My mom has MS and fractured her hip 3 years ago (bone is basically dissolved now), is in a nursing home, and the last two years has been in a lot of pain. For about a year, all her old Dr would do was give her a fentanyl patch, Norco and neurotin for pain. She now has a new Dr who wants to try new things. The Dr has put her on Cymbalta and removed one of three doses of Neurotin (it made my mom very confused) and she just swapped the Norco for oxycodone. So now my mom has the fentanyl patch, cymbalta, oxycodone and afternoon and evening dose of neurotin. Her pain is finally manageable now, but now she’s very forgetful. This week the Dr wants to up cymbalta to 30mg and in a few weeks swap oxycodone with methadone. I’ve read horror stories as well as wonderful stories of methadone. I’m honestly a little nervous of her on this and if future Drs will keep allowing her to take it and withdrawals if she ever needs to go off. Does anyone have experience with this and can offer me advice or should I put my trust in the Dr?
A little of my mom’s background is about 1 1/2 years ago my moms old nurse practitioner almost killed my mom with a new mix and increase of meds she gave her so I have been very cautious about everything. Something needs to be done and this new Dr seems very knowledgeable and wants to help. It’s hard for me to trust and I just want what’s best for my mom.
It was described to me this way by the CNA that helped care for my Husband while he was on Hospice, the body that NEEDS morphine (or in this case methadone) will use it and react differently to it than a person that takes it to "abuse" it.
It sounds like this doctor is actually trying to manage pain and not just drug her.
I would go with the changes, give it a while to work. It will not happen overnight.
I think given your Moms condition, her level of pain and her life now addiction would be the least of the problems. As I said a lot about my Dad while he was undergoing treatments for cancer....they should have let him have what he needed for pain, if they can cure the cancer then we can worry about addiction.
Per Drugs.com website; "You should not use methadone if you have severe asthma or breathing problems, or a blockage in your stomach or intestines. Methadone may cause a life-threatening heart rhythm disorder. Call your doctor at once if you have a headache with chest pain and severe dizziness, and fast or pounding heartbeats.
Some medicines can interact with methadone and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications."
Like any narcotic, it has the potential to cause a dependence on it and can be "habit forming." That really is beside the point for your Mom. She will need life long pain treatment because of her chronic conditions.
If she will need to stop taking it, I can't imagine any doctor NOT knowing that she will need to be weaned off it, because it is a narcotic. That will take a long time. She also will need to be medicated for pain during her withdrawal, so a delicate balance of adding a different narcotic while weaning her off Methadone.
From American Addiction Centers website; ;
"The drug’s half-life is about 24-36 hours on average, but some of the drug can stay in the body for up to 5 days after the last dose. Stored in the liver and even other body tissues, it is eliminated at different rates depending on the individual. The faster methadone is metabolized, the more tolerant a person is. "
(HolidayEnd-Never heard of a drug with a half life of a YEAR. Even marijuana only lasts from 13-90 days.)
From www.bpac.org.nz keyword: methadone;
Example of methadone titration
Week 1
2.5 mg twice daily
Week 2
5 mg twice daily
Week 3
7.5 mg twice daily
Week 4
10 mg twice daily
Week 5
10 mg three times daily or 15mg twice daily
Week 6
20 mg twice daily
or 10 mg four times daily
Hope this info was helpful.
Talk to the doctor about your concerns and verify how she would be winged off if ever.
I think that mom being pain free is worth it to trust this doctor after you talk about your concerns.
I've been caring for my husband, who is in pain 24/7, for the last dozen years. You both have my sympathy and warm hopes that this new concoction will really help.
I have been quizzed when going to new docs. They want to make sure I'm not a druggie looking for pain meds.
Of course this is my experience. I'm just so surprised you were given those meds. Perhaps botox for migraines would work for you? I've been tempted, but I don't have 15-20 a month. Hope that med works for you. Mine doesn't always work. Good luck.
As a newly graduated registered nurse I had an older male patient, 70 years old approximately, who was shaking so badly his hospital bed was clattering. I couldn’t imagine what was wrong. We hadn’t been taught about drug addiction in nursing school (1980) or what withdrawal looked like.
According to the patient’s chart and what he told me, he’d been on METHADONE for a good number of years, to treat rheumatoid arthritis. A doctor had decided this man didn’t need methadone, so he was in about day three of WITHDRAWAL. I made a call to the patient’s prescribing doctor, who ordered he be given his methadone. It was written in his chart.
I read about methadone in my nursing drug book. Methadone has a half-life of over a year. That means it takes over a year for even part of the methadone to leave the body if the methadone is curtailed. That results in a HELL of a withdrawal. So ideally, methadone is for life. It WILL relieve pain though.
So I’m sure you’ve heard of how our current US government is conducting a hysterical ‘war against opiates’, resulting in many elderly chronic pain sufferers to do just that, SUFFER. This is a time when a patient can’t be complacent about the medications they take, because the doctor could cut them off for very little reason.
I urge you to read up on methadone online. Then knowing methadone is for life, your mom and you need to decide if the benefits (pain relief) outweigh the drawbacks (big time addiction!). If you decide pain relief is the most important thing (I’d lean toward that for my mom) be aware that the methadone could be discontinued abruptly. And a horrendous withdrawal would begin.
Other opiates could help (Dilaudid, morphine, even a high dose of Norco) but I imagine new doc is thinking about how methadone’s relief from pain lasts longer than the other drugs, just like withdrawal from them is short.
My own mother has the hip joint that collapsed onto itself, causing mobility problems and pain. Her doctor has only given her Ultram but she claims it makes her pain bearable. So I’m not interfering now but if her pain worsened I’d ask the doctor for Norco for her relief.
Expect mom to be sedated, but know she’s not suffering. Good luck to you and your mom.
Addiction and dependency are not the same. Addiction is a behavioral issue. Obviously there will be a dependency because of the nature of these drugs but it does not mean mom will become an addict.
I would think a nurse would know the difference and not use a scare tactic. And quite frankly, quality trumps quantity, every time for me.
If you choose to try methadone, start with a very small dose like 5 mg. The pharmacy may not carry it and may have to order it. Watch her for a few days and make your decision. Keep in close contact with the doctors about anything you notice. Your mother may be fine, but it is well worth keeping a close eye on things.
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