Long term use of NSAIDs has its own issues
>yes it does, but non daily use, or use as a break through is highly advisable IMO< I do find they can work okay for my type of pain sometimes but in no way do they allow me to function without opiates.
>never said he should give up the opiates if he needed them, suggested that he may consider adding it to the program in order to experience a higher quality of life< They only allow me to take less opiates that I would if I wasn't taking the NSAIDs. NSAIDs are actually not recommended for long term use because of the possible damage to a patient's kidneys and GI tract.They also increase the risk of myocardial infarction and stroke. Here is a link about NSAIDs and their risks:
http://en.m.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug
In that link it even states that NSAIDs should be used for short term.
>some groups of short terms in a year could make a big difference through out a year< My GP and my pain management doc both consider NSAIDs to be more damaging to the body than opiates.
>agree.. but long term opioid therapy can play havoc with the brain and so many others besides me developed fibromyalgia when we reached really high doses of pain meds and were prohibited or refused to increase our doses as the tolerance climbed higher, resulting in severe brain generated pain and even worse fatigue. This only became much worse for the acutes well into abstinence, my has completely gone but there are others out there that are still struggling with this really unpleasant condition. Also constipation if not addressed properly can cause some issues and methadone as well as other opiates have side effects that, can in turn cause severe dental and gum issues.. and since we cant discount addiction.. i'm not trying to get into a opait nsai, whose shit dont stink, but as with any medication there are going to be positives and negatives, so I just wanted to state some of undeniable negatives to opiat therapy<
I think opiates do less damage to your body. Do you develop tolerance with opiates and need to increase your dose? Yes but this can be mitigated by taking your opiates with an NMDA receptor antagonist, ultra low dose naloxone or possibly zofran (according to recent studies). Also with a drug like methadone or buprenorphine , your tolerance would grow much more slowly. On methadone some patients can stay on the same dose for years for pain management.
>to any one else that is considering or on methadone for pain, please remember that even though the effects of methadone go on for a long to for most people it will be necessary to redose every eight hours as the analgesic effects of methadone have been show to deteriorate of disappear after this time period.. and as this is often unknown or ignored by physicians and I thought some people who will receive the benefits of methadone for pain (this was by far the best Opiate antagonist painkiller for me, really made my life bearable
and i tried almost them all) could benefit from this knowledge
.. after being on methadone and oxy for years and experiencing some of the major side effects of these drugs I would warn you against looking at long term opiat therapy a being relatively safe, or all that effective in the long run. I think a persons best option is as you have really emphasized the need to keep tolerance down and i think that the addition of nsai's as an occasional weapon in this difficult fight is a good idea<
As far as opioid hyperalgesia, yes, it can happen. However, there are conflicting studies on this. If it does happen to a patient it is treatable (and it doesn't seem to be that common)
>i bet is will be shown to be almost universal in the future, just my prediction<. The patient can be given an IV ketamine infusion (yes, they actually do this!)
>thats interesting as hell, do you know why this would work.. i need to become more familiar with ketamine and its effects and mechanism, but thanks that super interesting and I look forward to checking this out
< , the patient can be switched to methadone for pain control, the patient can detox from their meds and take a break, etc. Opiates are the gold standard in pain control and relief for a reason. They work! They work a hell of a lot better than an NSAID for moderate to severe pain and they won't damage your body as bad as long term NSAID use will. I know someone at my doctor's office whoose kidneys are completely screwed up from taking NSAIDs for years. I'll be sure and tell her how safe they are. I'm sure she'll believe me when I tell her that they'll work better for her cancer pain than the morphine she's on too. "Here just take an Advil!" Opiophobia.... >if this was directed at me i dont think that anything I said could be construed as Opiophobia.. though your sensitive reaction to me suggesting common experiences with opiates as well as possible treatments TO BE ADDED says you may have a little Opiophobiaphobia
Anyway, this has gotten off topic. Back to the OP. If you don't think your pain is that bad then don't switch to something else. Just get off of the opiates and take something non narcotic for the pain (maybe try physical therapy too). Only you can judge your own pain and in your last post you basically said that you probably dont need narcotics. If you think you don't need opiates for pain then you need to get help to stop using. Have you thought about going to NA, AA or a SMART meeting? It sounds like you need to focus on your recovery hon. You have a lot of options. You could go into a rehab or just do it at home (I wouldn't reccomend suboxone or methadone, your habit isn't that big). You could tell your doctor that you want off your medication and you could try a taper. Your wife can hold on to your meds and give them to you when they are due.
Or you could just jump off since your habit isn't large. It's really up to you and your doctor. There are a lot of comfort meds that can help with the WDs. I don't think I'm allowed to list them here but if you PM me I can make suggestions for you to discuss with your doctor.
> you are not only allowed but encouraged we just discourage specific brand names as this is a world wide form and the generic names are much easier to work with in a world that has so many individual brand names for substances that switch from country to country< you will need to talk to your doctor about them because most of them are prescription medicines. I can even tell you what helped me with my PAWs
>super encouraged!!!< . But you have a great opportunity here. You realize that you have a problem. You have recognized this before you got arrested, overdosed, lost your family, etc. Please don't waste it.
With your pain issue, on the days that I don't take opiates I use a TENs unit, ice, voltaren gel (its an NSAID gel that's safer than oral NSAIDs), lidocaine patches, muscle relaxers, meditation and physical therapy exercises. I also see a chiropracter and a masseuse. My pain management doctor gives me trigger point injections and epidurals which help my pain even better than the opiates but they are only allowed to do these a handful of times a year. I don't know if any of these will help you. Obviously you need to discuss any possible treatments with your doctor but these are some nonnarcotic therapies I found helpful. Oh! It turns out that a lot of chronic pain patients have low vitamin D levels which can increase muscularskeletal pain.
>+a billion this is all just golden and low vitamin D is being looked at being linked to more and more things including probable Immune system regulation as well as mood etc etc so it just may turn out to be vital in proper stabilization of the hypothalamus and pituitary, I was taking the max amount of vit d and when I insisted that it be checked it was shown really really low.. within two weeks of a double the max dose.. DR approved of course, the bone pain as well as many other symptoms disappeared< So I got my levels tested and I was really low. I've started taking a prescription vitamin D supplement also. I have noticed some improvement.
I'm sure I'm forgetting something but that's all I can think of right now. Good luck in your recovery! Any questions, just ask hon.
. It is too hard when they are right there in my drawer. May need to give them to hubby to hold for me for a few days. And definitely need to talk to my doc about switching meds. I just need to do it in a way that doesn't get me labeled an addict.