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Opioids Opiate to fulfill the need of a student

GABAking

GABAking

Bluelighter
Joined
Feb 6, 2012
Messages
255
Location
Midwest
I have real bad tailbone issues (2 surgeries due to cysts, lots of scar tissue) plus I have an extra 4 bones in my coccyx that is extremely irritating. The pain is exponentially worse when I sit for prolonged periods of times. Removing the tailbone isn't a possibility at the moment due to the amount of time it takes to recover. I can't do that unless I take time off school. I'm in an accelerated BS/MD program that goes year round; I don't get frequent breaks. Here in lies the problem...

I'm always sitting on my ass studying. No way around it. 20+ hours a day of studying for an upcoming exam is the norm. I spoke to my pain management doctor about wanting relief without being overly sedated, a common side effect of almost all opiates I've tried. He prescribed me Nucynta, which worked fine until it started fucking with my vision (double vision while reading, really bad eye straining, etc)... I've been on Norcos (10/325), all doses of oxy/APAP, so I do have a tolerance. To take an effective dose to relieve my pain, I got too apathetic/tired to study.

I have an appointment on Tuesday and am wondering what drugs could possibly give me relief. Tramadol makes me vomit every time I take it, so that's outta the question.

I don't take pharmacology till the fall semester so I wish I could answer the question myself...any help/personal experience would be appreciated. I've heard/read that low doses of Opana (when taken orally) isn't sedating but am finding somewhat conflicting reports online...

As an aside, I'm planning on getting the tailbone removed in December (my last break before beginning rotations) so I'm not gonna be doped out for my clinical rotations or anything like that. I understand my duty to be alert and coherent for my patients is of the utmost importance, but I'm currently still in the phase of just lectures/minimal patient contact. I just need something to get me through till then
 
Have you tried methadone? I've been on that for years as a CP patient and I don't get tired at all. And it has the extra benefit of lasting at least twice as long as most other IR drugs available.
 
^^I have been. It's just that he keeps on telling me to take the Nucynta and "let my body adjust" It's been over a month and it's clearly not settling with me like I had hoped. I went through a couple weeks of it working fine but things turned sour. I'm pretty sure he's getting some type of compensation from the drug companies which is why he's shoving it down my throat.

I haven't tried Methadone...I'll ask him about it.
 
Another option is buprenorphine as in Temegesic, Subutex, and Suboxone. I have heard reports of it having quite a stimulating effect. I don't know your tolerance, but this could be an option at the right dose. It is an agonist/partial-antagonist and has unique opioid effect. Morphine is generally regarded as being quite sedating, but it is a good analgesic with a nice long half-life. I might look into NSAID's as well as opioids, and maybe gabapentin or pregabalin, too.
 
I can't take NSAIDs due to some GI issues, but I was wondering about DHC? Codeine is a complete joke in my experience, but have any of you guys had good results with DHC?
 
I've taken all the non-opioid medications offered by my physicians. APAP, NSAIDs, Lidoderm, Pregabalin, Gabapentin, Tramadol, anti-depressants. No luck. If there are other options I'm open to it. I'm not looking to get stoned. I'm looking for relief and unfortunately, only opioids have given me that thus far
 
Buprenorphine as was mentioned can be quite stimulating. A mix of tramadol and oxycodone might work.

Codeine, DHC, and hydrocodone will all likely be too sedating.
 
Yeah, if you have tried all of the non-opioids you listed, and opioids are the only drugs to provide sufficient relief, I strongly suggest buprenorphine. It is quite long-lasting, stimulating, and has good analgesic properties. I have a feeling the right dose of bupe might work well for your pain under your circumstances. I also mentioned morphine in my post above. That might be worth giving a go-around. Those are the two I would look into especially. If you need to, you can always take an amphetamine or methylphenidate-based drug as needed. That would also help significantly with the pain, and help with concentration and attention.
 
Sorry to hear you're in such a painful situation! In addition to whatever you do pharmacologically, have you tried alternative seating? I'm thinking of one of those odd-looking "kneeling chairs," which are not expensive and are available from multiple sources. I also sometimes do desk-work standing up, when I'm stuck with repetitive tasks, by putting boxes under my keyboard and mouse pad to raise them. I know your options are limited when you're in class, but it sounds like taking the pressure off your coccyx for even a few more hours a day might help.

In any case, I hope your situation improves, and I wish you the best.
 
GABAking said:
...I'm pretty sure he's getting some type of compensation from the drug companies which is why he's shoving it down my throat...
Click to expand...

Doctors don't receive compensation from drug companies. That's a common myth that has no basis. Especially not for a controlled substance, not since the FDA cracked down on Purdue Pharma for the Oxycontin fiasco several years ago.
 
Missykins said:
Doctors don't receive compensation from drug companies. That's a common myth that has no basis. Especially not for a controlled substance, not since the FDA cracked down on Purdue Pharma for the Oxycontin fiasco several years ago.
Click to expand...

You're the first person to tell me that, although what you say about scheduled substances makes sense. The doctor that I shadow every week in clinic tells me that he's always having people knock on his door from pharm companies. He kinda implied that physicians get some sort of compensation, whether monetary or other
 
I got Butrans from my doctor. So far, it's great! Thanks for the suggestions on the buprenorphine, my doc said that was gonna be his suggestion regardless of me even bringing it up haha. Looks like bluelighters know their shit...
 
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