Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

[Desdenova]

I was on MS Contin for awhile, and I had a real bad problem with side effects

I switched to OxyContin, and it works fanstastic, but it's way too expensive for me to continue with

I'm wondering, do you think that Oxymorphone would create side effects more similarly to OxyContin or MSContin?

 

[opioidnomore]

im realy sorry about the pain but if yo keep taking all that then it will be hell to keet of them trust me

 

[taitpeter]

I was on MS Contin for awhile, and I had a real bad problem with side effects

I switched to OxyContin, and it works fanstastic, but it's way too expensive for me to continue with

I'm wondering, do you think that Oxymorphone would create side effects more similarly to OxyContin or MSContin?

im not a doctor and i dont know your history, but from what ive heard from doctors oxymorphone feels and has the effects/side effects of morphine...so i would say the answer to your question is MSContin....there are a lot of cheap alternatives out there (i.e. methadone) for pain relief

 

[taitpeter]

^^^^^^^
thanks for your reply Mr. Blond, your the man, anyways...

I see the dosage charts on opana.com and they say 10mg of oxymorphone is equal to 20mg of oxycodone, if BA is put into account wouldn't it be 10mg oxymorphone = ~ 40mg of oxycodone because the oral BA of oxymorphone is ~10% and oxycodone's oral BA is ~40%....it isn't makin much sense

any insite on this subject? personal expieriences? texts or anybody that can help with this topic would be very appreciated

im kinda worried about it

i hope you guys/gals can have some input, it would be much appreciated, thanks

-TP

anyone know anything about that?

 

[Mr Blonde]

The BA, as you know, is the amount of drug that makes it into the blood stream from a particular route of administration.

10% of 10mg is 1mg.
40% of 20mg is 8mg.

So that's how much of the drug is actually getting into your circulatory system.

I wouldn't worry about it, when they make these conversion charts BA is taken into account. That's why when they switch the MOA on a conversion chart to IV, the amount of drug needed drops a whole lot since 100% makes it into the blood stream.

 

[Gerbee]

I have a quick question about my chronic back pain that has been progressing rapidly over the past 4 years.
I have a herniated disc in my mid back and 4 to 5 bulging discs right above those, then in my neck I also have one protruding disc. I have been given all kinds of meds, from percs, tabs, RX ibuprofen, vicodin, and darvocet.
The ibuprofen, darvocet, and tabs did nothing to help with my pain.
The vicodin did a little more than tabs because they were a higher dosage, and percs worked perfectly. Only problem I have is that in order for the vics/percs to block pain would also make me very nauseous, so I stopped taking them because I hate the nauseous feeling.
Does anyone know of any pain meds that are just as strong as percs but dont have the nauseous side effect?
THe doc also said he was willing to give me cortisone shots, but I have panic attacks just thinking about a needle being shoved in my spine, so that's not an option for me.
I have also done physical therapy 4 times with no improvement.
The doc has also suggested surgery but that is not an option for me.

 

[Rexeh]

^I have chronic back pain as well (Scheuermann's Kyphosis) and am currently using a combination of Tramadol (3 x 100 mg) and Codeine (4 x 20 mg) every day. This combo worked well at first but after the weeks went by the pain became worse again :/.

Maybe Dihydrocodeine would be an option for you, but I doubt it is as strong as Hydrocodone. There are a lot of sources that mention the nausea as a side-effect, and it seems that more Vicodin = more nausea.
There are some other options but that would require you to either take heavier meds like Oxycodone or Morphine, maybe smoking Cannabis would be an option for you? It works pretty good for pain and nausea in my experience.

I had the same reaction when my pain management doc mentioned the option of using epidural anesthesia injections into the epidural space in my spine so my pain would be gone for a while at least. I completely freaked out and haven't done the injections yet since I'm also scared about the fact that a needle / catheter is shoved up into my spine. I do not know anything about cortisone injections though so they may be very different.

I have 6 deformed vertebrae in my back and surgery is not an option for me yet since it would require a difficult procedure and a recovery time that can last up to an entire year.

Good luck with finding the right meds for you and try to focus on the 'good' days, it's best to stay positive even if it seems impossible.

Peace o/

 

[Mr Blonde]

Maybe Dihydrocodeine would be an option for you, but I doubt it is as strong as Hydrocodone.

It's about 1.5 to 2 * the potency of codeine, so yeah not as strong as hydrocodone.

Only problem I have is that in order for the vics/percs to block pain would also make me very nauseous, so I stopped taking them because I hate the nauseous feeling.

Have you tried using an anti-emetic or anti-nausea agent of some sort? A lot of anti-histamines have this effect, but they also will increase sedation. Ginger can help, so can marijuana.

 

[ofukibenhearB4]

yeah this is my prob too is that I have to take SO many norcos that i get sick as fuck from all the aceta. I Hate cwe which is rediculous but JUNKIE me can BEAR the though I might be losing 20 mg hydro hahaha PLUS they are TOO good and its too much like taking heroin. Cau fuck you can CWE 20 norcos and take 200 mg hits throughout the day All day and they hit you FAST just like snorting some dope. so yeah I get carried away with cwe
for Pain manegment-Idealy, I would take
Oxycontin 80 mg 3 times a day, norco 4 times a day soma 3 times a day pot three times a day

as it IS-I can only get 4 norcos a day. thats it. some fucking darvo or tram if I want it but i dont. so yeah im basicaly fucked cause I cant afford a pain clinic and my doctor is Ignorant and doesnt believe in tolerance. he also doesn understand it. he thinks that No one needs any thing stronger than hydro unless they have fucking cancer. i mean hell give me norcos all day long write early scripts an all...........but he thinks that shoudl take care of ANY pain.
he has also been prescribing me 30 mg a day for about 8 years. and he wont up my dose so im constantly in interdose wd

 

[bingey]

^
when i take more than 1000 mg of acetaminophen i usually get sick too

 

[Gerbee]

Have you tried using an anti-emetic or anti-nausea agent of some sort? A lot of anti-histamines have this effect, but they also will increase sedation. Ginger can help, so can marijuana.

I have never even though about using an anti-emetic, that's a great idea and will definitely give that a go. I will try the ginger too, but as for marijuana unfortunately it just doesn't agree with me anymore

Thanks for the advice!

 

[LightTrailz]

I wanted to ask about developing a tolerance to the analgesic effect of opioids. Analesia and euphoria go hand in hand, and you cannot indefinitely get high on opioids, so does there come a point where you build up such a tolerance to opioids that no dose of an opioid will provide adquate pain relief if you suffer from a chronic pain condition?

Well if you really want an idea , ive been on 60-100 mg of oxycodone for a year already and can still feel my medication working and still get a buzz of 2 percocet .. so no , not everyone will experience steadily increasing tolerance ..

 

[I_Stay_Dead]

I'm on the 50 micrograms per hour strength Durogesic patch now. I've checked out the dosage converters, and there seems to be a range of equivalent doses for morphine. I've used the average morphine dose (180 mg/24 h) to calculate the equivalent doses of oxycodone and methadone. I'd like to know whether anyone else has made this change, and do they find these dosage equivalencies accurate? I'm finding it difficult to find out the equivalent daily methadone dose to my current fentanyl dose. Does anyone know? Would about 50 mg of methadone per day be about right, such as five 10 mg tablets, two or three times a day? (I.e. maybe 20 mg in the morning, 20 mg at lunchtime, 10 mg before bed.) Or perhaps 25 mg of liquid, twice a day? Would once-daily dosing work for methadone to treat chronic pain?

Another thing, I have chronic anxiety as well as pain. I know opioid analgesics aren't used primarily for anxiety, but they can help. Which is the best opioid to help with anxiety, as a secondary effect? Also, I don't want to become depressed... I've noticed 'depression' listed as a side effect of fentanyl so am wary of this, since I have been depressed before - not now though, although I don't want it to return.


Fent. 50 is working OK, but I still have some pain, possibly neuropathic. I know 'done is supposed to be good for this, but I've read different opinions about it's effect on mood. BTW I don't want to be high, just pain- and anxiety-free, and not depressed or in a strange or gloomy mood caused by the meds. I've also read that ketamine (oral liquid) can be taken with an opioid to ease neuropathic pain, as an alternative to methadone. Has anyone tried this? What was/is your dosage?

I may stick with fentanyl; I'm still undecided.

 

[Mr Blonde]

I have never even though about using an anti-emetic, that's a great idea and will definitely give that a go. I will try the ginger too, but as for marijuana unfortunately it just doesn't agree with me anymore

Yeah, I can't smoke weed anymore either... which is a shame as it's supposed to really help with nausea, but it dumbs me down too much and can make me very paranoid.

 

[comptonking]

Hey everyone, I'm 19 and for the past year have been having bouts of lower back pain and recently through out my middle back by lifting a box wrong, I want to know if theres anything wrong with my back that can be fixed easily... Should i schedule an MRI? How does this work? Do i need a doctor to order it or what? It is very hard for me to get off work so im wondering if i can just call, schedule an MRI and find out if i have problems or not..

 

[papa]

Hey everyone, I'm 19 and for the past year have been having bouts of lower back pain and recently through out my middle back by lifting a box wrong, I want to know if theres anything wrong with my back that can be fixed easily... Should i schedule an MRI? How does this work? Do i need a doctor to order it or what? It is very hard for me to get off work so im wondering if i can just call, schedule an MRI and find out if i have problems or not..

You definatly need to see a doctor about your problem and have him order the MRI. I don't know of anyone who just gets an MRI on their own. I don't know if you can even do that.

 

[willymattman]

def, ask about fenteny and couple it wit promethazine or reglan. Start low and work your way up. I had a simular problem to another med. I took awhile but was worth it. Also your tolarance may be higher now.

 

[willymattman]

Check with your insuarance. You will probley have to see a Dr. first though. At such a young age with a cronic pain problem i would definutly have the MRI done as soon as possible.

 

[kratom luver]

I'm on methadone, which doesn't seem to help with pain I have in my left leg. Could this be because it's neuropathic pain? It's a shooting/stabbing pain which gets worse when I stand on it. I've tried gabapentin but this didn't work and I'm on duloxetine, but this doesn't seem to have much of an effect. I'm currently on 50mg methadone. Should I just keep getting it increased until it has an effect? My doctors can't seem to be able to come to a conclusion about what is causing the pain. Three different doctors say three different things.

Also, which in general is a better analgesic - oxycodone or methadone? The oxycodone is more euphoric, so should it therefore be a better pain reliever?

 

[hexxx]

@comptonking
Not to worry you unneccesarily but lower back pain in a 19 year old male is a symptom of testicular cancer (how I was diagnosed). Bottom line is that it could be anything - no one here (not even a doc online) could diagnose you, rather go see one and get your problem sorted. See a doc and he'll do the blood tests and order the relevant scans.