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Thread: Methadone Accidental OD in Pain Patients

  1. #1

    Methadone Accidental OD in Pain Patients

    As methadone has become much more widely used in pain management, there's been a huge increase in accidental overdoses. I think any pain management patient should be aware of possible problems with methadone, especially when it's rx'd along with muscle relaxants.

    Obviously it works great for many patients and many doctors know how to rx it correctly and to monitor patients closely.

    But anybody considering switching to or starting on methadone should be aware of the risks and make sure their rx'ing physician is aware also.

    If this has been recently addressed in the CC forum I couldn't find a thread. I posted a link below to an older thread where the subject was met with a lot of derision.

    Question: What is known about the risks of opiate-induced respiratory depression in SCI patients with injuries that affect breathing?

    Below are recent excerpts and links regarding the safety of methadone in pain management.

    “On November 27, 2006, the FDA issued a public health advisory warning of dangers associated with methadone and endorsing more conservative prescribing guidelines [FDA 2006]. Yet many professionals in the medical community who administer methadone for pain remain largely unaware of the need for extraordinary safety measures.”
    “Methadone for pain incurs unique safety risks if incorrectly prescribed. It has a long elimination half-life, with analgesia that may last 4 to 8 hours and respiratory depression effects that could linger closer to 2 days on average. Its properties heighten the risk for drug-drug interactions, thereby resulting in unexpectedly excessive initial dosing, among other dangers.”

    Government Accountability Office concluded that a lack of knowledge about the“unique pharmacological properties” of the drug among prescribing physicians and patients has contributed to the problem, as has a rise in methadone’s use as an illegal street drug.”


    http://www.webmd.com/pain-management/news/20090930/alarming-increase-in-methadone-deaths (2009)

    http://seattletimes.nwsource.com/flatpages/specialreports/methadone/methadoneandthepoliticsofpain.html (2012)

    http://sci.rutgers.edu/forum/showthread.php?t=77332

    http://pain-topics.org/pdf/Webster-MaximizingOpioidSafety.pdf

    http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProvi ders/DrugSafetyInformationforHeathcareProfessionals/PublicHealthAdvisories/ucm124346.htm

  2. #2
    Quote Originally Posted by avictoria View Post
    But anybody considering switching to or starting on methadone should be aware of the risks and make sure their rx'ing physician is aware also.

    Question: What is known about the risks of opiate-induced respiratory depression in SCI patients with injuries that affect breathing?
    With a T3 - T8, level injury, I would love to see this question answered! One of the first things my NS warned of, was breathing difficulties with my level injury.

    The side effects I went through during 4 days on 5 mg Methadone, and 48 hours after discontinuing it were horrific! There were times I didn't think my heart would hold up to the stress.

    I'm happy to say, I'm feeling myself again.

    Thank you, Avictoria for taking the time to post this!!!

    T
    Incomplete, SCI, T1-T8, w/ Arachnoid Cyst. Bilateral shoulder surgeries, 2 on the left, 3 on the right, right forearm surgery for a crushed radial nerve.

    "We can always choose to perceive things differently. We can focus on what's wrong in our life, or we can focus on what's right."
    — Marianne Williamson

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