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

[tricomb]

This thread is for all your questions on chronic and acute pain management with emphasis on the first (Chronic Pain)

DO NOT POST IN HERE IF YOU ARE ATTEMPTING TO GAIN INFORMATION ON HOW TO SCAM DOCTORS FOR NARCOTICS. FAILURE TO ADHERE TO THIS THREAD'S EVEN STRICTER, ZERO TOLERANCE POLICY ON SOURCING ANY DRUG FROM ANYWHERE WILL RESULT IN YOUR BAN. ITS HARD ENOUGH TO BE A PAIN PATIENT IN THIS DAY AND AGE AND BE TAKEN SERIOUSLY WHEN PEOPLE WHO DON'T EVEN HAVE REAL CONDITIONS FAKE REAL ONES FOR THEIR ADDICTIONS.

Do make sure to post a question... You can ask other for an opinion on what medications might work for you, discuss dosages, side-effects, and comparing different medications etc.

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Be respectful and follow the rules, please and thank you!

 

[AnonymousAbuser]

I've had chronic pain in some of my tendons in my legs for years. Hydrocodone(up to 30mg) only took maybe 10% of the pain away. I also don't want to deal with dependence anymore. Does anyone have any suggestions as to what might work for me?

 

[Jabberwocky]

once your records show that you suffered addiction in the past, there is no way they would supply w/ you actual pain killers, right?

I had a recent problem and have been clean now (subox tho) for the last 3-4 months. now that I am clean I am starting to feel the pain in my head where the surgery was on my head. the left side of was cut and head/skull split to operate on a brain tumor. i was given pills then and it lead to a year of addiction. now that I have worn off I am starting to feel pain on that side of my head. it will be painful throughout the day; even at night when I sleep on that side of my head hurts. lastly, god for bid I ever get in a fight, but if I were to be hit there I would be in some serious trouble.

how would a Dr. go about this?

 

[Whosajiggawaaa]

once your records show that you suffered addiction in the past, there is no way they would supply w/ you actual pain killers, right?

I had a recent problem and have been clean now (subox tho) for the last 3-4 months. now that I am clean I am starting to feel the pain in my head where the surgery was on my head. the left side of was cut and head/skull split to operate on a brain tumor. i was given pills then and it lead to a year of addiction. now that I have worn off I am starting to feel pain on that side of my head. it will be painful throughout the day; even at night when I sleep on that side of my head hurts. lastly, god for bid I ever get in a fight, but if I were to be hit there I would be in some serious trouble.

how would a Dr. go about this?

It depends on the Dr really. A kind and compassionate Dr will overlook your addiction problem of the past and want you to have quality of life and not be suffering. Also balance up the risk's of course and find the right treatment for you. You don't even want to know what an addiction-prejudiced Dr will prescribe pain relief - wise.

EDIT: Didn't notice you were on Suboxone. That complicates things tremendously (full agonist opiods won't work on it or many days after stopping it for a long time user).

I've read tramadol works well with Subxone.

 

[Jabberwocky]

funny you mention Tramadol/Ultram. A long time ago when I first got my hands on Ultram I was shocked at the feeling; then of course from there it lead to Oxy's and heroin eventually. its a tough situation right now but I am just fighting it out. I try to NOT sleep on the left side of the head. same goes for when getting a hair cut, showering, etc. even when I slap it gently it hurts like a mofo (am I am moron for slapping it as I was writing this?

 

[Whosajiggawaaa]

funny you mention Tramadol/Ultram. A long time ago when I first got my hands on Ultram I was shocked at the feeling; then of course from there it lead to Oxy's and heroin eventually. its a tough situation right now but I am just fighting it out. I try to NOT sleep on the left side of the head. same goes for when getting a hair cut, showering, etc. even when I slap it gently it hurts like a mofo (am I am moron for slapping it as I was writing this?

Get some paracetamol or what you guys call APAP, it'll work for your pain on bupe or maybe ibuprofen, perhaps rotate the 2 for a bit see which works best. Also get some professional medical advice too.

 

[Felonious Monk]

Just wanted to add my .02, maybe get some recommendations. I've been an occasional user of opiates for a few years and have recently entered Pain Management treatment for chronic abdominal/intestinal pain from IBS/gastritis/Crohn's. I wanted to see what my symptoms were like only treated with MMJ so I went into my first appt (10/31), having gone 4+ weeks totally opiate-free (it wasn't easy or fun but I made it).

Anyway, first appt with this doc and he gives me 12mcg/hr Duragesic patches!!! I didn't want to ask too many questions in the office but I was concerned about such a strong med (especially it being fent) to start with, especially when I'd been totally honest with him and told him I'd self-medicated some in the past but had never been physically dependent and hadn't done ANY in the last month. I don't really want to become straight-up dependent so I only used one of the patches, since I'd really just like treatment I can use as needed, and not mess up my digestion too much.

My next appointment (last week), 10mg Norco, which helps some but has the tendency to give me a headache late in the day (plus I'm concerned about all the APAP further irritating my GI tract). I'm thinking next next of asking to switch to hydromorphone or IR oxycodone, since they're the shortest acting w/o APAP--to avoid excessively throwing off GI movement or irritating with Tylenol. Any other suggestions/ideas?

 

[Whosajiggawaaa]

Just wanted to add my .02, maybe get some recommendations. I've been an occasional user of opiates for a few years and have recently entered Pain Management treatment for chronic abdominal/intestinal pain from IBS/gastritis/Crohn's. I wanted to see what my symptoms were like only treated with MMJ so I went into my first appt (10/31), having gone 4+ weeks totally opiate-free (it wasn't easy or fun but I made it).

Anyway, first appt with this doc and he gives me 12mcg/hr Duragesic patches!!! I didn't want to ask too many questions in the office but I was concerned about such a strong med (especially it being fent) to start with, especially when I'd been totally honest with him and told him I'd self-medicated some in the past but had never been physically dependent and hadn't done ANY in the last month. I don't really want to become straight-up dependent so I only used one of the patches, since I'd really just like treatment I can use as needed, and not mess up my digestion too much.

My next appointment (last week), 10mg Norco, which helps some but has the tendency to give me a headache late in the day (plus I'm concerned about all the APAP further irritating my GI tract). I'm thinking next next of asking to switch to hydromorphone or IR oxycodone, since they're the shortest acting w/o APAP--to avoid excessively throwing off GI movement or irritating with Tylenol. Any other suggestions/ideas?

Fent, does seem to be a bottom of the road med in pain management so it's strange he'd jump straight there - you didn't happen to notice Duragesic posters and pens and mouse pads all over his office did you *jk*.

I'd say grow a back-bone, these Dr's are people not god's and should not be feared as such, and voice your concerns to the Dr. I would have asked why start with such a potent painkiller right in the consultation.

 

[Morphling]

A lot of docs are hesitant to prescribe large amounts of IR medication, as they're more abusable, which would seem to be the way to go with the way you want to use the meds.

Fent is, well yes, strong, but that is the lowest dosage available for fent patches, comparable to taking a low dose of any other ER formulation. If you don't need round-the-clock relief I don't see why you need the patches, though. Odd. If you bitch that they don't work he might switch you to something else rather than bumping up the dosage.

You're somewhat lucky to get opioids scripted for IBS issue, a lot of docs won't as they can actually make the problems worse, as you seem to already know.

 

[Jabberwocky]

I have a Dr. appointment w/ my Subox doc. he's a cool guy and I will openly tell him that I am feeling some pain on the left side of the head; afterall, I feel I have a legitimate reason, thus being my WHOLE HEAD and SKULL was sliced over a little over a year ago due to brain tumor/cancer. my ONE concern is that he will THINK I am again after painkillers and that will lead to problems. I am FINE w/ Subox but they do nothing for pain. whats funny is I had NO IDEA I had this type of pain until I stopped using. I used daily for the last 3 or so years, so pain was never something I ran into much. now w/o the dope I am starting to feel the pain in the head.

I remember when I originally got the surgery the mentioned there would be pain and I always told them I felt fine, no worries, blah blah. I guess I should have mentioned I shoot 2G's of dope a day and that was why there was on pain.

 

[Felonious Monk]

Fent, does seem to be a bottom of the road med in pain management so it's strange he'd jump straight there - you didn't happen to notice Duragesic posters and pens and mouse pads all over his office did you *jk*.

I'd say grow a back-bone, these Dr's are people not god's and should not be feared as such, and voice your concerns to the Dr. I would have asked why start with such a potent painkiller right in the consultation.

Haha, no Duragesic ads around the office, that's something I would have noticed. And I agree about Docs not being gods, they're nowhere close.. what I wanted to avoid was sounding like an internet-informed know-it-all to him---I know my pharmaceuticals, but I don't claim that my own medical knowledge is infallible, so while I thought his choice somewhat odd-I was paying to see him, so I figured I could try his path and see how it went, I knew it wasn't gonna kill me (I wasn't gonna mess with the patch, and it ). And I'm glad I did, it just confirmed for me that I don't need 24-hour opiation, and I don't want that much medication all the time.

A lot of docs are hesitant to prescribe large amounts of IR medication, as they're more abusable, which would seem to be the way to go with the way you want to use the meds.

Fent is, well yes, strong, but that is the lowest dosage available for fent patches, comparable to taking a low dose of any other ER formulation. If you don't need round-the-clock relief I don't see why you need the patches, though. Odd. If you bitch that they don't work he might switch you to something else rather than bumping up the dosage.

You're somewhat lucky to get opioids scripted for IBS issue, a lot of docs won't as they can actually make the problems worse, as you seem to already know.

Yes, he did switch me up (from the 12mcg patches to 30mg/day hydro) but I think those are still problematic because of the Tylenol (irritating to my stomach/intestinal lining, which is why I want to move to a non-compounded IR). He's a reasonable guy though and I think he suffers from chronic pain too, so he's compassionate to the limitations of medications.

And yes, I know I'm quite lucky, it's taken years of suffering for me to get relief (GI doctors have ZERO compassion, had to see a pain management doctor-almost against GI medical advice, even went in and saw him when I was flaring and in so much pain I couldn't stand up straight or take a full breath and he still gave no fucks). I can tell the negative effect it has on "the movement" as it were, but I've come to accept that's part of treatment, managing side effects and relief together (since my health and diet is so far off "normal" and has been for so long, I just try to keep it at an acceptable equilibrium).

 

[nordkraft]

I have a quick question for you guys,

I am currently on 100mcg Fentanyl, for chronic pain (fractured C7, fibromyalgia, chronic migraines, hip dysplasia and endometriosis. Yeah, my body sucks, I know)

It is doing NOTHING. for my pain. Not to mention I've got major withdrawal for some reason. I was moved up from 60mg methadone, which actually worked pretty okay, but I was still in a lot of pain and my doc didn't want to up the done, so he said I should go on Fent instead. It's been over a month now and I STILL have wd's every minute, every day. Plus the pain.
He says there isn't anything stronger he can give me, but is that really true? I live in Denmark and the following painkillers are the only ones approved here.

Buprenorphine
Codeine
Fentanyl
Hydromorphone
Ketobemidon
Metadone
Morfine Sulfate
Nicomorphin
Oxycodone
Pethidin
Tramadol

I've tried almost all of them, but I don't know wtf to do now that I apparently have such a megatolerance. I've been discussing Dilaudid with my doctor but he said he's never used that before and will have to consult a colleague. So I don't know what he'll decide. I just wanted to ask if anyone has any suggestions? Do I go cold turkey til I can use a lighter opiate again, or do I continue to fight the system for something stronger.
What would YOU do?

Thanks for reading

 

[Jabberwocky]

to all those on methadone; do you ALWAYS have to go to the clinic OR can you get some type of take home pills for the daily medication? I cant imagine waking up EVERY morning just to go to the clinic; esp. for those who are working an 8-5 type gig. how do you do it?

 

[Morphling]

That's not a mega-tolerance.

Bupe is not good for chronic pain, I don't feel. It doesn't lack for addictive potential either.

Codeine...Nah.

Fent is clearly lacking to you, isn't not working right now, is it?

Hydromorphone is very helpful to some people, just don't stick it in your veins like me cause then you'll be really fucked.

Ketobemidone is supposed to be pretty good stuff, but I don't have personal experience.

Metadone...no clue!

Morphine Sulphate would be a damn sight better than Fent!

Nicomorphine is supposed to be pretty insanely addictive. Not had that one tho.

Oxycodone is good, but you really need good self-control to not abuse it.

Pethidine...not for chronic pain

Tramadol I would only add on TOP of another opioid.

Does any of that help, I don't know. The best strategy is to just try them and see what works!

 

[Survival0200]

Nicomorphine would be cool for someone exploring rare opioids. %)

 

[Felonious Monk]

to all those on methadone; do you ALWAYS have to go to the clinic OR can you get some type of take home pills for the daily medication? I cant imagine waking up EVERY morning just to go to the clinic; esp. for those who are working an 8-5 type gig. how do you do it?

You can get an Rx script that you can fill at a pharmacy for chronic pain. Only for MMT do you have to do the daily clinic. I was once scripted 10mg dones for anxiety and got my bottle of 30x10mg at CVS--they had them in stock and everything.

For nordkraft, do they make ER versions of those medications or the just the IR formulations. You didn't specify if you've tried everything on the list but possibly high dose morphine or oxycodone Extended release plus Dilaudid or Oxycodone IR for breakthrough.
Have you tried Bupe? I've heard some amazing success stories with people that have tried everything else and were finally able to get relief with just a couple mg (or even less) of bupe.

 

[lovegluegunnin]

I have fibromyalgia and I'm a minor, so my doctor won't prescribe me pain meds. I don't think he would prescribe me pain meds for fibromyalgia anyway, but it causes chronic, widespread pain. I've tried exercise, change in diet, anti-depressants, everything. I still experience lots and lots of pain. Also, I can't smoke weed because I'm looking for a job, so there goes that. Any suggestions?

 

[Whosajiggawaaa]

I have fibromyalgia and I'm a minor, so my doctor won't prescribe me pain meds. I don't think he would prescribe me pain meds for fibromyalgia anyway, but it causes chronic, widespread pain. I've tried exercise, change in diet, anti-depressants, everything. I still experience lots and lots of pain. Also, I can't smoke weed because I'm looking for a job, so there goes that. Any suggestions?

Lyrica(pregbalin) is awesome for Fyb pain, and you not gonna get crazily addicted but still feel good, with a GOOD anti dp + beta blocker and exercise. Really give that a go.

Only main reason I'm on oxy is for my mechanical injuries and surgeries and their complications. the fybromylagia not many docs will prescribe narcotics for that alone, not many good ones at least.

 

[BigG]

I have a quick question for you guys,

I am currently on 100mcg Fentanyl, for chronic pain (fractured C7, fibromyalgia, chronic migraines, hip dysplasia and endometriosis. Yeah, my body sucks, I know)

It is doing NOTHING. for my pain. Not to mention I've got major withdrawal for some reason. I was moved up from 60mg methadone, which actually worked pretty okay, but I was still in a lot of pain and my doc didn't want to up the done, so he said I should go on Fent instead. It's been over a month now and I STILL have wd's every minute, every day. Plus the pain.
He says there isn't anything stronger he can give me, but is that really true? I live in Denmark and the following painkillers are the only ones approved here.

Buprenorphine
Codeine
Fentanyl
Hydromorphone
Ketobemidon
Metadone
Morfine Sulfate
Nicomorphin
Oxycodone
Pethidin
Tramadol

I've tried almost all of them, but I don't know wtf to do now that I apparently have such a megatolerance. I've been discussing Dilaudid with my doctor but he said he's never used that before and will have to consult a colleague. So I don't know what he'll decide. I just wanted to ask if anyone has any suggestions? Do I go cold turkey til I can use a lighter opiate again, or do I continue to fight the system for something stronger.
What would YOU do?

Thanks for reading

Mate 100mcg/hr of fent isnt a mega tollerance...I was on 3 times that but in actuality more like 6 times. Im not saying its nothing at all but its not THAT large. As someone else mentioned have you not tried Lyrica ( pregabalin)?

 

[Rybee]

Hey guys,

I'd really appreciate if any of you guys in the UK can help me out with this thread regarding pain management:

http://www.bluelight.ru/vb/threads/701642-UK-Opioids-For-Genuine-Pain-Relief-Slipped-Spinal-Disc