neuropathic pain, pain caused in ya body from an imbalance in ya brain any treatment?

[Anon54]

so i was inquiring about Lyrica (Pregabalin) with a pharmacist for treatment of anxiety. it seems it works as strong as benzos without the addiction. Have a read here:
http://en.wikipedia.org/wiki/Lyrica
he said it's only for neuropathic pain (not sure of the spelling) & wont be prescribed for anxiety.

neuropathic pain is where ya brain shoots pain signals to parts of ya body even though there isnt anything wrong with them.

im just curious how they diagnose this & what treatments ppl have received. any opiates.

I get aches & pains sometimes & anxiety. Lyrica sounds like it could be a good med

http://en.wikipedia.org/wiki/Neuropathic_pain#Opioids
it says the best treatment on wikipedia is methadone.
it's just got me thinking. maybe all the ppl addicted to opiates may actually have this disorder.

ive known quite a few ppl to try opiates but not many imo get addicted. & i believe the ones who do get addicted get aches & pains even though it seems there is nothing wrong with them.

anyone out there been diagnosed with this & what meds have they been given to help out?

 

[Cane2theLeft]

Neuropathic pain isn't a singular disorder but a type of pain and symptom of other conditions and it's not caused by your brain shooting pain to other parts of your body. Certain conditions in your brain can cause neuropathic pain but there are lots of different causes from diabetes, to shingles, to damage to peripheral nerves such as a herniated discs to lots of other causes.

Everyone gets aches and pains sometimes but lyrica is prescribed for serious chronic pain, seizures and off-label (in the US) for anxiety. Your doctor might be willing to try it for anxiety but it DOES have abuse potential, although not as serious as benzodiazepines.

Methadone has some increased efficacy for neuropathic pain due to NMDA antagonism but any medications that treat pain are used to treat neuropathic pain including anticonvulsants like lyrica, tricyclic antidepressants, SNRI's, of course opioids and many other types of drugs.

To think that every person who becomes an opioid addict just has neuropathic pain is silly. Addictions develop for lots of reasons - some people DO self-medicate untreated or undiagnosed conditions but generalizing as you did is far off-base.

People who are more sensitive to physical or emotional pain are of course going to be more prone to opioid abuse and subsequent addiction because those drugs numb their pain (whatever its etiology) but that doesn't mean all opioid addicts have some underlying pain disorder.

I have neuropathic pain (RSD) and lyrica and opioids are very effective at treating it but in an effort to not have to use increasing doses of undesirable drugs my whole life, have found alternative ways to manage the pain and deal with it. I still use opioids occasionally but not all the time.

 

[BabyGurl3171]

I have diabetic neuropathy. The upper right side of my stomach stays numb (like pins & needles), it feels like it's burnin from the inside & I get random "shots" of pain in that area. Only thing my dr is tryin so far is gabapentin. It's not workin but I haven't seen him for my follow up yet..

 

[Swimmingdancer]

Methadone has some increased efficacy for neuropathic pain

Lol, I think methadone can cause neuropathic pain once you stop taking it. Most opioids can make you more sensitive to pain, so if you're going to take them long-term for chronic pain you have to ready to commit to taking them forever.

Is it just me, or doe the OP sound like a covert way of asking "How can I get my doctor to diagnose me with neuropathic pain (which I don't actually have) so that I can get some sweet meds legally? What symptoms should I claim to have and what kinds of meds could I get if I do this?" (No offense to the OP if I'm wrong and you legitimately think you have neuropathic pain)

 

[Swimmingdancer]

ive known quite a few ppl to try opiates but not many imo get addicted.

What? Most people IME eventually get addicted (if they try them multiple times).

& i believe the ones who do get addicted get aches & pains even though it seems there is nothing wrong with them.

That can be caused by depression, or can happen once someone has already become physically dependent on opioids.

 

[Cane2theLeft]

Statistically, only 1 in 4 who try heroin recreationally become heroin addicts and if you look at nearly everyone in society trying opioids at some point for medical procedures, only a tiny percent ever become addicts (single digits). Of those who try alcohol and cocaine, about 1 in 6 become addicts.

Most addicts tend to hang around a circle of people with similar views and experiences so if everyone you're around gets addicted, it will seem like a much higher amount of people do. I question the 1 in 4 number with heroin simply because I don't know many people who every try heroin who don't already have some history of drug abuse. People who aren't at least on the path to addiction rarely even try heroin... I bet the 1 in 4 figure would be accurate for those who try opioids recreationally though. Statistically, heroin is the most addictive substance with the 24% addiction rate but that is still a rather low percentage of those who try it.

Lol, I think methadone can cause neuropathic pain once you stop taking it. Most opioids can make you more sensitive to pain, so if you're going to take them long-term for chronic pain you have to ready to commit to taking them forever.

I took opioids daily for legitimate chronic pain (that I still deal with) for 4.5 years and do not have to take them all the time anymore. I was completely off them for 6 months and used them sparingly and never regularly for the 2 years following that. I think you're exaggerating the inevitability of Opioid-Induced Hyperalgesia to a degree. When opioids are used carefully and therapeutically at the lowest possible doses and not increased often, the risk of hyperalgesia is very low. It's much higher in populations using large doses recreationally.

 

[Swimmingdancer]

Statistically, only 1 in 4 who try heroin recreationally become heroin addicts and if you look at nearly everyone in society trying opioids at some point for medical procedures, only a tiny percent ever become addicts (single digits). Of those who try alcohol and cocaine, about 1 in 6 become addicts.

Most addicts tend to hang around a circle of people with similar views and experiences so if everyone you're around gets addicted, it will seem like a much higher amount of people do. I question the 1 in 4 number with heroin simply because I don't know many people who every try heroin who don't already have some history of drug abuse. People who aren't at least on the path to addiction rarely even try heroin... I bet the 1 in 4 figure would be accurate for those who try opioids recreationally though. Statistically, heroin is the most addictive substance with the 24% addiction rate but that is still a rather low percentage of those who try it.

Honestly I'm not sure if I have a lot of faith in the statistics because self-reporting is notoriously unreliable for drug use. And I'm not sure how they define an "addict", is that only counting people who became physically dependent and use for a long period of time, or seek treatment, or what? But to clarify I was referring mainly to people who use strong opioids recreationally (not as prescribed for pain etc) multiple times within a relatively short time frame. The statement that "not many get addicted" may have led me to exaggerate a little in my tone, as I often get the feeling people around here who are new to opiates don't take the prospect of addiction seriously. And when Anon said "try" I assumed he/she meant recreationally/illicitly. I think there is a substantial number of people who get mentally addicted but don't become physically dependent, at least not right away, so they wouldn't consider themselves addicted.
Btw, I'm also not just going solely by what my friends or former friends think/experience, although they are actually extremely diverse, but have also done a lot of reading about it and talked to people I didn't know, etc. But regardless of the true statistics I don't think it's worth the risk.

I took opioids daily for legitimate chronic pain (that I still deal with) for 4.5 years and do not have to take them all the time anymore. I was completely off them for 6 months and used them sparingly and never regularly for the 2 years following that. I think you're exaggerating the inevitability of Opioid-Induced Hyperalgesia to a degree. When opioids are used carefully and therapeutically at the lowest possible doses and not increased often, the risk of hyperalgesia is very low. It's much higher in populations using large doses recreationally.

I'm really not sure about the prevalence, I'm sure it doesn't happen to everyone and depends on the person and the specific opioid and the way it is used etc, I just said it can happen. And of course when you are dependent on an opioid and go into WDs that definitely makes you more sensitive to pain and/or feel pain with no physical cause for a while.

 

[uponbenzos]

I couldnt get addicted to heroin if I tried. its so expensive & ya have to spend alot of effort getting it.
its like benzos. they're very addictive but hard to get addicted to because usually a dr wont give u a high enough supply to get u to deep under its spell.
it's really not who u are but who u know which makes ya susceptible to addiction.
im sorta addicted to codeine cuz its easily obtainable & cheap. & I can get benzos easy too but they cost & even though I take more than 100mg of diazepam or its equivalent dose to other benzos when I take them. Ive hardly ever noticed any w/d.
all in all caffeine is the most addictive drug cuz u can by huge jars of it for cheap at a super market. smoking is also hard to quit because its otc. if tobacco was illegal I dont think many ppl would bother going out there way to get it.
pots easy to obtain too.
but yeah if all drugs were legal. heroin & benzos would be the hardest habits to break. id much rather a cup of poppy pod tea over a cup of coffee.
btw i once read I think that valium & dihydrocodeine were available otc without a script in eastern china. might have to go for a holiday there. straight dhc would be pretty powerful. Ive drank a large bottle of Rikodeine before & its one of the more sedating opiates. pitty the syrup also contains sorbitol.
Id be more than content with a dhc & valium combo I could take whenever I felt like walking to the pharmacy.
what amazes me if they still have syrups with only dxm in it. they may as well legalize PCP.
& I dont understand why they just dont ban pseudoephedrine. they have other decongestants as alternatives. Isnt most meth made with that stuff?
I aklso dont understand how theres so many ppl who grow pot but its pretty rare to ever see poppy plants. I've been told they're actually easier to grow. wonder why ppl arnt selling poppy pods in little bags.

I also read a study one time that they got ppl off heroin easier by prescribing it to them rather than methadone.
I also think they should have programs for meth addicts where they can get scripted dexamphetamine or something like that. would reduce crime. I mean they give the stuff to kids ffs
one more thing. I think all drs should be able to prescribe subutex/suboxone without having to go onto a waiting list for a year.

 

[Cane2theLeft]

Swimming, it's good to question those numbers. They define addict how they do clinically using the diagnostic criteria for substance dependence disorder which, in the US, is the standard. Using that diagnostic criteria, physical dependence is often observed but is not necessary for a substance dependence disorder diagnosis and physical dependence alone doesn't make someone an addict based on their criteria. To sum it up, they define addict as someone who uses in increasing amounts over time; gives up their normal activities for their use and spends an excess amount of time acquiring, preparing and using; whose use affects aspects of their life such as work, school, friends and family and who continues using despite consequences such as health or legal problems, etc.

There are 7 criteria for SDD and only 3 are required to make the diagnosis so not ALL of the above have to apply but more importantly, their use has to produce clinically significant distress. Someone can use substances with regularity but if it's not adversely impacting their lives, then they might not meet the criteria (such as someone who has a couple drinks after works and is healthy and productive). Here is the diagnostic criteria for both.

There is also the diagnosis of "substance abuse" that only requires 1 of 4 criteria. Essentially a diagnosis of substance abuse shows that someone has a problem with drugs but it isn't serious enough that based on their use up until that point, they won't be labeled an addict forever whereas a diagnosis of substance dependence disorder is considered life-long... not that they will inevitably use their whole life, but if they get clean the diagnosis is akin to a diagnosis of a disease that later goes into remission.

The reason I reference numbers such as those sometimes is less to precisely show how many people become addicted but that regardless of the substance, it's not the drugs that make people addicted... essentially that it's not exposure ALONE to the drug that makes people addicts but typically is a complex confluence of factors involving genetics and lots of other aspects. People sometimes want to act like anyone who is exposed to a drug will become addicted and in reality that is not the case and most people wouldn't... it takes various predispositions to create addicts such as mental illness, trauma, genetic factors and not simply exposure alone.

You're spot on though that it's not worth the risk!

 

[Swimmingdancer]

regardless of the substance, it's not the drugs that make people addicted... essentially that it's not exposure ALONE to the drug that makes people addicts but typically is a complex confluence of factors involving genetics and lots of other aspects.

Thanks for the info
I agree that it's not the drug that makes you addicted (although of course some drugs are far more prone to addiction and physical dependence), it's your individual propensity for addiction and other factors, and there is really no way to know beforehand whether you will or won't get addicted. It just makes me sad when so many people use the fact that not everyone instantly gets addicted to rationalize their use of a dangerous substance that has destroyed so many lives. People often seem to think that just because it's possible to not get addicted that that means that it won't happen to them or that they will be able to control it. No one plans on getting addicted.

 

[Cane2theLeft]

I agree but there are thousands of rationalizations that addicts use... don't get hung up on the illogic of individual ones. If someone is going to get addicted, they're going to lie to themselves in SOME form. Unfortunately you can't combat addiction by reason alone.

Regarding what we're specifically talking about - you have some people say "most people don't get addicted so I'll be fine" while another says "the DRUG is so addictive that after I tried it once, it took over and I couldn't help it" (or less hyperbolic wording with essentially the same idea)

 

[Swimmingdancer]

I agree but there are thousands of rationalizations that addicts use... don't get hung up on the illogic of individual ones. If someone is going to get addicted, they're going to lie to themselves in SOME form. Unfortunately you can't combat addiction by reason alone.

Regarding what we're specifically talking about - you have some people say "most people don't get addicted so I'll be fine" while another says "the DRUG is so addictive that after I tried it once, it took over and I couldn't help it" (or less hyperbolic wording with essentially the same idea)

True. I was more thinking of people who haven't yet tried opiates or at least haven't yet become addicted. The belief that since it's possible to not get addicted that they personally will be able to control it seems extremely prevalent on these forums, and it doesn't help that there are people who haven't yet developed a physical dependence and tell others that they managed it through "willpower" and just choosing not to use every day. And I think that viewpoint is far more common than the rationalization of "heroin addicts everyone and I've tried it once so now I have to keep doing it and have absolutely no control".