Opioids Downside of long-term opiod use?

[tricomb]

I think it would be easier and shorter to name the positive's of long-term opioid dependency....

Im a chronic pain patient. And an opiate addict. What a twist, certainly made my life..... interesting........ have found myself staring down the barrel of my own guns many times.

I think that honestly, every patient knows whether they can or cannot benefit from opioid therapy, it's just a matter of when they realize just how far in over their heads they are, and just how many years you've been dependent that it all sort of hits you like a freight train and well, for an addict CPP, I definitely must say that while opioids have given me the ability to function and not be bedridden, they have taken away from me things that I would gladfully be bedridden just to have one more time..... My soul mate, my friends and family, my own health, in the end, all of these I put second to my pain medication and if I could do one thing in my life all over again, it would be to have spent more time trying to get off opioids and less time making them more and more accessible to me.

My chronic pain may be temporarily alleviated while the opioids in my bloodstream, but my prescribed dose is not enough for me to function and at the rate my tolerance is increasing, I'll be on the patch and at the end of my rope before I turn 25 years old. I fucking refuse to be put on fentakill or to have exhausted EVERY OTHER OPTION before surrendering to the ease of opioid therapy and relying on a big bottle of little pills that control every aspect of my life, what I can do, what I can't do, when I can do things, when I can't do things, freedoms most take for granted such as the ability to operate machinery and motor vehicles without ever endangering the lives of another person, the people I'm allowed to see, the people I'm not allowed to see.

This subject is far too complicated and patient by patient each case is different so we're basically all just speculating here...

 

[bob123]

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!

by "Peruvian powder" do you mean cocaine or heroin?

 

[THE_REAL_OBLIVION]

Your dose of daily oxycodone is now pretty low, but if you kept it at 200mg or so, it could mess with your testosterone and especially cortisol levels. I know methadone did that for me and it is strong as hell, and I didn't even ever get to the ridiculous dosages some go to, I maxed out at 60mg before going down and switching to suboxone, being a partial agonist, is a lot safer regarding how opiates can mess your hormones.

Other than that I wouldn't worry, some people have to take opiates for life due to injury pain. Maybe you could try BuTrans patches if you want to eliminate the hormone messing caused by long term opiate use, they are the same ingredient in subutex/suboxone. I'd try to ask for the largest dose 20mcg/hour.

To potentiate with something harmless, use benadryl or even yet hydroxyzine, especially with hydroxyzine scripted you can take less opiates for the same effect, it is very useful for that, only antihistamine with such properties (available, anyway).

If you like the pain relief of opiate, but are stuck with an oxycodone fearing doctor which makes you fear it. There's a lot of other options out there, High dosage IR morphine pills, levorphanol, demerol, dilaudid/exalgo (you're american, sad you can't have HM Contin), methadone (yes, plan to use this for pain before goddamn Fentanyl patches, I think fentanyl should be reserved for dying cancer patients) and honestly you guys are lucky with ZoHydro (day long hydrocodone), we have Codeine-Contins in canada, but the 50 and 100mg pills are useless, only the 200mg pills are great, a couple every 12 hours is what I needed before for many reasons, which were not abuse, I was unable to get anything legally, and ended up shooting dilaudid obtained illegally until I was sol and needed to get on ORT, anyways about ZoHydro and Exalgo, you said you are affluent, you can certainly afford it. Forget Opana (Oxymorphone) if you are afraid of oxycodone... Only problem is those I mentioned at the beginning of my post, buprenorphine has very little long term bad effects.

Good luck.


p.s about > and just the demeaning feeling being addicted to a drug.

Look, this isn't an actual problem but one you create yourself. I have to take Cortef (hydrocortisone pills) because of the damage to my adrenals methadone did, without hydrocortisone I'm barely alive and could even die if i'm unlucky, like anything replacing endogenous hormones and neurotransmitters, it has to be titrated down slowly, but why bother ? It makes me feel normal and alive again, it's all what it comes down to.

 

[iamhoss]

I have been suffering from nondescriptive lower back, hip, and leg pain for several years now. I started low and climbed the ladder at an exponential rate. My tolerance is blown off the chart and I can't take enough of anything to kill the pain. I'm about a week clean but a couple weeks ago I went through 90 30mg IR Roxys in four days. All while wearing a 100mcg Fentanyl patch and cheeking at least half of a patch almost constantly. I also ran through 90 350mg Soma in that time. In addition I take 4 30mg Adderall a day for ADHD. Nobody at home or work had any idea I was taking that much meds. Even at that level I got no pain relief nor buzz. It was just time for me to quit because I have too much at stake in my life.
Three days of hell and three months of depression. What goes up must come down. Your ride and tolerance. I am very similar to you as far as our lives go but about 10 years younger.

 

['medicine cabinet']

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.

yuuup. those esp with methadone. uggh. but yeah any extended release opi that you are constantly takin is going to cause dependence, which is different than addiction, unless you actually become addicted to them. you also will have hormonal imbalance low sex drive, cortisol will be off, will feel lethargric, pain sensitivity will be huge (for me anyways, i used to have a decent pain tolerance, its not shit tehse days) also perhaps the worst and there is a thread on this believe ir ot not, is the emergency opioid shit lol. when you feel like you have a football somewhere in your body trying to punt its way out lol....super gros but its a fact of the life unfortunetly.