Opioids Best painkiller to switch to?

[John15243]

I've been on anti depressants before, non of them really helped anything, even depresion. No gabapentin, but a few others that are sometimes used as off label treatments. Ivee gone as far as trying herbal treatments. Why would they want me to come off them? I've tried almost everything, and the only thing that even numbs the pain a bit is the percocet. I don't knw what id do if my last little crutch was taken from me :x and I am thinking about it, but I've tried everything, and I just want some sort of change. Something where I'm not going cross eyed, or can't make it to school nearly on time, or can't even handle talking to people because of a godaweful pain in my haed. So far only the percocet has come close to this, so I'm REALLY hping that, knowing that, id get some different/better painkiller to help me. I am kinda scared to go to a pain doctor because all these stories about everyone going being treated as an addict. And its rather hard to prove the headaches are so severe, since there's only a tumor to proove their existance. :'(

 

[madog11]

Just to point out there are 2 types of anti depressants, SSRI's and Tricylics, SSRI's are not used very often for pain as they are not very effective, Tricylics on the other hand are great for chronic pain. The thing is, is that they take a few weeks to start having any effect. Also i actually think you may be making your pain worse with opiates now as going by your posts you are quite dependant on them. Gabapentin is an anti epilepsy drug also used off label for chronic pain. I believe a specialist might take you off opiates because you havent tried everything else and opiates are a last resort drug for chronic pain as they are known to make things worse when you are as dependant as you currently are.

I have to admit, if i was your doctor i would take you off them. You are treating the pain rather than trying to prevent it and you don't seem open to trying anything that isn't an opiate. Pain is hard to prove, but i believe your addiction to opiates is only making it worse. I am sorry if that isn't what you wanted to hear.

 

[John15243]

I knoww, I've been on both SSRIs and tricyclants in the past. I've tried every different NSAID, prescription ibuprofen, excedrin, seroquil, pregabalin, and a few others. Besides Gabapentin, what else is there? They put me on the oxy as a last resort now, so I'm confused as to what else they could try. I'm dependant on them because I knoww that they out of anything have actually worked.

 

[madog11]

Gabapentin is just one of a group of anti epelepsy drugs. There is also benzos that are used in hard to treat headache cases. And beta blockers. NSAID's, opiates and most other actual pain killer are known for causing rebound headaches.

It's also about how long you give these drugs to work. I use a mix of trycilics and beta blockers after 5 years of trying different combinations.

 

[itsok]

Id get off the perc due to the APAP poisoning of the liver. Just use roxicodone (roxicet - oxycodone ir) for breakthru pain or another alternative is dilaudid. For around the clock XR/ER pain mgmt - what about opana ER, morphine, or methadone.


My mom just checked into the hospital for malignant lymphoma- and she has like a softball size cancer ball pushing against her colon, which makes eating painful. it is necessary for her to take pain meds even though she doesnt want to and doesnt like pain meds, but it allows her to eat and drink water/juice, and get nutrients - until everything goes IV for her. She takes amitryptaline, a tricyclic antidepressant, slight pain med, and sleep aid, and this also potentiates the dilaudid or hydrocodone she is prescribed. On occassion she takes xanax or halicion, but a low dose and infrequently.


Cancer pain is no joke. i hope you feel better. What are your plans for removing the tumor? Have u seen a radiologist or oncologist?

 

[John15243]

What benzos? I've been on quite a few of them, they hardly help anxiety alone. And I know there's quite a few solutions to chronic headaches, but what's been tried has failed. Opiates and some NSAIDS working slightly. I guess I miss spoke on quite a few things. I have a tumor on my pituatary gland, which causes a constant headache, due to pressure or it pressing on something, I don't quite remember. Either way, my neuroligist is the one who told me most conventional methods won't work but still tried a few things before giving up and saying tylenol, until I ended up prescribed opiates. In all honesty, I don't like the thought of non opiate treatments because they normally let me down, and a lot of them would bess with my condition. The only long acting fix so far has been surgery. So I'm very skeptical as to if something could somehow remove the pressure of something that's physically, always there. If someone can think of a headache med like that, or something, then I'm all ears. But otherwise, I don't see any other option than a chronic opiate pain treatment.

 

[madog11]

If you see someone about pain they may have some better ideas and they will have your medical notes, i dont but i still think opiates could be hurting you more than helping, it could also cause anxiety. Pain specialist may well help you but just dont get your hopes up about being given more opiates, because what happens when you are tolerant to the strongest one? You'll end up on heroin or worse. Your tolerance will continue to rise, that is for sure.

I don't know much about tumors and the cause of your headaches but all the treatments i mentioned are for chronic pain, not just headaches. They don't know how they help it but they do. I personally think you and your doctor gave up too easily on other methods of treatment before opiates.

 

[MemphisX3]

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.

for and extended release medication i think your best bet would be a lower dose of oxymorphone....have you asked you doctor about this?

 

[JusTrynaNod]

Have you tried cannabis for your migraines man? I don't know if you live in a Medical-Friendly state like I do, but MMJ is the only thing that lets me live a NON-Addicted-Semi-Pain-Free-NORMAL-Life without having to take my prescribed prescription pain pills for my Degenerative Shoulder Disease & 4 failed Shoulder Surgeries with nothing left to do! I also have terrible migraines, anxiety, & stomach issues. Cannabis is literally a cure-all! You should give it a try! It's completely harmless, and opposed to those devil pills the Doctors prescribe, its a true life saver from the hell those pills will take you to! Try to beautiful non-addictive flower!

 

[Alex000]

I want to respond again a bit more fully this time, giving some more ideas. You say the oxycodone is becoming quite ineffective in managing the pain, and you think that switching to another opioid analgesic (painkiller) would be best. That may very well be. I often recommend that those in chronic pain look into morphine, either IR or ER, but because of your particular situation, I am not sure it would help much more than the oxy, and I would actually guess it would help less. Opiates themselves can cause headaches due to the fact that they cause histamine release and increase intracranial pressure. Morphine is one of the opiates that is known to cause a very prominent histamine release, and sometimes very bad headaches. I am not saying it couldn't work, it could work well, but I would try different meds first if I were you. I said I thought a fentanyl patch might help you, and I do, but this will quickly jack up your tolerance, though it seems you really need relief, so I'd consider that option. I don't see hydromorphone or oxymorphone working much better than oxycodone at equipotent doses, that meaning you might as well up your oxy dose. You could try buprenorphine (Suboxone, Subutex, Temegisic). It is long lasting, and it quite potent, with good analgesic (painkilling) properties. Again this would hike your tolerance up a bit more quickly. Another drug I wouldn't write off, but normally wouldn't recommend is methadone. It is very long acting, relieves pain, and is quite potent as well. A breakthrough med might be necessary regardless of what opioid you are taking for "main" control, so you could stick with Percocet or switch to non-APAP oxycodone in an IR formulation for that. If you do choose buprenorphine, an opioid breakthrough med wouldn't be effective, and it might not be so effective if you choose methadone.

A good med, as I mentioned before, might be a butalbital product like Fiorinal or Fioricet etc. Butalbital is a barbiturate, and barbiturate addiction is one of these most dangerous and hellish addictions to have, but if you used it only for breakthrough pain, I could see that working fairly well. Gabapentin (Neurontin) really is a good option, and has generally fewer side effects than pregabalin (Lyrica). I would seriously consider adding the Neurontin to your opioids meds to really subdue the pain. Also look into some unorthodox practices like accupuncture, refelxology etc. There is nothing the right drugs can't help. As mentioned above, cannabis could help as well.