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switching meds for pain management

A

Aporia

Bluelighter
Joined
Aug 8, 2011
Messages
164
Hi all! I had a question that maybe a few of you might have some advice on. Currently I am prescribed 4-6 norcos a day for chronic pain in my left wrist due to carpal tunnel syndrom AND a ganglion cyst that sits on top of the carpal tunnel nerve. I use my wrist/hand extensively while working and the pain gets so bad that I can't grip or carry anything. To the point: The norco's were managing my pain alright, expect for the flair ups I'd get about once a month, a week or so long. I told my doctor this and also said that I wasn't asking for anything else, just wanted to let him know so it's on the record. He said that it's not okay and that he wanted to change my meds to something that would control the pain better. He talked about switching me to morphine or methadone next month at my monthly visit. Here's my concern. I'm fairly young, 29, and will be moving in a few months. I also may not serve for the rest of my life so I"m really concerned about something that is longer acting. I like the short acting meds because I can control what I take and if the pain isn't bad one day I can take less. With the longer acting meds I am afraid that when I'm ready to come off the meds (for whatever reason) the physical dependence, and thus withdraw will be loads worse. I told him I'd research some medicines and come back to the appointment ready to discuss our options. My question is basically, what are some of my options to talk about..and what are the pros and cons of both. If this is not a topic that can be discussed I understand but I would love to be knowledgeable when I go back. Thank you all for you help!

*Aporia*
 
Anything Insant release isn't going to be too much longer acting than the norcos. You definitely don't want methadone or oxycontins. Morphine seems like a good choice or maybe roxicondone. I would go for the roxis. They'll be more similar in effects to your norcos then morphine would be and still more potent. Plus none of that Tylenol getting to your liver is a huge benefit to getting off the norcos
 
If your taking opiates of any kind everyday, it doesn't matter if they are instant or time released, your gonna get withdrawal. I would agree that Roxi (30 mg oxycodone) would be a good option, or something like MS-Contin or Oxycontin, then use norco for breakthrough pain like you say you have once a month.

Its up to you how far you want to get into this, you gotta take what works for you in your daily life. Its important to be able to take care of some of your pain if it is hindering your work performance.
 
Flabu said:
If your taking opiates of any kind everyday, it doesn't matter if they are instant or time released, your gonna get withdrawal. I would agree that Roxi (30 mg oxycodone) would be a good option, or something like MS-Contin or Oxycontin, then use norco for breakthrough pain like you say you have once a month.

Its up to you how far you want to get into this, you gotta take what works for you in your daily life. Its important to be able to take care of some of your pain if it is hindering your work performance.
Click to expand...

The reason he didn't want extended release wasn't cause of WD. It was because some days he doesn't need as much medication throughout the day but an ER med automatically means he's taking the whole dose
 
whatever you do, do NOT, I repeat, do NOT touch methadone, ever. It is way, way harder to kick than even heroin, and going from norco to methadone would be like going from caffeine to meth.

Morphine is wonderful for pain management, so is oxycodone. Really just comes down to what doc is willing to do and what your unique preference/body chemistry is.

If you need all day coverage get something ER and a smaller bottle of something IR as needed for "break-through" or when the pain flairs up
 
You could always try going on a low dose of a long-acting opiate. They make some very low doses of those E.R. meds. I know, because I have severe chronic migraines and for YEARS my neurologist undermedicated me. A low dose of an E.R. opiate didn't even touch my pain. Perhaps it will help your pain.

By the way, I use to taper off of these meds at least twice a year, because my neuro was paranoid of the DEA and didn't want me on "opiates all the time". I learned how to taper, with NO help from my neuro.

I didn't get sufficient pain relief until I FINALLY got myself in to see a pain management doctor. Now, for the first time in YEARS, my severe chronic pain is finally being managed to a point where I can function. Good luck to you.

Eva
 
You are being very smart. Do not go on an ER med...it will do exactly as you describe....raise your tolerance and possibly cause physical dependence. I would agree that roxycodone would be a good choice...plus, it has no Tylenol so you have that freedom as well.
 
Hi Aporia,
Please don' t ever get mixed up with long acting pain meds. I let my doc talk me into going on Oxymorphone ER, and after 2 years I' m still struggling to get off of it. Your suspicions are correct- the withdrawals from time released narcotics are probably worse than heroin. I have detoxed from roxicodone in the past, and of course it sucked, but it was much briefer in duration and much more bearable than these nightmare time released meds. I second the motion to go with Roxicodone. It will be much easier to walk away from in the future.
 
Well Aporia,
whatever you do, don't touch the fuckin methadone, as Red Rum very wise said..also i read your blog, (really very emotional, sentimental, it touched my opiate fuckin heart..), and you've tried the methadone..maybe the worst opiate. Your thoughts and concerns about ER meds, are very clever, as someone above^^ have allready told. Anyway, i don't think that i'm in a position to tell you which med to choose, but i really wish you good luck whatever you decide, take as lilttle as you can, be safe and happy, and of course, be happy with your lovely (i suppose) daughter...I'm also a father of two wonderful kids, and i think nothing in life is better than kids..even when they grow up, and come closer and closer to the teens age, the most difficult age i think..but fuck, even then, the children are the most important gift of God to the people..well, i think i'm fuckin rampling, sorry, and always be fine..%)


MartinFn
 
Thank you for all the replies. I have been looking into some material that I can print out and take to my doctor when we discuss our options. It seems like roxicodone would be the best route so far. I understand that ALL narcotics will cause w/d's in physical dependent persons, I just thought that a shorter acting opioid would be easier to taper and easier to kick once I finally stepped out of my current work force.
 
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