Dr. retiring & orders to discontinue 18 yrs. of Methadone for pain

[slamina]

This is my 1st post so please excuse any errors. My issue is very concerning to me and I just need to give some basics on myself and ask for some ideas or knowledge on discontinuation of medication.

I am 62 and have a long history of spinal and cervical stenosis, fibromyalgia, sciatica, chronic major depression, generalized anxiety disorder, ADD and high blood pressure. 18 years ago my reumatologist began me on oxycontin which I couldn't tolerate the highs with brain fog. So he started me on Methadone at 10 mg. 3 times a day. I was able to decrease my dose to 5 mg. twice daily after 1 year. This is the dose I currently at. I have no problems with the medication as it helps with the major part of the pain and also with my mood and anxiety.

Last month my reumatologist informed me he's retiring in Dec. 2022. He said there is no one else he knows who can prescribe it for me so I need to start cutting back and getting off of it. I cannot fathom my life without this medication and at 62, I don't want to have to. If you read anything on methadone and the withdrawls, it's a he-l of a place to be and relapse is extremely common and withdrawals can last for 9 months. If I'm taking a minimal dose and doing good on it, why force me now into withdrawal and a life of more pain than I'm having now?

Can anyone help me understand the reasonings or to find a contact or someone who can? Has anyone else gone through this? Please I need you..

[vk1678]

Is medical cannabis available in your state? If so, get in touch with a doctor who performs exams for Medical Marijuana. Cannabis may save you a bunch of heartache and pain. It is even better if you can find an MMJ doctor who specializes in managing chronic, intractable pain because you can also get pharmaceutical medicine if needed, and they tolerate the presence of cannabis in your system with your pharmaceuticals. Doing so has pretty much saved my sanity.

[slamina]

Iowa will probably be the last state to allow cannabis

[T23]

Begin searching for a new doctor today. It is very important that you do not delay. Do this while your current doctor is still available for a new doctor to consult. You have a year, until Dec 2022 to find a new doc, take action today make as many new doctor appointments as possible. As a patient you must 'interview' a doctor to determine if they and their staff are suitable to you and your needs.

Often doctors sell their practice, find out if your doctor is selling and who is the purchasing doctor. If your doc is not selling his practice and is closing it down, obtain a copy of all your medical records.There could be a fee charged for copying your records, regardless, at least get the last past 5 years of records.

You have to begin to build a case to advocate for yourself and your care. Be prepared for an uphill battle because the health care industry attitude due to the recent 'opioid crisis' is anyone requesting pain medication is an addict. Some doctors routinely request an in office urine test without advising you what the purposes is, what they are testing for is pain meds and illegal drugs. All patients, before you submit to any lab test, ask what is the purpose of the test, does your insurance cover it. All pain meds are highly regulated, doctors have to sign into a State website prior to prescribing any pain meds. Investigate 'Pain Management' doctors you may find appropriate care there.  With cervical stenosis and all spine issues there has been a shift to spinal injections.

You must do a lot of research on spinal injections (a/k/a epidural). Dr. Oz did a show on them and he advised against them for a number of reasons one of which is the medication being used is  'off-label' and when you see how close they come to the spinal cord to do the injection that is a concern. No matter the experience, education, even an excellent, the best doctor can have a bad procedure and you don't want to be that patient that day. Using medication 'off-label' isn't necessarily or always concerning, it is concerning when being directly injected into the spine.

Do know they will try to 'force' you into other treatment and you will have to gear up for that. Many doctors now pathologize their patients. In other words doctors: view or characterize their patients as medically or psychologically abnormal when they are not.

A professional that may help bolster your case and help advocate for you is a psychologist, so consider an approach from that angle as well. It may be advisable to appear willing to consider other therapies as apposed to being planted firmly that this is the care you will only accept. I would anticipate that you will come across a doctor who will seem willing to treat you your way but with the firm intent of switching you to another form of treatment. Keep in mind as the patient it is your job to advocate for your own care and that means actively participating in it, read, research, prepare questions and reach out to others as you have done here.

[GailL1]

You are gonna have to find a new doctor; that's a given - make it somebody that has some expertise with your skeletal / neurological, etc. problems. (Rheumatologist) Get your records and take them to the new Doc.  

You are on a low dose - Is it being prescribed in that lower dose or are you still getting the 10 mg X 3 Rx that the doc originally prescribed?  

Be honest - Tell the new doc how you feel about how Methadone is helping you - the rest is gonna be up to the doc.  The doc is the expert.  - He probably won't pull you off of it cold turkey,  The new doc may agree with you on the low dose for your neuro-skeletal pain but still try other things to help you and your body, especially those other conditions. 

Opiates aren't exactly the best med for depression, anxiety, ADD or high BP.    Sure they are great in taking away pain - that's why cancer patients in a tremendous amount of pain take them - then the dose and type escalates as the disease spreads and becomes more painful.  With terminally ill cancer patients, they aren't worried about the whole body and mind becoming dependent on them.  With Chronic pain management, it is a concern.  

In reality, know what you are dealing with -

SAMHA.gov - Methadone

CDC:  GUIDELINE FOR PRESCRIBING OPIOIDS FOR CHRONIC PAIN.

Re-read your own comments -

" I cannot fathom my life without this medication and at 62, I don't want to have to. If you read anything on methadone and the withdrawls, it's a he-l of a place to be and relapse is extremely common and withdrawals can last for 9 months. If I'm taking a minimal dose and doing good on it, why force me now into withdrawal and a life of more pain than I'm having now?"

Good luck in getting help from the new doc.