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Old 04-04-2009, 08:12 PM
Una Persson's Avatar
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Is methadone more common than I thought?


So I'm sitting in a hospital room right now, and listening to the moans of agony from the roommate of Fierra. Fierra has been in the hospital three times recently, different hospitals, big, suburban ones in an affluent area. OK, that's the setting. Now, the first time she was admitted I overheard* that the roommate was on methadone, and I thought "huh, heroin addict getting off the stuff?" But of course I didn't really pry or find out what was up. Then the second hospitalization came, and again the roommate was on methadone. I thought "huh, that's an interesting coincidence." Now here I am the third time in a couple years, and again we have a roommate whose primary medication seems to be methadone.

In all three cases the patients seemed to be in pain and having serious trouble breathing. In the latest case it turns out that the patient has been admitted for "fibromyalgia" and apparently unknown, widespread pain.

I looked on Wikipedia and it implies that using methadone as a painkiller is unusual. Since I trust folks on the SDMB much more, I was was wondering...in the US, is methadone really so commonly prescribed as an analgesic that we should encounter it three times out of three?
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Old 04-04-2009, 08:30 PM
starwarsfreek42 is offline
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I have an aunt who died from an overdose of methadone. She was using it recreationally (I assume) but it was prescribed to her, so it is definitely available. I don't know if her condition required that particular drug for some reason or if that's just what they happened to give her. Sorry I can't be more helpful.
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Old 04-04-2009, 09:04 PM
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Methadone is a very useful narcotic analgesic, when used properly.

It is long-acting, very potent, and less likely to be abused than other long-acting meds such as Morphine Sustained Release and Oxycontin, both of which can be ground up and snorted/injected to give an immediate rush. Methadone doesn't work that way. It doesn't give the extreme opiate-style euphoria usually associated with heroin, morphine, and oxycodone.

It's my 1st long-acting narcotic prescription of choice for my patients with malignant pain who need constant levels of something in their system to alleviate pain. It's also used frequently for chronic non-malignant pain (though not often prescribed by me for that purpose).

It's a bit tricky to prescribe, because of its odd pharmacokinetics. But one the prescriber has the hang of it, it's pretty straight-forward.

Another advantage is that it's dirt-cheap. We're talking a few pennies a pill.

It is quite abusable, and folks do die when they abuse it, often because they take too much, trying to get the euphoric levels they're used to with oxycodone. They get dead instead.

Last edited by Qadgop the Mercotan; 04-04-2009 at 09:07 PM.
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Old 04-04-2009, 09:29 PM
Una Persson's Avatar
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Quote:
Originally Posted by Una Persson View Post
In all three cases the patients seemed to be in pain and having serious trouble breathing. In the latest case it turns out that the patient has been admitted for "fibromyalgia" and apparently unknown, widespread pain.
FTR, I'd better add (since my stalker who keeps making threats against me every time I use quotes wrong is still posting on the SDMB) that I put fibromyalgia in quotes only because I did not hear it directly from her physician, it was just an overheard comment in general. It means that I'm not sure if that is her real condition. It does not signify anything else.

Qadgop, thank you for the physician perspective. Part of me wants to wonder why they freaked out on that House episode when he was taking methadone and feeling totally better, as opposed to his popping Vicodin like Tic-Tacs.
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Old 04-05-2009, 01:07 AM
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Although addictive tendencies represent a subset of the population, everybody can develop physical dependency on opiates with extended exposure. When I worked ICU, it was common to wean such patients with tapering doses of methadone.
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Old 04-05-2009, 06:48 PM
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Quote:
Originally Posted by Una Persson View Post
Qadgop, thank you for the physician perspective. Part of me wants to wonder why they freaked out on that House episode when he was taking methadone and feeling totally better, as opposed to his popping Vicodin like Tic-Tacs.
Because methadone is so strongly connected with heroin addiction in the average mind. You yourself said you assumed Fierra's roommate with methadone was an addict. As Qadgop points out, it is used legitimately for various conditions that cause pain.

Vicodin is seen as a drug "normal" people take. Methadone is for junkies. That's how a lot of people see it, even people in the medical field.
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Old 04-06-2009, 10:48 AM
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Another anecdote: I also know of a few Restless Legs patients (through online lists) who are using methadone as their treatment of choice for that. IIRC, none of the people involved have any pain-related issues. Narcotics are known to be beneficial in treating RLS (if not the usual first-line choice), and I expect they arrived at methadone after non-narcotic options failed them.

It's not a *common* option, but it is an example of one more non-abuser use of the stuff.
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