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Opioids Tolerance and Withdrawal - Pain Management Advice

B

brewdALLday

Greenlighter
Joined
Mar 6, 2011
Messages
3
Location
my house
Hi everyone,
This is my first post so I appologize if I missed a thread on this somewhere.

I had my first major surgery 3 years ago and started on quite a few Oxycodone due to this. Due to re-occuring pain I was never truly off for more than a month; however, I never experience more than a very mild craving if I was depressed.

Due to a crack in my vertibrae, nerve damage, and surgery I have started taking Hydrocodone (10mg) 6x daily along with Oxycontin (20mg) 2x daily. I have been on this for 3 months now and am taking it as prescribed until three weeks ago where I started taking at most 30 mg over my daily dose.

Can someone offer some advice on how I should handle this situation? I am concerned my tolerance is growing and the dose is not helping the pain like it used to. I also am very set on not becoming addicted, no matter what the cost!!!

When will I start physically feeling withdrawl symtoms physically? And how can I keep my pain down without ever going into the point of withdrawl?
 
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Hey brewedALLday,

Since you are using opiates for chronic pain you need to be very careful to try and minimize the build up of tolerance. After three years or so of use you are now up to the equivalent of about 100mg/d of oxycodone. As you mentioned the drugs don't seem to be working as well and this is because your body gets used to them and you need more and more to get a good effect.

Depending how you view addiction, if you were to stop using opiates cold turkey today you likely would go through a few days of unpleasant withdrawal and have to deal with PAWS (post acute withdrawal symptoms) for sometime afterwords. That being said as you currently don't see yourself as addicted, your view on your situation is good and you could very well not have a 'mental' addiction.

If you want to try and lower your opiate dose then that is fine, but as it is for treating real pain you may find your back and nerve pain is too much handle. There are other options such as muscle relaxers, nsaids, and other drugs which you can take to try and help reduce your reliance on opiates. The Pain Management Mega Thread is a good resources for finding help. I've also heard that Tramadol is known to be better suited for treating nerve damage which can be resistant to typical narcotics.

This really isn't my area of expertise so I'll leave it to others to comment and give advice but good luck on dealing with your pain.
 
It depends on how you define "addiction", but, OP, I'm not going to argue yes or no to that fact, you certainly are dependent on the hydrocodone and oxycodone for pain relief and that is perfectly normal.

The development of tolerance to these drugs is also perfectly normal, and to be honest I'm surprised that it hasn't happened quicker than it has. It is very good news that you haven't experienced any really bad withdrawal symptoms upon stopping your pain medication.

What this says to be is you really do need these drugs to live a pain free live. I'm with amapola on this, check out the pain management mega-thread and also check out the Healthy Living forum.
 
In my opinion, based on 3 months of daily use, you are already addicted. Addiction can happen as fast as 7 days of daily use. The only thing that you can change now is the level of withdrawals you would experience. To do this you would have to reduce your dosage.

There is nothing wrong with being an addict. I rather be an addict than be in pain every time I take a step and, surprisingly, I'm an addict!
 
^I'm an addict as well, and it's got nothing to do with pain management, I just really love opiates. Although, I was introduced to them as the result of a doctor prescribing me hydrocodone.

I think the OP has many options, however :)
 
I wish I didn't have pain issues. It makes w/d so much worse. Not only do I get dope sick, but I'm in horrible pain as well! Not cool.
 
Thanks for all the information and help. As for NeighborhoodThreat's comment on being surprised that I was not feeling the addictive nature of these medications yet. What is a typical timeline that you would say a typical athletic, 6'3, 185 pds, person would become addicted?

BlueLightBeam stated that I have been on this for three months now; so, I am already addicted? How do I prove that I am not. What do I need to do to show that I am not. Is my mental state ok as is or do I need to just cut all medication, (trying to ignore the pain).

I want to prove to myself I am still in control. I have read so many posts where people speak about becoming addicted without even knowing they are. This is my largest concern.

Thanks for everyones responses, they have been very helpfull.
 
You need to stop letting being addicted affect your self esteem. It's not necessarily a negative attribute, and not even a sign of a loss of control. Get over that bullshit. God gave us drugs for a reason, you'd be a fool to live in pain just to prove some cockamamie ideal to yourself. Honestly.

Oh, and withdrawals are the symptom of addiction. However the symptoms of w/d can range from a sour mood to full on sweating, puking, shaking, and agony. Results will vary by the person.
 
I don't want to get into a discussion on the semantics of addiction but unfortunately that is exactly what I am doing.

In contradiction to the post above I feel that a loss of control is a good indicator of addiction, and withdrawals are not necessarily a symptom of it. There are many people who associate themselves as addicts who haven't touched their DOC in years but are afraid they might not be able to stop themselves if given the option to use, and many others who go through withdrawal after taking drugs for pain and never become 'addicted'.

This however is just my view on the term and it may differ for other people. I'm sure there are official definitions as well but the point is OP there is no clear addicted/not addicted line. As BlueLightBeam was saying being tolerant to a drug whether it is called an addiction or not is not necessarily a bad thing. You are in pain and using a drug as a tool to help live your life. The fact that the drugs you are using are "addicting" is merely a side effect of the drug and this side effect has a worse stigma than most.

All of that aside you are currently looking to take charge of your own treatment and recovery which is a very good thing. Attempting to cut down on your dosage will definitely help you keep your meds under control and at manageable levels. It think it would be worthwhile to speak to your health care professional about your fears and what you want out of your pain treatment as well.

Feel free to use any of the resources this site offer and good luck on your recovery. Try not to let yourself be labeled and grouped together with others (such as the term 'addict') unless you think it represents you well and will aid you in recovery.
 
Hey BrewdAllDay,

I want to come out and say that I am taking opiates for pain management myself. I have pain in my back and neck that has been going on for about 6 years, and am just within the last year happy with the medication I'm on. I'm on a Fentanyl 100mcg patch changed every 2 days, along with 30mg Roxicodone 5x/day and Opana 10mg IR 2x/day. I don't take all of this all of the time, but after suffering for years, I welcome it. I understand your focus on not wanting to be an addict etc, and that is very admirable and crucial. Here is the thing, addiction is so multifacited and poorly understood, you have to really take a look at your personal situation in order to have a real understanding of it and do what is best for yourself. So let me make some key points here to look at...

1 - You are taking medications that cause your body to become PHYSICALLY addicted to them. So if you stop taking them abruptly you will become ill.

2- You are in chronic physical pain for reasons understood. This means you are really in pain and it makes complete sense that you should do something about it to solve or treat it.

3 - You want to feel like you are not a prisoner of your medication or "addict".

As best I understand it from what you have stated, you really should be on these medications because they improve your quality of life and your doctor believes this as well. Part of being in pain and on opiate medications is that there are times the medication stops working as well and/or there are flare ups. So I think you have to accept that you are on these meds for a good reason, and it's not like you're stealing or hurting anyone to get these medications. And the reality is that you could get off of them easily yourself if you weren't in pain. You could probably get off them yourself anyway, but then you'd be in agonizing pain.

So unless you feel like you're wildly out of control for reasons not stated, it makes sense to come to grips with the fact that you are trying to manage your pain as best you can with the tools you have at your disposal. Addiction is primarily talked about in a psychological sense, and in that way it is only in your head. As far as I can tell, you're just taking this medication because you are in physical pain which is what they are there for. So my advice would be to truly educate yourself on the medications you're taking, their role in treating pain, and everything related to your condition and what you can expect your life to look like with medication.

It is very common for doctors at this point in time to give patients a hard time about being addicted to pain medication if they just don't know what to do with the patient and don't know why they're in pain. I've had my friends who are terminally ill cancer patients be called addicts by their doctors as a way at getting back at them after telling other patients in their practice about the positive benefits of juicing and proper nutrition.

I hope this helps. :-)
 
the general term addiction, is defined as either having mental or physical dependency...........

the medical term addiction focuses on the metal, and states that physical dependence is NOT addiction. (meaning physical dependence happens to everyone over a short period of time, from daily use) , where as addiction is a compulsion to use more and more of a drug because you like the effects of the drugs, even if your hurting yourself by abusing the drug....

the medical definition is correct.

=pain=

p.s. i think you should try and take ONLY the prescribed dose. NO extra.

you can certainly prove something to yourself by USING as prescribed.
 
I can tell you for a fact that in AA or NA they condone taking addicting medications as long as you take them as prescribed (and this is for people who are addicts aka. Addictive Personality).... theres a big difference between addiction and taking medications as prescribed and as needed. If you are using them to get high and not to kill pain that's one thing but as long as you are only using them as prescribed and you are taking extra because of the pain I think this is completely fine. The addiction piece is a mental thing.
 
lots of people think cause they don't feel a opioid hardcore like.. that it's not having an effect on the pain. some of that has to do with hormones changing, and causing less pain to hurt more that it should, and some of that is due to tolerance to the drugs effects.

if you could suddenly be off the meds totally the next day (as if you tapered down over a long time), the pain would be much more then if you just took your meds as prescribed. i believe

i hope you get in the right place, mentally as well as in your treatment plan, so it works optimally.

good luck man!

=pain=
 
Hi everyone, this has been really helpfull. I was concerned because I was waking up with horrible night sweats and I was very fearful that my mental state was good but my body was addicted. I just recently found out I had an infection that was causing a fever so they have stopped and I feel much better. You all had great points and helped me feel much better regarding the control I have over myself.

Thank you very much, I am still on the medication and am tapering down just to make sure I can. I will post when I see how the lower doses affect me physically, mentally, and with pain toleration.

Thanks
 
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