Starting Methadone Maintenance? You need a conversion chart!
Know Your Opioid Time Tables, It Can Save Your Life!
Just started methadone maintenance? Been on methadone maintenance for a while? Tired? Lethargic? Nodding off? You may be overmedicated. Overmedication with methadone typically occurs on first starting MMT and happens more often when switching from an addiction to a less potent opioid to methadone. How do you know if you're being prescribed too much? How do you know how much you may need to stop feeling withdrawal sickness?
Believe it or not, there are opioid conversion scales in the literature and freely available on the internet. These scales allow you to enter data say 250 mgs of hydrocodone (Lortab, Vicodin, Hycodan) and see how many mgs of methadone this converts to. This will give you an idea of how much methadone is too much and how much is too little.
For example, drugs such as hydrocodone, codeine, and demerol may be significantly less potent than methadone, while oxymorphone and fentanyl may be significantly more potent. You will tend to confuse hydrocodone, hydromorphone, oxycodone, and oxymorphone even though their potencies are on opposite sides of the spectrum, so rely on the on the advice of your doctor to help you understand.
In practice, the gravest dangers with methadone maintenance therapy appeared with overmedication and benzodiazepine abuse. Benzo combined with methadone is deadly, as is taking too much methadone. While undermedication is shown to be dangerous due to increased likelihood of polysubstance abuse to help with withdrawal symptoms, undermedication alone cannot lead to death unlike overmedication and concurrent benzo abuse.
If you know your opioid timetables, you will be able to help your doctor figure out the right dose for you!