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Re: Methadone - AndrewB and all interested

Posted by H. Vincent MacGruder on May 7, 2001, at 9:32:55

In reply to Methadone - AndrewB and all interested, posted by DianeD on May 1, 2001, at 10:52:16

> My arguments for methadone over other pain meds will be

Several of your arguments are ture, however, several are incorrect. Specifically:

> 1. It doesn't incapacitate you. There is no "High".

This is just false. Methadone is a full mu-agonist and has effects essentially the same as those of morphine. The myth that it doesn't produce a high derives from its use in maintenance of heroin addicts. The reason it doesn't produce a high in this case is simply that the dose is titrated exactly to the limits of the subject's tolerance. In maintenance, you are not trying to produce any effect -- you are only trying to stave off withdrawal. If you wanted to produce an effect, you would have to give a higher dose, and that dose would produce all of the typical morphine-like effects. If an average, opioid-naive individual takes 10 to 20 mg of methadone, that person will be knocked on his or her ass for two days.


> 2. Is long acting (24 - 36hrs) No ups then downs.

True.

> 3. Once right dose is reached you can be maintained on that dosage indefinitely. You don't need more, more, MORE! like all other pain meds.

False. Methadone produces tolerance just like all other full agonists. Again, when used in maintenance, you are not *trying* to produce any effect, so the dose never needs to be increased. This is *not* true for use in pain, depression, or anything else.

> 5. Does not impair ones mental or physical faculties.

Again, false, for all of the above reasons. Methadone's effects are pretty much interchangable with morphine's, although the time course (pharmacokinetics) are very different.

It really should be obvious that methadone does all of these things. I mean, it isn't a Schedule II drug for no reason at all.

> 6. It is non toxic. It does not damage your liver etc. I have Hep C (had Hep.B).

This is true, as it is of most opioids. They're among the most non-toxic of all drugs for prolonged use.


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poster:H. Vincent MacGruder thread:17065
URL: http://www.dr-bob.org/babble/20010507/msgs/61870.html