Opioids Downside of long-term opiod use?

[LAScriptdoc]

I have been using opiods.. exclusively oxycontin and oxycodone, since a complicated neck fracture about 30 months ago. My initial dosage was extremely high, and was combined with steroids, neurontin, and god knows what else, as my pain levels were unbearable. I was as high as 200mgs+ daily for a month or two. I quickly reduced to 40-60mgs, and have been stable at 20-40mgs a day for about 20 months. I do not consume alcohol basically at all (one drink or glass of wine a week or less), but do use Valium for anxiety and muscle relaxant for sleep three times or so a week. To be perfectly honest, I occasionally use some of Peru's finest as a potentiator when I am feeling particular pain breakout, or just want to escape into the warm world of a buzz and forget all the aches and pains.

I am under the care of a respected pain management doctor, get my blood tested every couple of months, and force myself to work out 3x a week hard, although I have had to give up boxing and running, as my body can no longer take the beating. I have had multiple nerve blocks and PT and all else. The damage seems real and permanent. I am a mid-50s affluent white male. So basically, I have every possible advantage a human being can have in the 21st Century world, and I know it. I don't want long term oxy use to screw up my health, but I honestly need it to cope with the nasty lingering damage from the neck fracture and nerve damage from the impingement into the spinal cord. Nothing else I've tried works. Gabbapentin helped a little, but made me an amnesiac zombie.

No one in the medical community wants to talk about these drugs. Basically, the quality of replies to my questions I get are on a level with "Drugs are baaaaad" from South Park. So I'd rather go to a forum to ask the questions, and figure I'll get more honest and tougher replies.

1) What are the real negative effects of long-term oxy use? I'm not talking about abuse, except the occasional nick to feel high. I'm talking 20-50mgs a day, with no tylenol or aspirin additives. No alcohol, no other drugs. I have tinnitus, from a previous illness, so I can't say that it's because of oxy. I am not stealing money to buy the drug, it's prescribed, plus I have a huge quantity from my trauma treatment that would last me a couple years if a doctor stopped prescribing (kept in a bank safe deposit box so no one stumbles on it and steals it or kills themselves with it.) I have managed to complete a long technical manual while using it, and kept my rather complicated family life running smoothly.

2) What would make a better potentiator than Peruvian powder? I use it because it makes the effect more powerful, without increasing my dosage. I'd rather not be buying and using that stuff, but the first time I tried it at a friend's house I was amazed at how suddenly 100% of my pain was gone and the world seemed truly lovely. I don't want to up my oxy dose, ever.

3) Why should I stop taking oxy? First off I'd have to get through withdrawal, which I am not really anxious to do (I did it once and suffered, but could not live my life with the pain, so went back in.) Maybe I could learn to live with the pain, but for the past 20 months, my life is fine and normal, even with the oxy in it. In fact, it has been the periods when I reduce my use and the pain makes me a sullen asshole that my marriage has suffered. I don't talk to my wife about the drugs or the pain. She's a ten as a wife, but believes men are pussies, and she may be right.

Amazingly, I can't get straight answers to this from my doctors. the pain doctor says it's no big deal, but he'd rather I quit so he doesn't have to deal with the Feds up his ass about one more chronic oxy user, even a model citizen. My GP just thinks all drugs are bad. My hearing doc says it can effect hearing longterm, but my loss since my illness 12 years ago hasn't gotten worse (nor has it improved.)

This is a long post and question, but I am at a crossroad. Advil and aleve and aspirin are not viable substitutes. I tried them all when I came off the oxy, and they were a fart in a windstorm. The opiates seem to block just the receptors I need. I feel this overwhelming guilt and shame every day that I'm a drug addict, but I don't know why, or what my other options are. I don't want to live with pain if I don't have to. Is there some compelling medical reason to stop taking the drug? A compelling psychological one?

BTW, my handle refers to my work as a writer on film scripts, not that I'm a doctor or write scripts, lol!

 

[RedRum OG]

Addiction. Almost all popular opiates/opioids are not harmful to the body/liver/kidneys/ etc. There can be secondary peoblems, like damage to the intestines because of hardcore constipation,

but realistically the biggest effect is the opiate receptors in your brain and throughout your body. They will take a while to recover, called PAWS (post acute withdrawal symptoms) such as depression and anxiety, sensitivity to pain and temperature, restless legs, insomnia, stuff that

the longer you are on oopiates, the longer PAWS will last. Addiction, physical and mental, is the only thing you have to worry about. Unless you start throwing regular tTylenol use in there, your organs and everything will be fine

 

[Harrisment]

If you leave withdrawal out of it, the real challenge is the mental part of it and keeping your usage in check. They very easily can become the thing you look forward to the most every day. Also, chronic use of opiates leads to a loss of sex drive, which may or may not be a big deal depending on the individual.

 

[InHerOwnWrite]

Really, if you feel your pain is severe enough to merit oxycodone, and your physician agrees, it's ok to continue taking them. The only real issue, as others mentioned, is addiction. There are a couple red flags in your post that indicate you could be at risk for this, such as how you like the buzz and occasionally take oxy to get that good feeling, not just to relieve pain. I'mnot saying you are doomed to be an addict, but it is certainly something to watch for. It will cause you to do things you'd never normally do and can ruin your personal relationships. Just be careful.

 

[belfort]

long term problems with oxy use were -lethargy, i was tired all of the time..i had increased pain sensitivity while on oxy believe it or not..my sex drive was basically zero...i was even more of a recluse than i normally am..i saw no point in doing much besides taking more opiates/oxy..

 

[1800-GOT-JUNK]

Opiates have a way of consuming even the strongest people. Using them is like playing with fire. If you have a healthy fear and respect of it and use it responsibly you should be ok. When u start liking it too much, maybe start playing with ur ROA for a better rush things can start going down hill faster and exponentially faster. Fear and respect junk like u would God or else it will become your God.

As far as potentiating ur pills try benadryl or look up other threads that specifically address opiate potentiators so we don't repeatnourselves here.

 

[Dr. Opium]

If it was codeine, or even hydrocodone, I'd say keep taking it.
But oxycodone... If it's so difficult to get a prescription, it's because of it's more potent and therefore -I guess- more addictive.
Yes, all the opioids are addictive. But oxycodone scares me like heroin does.
I suggest you to try to switch to something else like hydrocodone. I'd rather have a bit of pain (it's weaker than oxy) than be an oxycodone junkie.

Regards,
Dr. Opium.

 

[brutus]

^ Your post makes no sense. We don't look down on other people's drug of choice here. An opiate addict is an opiate addict, regardless of their poison.

 

[brutus]

Some of the downsides of long-term opiate use can include low testosterone, low sex drive, increase pain sensitivity, changes in the reward system in your brain.

 

[Dr. Opium]

^ Your post makes no sense. We don't look down on other people's drug of choice here. An opiate addict is an opiate addict, regardless of their poison.

Well, that's not what I meant. I just thought that, since oxycodone's withdrawal is usually harder than other opioids (i.e. hydrocodone), I'd stop taking it right now - yes, it'd be hard, but the longest you take it the harder it's to withdraw.

Regards,
Dr. Opium

 

[brutus]

That's completely subjective. For some people, hydrocodone withdrawal could be a lot worse. Don't derail this thread any further and if you want to prove to me with scientific articles that oxycodone is harder to withdraw from than other opiates such as hydrocodone than PM me. You shouldn't tell anyone to quit taking their drug of choice just because you are biased against it.

 

[LAScriptdoc]

These are great replies. I There is an awful, depressing character about knowing you have to take the next dose or go through three to four days of utter hell, and then weeks of craving, plus the re-introduction to your nerve damage and pain. I am just not up for that. I looked into the Waisman method to just get it over with, and see if I could get through living with the pain, but then I read about an alarming number of people who have died undergoing rapid, sedated detox.

The sex drive thing is definitely true. On the other hand, it makes cheating on your spouse a whole lot less likely (lol.)

One last question: Does Tramadol serve any purpose to ease titration and withdrawal, or is it just replacing one problem with another? I have an old script of that, and wonder if alternating oxy and Tram as I titrate might make it easier to step off.

This whole thing is the most demeaning experience of my life. I blame the doctors who put me on 240mgs a day, and then just cut off prescriptions and wished me good luck. I found a top pain management doctor. Until him, not ONE of them told me about long term addiction, withdrawal or anything. I still would have taken it, but while I was disabled anyway, I would have checked into the hospital and gotten off of it immediately. Once I was back to my everyday life, and being productive, it was just like Lipitor - a drug I took every day. Considering that I am an affluent middle-aged guy who used plenty of recreational drugs in my 20s, any counselor would have figured that I'd be better served to try any other route. God help people who get addicted to this shit and don't have the resources to deal with it.

 

[brutus]

I doubt tramadol would do anything for you with your tolerance so high to oxycodone.

Are you wanting to stop taking oxycodone are are you just worried about the long term effects? Look at it this way, if you need a medication to live a normal healthy life, why wouldn't you take it? If you were diabetic, would you not take insulin or some other alternative just because you are dependent. I am dependent on benzos and I am in my early twenties. I realize that my life without benzos is complete hell and I know I will always be on benzos. Do you feel the same way about Oxycontin? If so, then why are you worried about stopping it?

Withdrawals from Oxycontin are rough, I have quit 240mg just like you via cold turkey. It's not impossible.

As far as a better potentater, I would suggest grapefruit juice. I would steer clear of tagamet, because it has been known to cause "bitch tits" and I've seen it happen to several people IRL. Potentaters really don't work that well IMO, but everyone reacts to drugs differently.

Feel free to PM me if you feel the need.

 

[bingey]

I think long-term opiate use can and often will lead to depression. But i am not in serious pain , i can imagine that pain relief and the subsequent ability to go out and do things that are rewarding might mitigate this effect. Also some kind of health problems can be worsened with opiate pain treatment, for back problems they can worsen the situation by relaxing your muscles/causing bad posture. Some opiates might even increase pain directly (codeine for instance).

 

[LAScriptdoc]

I want to quit because I am concerned about the long-term effects, and just the demeaning feeling being addicted to a drug. It does seem that the medical consensus is that the long-term effects of "on label" use are limited mostly to psychological ones, and the posts here seem to confirm it.

My tolerance is not that high. I havent taken more than 60mg in one day in two years, and most days 30-40 a day is more than enough, even to give me a little buzz most of the day. I can't use grapefruit juice because I take lipitor, although my brother is suggesting I stop the statin as well, because we don't really have heart disease in my family, and my "high" cholesterol at 240-260 without the lipitor is negligible since my ratios and triglycerides are excellent. He says the statin can be contributing subtly to my aches and pains and perceived muscle weakness, which the neurologists all attribute to the nerve damage and scar tissue associated with the neck fracture.

You are right -- I have never thought of chronic pain as a disease. I guess I'm part of that culture that believes bitching about pain is unmanly. Take the meds and shut up.

One of my nephews is dependent on benzos for his anxiety disorder. That's a rough ride. Seems much harder to control even than oxy.

The great irony of the human condition is that every single thing that relieves a problem creates another, and pretty much everything that feels good can kill you or lead to a destructive or dangerous addiction.

Goddamit my neck hurts, and my stomach is beginning to sicken. That pill will look about 20 feet wide in about an hour.

 

[Dr. Opium]

Ok, so finally... As an answer to 3) Why should I stop taking oxy? I say:
Because of, as with all the addictive drugs, the more time you take oxycodone, the hardest the withdrawal syndrome will be. It might be difficult to stop now, but it will get harder in the future - assuming that you will quit later.

Regards,
Dr. Opium

 

[MrsMorphine]

Dear Mr. LA (I'm a displaced native), chronic pain is a disease. It can be horrendously demeaning to seek and even to obtain treatment, especially if the source of the pain doesn't easily show up on imaging. But I have been on opioids for more than twenty years, BECAUSE I am in pain. Opioids are the only thing that give me some semblance of a part-normal life.

I am in pain every time I wake up, as well as other times. In addition to time-release Fentanyl patches, I have morphine IR and Fioricet with codeine for BT pain. I hate having to always know where the drug pouch is, how long until my next trip to the pain management practice and then my friendly independent pharmacy--but consider the alternative! Being in so much pain I'm a huddled heap under the quilts.

One of my twentysomething sons just shambled in, rosy and winded from six hours of ultimate Frisbee, moaning, "Ooooowoooo my legs hurt..."

Go home and take a hot shower and an Advil, I said, adding, "I would KILL to have THAT kind of pain..."

Yeah, Mom, I know, he said sheepishly.

So Mr. LA, if you need to take opioids, take them. Ain't nobody's business but your own... and the doctors, pharmacy, and insurance company's... but I digress.

 

[Tommyboy]

One of the downsides of opioid use is constipation. It is often suggested that chronic pain patients using opioids use a stool softener along with their pain meds to help with making healthy bowel movements.

2) What would make a better potentiator than Peruvian powder? I use it because it makes the effect more powerful, without increasing my dosage. I'd rather not be buying and using that stuff, but the first time I tried it at a friend's house I was amazed at how suddenly 100% of my pain was gone and the world seemed truly lovely. I don't want to up my oxy dose, ever.

What drug are you referring to here, as I don't know if you are referring to heroin or cocaine, although heroin is not from Peru?

 

[Cartesia]

Depends on the nature of your injury/pain. If its permanent -
The main issue - tolerance to opiates will build until you reach a point where they dont help. Theoretically you up the dose, but it cant go on forever. It took me about 5 years before this became an issue but once it does youre pouring vast sums of money down the toilet just to not feel sick from WDs, and theres no actual painkilling/euphoric effect at all. The further you dig the more nightmarish the idea of stopping becomes. The pain will be back eventually if its permanent.

Besides that - motivation. Some drugs give you 'excited, energetic, momentum'.. opiates give you lazy daydreaming contentment. I let my life become dull and empty, i didnt develop relations or careers or plans or possessions etc etc... stagnant life. Then one day i realised everyone else had moved on and developed without me. This isnt a bother until the feeling of contentment fades.

Basicallly what im saying is it is an unsustainable situation.

 

[Zerrr]

What are the real negative effects of long-term opioid use?

The longer you take them the harder it is to find joy without them.