Everyone in NT land who takes Methadone.......

Do you mind me asking, how are your doses scheduled and how do you manage break through pain ?

I believe I will be starting Methadone soon.

I have been taking Vicodin 10/325 mg consistantly every 4 hours if I am out of bed in my home. If I am showering, getting dressed, going to a family event, etc I need 2 tabs every 4 hours. If I go to a concert, casino, beach, etc where I do not have the perfect chair to sit in and/or ice packs readily available, I need 3 tabs every 4 hours. On those days, I can get over the 4000 mg daily limit of Tylenol.......so, it's time for a change.

I am also concerned with expenses. My neuro is no longer covered by my health insurance, so I have to pay privately for narcotics. My pain clinic and primary doc don't write for narcotics. My neuro wanted me to try Avinza, but that is way too expensive. I was the one to suggest Methadone because I know it is cheap.

Now I am second guessing the change.

I have read Mrs D's Methadone posts before and am aware of the risk of cardiac death because of issues with QT wave arrythmias. It's not that I dismiss that concern, it's that I consider my risks of cardiac death are far greater from the severe high bp that comes with my increased pain. Unfortunately, now I see that the antidepressant that I am on , Zoloft, as well as many other antidepressants increase the chance of the QT wave issues. My neuro is off for the summer. I do have an appt with my primary this week to discuss possibly weaning off my antidepressant if she thinks that's a concern. I also worry about the fact that Methadone is longer acting/has a longer half life. With the Vicodin I know if I take one it will wear off in 4 hours so then I could drive. How long do you all find the Methadone lasts for ?

My script is for Methadone 10 mg q 6-8 hours. I'm planning/hoping that 5-10 mg 2-3x a day will do it. How much does everyone take for a break through dose compared to the regular dose ? How long do you all find a dose lasts for ?

Thanks for any input !