Combo of Pharmaceutical and non Pharmaceutical Questions

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
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bluefin
Posts: 12
Joined: Sun Dec 21, 2008 11:20 pm
Location: Canada Ontario

Combo of Pharmaceutical and non Pharmaceutical Questions

Post by bluefin »

I have been on Marijuana for just over three weeks, one or two puffs at bedtime and my RLS; PLMD’s were gone, now this effect only lasts for 3 hours. I have to get up during the night and have another puff, which sometimes works and others times does not. I was wondering if this has happened to others using MJ, is this going to keep escalating, as I do not want to get into heavy use of MJ.
I took advice and notes from this web site and, I now have one Doctors approval for Medical MJ. I meet with other Doctor on Monday to try and get his approval as well. In Canada we need two Doctors to approve MJ, if treatment is outside a narrow list of ailments set out by Health Canada.
I am traveling to USA. for two weeks, and I am not taking my MJ across border, risks are to great (up to year in Jail, $1000 fine and never being able to enter USA again, as well as having to declare at any border for any country I was refused entry to USA and my vehicle could be confiscated).
I have in my medical arsenal, new prescriptions for Tramadol, Codine, and one for Methadone that I hope I will be getting next week. I have, read here about quantities when to take, etc. I need something to get me through these two weeks in USA. Then come back to Medical MJ in Canada after the holiday without to much withdrawal.
I hope with a new President things will change and Legitimate legal use of medical MJ will become a reality in the USA.
Last point can I take Ambien, Imovane, sleeping type meds, with MJ, Tramadol, Codine and Methadone.
You people are the best, I do not know how I would have survived over the years without this board.
Bill

ViewsAskew
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Post by ViewsAskew »

Oh, how those long trips can be difficult. But, even more so in your current situation.

Since I haven't tried MJ for this, I don't know how it compares to the others. For me, methadone works well. I had 24/7 RLS when starting it and now have minor RLS only about 20% of the time, and usually only at night. Today is an exception when I have a bit here in the afternoon, but am just trying to stay busy until my nightly dose.

If it were me, I think I'd try each of these before I left so I knew how they worked and how much I needed (of course, the doc hopefully gave you some guidance).

Not sure why, but I'd probably try the tramadol first. If it worked, I'd just take it and not worry. If it didn't work, I'd try tramadol during the day and one of the other two at night.

Have you taken any opiates before? Do be careful if you haven't.
Ann - Take what you need, leave the rest

Managing Your RLS

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.

Neco
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Post by Neco »

I find it interesting you have scripts for 3 different opiates at once.. were they given in close proximity as well? It just seems rather dangerous for a doctor to throw out 3 scripts for something, especially Methadone being one of them, but I also don't have all the details from you either..

Start with the Tramadol or Codeine.. They are most comparable in strength, but I think the Tramadol may last longer or work a little better..

Codeine has issues with stomach cramps (taking with food, milk, also helps avoid them if possible) as well as the general side effects. But can still give relatively good relief, even if not 100%.

Tramadol has issues with seizures, although only typically in doses above the daily suggested limit of about 400mg. I've taken way more and been fine.. However if you are taking an anti-depressant do not take this stuff. You will almost certainly have a seizure like I did. It totally wrecked my ability to take Tramadol anymore, even in low 100 - 200mg doses.

Methadone.. please be very careful with this if you haven't received any instructions from the doctor about how to begin taking it.. (and if you didn't.. I would be very suspect of their qualifications) If you have had no previous exposure to opiates, especially strong ones like Oxycodone, you need to start slowly.. They usually come in 5mg tablets, so you want to break it into halves, or 2.5mg doses.. Take one half and wait a few hours to see how it affects you, especially your breathing. You want to try and take no more than 1 pill a day for the first couple of days, breaking it into smaller doses as needed. Then you can slowly increase it to the prescribed amount as time goes on and your body develops a proper tolerance.. The initial stages of Methadone treatment are the most dangerous, because you can easily OD if you don't pay attention to how much you are taking.

Quite a few of us here take Methadone, and we believe it is a great treatment option for difficult RLS, but we all started out within our tolerance range if we had previous opiate exposure, and we always recommend starting very slow for those with no opiate exposure.

All 3 of those meds should easily last you 2 weeks, as long as you don't overdo it. However I don't know what kind of attention crossing the border with all 3 in your posession will get you.. I would say if you have at least 25 to 30 pills of both the Codeine and Tramadol, to leave the Methadone behind.

Quitting Tramadol and Codeine cold turkey after two weeks should not be much of an issue, especially if you are not unnecessarily escalating your dose, and if you apply a rotational schedule between the two every 2 or 3 days, it should also help..

Methadone should be titrated down slowly to ease the withdrawal symptoms.. Methadone has a long half-life and stays in your body for a much longer period than other opiates.. If you try to quit cold turkey your withdrawal symptoms may be difficult to deal with, possibly painful, and it will last for a longer time than other opiate withdrawals do..

Methadone by its long half-life nature will always have a more extended withdrawal period than other drugs, even Heroin (which is why some say its better to cold turkey from Heroin than Methadone) but in most cases, if you are properly titrated down to smaller doses, the withdrawal will be much easier to handle, if even present after 2 weeks.

bluefin
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Joined: Sun Dec 21, 2008 11:20 pm
Location: Canada Ontario

Post by bluefin »

Thanks ViewsAskew and Zack
The reason I have three scripts, is the doctors and I have built up trust over time. They know I always go for lower doses, and that I will not abuse the drugs. They also know that I want to switch around from drug to drug as not build up a tolerance to any one drug. I have been waiting along time for this holiday, not wanting to go on vacation because of staying up all night in pain and not being able to do anything the next day. I was all set to take my new found relief (MJ) south, but decided against it because of the risk.
Yes I have good instructions from my doctors regarding Methadone, and I appreciate your cautionary notes as well.
My last point was not answered, can I take Ambien, Imovane, sleeping type meds, with MJ, Tramadol, Codine and Methadone.
Best Bill

Neco
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Post by Neco »

It normally shouldn't be an issue.. However, I would caution not to take any right away with Methadone in particular. At least until you've built up a tolerance to it. If you end up in trouble from the combo or something, and you took ambien or another hypnotic med, you'd likely be out of it if someone found you; no guarantee you'd snap to and be able to tell anyone what medications you recently took.. Also stay away from OTC sleep aids, especially diphenhydramine, if you don't already know better. It will send your RLS into Lunar Orbit.


I do think the Tramadol and Codeine should last you two weeks, although I understand the rotational thing.. Rotational tolerance resistance is somewhat anecdotal however.. There are some people who can identify specific medications they can successfully rotate to help keep tolerance and cross-tolerance down, but that can be a lengthy process to truly get data on for your personal plans..

But in general if you take one opiate, you build a tolerance to all opiates. Likewise taking a strong opiate will wreck your tolerance for weaker ones.. As an example, I went through one period where I got a gap filler of Hydrocodone before I could refill my Methadone. I had to make it last for a week - 8 pills a day (5mg) and I was barely able to cope between doses. Even the relief they brought wasn't as full as it used to be. I had previously taken Hydrocodone for a couple years on varying up and down dose spikes and been relatively fine, but Methadone in particular is going to wreck your tolerance to other lesser strength opiates - period. That's what it does by nature. So I really would save it as a last resort medication if you manage to blow through your other two scripts.

bluefin
Posts: 12
Joined: Sun Dec 21, 2008 11:20 pm
Location: Canada Ontario

Post by bluefin »

Thanks Zack, great advice as always.
Bill

gymper
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Post by gymper »

Last time I was using MJ for RLS - yes my tolerance went up. I had to take like 5 bong hits or more to get to sleep and then I would wake up and take bong hits in the night. I used it for about 3 months. For some reason now I can't stand the effects of MJ so I'm looking for something else. If you don't mind the effects, you may want to try an edible version - that will probably stay in your system longer. Also the Indica strains are the most effective for RLS.
Good luck!
--jim

Aiken
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Post by Aiken »

Zach wrote:But in general if you take one opiate, you build a tolerance to all opiates. Likewise taking a strong opiate will wreck your tolerance for weaker ones..

Caveat: Unless the weaker ones hit more receptor types than the stronger ones.

Example: I've taken hydrocodone for quite a while now, and have built up a reasonable tolerance to it. However, recently I tried cycling in some of my old propoxyphene for a drug holiday test. The propoxyphene was surprisingly strong in comparison to the hydrocodone. I did some research and found that propoxyphene, while a weaker drug, tends to hit several opioid receptor subtypes, while hydrocodone hits only one. Thus, while I got little effect from the tolerant receptors, the naive ones hit me like I'd never taken the drug before. Alas, the tolerant ones remained tolerant and, when I switched back to hydrocodone, the holiday had had little to no effect.

(Note: Most strong opioids do work on just the one mu opioid receptor type, so in most cases, Zach's rule of thumb applies exactly as stated.)
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.

ViewsAskew
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Post by ViewsAskew »

I haven't read anything about this at all, but keep remembering the research that was found and posted earlier this year (Susan or Corrie, I think). It said that they were having success with tolerance to opiates by rotating them.

To digress, I once read that some of the niftiest inventions and solutions to problems came from people who didn't know the complex research and accepted rules about the subject. Since they didn't know that something was not supposed to work or violated some accepted rule, they did it anyway. When it works, all the scientists or people on that field say, "I never would have done that! That shouldn't have worked!" Or some such.

It's possible that there are studies that show rotating does not work. But, how did this other study get it to work?

I keep thinking there may be something involved here that we're not seeing because we accept that this can't work. Then again, the one study could be unrepeatable (there's a better scientific word for that, but the words are unavailable to me today, lol).
Ann - Take what you need, leave the rest

Managing Your RLS

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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