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

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Speed King said:
Anna, are you asking me?
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Yes; I should have quoted instead of replying, I guess. How is your dosing? When I took morphine ER, I had 2 different kinds of purple pills, but neither could crumble. Weird. I'm wondering if you got a dump and then it didn't last as long?
 
I wish It did. Honestly it wasn't much different than swallowing it whole.
Mines blue with a 15 on one side and I think ABG on the other.
I plugged one, and that seemed to help.
I'm starting to get used to it. It's pretty mellow. I think it's a little low dosed at 15mg ER x 2 a day.
 
I'm thinking of picking up some herb to make the pain pills stronger. I don't want to call doc and tell them it's week. I think I just have to get better used to it.
Rtp said it was equal to the Percocet I was taking.
I can tell it's the better medication then the oxycodone in my case. The dose simply has to be raised.
 
Jlosnow said:
@RTP do you think if I asked my PM doc to change me to the same dose of oxycodone based meds that he would label me a drug seeker? I believe I have a tolerance to the ms contin and the hydro because I have been on those same two meds since 2012. Am I grasping at straws or do u think a change would give me better pain relief? I'm just trying to find SOMETHING that works so I can drop my daily pain number from 6/7:to even a 3/4.
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Have you tried oxycontin/codone previously? It is perceived as more addictive/abusable by some drs, & sometimes asking outright for a particular med can be interpreted as drug seeking.

If you've been prescribed it prior to the MS Contin & hydro(codone/morph?) & feel it worked well it's more than reasonable of you to ask to change back.

There's also plenty of other opiates to rotate to, they all work slightly differently & on different or dual receptors.

No doubt you have developed a tolerance to your current meds after three years. I think I've read that your PM is not willing to increase them further, am I correct in saying they?

Again, PM drs are well aware cpps really can't remain on the same opi dose long term. Unless miraculously we heal & stay on meds to keep withdrawl at bay. (Has happened..)

So, I'd prepare to have another chat with him, maybe say that your current meds aren't working as well as they once did. (Well, I presume they helped at some stage, three yrs is a long time).

Ask if he's prepared to trial you on a similar medication for a period of time to see if you can achieve more analgesia without having to raise your doseage?

Above all, unless you are very close to your PM, I'd refrain from using medical terms, & using specific drug names. But, at the end of the day, you're paying this fella to help manage your pain & increase your quality of life.

Hope that's of some help, feel free to PM me.

Rtp
 
Speed King said:
I'm thinking of picking up some herb to make the pain pills stronger. I don't want to call doc and tell them it's week. I think I just have to get better used to it.
Rtp said it was equal to the Percocet I was taking.
I can tell it's the better medication then the oxycodone in my case. The dose simply has to be raised.
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It is equal to the oxycodone amount you were scripted, without the added ingredient that Percocet contains.

Did you raise your concern of the perc's not feeling strong enough before you asked to be switched to an ER med?

Morphine has a very different "feel" about it, oxy works on mu & kappa receptors.

I'm glad you're prepared to be patient before talking to your doctor again. Too much mucking about with med changes will be not regarded highly.

Are you with a physio? Taking the usual low dose tricyclic & pregabalin or neurontin that we all seem to hate, but is all part of the "game"?

Btw, no ER tablet should crumble, they're pretty tough as a rule,- but yes, finely chewing one will alter the time release & revert it to IR.

Rtp
 
I have another sleepless night due to not being able to get comfortable because of my back(have Degenerative Disc Disease, a herniated and ruptured disc). As of now I'm on 10mg oxys 4x day and 350mg soma 3x a day and as I stated previously my new doc wants to add methadone to the mix(not thrilled about it).Anyhow I was wondering if I made poppy tea would it have any analgesic effect on top of my meds I'm taking or would it be waste of time?
During the day once I'm moving I'm in bearable amount of discomfort it's the nights when I'm lying down I can't stand it,I wake up every 30 mins so I can re adjust and it seems as soon as I go out I'm back up. I take 2 10mg oxy before bed and 2 in morning I make do without them through the day.
Also would poppy tea come up ,I assume, as morphine on a drug screen?
Please any help I can't deal with the insomnia it's what had kept me being a junky for 15 years(been sober for awhile).
 
Conman, just a word on methadone tablets (though I hear you re: the carrot, my PM put me through all sorts of procedures & every injection possible, saying I had to "earn my stripes").

Methadone tablets won't turn you into an addict again, not while taken as scripted. This was a huge fear of mine that I'd turn into a dribbling mess on antipsychotics & methadone stumbling around the CBD drooling like other junkies. Such a stereotype.

I tried PST & it did nothing for me. Mind you, I was often in wd at the times I'd make my concoctions up. There may well be an additive effect.

It will show up as morphine, thebaine & codiene unless you're talking of pod, not PST. Of course, depending on the test & how accurate it is for such substances. Some just test for opiates, amphetamines, benzos, weed

Will your dr not prescribe a sleep aid? They likely have if your insomnia is that severe. I used to take two mogadon (strongest avail here), still could not sleep.

Does alcohol help you get to sleep? Or weed? Heat packs? Milk? Lol, sorry, clutching at straws. Other "relaxing activities"?

I guess you have nothing to lose by trying poppy tea. You'd have some idea of tolerance. IME it took a kilo of seeds each time & a fair amount of icky liquid to drink.

Have you tried adding in plain codiene? Depending on if it's OTC where you are & also how often you're drug screened could that be an option?

Best wishes for a restful night,

Rtp
 
Thank you rtp for your advice. I'm afraid of the methadone because years ago I was on methadone maintenance and it was much longer withdrawal then heroin. I still have hope(probably unrealistic) that I can strengthen my back muscles through rounds of physical therapy and it can make up for my deficiencies so that I won't have to be on pain meds for life.
Weed works great for me but had to give it up after getting switched to pain management and alcohol gets me to sleep but it wears off in the middle of the night and insomnia is worse(also have 2 lil ones can't be hung over or reeking of booze getting them off to school).
What's a shame is they just legalized mj in my state but it's either or because most doctors that prescribe weed don't do narcotics and vice versa. I would gladly quit my opiates and get the mj but because marijuana is illegal federally in the U.S.(local government legalized it,dichotomy of U.S.) my insurance won't cover it and I can't afford it out of pocket(was trading some of my oxys for it).
I'm going to try the tea after my next visit just in case they give me a urine and see how that works.
Oh one more thing,my primary doctor won't prescribe me shit (he's writing my last few scripts for oxys,think he 's in trouble for treating pain patients) and I don't want to ask pm doctor because from what I understand anytime you mention you need more meds they view you as a drug seeker and I don't need to be blackballed. But I did tell him(pm) that I have problems sleeping and see where it goes.
 
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^Just to be clear, even at 1kg+, with a decent opiate tolerance the seeds didn't do jack. Hopefully they do for you!

Also, what's the possibility of finding a replacement primary care dr in your area? Good & well for them to say "sorry, no longer treating pain patients", but you are such a patient & require a doctor to write scripts.

Rtp
 
Need Something Other Than Dilaudid

Hello all,

I am looking for some advice. Tomorrow I am meeting with my chronic pain specialist and I would like to try something else for my pain management. Currently I am on the following prescriptions:


  • Gabapentin - 400 MG 3x Daily
  • Nabilone (THC Pills) - 1MG 3-6x Daily
  • Fentanyl (Mylan) - 50 mcg/h changed every 3 days
  • Dilaudid

With the Dilaudid I am snorting 6mg about 3 times daily to control my pain but 12mg in a single dosage is better, obviously. I just don't have enough pills to support that. Thing is I don't particularly like snorting these things especially the 2mg pills, as I particularly don't like sneezing out orange goobers in public. So what oral opiate would be equivalent to 12mg dilaudid snorted? What should I be asking for? Percocet? Or is their something without the acetaminophen?
 
I think you would be better with oxycodone but if you want something that lasts longer maybe try methadone. Hydromorphone and oxymorphone has a very short half life.
 
Oxycodone is Percocet without the acetaminophen. Aka roxicodone.

And almost anything is more long lasting than dilaudid. Dilaudid is like the crack of opiates. Hits hard and gone quickly.

Oxycodone is like 3-4 hours unless it's extended release. Methadone is very long half life, but when taken for pain is taken about every 6 hours. (The analgesic effect is much shorter than the wd relief). Morphine is another good choice for pain--can be instant or extended release.


But I just realized --you're on fentanyl patches which are extended release. So the other pain meds you are being given are intended to be "breakthrough" meds for when pain breaks through the constant level of painkillers (fentanyl) in the body. So most likely they'll stick with an instant release. Oxycodone is common for this. As is dilaudid, short acting morphine. You won't be given extended release on top of the fentanyl which is extended release.


So basically I would try oxycodone or morphine for the breakthrough pain. But if you are constantly in pain I would also ask them to raise the fentanyl patch dose
 
crzydiamond said:
Oxycodone is Percocet without the acetaminophen. Aka roxicodone.

And almost anything is more long lasting than dilaudid. Dilaudid is like the crack of opiates. Hits hard and gone quickly.

Oxycodone is like 3-4 hours unless it's extended release. Methadone is very long half life, but when taken for pain is taken about every 6 hours. (The analgesic effect is much shorter than the wd relief). Morphine is another good choice for pain--can be instant or extended release.


But I just realized --you're on fentanyl patches which are extended release. So the other pain meds you are being given are intended to be "breakthrough" meds for when pain breaks through the constant level of painkillers (fentanyl) in the body. So most likely they'll stick with an instant release. Oxycodone is common for this. As is dilaudid, short acting morphine. You won't be given extended release on top of the fentanyl which is extended release.


So basically I would try oxycodone or morphine for the breakthrough pain. But if you are constantly in pain I would also ask them to raise the fentanyl patch dose
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Thanks for this, yes I am looking for something else for the break through pain. In the hospital I preferred Dilaudid for the pain over morphine, but that was IV. When I went from Dilaudid IV/Sub-Q to oral it was rough to say the least. Of course it didn't take much time to realize that Dilaudid has a poor oral bio-availability, so I started snorting them. I cannot IV them, not only because I am chicken shit, but I already have clots in both arms. Plugging is out of the question as I have a colostomy (cancer/surgeries reason I am in pain).

I will look into these suggestions and try and find something that works better for me. Obviously I am pretty new to all this so I appreciate the help
 
IMO your doctor seems to be doing a really decent job so far covering a lot of biological ground with what you're on already. They also know your history best so I say let him/her make the suggestion and give it a shot.
 
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