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Thread: What is the main difference between Methadone and Hydrocodone

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    Default What is the main difference between Methadone and Hydrocodone

    Hello all, I have taken both of these for my back pain and I really feel that Methadone does a better job but I don't like the fact that people think that methadone is strictly for people coming off heroin. What is the main difference? Why is methadone used for heroin Junkies? Thanks in advance for the help:-)


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    I prefer Methadone for pain. I find when I take hydrocodone it helps the pain but gives too much euphoria. Same as oxycontin. Methadone is more effective and much less likely to lead to abuse in my opinion.

    Methadone is usually not prescribed because of the stigma that you referred to.
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    More and more pain management specialists are treating their chronic patients with methadone lately.
    Its painkilling effectiveness is longer lasting than a shorter acting opioid like hydrocodone with an additional effect of less euphoria thus potentially less opportunity for abuse.
    Compared to some other strong narcotics like OxyContin, methadone is also dirt cheap as a generic.
    Another reason pain doctors are somewhat more comfortable prescribing it is its less valuable demand profile when diverted to street sale.
    Some people have heard horror stories about quitting methadone but, personally, I have not seen a dramatic difference between discontinuing it versus hydrocodone when methadone is taken in typical pain management dosages such as 10mg 3x/day.
    Stopping it at the 100mg+ daily doses used in some methadone clinics would be a different situation entirely, though.
    In the pursuit of relief from intractable, chronic pain, I wouldn't worry too much about any "stigma" you might perceive.

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    I think another reason doctors are reluctant to prescribe methadone is that because of the delayed onset, there is an increased risk of overdose. People will take one, not feel immediate relief, and keep taking more until they OD.
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    Quote Originally Posted by nj754 View Post
    I think another reason doctors are reluctant to prescribe methadone is that because of the delayed onset, there is an increased risk of overdose. People will take one, not feel immediate relief, and keep taking more until they OD.
    Very true. But the flip side is that some people develop a tolerance to oxy and wind up taking more which leads to the same cycle. They eventually end up taking more daily. This is what leads to the abuse, over medication, addiction and withdrawal issues.

    Both have their place for treatments and care should be taken when using them as not to get yourself in a bad place with either. The danger is there with either.
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  6. Hello all, I have taken both of these for my back pain and I really feel that Methadone does a better job but I don't like the fact that people think that methadone is strictly for people coming off heroin. What is the main difference? Why is methadone used for heroin Junkies? Thanks in advance for the help:-)

    personaly i would stick with the hydrocodone i could be wrong but as far as im aware it does contain some apap so you wont be able to abuse it plus it wont freak people out if they see you take it at work or in the bathroom cabinet at home.

  7. #7
    It is used in methadone clinics for "harm reduction" treatment for all of the same reasons I noted before. Long lasting, less euphoria, cheap, etc.
    Regarding your medicine cabinet and taking it at work, I don't see how that would necessarily be a problem. Lock it up at home (which should be done anyway) and use a bathroom stall at work if you're afraid of someone reading your prescription label and freaking out. Seems unlikely, though.
    Comparing the statistics of health problems from possible hydrocodone abuse and methadone abuse in a pain management context, methadone would likely be safer.
    The previous warnings about potential accidental overdose are very valid, however. Methadone really is one of those drugs that must be taken as prescribed and the doctors I know who prescribe it go to great lengths to emphasize that danger.

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    Methadone has a half-life of 24-36 hours, hydros about 3-4, someone correct me if I'm wrong. And yes, use ONLY as directed and do not combine benzos, alcohol, etc. Methadone is also used in terminal patients, and old people who will probably never need to W/D from it.

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    The difference between the two is that one is a short acting narcotic for mild to medium pain, the other is a very long acting med for chronic pain or patients going to a clinic to get 'clean' from street drugs.

    As far as usage in pain clinics? The ones in my area script Methadone as your long acting narcotic, with oxyiRs or morphine ir for breakthrough pain. Neither clinic I've gone to has ever scripted hydrocodone for b/t pain. I don't know why.

    Right now I take 40mgs of Methadone a day and have for about a year. It works so much better than the other long acting pain meds and I never have a sense of withdrawal. When I was on other long acting meds there would be several hours everyday that I was in withdrawal until it was time to take the medicine again. I hated that because it would make you waste your b/t meds trying to get through that period. I've been on the same medicines for a year without any problem, although my b/t meds have been slightly increased because I was started with a very low dose.

    Even though it's counterindicated in Methadone patients, I also take Klonopin everyday. I guess my doctor really trusts me to not abuse my medicines. I've never called and said "I ran out early" although I had one scare where I did come up short and had to use another medicine. Two months later he increased my Kpins to 2mg a day from 1mg a day and now I have no problems.

    Chronic pain patients shouldn't be scared of Methadone. As long as it's taken like it should you'll never have a problem and since many pain clinics script it now the drug stores don't think much of it. I get more dirty looks for my Kpins prescriptions than I do for the Methadone. (but then, I get 4 fills of kpins whereas my Methadone has to be scripted monthly and the drug stores act strange about that. I know they've called my doctor but I don't care. He told me to change stores if they give me any more problems).

    Sorry to go off topic. In the end, you can't really compare hydrocodone with Methadone. One's short acting, one's long acting. One would never be given if you had acute pain, one is always given for acute pain. Some people may take hydrocodone as their b/t med and Methadone as their long acting med but that's probably about the only time the two would meet.
    Helpful alumni Rated helpful
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  10. #10
    Lynx is correct about done being good for pain. The only other good thing about done is the half life keeps you level so no ups and downs or good and bad hours.

    I would not recommend done for anyone unless they are terminal, old or just a junkie who cannot keep needles out of their arm and living in the gutter. The biggest mistake is for someone who does not really need it to take it because it will change your life. That shit gets unto your bone marrow and can take months to get over withdrawals so most never get off. Treatment centers may even refuse to try and detox you if you are on a high enough dose for long enough.

    I know some indicated done was perhaps safer than hydro. Do yourself a favor and research this stuff before putting it in your system. Seriously, you know it's bad or like a life sentence when treatment centers say they cannot detox you or help you if your on done.

    Lynx: I am blown away that your PM only uses done. I am sure they do this because lower abuse potential and diversion potential because low street value. I would beg to get on Fent patch. I don't even think you could switch over to opana or morphine extended release without severe discomfort even at 40. 40 is the threshold for being screwed. I think that is the level treatment centers tend to say no or may even be 20. Heck, you would have to be on subs so long and at such a high dose to get over the done you would be stuck on the subs. You can taper patches pretty easy if you get the ones without gel and cut them.
    Last edited by 996ttcab; 06-04-2011 at 10:26 PM.

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    Post There is a difference between the two

    Yes you can tell the difference in Methadone and hydrocodone Methadone has to be tested separately in a test it is not on the 5 panel test. Hydrocodone however is an opiate and will show up as an opiate. Methadone is a synthetic opiate and is in a class all of its own. Methadone tricks the brain into thinking that its still has heroin/opiates in the body it works the same in the brain. So to answer your question they would have to test seperate for methadone. It is two totally different drug classes.


    Remember good information is good medicine!

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    Quote Originally Posted by alumni View Post
    More and more pain management specialists are treating their chronic patients with methadone lately.
    Its painkilling effectiveness is longer lasting than a shorter acting opioid like hydrocodone with an additional effect of less euphoria thus potentially less opportunity for abuse.
    Compared to some other strong narcotics like OxyContin, methadone is also dirt cheap as a generic.
    Another reason pain doctors are somewhat more comfortable prescribing it is its less valuable demand profile when diverted to street sale.
    Some people have heard horror stories about quitting methadone but, personally, I have not seen a dramatic difference between discontinuing it versus hydrocodone when methadone is taken in typical pain management dosages such as 10mg 3x/day.
    Stopping it at the 100mg+ daily doses used in some methadone clinics would be a different situation entirely, though.
    In the pursuit of relief from intractable, chronic pain, I wouldn't worry too much about any "stigma" you might perceive.
    PMs may be doing this with patients whose seem to be increasing in dosages too often on regular protocol or who have a questionable UA and need to be switched to something that won't be used up to quickly each month.

    My PM doc said 15 or 5 3 times a day is way to go and easy to stop if you want. I had weaned myself almost off the Fent patch and let him talk me into the done at a low dose as being a safe alternative. Big mistake and hated side effects so thank God I stopped it after may two months. I still felt that stuff leaving my body for weeks after stopping only 15 mgs a day even with Fentanyl patchs, dillauded and percocet as needed.

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    Quote Originally Posted by 996ttcab View Post
    Lynx is correct about done being good for pain. The only other good thing about done is the half life keeps you level so no ups and downs or good and bad hours.

    I would not recommend done for anyone unless they are terminal, old or just a junkie who cannot keep needles out of their arm and living in the gutter. The biggest mistake is for someone who does not really need it to take it because it will change your life. That shit gets unto your bone marrow and can take months to get over withdrawals so most never get off. Treatment centers may even refuse to try and detox you if you are on a high enough dose for long enough.

    I know some indicated done was perhaps safer than hydro. Do yourself a favor and research this stuff before putting it in your system. Seriously, you know it's bad or like a life sentence when treatment centers say they cannot detox you or help you if your on done.

    Lynx: I am blown away that your PM only uses done. I am sure they do this because lower abuse potential and diversion potential because low street value. I would beg to get on Fent patch. I don't even think you could switch over to opana or morphine extended release without severe discomfort even at 40. 40 is the threshold for being screwed. I think that is the level treatment centers tend to say no or may even be 20. Heck, you would have to be on subs so long and at such a high dose to get over the done you would be stuck on the subs. You can taper patches pretty easy if you get the ones without gel and cut them.
    The views expressed in this post are bang-on-the-money IMHO. Especially, "I would not recommend done for anyone unless they are terminal, old or just a junkie who cannot keep needles out of their arm and living in the gutter. The biggest mistake is for someone who does not really need it to take it because it will change your life."

    I have suffered with cluster migraines (and a panic disorder) since having a cerebral haemorrhage in 2005. Unfortunately, this has meant battling with various opiates to combat the pain. I can't take anti-inflammatory drugs because of an ulcer, and I can't take standard migraine meds because, in my case, they increase the risk of a stroke. After taking hydromorphone (Dilaudid) for these migraines, I ended up becoming opiate dependent.

    I'm very stubborn and I hated the thought of being dependent, so, reluctantly, my doctor switched me to methadone. I lasted two awful, hellish days on it. I know it's horse for courses, but for me it was like consuming a highly poisonous substance. I was actually quite excited about the prospect of taking it at the time (yes, I know.....), but within six hours of taking my first dose everything turned very ugly indeed. Running (make that crawling) to the toilet and vomiting every hour was only the start of it. I couldn't eat anything without being sick. I couldn't stand up, or even move my head without getting incredibly disconcerting whirlies. I had profound shakes, sweats, and panic spikes that became totally unmanageable. In the back of mind I kept telling myself it would wear off as I became "used" to it. This proved to be wishful thinking after taking my second dose..... Also I was taking a relatively small dose (20mg per day). Goodness only knows what it would have been like if I'd been on a higher dose.

    Thankfully, after coming stopping the Methadone, and switching between a few other drugs, we discovered that high dose Dihydrocodeine worked well for me. Unfortunately, just lately my intake of DHC has rapidly escalated, so I'm not sure where I will go from here. There have been several successful trials here in England (and Scotland) that have focused on stabilizing people on DHC (at much higher doses than used therapeutically) instead of Methadone when coming off street heroin.

    Having had to switch between several different opiates since my illness, I can safely say that Methadone was by far the most troublesome. I reluctantly accept that it may work for some people at managing pain, but I would question the prescribing doctors motives for putting a person on such a drug when there are so many more safer drugs with lower side-effect profiles. My logic would say that if a person is in severe pain putting on them Methadone may not make them feel better. It may take the offending pain away, but there is a very high risk it will replace the pain with a miasmic, but different set of equally horrible problems.
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    @miffytherabbit I don't think methadone has any worse side effects than the others. You happened to have an idiosyncratic reaction to it. I took some for kicks for around a week and found it pleasant. Maybe not truly euphoric, but it made my depression and anxiety go away. Obviously it isn't a long-term solution for psych problems.

  15. #15
    Quote Originally Posted by Bnjar5 View Post
    Yes you can tell the difference in Methadone and hydrocodone Methadone has to be tested separately in a test it is not on the 5 panel test. Hydrocodone however is an opiate and will show up as an opiate. Methadone is a synthetic opiate and is in a class all of its own. Methadone tricks the brain into thinking that its still has heroin/opiates in the body it works the same in the brain. So to answer your question they would have to test seperate for methadone. It is two totally different drug classes.


    Remember good information is good medicine!
    Absolutely agree that good information can help with good medicine.
    Typically, neither hydrocodone nor methadone will show positive on a five panel UA test since neither are natural opiates but raher semi and fullly synthetic "opioids" respectively.
    Since methadone is simply another narcotic drug, it just fills opiate receptors in a similar way to other narcotics. As I said earlier though, it is much longer-acting and causes less euphoria, hence less potential for abuse.

  16. Quote Originally Posted by momentum View Post
    Hello all, I have taken both of these for my back pain and I really feel that Methadone does a better job but I don't like the fact that people think that methadone is strictly for people coming off heroin. What is the main difference? Why is methadone used for heroin Junkies? Thanks in advance for the help:-)
    What is the main difference between methadone and hydrocodone?

    Hydrocodone is more of an "organic" opiate, derived from thebaine or codeine, both occurring naturally in the poppy. Hydrocodone is one of the milder opioids, it is often prescribed to patients with no tolerance and sometimes prescribed to help with a cough. In short, it's not that strong. You are less likely to overdose on it than other, more potent opiates. Unfortunately, hydrocodone is only available in combination with tylenol or ibuprofen or some other type of non-narcotic pain killer. This is to prevent abuse, but if you are in genuine pain, you may find yourself unable to take enough to control your pain without also ingesting a potentially fatal amount of acetaminophen. Usually withdrawals to hydrocodone are relatively mild (when compared to withdrawal from other opioids), meaning that if you take it for a while and then stop, you won't have as hard of a time giving it up.

    Methadone, on the other hand, is a synthetic (made in a lab) opioid. It acts on the opiate receptors, but chemically it is very different from morphine. Methadone is one of the more potent opioids on the market. Although not quite as potent as fentanyl, it is still very easy for somebody to accidentally overdose on methadone. It is not combined with other pain killers so when you take a methadone pill, you are only ingesting methadone (and the binders and fillers in the pill). A reasonably small dose usually provides pain relief for most.

    The withdrawals to methadone are absolutely horrible--they are some of the worst withdrawals of any opiate, far worse than those caused by heroin. The reasons methadone is used to help people quit heroin:

    a) Methadone is cheap. Therefore, clinics can afford to practice in the inner cities and still make a substantial profit. It is also more affordable for heroin addicts (who are often broke) and a cheaper alternative to Suboxone.

    b) High doses of Methadone "block" other opiates. When somebody ingests a reasonably high dose of methadone, the methadone binds very strongly to the opiate receptors, to the point where other opiates are unable to. What this means is, if a heroin addict takes methadone, and then shoots up, he will not be able to feel his heroin and it will be a waste of a bag and his money.

    c) Methadone has a long half-life. So one dose will keep a heroin addict "unsick" for quite some time. Thus, they only have to dose once a day.
    Helpful C_Dub Rated helpful

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    I agree with the post about methadone I kicked an 60 mg. a day methadone habit cold and it almost killed me. The stuff is liquid death the only purpose for methadone clinics is so the cops know where you'll be everyday at a certain time. Hydro is easy to come by CIII which isn't a big deal with the DEA. And if you need to kick Temgesic is easy to buy at RXIOP 99.00 buys you a two week supply you will not get sick if you slowly ween yourself off the Temgesic

  18. I have been on a methadone maintenance program for almost one year. I currently take 140mgs per day. Let me tell you this. Methadone has an extremely long half-life which is why doctors prescribe it for pain. Also, it is extremely cheap.
    I was an addict, addicted to opiates and decided to go to the methadone clinic. It saved my life, my marriage, etc. but that is besides the point. The point I am trying to make is that methadone lasts a very long time and dosing can be fluctuated very easily to get you to the right dose, where hydrocodone cannot....Also, the hydrocodone is prescribed in 5,7.5, and 10 mg doses i believe.....methadone comes in 10mg,20mg and 40mg (wafers) The side effects are the same as any opiate.....

    once again I refer back to the half-life. It lasts a very long time and stays in the body for a very long time. I take it once daily. But my dose is extremely high so that is actually blocks an other opiates from taking effect in my body.

    Methadone withdrawal is horrible but like any other opiate, it is a decision you make, and a scary one when you want to stop. Your doctor will help you and you need support from others also.

    Methadone has been researched extensively for over 30 years and it has had no detrimental effects on your body (liver failure, etc...) most hyrdocodone contains tylenol which is damaging to the liver over time.

    Just some thoughts from a person who has extensive experience with methadone.
    Also, like any other medicines, there is a difference in the brands. I take the Orange ROXANE 40mg wafers. 3.5 of them every morning at 5:30am and I am ready to go 24 hours.

    If you need any more help or suggestions please don't hesitate to ask as I am here to try to help.

    Thank you and I hope this helps a bit.

    -A

    ps: methadone is nothing like fentanyl at all! Fentanyl is given to cancer patients and people who are on their death beds. It is 400X stronger than heroin and has a very short half-life. It is dangerous and prescribed in MICROGRAMS.....I would certainly research this thoroughly before I make a decision and talk with your doctor. There is misinformation galore out there.
    Last edited by alchemy; 07-23-2011 at 04:24 PM.

  19. I've been told that about 30mg of Hydrocodone which would be about 3 pills of 10mg hydrocodones = to 5mg of methadone. I can't confirm though exactly if that is true or not so don't take my word for it, that's just what I've been told. I've seen this med on places like meds express but wouldnt order it just because it is too unsecure to get since the only form of payment that they use is cash on delivery. I'm either too paranoid but I've been ripped off that way before with fastmeds.

  20. #20
    Methadone is very strong. I would say much stronger than that even. The problem is methadone does to produce the strong euphoria and takes very long to hit you versus hydro hitting you all at once at about the hour mark so people confuse strength with rush of euphoria.

    Methadone last 12 to 24 hours whereas hydro is in out quick. 15 mg of methadone to me is equivalent to 150 to 200 mg of hydro a day. People tend to take way too methadone and starting out on 40 mg is insane and a death sentence in my opinion. 15 mgs covered me when I was on a 50 mcg fentanyl patch with oxy for break through. Done takes a while, few days, to really build up in your system and start working. Be patient and 15 mgs is plenty.

    I stopped done because 15 mgs a day was still strong enough to numb me out and make me apathetic to the world. I want to numb the pain, but I still want to participate in life so I stopped the done after 2 or 3 months.


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