Methadone detox

[scaredasever]

I've been taking Methadone now for 8 yrs.I've been diagnosed with Fibro. And Arnold Chiari malformation.I have been taking 60ml of Methadone the whole time and never increased.Now my DR. Has decided to take me off Methadone by cutting down 10ml a month.I am very nervous about this.I have a good job and move arund aot at work.I'm not sure how I'm supposed to get through this by myself.I have no family and live by myself.What will I do with all the pain I have and kee my job.I was told I could take 1 week off of work that's it.SO VERY CONFUSED.What can I do.I was put on this by my Dr. And was told I would need it for rest of my life,now he wants me to stop.I'm trying to read up on it as much as possible,but everything I read is freaking me out.I went without methadone for 4 days once and had seizures.What em I to do????

[Julia M Aharonov, DO]

You are too young to be simply stuck on strong opiates  for the rest of your life. You can not allow yourself to be written off as an invalid and be put on maintenance narcotics for the rest of your natural life. What then do you have to look forward to? Dependence, tolerance, the need for more and more medications as the time  goes on? Chronic use of opiates leads your body to experience hyperalgesia - a state where your central nervous system actually lies to you and tells you that you are having more exaggerated pain than there is physical cause for.  The pain you feel is real to you, but the physical cause for it may be absent.
Your doctor may want to reevaluate at this point and time the actual amount of pathology you physically have, which is impossible to do while you are on maintenance narcotics.
We deal with this in our clinic quite often. The pain doctor will work in concert with us to "reset" the patient: we will detox all opiates out of the system, the pain doctor will re-evaluate the pain level in four to six weeks and then resume treatment at usually much lower levels of opiates with better results. Very often patients will be shocked to find that their pain level is actually much better after the detox and off of their medications.
Talk to your doctor and see if that is what he is thinking.  Have you ever been evaluated by someone else? It is just hard for me to swallow that a young man should be on a life long narcotic unless you choose the life of dependency. Just food for thought. Good luck to you.

[scaredasever]

Thank you for your quick response.I guess I left out a few things.The first 3 yrs after being diagnosed with Fibro. And Arnold chiari,me and my Dr. Tried Numerous meds. Savella.cymbalta,lyrica..etc.Also no narcotic tramadol.etc...Found out that I'm also alergic to Tylenol and Ibuprofen.So after 3 yrs he started me on Methadone.It has worked wonderfully for me,3 yrs prior I was unable to work in bed a lot.Now I have a good job and am a lot more active.But Dr. Says I'm becoming tolerant to the methadone.Which I don't understand because I've never went up in mlgs,and it keeps my pain way down.Well anyways I have a tough ride ahead and wonder how I'm supposed to stay an active part of society and keep my job.Because what I've read I'm going to go through hell.

[scaredasever]

Thank you for your quick response.I guess I left out a few things.The first 3 yrs after being diagnosed with Fibro. And Arnold chiari,me and my Dr. Tried Numerous meds. Savella.cymbalta,lyrica..etc.Also no narcotic tramadol.etc...Found out that I'm also alergic to Tylenol and Ibuprofen.So after 3 yrs he started me on Methadone.It has worked wonderfully for me,3 yrs prior I was unable to work in bed a lot.Now I have a good job and am a lot more active.But Dr. Says I'm becoming tolerant to the methadone.Which I don't understand because I've never went up in mlgs,and it keeps my pain way down.Well anyways I have a tough ride ahead and wonder how I'm supposed to stay an active part of society and keep my job.Because what I've read I'm going to go through hell.

[Julia M Aharonov, DO]

Let's take it one step at a time. Your doctor is right, your medical conditions do not warrant methadone maintenance as treatment. Arnold-Chiari malformation has lots of different symptom, but pain is not a main one. So we will leave it alone. Fibromyalgia has significant pain associated with it, however opiates are not a first line treatment for it, not should it be last. There are a slew of medications that should have been tried eight years ago and there are many new ones that have came out since that have proved very helpful for fibromyalgia. Together with those medication therapies physical therapy, exercise, weight loss, smoking cessation, meditation, yoga, Pilates, better sleeping patterns, etc.; all have been shown to work better long term then opiate maintenance.
What I am hearing from you is that at this point you are drug dependent/ addicted and are unable and unwilling to entertain other options.
You are absolutely correct. Withdrawals are hell. But there are options, if you are willing. You can try switching to Suboxone and tapering down, you can try our tape of detox that gets you clean quickly. You can read more about it in my blogs or on my website www.mdsdrugdetox.com. We are always there to answer your questions. But talk to you doctor, see what your treatment options are. And there are many now (Lyrica, Savella, Zyrem, etc...). Good luck