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    mage above: Methadone molecule, from


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    This entry was posted in fibromyalgia, health, mind & brain and tagged fibromyalgia, health, medicine, methadone, pain. Bookmark the permalink.
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    81 Responses to Methadone and chronic pain: a personal account

    Catherine Fidler | Saturday, September 6, 2008 at 2:06 am | Reply

    Susie | Tuesday, August 3, 2010 at 2:41 pm | Reply

    absolutely it is…I am a total bitch when I miss a dose of morphine .
    nosleepingdog | Saturday, September 6, 2008 at 3:59 pm | Reply

    @Catherine Fidler,


    Well, withdrawal can make you jumpy & nervous, sleepless, impatient, selfish, basically only interested in getting drugs to feel “normal” again. So yes, it could make him act like an extreme butthead.

    But what’s the deal with him taking methadone AND getting (giving himself??) morphine shots too? Is this through a pain doctor? Pain docs usually prescribe morphine as extended release tablets for chronic pain; injections would be for those in hospital or with an implanted morphine pump. The combination of morphine and methadone is dangerous: they are both opioids and would have a combined reaction that may include stopping the person’s breathing. And of course both are addictive.

    For these reasons it is very surprising to hear of someone (not in the hospital or terminally ill) being prescribed both of these powerful drugs. If he is just buying this stuff and using it then you and your daughter have bigger worries than his being a butthead sometimes. Those worries would include the boyfriend dying, becoming violent as a result of withdrawal and drug-induced mental problems, committing crimes to get street drugs, and being arrested. If he’s arrested your daughter could easily find herself in trouble with the law also. She could easily get into using drugs with him, too.

    nick | Monday, July 13, 2009 at 2:40 pm | Reply

    Hi, are you the one who wrote the lengthy article on methadone, and used morphine to quit? If you are, could you please email me, when I find out you are the one who wrote it, I will email you with what’s happening. Thanks so much for the informative article. Nick
    nosleepingdog | Wednesday, July 15, 2009 at 7:31 am |

    Just post your news here, so others interested can see it too.
    nick | Tuesday, September 8, 2009 at 9:55 am | Reply


    in your long post, you stated, I believe that you went off methadone the first day you saw the new pain dr., oct? and in feb. you quit methadone, gradually decreasing over the 4 months or so. In you post to, I think Sandy,? you state that you were on morphine for 3 or 4 weeks, if I read it correctly. This is a big difference, can you clarify which is correct and I read it wrong, I apologize.
    I am taking morphine now, taking meth., 2.5 or so mgs per day with it, this is the 4th day i have been down to this low amount of methadone. my thought is to quit the methadone completely in another 3 or so days. not feeling the greatest, but better than when i tried to quit methadone a few years ago without any help. made it for 32 days and sick every day. thanks for any help you may have. nick
    nick | Tuesday, September 8, 2009 at 9:57 am |

    sorry, in my last post, i meant you stopped the morphine, i put methadone. so where it says feb., it should state morphine. sorry! nick
    nosleepingdog | Friday, September 18, 2009 at 9:41 am |


    I’m sorry I hadn’t checked comments and replied to you sooner.
    The time when I went off methadone, 2 years ago, was a blur, and now I wish I had kept notes about the specifics. The best recollection my husband and I have is that I was on the morphine for about 6 weeks (having stopped the methadone the day I started the morphine). I cannot remember for sure if I then went off the morphine all at once or gradually; I do remember the doctor saying that given the size of the dose, and the relatively short period, it would be easy to stop it. And of course, compared to getting off methadone, everything else is apparently easier!
    This is probably too late to be of any assistance to you and again I apologize. I hope it is going well and by way of encouragement I’ll add that getting off methadone for pain was one of the best things I ever did. Even after two years I think I’m still gaining mental and physical strength compared to the ten years on methadone. This despite getting older and not doing any regular exercise routine. For me, there were no pain relief benefits to the methadone by the time I began trying to quit it; others with different types of chronic pain will have that to deal with when they quit taking methadone, so they will have face a different situation than I have.
    Robert Wallace | Thursday, January 6, 2011 at 8:57 pm | Reply

    Thank you, thank you, thank you! I had a parachute malfunction in 1988 and as a result have suffered low back pain ever since. I will keep this short as I know I don’t have room for over twenty years of pain.
    I got to the point in my pain “management” that I was sick of multiple narcotics and their side effects that I said I want more relief less drug. Well, methadone was the doctors plan of choice. I am, no I was sent to come off the last of the narcotics (fentanyl patches) and start methadone next month. I am so close to tears from reading your article for many reasons. But most importantly is that I think you may have saved my life! It has been a living nightmare dealing not only with the constant pain but also the dependence and side effects of serious drugs that I just really don’t think I could go through anymore.
    Thank you from the fullness of my heart! Now all I need to do is figure out what’s next for me!
    Robert Wallace
    Combat Medic, Airborne
    United States Army (medically retired)
    theblindsalesman | Tuesday, September 30, 2008 at 10:57 am | Reply

    Re: Catherine’s comment, Burroughs, a more practical investigator into the effects of opioids than say the pleasure dome dude or some chase the dragon hipster, intimates that opium may be a parasitic plant that inhabits the host until it is reduced to a plant itself until exhausted. It is the nature of parasites to exhaust their hosts, like hag fish or tape worms. So, if boyfriend is a butthead without a confection of both synthetic and natural wit inhibitors then he is a butthead, plain and simple. Keep a close eye on your valuables – they be slipping right away. If the kid wants to be compost he can arrange the meeting himself. If he doesn’t, the pusher will.
    Lisa Pfistner | Saturday, April 4, 2009 at 8:10 pm | Reply

    I have been searching the internet for the last year hoping to find any answer to my problem. I have had severe back pain for years. Doctors have tried everything but surgery. I have been on methadone for two years, they just keep uping the dose everytime I complain of more pain. I have begged to be taken off of methadone because I have felt the horrible withdraw symptoms that they claim are not bad.
    My family doctor will not help me go off of it, he claims all or nothing. I feel like you are the only person who knows my pain. Any advice will help?
    sandy | Sunday, April 5, 2009 at 9:11 pm | Reply

    Thanks for your input. I have a cousin that has been on this for a long time for fibro…but she is loosing her family etc. because it is taking her life over. I appreciate your information. She is in the addict mindset right now. We might have to do an intervention .
    nosleepingdog | Monday, April 6, 2009 at 9:38 am | Reply

    Hi Lisa,

    If you are still in pain despite methadone, then it doesn’t justify the effects of the methadone, in my opinion. Family practitioners are not pain specialists. Mine got her info from my first pain doc (the evil one!), both saying that withdrawal was all in my head.

    Find a good pain specialist in your area. Possible sources of referrals are another doc you trust, or a sympathetic pharmacist—they know who is prescribing what, and hear a lot from patients. Do not sign on with a doctor who makes you feel weak or guilty or that you are an addict. You are trying to get better, willing to do something hard to get there, and you deserve support and help.

    For me the pain specialist prescribed morphine for 3 or 4 weeks, just replacing the methadone with the morphine, to help with the withdrawal, and also gave me sleep medication and was ready to give me Xanax (for mental distress, extreme nervousness) if needed but I did not need it. I was weak and slept nearly all day for 2 weeks, then gradually came out of it, but never had the excruciating bone pain and mental distress that I had trying to get off without help. With the morphine and sleep meds I slept, rather than staying up for a week straight as when I tried it on my own. And I had confidence that this doctor was ready to help if things got unbearable; there IS symptomatic relief to help you through withdrawal.

    Getting off the methadone is step 1 with the pain doc, then step 2 is figuring out how best to control your pain. For my particular back pain, what worked was a nerve block that silenced the pinched nerves temporarily so that I could move normally and do exercises to strengthen and unclench muscles that had been knotted up for 15 years. But no telling what will be right for your problem. Often from what I hear a combination of things helps: learning how to move better, and what to avoid; just the right exercise (in the water perhaps); relaxation techniques; muscle relaxants for a period of time; non-addictive drugs like marijuana, which is legal in my state for medical purposes. There are those who think exercise and relaxation can cure these things all by themselves, I do not agree, but they can definitely help. Some pain patients need opioids, but I think methadone is worse than the others, and the pain doctor told me that too. Methadone is cheap so it gets prescribed a lot.

    When you can get help to stop the methadone, I bet you will then feel like you can tackle the back pain, feel more positive and in control. Methadone really saps your spirit.

    You can do it! let me know how it goes.
    nosleepingdog | Monday, April 6, 2009 at 10:10 am | Reply

    Hi Sandy,

    It’s good that you are concerned about your cousin, and looking for information. Be sure to keep in mind the difference between the chronic pain patient and the addict. Chronic pain patients can act like addicts, 1) because their pain is not being adequately controlled so they keep trying to get relief, 2) because they fear the loss of the medication so they hoard, try to get more, etc., and 3) because of the personality changes caused by both constant pain and the drug (methadone in this case). This does not mean that the patient is an addict, however, and treating them like one will make them resist even more, and misdirect your attention.

    The pain patient wants relief. There are other methods besides opioids, although for fibromyalgia the other methods may not work too well. I myself tried 2 drugs approved for fm, which are supposed to lessen pain for some (Lyrica and Cymbalta) and neither worked. With Lyrica, I had to take such a high dose that it sedated me way too much. There is now a third drug approved just this year, Savella (milnacipran); it should be available now or very soon, although most doctors probably do not know about it.

    Your cousin first needs to know that her family takes her illness seriously. This is conveyed in how people talk to her, whether they remember how she may be feeling even though, as people always tell us, “You look fine!” And whether people close to her try to give the help they can, whether it is her spouse or children taking responsibility for some of the family’s work/driving/housework, or giving her a ride if she is too tired to drive, etc.

    If she feels people discount her illness, or don’t believe in it, then she is not going to be receptive to conversations about what the methadone is doing to her life. Before I ever took any pain meds for fm, I watched my life seem to vanish before my eyes: I gave up everything that was optional, only the mandatory stuff remained and I still felt like a wreck and a failure. Finally I had gone to 3 days a week at my job, and the other 4 days were not enough for me to rest up from 3 days of work. Other people had energy to go out to eat with friends on their Friday night; at the end of my 4 days off I did not have that energy.

    It is not surprising that people with fm, and other severe chronic illnesses, get depressed—anyone would under such circumstances! So there is a question to look at: is your cousin being treated effectively for depression? Some anti-depressants are popularly prescribed for fm because they are associated with a reduction in reported pain, but they may not reduce the depression, since anti-depressants are different with different people. The anti-depressant I finally ended up on helps me not go into black moods where everything seems hopeless and pointless, but does not do anything for my pain. I have to cope with the pain by other means I have evolved: there are a lot of physical things I cannot do or can only do for a few minutes; I try though to keep as active as I can, use it or lose it! inactivity can just worsen things; I keep regular sleeping hours, take naps when I need them, pace myself, know that I have about 3 good hours a day (beyond the time taken for such activities as bathing, feeding the dog, washing the dishes after my husband cooks). I find things that take my mind off how I feel—reading, music, writing—and use time spent in those activities as relief. If I lived close to town I would probably try to get in some time in a pool, one with warm water if possible, because that is a relaxing and no-impact way to keep the blood flowing and the muscles working.

    I don’t mean to go on and on, here. My main points are to try and understand what your cousin is going through; present positive options rather than a confrontation about methadone use; let her know she is not in a corner (“the only thing that helps me is methadone” or “getting off methadone will be awful and no one will help me”); help her find a good pain doctor who’ll help her through withdrawal and will then explore other pain-relief options. My answer to another commenter, above, gives a few suggestions about finding help to get off of methadone—it is harder to get off of than heroin. That is what my 2nd pain doctor told me, and while I know nothing about heroin, I know that withdrawing from methadone without supportive medication was flat out impossible.

    You might be interested in looking at two other posts I have done, one about fibromyalgia itself ... -overview/

    and the other one about the difference between addicts and pain patients ... -patients/

    Good luck with this and good for you for being willing to help your cousin.
    Heather Hickerson | Tuesday, May 5, 2009 at 7:01 am | Reply

    Your post was so informative. I have been in pain for 4 1/2 years and I still don’t have a solid diagnosis. My neurologist has thought that it may be everything from Lupus, MS, and fibromyalgia to “idiopathic brachial neuritis”. That basically means that they don’t know why I am having the pain that I do. It basically feels like someone is holding a blow torch on my back 24/7. Anyway, just yesterday I got an email from my doctor responding on one I sent to her about not being able to tolerate the most recent prescription that she gave to me. She is now suggesting Methadone. I didn’t even realize it was a medication that was used for any reason other than helping heroin (and other drug) addicts get off the drug. I have not yet responded to her email as I like to research things for myself. That’s how I came across your post. You’ve given me much to think about. Thank you for sharing your story.
    Bianca | Saturday, May 30, 2009 at 3:53 am | Reply

    Thankyou thankyou thankyou thankyou!!! I wish I could have read this before agreeing to methadone treatment. Just out of chance I decided last evening that enough was enough. After a lot of soul searching I decided I wanted to be drug free. I’m 24, been “properly medicated for pain” (yet still in loads of pain every day) since I was 14. I have taken methadone for a few years now. And I was diagnosed with FMS approx 2 yrs ago. Your information has been a great help to me. It’s wonderful to know I have done some things right! Any advice for non-drug ways of lessening the effects of withdrawl?
    Much love and appreciation
    nosleepingdog | Tuesday, June 2, 2009 at 5:51 pm | Reply

    Hi Bianca,

    I’m really glad you got some useful info from my post!

    you asked,
    “Any advice for non-drug ways of lessening the effects of withdrawal?”

    Other than getting enough sleep (which for me was about 20 hours a day for the first week or so), no. I had tried on my own, as I described, and what helped me succeed finally was drugs—the month of morphine to lessen the terrible withdrawal pain and let me sleep; I think I also had sleeping pills, maybe klonopine, for the later weeks when sleep was hard. You may need anti-depressants or something like that. The pain doc I saw was up on all that and ready to give me the temporary help of appropriate drugs. Seems wrong, maybe, to use more drugs to get off of one drug, but sure worked for me!

    My pain now is fibromyalgia and nothing has helped that (new drugs have been approved and I guess help some but not me) but I am happier with some pain than ever with the methadone!

    Find a good doc!

    Let me know how it goes.
    Lulu | Friday, June 19, 2009 at 7:35 pm | Reply

    An extraordinary service you have provided, beautifully written. What a good soul. Thank you so much. At this moment I am too tired to say more than thank you, continue with your good works and God Bless.
    Lynn Bee | Wednesday, July 1, 2009 at 9:36 am | Reply

    Bless you for sharing your story. There is a huge difference between true chronic pain sufferers and phony “pill poppers”. Those who pretend to suffer, or greatly inflate their pain to get meds, have so destroyed the medical system for those who require pain management. Shame, shame on you it you are one of those frauds. I sparingly use pain meds for a debilitating condition. I have access to more; however, I know there is no free ride. This blog gives an absolutely true account of drug use. Your physical body does not differ from abuse or need. You will go through withdrawl regardless. Psychological withdrawl is addiction.
    I do not get high on pain medication. I only know I am on it because my pain starts going away. My personality stays the same; no euphoria. As far as I am concerned, the best pain med is Advil. The only reason why, after 15 years, I had to start taking pain meds was due to the fact I needed too much Advil, and there was a concern about it damaging my kidneys and/or liver. I thinks my willingness to try something else for so long went a long way with my doctor when I finally had to take something else. I had been under her care for that length of time so she knew I was being truthful. The one good thing about chronic pain: it feels like Christmas morning on those days I don’t have it!
    Lulu | Wednesday, July 1, 2009 at 1:03 pm | Reply

    Dear Lynn Bee:
    Shame on you for lashing out at the sick and suffering from your soapbox of thick ignorance on the nature of addiction, the pain industry and the roller coaster suffering of others. Try informing yourself before blaming and shaming others. There’s something wonderful awaiting those who seek knowledge and experience: wisdom. Sure there are those who scam and lie and cheat. But your self righteous indignation is no less a crime. Watch that halo doesn’t slip and choke you.
    nosleepingdog | Saturday, July 4, 2009 at 9:50 am | Reply


    Easy there, I think we can all relate to Lynn Bee’s feelings about the effect on pain patients, of those who are purely seeking the drugs for reasons other than physical pain. Because of our country’s hysteria about drug use, the reaction to these folks make it harder for the rest of us.

    [There's a typo in LB's 4th sentence, ". Shame, shame on you it you are one of those frauds. " which at first read to me as if she thought I was "one of those frauds", but I think the "it" should be an "if".]

    But even though the people who are addicts make our lives harder, and threaten doctors who do good pain management through stirring up witch hunts, we pain patients need to extend compassion to the addicts also. Nobody sets out to become an opioid addict. Lots of factors contribute to people becoming addicts from the consumer-based society created by advertising, to social dislocation and family breakups.

    Those of us who have used opioids and become physically dependent on them know better than most just what a hell it is, once your body has acquired that habit.
    matthew | Wednesday, July 22, 2009 at 1:11 pm | Reply

    Wow. Fantastic post on your experience with opioids–thanks so much for taking the time to share that.
    maddie | Wednesday, July 22, 2009 at 7:14 pm | Reply

    Bravo. Your article smacked the nail right on the head. I could have written it myself. I am in the care of ‘one of THOSE’ physicians. I expect a call everyday from her advising me that she is’uncomfortable’ prescribing to me.
    Needless to say, I have 10 years of ‘proof of pain’, so her attitude baffles me.
    My once wonderful pain doctor left the state because he felt he couldn’t help his patients like he wanted to. As a result my present doctor ‘inherited’ me. I know she wishes I would disappear.
    Because of this, and other experiences with pain medication management, (travel, fear of losing medication etc.) I have been thinking about weening myself off of Avinza (morphine).
    After reading your post, I think I may just give it a try.
    kelly p. | Sunday, August 9, 2009 at 10:54 pm | Reply

    Dear nosleepingdog,

    I am so happy that I stumbled upon your website. I have been taking methadone for chronic pain for about 5 months and was VERY reluctant to begin b/c I have heard of the horrible side effects when trying to get off of methadone. However, with my doctor’s consistent urging and my nagging pain, I gave in. It has worked for my pain, but I do not like many of the side effects, so I am thinking that it is time to get off of it now. One very strange thing that has happened since around the time I started taking methadone is that I began spotting/bleeding vaginally throughout the month. I went to see my doc several times and after pap smear results and other tests, everything appears to be normal. But why this frequent bleeding and why so tender?? I have thought it must be tied to the methadone all along. After reading your post, I am convinced that the methadone is to blame. I hope to hear a reply from you so I know that you might be able to offer advice as time passes. You’ve already helped me so much. Thank you and take very good care…
    nosleepingdog | Thursday, August 13, 2009 at 9:55 am | Reply

    Hi Kelly,

    You’re the first person I’ve come across who reports that same symptom, vaginal tenderness & bleeding, associated with methadone. I would never have thought the 2 might be connected except for the dramatic improvement soon after I went off the drug (and nothing else had changed). And now, nearly two years after quitting methadone, I am still experiencing improvement; the occasional bleeding during sex quit almost at once, the severe pain got less and less, and and now I am pain-free in that department! It is not something one talks about much, I mentioned it to my gynecologist and she ruled out other worse causes but had no real recommendations. Maybe lots of women on methadone experience it and it just is not reported.

    I also can say that even now I continue gradually to feel better, in terms of mental clarity and overall energy, and that *may* be slow recovery from nearly ten years of methadone. No way to prove it. Fibromyalgia-related fatigue and problems with memory, concentration, mental energy, have not gone away but every few months I notice that I feel a little better in those regards than previously. As I get older I am grateful for even small improvements!

    I wish you the best in your efforts, getting off the methadone and then finding other ways to deal with pain. I hope that it may be much easier since you have only been taking it for 5 months. But definitely do have an experienced & sympathetic doctor ready to assist you. Your doctor may feel you can simply taper off gradually and then go off of it, and that may work after only 5 months of use, but be sure he or she is committed to helping you if you find it too hard to do on your own. The 3 or 4 weeks of morphine that my 2nd pain doc gave me when I went off the methadone made it possible for me, and I know from previous attempts I could not have simply “toughed it out”. Then I stopped the morphine, no problem.
    Lois | Friday, August 14, 2009 at 7:39 pm | Reply

    Thank you for sharing your story. I do not suffer from FM but from a deteriorating situation involving a bum foot, the arthritic opposite hip, an adult-acquired scoliosis (guarding an originally ‘minor’ spinal injury) which feeds into the hip/foot problems, and assorted other spinal maladies. I’m hopeful of a coordinated approach to care that may finally bring some degree of resolution to all, later this year. Meanwhile, my PCP has advanced me over the past several years, through vicodin, dilaudid, now to methadone, as the symptoms (P-A-I-N!) and visible damage have increased and I have found I can no longer ‘manage’ – nor do I want to just manage, in a life now so restricted. Anyhow…I especially appreciated your mention of dreaming. That’s the one side-effect that I have noticed here in just the first few weeks taking methadone…a conviction that I am indeed, still dreaming (at least I’m getting an almost acceptable amount of sleep now) — but cannot remember any single aspect of any dream I might have had. Sleep had gone from being my refuge from the pain, in years past, to being made almost impossible by the pain itself. Now, with the methadone, I can sleep…but I have no knowledge of my dreams. It was at least reassuring, in that “misery loves company” way, to learn that I am not alone in my experience. I thought there was something wrong with me…besides all that known stuff, of course, LOL! Thank you again for sharing. I wish you well…literally.
    nosleepingdog | Sunday, August 16, 2009 at 1:42 pm | Reply

    Lois and others,

    Good luck with your new approach. Maybe a pain specialist rather than a primary care physician, too?

    It’s great that doctors are taking chronic pain more seriously; now we need to push for a wider range of approaches instead of so much reliance on opioids. There must be some for who the side effects of long-term methadone use are worth the reduction in pain, but there are many of whom that is not true. Then we have to beware of the pendulum going back the other way, as proponents of non-drug approaches can slide off into telling us, in effect, that positive thinking will do it and if it’s not working we’re not thinking positively enough!

    As an aside, I live in one of the 13 states where medical marijuana is legal, and it seems to help quite a few people with intractable pain. Doesn’t work for me, but it may be worth a try.
    kelly p. | Friday, August 14, 2009 at 10:22 pm | Reply

    Thanks for the reply nosleepingdog. I feel so blessed to have you as a support. I feel that the greatest accomplishment I will have survived is getting off of pain medication, once I am finally able to! I don’t expect it to be easy, but I certainly have the expectation that I won’t have to do it alone.
    I was prescribed Vicodin/Norco for 3-4 years and several times I tried various ways to get off of the medication: weaning, going cold turkey, “toughing it out.” Each time the horrible, impossible effects of the withdrawl brought me back. That is why I AM CERTAIN that I cannot get off the methadone without support. And, as I mentioned before in the earlier post, the methadone has helped with my chronic pain, but I find it extremely difficult to enjoy the relief from pain because in the back of my mind is the haunting realization that without this drug ever 6 or so hours, I will be in a WORLD of pain and hurt. Freedom from chemical addiction is now more important to me than freedom from chronic pain. That being said, I have created a large support group that consists of: massage therapist, chiropractor, acupuncturist, therapist, friends with FM and chronic pain. I am lucky to have good medical insurance with my husband’s work; however, we don’t eat out or take trips of any kind…all of the extra money goes to medical bills and copays at this point. I feel like my spirit is strong and my body is stronger than ever before because of my support system and my higher power. I am just still so terrified to tell my doctor that I want to get off of the methadone b/c when getting on it she said there wouldn’t be a problem with getting me off of it when my pain was being managed. Yesterday I decided to skip a dose of methadone…within a couple hours of the missed dose, i felt miserable physically, emotionally, spiritually. Within a half an hour of the next dose, I felt normal again. Thankfully, I tried this with plenty of medication left.
    The good thing is that my Doc, although seemingly misinformed or uninformed off the negative effects of opioid medication, is still an open-minded doctor who seems willing to try new things. I am preparing to go to her with my plan to get off of the methadone. Before I do, rest assured I will have several back up options for doctors who are open to treating me during the detoxification process.
    Thank you again, all of you, but especially you, nosleepingdog. I’ll be in touch…
    nosleepingdog | Sunday, August 16, 2009 at 1:46 pm | Reply

    Sounds like you have put together a great team!

    So, your doctor is another who is “seemingly misinformed or uninformed of the negative effects of opioid medication”—like my former pain doc and my former primary care physician. There must be one of those “gaps” at medical school, like the ones about nutrition, care of the elderly, etc.
    kelly p. | Monday, August 17, 2009 at 9:40 am | Reply

    Yes, or maybe certain doctors develop selective memory loss when the pharmaceutical companies give them “incentives” to use their products. Not too long ago I heard that the physicians were getting paid to use the drug manufacturers products…does anyone know any thing more about that? It sure would explain why doctors where I live are very quick to prescribe opiates. It’s disturbing how cheap it is to get a prescription for narcotic medication versus how much it costs to treat pain and injuries with alternative medicine, homeopathy, etc.
    nosleepingdog | Sunday, August 30, 2009 at 9:05 am | Reply

    kelly p., regarding doctors getting paid to prescribe certain medications—-

    I did a quick search on this topic (not thorough!) but found some information. It mostly relates to various “considerations” given doctors, and hospitals, for prescribing the drugs that are under patent and so very profitable for the companies. This generally does not include generic versions. As I recall my methadone was generic and very cheap; the time-release morphine I took for a while, was not generic. Things like Fentanyl patches, which I also used for a while, are extremely expensive. So the possibility that doctors are receiving anything as an incentive to prescribe certain drugs depends entirely on the particular drug.

    The “incentives” include a variety of things, including the very common practice of giving samples to doctors, which does enable them to help their patients (an altruistic motive) but also makes them look good to their patients, and promotes the continuing use of the drug that is given as a sample. A relatively few doctors receive “speaking fees” for professional appearances that I suppose might be to promote use of a certain drug, or might be more general in subject but the company can still pay them. I saw a psychiatrist once who was being paid to travel and speak to general practitioners about how to evaluate their patients for depression and how to choose one of the new “very safe” drugs to treat the depression. At the time it sounded like a genuine service since depression is common and few people see psychiatrists, but as more has come out about effects of anti-depressants, and potential for inappropriate subscribing, I have seen it differently.

    Payments for clinical trials are another possible type of incentive, and no doubt range from simple payment of expenses, to larger padded payments. The big threat here clearly is that the clinic/hospital/doctor have a financial incentive not to report results in a way that makes the drug look bad.

    Here are some articles turned up in my brief search, including one about Vermont where under Gov. Howard Dean (an MD) a unique law was passed requiring disclosure of most of these “incentives”. Also one reference to a law under consideration in Congress to ban companies with drugs about to go out of patent, from paying off other companies not to market generics! Not sure as to status of that.

    Health care reform, anyone?

    News Analysis: Vermont Law Sheds Light On Big Pharma Payouts | North America > United States from ... 681-1.html

    Psychiatrists Received Biggest Chunk of Pharmaceutical Company Payoffs, Vermont Study Finds ... eived.html

    Jeff Matthews Is Not Making This Up: Legal Payoffs in Healthcare, but Who’s Complaining? ... -whos.html

    New Law Would Outlaw Payoffs to Keep Cheaper Generic Drugs Off the Market — Attorney At Law ... he-market/
    speedyrs&cs | Saturday, October 17, 2009 at 2:21 pm | Reply

    Thanks for your informative article. My mother has FM and chronic back pain. She has been on methodone for awhile. She just had a car accident and had 3 surgeries. They are still trying to find the right pain meds. I appreciated all of your honesty about what you went through.
    nosleepingdog | Sunday, October 18, 2009 at 3:17 pm | Reply


    My heart goes out to your mom! I hope she can find an effective treatment for the back problem, then she will be in a better position to evaluate whether the methadone helps her fibromyalgia at all. It’s good that she has your support!
    SteveK | Thursday, October 29, 2009 at 10:19 pm | Reply

    Hmmmm I dunno Methadone weems to work for me; I don’t really need more of it over a long time; This maybe due to individual variations; I have never tried to “kill to zero” my pain and am just happy when it happens; Of course the cause of my pain shows up in blinding bright blue on x-rays so there is no real problem of saying this caused it.

    I tired and exahusted all the non-pharm “natural” fixes for my pain. ALthough the use of the word “natural” in this case because the standard opiates come from nature via a plant!

    I was originally on Duragesic which worked very well. I have in the past had acute repeating pain from kidney stones and got dependent on oxycodone but broke vfrom that with moderate effort; It was after the pain from degenerating joints on my left side became chronic and trying every new age “natural” trick that I decide oh well pharmacuetical pain relief might be better. Celebrex and Bextra did nothingand were expensive. After I got to the point where I couldn’t work that everything went downhill and I started drinking heavily which I had never done before. I had reasoned that one does not have to have atrgue with someone at the package store if one wants a 6 pack of beer.

    I tried and tried all the distraction stuff an new age modalities and found they just didn’t work for me Anyway after a big disaster I was put on Duragesic by a surgeon at the hospital and it worked so well that the Psych where I was shipped off too for about a week thought that I was depressed because of pain and pained because of depression.

    I was switched to Methadone and found it worked about 70% to 85% as well as Duragesic. I needed no “breakthrough fast acting opiates such as oxycodone” . With methadone I do; I find Methadone easy to adjust up and down and curously if one likes the pleasant effects less is oddly more, because for me above 60mg a day the pleasnt effects go away.

    This is all very curious to me how people can come at things from very different places. It maybe that we live in a “one size fits almost all” society.

    I agree people should read uop and consider what they are doing if they go onto chronic opiod use of any kind. Being physically dependent is a big change. One has to consider is it worth it. In one’s heqart of hearts I think opne will find the answer.

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