Doctor and opiod crisis

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Joined: Sat Jun 04, 2011 8:06 am

Doctor and opiod crisis

Post by peanut1 »

I am at the max amount of my medications (horizant/gabapentin and balsomra) and my doctor is not offering to have me try anything else. I'm thinking about asking him about Lyrica and alternating it with the horizant. It would be nice to have either clonazepam or something else as an add on but doctor is not letting me do that. Mirapex and requip does not work for me, I get sick on vicadon (spelling?) and methadone keeps me up all night. My big fear as I've written over the years is that there will be nothing left for me to take. It's not fair that we get the brunt end of the opioid crisis.

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Re: Doctor and opiod crisis

Post by Rustsmith »

I totally agree that it isn't fair that we pay the price for something that is not only beyond our control but also isn't relevant to our condition at all.

I have a couple of comments:
1. Methadone frequently causes a condition that many of us refer to as "alerting" that will keep you up all night. Since methadone only needs to be taken once/day, I resolved this by simply taking the pill early in the day. That way the alerting effect is gone by bedtime and my gabapentin has a chance to help me fall asleep.
2. Another opioid option that your doctor might feel more comfortable with is tramadol. Methadone and vicodin are both on the DEA's Sch 2 list. Tramadol is Sch 4. Not only does this cause fewer issues for most doctors, but it also means that you are free of the 30-day/no-refill limits on prescriptions. Tramadol is weaker, so you need more milligrams, but it works. Tramadol is also an anti-depressant, if that is of any use. If not, then it just means that it is a bit more difficult to stop since it is a bit more complicated than simply switching to a different opioid.
3. The potential benefit of Lyrica for you is that it is a little bit less expensive than Horizant. Beyond that, the two will have similar properties when it comes to treating your RLS.
4. Clonazepam was a very effective sedative for me for the short time that I took it. But like the opioids, it is a central nervous system depressant, so it should not be combined with an opioid. You can get away with both for a while, but the combination means an increased risk that you will stop breathing during the night and thereby not wake up. Getting off of clonazepam can also be very difficult.

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Re: Doctor and opiod crisis

Post by ViewsAskew »

Peanut1 - I take methadone about 6-7 hours before I want to go to sleep. That's the only way I can get through the alerting. I still can fight going to sleep, but I have a chance when I do that. You likely have tried that, but in case not...
Ann - Take what you need, leave the rest

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Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

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