Concerns about switching oxycodone to methadone

[mrsmark]

my husband is recovering from cancer surgery, chemo, and radiation. he is a recovering alcoholic for 12 years, but through all this had no choice but to take narcotics for the pain,which is still ongoing. he is now either dependent or addicted, depending on who you ask, but is taking it solely for pain control.

he is currently taking 160mg of oxycodone, but is building up a tolerance that is not supportable. so he oncologist gave him a subscription for methadone to control the pain more evenly over the day along with a script for Ultram for breakthrough pain. my husband was told to take 10mg methadone 3x a day along with the 160mg of oxy for the first three days until the methadone started working and then to taper off the oxy and onto the ultram.

So the questions are: is taking this much narcotics safe? do you think this dosage of methadone is sufficient at the beginning to replace the oxy for pain control? is it ok for him to start using the ultram as he is tapering off the oxy (to be taking all three drugs for a period)?

any other thoughts or suggestions are very much welcome.

thank you.

[philnoir]

Glad to be of help.

I imagine that the medication rotation is complete, and that your husband is feeling much better. Methadone is one of the best pain medications available.

Please keep us informed.

[mrsmark]

thanks so much to both of you for your input. i appreciate the reassurance.

[philnoir]

As your husband is opiate tolerant, there is very little danger of overdose. When switching from one pain medication to another, there can be periods of overlap.

The 30mg of methadone may not be sufficient, but because methadone can build up in the system over a period of days, your doctor will want to slowly increase the methadone dose until the desired pain relief is achieved. Just follow his instructions. The addition of tramadol (Ultram) should not cause any significant side effects.

Methadone is an excellent pain medication and your husband will likely feel much better when a therapeutic dose is reached.

[mrsmark]

thanks for the response. right now the goal has to be pain management, because we don't know if or when it will subside. it's been several months already and has not let up yet. of course, getting off the drugs completely would be the best case scenario. he's real aware of what's going on and has a healthy fear of it.

[weaver71]

The transition method seems valid, though I don't recommend long term methadone use. Methadone is actually that much stronger and long lasting 30mgs will cover 160mgs of oxy. If your husband is an alcoholic, he is an addict, with enough time, his new drug of choice could become opiates, which is worse in my mind, the the consequences are the same though. The detox from methadone is about 90 days on average, it's 2-4 weeks for oxy, so it really depends on what his long term goals are. I think methadone works better for chronic pain, that's how I became addicted to it. If he wants to switch, then follow the doctors orders. If he is planning to be totaly clean, I wouldn't stay on the methadone very long. Give us some more info on his long term goals, maybe we can be more specific with our opinions.