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Ending a 10-year span of using codeine for chronic pain

oceanhope

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Joined
Nov 16, 2015
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4
Hi there, this is my first post here, and I have a LOT to learn about the journey I've chosen to take, so I really would appreciate your help. I've been taking Tylenol 4's for chronic pain management (casually labeled fibromyalgia but who knows if that's accurate), for the past 10 years. My dose was relatively low (but daily) until I was in a car accident in 2008 followed by a hernia surgery that did some nerve damage...long story short, I've been taking 8 Tylenol 4's a day for the past 7 years. I did this because my doctor of 20 years told me it was safe. She said the dose was ok, that I was not going to get addicted. Recently I moved to a bigger city, and apparently the doctors here are hyper-vigilant about prescribing opiates. In fact, they won't even take me as a patient at all until I completely go off my meds. There is a HUGE stigma around it and I've never been treated so poorly by medical professionals in my life...it's very upsetting. I don't want to take this drug illegally or through "underground" means - I don't want to take it at all, if it's as bad as these docs seem to think it is. I think my doctor was doing all she knew to help me manage my life, and it worked - I've been functioning well and I'm very afraid to go off the meds because I don't know what med-free life even looks like anymore. But, the codeine has now become a barrier to me seeing a doctor, and being referred to specialists who could perhaps help me lead a more pain-free life. It looks like I won't have a choice whether or not to stop taking it...and I won't have a doc to support me in the process so I'm doing it alone. I've got half a bottle left to taper down with. Now I have some questions for you awesome, brave, and compassionate warriors who have walked this path before me:

1.) At my level, how much will tapering down reduce my potential withdrawals - both long-term and acute? (I originally took 2 pills 4X daliy - I am already down to 1.5 pills 3X daily, and plan to reduce the dosage a little bit every week to two weeks until I am out of them...ideally, I'd like to be off them before I run out of pills, so I have a few for future pain emergencies since I don't know that a doctor would give me pain management if I lost a leg in this city lol).

2.) At the rate I've set, I will be codeine-free in late January, barring any set-backs. Assuming I survive the taper without messing it up, what kind of withdrawals am I likely to experience and at what point can I anticipate that to start hitting me? Will that happen near the end of the tapering (i.e. maybe when I'm taking one pill every two days, or every three days), or would it likely start once I'm completely off them?

3.) I can't afford to take ANY time off work but I do work from home (thank god). Other than the increased pain from my underlying health conditions, how likely is it that I will be able to function during the tapering and after it - and is it realistic to think I can do this gently and get away with a tolerable transition into opiate-free life? Please bear in mind, I've never used this drug recreationally...I had no flippin' idea the dosage I took would be such a huge problem and I'm feeling pretty low about myself for letting it happen.

4.) I have depression and anxiety, and no medication for either. Won't have meds for any mental health conditions until I'm opiate-free as the docs won't see me until that happens. I feel like I have a couple months left to live, like as if I've only got a few weeks of pain-managed life left and every joyful activity I have now will be my last. It's an awfully dangerous state of mind - I am very afraid that an increase in depression and/or anxiety during my withdrawal period may actually lead me to take my own life. I'm already in a precarious place most days, and I can't afford to have any further decline in my mental health. The stress of the doctors shaming me and knowing I am forced to stop the only med that's ever worked for my pain, is already causing me to be physically sick. Any wise tips to help me through the fear and depression I've got around stopping this med?

5.) How likely is it that I'm going to suffer severe PAWS, and what should I be prepared for? I've read lots of accounts but none were from users that used the same drug I am using for the time I've been using it :(

6.) What should I be telling my partner to expect? We live together, and she wants to support me but she has zero experience with any kind of drug withdrawal and I don't want to lose her because we got hit harder than expected by all this.

7.) After all the withdrawals are done, including PAWS (assuming it is temporary...please god tell me it's temporary), will there ever be a light at the end of the tunnel? Will my brain chemistry ever allow me to be happy again? I know no one can promise me that...I just wonder if most codeine users who stop, are able to regain energy, health, happiness, to have feelings other than sadness and worry? Do you ever completely heal? I don't mean in terms of "cravings"...I've not had those, yet. I just mean in terms of going on with your life and regaining a normal brain chemistry. I finally built some kind of life for myself and I feel like a doctor just sentenced me to death.

8.) Is there ANYTHING that will get better for me, once I am off them? Any plus to look forward to? Personally I look forward to rubbing it in the face of the doc who told me "people who take this much never stop...you won't be able to stop either." But aside from being smug lol, are there any benefits to my health or well-being that I can focus on to get me through the hard parts? I need a good solid reason to quit, because even though I was pushed into stopping I want it to be my choice. I want to want it for ME. No doctor has been able to tell me why it is bad for me...only why it is bad for THEM to prescribe it. I wanna know what's in it for me.

Thank you for reading this long-winded blathering. Please give me some kind of hope here - anything. I know it's not going to be easy - I lowered the dose too fast already once and I seen what happened - no withdrawals but omg the pain in my body was out of control. I realize that is going to be only the beginning...I'm under no illusion. I've done nothing but cry since I made the decision (or, it was made for me). I had finally decided to stick around and now I'm afraid I won't make it. So please, give me something...give me some spark of hope here that there's something good to come from making this choice. I need something to hold onto, I need advice, I need tricks of the trade and encouragement from those of you who have kicked this. It feels impossible right now and the alternative terrifies me. Help. Please.
 
so 480mg of codeine every day for 7 years.

my doctor told me that he will substitute codeine for suboxone when people are addicted to it.

i suppose you could do a taper with that with a doctor? surely a doctor will help supervise you with a taper plan?

what city have you moved to?
 
I moved to Surrey. No doctor will take me on, including to do a taper plan. They just snap at me, "I don't give narcotics, EVER." I wasn't a difficult patient, but I think (without having read my medical records, only knowing what meds I take), that they were afraid I might be drug-seeking for recreational reasons, and were trying to protect their licenses. I don't know if I looked guilty (I was very nervous, social anxiety has always been an issue), or what, but the minute they hear I'm on narcotics, their friendly bedside manner disappears and they do not want me as a patient.

I am concerned about suboxone being just as addictive as the codeine...but I'd be willing to possibly try it if I could find a doc to see me. I'm actually quite shocked by the unprofessional manner they treated me with. Even if I was doing exactly what they accused me of, there was no excuse for being rude or refusing to help me help myself. Good lord I wasn't even asking them to prescribe me ANY pills, I just wanted help to support my body and mind while I taper myself off the ones I have left.
 
Get used to the stigma associated with someone that needs pain management. Addicts are the last group of people that can openly be stigmatized and discriminated against...(ie. most doctors have a distinct prejudice against people that take opiates) There are good, and understanding doctors out there but they are few and far between. I would keep looking while you are doing your taper. I would be honest with every doctor about your situation (wanting to taper off and be free of codeine [if that is indeed what you want]).

There is lots of hope and light at the end of the tunnel. You are embarking on a journey of self discovery that will leave you stronger and wiser. The journey never ends. If you were addicted and dependent on opiates it has left an indelible mark on you. You have experienced the relief that only an opiate can provide and that never truly washes away. Dependence will go away....basically after the first week and a half you should be feeling nearly 100% better from the withdrawals, however PAWS does happen. It is how you deal with the mental aspects of stopping the codeine that will determine how well you do with PAWS. Yes you will have cravings from time to time, however they get easier to manage and overcome with a little time.

Being hooked on opiates is a twofold illness. One is the dependence. This can be arrested and stopped. The addiction, which is more a mental problem than a physical one will take some work to put in remission. It never goes away completely, however it can be put in remission. Seek therapy (in whatever iteration you prefer be it one on one counseling, group therapy, NA/AA etc..) This is an extremely helpful tool to keep from going back. One slogan from NA/AA that I really like is "progress over perfection". As long as you are moving forward you don't have to get everything perfect. This is a lifelong endeavor, but it can be extremely rewarding.

Just always bare in mind that you can do this. You are much stronger than you know. It is going to take your strength, courage, and perseverance as well as the help of those that are close to you to beat this. Is your partner willing to help you? It is going to take him/her doing some research to understand how the addicts mind works. Keep us posted here...we are cheering you on.
 
Thank you, that gave me some hope. I don't know if I am addicted or just dependent...I guess I won't really know that until I stop. But there are definitely emotional aspects...more related to my physical health. E.g. "Boy I'm having fun dancing at this club...soon I won't be able to do this anymore." It's sad to think I will lose the very limited functioning I have physically, and I think that's what's making me so depressed. At least I hope it's that, and not the lowering of the meds...I have no idea how to tell which. I do wish I could stop taking the doctor responses so damn personally. It's playing havoc with my self-esteem. I just want to survive it. Thank you very much for the hope, you did make me feel better.
 
I haven't read any of this, but Kratom can be a life saver for opiate withdrawal as well as an alternative to moderate-moderately severe pain. I would look into it.

Okay read a little bit of the OP's post. Some reasons to quit would be that you are desensitizing your opiate receptors. Your body uses these on a daily basis to deal with pain and your mood, your GI tract, and all sorts of things. At this point they are VERY desensitized and when you stop they will begin to start growing once more.

As far as what your significant other should expect, you are gonna be in a lot of pain, snappy, pissed off, diarrhea (use loperamide), shakes, inability to sleep and such. I wish you the best of luck friend and hope to see your success in then near future.

Another edit; you will feel like nothing will be enjoyable because of the lack of endorphins when you stop. You NEED to do things to increase your endorphins naturally. I will give you a list.

- Light set of workout (curls, benchpress) IF POSSIBLE
- Whole Milk (Love those casomorphins)
- 5-htp supplements, L-Dopa supplement
- Multi-vitamins
- Music
- Please rest if you can
- Eat some chocolate on occasion (releases endorphins)

There is more you can do that will release Endorphins with a quick google search.
 
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