Prednisone Affecting My 1-dose Methadone Maintenance

Theresa Says:

Hello. I'm an addict in recovery, using the methadone maintenance as the way to wean off opiates. I currently take 1 95mg dose (methadone) in the morning, and I'm weaning down 2mg/month. I also have spinal stenosis, degenerative disc disease and major lumbar pain. I take only Aleve for pain, as I'm told the methadone will not help me because I only take 1 single dose/day and not for pain management. I have had 2 surgeries on my back. A simple laminectomy, but my 2nd surgery was spinal fusion surgery. I have a metal cage in my lower back, but now; I need a 3rd surgery to repair the discs higher on my spine, as all the pain has returned and my very well-respected doctor highly suggests this. He ordered a series of steroidal epidural shots in my back. I did the 1st round of shots and had hot flashes, headache, slight fever and insomnia by RLS. I know 2 take 10mg prednisone tablets 4/3 days to 3/3 days to 2/3 days and finish with 1 tablet for 3 days. I digress. I apologize. I just need some help with information or experience. Will all this prednisone weaken my 1-morning dose of 95mg's of methadone?

17 Replies

Earliest Newest Votes
Indigo47 Says:

I'm not sure about methadone specifically. But I know that it doesn't affect other similar medications in a negative manner. I would take them at least one hour apart from each other for best results of both though. Congratulations on your recovery process! How long have you been on the methadone for recovery? (If I may...)

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Beth Says:

Hey there, sorry you are dealing with all of this. I don't know about the steroid, but whatvI do know about is being an addict in recovery on methadone maintenance and then developing problems that come with SEVERE pain which methadone once a day doesn't touch. Is there a Pain Clinic near u that would discuss splitting your dose to 3x daily? I am currently in the hospital for a new Cancer diagnoses (took me over a month of complaining to my doctor cause she brushed me off as a junkie) and the hospital split my dose to 3x dailyv and upped it a bit. I also am on some steroid n a bunch of other stuff. But you have a legitimate condition that is PAINFUL. You should be able to take your meds in a way that helps your pain. Noone should have to live in such pain. I feel for you and I am praying for you:)

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Curious80 Says:

Prednisone effects the metabolism of methadone so they should not be taken together. Everytime you mix the two together yes you are going to feel terrible. The steroid speeds up the metabolism of methadone so that it leaves the body faster.

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Burbot Says:

I don't trust prednisone at all for anything to do with myself. I was in the hospital and taking it for COPD. Prednisone threw my blood sugar so far our of whack that it didn't return to normal to normal for a full month after I stopped taking it. It also made me very ill. I have cervical spinal stenosis and pinched nerves in my neck. I have undergone many treatments for this condition and some with steroids, but I won't allow Prednisone to be used. If I were you I would request a different steroid.

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KenieK Says:


I was on MMT for many years prior to transitioning to drug free, but an orthopedic procedure required the administration of prednisone. I suffered no ill effects or anomalies. The clinic that I work for now has reported a few incidents of clients claiming false readings on their drug panels and rapid metabolism issues resulting in relapse. Although I process these complaints judiciously, our medical director consistently claims no untoward effects with this combination. Just thought I would add this to the discussion. Enjoy your evening...

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Theresa and Keats Says:

Hello. Thank you for your response. It's the most way, nowadays, that people become addicted, then becoming an addict. I never used opiates, coke, LSD or methamphetamine, all the way to 33 yrs. old. A drink at holidays or parties was the extent of my substance use. But, around 33, I had back surgery and the Dr. gave me a script for the narcotic pain-reliever, Percocet. I was totally naive about physical addiction. I trusted my DR. I know ignorance is no's what follows that it became harmful. I was in great pain and told, over-n-over, to keep taking my Percocet. Well, when I tried to stop, you probably know, I went into severe withdrawal. I went 2 said Dr. and asked for help to get off Percocet. His response was 2 pull-out his prescription pad and ask me what narcotic I needed, instead of informing me about addiction or how I could get help?? I was confused, in-pain, angry and felt stupid and betrayed. We had it out, by loud argument, and we severed ties. But, I was in a manic, depressive and desperate place. I was raising 3 kids. I didn't know where to go? Hospitals couldn't help me, family and friends, alienated me and all beds (room) within all the surrounding rehab were full. I left rehab in 3 days n went on a drug binge (I'm not bragging at all). I hit my rock-bottom, went to a methadone clinic. Methadone isn't a cure. It's a stepping stone toward sobriety. People say I'm trading one drug for a other. Well, if u are not sure about using methadone in a clinic, let me say: It's legal. I don't have to worry about jail, Institutions or death or getting robbed, beat-up or overdose. The Methadone clinic is a means to an end. That end being sobriety. Also, methadone has been studied for centuries. It's an antagonist, which means, if I try to use other opiates, I wouldn't feel any better or high. I apologize for such a long reply. I have been at the clinic 4 yrs., but, once again; I was ignorant about methadone n trusted my counselors. Well, they took me up to 160 mg's per day. Hindsight is 20/20 right? Nobody should ever go above 100-120mg's/day. EVER. I'm currently weaning off methadone and I'm now at 45mg's....down from 160mg's/day. It's a slow process, but a hopeful process toward sobriety. I have heard 3 yrs. is the average time, but everyone is different. I want off methadone, but I want to do it the right way. It enabled me to make amends with my family and friends, cleared-up my head, handling money the right way and have a set of goals and dreams that now look possible. Lastly, the clinic holds me responsible for my recovery, by random drug panels, In-house group therapy sessions (from such titles as 'relapse prevention', 'dealing with stress' or 'addiction videos' and many others). I also have to see my assigned addiction counselor to make a treatment plan or goals......It's a stepping stone towards my real, heartfelt dreams for my future and I don't have to worry about police or shady dealers or crack-heads trying to hurt me. I have hope again and best of all...... My Faith IS Restored. I should be done-n-out of there by next Christmas. Thank you again for the response n feel free 2 post anything, regarding my stuff or if you have questions for me?

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blackydee Says:

I have been on methadone for 19 years. It has been my experience that when a medication "eats up" your methadone your best bet is not to decrease but increase the dosage until the meds are stopped. Very few programs do what is called a split dose where they medicate you at the clinic with 1/2 your dose and give you the other half daily in a take home. In NY where I am only a handful (if that) do split doses. I have a herniated disc, neuropathy, I need a hip replacement, DVT, and chronic osteoarthritis. You know what I take for pain? Just my methadone and Relafen 500mg. 3x a day. Pain is my constant companion but I don't want to get hooked on pain meds, I weaned myself off of 80mg. Oxycontin 2x a day once before never again....

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Dixie Says:

You are a very courageous soul. I was also ignorant about how quickly a person could become addicted. Several events (tragic but unstoppable) happened to members of my family as well as my family Dr. All of the sudden I realized the reason I wasn't able to cry or grieve, I was medicated with opiates. I stopped cold turkey. I wanted to feel the pain and be able to cry. Opiates change you (hence the 'Morph' in morphine). I even noticed after my head and body were cleansed that the sound and tone of my voice changed for the better. Keep going the journey is worth it. I am so proud of you!!! Many Blessings to you!

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Chris Says:

Hi Theresa,

My story is like yours but ends at your/my laminectomy. I was on 165mg of methadone for a year at the Methadone Clinic once a day. My Doctor decided to give me a chance and I also took a chance by dropping to 100mg of methadone a day by splitting the dose. The first 2-weeks was a struggle with LRS but went away after 2-weeks. It was doing good for 3-years for pain management until it just didn't work. I had a Laminectomy and 12 months later I'm now on 60mg of Methadone but I'm at a standstill. Like you, I was also taking Aleve with Methadone for years but now I only use it a few times a week when I really hurt. The weather changes from cold to warm to rainy to snow and back to warm constantly in New England this year and I feel it in my lower back & I also have mild leg cramps. I've not gone through what you have but your story really helps me because it's so close to mine. I was told methadone is not for pain but it sure works for me and I'm told more local Doctors clinics are doing this. I don't go to a Methadone clinic but a walk in clinic that has a lot of Doctors. I see a nurse each month for my meds and pee in a cup...hell, I'd pee in 2 cups if they tell me too. I see a doctor every 3 months or sooner if I need to. I take it 3 times a day. I may not have answered your question but you're not alone, and now I realize I'm not either. Thanks for your question.

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Dani Says:

hi theresa, not sure if you were able to ask your doc yet about the possibility of your prednisone dose minimizing the efficacy of your daily methadone dose. i've been on suboxone for several years & due to some very infrequent dermatitis flare-ups on my hands, my subox doc has prescribed me oral prednisone 2 different times. it's been a few years now but i do recall taking it in that special way you described, where you start off with more & end up with less & i think i took it in an increment of 1 week. i had no side effects at all & my suboxone was as effective as it has always been. i do recall my doctor stressing with me something i was somewhat already familiar with due to having a good friend who took prednisone for quite a while, and that was to take it for as short a time as of those quirky meds that is so helpful for so many uncomfortable conditions yet if taken too long of a period produces some unpleasant side effects, weight gain & "moon" face....good luck to you!

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Shar57 Says:

Methadone for me was the best pain medication ever. For both peripheral neuropathy (nerve pain) and for hip I shattered and bad surgery left me in pain. So ur prob at a methadone clinic ? If so and get to bring it home, try breaking up the dose in 2 doses instead of just one. So long as ur not chasing the nod and are truly after pain relief this will work for pain. U might feel a little edgy for a week. But remember ur after pain relief. Then get it so u can break that 95 mgs into 3 doses. Prednisone is kind of a stimulant. So u may notice it SEEMS to block ur high. Or maybe feel like it's not working as well. It's working the same. Just the pred is giving U a bit of speediness. U won't be on the pred for long. I wouldn't think. also if u are at a methadone clinic, DON'T TELL THEM U R USING the METHADONE FOR PAIN. OR U WANT TO TRY USING IT FOR PAIN. They could kick u out. I was taking 250 mg for pain. Yes 250 mg. But I was seeing a pain dr. It worked SUPER GREAT FOR PAIN. Kept me away from other drugs too. one day I decided I just didn't want to take that much anymore. So I dropped down to 90 mg a day. Just boom did it. BUT the diff is I was taking the 250 a day in 3 doses. That's the trick is the dividing ur dose into 3 a day. So for u about 30 mg 3 x a day. I wasn't after the buzz. I didn't want to chase other drugs anymore. This got me off everything else. Worked on the hip and nerve pain and gave me back my life. I was taking the pill form tho. But U can do this with the liquids if u have take homes. Or maybe u can switch to pill at the clinic. I see some others agree about splitting the dose.

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Julie Says:

That is wonderful news! Thank you so much for sharing!

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Kate Says:

Yes, honey, unfortunately the prednisone will cause a withdrawal effect with the methadone. I am currently going thru the same stuff. I am scheduled to get a steroid epidural today, but I have been scared to death to get this done, and it has been scheduled several times with me cancelling every time because I'm afraid of experiencing withdrawal of the methadone. I didnt know if the steroid being injected would cause the withdrawal, but its safe to say that bc u experienced it, i will too, so I'm going to cancel yet again. However, I'm going to have to talk to the Dr to try to figure this out. I know when I took prednisone by mouth I experienced withdrawal effects, which is why I'm hesitant.

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Ray Says:

Re: KenieK (# 5) Expand Referenced Message

On mm and just got prescription for 10 days @40mg of Prednisone I concerned about the interaction. Is it anything to worry about I see alot of people saying it put them into wd but I've been around long enough to not believe everyone in a mm clinic setting any help would be appreciated I don't wanna risk my it if I don't have to.

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Paula Says:

I can't respond on that because I came off those after being on it for 20 yrs. I do have back problems.

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Laura Says:

Yes!!! Absolutely, my old man was on 50 ml of methadone and went up to 80 ml. And still felt like he was going through withdrawal. Stop the damn prednisone ASAP. My man died on thanksgiving day. You are not to get vaccines for ANYTHING. His dr gave him a flu shot, i believe they killed him in 9 days. Most drs., especially old ones don’t know what methadone is!!! Be careful and get off the prednisone. It takes away the methadone‘s effectiveness.

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Cgirlclean Says:

Re: Theresa and Keats (# 6) Expand Referenced Message

I know this is an old post and you probably won't see it but I've been on methadone maintenance myself. I've been on it for 7 years. When I was 15, in the heyday of House MD who made Vicodin look sooo cool, I had a tumor removed from my breast. The doctor gave me 40 Vicodin and I only needed probably 8-10 for post-op so I did what any normal teenager would do who thought they were cool and didn't understand they were just like heroin. When I got my wisdom teeth out 2 years later my oral surgeon gave me either 60 or 40 Vicodin with a refill of another 40. I was on 100mg for a while but at my clinic in order to get over 125mg they do a troph (sp?) Level on you, if you are metabolizing it too quickly and only then do they allow you to go above that (unless you're pregnant because withdrawal can cause the baby to tense and pull from the placenta). I've definitely noticed the steroids I'm on and off of (currently on ugh) do definitely make me sicker. I'm tapering down again (the first time I got to 25mg but I got pregnant and had to go back up bc the docs said that will def raise your metabolism AND blood volume hence more blood same amount of methadone). I only went back up to 50mg during the entire pregnancy which is much less than most girls on my clinic go up. I'm finally back down to 26mg, going 1mg a week. The first time I went down I didn't feel any withdrawal and I was doing 5mg every 2 weeks, this time when I went from 50 to 45 I felt withdrawal within a few days and they told me that wasnt possible (even though 40 is the minimum "holding" dose and its different for everyone) and to give it time. 2 months later with no further decreases I was still withdrawing so I decided to go down 1mg per week so I could get the withdrawal over with. I'm ok for the first 3 hours in the morning and then it's back to sick. I've been taking gabapentin for my nerve damage. I'm supposed to take 1 pill every 3 hours but I found if I take 2 in the morning I don't have withdrawal symptoms at all for almost 12 hours and the 1 at 5pm keeps it just bearable enough to get to sleep but between 1 and 3 I start getting the hot cold hot cold feeling and heebie jeebies and can't sleep. The prednisone makes it 100x worse.

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