Opioids Tramadol - not working for pain Alternatives?

[Jumprope85]

Good evening,

So I had the pleasure of being a front seat passenger in a head on collision late last week with total speed of collision being around 60mph. Hit my head a little on impact and don’t have a great recollection of collision itself just the before and after.
I have rushed out providing first aid and help to others and about 30-40 minutes in the severe pain in neck, back, shoulders, head, the works has kicked in. Ambulance insisted on me going A&E who gave me full CT scans of head, neck, back, chest and X-rays. Everything looked ok just soft tissue damage to muscles, tendons etc and mild concussion so I was discharged with codydramol 10/500 which did very little for me.

GP a few days in as pain getting worse and muscles seized up. Can’t move head up or to right. Can’t lift arms above shoulder height. Pretty extreme pain at night like 7/10.

GP gives tramadol IR 2x50mg 4 times daily. Naproxen 1x 500mg twice daily and 7 days worth of diazepam 1x5mg which I thought was a very reasonable and sensible prescription.

sadly naproxen and tramadol wasn’t touching the pain. Diazepam helped me sleep but not much else.

Further chat to GP yesterday - same surgery but different GP. His solution.. paracetamol. I’m not convinced but go with it.
Today I try some physio and they tell me they can’t worth with me as muscles too rigid, can’t move and I’m clearly in too much pain. Tell me to come back once pain managed better..

So GP again tonight; he gives 14x5mg diazepam to help with spasms but says I’m at maximum dose for tramadol so nothing else he can do.

I like the GP and don’t like to second guess advice but I had been hoping for perhaps some oramorph instead of tram as I think it would work better for pain relief. Or maybe even a bupe/fent transdermal patch (which I used for previous spinal injuries and they were great) to allay their concerns of abuse/recreational use. I didn’t want to push this though so didn’t mention it.

not really asking for medical advice here as it’s not the place for it but wondered if
1) anyone found any way to make tramadol a bit more effective for pain relief
2) anyone away of any other pain relief options better than tramadol that my GP wouldn’t be as concerned about prescribing
3) anyone had a similar experience and have any advice for what worked for them?

to be clear my goal here is pain relieve to allow me to crack on with physio and get back to full duties at work. Not interested in euphoria or recreational use or anything.

Any advice muchly appreciated

Thanks

 

[Cannix]

First off sorry to hear about your accident hope your feeling better soon. Sadly if tramadol isn’t helping your pain chances are you will need something stronger to help you get back on your feet. Tramadol did absolutely nothing for me and was pretty much worthless. As far as increasing potency I do not know of anything that works with tramadol. It sounds like you and the doc need to have a serious discussion about what you need from him to get back to living your life with the same normalcy as pre accident you had. Good luck, now a days you are most likely going to need it.

 

[negrogesic]

Generally, without an x-ray/MRI/etc showing something that clearly justifies stronger opioids, it is going to be a hard sell unfortunately.

 

[Jumprope85]

Generally, without an x-ray/MRI/etc showing something that clearly justifies stronger opioids, it is going to be a hard sell unfortunately.

Hi, I thought this would be the case so discussed my scans. Turns out that what A&E consider as nothing to worry about isn’t the same as nothing is wrong. If that makes sense .

I do have a torn rotator cuff and several fractured ribs - I probably should have mentioned these above - obviously not nice and cause pain but from an A&E perspective; no internal bleeds, no bad breaks, nothing that required immediate treatment and all would eventually resolve with rest and physio..

Unfortunately the rest is making pain worse and physio sessions are a no go at present as the guy says he can’t/won’t work with me while I’m still in this much pain.

chasing around after two little kids and lifting them etc is no fun right now either so I’m useless at work, useless around the house and just feeling a bit shit at the moment. I have had far worse injuries before so in my head reminding myself that it’s only temporary and that pain is a mental thing which I can and have overcome without meds but still .. it’s pretty painful and annoyingly getting worse each day.

Guess I should just stay grateful that no one was seriously critically injured. I won’t hassle / push my GP too much as they’re busy people and ultimately I don’t want to give the appearance of drug seeking behaviour - i would like to think we have a solid trust based relationship. We have always been very open with one another and once when I was on fentanyl patches and oxy following an emergency llaminectomy and cauda equina he accidentally left fent, oxy and diazepam on repeat for ages after I needed it. I took all the drugs unopened in to him to let him know I didnt need them anymore but that boots were still ordering repeats like it was sweets. He was a little embarrassed and grateful I had brought it to their attention. He also knows I have to tell my employer about any prescription only meds and am subject to weekly drugs testing to make sure I’m not taking more than I should. He’s never shown an reluctance to prescribe me what I’ve needed and I like to think I’ve earned some trust points over the 30 odd years he’s been my GP but I do understand that they are under increasing pressure to avoid opiates at all costs. I would ask for a pain clinic referral but these days by the time I get an appointment I’ll probably be healed up.

I guess all I can do is follow his advice for now stick it out and hope it improves and if mk improvement in a few days I’ll have another chat and just said it’s not working for me - we need to try something else.

just thought I would check here incaae someone had a similar situation and Managed to make the tramadol work effectively by tweaking the dosing or something or if they did change meds / what did they find that helped in the end? I don’t Oramorph for the sake of it - it makes me nauseous and gives killer constipation so I’d there are any other alternatives then by all means I’d give them a go but I am just keep to back to being an active dad and constructive employee again asap. Sitting around on my ass drives me insane!

cheers for input - I know there is so much anyone can really suggest on herr as not a medical advice forum but just wondered it anyone else was in a similar situation!

 

[hkanchor]

Good evening,

So I had the pleasure of being a front seat passenger in a head on collision late last week with total speed of collision being around 60mph. Hit my head a little on impact and don’t have a great recollection of collision itself just the before and after.
I have rushed out providing first aid and help to others and about 30-40 minutes in the severe pain in neck, back, shoulders, head, the works has kicked in. Ambulance insisted on me going A&E who gave me full CT scans of head, neck, back, chest and X-rays. Everything looked ok just soft tissue damage to muscles, tendons etc and mild concussion so I was discharged with codydramol 10/500 which did very little for me.

GP a few days in as pain getting worse and muscles seized up. Can’t move head up or to right. Can’t lift arms above shoulder height. Pretty extreme pain at night like 7/10.

GP gives tramadol IR 2x50mg 4 times daily. Naproxen 1x 500mg twice daily and 7 days worth of diazepam 1x5mg which I thought was a very reasonable and sensible prescription.

sadly naproxen and tramadol wasn’t touching the pain. Diazepam helped me sleep but not much else.

Further chat to GP yesterday - same surgery but different GP. His solution.. paracetamol. I’m not convinced but go with it.
Today I try some physio and they tell me they can’t worth with me as muscles too rigid, can’t move and I’m clearly in too much pain. Tell me to come back once pain managed better..

So GP again tonight; he gives 14x5mg diazepam to help with spasms but says I’m at maximum dose for tramadol so nothing else he can do.

I like the GP and don’t like to second guess advice but I had been hoping for perhaps some oramorph instead of tram as I think it would work better for pain relief. Or maybe even a bupe/fent transdermal patch (which I used for previous spinal injuries and they were great) to allay their concerns of abuse/recreational use. I didn’t want to push this though so didn’t mention it.

not really asking for medical advice here as it’s not the place for it but wondered if
1) anyone found any way to make tramadol a bit more effective for pain relief
2) anyone away of any other pain relief options better than tramadol that my GP wouldn’t be as concerned about prescribing
3) anyone had a similar experience and have any advice for what worked for them?

to be clear my goal here is pain relieve to allow me to crack on with physio and get back to full duties at work. Not interested in euphoria or recreational use or anything.

Any advice muchly appreciated

Thanks

It’s a huge mystery why any self respecting doctor thinks Tramadol is even worth the waste of time discussing it. It’s the most worthless analgesic if it IS even a painkiller. Through 7 botched spine surgeries and each time an otherwise intelligent well meaning surgeon writes me up for Tramadol and each time I decline vehemently. In fact I decline in preop and tell them now that only: OxyNorm 20 mg Q4, MS instant release 40-50 mg Q4, Duragesic 50 mcg/hr, Subsys 100 mcg. Only these will work. The rest are essentially candy. Tramadol is a sloppy dirty pretend opiate. The pain killing effect is near nil. Tramadol also messes up your serotonin levels for no good reason. Avoid it at all costs. This garbage drug along with codeine and Dihydrocodeine are the most trashy awful sloppy unreliable drugs and why they’re still prescribed is a mystery. Oxynorm even on a low dose. 10 mg to start brings reliable pain relief. You can titrate up 5-10 mg at a time. At 30 mg Q6 (the higher dose should extend your analgesia cover duration) you should be managing quite reliably and consistently. And your total daily dose of 120/day or 180 MME should be in your doctor’s comfort zone.

 

[DeathIndustrial88]

Tramadol is certainly a narcotic and addictive as well.

My first wonderful "opioid" memories were from tramadol. Especially doses in the 400mg range. Anything past this can cause a seizure, so I do not advise.

I can understand how you don't like it though. After trying heroin & buprenorphine, tramadol suddenly lost it's magic after using it every month for 10 years.
I went through tramadol withdrawals every month from the age of 19 to about 29. I am now on buprenorphine daily. But some times I miss that stimulation and nice nod I use to get from tramadol. But they don' do much now.

Perhaps you are in the percentage where you don't metabolize tramadol well or it's just not strong enough for you.

You could try asking for gabapentin, lyrica, baclofen or a muscle relaxer for pain.

I found staggering your tramadol doses to work better. Don't take your doses at once. Take a small dose over the course of an hour or so. The more tramadol is in your body, the better it will metabolize into it's potent full agonist metabolite. Taking your dose all at once leads to a more stimulating, seizure-like buzz rather than any opioid warmth or relaxation.

You would want drugs that slow the enzyme that metabolizes tramadol or speeds it up (not sure which one would subjectively feel better, probably the ones that metabolize it slower). Im not sure of many drugs that do this though.

Taking diphenahydramine (benadryl) after your tramadol has peaked (if it does peak) can extend it some by slowing metabolism.

Sorry to hear this friend. They are trying to demonize opioids for good so that nobody feels good again. Fuck this war on drugs!!!
Good luck to you!

 

[dsd]

Guess I shouldof drug seeking behaviour - i would like to think we have a solid trust based relationship. We have always been verywith one another and once when I was on fentanyl patches and oxy following an emergency llaminectomy and cauda equina he accidentally left fent, oxy and diazepam onages after I needed it. I took all the drugs unopened in to him to let him know I didnt need them more but that boots were still ordering repeats like it was sweets. He.

How does that work?
You get a repeat of your prescription meds, without actually re ordering them?
For my parents who have 6+ meds listed each, I have to order repeat meds by email, listing each one required .

Also, paracetamol is pretty much a Dr insulting you when you've been in a car crash

 

[hkanchor]

Tramadol is certainly a narcotic and addictive as well.

My first wonderful "opioid" memories were from tramadol. Especially doses in the 400mg range. Anything past this can cause a seizure, so I do not advise.

I can understand how you don't like it though. After trying heroin & buprenorphine, tramadol suddenly lost it's magic after using it every month for 10 years.
I went through tramadol withdrawals every month from the age of 19 to about 29. I am now on buprenorphine daily. But some times I miss that stimulation and nice nod I use to get from tramadol. But they don' do much now.

Perhaps you are in the percentage where you don't metabolize tramadol well or it's just not strong enough for you.

You could try asking for gabapentin, lyrica, baclofen or a muscle relaxer for pain.

I found staggering your tramadol doses to work better. Don't take your doses at once. Take a small dose over the course of an hour or so. The more tramadol is in your body, the better it will metabolize into it's potent full agonist metabolite. Taking your dose all at once leads to a more stimulating, seizure-like buzz rather than any opioid warmth or relaxation.

You would want drugs that slow the enzyme that metabolizes tramadol or speeds it up (not sure which one would subjectively feel better, probably the ones that metabolize it slower). Im not sure of many drugs that do this though.

Taking diphenahydramine (benadryl) after your tramadol has peaked (if it does peak) can extend it some by slowing metabolism.

Sorry to hear this friend. They are trying to demonize opioids for good so that nobody feels good again. Fuck this war on drugs!!!
Good luck to you!

I’m glad you have found some good in tramadol. It’s been a waste of time to me and I assertively reject it when any doctor tries to add it on my chart during inpatient stays. I know my analgesic needs and no pain Mgmt doc will possibly know more than I do. When one tries to argue with me and load my chart with all kinds of slop like Lyrica, Celebrex, etc. then he even had the nerve to try slipping duloxetine in one evening. I demanded he come in and told him to stop fucking around pretending all the extra garbage was helping. He even slipped Tylenol every four hours in there. Jezuz Christ I don’t need him to experiment on me. I told him what analgesics work and if he wasn’t going to accommodate me then I would discharge myself so I can get my pain relief at home. He capitulated in the end. I am very extremely and resentfully sick and tired of dealing with opioidphobic doctors who are scared shitless of prescribing reasonable and medically sound dosages of opioids that work especially in patients with proven history. Have had it with these doctors who are scared off of properly treating pain patients because one too many videos from that fuckwit weasel waste of a life Andrew Kolodny and his detox center buddies at PROP who have an undeclared and ethically warped conflict of interest in their Phoenix House network of for profit detox centers. It’s all been a coordinated evil and malicious and inhumane pogrom by all the two faced scum at Physicians for “Responsible Opioid Prescribing”. One of their most despicable and heartless members is Jane Ballantyne who infamously coauthored a piece in the NEJM in 2016 along with a University of Washington Professor psychiatry colleague. They wrote paraphrased: pain management physicians should no longer treat pain intensity as the priority. The priority of pain sufferers should be coping and acceptance of their condition and to just get on with life”. If doctors should not treat severity of pain and instead should counsel people suffering from debilitating crippling pain to stop whining and just face up to it: cope accept and just “get out there and live life”then how can they call themselves physician or healers? These people, Ballantyne and Kolodny bring shame and disgust onto their profession. They go around the US telling everyone and anyone stupid enough to listen to the garbage that comes out of their mouths: that no one should use full agonist opioids. Their one trick canned speech is to ban strong opioids period. Oh but they’re ok with using morphine, Oxycodone, hydromorphone and fentanyl when you’re on the doorstep of death. That’s ok to them if you’re truly dying. Ballantyne and Kolodny will so bigheartedly let you have some pain relief if you swear you are dying because if you survive that ruins their mission to deny everyone they can the relief of pain for the living. You better make sure you goddamn die on MS Contin, OxyContin, Fentora or any of the strong opioids. Remember Jane Ballantyne and Andrew Kolodny are watching over you like the grim reapers they are. They don’t want anyone to get humane pain relief if they’re going to live and tell about it. No. They want you dead if you so dare to touch those true opioids. They’re clearly are doctors who took a Hypocritical Oath. May the world be rid of atrocious miserable people like Ballantyne and Kolodny and the sooner the better. Good riddance to those spawns of Satan masquerading as “caring human beings”. If you feel sick hearing all this you’re in good company.

 

[DeathIndustrial88]

I’m glad you have found some good in tramadol. It’s been a waste of time to me and I assertively reject it when any doctor tries to add it on my chart during inpatient stays. I know my analgesic needs and no pain Mgmt doc will possibly know more than I do. When one tries to argue with me and load my chart with all kinds of slop like Lyrica, Celebrex, etc. then he even had the nerve to try slipping duloxetine in one evening. I demanded he come in and told him to stop fucking around pretending all the extra garbage was helping. He even slipped Tylenol every four hours in there. Jezuz Christ I don’t need him to experiment on me. I told him what analgesics work and if he wasn’t going to accommodate me then I would discharge myself so I can get my pain relief at home. He capitulated in the end. I am very extremely and resentfully sick and tired of dealing with opioidphobic doctors who are scared shitless of prescribing reasonable and medically sound dosages of opioids that work especially in patients with proven history. Have had it with these doctors who are scared off of properly treating pain patients because one too many videos from that fuckwit weasel waste of a life Andrew Kolodny and his detox center buddies at PROP who have an undeclared and ethically warped conflict of interest in their Phoenix House network of for profit detox centers. It’s all been a coordinated evil and malicious and inhumane pogrom by all the two faced scum at Physicians for “Responsible Opioid Prescribing”. One of their most despicable and heartless members is Jane Ballantyne who infamously coauthored a piece in the NEJM in 2016 along with a University of Washington Professor psychiatry colleague. They wrote paraphrased: pain management physicians should no longer treat pain intensity as the priority. The priority of pain sufferers should be coping and acceptance of their condition and to just get on with life”. If doctors should not treat severity of pain and instead should counsel people suffering from debilitating crippling pain to stop whining and just face up to it: cope accept and just “get out there and live life”then how can they call themselves physician or healers? These people, Ballantyne and Kolodny bring shame and disgust onto their profession. They go around the US telling everyone and anyone stupid enough to listen to the garbage that comes out of their mouths: that no one should use full agonist opioids. Their one trick canned speech is to ban strong opioids period. Oh but they’re ok with using morphine, Oxycodone, hydromorphone and fentanyl when you’re on the doorstep of death. That’s ok to them if you’re truly dying. Ballantyne and Kolodny will so bigheartedly let you have some pain relief if you swear you are dying because if you survive that ruins their mission to deny everyone they can the relief of pain for the living. You better make sure you goddamn die on MS Contin, OxyContin, Fentora or any of the strong opioids. Remember Jane Ballantyne and Andrew Kolodny are watching over you like the grim reapers they are. They don’t want anyone to get humane pain relief if they’re going to live and tell about it. No. They want you dead if you so dare to touch those true opioids. They’re clearly are doctors who took a Hypocritical Oath. May the world be rid of atrocious miserable people like Ballantyne and Kolodny and the sooner the better. Good riddance to those spawns of Satan masquerading as “caring human beings”. If you feel sick hearing all this you’re in good company.

I couldn't agree more.
I've been very vocal about the drug war for years.

Unfortunately the generations are too brainwashed to understand anymore. This is how they are succeeding in eliminating opioids altogether. It's disgusting.

Not only do opioids have the power to treat pain and help people get on with their lives, they are also great for certain kinds of mental illness, which those people too could get on with their lives if they could just access the opioid that suited them best.

They have lied and inflated opioid dangers & overdoses. They record opioid overdoses like they do the corona. Most people who die from an "opioid OD" are people who also had xanax, vodka & prozac all in their system as well. But since they ODed and an ever so slight amount of opioid was found in their system, it can be labelled an "opioid overdose" or "heroin overdose" rather than what it really is, which is Poly-Drug toxicity.

Even then, less people die annually from opioids than they do alcohol, tobacco and sugar.

This way they can scare the uneducated masses and say "see, look at these deadly opiates killing everybody, we need to eradicate them all". Unfortunately most of this generation doesn't realize or remember that you once use to be able to give heroin to babies (talk about oh so 'deadly') and buy it in the grocery store. (Provided we're speaking about the US).

This entire drug war masquerading as a "public health issue" has been nothing more than a war on our minds & bodies. Wish people would have woken up to these "public health" charades a long time ago.

Truly feel for you the pain you're going through.

 

[plumbus-nine]

You might be a liver enzyme CYP2D6 slow metabolizer, this enzyme is necessary to turn tramadol into the opioid O-desmethyltramadol. People with highly active 2D6 get high from little amounts and other side of the medallion are slow metaboolizers which get next to no effects from tramadol and codeine which undergoes a similar metabolism.

Just tell your doc that the prescription doesn't touch the pain. Hopefully he comes up with something else, tapentadol would be an alternative which is similar to tramadol but doesn't need to be desmethylated for to be active.

 

[Just a little pinprick]

Good evening,

So I had the pleasure of being a front seat passenger in a head on collision late last week with total speed of collision being around 60mph. Hit my head a little on impact and don’t have a great recollection of collision itself just the before and after.
I have rushed out providing first aid and help to others and about 30-40 minutes in the severe pain in neck, back, shoulders, head, the works has kicked in. Ambulance insisted on me going A&E who gave me full CT scans of head, neck, back, chest and X-rays. Everything looked ok just soft tissue damage to muscles, tendons etc and mild concussion so I was discharged with codydramol 10/500 which did very little for me.

GP a few days in as pain getting worse and muscles seized up. Can’t move head up or to right. Can’t lift arms above shoulder height. Pretty extreme pain at night like 7/10.

GP gives tramadol IR 2x50mg 4 times daily. Naproxen 1x 500mg twice daily and 7 days worth of diazepam 1x5mg which I thought was a very reasonable and sensible prescription.

sadly naproxen and tramadol wasn’t touching the pain. Diazepam helped me sleep but not much else.

Further chat to GP yesterday - same surgery but different GP. His solution.. paracetamol. I’m not convinced but go with it.
Today I try some physio and they tell me they can’t worth with me as muscles too rigid, can’t move and I’m clearly in too much pain. Tell me to come back once pain managed better..

So GP again tonight; he gives 14x5mg diazepam to help with spasms but says I’m at maximum dose for tramadol so nothing else he can do.

I like the GP and don’t like to second guess advice but I had been hoping for perhaps some oramorph instead of tram as I think it would work better for pain relief. Or maybe even a bupe/fent transdermal patch (which I used for previous spinal injuries and they were great) to allay their concerns of abuse/recreational use. I didn’t want to push this though so didn’t mention it.

not really asking for medical advice here as it’s not the place for it but wondered if
1) anyone found any way to make tramadol a bit more effective for pain relief
2) anyone away of any other pain relief options better than tramadol that my GP wouldn’t be as concerned about prescribing
3) anyone had a similar experience and have any advice for what worked for them?

to be clear my goal here is pain relieve to allow me to crack on with physio and get back to full duties at work. Not interested in euphoria or recreational use or anything.

Any advice muchly appreciated

Thanks

In my experience the best way of approaching a doctor on strengthening a pain medication he prescribed is to first try what he prescribed and call him two hours after picking it up ,just tell him it’s not working and your still in pain , he should instruct you to return to the pharmacy and he’ll write a new script, it’s best if you let him tell you what he’s switching it too first and don’t just blurt out what you want cause you won’t get it, it’s hard to not look like a drug seeker when your seeking drugs

 

[Nas47]

Tramadol is certainly a narcotic and addictive as well.

My first wonderful "opioid" memories were from tramadol. Especially doses in the 400mg range. Anything past this can cause a seizure, so I do not advise.

I can understand how you don't like it though. After trying heroin & buprenorphine, tramadol suddenly lost it's magic after using it every month for 10 years.
I went through tramadol withdrawals every month from the age of 19 to about 29. I am now on buprenorphine daily. But some times I miss that stimulation and nice nod I use to get from tramadol. But they don' do much now.

Perhaps you are in the percentage where you don't metabolize tramadol well or it's just not strong enough for you.

You could try asking for gabapentin, lyrica, baclofen or a muscle relaxer for pain.

I found staggering your tramadol doses to work better. Don't take your doses at once. Take a small dose over the course of an hour or so. The more tramadol is in your body, the better it will metabolize into it's potent full agonist metabolite. Taking your dose all at once leads to a more stimulating, seizure-like buzz rather than any opioid warmth or relaxation.

You would want drugs that slow the enzyme that metabolizes tramadol or speeds it up (not sure which one would subjectively feel better, probably the ones that metabolize it slower). Im not sure of many drugs that do this though.

Taking diphenahydramine (benadryl) after your tramadol has peaked (if it does peak) can extend it some by slowing metabolism.

Sorry to hear this friend. They are trying to demonize opioids for good so that nobody feels good again. Fuck this war on drugs!!!
Good luck to you!

For me personaly tram is antidepressant with neglible opioid properties.Was hooked on this for about three years.It almost did not affect my pain,but in the beggining just feel ok-no depression,desire to work and nothing like opiate feeling.For me its a weaker even than codeine.Took this pills in dose 200mg daily.Max.daily dose was 400mg-same.Withdrawl was nothing like opiate/opioid family,but continious about a month-no pain,no goose bumps or similar.Only insomnia,depression,mood swings and strange dreams.Just like i am awakening and still feels like I am dreaming.Oh yes and bad restless leg syndrom.Nasty crap those trams-personaly for me

 

[Jabberwocky]

Hi OP. I don't know how tough is to get it prescribed but if you want to go up on the opioid strength latter and you are able to get prescription - tapentadol, as @plumbus-nine has mentioned could be the answer. Much less addictive than oxycodone or morphine but still great for pain relief. I am also one of those people who can get only tramadol (or buprenorphine and methadone in unlimited quantities, but thats another story...). I got tapentadol for few months (and was taken away cause it is "too addictive for me") and it worked better than I expected. So if you are in need and can get it prescribed in the future tapentadol is good one. Hope it works out for you.

 

[Nas47]

Yes i know about tapentadol.Here where i live you cannot find it officialy.May be in the dark web.Much stronger affinity for mu receptor,weak or no at all at serotonine.I guess it much better for pain or even recreationaly.If i have opurtunity would try definitely.Peace upon you

 

[Nas47]

Hi OP. U don't know how tough is to get it prescribed but if you want to go up on the opioid strength latter and you are able to get prescription - tapentadol, as @plumbus-nine has mentioned could be the answer. Much less addictive than oxycodone or morphine but still great for pain relief. I am also one of those people who can get only tramadol (or buprenorphine and methadone in unlimited quantities, but thats another story...). I got tapentadol for few months (and was taken away cause it is "too addictive for me") and it worked better than I expected. So if you are in need and can get it prescribed in the future tapentadol is good one. Hope it works out for you.

And some question.I have never had experience with bupe.Currently I am on oxycontine(targin-those with naloxone in it in ratio 2:1)at 50-60mg daily,but my stash will finish soon and I have only bupe patches-70mcg/h or 40mg in once.Is 12 hours will be enough after my last dose of oxy till i can apply the patch onto my skin.Talk about transdermal bupe wich slowly release its content and reach around 2mgs daily ammount after another 24 hours.Want to avoid some precipitate withdrawl which is horrible.My goal is with 3 patches to minimize oxy withdrawl without to get hooked on bupe.Methadone is no option for me even for gradual tapper.Thank you

 

[Jabberwocky]

Wait till you get the proper withdrawal symptoms and try to keep bupe at 2mg daily. You could take 1mg in the morning and 1 before sleep. For pain you can take it 3 times daily. 3×0.5mg or 3×1mg siblingual buprenorphine really helps. For a while. Do the dosage conversions for patches. When I am invoking SL buprenorphine I am talking about ~30% bioavailability.

 

[Nas47]

Ok.Thanks.I Will do it that way.I have been in precipitate withdrawl before couple of months.Its was insane and that for this targin pills.Woke up in the middle of the night with severe cold turkey and i had taken my daily dose.My explanation is that at that time I was with infection and on antibiotic,which may be somehow interfere with naloxone make him more active orally than normal.

 

[JoshLobbs]

Have you been through physio? If so stick with it. If not then demand that your doctors refer you to physiotherapy.

Other than that maybe chiropractic care would be good, possibly hypnotherapy would work.

Tbh I Try to avoid surgery and pain killers at most costs.

 

[DeathIndustrial88]

For me personaly tram is antidepressant with neglible opioid properties.Was hooked on this for about three years.It almost did not affect my pain,but in the beggining just feel ok-no depression,desire to work and nothing like opiate feeling.For me its a weaker even than codeine.Took this pills in dose 200mg daily.Max.daily dose was 400mg-same.Withdrawl was nothing like opiate/opioid family,but continious about a month-no pain,no goose bumps or similar.Only insomnia,depression,mood swings and strange dreams.Just like i am awakening and still feels like I am dreaming.Oh yes and bad restless leg syndrom.Nasty crap those trams-personaly for me

Some people lack a liver enzyme that turns tramadol into it's metabolite, o-desmethyltramadol, which is around 200 times more potent than the parent drug (tramadol).
You might be one of these people.

People's liver enzymes can change I think too. As tramadol knocked me the fuck out in my early 20's & was highly euphoric, but if you gave some to me now (in my 30's), I too would only feel maybe mild SSRI-like effects, unfortunately.

 

[Nas47]

Yes,I know cyt.450 C2D6.The enzime responsible for demethylation.Same that turns codeine into morphine