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Posted by: Sparrow on 2010-08-12, 11:51:33
I don't have a ton of expertise in this arena, but I can tell you that opiates have long been used in treating bronchial issues. The sedation translates to relaxing the muscles in your airways, and in turn, reduces the urge to cough. Traditionally, opium, tincture of opium, laudanum, and cough syrups with codeine were over the counter remedies. Today, because there is a better understanding of the risks associated with opiates (namely, dependency & addiction), it's generally not the first course of treatment. But in cases where the respiratory issues are terminal, or chronic, then a physician may use some sort of opiate therapy, since the benefits outweigh the risk. Methadone would be considered a candidate in someone with ongoing issues- I have a friend who passed away from Hemophilia related AIDS infection, and in his later years he became less responsive to the antibiotics~ as a result, they placed him on dilaudid (similar in terms of its potency and that it's an opiate, but different in that it's shorter acting, and therefore less likely to cause addiction problems IF only used in a PRN capacity- methadone being a single dose medication means the patient takes it and even when they aren’t experiencing bronchial distress, they're using it, where using a shorter acting opiate allows the person to only take it when absolutely needed, and hopefully not enough to create a dependency issue. But please note that dilaudid are highly addictive opiates if taken frequently). What I’m not clear on is if you're saying the methadone has made it harder for you to breathe, or that it's become harder to breathe since you stopped taking it; and it's scaring you b/ c it never happened before you took it either. If i understand that, and it's the latter (never had the issue prior to the methadone, never had it while taking the methadone, but now that you've stopped the methadone, you're having a hard time)- odds are that while taking it, you experienced a marked improvement, because the beneficial effects soothed your airways. Now that you're off it, they're reverting back to the previous condition, but in reaching for the CPAP, it feels like it's too much? Do you have a set level you used on the CPAP prior to the methadone? If so, you may just need to lower it, since you did have some benefit, and you're not as restricted as before yet. I would think eventually, without methadone, it will go back to the same restriction eventually, but remember, methadone provides a residual in your system b/ c it's time released- so if it's been only a few days sine your last dose, it's possible it still has some lingering, albeit mild, benefit. Think of it like this: You have a balloon, but the tube on your air tank that you use to insert air through is very small. The balloon fills very slowly. You switch to a larger tube, and after a day or two, for whatever reason, you decide to revert back to the old, smaller one. When you use the old, smaller one again, you use it at the same pressure you did before you used the wider gauged one- and suddenly, the balloon pops. Why? Because while it's not as wide as it was when the wide gauge tube was in use, it may have retained some of the stretching the wider gauge caused, and until it tightens back up, the old pressure settings you used from when it was smaller are now too strong. Again, my experience with CPAP is limited; but it's my understanding some of the newer machines regulate how much air flow is needed based the individual; so in that case, there may be some other issue at hand. Regardless, you need to talk to your physician- if you feel like they don't have a good answer, or one you're comfortable with, then maybe you should try talking to an MMT clinic physician. Even though you're not an opiate addict, the pharmacology of methadone is often very misunderstood; MMT Clinics have a much better comprehension of methadone and what types of issues it can have concerning interactions. It's not that your physician is incompetent, it's just that methadone isn't a commonly prescribed medication. I have a family doctor, and he's wonderful- but there have been plenty of times when i went to my MMT clinic physician because i was worried my own doctor didn't understand how methadone interacted with a medication or health issue. I hope that this helps a little (and that I actually understood what you were asking, and didn't just ramble on about something irrelevant, lol). I wouldn't wait, either way- breathing is one of those things you don't want to go without ;) Call your physician, if you don't get a good reply, then I’d call the company who manufactures the CPAP device; if they don't know, then maybe it's time to look into calling some MMT clinic physicians. NAMA, by the way, isn't just for opiate addiction methadone- they deal with pain management methadone prescription issues too; and they are the top authority on this stuff. They are a little slow to reply though, so if you can't get anywhere with them, email me your city & state, and I'll try and find some MMT clinics in the area who you can try calling. They're really the most informed resources, and it's in their best interests to help everyone understand how this drug works, regardless of its prescription basis. Lastly- methadone might be a good thing for you if it helped- and if it didn't, maybe it didn't have a chance to yet. You might need an increase in dosage, and even at the right dose, it'll take a little time to feel the full benefits. I do remember that dilaudid worked wonders for my friend's bronchial issues; but it was also heavily sedating. In his case, the disease had reached a terminal stage, and he was on hospice, so it didn't really matter- but to live a normal life and take something to alleviate the symptoms, methadone would be far better, since it won't sedate the way other opiates will. Again, don't hesitate to email me if you need help getting in contact with someone- take care, |
