Methadone (Methadose) Nursing Drug Card (Simplified) - Pharmacology

NCLEX Review: Methadone (Methadose, Dolophine) - Mechanism of Action, Uses, Side effects, and Nursing considerations
Action: 0:19
Uses: 1:03
Strength/Dosing: 2:01
Side effects: 3:01
Interactions: 3:42
Contraindications: 4:11
Nursing considerations: 4:47
Correction to increasing bulk-forming foods for constipation:
"Increasing dietary fiber, fluid intake, and physical exercise are the backbone to prevention therapy... All types of laxatives can be used as initial therapy except for the bulk-forming laxatives... The only laxatives that should be avoided are the bulk-forming laxatives, like psyllium. These laxatives increase the bulk of the stools, distend the colon, and augment peristalsis. Opioids prevent peristalsis of the increased bulk which worsens abdominal pain and can contribute to bowel obstruction." - Opioid Induced Constipation (2021) - PMID: 29630236
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"When people think of opioid use problems or addictions, they may think of street-obtained, or 'street' opioids, such as heroin or fentanyl. However, problematic opioid use can also include improperly taking prescribed opioid medications such as oxycodone, morphine or codeine, or taking an opioid medication that was not prescribed for you.
Opioids are a class of powerful drugs that are usually prescribed to treat severe pain. If opioids are abused, they can create feelings of intense pleasure or euphoria, but they can also lead to fatal overdose. Opioids are an effective medication when used as prescribed, but they carry a risk of addiction because of their powerful effects.
If someone is overdosing, call 911 right away! You can then use your naloxone kit while you wait for medical help." - camh.ca - Opioid Addiction (Retrieved Oct 21/2021)
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Instagram: / nurseryanyt
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Reference Images:
Methadone for dependency information: World Health Organization (2009) - Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
Brainstem image: Wikipedia - Brainstem
PQRST image: medschool.co - ECG trace
Narcan image: Narcan.com
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Music: Summer from www.bensound.com
Icons by Freepik: flaticon.com/authors/freepik
Intro: adMJ707
Outro: adMJ707

[@antonisinistaj649]

Thank you for this video Nurse Ryan, you constantly provide much needed information to help combat the rampant use of drugs in our communities

[@JuanLopez-ou6qm]

Thank you for this video Nurse Ryan am currently on 180 for mat program and it save my life from drug use

[@NurseRyan]

Wishing you the best in your recovery, thank you!

[@JuanLopez-ou6qm]

Thank you can you also suggest me something for constipation due to this med thanks love your videos

[@NurseRyan]

@@JuanLopez-ou6qm I always recommend speaking to your primary healthcare provider or pharmacist for any actual medical advice, as these videos are meant strictly for education. However, there are many different laxative options for opioids. Often prescribed at my facility to prevent opioid induced constipation are Lactulose and Sennoside (Senokot). Hope that helps!

[@ajppereira9767]

@@JuanLopez-ou6qm I been on methadone for about 5 years on 80mg daily I've had problems with using the bathroom I recommend starting a probiotic they have pill form you can take daily or you can buy yukult and drink one daily I was told from my primary care doctor to take probiotics for constipation due to opioid use and dependency ....... Or if that doesn't help take ducolax those are my recommendation

[@nikolaiastrov1099]

Hydrate! Drink lots of water! Trust me 🙏

[@bjoe74fm]

Hi, interesting overview of a opide, I was a addict of 20 plus years, morphine, opiate dependency of up to 700 mg daily, iv, I ended up 1000mg daily, Kapanol,, 2000mg would last 2 days, I stopped the opiate dependency without supplement replacement, 2 weeks of sickness and I was fine, I was also addicted to benzodiazepenes, that was a different story hehehe, 2 years of detox with all the nightmarish symptoms, now that was a issue, methadone helped me with that, actually initially I was given hemiurine, a sign of the times I guess,,,, I now have degrees in biomedicine and also organic chemistry,,,, i guess Im saying there is life after addiction,,, ergo I am living a sober life now of 10 years,,,,,,,,,

[@deadbeats4894]

Fentanyl is totally changing the methodone game.

[@Havingacrack]

On150mg methadone ten years saved n changed my life in every aspect

[@user-ee1wx4ub3m]

Will ruin yr life too. Was on33yr. Now14 mth clean. Reduce monthly by 2/5 mgs. Life changing 🙏 WDR. ODAT. Ruined my life !!

[@Havingacrack]

​@@user-ee1wx4ub3m All depends on the user for me ive relapsed many times until i tried methadone i stay on it because im an addict n being on my dose herion or oxy just doesn't work tolerance to high in no way has it been a negative choice once you accept it is what it is no relapse no problems living life to its fullest

[@Lolalaughsx]

Nurse Ryan, this is a much different (or at least different) medication than buprenorphine & naloxone? I take the sublingual strips and would really love to have an in depth video about it; your videos are just so easy to digest for me ❤

[@jhhyuu_DaveIsNoProfessor]

Fun FACT: Methadone uses Nitrogen (solid form I guess)to agonize mu receptors. It goes thru demethylation. It breaks down to the Simplist form , Nitrogen itself (pure). Everything else is/becomes inactive. This happens on the receptor & the Nitrogen-dominant amine is held in place by Methadone.

[@NurseRyan]

Just read some of "Advances in Understanding the Actions of Nitrous Oxide" (2007) because of your comment. Good to know!

[@weidles]

I am on Suboxone 1 x 4 daily, I only take 2 a day but love to drink vodka, I think Methadone would be better for me but refuse to get up early and get in line every day, I only get to sleep around 3 am. Help

[@user-sk5uy2ep7f]

I was on 90mg liquid methadone. I cold turkey off it. 2 months of physical withdrawal and 3 years mental roller coasters.

[@NurseRyan]

I'm sorry to hear that. I hope you're doing better now. Thanks for sharing

[@whitemamba0089]

U a strong mf I can tolerate the physical withdrawal it's the mental aspect I can't handle my mind just goes haywire with anxiety racing thoughts and cravings till I just cave in and see the dope man or the clinic

[@magchisholm3931]

Thanks was vhelpful. Could u look at GI meds for nurses

[@NurseRyan]

Definitely! They are on my list for future videos 😀 Thanks for sharing

[@lowlifeminitrucker6910]

I'm taking 120mgs. That's the highest my clinic goes. Not fair, I see alot of people on way more than 120mgs. Good video. 👍

[@richardpedley6291]

Hi m8 i was on metherdone for over 33 years at my highest i was on 140ml a day chaseing high scrips is not werth it m8 i now what your trying to do but your wasteing your life on the shit m8 its just not werth it see i was like you i was going to stay on metherdon for life but thir will come a day wen you will have to come off your script trust me it will hapen im not trying to preech to you bruv but if you dont get your shit togever your going to be as fucked in life as i am its not a game i trewly hope you here what im saying to you trust me i wish someone had siad all this to me wen i was 15 wen i got on heroin its a mugs game m8 i trewly wish you good luck becouse going that high on metherdone your goung to need it bruv all the best m8

[@NurseRyan]

Happy to help!

[@BushyHairedStranger]

Peak & Trough test is the Gatekeeper to increasing Milligrams of Long acting Opioid Medications. Levo-Alpha Acetyl Methadol or LAAM was used, briefly, in the 80’s & 90’s, unfortunately due to it’s long duration of effect and potential danger for overdose it’s largely been phased out of use.

[@richardpedley6291]

@@BushyHairedStranger i got my first script in 1990 iv necer herd of that b4 intresting tho

[@andygill9783]

Me to 120 mg

[@amethyst4990]

I have a spine compression fracture could this help my chronic back pain?

[@heathmcrigsby]

Yea. Good luck getting a script for it tho

[@NurseRyan]

It's definitely possible that it would help. You would need a prescription from your doctor for this type of medication!

[@heathmcrigsby]

@@NurseRyan Yea trying to find a doc who isn't worried about the government to actually prescribe that medicine will be nigh impossible.

[@kathleengivant-taylor2277]

Iam chronic pain patient and currently on hydrocodone or norco. If one wanted to withdrawal from norco, would this be a good choice too control chronic pain and get thur withdrawal?

[@NurseRyan]

I always recommend speaking to your doctor about any actual medical advice, as these videos are meant for educational purposes only. That being said, Methadone can be used to as maintenance treatment for opioid dependency.

[@kathleengivant-taylor2277]

@@NurseRyanthank you for info. Will check with dr

[@kathleengivant-taylor2277]

I did experience urinary retention sudden after years of using oxycodone in pain management. Ended up in ER and when I told them I was in pain management and I was on Percocet they immediately thought it could be the opioid and suggested I stop taking it. I followed advice and stopped taking the opioid and after a day I noticed a pretty quick improvement in the urinary retention. I consulted and went to my primary dr and withdrew off the Percocet and stayed off every thing for 30 days and problem corrected it self. Pain center changed my pain md too norco instead and have not had a problem thankfully

[@user-wn5vn9ct8o]

I have experience with this. I’m in an MAT program, and my mom has been on a large amount of pain medications for multiple issues. She had to go to a pain management clinic and was basically treated like she was seeking drugs for non pain related reasons and decided she didn’t want to be dependent on the medication and wanted to get off the medications and start from square one. She got into the MAT program and it was fine for a while until her pain started to get significantly worse. Her conditions with her back got worse, basically debilitating her. She also had to have shoulder surgery after a fall. So fast forward to now, she needs more pain management and is unable to get appropriate medication because she’s still on methadone. She says now looking back it she had any idea things were gonna go sideways, she wouldn’t have decided to do MAT. There are lots of restrictions regarding the types of medication you can take with methadone and it’s made pain management almost impossible right now. I’m by no means a medical professional, this is just what I’ve seen first hand. I think people with chronic pain that know their issues are still going to be there in the future should seek different options than MAT.

[@BDXextraction]

Nice video! I wanted to do a video on the synthesis of Methadone however, I dont have the legal authority to create any.😢

[@NurseRyan]

Glad you enjoyed the video! 🙂

[@Spooky-ghosty69]

Currently at 73 mgs...ive been on it for 3 months now an still get withrawls evrry week after ive dosed up every week...why is it doing this? It wont build up in my system no matter what i do or dont do. Im clean, no caffeine , i also work graveyard and have to goto sleep after ive dosed in the morning. Also im super skinny an work construction so i sweat alot

[@NurseRyan]

I'm sorry that you are going through that. Sadly, I don't have enough experience with Methadone to be able to help. I tried searching online but I think the best thing to do would be to ask your doctor or pharmacist for the best information.

[@quietbox2627]

How long should I wait to use this after using opiates

[@dabooser1048]

Call a methadone clinic and ask. I'm sure they would give you a safe answer.

[@jesusmalave3340]

You don't have to wait , methadone it's for opioids whitdraws now if You want subuxone You have to be clean a least 72 hours and to get vivitrol 10 days a least.. don't take subuxone or methadone they are the worst drugs to detox,i am in methadone for 19 and 2 in subuxone and it's almost impossible to detox get vivitrol cus You don't get whitdraws or cravings ok.

[@NurseRyan]

Like mentioned, I would recommend calling a Methadone clinic as they will likely have the most appropriate answers for you! You should talk to a healthcare provider for any actual medical advice, as these videos are meant for educational purposes only.

[@lakhbinderjitsingh7795]

Misery of my awakening I use methadone to calm down my life ok

[@NurseRyan]

Hope you're doing well. Thanks for sharing.

[@antishloll5234]

Am taking methadone for more than ten year now ,I want to know how much time I will have to take it's, is it's for life's time

[@drgreenthumb2190]

You can come of when eva your ready I was on 140mg now on 6mg

[@ambergranger7486]

Yes if I were you I would start tapering asap and in my case I literally thought I would have to go to my grace to get away from it. That was super depressing for me after using it for 22 years. I was only on 20 mg a day but even stoping that was not something I could do on my own. I had to get into a rehab to do it safely and it wasn’t so bad.

[@thetruth5791]

Can a use fentanyl and methadone for mye crushed knee and albue.....for pain

[@jmr6117]

What ? Wtf you want ? Yes you can ,but that don't make sence, you will fuck your life...you have to handle the pain whit another shit not whit Methadone and fentanyl they are the worst drugs ,specialy to quit ok

[@NurseRyan]

Hi, I always recommend speaking to your primary healthcare provider or pharmacist for any actual medical advice, as these videos are meant for educational purposes only. Fentanyl and Methadone are both opioids and are both used for moderate to severe pain, and are generally not administered alongside each other. Hope that helps

[@NurseRyan]

@@thetruth5791 Ah ok, I see. I hope they work out and help you with your pain!

[@daviddowns7552]

you can

[@stephlon801]

Can I message you privately? I checked for an IG or FB, I don't see anything

[@NurseRyan]

Hi, you can message me here: instagram.com/nurseryanyt/

[@stephlon801]

@@NurseRyan 🙏I will message you around 3pm today ...I am on PA time is that ok?

[@paulinendaru203]

Can you do a video on Suboxone

[@NurseRyan]

I'll add that to my list! Thank you

[@dalanwanbdiska6542]

My gums in my teeth are getting a different color and seem to be receding back and making my front teeth to move. Ive been on metha done for 2 years now and want to come down . I went up to 75 and now im at 58. I come down 1 ml every 4 weeks becaise it gets me to the point of dope siconess feeling and makes me cry and almost have anxiety . I want to come down fsster but afraid of hurting myself. My next dr appointment is in 2 weeks and thinking of going down 2 mls every 4 weeks instead of 1 ml. I need to get off this as it is starting to hurt my teeth health. I told the dr and he said not to worry about it. Hes full of shit I think.

[@jesusmalave3340]

Listen methadone don't do nothing to your teeth,what happen it's what You was doing before use methadone You was looking yo get high all the time and You wasn't sorry about watch your teeth or SEE the dentista,You SEE what i mind ,now You blame on methadone noo it's not the methadone it's the habits You have before get the methadone poor hygiene..btw i am in methadone for 19 years and i can tell methadone don't do nothing to your teeth ,it's what we was doing before methadone, something else You can droga 2 to 4 mg a month and if You feel it stop ,i drop 1 mg a week,i am in 8 mg right now after 19 years..My teeth are fine.

[@brettshamblin3180]

Get something g to keep up mouth wet chew sugar free gum floss twice a fudging day

[@brettshamblin3180]

@@jesusmalave3340 it does fug up ur teeth man... it dries ur mouth like no other and when u sleep it's dry all night it most definitely can cause toof decay but most likely the drugs also didn't help

[@animeaunty]

Dry mouth rots ur teeth faster than anything 😮‍💨 I've been on methadone for over 30 yrs & have helped MANY people detox 👍☺️ My first tip to going faster is don't let urself know the numbers. I don't know how u r being dosed but "blind dosing" is far more effective. This means u r given ur doses but u don't know how much it is. The numbers r a TRUE mind frick! 😳🤯 I have detoxed most people n 21 to 30 days. Many started at more than 60mgs too. Ask around & c if there's anyone skilled with blind dosing. When I did it with people, they were usually SHOCKED 😲 when I would tell them they hadn't actually had any n several days. They didn't notice when they had their last dose. If u would like, Im happy to chat more if u have questions. There's other ways to take the edge of kickin too 👍

[@jovantrendmaker4722]

Methadone coses dry mouth. Dry mouth kills teeth. You need to drink more. Strange how people on methadone dont know that. Its even mentioned in this video.

[@jamilsaif4502]

I am drug addict but I leave before one month This tablet are legal.? I am going to Dubai for job I am seamen I have docter prescription so please tell me about methadone tablet

[@jmr6117]

Don't even think about this shit, this its the wrost drug ever ,the whitdraws last for months...dont do it..the best choice its vivitrol if you get clean for a least 10 days to get the shot ,goo luck ok.

[@Havingacrack]

Viseptone

[@briancampbell8717]

Old dude at my clinic in nyc is on 320 mg

[@NurseRyan]

That's a large dose! Hope he is recovering well. Thanks for sharing.

[@whitemamba0089]

Jesus lol I wonder how heroin or fentanyl he was doin a day u should ask him

[@markmansfieldsbwc4674]

Omg! How old is he??

[@andygill9783]

I'm on 120 mg methodone but it dont help

[@GR8APE69]

Then you need to increase your dose. What exactly do you mean by it not helping? That you're still getting cravings? Either way, if it isn't working for you yet, then keep increasing your dose until it does. I've been hard-core addicted to the fent blues for a couple of years now and was doing over 30 of them a day toward the peak of my use, and it didn't click for me at 120 mg either, but now that I'm up to 150 mg, I'm no longer getting cravings and I feel really good! I'll probably stay ahead I'm at for about 3 months and then start to bring it down to 80mg if I can and stay at that as my maintenance dose. I plan to do maintenance for at least a year so that I can work on building my life back up after all of the damage I've done to it. Moat importantly, TALK TO YOUR DOCTOR! And be fully honest with them and all of the clinical staff! They're there to help us, and if you aren't getting the help you need at 120 mg then you should talk to them, see what they suggest, and then do exactly that!

[@jakethesnake4971]

Damn bro, I would make that last like 2 weeks

[@NurseRyan]

Like already mentioned, definitely speak to your doctor about it! Sorry for the late reply, but I hope you were able to get some help.

[@daviddowns7552]

the 10 mg tabs x2 per day gave me a little nausea. its ok but i like morphine alot better.

[@jakethesnake4971]

I wish I had access to the tabs, it's only nasty red liquid that I rarely come across

[@OVOBoopah]

I’m on 80mg and I take 2 Xanax a day

[@jmr6117]

That don't make sence you use methadone and xanax if you take xanax why you take methadone ,use one or other..you just want to get high and that don't gone take you no where..i am in methadone for 18 years clean not even a cigarrette..when you finaly want to tape out you will regret been in high dose and taking xanax...i just take 25 mg and i try to tape out so many times and i can't i hope this time....

[@jesusmalave3340]

80 mg of methadone and taking 2 Xanax a day ,i don't get it ,what clinic it's that ,who let You take Xanax and methadone at the same time .don't make sense, if You use methadone why or for what take xanax both are opioids and Drs don't give You both opioids,i think You bye xaxax ilegal it's the only way ..

[@greggbrown8137]

Are you tired

[@jakethesnake4971]

​@Gregg Brown he never responded 😬

[@cashwilson2571]

Lucky I only take 142mg methadone a day Xanax would b nice

[@aceto1900]

Take-home Methadone is mostly injected here combined with a benzodiazeppine like liquid Diazepam (Valium), on the other hand Heroin is mostly smoked on foil, rarely injected and extremely rarely snorted. Just sayin'. That WHO statement is not very sense-making.

[@jakethesnake4971]

What country for you?

[@NurseRyan]

Never heard of that! Thanks for sharing

[@Havingacrack]

WRONG herion is mainly shot up

[@alonelypotato2788]

yeah he we smoke heroin on foil too

[@daviddowns7552]

dolobid

[@NurseRyan]

Added to my list, thanks.

[@daviddowns7552]

@@NurseRyan you are welcome.

[@alexsveles343]

No .Methadobe ia not that potent.Not even close .it ia roughly equal to morphine 1mg vs 1mg....However by iv morphine is qcctualt 2x stronger than methadibe

[@DropdownDropdown]

and morphine is eqipotent to hydrocodone orally so , you're wrong.

[@NurseRyan]

Every article I can find that speaks to opioid conversions states that Methadone is not equipotent to Morphine, and that it has a variable potency depending on the dosage.

[@DropdownDropdown]

oh really? i was unaware cos i can take 2000mg of morphine in one go, if i took 2000mg of methadone id be dead as fuck

[@DropdownDropdown]

@@NurseRyan i said ORAL HYDROCODONE IS EQUIVALENT TO ORAL MORPHINE ..FACTS

[@kimmyhawk5612]

I'm just curious: Has anyone here had severe osteoporosis from taking methadone? I mean, does methadone cause bone loss, long term?

[@ambergranger7486]

Idk if a coincidence but yes I know 2 people that was on methadone for many years and both have severe bone loss.

[@SA77888]

Ive been on it since my early 20s, Im 46 now and I have had ZERO issues with methadone.....other than the fact of course its addictive/withdrawals. I have also never heard of anyone ever having issues.

[@ambergranger7486]

@@SA77888 I’ve heard it gets into your bones, which is why you withdraw for up to a year even after you stop taking it not to mention it Easter tea from the inside out so I can imagine that it doesn’t do damage to your bones. Just from my own personal experience, and I took it for 23 yrs. But have been off for almost 6 months now.

[@ambergranger7486]

Eats ur teeth sorry auto corrected

[@ChrisfromGeorgia]

​@@ambergranger7486 I don't know if it eats your teeth, but almost everyone I know who is on it smoke cigarettes and eat too many sugar filled sweet's.