Opioids tolerance and risk - help needed

[BeasleyMiller]

EDIT: removed ridiculous animal/SWIM code, saw it's against policy here.

Hi everyone,

First post after intermittent lurking for awhile now. Been taking prescribed oxycodone for managing pain in my knee post-op. There were complications and long story short, the knee got opened up 3 times in a couple of weeks. So it's pretty sore, but unlikely to continue to be a problem for long. Once the current scrip runs out, that's probably it.

After the initial day surgery I was on 4-5mg of hydromorphone 6x a day for about 5 days, and the plan was to drop to codeine, and then eventually nothing. It was a fairly minor procedure - no tendons or bones, just removing hardware from a surgery a few years back and a quick arthroscopy.

But a week after the pins and plate came out, I developed a hematoma and the whole thing required cutting and draining and more cutting and draining, and dragged out longer than it should have - roughly 3 weeks. I just had a 5-day hospital stay.

During this 3 week span doctors have prescribed hydromorphone, some emtec (T3 with no caffeine), and now, oxycodone. In the hospital at the end of last week and over the weekend for what I'll call the final procedure, I was given 20mg of oxy every 4 hours, and occasionally subcutaneous morphine (10mg, i think) for breakthrough pain.

I was sent home with roughly a week's worth of Oxycodone- well, it would be a week's worth if I took it exactly as prescribed. Tolerance, guts, and desire for Oxy seem to have built up quickly. Now, even though this entire thing has only been weeks (rather than months or years) I routinely swallow 5 or 6 of the 10mg tablets at a time, and have taken roughly 200mg each of the last 2 days. As prescribed, it would total 120mg a day).

I have some history of substance issues, so doctors are understandably cautious about prescribing heavy painkillers, wont let me stay on any one drug for too long, strongly urge me to drop to codeine if I can handle it, recognize the need for pain relief but also for caution, etc. We're on the same page in terms of all this - I don't want to turn into a prescription meds addict. Addiction is brutal - been there.

In truth though, the leg hurts, but not all that much anymore. My substance of choice back in the bad old days was 'up' rather than down, and this experience feels a LOT different than that did. The desire for oxy is medically legitimate... but the rapid escalation feels too familiar. 90mg and possibly even 60mg in a day gave me the desired effect 2 weeks ago. Now, not only does the same dose no longer feel like it's doing as much, I just plain want more.

Pain wise, days are easy—I get around fine. At night is when I need pain control most, what with it being near-impossible to find a comfortable sleeping position (immobilizer on the leg) and all the moving I do in my sleep. But the knee is healing rapidly and it seems pretty obvious that in another week, the pain will be almost gone.

What I'd like to know is, is my pattern of use consistent with a problem user? I don't have any experience with addiction to legally prescribed medication. Is it normal to 'just plain want more'?

And more importantly, am I in immediate danger? How quickly can a physical 'tolerance' to opiates develop? Even though 200mg doesn't get me all that gooned, can it stop my heart? I'm pretty sure that someone brand-new to opiates could get really sick (or worse) downing 200 or even 100mg in a day.

I get noticeably buzzed from the 200mg, and the pain is completely zapped. Am I going to get sick, or experience serious torment if I immediately drop to zero?

Input greatly appreciated.

Beasley Miller

 

[macd610]

Hi Beasley!

I first I want to welcome you to blue light. It's great to have you here, and that was a great first post!
Yes, I must say that it sounds like the problem has started already. I think people without addiction problems who have pain meds around pay about as much attention to their presence as they would a bottle of Tylenol or something.... I'm sure many of us have come across a bottle of pain pills from 2 years prior at a family member or friend's house. People who do have addiction problems, on the other hand, will often think about that bottle and take pills whether they need it for pain or not.
It would probably be a good idea to start tapering. It sounds like there are problems controlling your use. Do you have a trusted family member or friend who can give you your medicine properly ( after counting your pills and coming up with a taper plan and putting it on paper)
You're right, it is still early here for you. It could get much much worse and the best thing to do is nip it in the bud if possible. Obviously I know it's easier said than done.
Does that sound like a plan that might work for you? The reason I suggested a friend or a family member is because if you don't know where the pills are, you won't be able to take them impulsively. No reason to tempt or test yourself.
Again, welcome to blue light.
Cat

 

[BeasleyMiller]

Thanks macd...tapering is starting now and it'll be with T3s... Milder than the oxy and I think with the acetaminophen toxicity issue, I'll be much less likely to overdo them.

I don't have a problem with wanting to enjoy pain meds, but I don't want addiction - awakening those demons seems like a lousy idea...

It was pretty eye-opening, experiencing what I have the last few weeks. I'm positive 200mg of oxy daily is just too much. But it got to that in no time. For interests sake, can that kill you?

So 200-300mg of codeine a day, dropping to 180 max next week, then that's it. Don't want to drag this out.

Hi Beasley!

I first I want to welcome you to blue light. It's great to have you here, and that was a great first post!
Yes, I must say that it sounds like the problem has started already. I think people without addiction problems who have pain meds around pay about as much attention to their presence as they would a bottle of Tylenol or something.... I'm sure many of us have come across a bottle of pain pills from 2 years prior at a family member or friend's house. People who do have addiction problems, on the other hand, will often think about that bottle and take pills whether they need it for pain or not.
It would probably be a good idea to start tapering. It sounds like there are problems controlling your use. Do you have a trusted family member or friend who can give you your medicine properly ( after counting your pills and coming up with a taper plan and putting it on paper)
You're right, it is still early here for you. It could get much much worse and the best thing to do is nip it in the bud if possible. Obviously I know it's easier said than done.
Does that sound like a plan that might work for you? The reason I suggested a friend or a family member is because if you don't know where the pills are, you won't be able to take them impulsively. No reason to tempt or test yourself.
Again, welcome to blue light.
Cat

 

[dugefrezh]

swims been on suboxone films for a couple months. and swim just OD'd on 2 bags one day after stoppin the bupe. luckily narcan saved swim.

 

[KillSurfCity]

^^^^too much of this SWIM fellow today.
jk. anyway, ask your doctor at the hospital what the best way of coming off the opiates easily is. i'm sure he will understand and put you on a proper dosing regimen. do NOT deviate from his instructions and follow them explicitly...unless you want to end up like me. *eats 80mg oxy*

 

[Mr.Scagnattie]

swims been on suboxone films for a couple months. and swim just OD'd on 2 bags one day after stoppin the bupe. luckily narcan saved swim.

Glad Swim is okay... 8(

For the record since you're new, we do not use the swim acronym here or any other thing like it. Read the BLUA when you get a chance.

Just use "I".