Opioids Transitioning from one opioid to another for chronic migraine pain

I have had chronic migraines for the past 20 years. Prior to trying opioids for pain management, I tried every possible migraine treatment on earth. Nothing helped. About 7 years ago, I was on Percocet 10-325mg 6x/a day in addition to Naraptriptan (Amerge) migraine med when needed. A couple years ago I got off the percocet because I thought I could deal with the migraine pain through other non-narcotic methods but after approx. 6 months of battling the migraines I resumed the narcotics with Demerol. I am taking Demerol 50mg 4-5x/a day. And still take the Amerge for extreme pain. Now I want to go back on Percocet but not sure how to do it.

Is it possible to transition from Demerol to Percocet?
Any advice would be appreciated. Thank you.

You can switch directly from Demerol to Percocet, they're both opioids, all you have to do is get the right dose. You can switch back and forth between opiates as much/whenever you want as long as its equivalent dosing.

So yeah just switch back to Percocet if that works better for you.

^Thank you RedRum. Good to know on the transition. I do have a pain management Dr but he doesn't spend much time with me although I can ask him to change my meds.

I know so much how you feel. I suffer from migraines and I have been taking perc 10/325 for over a year. I just got put on exalgo 8mg. It has only been a week. I am not yet feeling the pain relief I got from perc. Have you ever taken dilaudid? I am wondering if this is a bad switch....

Sorry about the migraines Jkmkaye. Yes I did try Dilaudid and I absolutely hated it. It made me feel terrible, nauseous, shaky and exhausted. I only took it for a couple days. And it did nothing for my migraine pain. The percs are not an ideal solution and I did still get migraines but as far as I was concerned it was the best of the bunch. It helped me manage the pain and when it was extremely bad I took Amerge (naratriptan). Still take Amerge with the Demerol now. Triptans definitely help if you haven't tried those yet as a complement to the opiate. But they are more for acute migraine episodes -- not daily use.

As mentioned, I was previously on Percocet (oxy/tylenol) for chronic pain. I am definitely getting off the Demerol and was going to transition to Percocet but now I'm worried about the acetaminophen and liver damage. I used to take 6 -10/325 Percocets a day for chronic pain. So that's 1950mg of tylenol a day. That's not good, is it?

I have tried long acting 20 mg Oxycontin in the past but it made me very tired and wasn't as effective for my pain. And back then I was also given Immediate Release Percocets for break through pain. Is there a plain Oxycodone (no tylenol) immediate release? I guess I could always take Percodan instead of Percocet.

If the triptans do not work for your migraines they are not migraines. Drug trials are part of the process of differential diagnosis for migraines.

I was misdiagnosed with migraines by a neurologist. Wasted loads of my time, loads of money, and simply prolonged suffering. Dumb bitch wouldn't listen to me and give me an MRI despite the fact that I had broken a vertebra in my neck. *scoff*

Alas, the problem is skeletal, with spasms. Who'da thunk?

^^Thanks Morphling. Sorry about your vertebrae. Ouch. Mine are definitely migraines. The triptans do work for me, however they are only to be taken a maximum of 4 per month due to risk of Serotonin Syndrome. I am also on 20 mg daily dose of Lexapro so I try to adhere to the triptan 4 pill max. The triptans are a life saver but they really wipe me out for a couple days. I also get neck pain at times which goes up into my head so it's all part of the migraine picture. In the past I have taken Baclofen (muscle relaxer) and 400 mg of Motrin. It did help but not when the pain was extreme.

They started giving out oxynorm 5 10s and 20s (only oxycodone no APAP) to migraine sufferer's here now.

Did you ever try Cafergot when it was still on the market? It's the ONLY migraine medication that ever worked for me. I have found that most Psychedelic Tryptamines provide the same relief. But they all must be taken at the onset of the migraine otherwise your left tripping WITH a debilitatibg headache which could be a worst case scenario. The first chemical I noticed headache relief from was 4-aco-DMT but I've noticed the same thing with pretty much every 4 subbed tryptamine. They seem to also provide relief for 1 - 2 weeks after dropping.

^Whosajiggawaa - That's great. We don't have those here in the US. Wonder if we have plain oxy no APAP Immediate Release at all.....

^Ballz_Trippington No never tried Cafergot. Sounds interesting but guess the potential side effects made them take it off the market.

Hi, new here so please bare with me and I apologize if I'm writing this question on the wrong thread but I really need advice...
Ok so I have severe Crohns disease. For the past 10 years I've been on pain meds. The past 4 years I've been at pain management and had to move abruptly to Pennsylvania (3 weeks notice). While in Maine I was on Dilaudid 8mg every 4-6hs with the Duragesic patch 75mcg on top. I went from one doctor to another and they switched me to methadone 120mgs where I took 4 pills 3 times a day. Now I'm in PA and went to a PCP who said "that's for heroin withdrawal and I do not prescribe methadone". The pain management places around all do injections only as that is where the money is at now that drs are so afraid of prescribing narcotics. I've always been in good standing and I have legitimate pain so it's driving me nuts that I can't find a doctor with sympathy for pain who prescribes pain medicine in my area of central PA. I don't care what I'm prescribed at this point, I just need medicine for pain as I cant take any OTC pain meds due to my Crohns. Anyway, I finally found one place but they need a referral from PCP and need over a month to get an appt.
Long story, sorry to ramble, bottom line is that I am seeing a PCP doctor tomorrow and told the secretary I'm new to PA and need a new primary care physician and someone to refill my medications to which she replied "sure no problem". I'm going to need my other prescriptions (for my Crohns disease) but I know I can't go asking for methadone even though I have the records and one would think a doctor would hold you over on your prescribed medicine until you get to pain management but it doesn't work that way with pain pills, not these days at least. My question is what do you think I should say to the doctor tomorrow and if I should just say I'm on vicodin for pain so that I can at least get something since they're scared of class II drugs and all. Doctors have said to me "I just don't prescribe methadone" so I don't dare mess with that even tho that's what my records say I'm on. So I was thinking I'd dress decently and look clean and responsible,etc and go in saying I need refills on my meds and hand them my meds list and put one long acting like duragesic and one short acting like vicodin or Percocet and if he says I don't write for pain meds I can say "ok well what about vicodin only then? I just can't be expected to go cold turkey" yada yada...
Oh my Lord I'm sorry for the long question but I'm so sick to my stomach with nerves from this and so desperate that I don't know what to do and say at this appt tomorrow. Please, for the love of God, any advice as to what to say to "my new primary care physician"?