Opioids On huge amounts of pain killers for chronic pain, what to expect when finally mostly

[MuddyMudGuts]

Hi there.

4 1/2 years ago i suffered an accident at work requiring 2 back operations to fix ( l5-s1 herniated disc, discectomy followed by a fusion the following year ) and have been dealing with workers comp well.. crap to put it bluntly and what i perceive to be negligent or bare minimum health care ever since. I am hopefully nearing settlement of my workers comp matter meaning i will be able to afford a neurostimulator operation privately, which i won't get on the public system. Whenever i complained to the doc that the pain was too much, all that happened was an increase in my pain meds. My oxycontin got as high as 160mg x2 daily, and on my wedding day i ended up consuming my 2 80's in the morning, followed by consecutive 80's every 3 hours, either one or 2 at a time. Combined with my nightly dose, my total for the day was 11 or 12 pills.
Thing is, i have never EVER felt high after a dose, even when i was first put on it. My current meds and daily doses are as follows
Oxycontin 120mg bd, endone 5mg 4/day, Valium 5mgx2 3/day, 225mg lyrica bd, 100mg zoloft at night, along with 80-90mg baclofen/day, with metaclopromide for nausea and nexium for reflux.
They do next to nothing for the sever sciatic pain i have, just take the edge off. I don't get drowsy or nod off, nor feel any euphoria, the biggest dose of OxyContin i have taken is 400mg at once in desparation and depression.
I am a non using heroin and meth addict, so i know what a real high feels like, and the thing is, i smoked some ice 2 years ago on a rare outing and felt like it seriously removed a lot of the pain. I don't want to become a uaing addict again, but the draw of heroin is strong primarily for it's pain killing properties. The only thing stopping me is in fact the reason i stopped using in the first place, my sons.
I kicked heroin cold turkey ( was a somewhat functioning addict, everyday user with a fulltime job ) which hurt to high heaven. Kicked meth and smoking ciggies the next year the same way but didn't experience the pain i had with the heroin withdrawl.
I would be a fool to think that although my mind is not addicted to taking these pills, my body sure as shit is. I notice withdrawl symptoms creeping in if for some reason i have to skip a dose of oxy due to extreme nausea.
I have been advised that i will be hospitalised leading up to my operation to wean me off all the drugs, so that they can accurately see how effective the stimulator is. I have found that the medical professionals i see seem to think that these drugs are effective in treating pain, and they just are not.
With the above dosages, am i in for a rough time coming off them? The withdrawl symptoms i have experienced have been relatively minor compared to my heroin cold turkey. I'm just worried as i used heroin for about the same time i have been at this level of dosage ( it was higher, however even though a ct myleogram showed a blockage around the l5-s1 area, my pain management doctors decided my dosage was too high and i was experiencing hypersensitivity because of it ).
Has anybody come off anything similar? My pain doc who will be doing the operation was rather vague on the details, and won't offer any info over the phone which doesn't help much as i can't afford an appointment with him just yet.

Any help and info will be greatly appreciated, if this is in the wrong place i am sorry as i am a total noob using forums.

Thanks again, sorry for the long post.

 

[SS373dOH]

I dont know why you wouldnt feel euphoria from that dose of oxy.. I know the metaclopramide is a dopamine receptor antagonist, maybe that has something to do with it. Your dr really should be cycling through different opioid meds.

As far as withdrawals go, oh yeah, coming off that many meds, at those doses, you'll be in for one hell of a ride! I know it wont be easy given your pain levels, but I'd highly advise to taper yourself down, from the oxy, valuim, and the lyrica. Even the zoloft, if stopped suddenly, can give you serotonin complications! Medical supervision is almost a requirement, when detoxing from all those meds at once..

The only reason they want you off the meds, is to see how effective the stimulator is? Its not because of adverse effects? If thats the case, with me, I'd tell them you'll be able to gauge its effectiveness, while still on your meds. Coming off all that is a heavy price to pay, just to test somethings effectiveness!


- Hopeless 7nos

 

[tightlywound]

you know oxy doesn't really do shit for me either. I thought I read something once (this may be totally off base so forgive me) saying that certain people due to genetics could not properly metabolize codeine and got no effects from it. and oxycodone is codeine based so it may carry over? not sure. regardless I'd try asking for some morphine based pills -- maybe 100mg morphines (however many you need) as baseline pain control and hydromorphone (dilaudid) for breakthrough pain. you may find that to be more effective.

as far as detoxing -- yeah, I don't think it's going to be pleasant. obviously taper down as gradually as you have time for. if you know you're going to have the procedure w/in the next 6 months I'd start slowly lowering your dose now, take as long as possible w/ little increments to minimize withdrawl.

best of luck, I hope you find some solution to your pain.

 

[Raysu]

I also wonder if you are an exception as far as processing oxy. Unless there are other factors contributing. I too saw what was perceived as pain relief with street drugs and I have a spinal cord stimulator now. I've had it a few years. What sort of questions do you have that your doctor isnt answering?

 

[Kittycat5]

Some polymorphism could be at play here. They are not that uncommon and can be rather easily tested for but I think more likely its tolerance here. I thankfully have never been a chronic pain patient but oxycodone has been my DOC for years. I cold turkeyed at my peak use of 300-400mg daily a few years ago and about 2 weeks ago used a quick Suboxone taper to come off slightly lower doses (150-200mg IR). There were times Ive used as much as 500mg in 3 hours and my recent fight included equal amounts of Adderall. There were always some other things too (benzos, Soma, who knows, everything I could get).

Im not bragging, I couldnt give a fuck about that, but saying I get it. Long term use of multiple meds just blunts everything, including the positive effects of the drugs. I couldnt describe euphoria if it was here smoking a cig with me now because I forget. You reach a point where basically you feel nothing with such polypharmacy except not sick (I admit oxy's stimulating properties never faded on me, though. Its why I love it.).

Ive also been a pharmacist for 16 years and basically my whole adult life has been spent studying, dispensing and of course consuming drugs. So I have a bit of insight on your medical teams thoughts, as well.

So advice (I think Im justified in giving ) I will start with the easy and work through to the hardest.

I am not suprised the meth had analgesic actions. It has long been known, but also forgotten that amphetamines and opioids can act synergistically to provide analgesia neither can alone. The fact sciatica and neuropathy are involved is no suprise either. Its why things like tricyclics work. I am aware that amphetamine and antidepressants have different pharmacology, but there is overlap in the neurotransmitters each hits. I cannot say Ive read literature exactly proving this (I can look, I dont mind) but again, would not be suprised. On a personal level, just feeling anything different can be so rewarding that your pain is forgotten for a bit. You have a history of addiction, so please dont take this as some kind of affirmation to go back to using meth as it too will fade. But I am just giving you an answer as to why it worked.

Onto your doctors. No way in hell they know how you feel or even worse what you will feel if that withdrawal kicks in. They think they do, but nope, sorry. Unless they personally are familiar with high dose, extended duration drug use, any junkie (no offense, I use it as a term of endearment) is less ignorant than them. A favorite line in a song of mine is from Alice in Chains Junkhead that says "you can't understand the users mind, try with your books and degrees." And it is spot on. But I do not feel they are being malicious and are following medical and regulatory guidelines to try and treat you as safely and effectively as possible. Opioids are known to cause hyperalgesia and ever higher doses arent always the answer. Some of your drugs present bleeding risks that surgeons dont want to take (acetaminophen, Zoloft). The anesthesiologist will surely be shooting you full of fentanyl and post surgery pain must be considered pre-surgery. A highly opioid tolerant patient is manageable but harder. They are really attempting to look out for everyone's best interest but will never truly know how a patient like you feels.

Now the hard part, withdrawal. Man you do have a rough battle if their taper fails. You have just about every type of drug on board that will make you feel like shit when stopping save alcohol (its not too late to start ) They need to pay close attention to taking you off the Valium, Lyrica, baclofen combo as too quick a discontinuation of these drugs (Valium in particular) is actually dangerous. Fortunately Valium stays in the blood for a million years making tapering a bit easier but still not without danger.

Under no circumstance should they just stop Zoloft and tell them. SSRIs arent controlled substances and many in healthcare downplay how hard stopping them can be. But read around here and other places on the trials and tribulations of those who go through it.

Ive never had to go through those ordeals but opioid withdrawal I know a thing or two about. In many ways, I would take cold turkey. It fucking sucks but is ephemeral, a split second in time. I thought using bupe would solve my problem. It did. Till I stopped it. Now keep in mind I did a sub ten day course. But it fucks with your feelings in ways that oxy or heroin doesnt. I am not sure of your plan but let me end on this. Opioid withdrawal is miserable. But if you stay strong, I mean save your kids from a fire strong, you got it. Focus everything you have on the goal, whatever that may be and it cannot defeat you. It will kick your ass, but it gives up.

Good luck. Hope I helped. Perhaps this procedure will do the trick and you can leave all this shit behind you.

 

[MuddyMudGuts]

Hey thanks everyone for the input. I still identify myself as a heroin and meth addict, i believe once you are addicted to something then that addiction is there for life. It just depends on whether you are an active or inactive addict. It's not so i can claim any street cred, i could care less, but i would be lying if i said i didn't dream about getting high every so often, and once or twice have contemplated iv'ing the oxy to see if i can get better pain relief.
The negligent medical treatment i didn't go into detail i guess, but the point is, there is a physical blockage around the l5-s1 sciatic nerve root, and instead of treating that injury, they just wanted to lower my pain meds. They were not proposing any kind of additional treatment what so ever. Anyway, yeah hopefully this neurostimulator does the trick. Even if i have to take a small amount of pain killers i will still be ecstatic.
No chance of returning to full junkie mode, i have 2 young men ( 14 and nearly 10 ) that need to look at me leading by example.
Their plan is to squeeze me off the meds in 2 weeks, save the zoloft which is used for my depression ( i listed it above just in case it was relevant in some way ). Valium does probably the most for me, along with the baclofen. The valium unlocks my muscles in my upper back and shoulders, due to walking with a cane, as well as relaxing the muscles in my lower back and legs when thry tighten up. The baclofen stops my muscles from "fluttering" so to speak, it is a bit hard to explain. When i had the fusion, i woke up with a ketamine infusion being deposited via tube directly into my back, as well as a morphine buzzer, and my normal meds. At one point they had me on 4 5mg endone every 4 hours, now it is 4 a day.
I have asked for different pain meds, but my gp just tells me he is not qualified to prescribe me an alternative due to the cocktail i am on, and the last time i asked one of my pain management docs, she asked me if i was selling my medicafion because her friend was hooked on oxy and her dealer lived in my suburb. How off is that?
All i have ever asked for is help, not drugs, as i just want to be a good dad again, not having to lie down literally most of the day with a pillow between my knees.
Thanks again for the info everyone.

 

[spideymcheroin]

I got on suboxone
It works
It stopped all withdrawal
If you're at the point where you can't even get high you're just trying not to die
It's for you
But
The strips do fuck you up if you have a low tolerance
But after taking them daily you will loose the high you catch
Look up suboxone doctors near you
And if you have insurance it's 3$ at the pharmacy
And for meth a doctor will prescribe you adderal
It's exactly the same
You can snort it n stuff
But it doesn't have fucking Drano in it
Pure amphetamine salt
Same affect as dope
Hope this helps bud

 

[Kittycat5]

You should have stopped at look up suboxone doctors near you as everything after isnt true.

 

[noone1]

Baclofen is described to be like phenibut... phenibut will eventually block opiates if used enough. Maybe cut down or stop baclofen... along with this my suggestion is try to go sober for at least 3 days or longer and take low doses of magnesium and dxm and drink some grapefruit juice. Eventually opiates just stop working for me after day 3. The longer the breaks the more I feel it.

 

[SS373dOH]

" and for meth, a doctor will prescribe you adderal"

You do know adderal isnt methamphetamine, right?


- Hopeless

 

[Treefa]

You should have stopped at look up suboxone doctors near you as everything after isnt true.

Please, OP seems like he's in way too much pain for Suboxone to be worth a shit to him....I've estimated he's well over 1/4 gram of Oxy/day and if that's not helping his pain, I sure as shit don't see what good Suboxone is gonna do...except maybe make his MuddyMudGuts a little less muddy, lol.
Hard to tell from the OP though, But if OP is seeking euphoria more than pain relief....well it's just hard to say but i'd assume tolerance has more to do with it than anything....400mg is an incredibly large dose, however, I myself would likely be more Dysphoric from that kind of dose...cause i'd probably be dead lol..but more is not always better, especially with opiates....contrary to popular opinion here on BL.

The medical profession knows this; Opioids are the best tools we have to treat pain...they don't work for everybody, all people are not created equally when it comes to response to these, and all Opiates are not created equally.

If all you've tried is Oxy in the past maybe ask to switch to something different...Personally I like TightlyWound's suggestion of Morphine...works well for me, many don't care for it.
But there are more options than what anybody in this thread could possibly list, so I'd recommend an open, honest talk with you're doctor. If the pain is you're problem, let him/her know, and to what degree.
Because aside from that we can't really do anything but try to offer harm reduction.

 

[SKR]

Meth including MDMA and any drug that delivers superior euphoria are excellent relievers of pain, cos the euphoria overpowers the pain both mentally and physically - along with ketamine, that euphoria takes you to a different place to the one you're used to which is shit.

I know all about it man, I'm currently on suboxone to really just take me off full agonists (oxycodone mainly) cos i topped out at half a gram sometimes more sometimes less of oxy daily, and like another member above me said it's not dick sizing it's just the nature of opioid/opiate tolerance, which i find to be one of the quickest if not the quickest tolerance to ever develop compared too other drugs i have habitually abused, mostly stimulants.

So I will inevitably go back on full ags cos my pain is not controlled at all except with psyche meds and I include benzos in that psyche mix. I'd rather be on morphine fully addicted (of course) than be on Valium, effexor, Lyrica and everything else I'm physically addicted to that really do very little to nothing to help my pain.

I've been married to cannabis for 20+ years and sadly it appears to exacerbate my nerve pain especially but that has less to do with the plant and more to do with the strain and genetics of the plant. We have no official medical cannabis industry yet so no help in that area

 

[SKR]

Oh and just to add on to my bullshit - severe sciatica will not be directly relieved by any drug, I know cos I've tried. The best I can get is a full on euphoria to make me not care about the pain but I'll still limp. There are no drugs that work for it like paracetamol works for a head ache (APAP). Sciatica cuts through everything, forgetting harm reduction for a moment I suggest maybe setting aside once a month where you do speed balls - high grade H & meth delivered via the IV ROA, ahh yes fuck you sciatica I'm superman today!!!