I have weaned off pain medication (I am a chronic pain patient), have some questions

[GizmodiGirl]

This is my first post, so hopefully after reading the basic drug discussion guidelines I don't post anything that violates the rules.

I am a chronic pain patient. I am in my mid fifties, and was diagnosed with RA last year. I have had a number of spinal surgeries over the years, and have been seeing pain management physicians for years to control pain I live with on a daily basis. I have been put on prednisone off an on over the years, and was put on methotrexate for a short time. I had to stop taking methotrexate after my first week as it made me very sick. So I just stuck with Gabapentin, my Trazadone as needed, and I take my Naratriptan when I get severe migraines and then my pain medication (once every 6-8 hours). I have been going through a series of RFA treatments on my spine, can only do them once every 6 months. I have been on the pain medication, gosh, close to 6 years?

Anyway, I wanted to get off the pain medication. With everything that is happening regarding pain medication in the US and the issues I have had to deal with regarding my pharmacy, I am just tired of being anxiety ridden about trying to get my pain medication refilled. I had my pharmacy at one point say they had nothing in stock, I went through horrible withdrawal for a week, and eventually got my prescription filled, but ever since I have been in fear of having that happen to me again. Not only that my original pain management physician of 6 years (this was 2 years ago) dropped all her pain patients, and went into a different type of medical practice due to the changes in my state with regard to pain medication and patients. She said it wasn't worth staying in that field of medicine anymore. I had a hard time finding another pain management physician, but when I did, he was an hour away from where I live. So I have been with him for close to 2 years now. All of this has made me think seriously about getting off the pain meds.

So, I started weaning my dose down over a weeks time. I have been off the pain medication now for well over a week. However I have been really fatiqued, and my pain level went through the roof. I searched online to see if there was anything that could help me get through the withdrawals, or be an alternative to treating my pain. I came across information on Kratom here. I decided to give it a try, and bought a bottle of the stuff. I started out just taking 2 pills 600mg each of the green powder in capsule form, and I was pleasantly surprised that it got rid of my fatigue, and my pain level definitely came down! I thought wow, so I bought another bottle.

Now I am using it in the morning and at night, those are the two times I hurt the most, but I do still take my Gabapentin. Tonight however was the first time I started having some bad stomach cramping, gas and diarrhea. I just want to make sure that the Gabapentin isn't mixing badly with Kratom. I do sometimes get a headache when I take the Gabapentin and Kratom together, but not always. I tried to find some information online about possible drug interactions and such, but it is very limited.

I am also concerned after reading some threads on this site that using Kratom for an extended time could cause a type of physical dependence similar to the pain medications. Any suggestions, comments would be most helpful.

Thanks!

 

[cdin]

kratom is physically addictive similar to opioids if used for daily pain management (experience: me, eating 20g a day for torn hip tendon) - it makes you feel better because it hits the same receptors. I'm not sure what doses you were on, but it may be that the kratom is not covering the withdrawals fully, hence the stomach discomfort. I would strongly recommend taking as little of it as possible and tapering it as quickly as possible - if your goal is to be free of substances you have to be anxious about, which is what I'm hearing. (the thing that made me want off dope was fearing a natural disaster scenario in which I was disrupted from iv opiates) Kratom can be a sneaky bastard, I had to go back on hydrocodone and taper that because I found the withdrawals to be worse.

 

[GizmodiGirl]

kratom is physically addictive similar to opioids if used for daily pain management (experience: me, eating 20g a day for torn hip tendon) - it makes you feel better because it hits the same receptors. I'm not sure what doses you were on, but it may be that the kratom is not covering the withdrawals fully, hence the stomach discomfort. I would strongly recommend taking as little of it as possible and tapering it as quickly as possible - if your goal is to be free of substances you have to be anxious about, which is what I'm hearing. (the thing that made me want off dope was fearing a natural disaster scenario in which I was disrupted from iv opiates) Kratom can be a sneaky bastard, I had to go back on hydrocodone and taper that because I found the withdrawals to be worse.

Ok, yea I have only used 2-600mg pills once in the morning, once at night, and for several days. Today I am abstaining from taking it. I wasn't sure if the Gabapentin I am on was causing issues. Thank you for the response!

 

[thurston]

I took kratom for PAWS when I quit my pain meds and it really helps a lot, now I only take it occasionally. I took an oz a day for a year and the withdrawal was very very mild, a day or two. Stick with the plain leaf, nothing enhanced and you will be fine. Also it's way cheaper to buy the leaf and fill your own pills or make tea with a few grams. Most important thing is don't take anything concentrated or enhanced.

 

[GizmodiGirl]

Ok, thanks didn't know that about it being cheaper to buy full leaf? I noticed a few sites online that sell the stuff powdered in bags, and then the bottles with pills. I only bought the pills because I wasn't sure how it would react in me, and didn't want to purchase a large amount. I haven't taken any since last night around 9pm and I am definitely feeling a bit more pain. I was going to try going without it for a few days or longer to see how I do. Again, thank you so much for both of the replies on here, much appreciated.

 

[cdin]

reddit.com/r/kratom has regular updates on vendors etc. I would recommend taking it no more than 2 days a week for pain control without addiction forming - or as close to that as possible. you may still feel off between.

 

[g_dan1]

I recommend you find a good vendor and order some Red strains. In my experience, yes, kratom is physically addictive. I feel physical discomfort when i take a 1-2 days break. But if you don't have any other major problems or underlying issues in life it will be easy for you to come off.

Also are you taking kratom extract? you mentioned taking 2 600mg caps so I assume you got it at some headshop. but if its not an extract and 1.2 is enough then good for you! try not to increase ur dose and definitely get some plain leaf powder online to save $ and get better quality

 

[cdin]

i would like to contradict g_dan's statement. After using it for pain control for a few years, I found the withdrawals to be so unbearable I had to switch back to hydrocodone, taper that and jump off of it. It really boils down to what type of person you are/how long you use it. Kratom withdrawals are unpredictable, prolonged and primarily mental (although physical as well), opiate withdrawal is predictable, of a fixed length and primarily physical(though mental as well). I found 2 - 4 weeks of aches and low energy/insomnia to be vastly unpreferable to 3 - 7 days physical pain... Also, all of this is dependent on dose, length of time on it, genetics etc. I just don't want you thinking "oh, this is a legal plant, i'm fine". Because that was my train of thought, and it really bit me in the ass.

 

[Keif' Richards]

The only issue that I can see regarding your usage of Kratom, is that its active metabolites are also Opioids in their own right. A lot of us on Bluelight are long-term Opioid addicts, so we probably have a little more experience in living the complete cycle of dependenc and withdrawal. You should be aware that as much as we would like it to be, Opioid withdrawal (and withdrawal from many drugs) does not always follow a linear path. What I mean by this is, by introducing other Opioids into your system while still withdrawing, you can potentially set yourself back disproportionate to how much relief you receive from your dose i.e. it's not worth it.

We all sometimes have to bite the bullet and dose an Opioid even if its not best for our long-term interests or goals. For instance, if I'm simply too sick to do my job, I can't fuck myself over in that regard by getting fired, so I use just enough to get me through the process without it being a nightmare-hell.

It's my opinion that your best bet lies in utilizing to the best of your abilities drugs from other classes which are not cross-tolerant with Opioids. Gabapentinoids, including Gabapentin (Neurontin), Pregabalin (Lyrica) and Phenibut (OTC) are the most commonly found and used of the class. They are highly effective at relieving symptoms such as fatigue and Restless Legs/Akathisia. They also provide some psychological help and might spur your ambition to get shit done.

Additionally, Clonidine (Catapres) is handy to have around. It's not a miracle-drug by any stretch, but it's definitely made the difference between a night of rolling around in hell and sleeping for ~5 hours. A lot of folks get better results from Clonidine than I do, your experience may vary, of course.

Do you have access to any sedatives like Benzodiazepines and Barbiturates and if so, could you trust yourself to use them responsibly? They can be wicked helpful, but the biggest issues we have to grapple with include the potential for a dangerous blackout, overdose or the development of a chronic addiction. If you feel fairly confident in yourself, these can help you quite a bit. I never use them when I'm sick, because I cannot be trusted .

As a quick addendum, I always tell folks, Alcohol is almost universally contraindicated when in Opioid withdrawal. It typically makes things significantly worse physiologically. Also, I would recommend a sedating strain of Cannabis to help you eat and sleep. When I'm sick, my routing typically consists of smoking and then immediately eating a meal and drinking fluids.

 

[cdin]

^ truth, all of it. As much as it sucks the whole "no free ride" concept really applies here. and - if you're really smart(being facetious here), as I am, you'll do yourself the favor of copping a double habit - ya know, using the kratom to "kick in" the pills. Then maybe add some extracts - im telling you the pain that awaits in the world of polydrug withdrawal is not... at.... all... worth it. imo.

 

[GizmodiGirl]

Hi all, just now getting around to responding to all the responses. Thank you so much for all the good advice. Ok I have been several days without using the Kratom. I have not had any pain medications either. Now, I can say that the pain I am experiencing is pretty moderate, and I visited my pain management doctor yesterday who I told that I am off the pain medication and not needing anymore at this time. I am scheduled for a visit with my orthopedic surgeon this Friday to discuss getting the hardware out of my low back (if possible), and discuss ongoing chronic pain in the low back that spreads to my legs. My pain management doc is setting me up with another procedure to inject my left hip and address the sciatic nerve pain on that side. Anyway, I will have to wait and see how long I can go without pain medication and kratom. I won't lie, the pain is really making me re-think the pain medication. No, I don't want to exchange one drug for another, so if I do find the pain is unmanageable I may either A) get back on pain medication B) try kratom again, pick it back up. With that said, I am not using a lot of this kratom, 2-4 pills (it is the powder in gelatin capsules), each capsule is 600 mg. 2 capsules would be 1.2 grams, 4 would be 2.4 grams. So from what I am reading thats a pretty low dose. I only take the kratom (when I am using it) once in the morning, and then once at night at bedtime. But right now, I am off both. My biggest concern is with using the kratom along side of the gabapentin the doctor has prescribed for me. I am trying really hard to get up and walk everyday about 15 minutes. It is rough because of the pain in my hips and low back. I am trying really hard right now to stay off the opiate pain medication the doctor gives me.

One other thing that I am just a little worried about. My pain management doctor has me on a contract, and I do random urine tests, as well as a blood draw. I never know when they are going to do this. I don't use any other drug other than what is prescribed, and just this recent use of kratom (which is the first time I have tried it). Does kratom show up in urine or blood tests? If it does, does it stay in your system for a long time? If yes to these questions, then its probably safe to say I am not going to use it anymore. If it doesn't then I will probably keep kratom as a last resort back up drug to help with pain if I find it isn't manageable.

I really appreciate the responses!

 

[cdin]

unless they are testing for it specifically, you should be in the clear re: kratom and testing. If you are going to continue on pain medications, it boils down to quality of life. What makes you feel better/controls pain better etc? I'd say for those purposes, continuous release opiate pills do the best IMO. I actually prefer the kratom for straight euphoria/being high (eating a LOT of it). Good job, you're doing amazing. May I suggest some kundalini yoga. I know moving hurts - and certainly don't do anything but easier modified poses, but the combo breath/movement work is SOOO good for helping these things. I wouldnt believe it unless I had experienced it. Good Luck.

 

[Felonious Monk]

Do you live in a state with a medical marijuana program? I've spoken with many people that have experienced great benefit using cannabis for RA.

 

[finis]

GizmodiGirl, Your story sounds a lot like mine, only mine has gotten more complicated. Due to inoperable herniated discs, entrapped nerves, severe oesteoarthritis of hands/feet, Sjogrens, Raynauds, yadayada, I ended up in pain mgmt 5 yrs ago. Spinal cord stimulator implanted, pain meds went from hypro to oxycodone 80mg/day, 40 extended release, 40 immediate release. I was doing well. Feb 2017 PM (pain mgmt) doctor reduced oxycodone to 40mg/day, removing the ER. added Tramadol, Lyrica. Tramadol is useless for my pain. Increased Lyica to point I was dangerously clumsy and stupid. Lyrica is useless for my pain. Weaned off Lyrica to 75mg/day and I will get off of that. I know withdrawal from medications, as bad as withdrawal can be for days, weeks, months, it does stop, chronic pain does not stop.
Then I found Kratom, red Bali, powdered. Two one-gram doses during the day and 10 to 20mg oxy at night gave me a functional life. Now, two months later it takes two two-gram doses of Kratom. Kratom ingested after 2pm keeps me awake at night or I would take Kratom at night. Twice, Apr, May, pharmacies in my area ran out of oxycodone, a two-day wait once, a four-day wait the second time. Manufacturing of opioid medications has been drastically reduced, you know, the war on drugs.
Urine testing is done for three reasons, to determine if you are taking the prescribed meds (not selling them), to find out if you are taking legal meds but not prescribed, and to check for illegal drugs. Kratom is legal where I live. DO NOT take any Rx medication which is not prescribed for you. You will be kicked out of PM and blacklisted. You may wish to inquire about Arthrotec (a powerhouse NSAID) and tizanidine (muscle relaxer) which do help me.
Finally,
People in chronic pain who rely on prescribed opioid medications are not addicts, are not bad and are not doing something wrong.

 

[Keif' Richards]

Hey Gizmo, I think we'd all like to know how you're progressing. Feel free to post back in the thread or send any of us a private message if you feel like our style clicks with what you're looking for. Being an Opioid addict who hasn't gone "full animal" as I like to call it, are typically imbued with a sense of empathy for others in this position that is near-fraternal. Even though our circumstances are often quite different, in the end, our experiences all contain tid-bits that we can use and share for mutual benefit.

It's criminal what the medical community has done to those with chronic pain. Yes, I understand if the ER doc doesn't want to write me a Dilaudid script for my tooth because of my visible track marks, but what does that have to do with someone in legitimate, life-altering pain? They are putting all of their energy and motivation into covering their own asses instead of examing patients on a true case-by-case basis. It's the exact same thing they did when they began over-prescribing back in the 90's. "It's (Oxycontin) an un-abusable, less addictive Opioid"

MD's and big pharma were well aware of the addictive nature of Oxycodone for literally decades prior to the Oxycontin explosion. These people are supposed to be our best and brightest and all they do is toy with us for their own benefit.

 

[finis]

Thank you Keif, you summed up what I could not have put into words.
I guess what I, Gizmodi and many others are doing, using other substances to control chronic pain, will become common activities as Rx oxy dries up. this frightens me because we are all potential addicts.
I got way off the subject of this thread,sorry.