigated. He's a pinch short of being the most anal man I've ever met. He wanted to put DF on a morphine pump and due to DF's biker looks (not kidding) he's been subjected to more than the average person in terms of "Mr. Star we need you and your prescription to come in today at noon." (counting and urine test) to make sure he had the correct number of pills in the bottle and in the urine sample. At first we got calls all the time, now he just gets urine tested. We just laugh. Believe me - you can't get rich off methadone pills when methanphetamines are being sold across the road from you for pennies on the dollar by a teenager on a moped - besides no one likes coming in our yard due to the dogs and DF needs every pill he has.

    He does not want to go on morphine. I think it will wreck his stomach. I'm also afraid of the withdrawl symptoms. (GOSH not looking forward to that) but I'll tell him what is posted here.

    Thank you again.
  6. donna723

    donna723 Well-Known Member

    So this doctor is saying that there is some big problem with methadone? If there is, then why is it not being pulled off the market? That doesn't exactly sound right. When my niece was in the middle of her big drug problem, her doctor was trying to talk her in to being ON it to get her off of the other crappola she was on! Of course, that was one of our local doctors and most of them are about half a brick short of a load too!
  7. Marguerite

    Marguerite Active Member

    Star, definitely get a second opinion if you can because there does need to be a good sense of trust between a patient and the doctor especially when they're treating your pain.

    As for the difference between methadone and morphine - I rally can't say. Perhaps he might get more respect if he's on morphine, although I have found that sometimes people in hospitals can pre-judge even so.

    I've been on morphine for over ten years now and found for me that it helps my pain a grat deal. The important thing is to never let the pain medications completely eliminate the pain, or you risk addiction. You will of course have a tolerance problem but that cannot be avoided. Over time your body adapts to the opiate (whatever it is) and you require more to get the same analgesic benefit. I have found with me, however, that my dosage has stabilised. When I was on prednisone recently the morphine dose was able to be reduced (I did this myself) but coming off the prednisone I was unable to stay on the lower dose and have had to slowly go back to the earlier higher dose again. I have discretion to take a little more if I need to because my pain specialsit knows I do my utmost to avoid doing this unless the pain really is stopping me in my tracks.

    I'm not sure what you mean by the "dumb". When I first went on morphine I think I was on too high a dose to begin with, I did find it made me a bit sleepy. I put a lot of that down to the morphine eliminating the pain so completely that I was at last able to sleep and feel free from pain. That did not last, I rapidly habituated to the dosage.

    Since the first few weeks of being on morphine, I've not had any trace of sleepiness whatsoever. Far from it - I occasionally take 5 mg Valium to relax tight or twitchy muscles and THAT sedates me, but not the morphine and I'm now on double the dose I began on 12 years ago. However, apart from the recent adjustment I mentioned due to the prednisone, I'm on the same dose now that I have been for the last four or five years (maybe longer).

    Withdrawal - it's only a major problem if you are addicted to the drug, and you only get addiction if you take it to get high. You DO get habituated and if you ever cease to need it you will have to come off it gradually to avoid unpleasant withdrawal effects. These aer inevitable simply because the drug has side effects in the short term which the body rapidly adapts to. Example - the first thing that happens is constipation from the opiates. He will already have this problem from the methadone. But after a fairly short time (a week or so) your body adapts back and normalises. So if you come off the opiates, the first thing that happens is the opposite - diarrhoea. If this happens then your body begins to remove your remaining medications too rapidly and the reaction can accelerate. This is why you need to wean off gently if you need to avoid withdrawal.

    I discovered this for myself when the prednisone reduced the pain so much that I was able to cut back on my morphine. I cut back too fast and my body reacted, ridding itself of more than I intended. I found this eased after 24 hours and I was able to stabilise on a slightly lower dose. Then I dropped it a little further and again rapidly adapted to the lower dosage.

    There are things you can take to reduce this side effect (either the constipation or the diarrhoea).

    But frankly, this is all utterly hypothetical, because when you have chronic pain, the idea of that pain miraculously and suddenly disappearing completely - it's pure fiction. If that miracle happens, you cross tyhat bridge when you get to it. For me, the price is worth it because the morphine has made it possible for me to function.

    Some people can't tolerate opiates. mother in law is an example of this - she had to have heart bypass surgery with nothing stronger than paracetamol for pain relief. My father couldn't take opiates, he would hallucinate on it.

    If you can't take it, you can't. But if you can - don't be afraid because of the name. However, it does need to be managed with care and respect. If you respect it and manage it carefully, you will be its master and it will make your life functional again, as far as possible. However, you really should have the ongoing supervision of a good pain management specialist, one who you trust and who trusts you. Maybe that trust needs to be earned, but it is still necessary.

    Personally - I would want a second opinion before stopping the methadone, a GOOD reason which can be backed up by evidence from the drug company. Try calling the company, ask them if what the doctor has said has any truth to it. If the company cannot verify it, talk to the doctor and ask for clarification. The drug company could be lying, or the doctor. Or neither.

    There are also other ways to manage chronic pain, it's always good to stay in touch with these options in case something new presents itself. Chronic pain is very different to acute pain, it needs to be managed very differently. with acute conditions we tend to shut down and rest the injured area. With chronic pain, we need to keep living and not let our lives be too limited for too long. We do the best we can with what we've got.

  8. 1905

    1905 Well-Known Member

    Have DF offer to have a heart test done, the kind where dye is injected, and a few hours later you go back and do the 45 minute test. That way the doctor will be protecting himself....if the heart is fine, patient has been on the drug for 2 years, the doctor would have done all he could to make sure patient was not being harmed in any way by the drug. Although secretly the doctor is a ( you-know-what)

    I took a drug called Adriamyacin, it's chemo, and it DOES damage the heart, it's a definate side effect. My heart, and everyone who has taken that, has damage to their heart. We had to sign a waiver prior to having the drug administered. Also- We all had to take that heart test before we could even get that drug, to make sure we could withstand it.

    DF's Dr can take precautions to protect himself! DF is running the show- not the Dr. DF has to be proactive and not take no for an answer. If that means getting another Dr., so be it!
  9. timer lady

    timer lady Queen of Hearts

    Star, I've been on methadone for 2 years now; have not heard this about methadone.

    It may be the clinic manager or the oversight person whatching what is being prescribed & for how long. I kno my doctor has to justify ym medications to clinic supervisor who passes it along to whoever.

    Any other doctor you can work with? My pain medications are a set amt of methadone with another class whatever medication for break thru pain. Would doctor consider this or df tolerate it?
  10. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I would think that if methadone was causing heart attacks we would be seeing this in the news because of huge amounts of junkies dying of heart attacks outside of the methadone clinics. I think any drug can cause some side effect. Maybe heart problems is way down there in the list of side effects.
  11. judi

    judi Active Member

    While methadone doesn't CAUSE heart attacks, it can lead to prolonged Q-T syndrome which can lead to sudden death:

    "In addition, cases of QT interval prolongation and serious arrhythmia (torsades de pointes) have been observed during treatment with Methadone. Most cases involve patients being treated for pain with large, multiple daily doses of Methadone, although cases have been reported in patients receiving doses commonly used for maintenance treatment of opioid addiction."

  12. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Ok..when it says cases...and been observed...just how many? I always wonder about those things because...ya know...being in pain for years and years can cause the body to do odd things too. Its a kind of damned if you do and damned if you dont situation.

    I dont know if methadone is the best medicine to be on or not. I think it is the cheapest.

    Its a shame he cant do duragesic...thats an awesome way to get the pain relief. I wish I could do it too but Im so allergic to the adhesive I break out in welts. Im thinking of trying it again though along with some benadryl lotion applied before putting on the patches because someone suggested that one time. Cant hurt to at least try it.

    I know some of the morphine names...there is one that begines with O...cant remember the exact rest of it...opana maybe? My brain is failing me. I knew someone on that one who liked it.
  13. mstang67chic

    mstang67chic Going Green

    Star, I talked to mom again and this post came up. She said she's willing to let me pass on her cell number if you would want to call her. Like I said, she's a heart patient and is on Methadone and dad is on morphine so she would be a good one to talk to. Let me know if you want to do this. If so, Mom wondered if she could get your cell number ahead of time to program it so she would know who was calling. Otherwise, she would be liable to ignore the call. LOL