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

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Also, which in general is a better analgesic - oxycodone or methadone? The oxycodone is more euphoric, so should it therefore be a better pain reliever?

I'd like to know the answer to that too! Methadone is supposed to hep with neuropathic pain, so maybe your dose is too low? I've read that oxycodone works for neuropathic pain too. I'm on fentanyl now, which works quite well. Have you tried that?
 
I talked to my doctor today, I'm switching now to Duragesic patches. Starting at 25 mcg, even though he told me it might be too low. I'd rather start low and go up than start necessarily high.

I gotta say, I've never had a doctor as fantastic as my PM doc. Always addresses my concerns, been very patient figuring out what system works best for me, makes me feel like I'm involved in my treatment, and above all else, he trusts me
 
^Methadone theroretically works better for neuropathic pain because of its NMDA-antagonism but NNT's put it even with all opioids- around 3 people are needed to treat for every 1 person that receives a 50% reduction in pain.

Levorphanol (levo-dromoran) is supposed to be the best neuropathic pain opioid but its not the most common. Any successful pain management regimen has to utilize multiple drugs and preferably multiple nonpharmacological approaches as well.

This is the World Health Organizations common visual depicting how to appropriately treat pain pharmacologically (it was originally made for cancer pain, but it works for all forms):

fig1.gif
 
Percocet question

Hello, I am new and I have a ? about percocet.

I have a tumor, a large lipoma about the size of an egg, it didn't use to be painful, but now that it has grown it is starting to lean on my spine causing my discs to swell. I am scheduled to have it out soon.

anywho for pain I have been given percocet (oxycodone/APAP 5mg -325) if that helps.

Im instructed to take 2 every 4 hours not to exceed 12 in 24 hours.

It works pretty well for me, except I throw up a lot. It doesn't matter if I take it with food or not, i throw up, a lot.


My mom says I am probably allergic to it, but if that was the case, I think I would have more side effects then just vomiting. And she might be just trying to take me out of it so she can have them lol witch isn't happening.

My dr says that I can switch to morphine if I want to but I am not sure if it will have the same effect for the pain as the percs do.

I have never taken oral morphine, just in IV form, and that was ok although I prefer the dilautin to morphine.


So I guess my ?s are.. is there something I can take to make the nausea go away thats over the counter?

In your opinion does morphine have the same effects as percocet?

TIA for any advice or info. It is much appreciated!
 
You should take dramamine to help with your stomach issues. Please do not switch to oral morphine....you will probably have more stomach issues with it, plus, oxycodone(percocet) is far superior to oral morphine.
 
Geez I never even thought of dramamine, you rock thanks so much, I always feel silly not knowing, then I feel silly asking, then I feel even sillier when the answer is something so simple lol.

I think I agree about the morphine, I think I just have a weak stomach. I used to be on perc 750s when I had a knee replacement and i was sick all the time from it, I could never take a full pill ever.

I guess I am a wuss.

Thanks so much for the speedy reply! I am sending the hubs to get some dramamine!
 
5mg of oxycodone shouldn't cause any nausea or vomiting unless you are hypersensitive to opioids which seems like the most likely reason for your experience...

If you tell the doctor you are vomiting all your medication up and can't get any pain relief because of that, he might be able to prescribe you a suppository formulated with the same painkillers.

That way you can figure out if its some interaction in your stomach that is making you vomit or if its the opiates themselves causing it.

Morphine will be just as bad if not worse, and its not as potent of a painkiller as oral oxycodone is so avoid that at all costs.
 
I did tell my dr... but he just said I could take the perc or the morphine.

hes pretty much an asshat.

I just got off 6 days of predisone, it seems to be his cure all for everything. I hate him.. but at least he does give me something.


thanks drunken... i can't wait to have the surgery, It suppose to be a super simple operation, with most lipomas they just take them out right in the dr office. but because mine is so deep,large and close to my spine, I will be in OR and asleep. wich sucks because when I wake up, coming out of the anesthetic I always cry like a baby, for no reason what so ever, just bawling my eyes out.

But I will be so happy when I can move and jump around :)
 
theotherside26 I just wanted to thank you again, its been awhile now and I have not thrown up! yay! you rock!
 
Glad to help, just remeber not to take more than one dramamine a day. IF you take too many, some very disturbing things can happen!!
 
eer i took 2 the recomended dose...

um can I ask what disturbing thing can happen?

now im all scared.. poop!
 
Speaking of 5/325 mg percocet. How many is to much to take at once(speaking about the APAP) not the oxy, I cant get enough of that. But, how many would a person who has a tollerance take at once before they consider doing a cold water extraction of the APAP? Whats a good amount to even make a CWE worth it? 10 5/325 percs is not alot of oxy to take at once, but would you consider doing a CWE? You would want something like 15-20 pills to make a CWE worth the effort, dont you think? or is it better than just chewing up 10 - 15 pills a day?
 
eer i took 2 the recomended dose...

um can I ask what disturbing thing can happen?

now im all scared.. poop!

You take too high of a dose it'll cause delerium and hallucinations. It's hell.
 
Speaking of 5/325 mg percocet. How many is to much to take at once(speaking about the APAP) not the oxy, I cant get enough of that. But, how many would a person who has a tollerance take at once before they consider doing a cold water extraction of the APAP? Whats a good amount to even make a CWE worth it? 10 5/325 percs is not alot of oxy to take at once, but would you consider doing a CWE? You would want something like 15-20 pills to make a CWE worth the effort, dont you think? or is it better than just chewing up 10 - 15 pills a day?

The FDA recommends not taking more than 4grams of APAP which would be just over 12 of the 5/325 percocet. If you are only taking 10-12 a day everyday, its not great to have that much APAP but you don't NEED to cwe. If you are taking more than that, then yeah you need to.

Also, sorry for enabling a thread-jacker.
 
wich sucks because when I wake up, coming out of the anesthetic I always cry like a baby, for no reason what so ever, just bawling my eyes out.

When I woke up after having my wisdom teeth out, I cried too haha. I was freaking out and I kept asking for my teeth because I wanted to keep them. Anesthesia really fucks with you.
 
your just taking too many percs, your def taking 12 a day

the APAP (advil,tylenol) makes a person throw up

for me, i can handle up to 350mgs, but if i take 100mg of hydrocodone in vicodens i throw up.

so i tend to try to stick with OCs

you should tell yourr doctor u get nausus, tell him u think its the APAP, (if you think it is)

Its a possibility that u could get oxycontin, which is just oxycodone without APAP
 
no no i am not taking too much. it says i CAN take up to 12 in 24 hours, but I don't, I take about 6 a day.
 
the APAP thing makes sense because i throw up vicoden too.. but with vics I get wicked heartburn too. weird cause I had never had heartburn my whole life until I had a vicoden.


About a month ago I tried darvacet instead of percs, but it didn't even touch my pain at all.. felt like I was taking a sugar pill.
 
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