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

^well, its a harm reduction site and yada yada, so no potentially harmful advice ~ I mean its possible she could have left out some information that contraindicates your advice, and she could have a fatal reaction, and that would be reallllly bad.

how have we gone this far in a opainthread with neuropathic pain and not mentioned gabapentin/pregablin?! They are for neuropathic pain, which often doesn't respond to narcotics. not swallowing is a serious problem mention it asap to your dr. also maybe the lidocaine patches or flector patches if the pain is localized (flector patches gave me back my life, way better than systemic nsaids, did more than doubling my opioids would have).

triiper said:

she was prescribed the fucking patches before her current regiment. she can safely switch back as long as she doesn't take her other meds

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Difficulty swallowing when taking opiates presents a danger that is hard to overstate. 99% plus of the time it not a big issue -- the OP's doctor needs to decide that.

Diagnosis of the risk via newsgroup is not really feasible.

Ask your Dr. about methadone, it helps some people w/ neuropathic pain (I am assuming you have nerve pain because other people implied it) more than most other opioids. I would suggest you ask your doc about Methadone no matter what the cause of your pain, it tends to have less side-effects than other opioids as well. It causes much less of a mental 'fog' than other opioids for a lot of people which is a definite plus.

Can't respond

Because of my newbie status, I cannot reply to the pm's 'm getting. Sorry!!

The Pain Management - mega thread for all your questions on dealing with chronic pain

p.s merged the first thread that seems appropriate

Counter-acting methadone drowsiness

Hi folks.

I'm prescribed 75mg of methadone daily for pain relief due to arthritis.

I live in the UK and was curious as to how I might go about getting prescribed some kind of stimulant (e.g. modafinil, amphetamine etc.) to counter-act the drowsiness and general feelings of apathy that are one of the side-effects of taking methadone daily.

The reason I'm asking for advice (ideally from folk with experience of taking pain management drugs such as methadone or morphine etc who have approached their doctor for help to perhaps prescribe them some kind of stimulant drug which will help reduce the drowsy/ apathy side effect caused by strong opioid medication) is that I have heard of folk on opioids being prescribed stimulants to help them be alert enough to function properly on a daily basis...... but I need advice on how to explain my needs to my GP clearly but not shoot myself in the foot pain-wise and just have the doctor reduce my methadone doseage. It's a delicate situation.

Please note that I'm in no way wanting to scam my doctor and have no desire to be prescribed an "upper" for recreational purposes but I'm scared that if I approach my doctor and tell him that I'm feeling drowsy and/or apathetic from 75mg of daily methadone that he may reduce my methadone dose and I really don't want that to happen.

I have taken modafinil before but haven't had it prescribed and it works fabulously as far as I'm concerned e.g. today I took 400mg of modafinil on top of 100mg of methadone and I'm feeling alert and well-motivated whilst still deriving the necessary pain-relief from the methadone but just not feeling drowsy or apathetic at all.

But obviously I'm reticent to admit to my GP that I've taken modafinil without a prescription......

Any help and advice will be gratefully received. Many thanks.

^
I think if you tell him he will reduce your dose

the best option would be switching to a less sedating opiate like oxycodone or maybe temgesic.


I'm merging this into the mega pain medication thread

I recommend Meprobamate and Diazepam along with your Morphine. I would ask your doctor if he can script some Meprobamate and lots of Diazepam. Oh, and if you are able to get ampoules of Diazepam to shoot'em IM every 8 hours or so, it will be even better.

Bingeboy, why do you think the GP will just reduce my methadone doseage?

Surely if I stress that my current methadone doseage works wonders for my pain and that I'm not after a doesage reduction as such but simply wish to know if anything else (i.e. the prescribing of something like modafinil) can be done to improve my everyday mental alertness and clarity of mind then they won't reduce my doseage.......

Does anyone have any specific experience with this kind of problem? I'd be really grateful if you could help out and let me know your thoughts.

Thanks too to you Bingeboy.

gabapentin and vicodin Q..help N extreme pain

Sunday morning i was in a accident and got into a fight with a drunk after the accident resulting in a blowout fracture on my left eye a fracture or broken thumb on my right hand and multiple cuts and abrasionss on my left side of my body. Im prescribed 10/325 vicodin but i take gabapentin for epilipsey and etc....Will the gabapentin screw up my vicodin dosage cuase i took 2 pecocets at the hospital which did nothing.

Can some1 please explain the mechanism of how these drugs interact with each so i can be pain freee. im typing with 1 hand and 1 eye so spare me the bad comments i need help not a verbal assault. Anyone...somebody..this isnt about drug abuse or getting high off either of em....and i take 600mg of gaba spread over a 4-5hour peroid and then take 600 at once towards the end of the day. Resulting in 1200mg total not at once mind you. Help.....

The gabapentin will not reduce the painkilling effects of the vicodin...

If you're finding that the vicodin isn't doing enough for your pain, you can always run to the store and get some Diphenhydramine tabs and take 1-2 with your vicodin... it will intensify the analgesic effects by about 120%

Merging with the pain management thread

oh and the diphenhydramine will definately enhance the sedative effects but i doubt that wil enhance the pain killing effects although it is possible , do you have any sources to back that up wungchow?

There is no such thing as "pain free" , pain medication isnt meant to take it all away . its meant to make your pain manageable ... thats right MANAGEABLE , not make you high , not "Feeling good" .

More than one doctor has told me that the medication isnt meant to do that . even with cancer patients . trying to keep ALL the pain away is going to do nothing but lead to into addiction of chasing that feeling ..

ATF said:

^well, its a harm reduction site and yada yada, so no potentially harmful advice ~ I mean its possible she could have left out some information that contraindicates your advice, and she could have a fatal reaction, and that would be reallllly bad.

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This is so true. Theres people on here who actually read people saying stuff like oh I take 60mg's of (whatever) and have no problems. Then they take a dose like that and end up in the hospital.

BingeBoy said:

^
I think if you tell him he will reduce your dose

the best option would be switching to a less sedating opiate like oxycodone or maybe temgesic.


I'm merging this into the mega pain medication thread

Click to expand...

Modafinil has shown a lot of promise as a treatment for Opioid Induced Sedation (OIS) and seems preferred over other, more controlled options like methylphenidate or various amphetamines. I think you should tell your doctor what you told us about being very nervous about changing your PM regimen because you finally found the right dose and ask him for something like provigil to help with the OIS. Modafinil/provigil does not have a whole lot of abuse potential (especially compared to the other aforementioned stimulants) and I don't think it would be like asking a doctor for xanax for something. Of course some doctors will do anything to keep you on the least medications possible even if more will be more beneficial while other doctors will be much more open to adding another drug to combat the side effects of the first. I don't know your doctor so its hard for me to tell. My suggestion is to just have a plan for what you would like to accomplish and be prepared for any way that the doctor can respond.I doubt the doctor will refuse to give you a drug for OIS and demand you reduce your dose, but I suppose its possible so be prepared. Good luck!

I feel for everyone on this site who have to endure pain in their everyday life. I also suffer from chronic pain, Plantar Facititis, RSD, and Bunions.All the pain if people arent familer with these pain conditions, they are all assoiciated with my feet and the tendons in the back of my calves. It sucks like you dont even know. I can only stand/walk be on my feet for about an hour before my pain level jmps up to about a 7-8. I take Oxycontin, Methadone, although I dont usually take the methadone for a few reasons..Its a longacting med for 1 and my Oxycontin does that for me, and I really dont think that it works that well. I also am prescribed Norco for BT pain, not the greatest BT med but thats what my pain managment doctor prescribed so thats what I take. I also am prescibed Ativan for exteme anxiety

Im curious to know what other chronic pain patients are on for BT and general everyday pain. Im thinking about getting off the Methadone and Norco and just stick with the Oxycontin but want to try a differant BT pain med. So any information on pain meds that you guys are on or have tried would be greatly appreciated!!!

^ My regimen for neuropathic pain (most likely RSD but I haven't gotten a completely definitive Dx)

Lyrica 150mg BID
celebrex 200mg Qmorning
Norco 10/325 PRN (this was my BT pain med when I was on MScontin or oxycontin but I decided to discontinue those but I keep the norco and use essentially the same as a BT med but I don't use round-the-clock opioids)
Lidoderm patches (2-4 about 4 days a week)
And a few hits of a strong indica as a muscle relaxant, opioid-sparing agent and sleep aid.

I recommend Meprobamate and Diazepam along with your Morphine. I would ask your doctor if he can script some Meprobamate and lots of Diazepam. Oh, and if you are able to get ampoules of Diazepam to shoot'em IM every 8 hours or so, it will be even better.

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I think if he/she goes in and asks for injectable ampules of diazepam, they may find themselves suspected of drug seeking.

I i forgot to add that I use Lidoderm pathches and also a new patch called Flector (Diclofenac Epolamine topical patch) pretty new to the market and I must say that it works really well, not as well as the Lidoderm though. I was on Lyrica doe awile but it didnt help much so I stoped it. I gave Gabapentin a whirl and it has been ok thus far.

Hey Cane2- have you ever heard of a patch or cream that has a solution of Ketamine and lidocaine in it? I heard it is used for nerve pain and supposedly works reallywell--