Pain Medication for Chronic Pain

[Boston_Guy]

Hello,

Note: The purpose of the following question is not to ask for medical advice but to relay the experience of those of us who live with chronic pain. I already have plenty of medical advice from the appropriate pain specialists and specialized doctors. What I’m looking for is information on Methadone and/or Suboxone for chronic pain E.g. what are the side effects? How effective is it at removing pain and allowing patients to live full lives? Are there other complications of note? etc.

My question: I live with chronic pain from damage to my spinal cord. I had two surgeries that weren't 100% successful. I'm left with chronic pain that I have to live with. I tried various prescription painkillers over the last 7 years. In the end I went to a pain specialist who recommended either Suboxone or methadone. It's helped somewhat. Instead of constant pain levels between 5-7 all day long it’s down to levels of 3-6. I can sit inside my apartment all day long to keep the pain down but hat's no way to live a full life. Now that I've tried Suboxone and didn't get what I was hoping for. E.g. I took my med this morning and the sciatica is pretty bad today. On a scale of 1 to 10 it’s a 5. So I'm now looking into Methadone.

Here is my question: I've heard good and bad things about Suboxone. Not a lot of it was good, i.e. it wasn’t very helpful to them. Now I want to try the other medication that the pain specialist recommended, i.e. Methadone. I’m well informed about the downsides and danger of using methadone but I can’t live like this and I’m willing to take the risk, at least to see what it’s like. Who knows? I might just change it back to the Suboxone.

Does anybody here have any knowledge or references that may help inform me with regards to this issue? Are any of you suffering from chronic pain and would like to share?

Thank all of you!

Moderator Notice: For this thread to continue in the best possible way I would like to remind posters of our rules on medical diagnoses and reiterate that personal/anecdotal stories are not of sufficient standard of evidence when making factual claims. Please only post that which can be backed up by credible medical literature.[/color]

 

[Borek]

To all: please stick to the subject of chronic pain and methadone and don't try to address the OPs specific problems by recommending or diagnosing.

 

[gravenewworld]

Constipation is a BIG problem for people that chronically use opioids. Blocking up the bowels all of the time can lead to all sorts of complications as you can imagine.

There's really no good medication for chronic severe pain. I used to work at a biopharm company that specialized in developing novel pain drugs. Tricyclic anti-depressants are also used for chronic pain as well as SSNRIs and NET inhibitors, but still, not a whole lot out there that works very well with inconsequential side effects with chronic use.

 

[mazinse]

methadone is already a pretty hazardous opioid, did your care provider ever suggest any alternative treatments. There are some nasty cardiac side effects too, does your provider follow up with you on that

 

[Evo]

methadone is already a pretty hazardous opioid, did your care provider ever suggest any alternative treatments. There are some nasty cardiac side effects too, does your provider follow up with you on that

It seems lower doses of methadone are successful for severe neuropathic pain. But I absolutely agree that other options be exhausted first. I have neuropathic pain and am on oxycodone, it doesn't help the neuropathic pain much, I use it mainly for the stomach pain from a botched nissen fundoplication. Yes, my GI flipped out and told me not to take it for my stomach pain, but it's the only thing that helps. I suffer from chronic severe diarhea, so no constipation issues. I don't want to become dependent on pain killers, so I usually deal with the pain and try not to take more than 1/2 a tablet per day, so I can eat.

I found this article to be interesting. I hope to stay away from ever more potent pain medications, but one of my other doctors said right now the stress from the pain is more damaging than the pain meds.

Methadone is a synthetic opioid. Although structurally dissimilar to morphine (MS Contin), methadone has significant analgesic qualities. Because the high dosages used in preliminary testing of methadone caused substantial side effects, the drug was not used clinically for several years.1 During the 1950s, methadone emerged as a treatment for opioid addiction and has remained the primary therapy for this condition for more than 40 years. Recently, methadone has been used to manage cancer pain and other chronic pain states. Its unique pharmacokinetics and pharmacodynamics make methadone a valuable option, but physicians should be aware of possible side effects.

Continued...

http://www.aafp.org/afp/2005/0401/p1353.html