In my humble opinion, methadone is the most effective, and longest acting narcotic anelgisc available. It's finally gaining acceptance again in mainstream medicine for the treatment of pain, consequently what it was originally created for. The Germans knew they were eventually going to war in the late 1930s are were ordered to create a synthetic opiate in the event thier access to the South East or the Middle East was cut.
I've used just about every pain med for severe back problems. I tried methadone for about 2 weeks, and stopped other meds, and the results were quite shocking. It's a sticky subject with certain physicians because of the stigma associated with methadone. However, if your Dr. is willing to write you a 30 day, I suspect you'll also be happy with the results. No nausea, no itching, no upset stomach, no dizziness, and constipation is not as severe. I highly reccommend chronic pain paitents, especially as it relates to back (and other ortho conditions) give it a try. It's much more effective than Oxycontin, Hydro, Fentanyl, etc. Typically it's administered 3 or 4 times a day, and after a few days, it reaches is max potential as it builds into the body. From then on, as long as you are taking the medication regularly, you'll find it significantly reduces the pain. Only downside i've read about, is that supposedely the cessation effects are somewhat rough. I did not experience that when I stopped using the pain med after 2 weeks. I would definitely reccommend the medication for pain. It's really a great pain med.
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