RSD Puzzle #092

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

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INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

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RSD Puzzle #92
Is Methadone Treatment Safe?

Historically, in the beginning of the century, the chronic pain was treated by Freudian type of psychiatrists. The psychiatrist would convince the patient that, according to the teachings of Freud, the patient had a sick personality, the pain was imaginary and it was all in his head. Even as lately as the 1960's and 70's there were all types of Freudian archaic theories such as "pain personality", "multiple sclerosis personality", or "Munchausen Syndrome". The psychiatrist believed that the patient was a big liar just as Baron Munchausen of the 16th century. It sounded more scientific when the psychiatrist was projecting and accusing the patient of lying.

In the 1950's the new method of replacement of Methadone for heroine addicts was developed.

It was quite impressive because Methadone had a long half life, and even though the brain becomes dependent on it, the patient does not realize the dependence because the withdrawal effect is very mild. In addition, it was quite effective because frequently the heroine addict would take the Methadone, plus heroine, and would die of respiratory arrest. The cause of death was then declared as heroine overdose. This was a convenient way of quietly getting rid of the heroine addicts. Then, there was the resurgence of Methadone treatment in the late 1980's and early 1990's because of the doctors' lack of understanding of the dangers of this insidious, strong respiratory depressant opioid agonist. The patients taking Methadone have problems with shortness of breath, suddenly falling asleep, having apneic attacks, and death. These attacks are diagnosed as "narcolepsy", and the physician does not recognize the link between the respiratory depression and the Methadone.

Unfortunately, the general trend nowadays is to load the patient with every kind of strong pain medication, as if the patient has cancer. Morphine agonist narcotics have very little effect on neuropathic pain such as RSD, but they dope the patient so that the patient does not complain anymore. This is the reason for HMO's providing all of the cheap narcotics that the patient needs, but fighting any curative treatment which may cost more money. The agonist opioids are cheap and shut the patient up. The patient does not have any energy to get up and go to the ER, so it saves money for HMO's. More and more doctors are selling their souls to HMO's. If such an HMO doctor prescribes an effective and expensive drug, his salary drops through the process of "capitation contract" they have with HMO's. So, he has to resort to Methadone, which is cheap, but lethal. As a patient, you are better off with no insurance than an HMO.

H.Hooshmand, M.D.

The material on the Neurological Associates Pain Management Center Homepage and all it's associated, linked or reference pages is for informational and education purposes. It is not meant to take the place of your physician. Before starting, changing, or stopping any treatments or medicines consult your physician. H. Hooshmand, M.D., Neurological Associates Pain Management Center and Associates will not be held liable for any damage or loss as a result of information provided on this page or associated documentation. Again, this WEB SITE is simply published as an information source and should not be used to treat or make judgments on RSD/CRPS. All associated material on this web site may not be copied, reproduced or quoted without expressed written permission from the owner; Copyright © 1999-2012 H. Hooshmand, M.D.