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Opioids Best painkiller to switch to?

J

John15243

Greenlighter
Joined
Mar 1, 2011
Messages
34
I have a chronic pain condition from a pituatary tumor. I have a headache everyday, all day. These. Headaches make the worst migraines look like nothing. I'm currently taking 30mgs of oxy a day, 6x perc 5/325s. This dulls my pain for a bit.. but it always comes back quick, the pains ALWAYS there. I My doctor tried switching me to long release oxycontin but the insurance wouldn't cover long release because of the price tag. I NEED some sort of change. I don't even care if the doses equal in strength, I would prefer not, but I. Need something different, preferably XR but as long as there's some change. What would my options be? Any suggetions I should bringup? I was thinking something like morphine ER (is it cheaper than oxycontin?) And what dose would equal my percs? If not what about dilaudid? I know its a. Bit stronger and doesn't last but id be fine taking it more often andsuch. Idk, suggestions and help? I reallt need a change.

*Everyone seems to respond as if its a migraine. Perhaps bad wording on my part, but it isn't. So far its only responded to opiates. Its a tumor on my ptuatary causing it, its worse than a migrain, but it isn't one.
 
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Methadone destroys pain, and I would suggest giving it a try.

Like my co-volunteer suggested, talk with your doctor. I will leave this open for a bit so you can get some other suggestions from people with severe headaches.
 
I've had migraines for as long as I can remember, and I've been prescribed every drug under the sun for them. The most effective is the triptan class of antimigraine drugs.

I had a horrible migraine (worst headache of my life, banging my head against the wall "suicide headache" type deal) and went to the ER, was given orphenadrine+Demerol IV and it still didn't touch the pain for 45 minutes or so...the pain didn't go away completely until the next day.

I really would consider a non-opiate treatment option...
 
Demerol was the standard for breakthrough migraine headaches. I (apologetically) never had real migraines but got the shots either IV or IM. Demerol is not used or prescribed often anymore due to the side effects and complications of long term use so your chances of of getting it are best in an ER. Otherwise, I too have read that psychoactive drugs and other medications are standard practice when dealing with migraines. I would give them a try as they are helping millions without the use of opiates.

http://www.migraines.org/treatment/treatctm.htm

http://wehelpwhathurts.homestead.com/whichmedication.html

These may help answer some questions as to why the AMA has changed methodologies.
 
It isn't really a true migraine. Its a horrible headache caused by pressuree from a tumor. I more so wanted to know which switch was better/more possible.
 
true migraines = treated by sumatriptans (seriously, they come in various forms pills, subQ injections, generics, brands)
cheap opioids? MSContin (generic morphine time release) it's as cheap as it gets. Im about to switch from Opana ER b/c it is so expensive, moreso than oxycontin. so, disregard the post that suggested it.
 
I'm on Nortryptiline and propranolol for chronic migraines, however it sounds like you're way past that. To the person who says opiates dont help thats wrong, they did for me for quite a while but i found that you can't stay on the same dose you have to keep upping it, so my doctor and i decided to try another avenue, and i finally found a cobination that works after 5 years of looking.
 
Thank you so much for the help everyone. I'm gonna try to get switched to MSContin or maybe some form of long release dilaudid I suppose. But, my doctor is just a general physician/specialist in cardiology IIRC. It ws kinda hard to get on the percs. How do I go about bringing it up? Should I just keep on insisting what pain I have no matter what? Should I bring up other meds, or does that sound atoo "druggie" :( if all else fails what do I do? Would it be a smart move to ask him to refer me to a pain specialist? This seems ro
 
I'd suggest switching to Roxicodone (oxy without APAP), and a higher dose, too. Neurontin or Lyrica might help as well, maybe a butalbital product as well for breakthrough pain to reduce intracranial pressure. Switching to another opioid might help, but for your case something tells me oxy is a good option. A fentanyl patch wouldn't be something I'd normally recommend because it really ups your tolerance, but that could help along with a breakthrough med. Just some suggestions.
 
Thank you very much. The oxy isn't doing too much for me though anymore. Id be willing to try more, but it'd be so mucch easier to switch, and if switching ddidnt work, go back to a higher dose of oxy, you know? But my doc isn't too versed in pain meds as I've said before so should I try and tell him this, or try and have me referred to a pain specialist?
 
John15243 said:
Thank you so much for the help everyone. I'm gonna try to get switched to MSContin or maybe some form of long release dilaudid I suppose. But, my doctor is just a general physician/specialist in cardiology IIRC. It ws kinda hard to get on the percs. How do I go about bringing it up? Should I just keep on insisting what pain I have no matter what? Should I bring up other meds, or does that sound atoo "druggie" :( if all else fails what do I do? Would it be a smart move to ask him to refer me to a pain specialist? This seems ro
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I have always found that i can be honest with my doctor, in fact most of the time i pretty much choose my prescriptions. Thats due to trust built up of course. And of course it has to make medical sense. I have asked for opiates before, but never anything as strong as percs. However i do know that some doctors would automatically assume drug seeking behaviour so it really depends on your relationship with your doctor.
 
madog11 said:
I have always found that i can be honest with my doctor, in fact most of the time i pretty much choose my prescriptions. Thats due to trust built up of course. And of course it has to make medical sense. I have asked for opiates before, but never anything as strong as percs. However i do know that some doctors would automatically assume drug seeking behaviour so it really depends on your relationship with your doctor.
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I've had this doc for three years, so he trusts me and he seems like a good doc, but he doesn't actually do much maintenence wise. I've been on these 6x 5/325mgs for almost a year. Everytime I say my pains getting worse or the pills aren't helping as much he just casually say that yeah, I'm gaining a tolerance for being on them so long. Last time I just said whatever pretty much and delt with it, I can't deal with it at all even anymore. So I'm gonna try and get him to switch me next time, but if he doesn't feel the need to change it for whatever reason when I ask,should I try to get a referal to a pain doc? How hard would it be, and would the pain doc be more likely to switch me on to something more helpful? I really just want to be out of pain.
 
John15243 said:
I've had this doc for three years, so he trusts me and he seems like a good doc, but he doesn't actually do much maintenence wise. I've been on these 6x 5/325mgs for almost a year. Everytime I say my pains getting worse or the pills aren't helping as much he just casually say that yeah, I'm gaining a tolerance for being on them so long. Last time I just said whatever pretty much and delt with it, I can't deal with it at all even anymore. So I'm gonna try and get him to switch me next time, but if he doesn't feel the need to change it for whatever reason when I ask,should I try to get a referal to a pain doc? How hard would it be, and would the pain doc be more likely to switch me on to something more helpful? I really just want to be out of pain.
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I don't know how it works in the states but in the UK i got referred to a neurologist (at my request after 5 years of no answers for my headaches). The neurologist was the first person to ever ask me if there is ever any time when my head doesnt hurt at all and my answer was no. So her response was to tripple my meds. Worked an absolute charm and i'm finally pain free except for occasional breakthrough headaches which are unbelievably bad but better than having pain constantly.

She also booked me for a CT scan which i am having next week. So it really did help me to be referred. Hopefully your doctor will do the same.
 
Also, if he is aware of your tolerance, that means he's aware that you need more to manage the pain. But be careful, there comes a point with pain meds that you are probably making the pain worse. Have you tried other avenues that aren't opiates?
 
Yes, I've tried NSAIDS and a couple other headache medicines. I have a neurologist but I hardly ever see him, and he has openly admitted that he does not like to prescribe any opiates for I only see him twice a year, and he's only. There to moniter and take care of the pituatary condition itself. And my doctor knows I have this tolerance, but seems to do nothing. Probably just covering his ass since I'm only 18 years old :/ but I truly am and have been in pain. Should I just try and convince my current doc as hard as I can to put me on a chronic pain regiment, or ask him to refer me to a pain specialist if he can't change shit up? Would my doctor be insulted or aggrivated in anyway if I asked for this? I don't want him to just say its drug seaking behavior or something :/
 
John15243 said:
Yes, I've tried NSAIDS and a couple other headache medicines. I have a neurologist but I hardly ever see him, and he has openly admitted that he does not like to prescribe any opiates for I only see him twice a year, and he's only. There to moniter and take care of the pituatary condition itself. And my doctor knows I have this tolerance, but seems to do nothing. Probably just covering his ass since I'm only 18 years old :/ but I truly am and have been in pain. Should I just try and convince my current doc as hard as I can to put me on a chronic pain regiment, or ask him to refer me to a pain specialist if he can't change shit up? Would my doctor be insulted or aggrivated in anyway if I asked for this? I don't want him to just say its drug seaking behavior or something :/
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Have you tried meds used off label for headaches? ie. gabapentin, tricylic anti depressants? These are actually quite beneficial and treating chronic pain (especially headaches). I don't think being referred to a pain specialist will upset your doctor. But then i don't know your doctor. But a specialist won't just up your opiates, as they know better than anyone that they can make a chronic pain patients pain worse in the long run they may want you to come off them all together. You have to think about this when you consider being referred as they will make reccomendations to your doctor.
 
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