Methadone and Vicodin?
Some people say that you can’t take Vicodin and Methadone at the same time because the Vicodin won’t work since the Methadone takes you off, blocks the effects of, narcotics. But sometimes Percocet is prescribed along with Methadone, when Methadone is prescribed for chronic pain, for breakthrough pain. So why do people say that painkillers won’t work along with Methadone when they are prescribed together? It’s probably because Methadone helps with opiate withdrawals but opioids are derived from opiates and opioids are prescribed with Methadone? PLEASE HELP!! Thank You SO MUCH!!!!
Hi there,
First of all, Methadone does not act as an *antagonist* so if you were to mix Vicodin and Methadone, it would have an additive effect depending on your dosage.
However, everyone varies in their response to this. Some people on 40mg of Methadone claim that they cannot feel the effects of heroin on top of this. But there are yet others who claim that even on large doses like 160mg, they can still feel the effects of heroin. The general consensus is that high doses of Methadone (80-90mg and above) saturate the receptors thus blocking the effects of other opioids but as I mentioned earlier, this varies from person to person. On lower doses of Methadone however, most people still receive pain relief from other opioids. In general, the blocking effect starts somewhere around the range of 70mg and above. At a dose of say 10-20mg of Methadone, you would still be able to feel the effects of say 20-30mg of Oxycodone.
The question is whether or not you really want to take a chance with this. Honestly, this is a decision best left to your Pain Management specialist. Without knowing your medical history and severity of pain, it would not be right for me to recommend an opioid just like that, especially not one as strong as Methadone.
Methadone is an excellent drug for treating chronic severe pain. However, Methadone is an extremely strong opioid. You have to be very careful with the dosage (which is why I recommend that you let your Doctor handle this). Even low amounts of Methadone can cause an overdose in someone with no or little tolerance. It can also be incredibly difficult stopping Methadone compared with other opioids. I honestly do not recommend it unless,
(a) You have very severe chronic pain that has not responded well to other opioids (Oxycodone, Morphine, Dilaudid etc)
(b) You have a dependency on (or are addicted to) opioids
(c) Both of above
Think of Methadone as a last choice narcotic, to be initiated only if you are not responding to other opioids. Please discuss this with your doctor/pain management specialist. Feel free to drop me a line if you need.
—-
Notes:
As mentioned earlier, once you reach a high dose of Methadone, other opioids may not seem to work. This can also be due to the fact that you would already be dependent on Methadone. Methadone, at the lower doses, is about twice as potent as Morphine & has the nasty habit of increasing one’s tolerance very rapidly.
The doses for pain-relief start quite low, from 2.5mg of Methadone. Do not even think of taking a high-dose like 30mg if you are not tolerant to opioids. It could easily kill you. It is far easier to OD on Methadone than say Morphine.
(There is a scientific explanation for how this blocking effect works but it is rather long-winded (as am I) and technical. If you want to know, drop me a line.)
EDIT: The NMDA-Antagonist properties couple with mu-agonism are what make Methadone such an efficacious pain reliever and good for keeping cravings at bay.
But , these NMDA-Antagonist properties (mentioned by the first poster), have absolutely *NOTHING* to do with Methadone’s "blocking effect" at all. [Example: Ketobemidone is also a mu-agonist and a stronger NMDA-Antagonist than Methadone. But it does not exhibit any kind of blocking effect on other opioids]. You may have confused the "blocking effect" of methadone with NMDA-blockade.
September 30th, 2009 at 6:33 am
Methadone is a opiod receptor agonist which means that it activates the mu opiod receptors in the brain. This is what gives it its pain reliveing properties. However, the reason why it doesn’t get you as high and reduces the high of heroin is because of its NMDA receptor anatgonist properties. NMDA receptors have a very important role in modulating long term excitation and memory formation. NMDA antagonists such as dextromethorphan, ketamine, and ibogaine are being studied for their role in decreasing the development of tolerance to opioids and as possible for eliminating addiction/tolerance/withdrawal, possibly by disrupting memory circuitry. Acting as an NMDA antagonist may be one mechanism by which methadone decreases craving for opioids and tolerance, and has been proposed as a possible mechanism for its distinguished efficacy regarding the treatment of neuropathic pain.
References :
http://en.wikipedia.org/wiki/Methadone#Mode_of_action
September 30th, 2009 at 6:49 am
Methadone will partially block the rush you get when you intake other opioids.
It was designed mostly to get people off heroin and other opioids.
You could take a vicodin and a methadone but you wouldn’t (or aren’t supposed to) feel as much of the rush or high. I personally wouldn’t take both of those meds at the same time though.
Taking Methadone alone will make you pretty "high" at least thats how it is for most people who start taking it. Over time it is supposed to just make you feel "normal" and gradually your body will get over the opioid addiction.
References :
September 30th, 2009 at 7:21 am
Hi there,
First of all, Methadone does not act as an *antagonist* so if you were to mix Vicodin and Methadone, it would have an additive effect depending on your dosage.
However, everyone varies in their response to this. Some people on 40mg of Methadone claim that they cannot feel the effects of heroin on top of this. But there are yet others who claim that even on large doses like 160mg, they can still feel the effects of heroin. The general consensus is that high doses of Methadone (80-90mg and above) saturate the receptors thus blocking the effects of other opioids but as I mentioned earlier, this varies from person to person. On lower doses of Methadone however, most people still receive pain relief from other opioids. In general, the blocking effect starts somewhere around the range of 70mg and above. At a dose of say 10-20mg of Methadone, you would still be able to feel the effects of say 20-30mg of Oxycodone.
The question is whether or not you really want to take a chance with this. Honestly, this is a decision best left to your Pain Management specialist. Without knowing your medical history and severity of pain, it would not be right for me to recommend an opioid just like that, especially not one as strong as Methadone.
Methadone is an excellent drug for treating chronic severe pain. However, Methadone is an extremely strong opioid. You have to be very careful with the dosage (which is why I recommend that you let your Doctor handle this). Even low amounts of Methadone can cause an overdose in someone with no or little tolerance. It can also be incredibly difficult stopping Methadone compared with other opioids. I honestly do not recommend it unless,
(a) You have very severe chronic pain that has not responded well to other opioids (Oxycodone, Morphine, Dilaudid etc)
(b) You have a dependency on (or are addicted to) opioids
(c) Both of above
Think of Methadone as a last choice narcotic, to be initiated only if you are not responding to other opioids. Please discuss this with your doctor/pain management specialist. Feel free to drop me a line if you need.
—-
Notes:
As mentioned earlier, once you reach a high dose of Methadone, other opioids may not seem to work. This can also be due to the fact that you would already be dependent on Methadone. Methadone, at the lower doses, is about twice as potent as Morphine & has the nasty habit of increasing one’s tolerance very rapidly.
The doses for pain-relief start quite low, from 2.5mg of Methadone. Do not even think of taking a high-dose like 30mg if you are not tolerant to opioids. It could easily kill you. It is far easier to OD on Methadone than say Morphine.
(There is a scientific explanation for how this blocking effect works but it is rather long-winded (as am I) and technical. If you want to know, drop me a line.)
EDIT: The NMDA-Antagonist properties couple with mu-agonism are what make Methadone such an efficacious pain reliever and good for keeping cravings at bay.
But , these NMDA-Antagonist properties (mentioned by the first poster), have absolutely *NOTHING* to do with Methadone’s "blocking effect" at all. [Example: Ketobemidone is also a mu-agonist and a stronger NMDA-Antagonist than Methadone. But it does not exhibit any kind of blocking effect on other opioids]. You may have confused the "blocking effect" of methadone with NMDA-blockade.
References :
I’m a Pharmacologist & Addiction specialist