Posted by Elizabeth on May 10, 2001, at 8:55:00
In reply to Methadone - AndrewB and all interested, posted by DianeD on May 1, 2001, at 10:52:16
> Question: Can doctors track your medical history? Meaning, could this pain doc without my knowledge somehow find out and contact past docs of mine? in order to discuss my
> medical/drug history?
No. Confidentiality laws vary from state to state, but your permission will be required for any doctor to talk to anyone -- including another doctor -- about your medical history.
> My arguments for methadone over other pain meds will be
> 1. It doesn't incapacitate you. There is no "High".
If you are taking the correct dose to treat your depression, you shouldn't be getting high from methadone. (It's a myth that it is impossible to get high from methadone, although methadone does not produce the intense "rush" that results from the intravenous use of short-acting opioids such as heroin, hydromorphone, oxymorphone, etc. Addicts who are on MMT don't get high from it because they are on a stable dose to which they are tolerant.)
> 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.
We're talking about using it as an AD -- not for pain or opioid dependence. Most people using *any* full opioid agonist (including methadone) for pain will continue needing larger amounts. Most people in MMT will be stable on a fixed dose (often quite a high dose).
Most of the reports I have heard from doctors and patients about the use of opioids for depression indicate that many people do not become tolerant to the AD effects -- they are able to continue using the same dose (of morphine, oxycodone, etc.) indefinitely. However, if you become tolerant to the antidepressant effects of other opioids, you are also likely to become tolerant to the antidepressant effects of methadone.
> 5. Does not impair ones mental or physical faculties.
That depends on your reaction to it (highly individualised). Some people feel "foggy" on it.
> 6. It is non toxic. It does not damage your liver etc. I have Hep C (had Hep.B).
Opioids in general are nontoxic at therapeutic doses. It's the Tylenol, aspirin, and ibuprofen that are often added to them (e.g., Vicodin, Vicoprofen, Percocet, or Percodan) that can cause liver damage or GI bleeding.
> The excerpt below is from a legal proceeding Re BAART (a MMT program I was on for awhile in SF) and the city of Antioch.
You can't assume that the principles that apply to MMT will also be true of the use of methadone (or other opioid agonists) for depression. People on MMT are using the drug not to create an effect (such as mood elevation or pain relief), but to *block* an effect (protracted opioid withdrawal syndrome).
I hope this helps clarify some things. Take care and good luck.