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Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

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I've been on pain management for about a year now for Lombago & Sciatica and have been on 180 15mg Oxycodone per month. This is just not working well for me and am usually out of medication 10 to 15 days prior to my next prescription. Fortunately, or unfortunately depending on how you look at it, I found a street connection for Oxy and sometimes Methadone or Dilaudid. So I end up self medicating for half a month. Problem is this is extremely expensive. Any advice on how I can approach my Doctor to either up me to 30mg Oxy or change my medication so that it will last the entire month?
 
I've been on pain management for about a year now for Lombago & Sciatica and have been on 180 15mg Oxycodone per month. This is just not working well for me and am usually out of medication 10 to 15 days prior to my next prescription. Fortunately, or unfortunately depending on how you look at it, I found a street connection for Oxy and sometimes Methadone or Dilaudid. So I end up self medicating for half a month. Problem is this is extremely expensive. Any advice on how I can approach my Doctor to either up me to 30mg Oxy or change my medication so that it will last the entire month?
this was my exact situation, except I was prescribed methadone and also ran out on average about 12 days early and have a great heroin connection, so would use that until my script could be filled, plus once all the methadone was out of my system, so the H would work...

I went on like this for many years, each time I had a drug test, I got lucky and they never asked for one close to me using H, but this past time, it caught up with me, and am in the process of being discharged, and trying to accept that I got to get off this shit, Ive been using H the last week or so, but I cant afford to keep buying a gram or 2 every 3 days much longer...also getting pissed off everytime I hear how 'cheap' heroin is, on the news on such, I dont know where they are, but it AINT cheap here!!!

Im kind of in the pissed off at the Govt, DEA , for forcing all these fucking drug tests, pill counts, discharges, etc. mode right now, just so someone can get pain relief with narcotics, but absolutely nothing I can do about it, and I doubt full legalization and OTC opiates will happen anytime soon...I guess Im going to get clean or waste every dime I make on H..??
 
I've been on pain management for about a year now for Lombago & Sciatica and have been on 180 15mg Oxycodone per month. This is just not working well for me and am usually out of medication 10 to 15 days prior to my next prescription. Fortunately, or unfortunately depending on how you look at it, I found a street connection for Oxy and sometimes Methadone or Dilaudid. So I end up self medicating for half a month. Problem is this is extremely expensive. Any advice on how I can approach my Doctor to either up me to 30mg Oxy or change my medication so that it will last the entire month?

Aloha thashcanaddict :) Your best bet is to really make your medication last the entire month! I have been on really high levels of IR opiates and the pain is always better when meds are initially raised however eventually you will find yourself doing the same thing your doing now with the only difference being taking more oxy! have you tried epidurals mixed with physical therapy ? Get a deep tissue medical massage maybe some acupuncture? also if you ask your dr for more meds you should always leave it up to what the dr thinks is best for your particular situation! that being said you should really take a longer acting extended release medication and use the IR for breakthrough pain ! If you do take a longer acting med you will have a certain amount of medication in your body consistently!This will also help to stabilize your opiate use and you will not wake up in the morning in agony waiting for the first pill to work! taking loads of IR opiates can really bring your tolerance to a high level or really bad addiction. Another thing you can do is decrease all opiate meds to the lowest level that you can tolerate, therefore bringing your tolerance back down. Then when you raise the amount again you will have better pain relief ! Pain tolerance is a tricky thing when using opiate's! Abusing any opiate medication and or taking all your meds before your next visit will really bring you to a bad place with addiction! you might consider trying suboxone ! some people find suboxone to be a godsend for the roller coaster of pain management! however some people do not get sufficient pain relief with suboxone! you should really listen to the doctor within yourself and do whatever you can to stabilize your opiate use! I hope this helps you! Please be careful taking medications that were not prescribed to you, Extremely expensive is nothing compared to getting red flagged as a drug seeker. one toxicology report will show all medications and the exact plasma levels. You could find yourself in more trouble then you think additionally after your dr discharges you as a patient it will be really hard to find a dr that will prescribe any narcotic medication leaving you in a really bad place! again good luck. and i truly hope you get the medications that you need. Feel free to PM me Aloha
 
We don't have them in the UK either (at least I've never heard of anyone having to sign one over here) but from what I understand they are commonplace in the US. I think they basically state that the patient won'tattempt to see more than one doctor for narcotics, won't try to get scripts refilled early, will submitted to drug testing, possibly submit to random pill counts etc. While the exact terms of the contract may differ from doctor to doctor, this is the general form that I believe they take.

Could someone who has to actually sign a pain contract explain EXACTLY what they contain as myself and probably most other non-amercain pain patients would be interested to see the details.

You pretty much nailed it..mine was about 3 pages in length with about 9 or 12 stipulations.

No doctor shopping, no early refills, no use of illegal drugs*, you won't sell or share your meds, You will keep your narcs in a safe place to prevent lost or stolen pills. They will NOT replace lost or stolen pills. You may be subject to random pill counts and/or drug screening. You will use the narcotic EXACTLY as the doctor prescribes.

That's what I remember from it...this is from my family physician too, but he's pretty lax on the weaker opioids thus far. From what I could tell though, it was a run-of-the-mill narcotic's & pain contract.
*they have not mentioned my cannabis use, I don't think my doc minds, but I would not chance it with others. MUST have failed at least 4 screenings for it now..
 
I have a doctors appointment in APPX. 15 hours from now..

I'm nervous, always plan for the worst, and really hope for the best.

Anyways, my neck hurts now, i'm going to get off the damn computer and play some guitar or something..

If anybody can offer any advice on my situation* several posts above, before I go to the doctor, I would be very grateful..

I shall check one last time in the a.m. it's mostly out of my hands now, though. No need for me to worry..but I often get very nervous at the doctor's office, this is my future here, pretty much.
If I can't be somewhat comfortable, I can't contribute, bottom line.

Goodnight bluelight...
 
Is there anyone who uses benzos as part of their pain management?

I have excruciating chronic pain in my mid-spine, makes me want to die.

I find that benzos vary in their effectiveness at relieving this, which must be due to differences in skeletal muscle relaxant effects.

Etizolam is awesome, but it's so short acting that I'll take it 3 times a day and I'll still be anxious sometimes (I also have extreme chronic anxiety and never-ending panic attacks, I wouldn't last a day without my benzos)

Alprazolam I find just isn't as good. Maybe it's because I get the anxiety relief at a lower dose though. But I don't use it.

Clonazepam for me is amazing. I can get by on a pill a day and personally I find the muscle relaxing effects to be better than alprazolam. But still, my back suffers quite a lot. I'm usually not bedridden though.

I've heard a lot about valium. Supposedly it is ideal for relaxing the body could anyone confirm this? I have not tried valium.

Of course this is not my only strategy, since I am in hell due to all of the suffering and agony that makes me wish I was dead if I had no meds. Therefore I take percocet as well.
 
As far as I know, most of my doctor's pain patients who take narcotics everyday have to sign a contract. I'm a pretty new patient too. As far as I know...but then my mom doesn't have to sign a contract OR take a pee test...I don't think anyways..but then she knows the doctor rather well and she's a lot older than me. As far as I know, i'm not a known drug seeker, though technically if I were it would be because of the drastically low doses of weak opioids i'm given that don't adequately control my bowl movements much less my chronic back and neck pain.
My state is like #1 or #2 in the U.S.A for Opioid abuse and diversion, if i'm not mistaken. Might have a little to do with it...

I don't ever expect jack shit from a doctor's appointment...I always go in just waiting for the doc to say something like "well son, you pissed pure reefer for the past 12 months! Gotta let you go..good luck!", but he ain't mentioned the pot yet, just like I aint mentioned my exponential tolerance to opioids.

Fuck it, took my last 2 Norco I was saving for my drug test last night, along with 1/2 gram or so of tramadol....idk if the Hydro will still be in my pee, but i'll tell him I ran out a few days early and maybe he'll get the picture
I'm just sick of having to beat around the bush.

Shit, i'd just like to not have to worry about it anymore, constantly.
As for pain management, i'm frankly quite opposed to the idea...some of the things I've heard about them clinics...that they treat everybody like dirt, too strict with rules...I'm only human here, man!

T-50 someodd hours until doctor's appointment...Opioid supply-nil. Marijuana supply-very nearly nil. Hope supply-nil. Morale-dangerously low. Back&neck-aching steadily.

So what i would do if i were you is say nothing about running out early ! many pain management contracts have in the contract that you are agreeing to take all medications as prescribed! you go in there and basically admit to increasing your medication without communicating to your dr that may be grounds for discharge ! Furthermore depending on how strict this dr is he may or may not discharge you for breaking the contract and increasing your medication without prior approval ! This being said if you want your dr to help you with your pain you need to feel comfortable communicating with your DR ! He obviously is being ok with you using marijuana !? and i hope you realize that is really awesome of him, he could discharge you and red flag you within the pharmacy system for using an illegal drug, again breaking the signed contract ! the FDA guidelines against marijuana is asinine! bottom line if you are listening to the dr within yourself that Little voice is telling you that your abusing this medication to the point where you may be getting whats called " white coat syndrome" or "wight coat hypertension" look at the full definition on Wikipedia. You should not be scared to be complacently honest with you doctor and it sounds like you have a really great one ! if your in pain and need more opiate therapy then tell him that your in pain and what you are getting is not working any more! Many people would have had there medication raised several times with the time period your talking about ! i think you said a year and a half ??? He should be able to help you; however its only a matter of time until your back where you are now asking him to increase the opiate therapy again. This can be a cycle leading you into addiction and or further opiate dependence! Ask yourself are you doing this for the befit of your health? are you doing it because your seeking more drugs??? have you tried epidurals and physical therapy ? maybe seeing a medical massage therapist could help tremendously! you would be surprised what these guys can do with just there hands !!! additionally you should research suboxone ! or at least a ER extended release opiate medication so you do not wake up every morning in agony waiting for your first IR dose to kick in! Waking up in pain and WD everyday is not a sustainable practice for anyone; additionally creating havoc with in your biochemistry and CNS central nervous system! Its really astounding the amount of addiction rationalizing I personally went through to convince my self that awww its ok ill just get more and again within 6 months and again ect ect eventually you will hit a sealing to the FDA guidelines and you will have to taper back down to obtain any real pain management! After all i only was doing it because i have such bad pain ! whats wrong with wanting to feel good and pain free ! Hell if it were entirely up to me like it almost was when i was seeing a dr in a pain clinic in south Florida i would just keep upping the dose ! taking 8x a day 30mg ir and 4x a day 15 mg ir , also i had such bad anxiety so naturally i needed 3 x a day 2mg Xanax ! but no wait dr i have the ADHD too so hit me with 30mg adderall 3x a day! Ill tell you what after making the decision to take so much medication it was great i felt great and i made some of the worse decisions of my life wile on all the drugs from losing good jobs to sabotaging relationships! which i then lost my insurance that covered all the pills ! so naturally i started using my mortgage $ to pay for all these drugs that i NEEDED ! there was no way i was going to work without my pills ! so i lost my condo after paying 11 years on a 30 year fixed mortgage and that's not even the lowest i went to continue getting the medication i Needed that all started with a 120 a month 10/325 percocet prescription! but shit man i felt GREAT through the whole thing and all i cared about was getting my pills. You should see the awesome garage i'm living in right now, got carpet a little shower and kitchen all retro fitted into a large garage that i'm paying 800$ a moth for, ha only 400$ less then my mortgage was for my nice 2/2 condo in south Florida broward county! Shit i am living in Hawaii though and i go to see my dr on the 2nd to get my pills where i will be doing the same thing you are doing today ! just trying to get some pain relief so i can continue to work my job that's physically demanding ! Its no walk in the park being so damn dependent on what i can whole hardheartedly call my DOC "oxycodone" man i hope i can get my oxy increased because im at the point where im just fighting off withdrawals forget pain relief ! how great would it be if oxy was OTC :)
 
Chronic pain and wds

So, another long time lurker here... A chronic pain patient, I've tried pretty much every opiate except methadone for pain. I've experimented with much, and found oxycontin and oxycodone the most helpful. My pain mgt doc is big into Ketamine, subcut,- as an inpatient, which, as a sole parent I can't always find the right help for my little one. I'm not even sure these admissions are worth it,- last time we cranked my dose up to 1000mg over 24hrs, to no avail. These admissions can last up to fourteen days,So now we're stuck at a point, what to do next, or more lack of what can be done. My specialist says that where I live is "cutting edge" in pain mgt. Not a lot more can help me.So right now, I'm about 40 hrs into wds, with another three days to go til I can fill my script.. I'm struggling, but finding Lyrica helps, and I had a script for Diaz filled today- not my doc.So I guess I'm just wanting some help, support, a new friend who goes through similar.I understand the Ketamine works on NMDA receptors, and my pain doc hopes this will make my meds work better, and he has scheduled in a ph call to my gp later in the month to discuss raising my oxy scriptHow do others manage these weeks?Rtp
 
dang you might just be the only person rx'd more oxycodone than me. To answer your question I don't/, and will buy an illicit opiate to get me through the script gap at this stage w/d has become too severe for me to just ride out so to speak.
 
how great would it be if oxy was OTC :)

Honestly though mate its all relative when it comes to opiate tolerance. Back in 2002 I was prescribed 400mg of oxy a day (4x80mg oxycontin along with 4x20mg IR oxycodone per day) and I still used to run out of a months script anywhere from 10 to 14 days early. If you have more available to you then you take more and tollerence raises then no matter how much you get its never enough. That's part of the insideous nature of opiate drugs. I bet even if your doctor doubled your current oxy doseage, within 6 months you'd be praying for another increase again. I've been there myself and I genuinely feel for you mate.
 
Honestly though mate its all relative when it comes to opiate tolerance. Back in 2002 I was prescribed 400mg of oxy a day (4x80mg oxycontin along with 4x20mg IR oxycodone per day) and I still used to run out of a months script anywhere from 10 to 14 days early. If you have more available to you then you take more and tollerence raises then no matter how much you get its never enough. That's part of the insideous nature of opiate drugs. I bet even if your doctor doubled your current oxy doseage, within 6 months you'd be praying for another increase again. I've been there myself and I genuinely feel for you mate.
yea the only responsible thing to do is taper back down so pain management can work again ! its such a painful process ! physically and emotionally :(
 
Yeah I think that's about all you can do. I got into a sticky situation with fentanyl patches a year or so ago where is was going through 6x50mcg patches a day (used bucally), so god knows how much fentanyl that worked out at....and was still in pain. Luckily my doc was pretty understanding and helped me taper downon methadone tablets to my current more reasonable doseage of 180mg of methadone per day.

You sound like you have a sensible plan and I wish you the best of luck in reducing to regain some semblance of effective pain management again keeps us informed of how you get on and I wish you the best of luck.......fingers crossed.
 
Hello runtoparadise,welcome to Blue Light.
I too suffer from chronic pain and I know what you are going through with hurting all the time and being undertreated.My pain comes from a blown out knee about 18 years ago.I have,if I remember correctly,2 screws and 3 pins holding it together and I'm missing the middle third of my patellar tendon.I have a constsnt level of moderate to severe pain and,as is probably the case with you too,some days are worse than others.This undertreated pain,along with a severe panic disorder,caused me to become a heroin addict for many years(clean for 3 years now thank God).Now my body is so opiate tolerant that nothing hardly works for me.I recently moved to a rural area in a new state where they are very strict on prescriptions and the strongest I can get,after much,much effort,is Percocet 10/325s,120 of them a month.I feel lucky to even get this inadequate medicine around here.

This causes me to run through my presccription too fast so I'm in pretty much the same boat as you: running short the last week or 2 out of the month and battling withdrawls.Granted,it's nothing like heroin withdrawls ,but it's still enough to suck.What I usually do is when my bottle looks really light and I know I've got another 2 weeks untill my next doctor visit,I'll do a pill count,do the math,and just take one in the morning and one in the evening.Ten milligrams of oxy twice a day does little for pain control but it at least keeps the withdrawl symptoms from being so bad.So,if it's not too personal of a question,what is the source of your chronic pain and what medications do they currently have you on besides the ketamine treatments?
That's the first I've ever heard of pain management using ketamine.Does it work pretty well?If nothing else,i would imagine it's disassociative properties would at least make you not care as much.I used to be a veterinary technician and we used lots of ketamine for minimally invasive procedures where you didn't want to knock the animal out completely and have to intubate it and put it on oxygen and monitor it's EKG etc....We normally put it in a cocktail with liquid Valium.I tried it and didn't care for it.The Valium,however,I loved.Even though it won't take away the opiate withdrawl,taking a few Valiums will help you deal with being miserable better.Some alcohol mixes nicely with this and will further help with not just the anxiety of withdrawls but the body aches as well.When I'm withdrawing I use my RXd Xanax and a few bourbon and cokes to help me deal with it.Another little trick I use that you may find helpful in avoiding this situation is that when I get a fresh prescription of Percocet I will immediately take out about 10 or so and put them away as an emergency stash so that when the other 110 run out I at least have enough for a little taper just to keep the edge off untill I can get my next script filled.I know lots of people will bitch about me advising the use of benzos mixed with alcohol,especially on top of opiates but if you've dealt with this condition for a while and have become used to these meds I think you can handle a few Valiums and a little booze.It certainly helps me when I'm withdrawing from a Perccocet 10 script that I can't get filled for another 2 weeks.In fact,I'm going through this right now,about a dozen perc 10s left(plus my emergency 10)and can't get my script filled untill I see my doctor again in 15 days.
So what are your tips and tactics for getting through untill your next script?I've heard some people use moderate doses of dextromethorphan HBR (Robitussin) to help withdrawl symptoms.The red vein strains of the tree Kratom have reportedly been used with some success to combat opiate withdrawls since they work on the same receptors.The green vein strains are stimulant so definitely not what you want.The white vein ones are supposedly a mixture of the two.What I've heard people do is make a horrible tasting tea from Bali or Borneo red vein kratom(I've heard around 5 grams of crushed or powdered leaf,easily obtainable online from several vendors since it's legal in all but 2 states,TN being one),I've never tried it myself as I am currently unemployed,having just moved to a new state in a very rural mountain area and completely dependant on family untill I can get my pain to a manageable level and obtain employment,but I've heard it makes the WDs more bearable.It's supposed to be quite expensive but if you can afford it I hear it's worth having around.Another possibility would be to find a pharmacy that carries the cough syrup Dyhistine(sp?).It contains codeine,you just have to present a valid state ID and sign for it.You can only buy it every 10 days or so but when I was a heroin addict my gf and I found the 4 drug stores in our area that carried it and would go in a few minutes apart and each get a bottle so we would have up to 8 bottles lying around for emergencies.It won't completely remove the WD symptoms but a half a bottle sure helps significantly and it doesn't cost that much.Best of all,it's perfectly legal so there is no worry of legal trouble if you get stopped and have it it your possession.I highly recommend keeping a couple of bottles around.You might also want to check out the chronic pain management mega thread on this site if you haven't already.There are lots of prople in the same boat on there who can offer good advice.Of course,just like with any web sites or group of people,you meet a lot of douchebags too,I just ignore them or enjoy pushing their buttons when they want to be know it alls or just plain holier than thou assholes.I hope that I have been able to be of some assistance.Chronic pain really makes life suck,especially when undertreated and I feel for you,literally.Feel free to PM me anytime.I'm usually on here a couple times a day and my phone will beep and let me know anyway.So if I can be of further assistance or just want to talk away from the public forums shoot me a message and I'll be glad to help anyway I can.All the best,downerhead.
 
I have been suffering from chronic back pain for 500+ days now and have been using opiates for about 400 of those. My current script is 15mg/day Oxy and 20mg/day Morphine. I basically need to take my daily dose 3x per day to get adequate pain relief due to the short lived nature of these IR meds. Is there any safe way that I could inject the morphine pills IM (I don't want to IV) safely to maximize my script? I don't care to be high, I just want to feel pain free and functional. This way I could IM 10mg of morphine 2x per day and then take the 15mg/day of oxy at one time. I want to do this since the bioavailability of oral morphine is so low. Am I basically just asking for an absess or infection or if there a safe way that I would be able to do this regularly? Willing to invest in micron filters and whatever else I may need... Sorry if this is really stupid.

EDIT: The morphine pills I'm prescribed are the small blue 10mg ones.
 
Rave, diazepam is a must for muscular pain I'm on 10my a day have been for 4 years now. It's a pure last resort thing though
 
Pretty excited to try diazepam. I'm hoping it has superior muscle relaxing effects to clonazepam, while blocking my panic symptoms in a similar way. If 10mg's is enough to get me through the day, I'm in.

Etizolam is really nice but it's just too short acting to be an effective medication for my problems. I'll totally still use it sometimes though, I love the stuff. So clearheaded in comparison to the traditional benzos, I just don't like the interdose withdrawals/anxiety.

I am definitely a last resort type person. End of the line kind of individual. Extreme agony in my thoracic spine which has ruined my life to the extent that I developed a vicious panic disorder after having a complete mental breakdown due to the pain I had been in for years and everything I lost due to the pain and the total lack of support and betrayal of the medical system. The ass-faced clowns in white coats can't do shit and I say damn them all to hell because they don't even TRY. It's like I have to go out of my way to get them to do anything at all. I guess they are complacent with their high salaries, and they wouldn't want to risk their reputation by prescribing - oh, gosh - something as silly as a long acting benzo or an opioid to a bedridden young adult in excruciating pain and with crippling, 24/7 panic attacks. No, "those are addictive." That's all I ever hear. Yeah, no shit they are. I still need them dummies. I'll take addiction over hell.

Now I have my life back on track, after years of miserable torture. Go figure. Kind of miss the days when I wasn't suffering though, and I really miss being a pothead sometimes. I used to love that weed, but I can't touch it now. Fucking sucks actually, but that's the least of my concerns. Damn, do I ever miss it though. Damn, as if I was forced to quit upon the psychotic break...

I was severely dependent on benzos before I even knew what they were. Luckily, they found me that wonderful day in the ER when I was begging for mercy and getting myself checked out for heart attack symptoms. I was stupidly prescribed xanax once, which is the worst benzo I've tried to treat my symptoms. It was better than nothing - I was reluctantly given a second script but it was for "weaning myself off" haha. I asked for a re-up after that and - get this - I was prescribed THREE FUCKING 0.5mg's!!! So I picked a gram of raw alprazolam, figured out how to dose it and went about my way... the doctors office is a waste of time.

I need to be on low doses of the long acting ones, constantly for the rest of my life. I may as well ask a cop for any benzos or oxycodone though.
 
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I have been suffering from chronic back pain for 500+ days now and have been using opiates for about 400 of those. My current script is 15mg/day Oxy and 20mg/day Morphine. I basically need to take my daily dose 3x per day to get adequate pain relief due to the short lived nature of these IR meds. Is there any safe way that I could inject the morphine pills IM (I don't want to IV) safely to maximize my script? I don't care to be high, I just want to feel pain free and functional. This way I could IM 10mg of morphine 2x per day and then take the 15mg/day of oxy at one time. I want to do this since the bioavailability of oral morphine is so low. Am I basically just asking for an absess or infection or if there a safe way that I would be able to do this regularly? Willing to invest in micron filters and whatever else I may need... Sorry if this is really stupid.


EDIT: The morphine pills I'm prescribed are the small blue 10mg ones.

have you really been counting the days ? man i had no drugs the first 2 plus years i was in pain too, just smoked a shit ton of weed
 
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