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Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

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[Ali- Its a tight rope to walk trying to get pain relief. Have you heard the term pseudoaddiction? If you watch the show House, when he was cut-off before his trial it was a perfect example. In his desperation for pain relief he tried to go to a clinic and say he had a broken face and eventually stole a dead patient's oxy script.
/QUOTE]


That is what I was diagnosed with when I first got referred to the pain clinic I go to. My first doc there was pretty good. He was a relatively close monitoring sort ( 9 Times out of 10 a piss test). I learned all the metabolites to see what was 'compatable' with what. Luckily he was Rx'ing me morphine so H was not a problem.

My second doc is one who is not afraid to treat pain with meds (I also get local blocks). That can be more of a curse in a sense. At least for me. I am trying to quit. I haven't talked to any old friends for a while now. However, I am really having trouble giving up my script. I'm not even using daily anymore, although the doc thinks so. I usually use 2-3 times a week and never take the long acting anymore. She was Rx'ing hydromorhone both extended release and IR. I was getting 150 IR's a month and along with the hyromorph-contin got myself throughly addicted. All thanks to my benefit plan which is pretty ironic.
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Cane2theLeft said:
^seriously? Big Pharma is the single most profitable industry in this country, they don't give a shit if you have to break the bank. They know meds are necessary, they are some of the most inelastic goods- you NEED them so they know you'll pay almost anything within some reason.
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Pharmaceuticals is the biggest industry for the U.S. civilian market but illegal drugs and legal weapons manufacturing (U.S.) both exceed the pharmaceutical industry in terms of profits. There's a chance I could be wrong; regardless your points are very valid. I can't believe name brand OCs costed papasomni over 5 bills :X
 
RainingDownOxy said:
papa^^ hey brother.what do you mean by generic oxycontin being brought back again?Im confused. I am Rxd the Purdue Brand name Oxycontin. I know there are Tevas and other types of Oxycontin out now. But I just dont understand your statement about bringing them back again??....

Not trying to flame you bro or anything!!!!;)
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Yeah, a month ago they told me that there were no more generic oxys and I would have to buy the purdues at twice the cost I was getting TEVAS for. Then, This month, after I had bought a bottle of purdue 40's #90 for almost $600, that now the generics were available again. I don't understand why I got fucked for $600 when they were going to bring the generics back again. The brand I have now is M'CKR ? They look the same as the purdues. They smell different. Like the coating is made of something different. I wanted to find out if they waxed up, so I chewed one and I got a gummy blob of waxy stuff in my mouth. So, they are definatly "abuse proof". Anyway it just pisses me off that we have to go through all this expensive crap when it just turns out that it wasn't necessary to begin with.
 
kadaj said:
Pharmaceuticals is the biggest industry for the U.S. civilian market but illegal drugs and legal weapons manufacturing (U.S.) both exceed the pharmaceutical industry in terms of profits. There's a chance I could be wrong; regardless your points are very valid. I can't believe name brand OCs costed papasomni over 5 bills :X
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Its not the biggest industry or even close, but Big Pharma make the most per dollar they spend, they're the most profitable.

http://www.citizen.org/documents/fortune500_2002erport.PDF
 
papasomni said:
The brand I have now is M'CKR ? .
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They are malinckrodt- they make a lot of generic pain medication like all the hydrocodone that are 3xx- like the 367 marked 10mg norco, 357 I think is 5-500, etc.
 
I don't like them. I can't chew them for stronger action when I need it. I'll have to ask for something for breakthrough pain now.
 
re: pain management

Hello everyone I am wondering what I can do . I live chronic pain due to be shot in the back with a 9 mm. The bullit is still in me. Anyway I live in pain all the time and all my doctor will give me is 2 7.5 mg. of hydrocodone a day. He says he is not allowed to give me much more . I am scared to talk more to him for I am afraid he might get mad and take what little bit of pain med I get.Plus I really do not know what to say because I don;t want him to think bad of me. But it has gotten to the point that I cant even stand long enough do wash my dishes Please if someone can help me I would truly appreciate it.
 
You need to get to a pain clinic. Instead of asking THIS doctor for an increase in meds or stronger meds, ask for a referral to a pain doctor/specialist. This will be better for you in the long run and it doesn't sound like that bullet is coming out anytime soon so it sounds like you are going to be in pain for a while and Gp's don't always understand pain, you need to get to a pain specialist so he/she can treat your pain properly.

From how you describe your pain I would think you need to be on a long-acting and a short-acting for break through meds. For long acting- Ms Contin, OxyContin, Fent patches and for short-acting you could maybe continue with the Hydro's until they didn't work for BT pain and then you'd have to be upped to something without tylenol if your going to be on long term pain meds such as Roxicodone.

Good luck. Sorry for your pain, i can 1000% relate to you.

Take care
Rpg
 
Legend---brother I have 2 things to say to you, 1st)goddamn your the shit for living through being shot in the back!Im glad to here your ok. But putting this aside is my 2nd thing I will add is that you must get into a painmanagement clinic!! this is very importent. You need to discuss a pain control plan with a Doctor who specalizes in pain managmanet. He will be able to help you where your PCP has his hands tied. By that I mean that PCP usually, after awile of RXing mild narcotics meds, he knows that you will evenutally need stronger meds. So he will just refer BAM just like that and your in.Well, so long as the clinic your refered to is accepting patients;) Best of luck to you brother---
 
Yeah Pain is pain. Never be afraid to speak to another doc and get a different opinion... I would seek a pain management doctor also.
 
My friend hurt his back a long time ago biking (BMX). He was only getting Perc 10s from his regular doctor (many years later) so he went to a pain doctor and was upgraded to 2mg hydromorphone (even 4mg for a couple scripts). Not a bad idea to give it a try.
 
PM - morphine or fentanyl?

Hey guys and girls,

I have the choice of a fentanyl patch at 25 microgrammes per hour, or morphine sulphate 20 mg every four hours (or 80 mg controlled release daily.) Which is better purely for pain control?
 
^^ I don't believe I'll get addicted; I'll become physically dependant for sure, I just want the best analgesic. I have no interest in abusing my meds., I'd like to feel 'normal' (pain free.)
 
then most deffinetly go w' the fentanyl, it is far stronger and IMO it is WAY better for pain
 
FENTANYL!!!! That is the one that has worked best for me and I've tried all of them. Are you just interested in pain control and/or recreation? From what i read it sounds like you're just interested in pain control.

I'd totally go with the fent. It works the best for me, it's convenient and if you are interested in recreation you can use them for fun after your finished with each patch (used patch).

Anyway.... that's what I'd go with if it were me

Good luck and let us know what you decide.

rpg
 
Thanks. :) I'll have a think about it, and reply on this thread with my final decision after going to my PM appointment in a couple of weeks time. If anyone else has a POV on this, please feel free to add your opinion; I'm happy to hear it.

PoppyGirl: I just want to be pain free. I have been told that morphine is the 'gold standard' and 'ultimate painkiller' etc. and I've also heard good things about fentanyl patches. Right now I'm prescribed weaker opioids which work out as equivalent to over 100 mg of morphine (I've checked with several dosage converters.) I'm not really looking for recreation - my idea of recreation is computer games and pool with friends :p . I'd like to be pain-free, and anxiety-free. Also, it's important for me to be able to think clearly - actually I don't want to be 'high' the whole time, this would be a hindrance.
 
^^ There's the option to increase if these doses are too small, these will just be my starting doses for either. The point isn't really the dose, because this will be adjusted to what suits me best, it's which one of the two is better at relieving pain. Or please suggest another opioid if you think there's a more effective one.
 
The lit would say go with the fentanyl.
In my experience, when fentanyl works, it works very well, with far fewer side effects than morphine.
However, my big problem with the fentanyl patches was that the dosing was VERY uneven. This was many years ago, though, so maybe they've gotten better. I could take breakthrough meds, but long-acting pills proved to provide overall better pain control.
The only thing you can really do is to try both, see which works best.
IMO, you're far better taking sustained release morphine twice daily than immediate release.
 
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