Pain Medication

[CuriousJungleGeorge]

Is there are preferred drug to control post-procedure pain? Vicodin? Oxycontin? Methadone? ...Heroin? (Yes, kidding about the last one.) Thank you, all.

[Goldilocks]

After my procedure, my doctor had given percocet (oxycodone) for pain, which I never ended up taking. (I probably should have since I had quite a bit of pain, especially in the donor area!)

[Take a chance]

I was given a pain killer with codeine which helped. Also valium for sleep.

[CuriousJungleGeorge]

Thank you.

[john2008]

I have had two HT's and both times the doc prescribed Vicoden. But to be honest, I am not 100% sure that I really needed it past the first night.

 

John

[CuriousJungleGeorge]

What's something like methadone generally prescribed for?

[john2008]

Here is what I got off of Wikipedia. It looks like it is used to break narcotic addictions. I am not sure that I would say that this would be the most necessary thing after an HT though - but that's just me lol:

Methadone maintenance treatment

 

MMT (Methadone Maintenance Treatment) reduces and/or eliminates the use of heroin, and criminality associated with heroin use, and allows patients to improve their health and social productivity.[21] In addition, enrollment in methadone maintenance has the potential to reduce the transmission of infectious diseases associated with heroin injection, such as hepatitis and HIV.[21] The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with heroin. Methadone maintenance has been found to be medically safe and non-sedating.[21] It is also indicated for pregnant women addicted to heroin.[21]

 

In Russia, methadone treatment is illegal. Health officials are not convinced of the treatment's efficacy. Instead, doctors encourage immediate abstinence from drug use, rather than the gradual process that methadone substitution therapy entails. Patients are often given sedatives and painkillers to cope with withdrawal symptoms.[22]

 

[edit] Effect

 

Methadone maintenance treatment significantly decreases the rate of HIV infection for those patients participating in MMT programs (Firshein, 1998). At proper dosing, methadone usually reduces the appetite for and need to take heroin, and also provide cross-tolerance and block the euphoric effects of other opioids such as heroin, fentanyl, hydrocodone, oxycodone, hydromorphone, and morphine or codeine, thus greatly reducing the motivation of patients to use them.

 

Methadone offers patients the freedom from active addiction and use of mind-altering drug use and in turn allows them to seek concurrent psychological, psychiatric and self-help based therapies for both the disease of addiction and any comorbid illnesses they have, freedom they would not have when experiencing severe ongoing withdrawal and/or cravings. In addition, and perhaps most importantly, methadone allows addicts to become productive members of society; freed from the need to obtain money through often illicit means, opiate addicts can return to their normal lives, or develop skills, further their education, and (re)join the workforce.

 

A proper dose used in methadone maintenance therapy will block or greatly reduce cravings for illicit opioids, while not inducing any euphoric feelings or other subjective sense of being high, and if dose is high enough, will actively prevent the patient from experiencing any high if they do use other opioids. Methadone-based treatment is significantly more effective clinically and more cost effective than no-drug treatment modalities for opiate-dependent patients.[23]

 

[edit] Dosage

 

A majority of patients require 80-120 mg/d of methadone, or more, to achieve these effects and require treatment for an indefinite period of time, since methadone maintenance is a corrective but not a curative treatment for opiate addiction.[21] Lower doses are sometimes not as effective, or do not provide an equivalent blockade effect as higher dosages can. Some patients will be prescribed as much as 500 mg of methadone a day, though a person without a methadone tolerance may get sick from a dose as low as 20 mg.

 

In the United States clinics typically start patients at a low dose, generally only starting patients on methadone when they are in withdrawal and providing a small test dose, after which the patients are observed for possible adverse effects. Assuming there are no complications, the remaining portion of the first day's dose is then given. After this the doses are titrated until they reach either a clinically sufficient level that prevents withdrawal, cravings and possible continued use of illicit opioids, or until they reach a maximum dose set by clinic policy. For example, a clinic may start patients at 30 mg and raise the dosage 5 mg a day until the patient feels at a comfortable level, or will stop at 80 mg and allowing the patient to move up by 5 mg or 10 mg every 2 or 3 days, free from withdrawal symptoms and intense cravings. Once stabilized patients may require occasional dose adjustments as their clinical or subjective tolerance changes.

 

The most common and traditional dosing regimens, however, tend to fall far short of providing optimum or even sufficient results for a number of patients. This is due to the ceilings many clinics place on dose levels.[24][25]

 

Until recently a 100-mg/d dose was regarded as a 'glass ceiling,' rarely to be penetrated. In practice much lower thresholds were maintained even though the optimal dose varies greatly between patients, often quite higher than this and with no inherent threshold in the possible dose, as the toxic dose for patients with very high tolerance can exceed this ten-fold or more. The blood concentrations of patients on an equivalent dose (when adjusted for body weight) can vary as much as 17-fold, or up to 41-fold when influenced by other medications, leading to a vast range of potentially required doses.[26][27]

 

In the United States, federal law was changed in 2001 to eliminate some restrictions imposed on patients dosed on more than 100 mg per day.