Astonishing

[CouldDoBetter]

I recently had to switch from methadone to morphine due to a medical condition arising from methadone usage (long qt cardiac symptom) and I just cannot believe how ill I am from switching.
According to the conversion rate I should be on 70mg mst daily yet within five days I was climbing up the walls with traditional symptoms, it seems no matter HOW much mst I take methadone is insistent on letting me know it's not happy about being ignored.
But perhaps its expected after thirty years of continued methadone usage........................

[Flip]

Hi
It's almost impossible to say without knowing how much methadone you were on previously but 70 mg of mst sounds a  pretty low dose to me unless your methadone dose was fairly low also. Theres a fair amount of difference between how well people will metabolise any given opiate and in my experience morphine seems more prone to that than some of the other oral opiates. Again this is just my experience but it seems like its a lot easier to go from another opiate to methadone than it is  reversing the process.

  I guess your best bet would be to tell your prescriber about the problems you are having if you havent already done so. You might do better on somethnig like oxycodone or hydromorphone  or you may just need a dose increase . Conversion from one opiate to another is not an exact science and conversion factors often dont tell the whole story.  Also methadone has a much longer half life in the body than morphine , it shouldn't matter quite so much if you are on the slow release morphine tablets (MSContinus) but if you are on an fast release formulation say" Severadol" or "Oramorph" that could be partly  responsible for your problems.

Have a look here...  http://www.globalrph.com/narcotic.cgi 
you will see that there is a section for "incomplete cross tolerance". I'm afraid I dont know what the figures are for this but your prescriber should know ,also note that there is a different conversion factor for acute or chronic usage

Hope that helps
Good luck
Flip

[alli]

Hi Could do Better, - it would be interesting to know how you are getting on now and how long it will take until you are completely symptom free.  Are you still on your new medication?  How long have you been on it now and how are you doing symptom wise.  I know that for people who go into rehab here and reduce 5mls every 3 days, - that when they are finally off it, it takes 3 weeks for the major symptoms to subside (sleepless nights, nerve tingling, sweats, depression, lethargy) and a few months for the lesser ones to go (gen. lacking in energy, continued depression but less severe). So it would be interesting to know if it is like that for you converting to your new medication. alli

[theluckyone]

I have long term disability and since my accident 5 yrs back, I've been on the lot. Methadone, MST, Oramorph, Oxycontin, Oxynorm & Buprenorphine etc.
That is a low dose. I'd ask for a break-through pain killer to i.e Oramorph to top up with. Dont forget, if you're on MST, its only a 12hr coated med and it doesn't last 12 hrs either.
People say (and I agree) that Meth gets into your bones and is harder to kick than Heroin so don't sit and suffer.
Tell them things aren't too great and a higher dose is needed. Then work out a plan where you slowly reduce over a period of time.
I was on 240mg of Oxycontin for my pain but it was effecting me day to day so i've slowly dropped 5mg per month and now take 80mg twice daily. But I also have the Oramorph for the bad days.... and theres enough of them.

All the best.

[Lelee]

There's been some helpful replies but I need to respond to this.

'People say (and I agree) that Meth gets into your bones and is harder to kick than Heroin so don't sit and suffer.'

This is a common myth about methadone.

Methadone does not get into your bones or in any way harm your skeletal system. Methadone has been widely used and researched for decades.  It's a long acting synthetic opioid. It is primarily metabolised in the liver and is stored in 'lipid body fats and tissue'. Studies have shown that methadone is not stored and does not accumulate in the bones / bone marrow.

CouldDoBetter - let us know how you're getting on. I hope you're now adaquately dosed  and feeling better.

Linda

[theluckyone]

Tell them they ain't working and ask to try Oxycontin.
I've been on them all for spinal pain and 70mg of Oxycontins more like 140mg of MST.
Buprenorphine no good to ya? Worked very well for me..... pills or patch!

[derek d j]

I dont knnow how what CouldDoBetter reports actually happens, but it does.
Years ago, i 'swapped' a 30mg methadone habit for 120mg morphine amps.  (this was in italy, and at 'the conversion rate' then in use there)
I expected to be stoned out of my gourd..instead for 30 days all i could feel was bad from the absence of methadone.
It's a weird drug.  its worth noting that, owing to its relatively recent if all-encompassing appearance on the 'drug treatment' scene, nobody yet really knows the effects of very longterm use.
I heard a rumour that the brains of dead methadone oldtimers were being autopsied to find out, but i'd imagine this was just another rumour.
It'll pass, CouldDoBetter, good luck to you.

[OP8S]

I know what you mean about mst/oramorph being different, reading your thread took me back to a period when the only opiate I was taking was mst's. A 1000mg a day was the usual dose, I would of preferred at the time to be recieving dihydrocodiene which is the weaker of the two. I couldn't put my finger on it but there was a tangible difference between the two drugs. I'm far from a pharmacoligist but I thought it might be something to do with the use of the different opiate alkaloids which make up the raw opium. I apoligise that this post is not really of any use to you & hope that you get things sorted out with your GP but I totally know where you're coming from. Morphine seemed different to other similar opiate pain-killers.