Vets: The VA doesn’t feel your pain.

I am being involuntarily removed from my methadone prescription for chronic pain. I was taking 5 mg three times a day. The doctor says she is “weaning” me off of methadone. She didn’t say why.

Some months ago I went to the so-called “Pain Evaluation Clinic” at the Michael E. DeBakey Veterans Medical Center in Houston. I saw a psychologist for about an hour and spent about the same with a physician assistant who proceeded to make clear that I would be taken off methadone. I have taken the drug for more than 11 years. I had a couple of medical tests on the horizon that concerned me so I was spared from the weaning for the time being.

I never really received an explanation why I was being taken off methadone. The PA told me that my prescription for 15 mg was equivalent to 60 mg morphine equivalence. In extensive reading this afternoon, I found nothing to indicate whether this equivalence is accurate due to the medication itself.

The PA, I suppose, tried to scare me out of my methadone prescription. She gave me the impression that I could all of a sudden overdose while taking just a normal dose. I found nothing to support such claims.

It is true that methadone overdose deaths represent about 1-of-4 total fatal ODs. I found this on one government medical site:

“Methadone is a very strong painkiller. It is also used to treat heroin addiction. Methadone overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

 “Methadone overdose can also occur if a person takes methadone with certain painkillers. These painkillers include oxycontin, hydrocodone (Vicodin), or morphine.”

Look Ma, no spontaneous overdose from normal dosage for years.

Here is some additional illumination about methadone overdose from CRC Health Group, a West Coast addiction and behavioral treatment group based in California:

“Between 1999 and 2004, deaths attributed to methadone increased by 390%, an effect primarily related to increased utilization in pain clinics , as well as diversion.

 “Methadone accumulation can lead to sedation, respiratory depression, respiratory arrest and even death. Lethal respiratory depressive effects can occur in doses as low as 30 mg in non-tolerant persons

  “Initial efforts to characterize risk factors derive largely from Australia, where deaths related to methadone tablets prescribed for chronic pain increased markedly between 1984 and 1994. Diversion of methadone tablets accounted for about half the deaths, whereas deaths from prescribed methadone declined over this period. “

As CRC quite succinctly pointed out:

  “You must take methadone responsibly and with respect for its power, but the careful and considered use of methadone has proven quite safe, even for long-term consumption. Methadone has been proven not to harm the lungs, heart, brain, liver, kidneys, or any other organ.n 4,000 deaths. However, many of these deaths did not involve methadone treatment for opiate addiction — instead, they involved individuals who were using methadone without medical supervision for pain treatment, or who were otherwise abusing methadone.

 “Methadone use saves far more lives than it endangers. According to the National Alliance of Methadone Advocates (NAMA), opiate addicts who are not on methadone are more than three times more likely to die than are individuals who are using methadone as part of a supervised addiction recovery program.

 “Methadone, much like any strong opiate analgesic, has a respiratory depressive effect. If you take too much methadone, you can stop breathing and die.”

Simple enough!

A registered nurse friend of mine said recently:

 “You’re right that it’s the fentanyl and oxy and it’s the serious main-liners fucking it up for all of us. This entire thing is blown up by big pharma – I’m sure we could follow the $ and figure it all out, but the guy in pain is paying the real cost of trying to make it without his pain meds. It’s a mess,” she said. “It’s horrible and I can’t believe the medical system is letting them interfere with medical practice like this. It’s illegal and malpractice not to treat a patient with the correct medication when it’s available. Period.”

My weaning is in a rapid fashion. It makes me wonder if VA practitioners receive a bonus for cutting off opioids for some old vets with severe pain.

I started with being prescribed 10.5 mg three times per day. This month I received a prescription for 5 mg twice a day. Next  month it will be 5 mg once a day and 2.5 mg once a day.

I was never given a firm reason why I should quit taking methadone. I don’t have to though. It seems most VA top leaders want to look good for their boss in the White House. I doubt he could tell an opioid from a hemorrhoid.

Even worse than how I will fare without methadone from a withdrawal standpoint — almost 12 years is a long time on an opioid — is the pain.

I have not been offered a firm solution to the often severe chronic pain from spinal stenosis in my cervical spine, this despite having two surgeries. I also suffer from excruciating lower back pain that doctors at the VA have never seemed to agree on the reason. It limits my walking and the problem has never been substantially addressed, with the exception of a diagnosis of arachnoiditis. The condition is a pain disorder caused by the inflammation of the arachnoid, one of the membranes that surround and protect the nerves of the spinal cord.  The diagnosis seems dubious after seeing a number of different doctors.

Most disturbing are the VA pain strategies involving high doses of over-the-counter analgesics such as Tylenol or Ibuprofen. For real? Do they seriously believe such OTC drugs will help after taking methadone for almost 12 years?

Other VA “pain control” suggestions include physical therapy, chiropractic, acupuncture and group therapy. I just know sitting with a group singing “Kumbaya” will kill the pain.

I don’t know what will happen in the future. Most certainly, I am scared. I was put on methadone by a VA pain doctor in Dallas who suggested methadone after he told me there was nothing he could do to help. I have tried all the VA has had to offer since 2006 and those strategies that do not work for me have only grown 12 years later.

I can certainly understand why many VA patients may go elsewhere for help with pain. I don’t plan to seek black market opioids. Beyond that, I will do what I need to do to survive severe pain on a daily basis.