Opioids (UK) Doctor(s) Refusing to Provide Adequate Pain Relief - Getting Desperate!

[ChemicallyEnhanced]

So I have severe chronic pain from multiple causes:
1) Pancreatitis
2) Unhealed Spinal Fracture
3) Two Prolapsed Discs
4) Osteoarthritis

8 years ago I was prescribed Oxycodone and had a mild "problem with it" (according to my doctor). I was prescribed 100mg/day and honestly never took more than 130mg in a day. However, when my G.P. found out I was switched to Methadone. I eventually quit the Methadone cold turkey due to intolerable side-effects. I was then given Tramadol and when that didn't work Dihydrocodeine. I have been on the maximum dose of Dihydrocodeine for about 3 years now, but my pain is getting worse, obviously in that time I have become tolerant to it and it was BARELY enough at the start.
My doctor refuses to prescribe me any stronger opioid but I am in agony every day. I'm trying my best to deal but always end up not being able to stretch my 14-day prescription beyond 10-11 days max, which then leaves me in agony AND horrible withdrawal for several days.

What can I do about this? How do I get my doctor to understand? I'm at my wits end. I ran out two days ago and have been crying from pain and withdrawal and depression over it all all day.
I'm also sick and tired of being labelled an addict when the only reason I've ever taken extra pills is because I needed them (same is true of when I was taking extra Oxy; I was trying to get out of pain, not get high).

 

[MsDiz]

Ask your Dr about trying another pain killer in the same level as it were. Tapentadol is a great analgesic and is along the same lines of Tramadol although slightly stronger.

Has your GP offered to refer you to the pain management program?

 

[ChemicallyEnhanced]

Ask your Dr about trying another pain killer in the same level as it were. Tapentadol is a great analgesic and is along the same lines of Tramadol although slightly stronger.

Has your GP offered to refer you to the pain management program?

I've asked about pain management clinic and he said I COULD go, but he'll be telling them that under no circumstances are they to prescribe me ANYTHING. And your GP gets final say.

I've actually stopped eating (lost 4lb the last 3 days) because meds affect you based on body weight, so if I lose say 20% of my body weight, my DHC will be 20% "stronger"...I'm THAT desperate.

 

[MsDiz]

I've asked about pain management clinic and he said I COULD go, but he'll be telling them that under no circumstances are they to prescribe me ANYTHING. And your GP gets final say.

I've actually stopped eating (lost 4lb the last 3 days) because meds affect you based on body weight, so if I lose say 20% of my body weight, my DHC will be 20% "stronger"...I'm THAT desperate.

Yeah don’t do that. Tolerance is still tolerance.

Why not find a new GP? Or complain? Have you citizens advice in your town? I’d honestly go down the complaint route because if you’re being unfairly treated then it’s not on.

 

[ChemicallyEnhanced]

Yeah don’t do that. Tolerance is still tolerance.

Why not find a new GP? Or complain? Have you citizens advice in your town? I’d honestly go down the complaint route because if you’re being unfairly treated then it’s not on.

I can't go there (I don't think) due to lockdown, but that's a good idea. I might google my local citizens advice centre and call them, at least see what advice they have or what they can do,

 

[DKs]

I've asked about pain management clinic and he said I COULD go, but he'll be telling them that under no circumstances are they to prescribe me ANYTHING. And your GP gets final say.

Again here: not true. You'll get your script, should more (or another opioid. I'm not sure if they'd really have to prescribe something else, though) be needed.

Anyway, why not back on methadone? It's certainly one of the best pain killers out there, seriously. You might ask Turning Point, or equivalent, to split the methadone on two doses per day.

If you just want more DHC or go back on Oxy (which I understand as all these "oxydised opioids" work in a similar way and are usually VERY enjoyable), I'm afraid you'll have to find an illegal source, should a pain specialist not agree with you. I'm writing this because I feel like you are really after that turn. And note: DHC, hydrocodone and Oxycodone are very similar, almost equal, regarding their pharmacodynamics. Yes, if you just take a high enough dose, DHC is orally very similar to Oxy. Who would have thought... That's also why I called your GP "incompetent" in your other thread. DHC might have a low potency and it should not be injected due to histamine storm, but it is not really a weak opioid, if the dose is adjusted accordingly.
One-fold oxidation (a redox reaction) gives you DHC from Codeine.
Two-fold oxidation (for example catalysis with an oxidising agent or alcohol) of Codeine gives you hydrocodone
A third oxidation will yield Oxy.
They rille belong, imho, to a pharmacological group of opiates, all acting in almost the same fashion. If you've had problems with oxy, you're be asking for trouble taking DHC daily... But again, I don't know you. Maybe you'll surprice me going to a pain clinic and accepting the kind of therapy they offer.

 

[kinkyjohn]

I'd say your doctor sounds like an arse hole. It's quite easy to change doctor in the UK so start there.

Granted opiates and their tolerance make them difficult to work with - but people in pain respond like addicts as pain is one of the main drivers of addiction (an addict flees from pain and to pleasure .. with a lot of classical conditioning thrown in for good luck). Remember to try and avoid the cliches around addicts .. so be honest about dosing and effectiveness. Since you have serious pain .. if you find your enjoying an opiate too much .. it would probably be a good idea to shift to another so again .. just be honest and say you enjoy it too much - can you try a different one. Honesty like that will build trust fast and they should let you experiement. Regardless - a decent doctor should understand that a person in serious pain taking more medication .. is probably still in serious pain. Opiates + ketamine are also a classic super pain killer that a good doctor may let you experiment with. You can often massively reduce opiate use though it doesn't work for all and some opiates (e.g. buprenorphine) have a ketamine like action built in. id actually recommend you try bupe .. as they'll hand it out like candy because you can't really OD on it. The only problem is the risk they may not let you back on opiates if you switch .. and bupe is a terrible opiate recreationally .. and is often a terrible opiate for pain (though for some it's a life saver). Pain control is a personal thing .. but with both mental work and chemical experimentation significant relief can often be found. A doctor that won't let you try alternatives probably thinks of medicine as some sort of mathematical perfection - in reality there is no such thing anywhere .. but it sure does make life easier for some people .. usually at the cost of others.

Also remember there is a "war on opiates ..." mainly triggered by the wave of super cheap fentanyl analogues from china. You are a victim of this war as an easy way to get the death statistics down is to stop providing drugs to people with terminal and severe pain .. as the painless death with low risk to others that opiates offer has been a gift to many people who are dying in agony. Obviously .. relatives don't always want to or appreicate that and it doesn't show up on the stats. And don't forget many religions still regard suicide as a sin.

And last of all .. best of luck. A life in pain can easily not be much of a life at all. Work at it .. and fight it .. and with luck and perserverence you'll hopefuly find a way you can regain your pre-pain life. I really hope it works out for you .. just remember - don't let the man bring you down!