Welcome to the current newsletter issue of
Advances in Medicine (AIM)- Take AIM against pain, brought to
you by Dr. Tim Sams and MyPainReliefDoc.com.
www.mypainreliefdoc.com
Feel free to send me an e-mail with your own thoughts
and experiences. Email: timsams@mypainreliefdoc.com.
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I just read an article in the L.A. Times about methadone that
described it essentially as a drug that had been used to help
heroin addicts get off heroin, and was now increasingly being
used for pain management. The article described recreational
methadone use as the fastest growing, current drug problem. It
was stated that overdose deaths had increased from 780 in 1999
to 3,800 in 2004. The article went on to say that methadone is
often combined with other drugs in a lethal combination.
*** A few facts to counter the hysteria ***
Methadone was developed specifically as a painkiller during
World War II as a substitute for morphine when morphine
supplies ran low. Methadone has the longest half-life of any
opioid on the planet. Half-life is the length of time it takes
the body to metabolize half of the active ingredient.
Methadone's half-life of twenty-four hours compares to Vicodin
at four hours, and Oxycontin at eight to twelve hours. It stays in
your system and keeps working a long time.
In the 1960s and 1970s, drug-and-alcohol abuse and treatment
were highly publicized for the first time. The long half-life
of methadone made it ideal as a substitute treatment for
heroin-an injected opium derivative with a much shorter
half-life. In the 1970s and into the 1980s, methadone
maintenance clinics were big business in the treatment of
heroin addiction.
In the early 1990s, pain clinics eased the prohibition on
long-term use of opioids for chronic pain. Research in the 80s
and 90s demonstrated that many patients did not become
addicted, out of control, or abused their opioids, but they took
them as directed and had less pain with greater activity. It was
quickly determined that pain relief for constant pain (24/7) is
maximized with a steady level of opioid in the blood stream.
The up-and-down blood serum levels of Vicodin and Percocet (due
to very short half-lives) were often very problematic and could
even make pain worse. Thus, the development of the continuous
release opioids arrived like Oxycontin and MS Contin.
Over the past ten years, the fact that methadone has a longer
half-life of any of the opioids led to it being increasingly
prescribed for chronic pain. The fact that methadone is much
cheaper than the other long-release opioids is another factor.
A pharmacy can buy an average monthly dose of methadone for about
$8.00, while a monthly dose of Oxycontin would cost about
$170.00. Your cost to purchase the designer opioids is
commensurately higher, as well.
Generally speaking, the shorter the half-life of a drug-the
more addicting it is. Vicodin is perhaps the most addicting of all
the opioids-in part because it has a relatively short half-life.
However, because of the long half-life of methadone, there is a
greater potential for stacking, i.e., multiple doses in a day
will increase your serum level of opioid additively, since
there is residual in your system from the previous doses.
This is true if other drugs or alcohol is consumed in the same day as
methadone. This is the cause of many accidental deaths with
methadone, though people are almost inevitably not using the
drugs as prescribed. (If you take opioids for pain, and
simultaneously pound down a fifth of scotch, you probably know
you're taking a risk even if you aren't operating heavy
machinery.)
Methadone is inexpensive and has a long half-life-the longest.
It is also very powerful. An equivalent dose of methadone is
much lower than Oxycontin or Ms Contin. Usually, methadone is
prescribed only after a patient has developed a tolerance to
another opioid-either short or long acting. If you have taken
other opioids, and are dissatisfied with your pain relief, you
might consider talking to your physician about methadone.
Good light,
Dr. Tim Sams
My Pain Relief Doc
www.mypainreliefdoc.com
Copyright 2007. Dr. Tim Sams and My Pain Relief Doc.
All rights reserved. http://www.mypainreliefdoc.com
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include the entire article, along with the web links
and copyright information. Thanks, Dr. Tim
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