Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

[kayaker318]

I'm sitting here with yet another migraine thinking about my appointment with my Pain Management doctor on Thursday. I want to get off the Demerol (pethidine/meperidine) because it is not an ideal pain med (and yes I gained 25 pounds), but I'm torn between either going on oxycodone or codeine.

In the past, I have used Percocets (oxy/tylenol) but I definitely do NOT want any acetaminophen products now due to toxicity. In the back of my mind I hold out hope that my chronic migraines will dissipate one day so that I can get these opiates out of my life once and for all. But unfortunately as much as I want to rid myself of them I simply cannot function like a normal human being without them. (I went off the Percs 2 years ago but after 6 months I started on the Demerol.) Please don't make me get into the NUMEROUS number of meds/treatments, eastern/western medicine etc. that I have tried so as NOT to have to use narcotics.

On that note....I'm thinking of asking my doctor for oxycodone WITHOUT tylenol. I just don't hear about people taking oxyIR's all that often. I cannot tolerate oxycontin delayed release because that makes me a zombie at even the lowest dosage and does nothing for my pain. I can only take immediate release. I have an impeccable narcotic pain management history. The only reason I was thinking of codeine (without tylenol) was because I thought it would eventually be easier to withdraw from than oxy. But I do NOT think it will help my pain.

Please help with any advice. I am at my wits end and my head hurts. Thank you everyone.

 

[BigG]

I was on pethedine tablets years ago as a bt med with MST as my main long acting. I disnt think it was prescribed any more nowerdays. Its metabolites are very toxic and I remember having a few bad experiences with it. Im not sure exactly what your asking though? Can you ask for IR oxycodone? ....yes of course you can ask.....will you get it? ...well thats impossible for anyone else to nswer. It alk depends on the prescribing doctor really. I would say though that your choice between IR oxy and codeine phosphate as an either or situation is a bit strange as the oxy is a lot stronger than the codeine so its difficult to compare the two directly in terms of efficacy. Yes codeine is easy to withdraw from but if you dont think its strong enough to control your pain then whats the point. You either use a med that satisfactorily treats your symptoms or you dont. .....best of luck.

 

[Heizenberg]

I am seeking advice for chronic back pain.
I have suffered for several years and have spent tons of time and money on doctor visits, chiropractic and physical therapy.
My current doctor has prescribed many different drugs (many of them prescribed for nerve pain or muscle spasm) and none of them have helped.
He recently prescribed Tramadol and that is the first drug that actually helped to relieve the pain.
I have had friends give me a vicodin or hydrocodone occasionally and I have to say that it seems to work the best.
I asked my doctor if Vicodin would be a helpful drug for me and he said he did not want to prescribe it because it is too addicting.
Does anyone have any experience with this type of pain management and/or advice as to what helps you?
Any help would be greatly appreciated.

 

[kayaker318]

@englandgz74 Thanks for the info. Sorry if my post was confusing. Probably because I was confused too. I'm having a hard time concentrating w/my headache pain. It's been a long time since I initially tried to treat my migraines with codeine which was insufficient in dealing w/the pain. Hence my change to Percocet at the time. All in all it is pointless to be on a narcotic if it isn't helping my pain so I am going to ask my doctor for oxycodone IR. If and when (hopefully) I can go off the drug I will deal with the withdrawal then. I appreciate the input.

@heizenberg I don't know much about Tramadol. You may want to go to a Pain Management clinic in your area. Not sure if that's where you're going now, but in my experience, they are best at dealing with chronic pain and the appropriate meds ie Vicodin, etc. Many primary care, speciality doctors, etc. are not trained to treat chronic pain patients sufficiently.

 

[regal]

I have chronic neurosis in the worst of places (testes) from a 12 hr torsion years ago. I've been on 5x10mg/325 hydro (Norco) for 13 years. Same dosage , same doctor for the last 10, never ran out or doctor shopped, no record of drug addiction (though when I come across something I take it. But as I get older the Norco just isn't cutting it. Tired of suffering. Can't have sex. My doctor just doesn't seem to want to prescribe schII, is this some DEA regulation or some law specific to Pennsylvania or should I keep trying. I know from exp. that a 30mg MSCotin makes me feel like I used to before the accident, but I can't tell him that. Got another appointment next week. Any advice appreciated.

thx.

 

[balcony]

I am on 20mg of methadone every 12 hours and 5 2mg tablets of klonopin daily. I am a pain management patient, I take the methadone for pain reasons, not as replacement therapy. Anyway, lately I have been getting *brain zaps*, the kind you get when coming off an SSRI like Effexor or such. Have any of you had this happen to you? The reason I chose to post this question in this thread is because A. I am on Pain Management B Have been for almost 3 years and C there is a higher chance that someone on similar medications long term might experience this. Also is this common? I am not on any other medications except for low dose multivitamins and Iron tablets as my recent blood work showed a very low iron count. Only reason I had it done was because I have had those little cuts on the sides of your mouth for over 2 months now...quite annoying. If this question does not belong in here, I am very sorry.

 

[BigG]

Y

@englandgz74 Thanks for the info. Sorry if my post was confusing. Probably because I was confused too. I'm having a hard time concentrating w/my headache pain. It's been a long time since I initially tried to treat my migraines with codeine which was insufficient in dealing w/the pain. Hence my change to Percocet at the time. All in all it is pointless to be on a narcotic if it isn't helping my pain so I am going to ask my doctor for oxycodone IR. If and when (hopefully) I can go off the drug I will deal with the withdrawal then. I appreciate the input.

No problem mate. It sounds like you have a treatment plan in mind and I think you are correct in wanting to get the migranes under control before worrying about what will happen when yoi stop taking the meds. I really hope you find something that will improve your quality of life.

 

[Doomed2pain]

My winter pain flare has kicked in big time today, I'm having to see a dr privately at a cost of £250 per consultation, but earliest appointment is on the 30th. Been convulsing all day screaming in pain way past 10 on the scale. If this goes on much longer I think I will end up getting sectioned for 6 months. I'm fucking sick of my drs taking the piss and not giving me the meds I need due to cost, it is barbaric. I've truly had enough to the point where I don't think I will see my next birthday. Hope everyone else is coping ok with their pain

 

[gingerbaker]

For chronic pain (chronic in the sense that it's constant for over 2 weeks), I've found Kratom to be a godsend. Not only does it relieve the pain, but I feel like it is much more mild than normal Rx analgesics which is good for tolerance and dependence issues. I first tried Ibuprofen, Acetaminophen, Naproxen, Meloxicam, and Diclofenac without any relief.

Also, certain strains of kava can be a very good analgesic for those suffering from musculoskeletal pain and even neuropathic pain and Fibromyalgia.

 

[bennyZA]

Rant:

I can't believe my pain doc, the only pain doc I can see, he finally acknowledges that my knee is hyper extending again and the recent shoulder has damaged a nerve... which my doc told him. What does he give me, Tylenol 3... I swear to god I can't live like this anymore. I can't believe I actually told him when I first started that we should just keep in mind that I have enjoyed opiates recreationally in the past. I thought I was being responsible, instead I ruined any chance for ever being pain free. I always advocate for honesty with your doc, but you've been warned.

/Rant

 

[tricomb]

yeah, it's sad that being honest with your doctor about some things can mean huge differences in how they decide to manage your pain. The whole pain management field is a fucked up one these days. My doctors are trying to get me off narcotics, they even suggested I begin tapering right now, I'm like wtf like the holidays already aren't fucking difficult enough?!?! Fucking bullshit that I have to even CONSIDER heroin now or other illicit means of treating my pain because of how incompetent the doctors are these days.

 

[BigG]

All I can now be prescribed is either methadone pills or fentanyl patches because i voluntarily told my doctor that i used to take more morphine and oxy than i was prescribed 12 years ago and it went on my records. I understand where theyre coming from sort of but i sometimes wish i had said nothing since fentanyl patches dont work for me and m methadone is to sedating at the doses i take due to my tollerance being rather high.

 

[Doomed2pain]

I'm conducting an experiment and need everyone's help. I need to guys to inbox me age, sex, condition, then a list of all medication combos they are or have been on and I want them to briefly describe how they found each combo, best worst side effects etc. also I want them to add if their chronic pain condition created any mental health condition even something as trivial as some minor depression. I want cpp's that have suffered for at least 1 year. Also tell me about any treatments and surgeries they received and the end result, did it help, cause problems and why. I also want to know if they followed a tailored physical rehabilitation treatment and again the plus and minuses and what their exercises consisted of.

If you pm me and want to do it by iMessage FaceTime phone calls and texts (uk only but I have unlimited texts and minutes) or Skype just let me know and we can arrange a date time. I'm doing this off my own back but I'm presenting the findings to a pm dr (private costs a bomb but he is good) and also to uni for my medical science degree, it's completely anon each person with receive a number. Again, this is only for CHRONIC pain of over 1 year, not acute pain.

The more I know the more I can put into my research for when I can get my crps charity up and running

Thanks everyone and I hope that the winter isn't hurting people too much

Peace love and hope

d2p

 

[Doomed2pain]

Regarding above, after tonight I won't be able to access bl so send your stories to my inbox and I will reply whenever I manage to get somewhere that has internet. Thanks

 

[Morphling]

Has anyone had the experience where their doctor told them he didn't think more opioids would help with their pain? Doc has been telling me this, even when I'm not asking for an increase. I suppose it's possible, but seems rather illogical to me. I'm on a bit of dilaudid, 40mgs daily, but I'm nowhere close to being topped-out dosewise at that level.

 

[Doomed2pain]

Yeah I have had plenty of drs say that to me

 

[BigG]

I think there is a point in a person's pain management treatment where further increasing opiate doseage is unlikely to help but that really epends on the patient, the type of pain, their individual tollerance, the choice of opitate and several other highly individualised factors. The thing that I personally find frustrating is that there appears to be no hard and fast rule between doctors and while some will prescribe a large amount of oxy for a toothache others wont give anything stronger that tramadol or co-codamol for serious debilitating bac lk pain........its very much just pot luck.

 

[Doomed2pain]

You hit the nail bang on the head there

 

[Rybee]

Has anyone had the experience where their doctor told them he didn't think more opioids would help with their pain? Doc has been telling me this, even when I'm not asking for an increase. I suppose it's possible, but seems rather illogical to me. I'm on a bit of dilaudid, 40mgs daily, but I'm nowhere close to being topped-out dosewise at that level.

Yeah. I was taking a fairly high dose Dihydrocodeine for a slipped disc and it wasn't touching the pain. I asked to be put back on Oramorph (used it the year before with fairly good results) and he said that in his opinion, if the Dihydrocodeine wasn't helping, then the Oramorph wouldn't help either. So he prescribed me some bloody baclofen. Never too the prescription to a pharmacy, waste of time and money.

Now finally seeing a different doctor who's put me on Fentanyl 50mcg patches with Tramadol to help with breakthrough pain. It's taken a few days to kick in but there's a massive difference.

That said, I also suffer from chronic daily migraines and was taking 4x250mg Naproxen and some Codeine for the pain and it wasn't helping much. His suggestion was to stop the Codeine and lower the Naproxen to 2x250mg 'because sometimes it works better if you take less painkillers'.

Safe to say the guy's an idiot and I no longer see him.

---

I think there is a point in a person's pain management treatment where further increasing opiate doseage is unlikely to help but that really epends on the patient, the type of pain, their individual tollerance, the choice of opitate and several other highly individualised factors. The thing that I personally find frustrating is that there appears to be no hard and fast rule between doctors and while some will prescribe a large amount of oxy for a toothache others wont give anything stronger that tramadol or co-codamol for serious debilitating bac lk pain........its very much just pot luck.

Yeah I've grown to understand that... I've sussed out what doctors in my GP surgery will understand that I'm in genuine pain and are willing to help manage the pain and the ones that think that 2x Codeine's 3x per day is sufficient for a slipped spinal disc when it's so debilitating I'm left in a wheelchair.

---

Also, whilst I'm in this thread. As aforementioned I've got a slipped spinal disc and it does cause me a lot of pain.

I was originally taking Oramorph for it with fairly good results but my GP has taken me off of it and put me on to Fentanyl patches at an equipotent dose. He just really doesn't like prescribing Oramorph and said he feels much more comfortable prescribing me patches.

As for the patches, I'm not really getting on well with them. They seem to take ages to kick in, they're unpredictable with how long they'll last, they don't seem to stick despite all of the tips and tricks I've read online, and it means I can no longer go swimming. I can't do much in the gym without putting pressure/pain on my lower spine, running, cycling, rowing all aggravate it so swimming is a blessing to get some exercise and take the weight off of my spine. But obviously I can't go swimming with the patches on as they'll just come off.

Are there any alternatives to Oramorph that are not Fentanyl patches?

 

[Doomed2pain]

Ask for 10x12cm waterproof me pore patches to stick on over the top, works like a charm for me. Are you under a pain management dr? Then I can give you some suggestions the more I know

Also always put the patches above heart level for maximum pain relief