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

what do you mean, "serious"? like "can i get busted for buying this online?" serious? or "will i get addicted if i start taking this stuff?" serious? (which would both be "yes")

Codeine will help your pain well. Vicoden is a bit stronger, so stay on codeine for as long as it works for you. Once you start to move up the painkiller chain the other meds won't work anymore.

Nickatina said:

Codeine will help your pain well. Vicoden is a bit stronger, so stay on codeine for as long as it works for you. Once you start to move up the painkiller chain the other meds won't work anymore.

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Vicodin (hydrocodone) is much stronger than codeine. OP, yes it is "serious" you will become addicted to it if you take it for an extended period. I recommend doing anything you can to avoid habitually taking opaites for pain. Unless you have a chronis illness and are going to die soon, i which case I think the individual should be given all the opiates to consume to preserve quality of life.

^People tell me that stuff all the time. Ie, once you've had a "strong" opiate, a "weak" one never works. As far as I'm concerned, all opiates with no ceiling are of equal strength. I can easily take hydrocodone in place of heroin or dilaudid.

what i meant by serious is like addiction, for me, i dont worry about that though, ive been scripted many meds that cause "dependency" and whatnot and i have never gotten addicted to any of those meds, including xanax, though ido like it....its just that i have a high tolerance and doctors dont understand that

they understand it all too well, and their instinct is to protect you from becoming dependent on it. doctors do weigh the severity of your pain and situation against the risks of dependency or addiction, and most of your doctors have decided your case isn't severe enough to risk going down that road.

do you have proof, something you can show a doctor to convince them you're not just looking for drugs? without tests, xrays, MRIs, etc etc, no doctor will just hand over the opiates when you say you have back pain. if you do and you aren't approaching your doctors like this- "the only thing that works for me is vicodin, seriously i mean i tried that neurontin for one whole day and it didn't do shit! by the way i also have a high tolerance, remember that when you give me my script." you shouldn't have problems.

The gabapentin (neurontin) you were prescribed takes about two weeks to establish stable plasma levels and become useful for pain. Its cousin pregabalin (lyrica) takes about one week but that doesn't really help you. If you are going to get other meds I would just take the neurontin as prescribed for a couple weeks to see if it helps before you write it off. It simply doesn't provide instantaneous pain relief like opiates but can be extremely useful for pain. GABA-analogues relieve aspects of my pain that opiates don't touch and allowed me to return to work and stop going to the ER once a week for severe pain. If I were you, I'd at least give it a shot and I understand your desperation for relief and don't blame you for looking elsewhere when the doc isn't helping... But really, you should find a doc that DOES help. Good luck man... And pm/IM/email me if you want to ask about meds, bitch about your pain or whatever, I've been there. Take care

ellua said:

they understand it all too well, and their instinct is to protect you from becoming dependent on it. doctors do weigh the severity of your pain and situation against the risks of dependency or addiction, and most of your doctors have decided your case isn't severe enough to risk going down that road.

do you have proof, something you can show a doctor to convince them you're not just looking for drugs? without tests, xrays, MRIs, etc etc, no doctor will just hand over the opiates when you say you have back pain. if you do and you aren't approaching your doctors like this- "the only thing that works for me is vicodin, seriously i mean i tried that neurontin for one whole day and it didn't do shit! by the way i also have a high tolerance, remember that when you give me my script." you shouldn't have problems.

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Exactly right.

OP:
You should be mad at the US government, the DEA, and people who abuse their medications and then sue their doctors for "getting them addicted", not the doctors themselves.

You're being completely selfish if you aren't considering the fact that your doctor puts his license, career, and way of providing for his family on the line when prescribing opioids. If they were not under this constant threat of losing their license/being sued, many people would be receiving better pain control.

As things are, you should expect to go through whatever treatments your doctor recommends until he finds one that works well for you. Telling him that vicodin is the only thing that ever worked for you is seen by many as classic drug-seeking behavior, so I really don't know what you were expecting.

toomuchpain said:

ive been having back pain since august, been rxd many different meds, including one time vicodin, the ONLY med that worked was vicodin, i told my doctor this yesterday, so he prescribes me nerountin or whatever, shit doesnt work at all, heard that it may have some recreational value from what i read on erwoid but i felt nothing, so it doesnt help for pain and it doesnt have any rec value, so now ive decided fuck doctors, im just going to buy my meds online.
is codeine a serious med?
i know vicodin isnt that serious compared to other pain killers

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What is you DX? Are you seeing a specialist or just a GP?

Have you had MRI's/CT/ X-rays w/ standing/Flexion/extension.Physical Therapy sessions, Massage or even ice/heat?

Have you tried Nsaids, muscle relaxers, supplements, steroid shots, rhizotomy, discogram to locate the pain?

I understand you desire for pain relief, but vicodin can only do so much, you basically admitted looking for euphoria so I have a feeling your demeanor with your doctor has exposed you.If your doctor has not given you true diagnostic tests, referrals to back specialists then-- yes he sucks and you would be better served looking elsewhere.Self medicating via the web is not getting to the root of the pain just masking at best, do you want a "fix" or a solution to cope and manage?

Also, pain brings on some bad depression too.I was bipolar/diabetic type 2- well before all my problems and scoffed at some of the medications they offered.Yet, the compounding of those two put me in a near suicidal state, the balance of meds saved me, only after I listened to what my P-doc, GP, Rheumatologist, and Podiatrist laid out for me.I also cope with the fact that a true DX is still eluding us what was a simple back issue has turned into some scary prospects.

Not degrading your pain, or even questioning it-that is your prerogative- just look at the big picture and get a doctor who will work with you and work with him.

mikemikemike said:

Vicodin (hydrocodone) is much stronger than codeine. OP, yes it is "serious" you will become addicted to it if you take it for an extended period. I recommend doing anything you can to avoid habitually taking opaites for pain. Unless you have a chronis illness and are going to die soon, i which case I think the individual should be given all the opiates to consume to preserve quality of life.

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Addiction is different from dependency. So he will bevcome DEPENDANT if he takes it for an extended period.

I think the term potentency may be more applicable in that comparison.

I.e. Fentanyl, because it is much more potent than codeine, is dosed in micrograms rather than milligrams.

ilovechronic said:

Addiction is different from dependency. So he will bevcome DEPENDANT if he takes it for an extended period.

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That's all very circumstantial. I don't believe he was making that argument so why must we bring it up?

Darkness- great questions but more importantly, great point.

In my opinion codeine would be a ad choice. It is hard on the gut, weaker, has a ceiling dose. Tramadol may be a better choice if you want to go the internet route.

But I think it is time to find a new doctor. You have ligitimate pain, correct? Something that can be proven that you have,right? Well maybe it is time to goto a pain management doctor. Also you need to not just be looking for a magic pill to take your pain away. You need to try other available treatments like physical therapy or anyother available treatment. Just asking for hydrocodone makes you look like a drug seeker which i understand you are in pain but your doctor may think you are just trying to get some drugs since you have said everything but narcotics dont work. You need to want no pain not want narcotics. So you should have the atitude that you are willling to try ANYTHING to get rid of the pain not just narcotics. find a new doctor. Explain to your current doctor that he is not effectively treating your pain so you are going to need a refferal to another doc or pain management or tell him/her that you will be finding a new doc yourself.Or just cancel your next appt and dont tell your doctor at all why you need a new doc.

Theone thing that you made clear in this post is that you do seem to be a psuedo drug seeker. I say that because your comment on neurotin being recreational. if you do want to have effective pain control you are going to have to cut that recreational stuff OUT. You should not be looking for recreation in your pain managment drugs you should be looking for pain relief. If youabuse your pain meds you totally ruin it for your self and tolerance will build far more rapidly. You will end up short on your meds and will lose the only thing you have to kill pain. So DONT use these drugs recreationally use them as prescribed PLEASE. i think your doc thinks you are seeking narcotics.

Lost and Confused said:

That's all very circumstantial. I don't believe he was making that argument so why must we bring it up?

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We must bring it up because addiction and dependency are diferent. He was using addiction incorrectly. While people on narcotic pain medicines can become addicted to their meds generally, people are dependant on the meds but not addicted. i was not trying to make an argument out of it, i was just saying that he used it in the wrong context and it would be likely the OP would become dependant and not addicted.

dokomo said:

Exactly right.

OP:
You should be mad at the US government, the DEA, and people who abuse their medications and then sue their doctors for "getting them addicted", not the doctors themselves.

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+1 to that. Doctors are usually just afraid because this dumb fuck country actually allows people to blame a doctor for their own weak will and stupidity and win. If you have a real issue you just need to find a doctor that cares more about doing the right thing than covering his ass (NOT common btw)

Lost and Confused said:

That's all very circumstantial. I don't believe he was making that argument so why must we bring it up?

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Yeah, why wouldn't we? Someone made a claim that he would be come addicted to something, not that he might become addicted. Its VERY important to differentiate between the two.

Them doctors put on that white cote and somehow it makes them automatically think they are gods.

I SWEAR some docs actually take joy in playing god with peoples lives.

Here in Brazil no one prescribes opiates to back pain. We have use other type of meds, and people live well. Forget about getting high on meds... if you really need it, try heroin... then you will have your "recreational value".

toomuchpain said:

ive been having back pain since august, been rxd many different meds, including one time vicodin, the ONLY med that worked was vicodin, i told my doctor this yesterday, so he prescribes me nerountin or whatever, shit doesnt work at all, heard that it may have some recreational value from what i read on erwoid but i felt nothing, so it doesnt help for pain and it doesnt have any rec value, so now ive decided fuck doctors, im just going to buy my meds online.
is codeine a serious med?
i know vicodin isnt that serious compared to other pain killers

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If codeine works for you more power to you mate , im cyp26 somethin or other deficient .. sucks balls..

Darkness2Light said:

What is you DX? Are you seeing a specialist or just a GP?

Have you had MRI's/CT/ X-rays w/ standing/Flexion/extension.Physical Therapy sessions, Massage or even ice/heat?

Have you tried Nsaids, muscle relaxers, supplements, steroid shots, rhizotomy, discogram to locate the pain?

I understand you desire for pain relief, but vicodin can only do so much, you basically admitted looking for euphoria so I have a feeling your demeanor with your doctor has exposed you.If your doctor has not given you true diagnostic tests, referrals to back specialists then-- yes he sucks and you would be better served looking elsewhere.Self medicating via the web is not getting to the root of the pain just masking at best, do you want a "fix" or a solution to cope and manage?

Also, pain brings on some bad depression too.I was bipolar/diabetic type 2- well before all my problems and scoffed at some of the medications they offered.Yet, the compounding of those two put me in a near suicidal state, the balance of meds saved me, only after I listened to what my P-doc, GP, Rheumatologist, and Podiatrist laid out for me.I also cope with the fact that a true DX is still eluding us what was a simple back issue has turned into some scary prospects.

Not degrading your pain, or even questioning it-that is your prerogative- just look at the big picture and get a doctor who will work with you and work with him.

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im only seeing a gp
i finally got the doc to order an x ray, i asked him a couple months ago for a x ray and he said lets wait on it, the results were that i have a narrowed vertebrae somewhere in my mid back, so he oredered a ct scan, but they said that their going to have to check my insurance before i can get the scan and i dont have insurance, im in the counties system, therefore i cant also see any other doctors, unfortunatly im stuck with this one
ive been scripted the following for back pain
ibuprofen 800
baclofen
flexeril
tramadol...this med did no pain relief, though i did get a seizure from it
ketoral or ketoralac??? i dont remember, something like that
neurontin

its funny you mention depression, i have mdd (major depressive disorder) and social phobia and social anxiety, doc knows this but hes not a pysch (which i dont currently have) so i understand that hes doing his best and i appreciate it, but hes prescribed me ativan 90 pills with 4 refills....and hes worried of me being addicted to vicodin??? somethings wrong there, imo
im doing everything i can, exercises, heat/ice, an occasional massage
does anybody know how much it would cost to see a physical therapist or pain specialist?


EDIT-- darkness, i forgot to mention that even though i admitted that, i felt absolutely NO euphoria, unless you consider numbness or the ability to not feel pain euphoria, i honestly dont consider that euphoria imo

^When I did physical therapy without insurance I had to pay about $800 a month while going for an hour twice a week. I have only seen pain specialists with insurance but whenever I have seen other specialists without insurance (neurologist and neurosurgeon) it cost about $500 per consult.

I don't know what you meant about being in the county's system... do you have a form of insurance through the state? If not, can you get on medicaid? You should check with your doctor about seeing a specialist and look into the aid programs. I'd just like to mention how fucked it is that we are paying triple+ per capita per year (~$8,000) what every other industrialized nation is paying for health care; 47,000,000 lack insurance; most are under-insured and people WITH insurance routinely get fucked; and finally 18,000 people die annually due to lack of health insurance.

I'm really sorry you are in this situation and insurance or not, you are going to have to fight for relief- its never handed to us but in case this is a chronic issue, you REALLY don't want to abuse your medication. You risk losing your doctor's trust and getting cut off, having to deal with addiction on top of chronic pain and overall it will just fuck things up worse.

Take care man and let me know if I can help in any way, I've been living in pain for 34 months now.