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

[CfZrx]

Oxy is strong oral and snorted I hear, and morphine is good for IV and butt

 

[Runtoparadise]

The "contin", is for continuous. ER as opposed to IR formulations.

Rtp

 

[namnoc16]

Oxycodone and oxycontin are the exact same drug just one is time release(as hillbillys call it,oxycotton) and the oxycodone is instant release. Percocet is oxycodone mixed with Tylenol. I'm not sure with morphine and the ms contin.

And cfrnx I personally never liked IV morphine I thought the codone was much better(totally different rush) but I put those days behind me and am now somewhat responsible,lol. Also morphine is what they usually give you IV in the hospital for severe pain(sadly they dilute it so no rush) I don't think legally you get IV oxy but I'm not certain.

 

[Nether Animal]

I have a degenerating disc in the thoracic region of my spine, the pain isn't unbearable but it is in a tricky spot that makes it difficult to get comfortable; it even hurts to take a deep breath. I have been forced to go to the ER 5 times in the last month because my insurance is really basic and no doctors in the area actually take it. I'm only covered for ER/Urgent care visits.

They give me a handful of norcos and send me home, and I bless them for even doing that because of some of the horror stories I've ready about legit chronic pain patients being treated like drug addicts. This hasn't happened to me yet but I see a long and difficult road in my future concerning this. I'm doing what I can to keep myself active, I am regular at the gym and am self-medicating with weed and flexeril that I was prescribed. Cheers guys.

 

[AnnaBanana333]

What's the difference ( as basically as you can get ) between oxycodone/oxycontin, and morphine/MS Contin? I only once had the ER oxy and a couple times MS Contin.

For me, morphine ER worked super well at managing the pain, but was SUPER constpating. It is pretty mello; I didn't feel weird from it. Oxycodone can make people feel 'up', gives me a little boost of energy. The ER version (OxyContin) was changed a while Bo, and I had trouble digesting it and felt NO pain relief, which is why I stick with the IR. plus, no Tylenol.

 

[rokkinrollaa6]

I'm sure it's not just me, but I actually had more relif on Percocet then straight oxycodone. This was at reasonable, lower doses. I'm still (based on much research) Leila take 10/325's to reduce the apap:

It's not just you at all; through years and years of use and abuse when I take these drugs for pain I often dose with not just the acetomiophen but usually a combination NSAID like Diclenoflac, Keterolac, naproxen, or if all else fails, ibuprofren. this always, always, always increases analgesia. when i have used oxy in large amounts, say 80-120 or high mg, i got high, but i was still in pain until i took an NSAID and usually an antihistamine like diphenhdyramine. i can take something like 40-50mg but with nsaid, get great relief, but if i take 3-4 times that to get high, i will often still feel pain.

wish something else worked honestly, nsaids are horrible for liver and kidneys and stomach, opiates are hard to procure, but anything else i have tried doesn't help whatsoever. marajuana makes me feel less in control than opiates as my body is used to the meds, not to the plants.

currently been taking ultra low dose codiene + nurofen + tramadol combos due to scarce resourses, trying to make it until teusday but im constantly misreable. sucks.

 

[Rachella666]

Guys does anyone know how long it takes to get addicted to dihydrocodeine? I am on 90 mg a day for the last few weeks, plus codeine 10mg due to my fibroblasts. Thanks xxx

 

[shady4091]

Hey man. You'd probably get a much quicker/better response if you posted this in Basic Drug Discussion.

Anyway, it's like you said, everyone is different. Personally, if I want to make sure my stomach contents aren't going to interfere with what I'm taking, I'd wait at least two hours. Any sooner and you're likely to feel less of an effect. Not because less of the drug is making it your brain but because it's getting there much slower. You would probably feel a less intense high for a slightly longer duration. But it also depends on what you've eaten and how much. I believe foods high in carbohydrates cause the longest delay and most diminished effects.

I would just eat half-hour to an hour after taking your dose. As a good benchmark, wait until you just start to feel the effects before you eat.

 

[Speed King]

It has a lot to do with your body chemistry and psychological make up. ( At least for me). Just off the top of my head and prior drug experience, as soon as three weeks. It could be longer. It depends on many factors.

 

[Kittycat5]

I wouldnt worry so much about eating. Food actually increases the extent of absorption of oxycodone in single dose studies. It is true it takes longer to reach its max concentration though. But assuming you are taking IR oxycodone several times a day, and that your diet does not vary extremely much, in a day or two you will reach steady state (absorption=elimination) and small changes in either the rate or extent of absorption will not be noticeable. So eat away.

 

[rokkinrollaa6]

Guys does anyone know how long it takes to get addicted to dihydrocodeine? I am on 90 mg a day for the last few weeks, plus codeine 10mg due to my fibroblasts. Thanks xxx

on such a small amount i doubt you'd be heavily dependant, but it is possible for the body to get habituated even taking several days off. for example for 1.5 years i took opium, codeine, morphine or hydrocodone every few days, never more than 2 days in a row, usually 2-3 in between doses, and still had a light withdrawal when i ceased (mostly just sweats and hot/cold sensations and nausea, dieareea, but not anything severe, after 5 days it was gone).

if your body senses something is regular, it will get used to it. if you've never had a habit and on such a low dose of dihydro i doubt you'd have much to worry about, but you may get light sweats or something if you stopped immediately. there's no real surefire answer for this man, but it does not hurt to try to take off on days you dont feel strong pain sensations.

 

[PriestTheyCalledHim]

Moving to other drugs.

OD mods, please merge this thread with this thread: http://www.bluelight.org/vb/threads...d-Acute-Pain-Discussion)-Version-5-0-V/page38

 

[Speed King]

Would it be a bad idea to call doctors office and say that the Percocet 5/325 (20mg/day) is not satisfactory cutting the pain. I guess I could not muff out and wait till my appointment on 9/23. Is that necessarily a sin?

 

[Runtoparadise]

^Depending on the doctor,- & their understanding & knowledge of pain pills & your condition. You may get an increase or told no, sorry, opiates don't work for your pain. Be prepared to get that kinda talk from your new PM.

Was it her that diagnosed your fibro? Did an oncologist not suggest that your pain might be neuropathic & caused by chemo related nerve damage?

I totally understand how bad it can get when the painkillers aren't cutting it & the need to increase. I've toughed out many a time where I really don't even know how I got through the day.

Given that you've been prescribed opiates for previous pain, the same treating doctor should recognise that you'd have some kind of tolerance issues.

Unfortunately, as I've debated endlessly with my PM, there is a huge difference in treating "end of life" pain to treating ongoing pain.

I argue that I don't have end of life as an option, rather, like the sound of you SK, & many other posters on this thread,- I have a life sentence..

Rtp

 

[rokkinrollaa6]

Would it be a bad idea to call doctors office and say that the Percocet 5/325 (20mg/day) is not satisfactory cutting the pain. I guess I could not muff out and wait till my appointment on 9/23. Is that necessarily a sin?

This may go against breaking rules and if so I apologies to admins. If your pain is LEGIT, the way this should be handled is one of two ways. if you have been taking your medication as prescribed, call the doctor and tell them that you are in pain and you want to see the doctor sooner if possible. don't tell them the meds do not work. they may ask you if your medicine is working or not, and you should be honest. but here is where it gets tricky.

as for dealing with your doctor, you should not volunteer or focus on the fact that your meds work or don't work in case they are hardline. tell them "i feel relief, but it doesn't last and i still feel enough pain to be in real discomfort". if you say it doesn't work at all, an overly cautious doctor may simply say that you should try a "weaker medication" instead of a stronger one. they may even script you a combination of antiinflammatory meds to go with your medication, and for pure and simple pain related problems, this often helps.

if you have tried a higher dose, say 10 miligrams, and it was more effective, tell that to the doctor. in this case, a doctor is more likely to raise your prescription to that. if you want another med than oxycodone and haven't tried tramadol, hydrocodone, codeine, be prepared, they could switch you to one. they may also add a weaker opiate for breakthrough pain.

but if you just say that it isn't working, a doctor will very rarely, these days anyway, just raise your dosage, and may not give you a stronger medication you have no history of taking. doctors are loathe to put you on medicine that is stronger for liability reasons. for example my doctor would not go above percocet 5. the best i got was tramadol and perocet 5 combo.

so be careful in how you handle the situation. when i tried to switch my doc, he took me off of percocet entirely, and i had to go back to my old one to get put back on it.

i would tread cautiously. say that you feel relief but you also still feel enough pain that breaks through. at the same time this may lead to a conservative physican saying merely, "well some pain is normal" which is when i usually say that a higher dosage or more frequent dosing schedule has made it so the pain is more effectively controlled. doctors are more likely to increase the amount of medication than to give you sronger drugs, but i would also look into potentiation and NSAIDS in combo. they help a lot.

 

[Runtoparadise]

I would also add that, (in another thread), SK spoke of getting around 50% pain relief.

In the PM world, 50% is a huge gain, from pharmaceuticals, & would be seen as such by a specialist.

I guess there's lifestyle changes as well as adjunct therapies. None of which I can say I've personally benefitted from (apart from hydro), but I know others who do.

Rtp

 

[AnnaBanana333]

Alternative therapies

I would also add that, (in another thread), SK spoke of getting around 50% pain relief.

In the PM world, 50% is a huge gain, from pharmaceuticals, & would be seen as such by a specialist.

I guess there's lifestyle changes as well as adjunct therapies. None of which I can say I've personally benefitted from (apart from hydro), but I know others who do.

Rtp

I'm generally the person who eats healthfully, willing to try PT, yoga, meditation, acupuncture (have done all), and will say that they did help at times, but when the pain is ripe, there is no 'meditating ' it away. Sure, PT helped (after finding the right one; went to 3 to do that) when it was muscular, but now that the pain is just bones fusing, there isn't much to do.

I agree that 50% is quite a gain, but 50% of horrible pain is still a lot of pain, especially long term.

 

[Speed King]

Runtoparadise, my current pain management doctor and I came to the conclusion that I had serious fibromyalgia. It explained a lot of the pain.
I also have siatica. I'm going to a spine doctor tomorrow.
As far as the oncologist goes, she's going by my record of the last year. She has not said yes or no that nerve damage may have occurred due to chemo, but I do have nerve damage in my feet that has worsened over the past year.
I will point out that I have some tolerance issues from the past.
I understand the big difference between end of life pain and chronic pain.

 

[Speed King]

rokkinrollaa6, I'll call doctor tomorrow and ask to see sooner if possible. I'll be honest about how the meds work. The best part of what you pointed out was the fact that I have relief that doesn't last and I still feel enough pain to be in real discomfort. I don't want to get in trouble for trying a higher dosage, but 10/325 would help, and 20 would be perfect right now for dosage. How could I not get in trouble for that? Going from 5 to 20 is a jump. Raising to 10mg Percocet and 20mg Percocet really helped. It would be nice to get a raise to at least 10/325, but is 20 too much to admit to at this time? So we're clear, I mean like 20/1300 x at least 3 if not four doses. If she went to 20mg, I would settle for 3 x day.
On a different note, I want an ER med.!i think the OxyContin ER is junk. I'd rather have Opana ER, 5mg to start.
I agree that I feel relief, but I still feel enough pain that breaks through. I'll tell her about my NSAIDs use. Naproxen, ibuprofen is my goto pills. They help. Naproxen is best for me for analgesia.
I hope she is willing to go up on dose. 20mg would kick ass, but I'd take 10mg to start. Thanks for the input. I took notes.

 

[Speed King]

Runtoparadise, for a short time it was a solid 50% reduction in pain. But that number changes. Today, I'm at maybe 25%.
I will be getting a gym membership soon. They have a pool, weights, etc. All my docs want me to swim. I'm working on alternative therapies.