Xanax and methadone

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Regular Member

Date Joined Mar 2007
Total Posts : 167
   Posted 4/27/2010 10:45 PM (GMT -6)   
I have a question for all of you and I hope I can get some good advice.  I went to my Primary care doc today for a routine visit and let him know of a good deal of anxiety I have been having.  I told him I may need something mild to take when my anxiety starts.  He knows I am on methadone for pain management given to me by my PM doc.  He said he usually prescribes xanax for anxiety and it works well for his patients.  I told him that I used to take xanax years ago when I was first diagnosed with GAD and it worked well for me.  He recommended it to me.  I told him I was concerned with all I have heard about people taking methadone and xanax together and dying.  I was very concerned it would be a bad combination.  He told me that the people I heard of dying are usually folks who have not been on these meds and just out of the blue mix them and that is what kills them.  He said these folks usually take hand fulls and abuse them and thats how they die.  He said folks who are prescribed them and those whose bodies are adjusted to them can handle them.  He said I should take a dose of the xanax at home to see how I reacted.  I am still kind of scared to mix the two.  He told me the best thing to do being I was so concerned would be to ask my PM doc if xanax can be taken safely with methadone  (as he is not as familiar with methadone as my PM doc is) or if there is something else for anxiety that be safely taken with methadone.  I just want to make sure and be safe about it.  DO any of you know if it is safe to take these two together?  Is there any other medications that can be taken for anxiety besides the xanax that can be safely taken with methadone?  THank you all for your attention and I hope to hear from you.
I really need something to help me as I believe every day I am going to pull out my hair because I get sooooooo worked up.  It is effecting my job.

Veteran Member

Date Joined Feb 2010
Total Posts : 914
   Posted 4/27/2010 11:04 PM (GMT -6)   
Hey Shaw31 , I respect your wanting to be careful , that is wise .I have been on a methedone maintenance prog for 6 years and I'm detoxing now I'm on 30mg .I never heard of anyone dying fron mixing the two but I do know people on the program do abuse xannex .But I beleive there are anti-anxiety meds that are non- narcotic , perhaps you be better suited for those .With a med that is narcotic theres always the possibility of an element of dependance or abuse occuring .To avoid that and put your mind at ease you may want to go with a non-narcotic for your anti-anxiety med .I know this doesn't directly answer your question but I wanted to offer you what I do know and support your decision to get more info . Good job never be afraid of getting a second opinion . Mikel 

HIV+ , Need hip replacement , have a cellulitus like condition on leg that is stubborn , using anti-biotics to try to get rid of but its stubborn .Started eating completley healthy juicing every day , no sugar , taking vitiamins and anti-oxidents , virigin coconut oil ,only veggies and fruits mostly , no red meat .feel better.Meds:viracept truvada,indothemicin. Pain from hip and leg use cane or rolator to walk .                                                                                                                 

Veteran Member

Date Joined Aug 2008
Total Posts : 3193
   Posted 4/27/2010 11:46 PM (GMT -6)   
Hi Shaw31...

I can only share my own experiences and that which I've read. I have anxiety issues, too... and have been on xanax or ativan at different times of life... I respect your cautiousness, definitely. The first thing I would do is contact your PM doc...before you take the xanax and just get his/her opinion on it.

I *think* the biggest scare of taking a combo of opiods/benzos is respiratory depression... it also depends on the doses of both medications that you are on...obviously, the higher the dose - the bigger chance of there being an issue.

I've been on methadone for pain management... at a fairly hefty dose. I used xanax for a short period of time while on it - and I DID have side effects from it... ranging from memory loss to being incredibly "loopy", etc. For other reasons, I switched off of methadone... and was able to then take the xanax on an "as needed" basis w/ the other pain meds I was on.

The last few years, though, I've stuck w/ Ativan... which I *think* is a slight step down for xanax (or maybe just for me...I don't know).. it helps very much w/ the anxiety w/ the least side effects.

I don't know if any of that helped or not :) I guess if I were in your position... I'd call my PM doc (which I do whenever I am starting a new med)...if I got the "ok"... I would try the medications at home, with someone around in case there is an issue... If you are really anxious about it... you might trying asking your doc for a benzo that is less strong than xanax... and see how your anxiety responds to that... Again, those are just my "not-a-professional" opinions :)

Regardless... I'm sorry you are dealing with so much anxiety...it's awful... Take care of yourself, and let us know what you decide to do...
Main Health Problems: Dysautonomia/POTS; CFS/Fibromyalgia; Severe Chronic Hypertension; Hypothyroidism; Hypoadrenalism; Mixed (Obstructive/Central) Sleep Apnea - on Auto BiPap; Depression/Anxiety; Severe Vitamin D Deficiency

Pain Issues: Cervical/Thoracic back pain (they called it DDD...but I don't know); migraines; carpal tunnel syndrome; widespread joint/muscle pain, nerve pain in hands/arms/feet; Future Plans: Intrathecal Pain Pump; already completed trial (Sept, 2008); awaiting my decision for implantation...

White Beard
Forum Moderator

Date Joined Feb 2009
Total Posts : 3702
   Posted 4/27/2010 11:59 PM (GMT -6)   
Hi Shaw31

I think Momto6boys has given you some very good and sound advice! But everyone reacts differently to these different medications, so like Momto6boys suggest, along with the others, is to check with your Pain Specialist. I do want to commend you on being cautious! It is better to be safe than sorry! And you really do have some valid concerns!
Good Luck to You!

White Beard

Veteran Member

Date Joined Nov 2007
Total Posts : 6795
   Posted 4/28/2010 1:34 AM (GMT -6)   
Hi, Shaw,
I want to commend you like others have for being cautious. A lot of doctors aren't familiar with methadone, so I think checking with your PM is the best thing. But there are a lot of other options for anxiety. Since you mentioned GAD, I wondered if you have seen a therapist who is skilled with anxiety. There are a lot of skills that can be learned to help. A book I've often recommended to others is The Anxiety & Phobia Workbook by Edmund Bourne, Ph.D. A lot of the same techniques in the book are also useful for pain, such as relaxation.

Another option would be to talk with perhaps your PCP or even a psychiatrist about an anti-depressant that helps with both depression and anxiety. And again, that can have double benefits of helping with pain.

These are just a few thoughts I have. Hope you find something useful.

Take care,

p.s. In case you didn't realize it, there's also a section of HW for Anxiety. You can post to the CP forum and the anxiety forum. It's easy to switch using the Quick Jump menu at the top right corner of the page.

Retired Mom
Veteran Member

Date Joined Feb 2010
Total Posts : 1753
   Posted 4/28/2010 5:32 AM (GMT -6)   
Hi Shaw,

I don't take Methadone, but I do take Dilaudid, Ambien, and Ultracet and I take the controlled release Xanax with it. Ativan makes me CRAZY...as does Klonopin. I have no idea why, but they just work differently for me.

Like everyone else, I commend you on your caution! I honestly believe you should get approval from PM before beginning this med. It may (or may not) break your pain contract if you don't. Each is different and I don't want to see you out in the cold without PM!

I have taken xanax for years. I was taking the immediate release for a lot of reasons and then my psych suggested the controlled release. It works great for me. No more (or much less) anxiety and no ups and downs while you are waiting on the med to kick in. It also helps that you only have to take it once per day. It releases so much in the morning and so much in the evening and didn't affect my resperation with the ambien because it is gone by night. It's certainly something that you may want to discuss with your Dr. Almost nobody here uses the controlled release and the pharmacy even had to special order it (but it is generic and cheap).

I wish you relief!!! Anxiety is horrible and I beleive makes the CP worse! I know it does for me!

All the best!
Retired Mom

Forum Moderator

Date Joined Feb 2003
Total Posts : 16781
   Posted 4/29/2010 7:53 AM (GMT -6)   
Shaw perhaps you should do as your PCP says and contact your PM sinxe he is more informative of Methadone. You know we all react differently with meds and its better to be safe than sorry. Its been awhile since we have heard from you, so I am assuming the switch to Methadone has helped your pain. Take care and don't be a stranger. Susie

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.

Veteran Member

Date Joined Nov 2008
Total Posts : 1037
   Posted 5/1/2010 9:18 AM (GMT -6)   
Shaw....you are right to be concerned about mixing the two drugs...I know of many people that have died taking them...but...and it's a big BUT...they usually abused them...they would take a bunch of xanax along with more then the dose of Methadone they are supposed to take.  That is why my Dr. will NOT give Xanax...  If you take the Xanax as you are prescribed you will do fine.  Just watch for problems breathing....that's what happens, they stop breathing.  And even though I will not take Xanax I know a lot of people that it really helps....Just be careful...

I have been a spectator for so long..Now it's time to participate.......
Post Lamenectomy Syndrome, Spinal Stenosis, DDD....
1999 Hemi Lamenectomy/2005 Spinal Fusion(L4-S1)
Methadone 120 mg. a day/  30 mg. Oxycodone as needed(up to 4 x a day)
High Blood Pressure: Lisinopril HCTZ 10 mg. daily
Type 2 Diabetes: (March 16, 2009)
Metformin HCL ER 1700 mg. at night..Glipizide 10mg. 2X in the morning and bedtime
Lantus 50 units at bedtime with Solostar Pen
Byetta 5 mcg. 2X daily                                                                   


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