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The Pain Management Mega Thread v2.0

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Captain.Heroin

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This thread is for all your questions on chronic and acute pain management with emphasis on the first. Do make sure to post a question , You can ask other for an opinion on what meds would work for you , dosage , side-effects , comparing different medications etc.

the original Pain Management Mega Thread
 

Cane2theLeft

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ladies and gentlemen, in the near future I'll be compiling a far more comprehensive mega thread and FAQ on chronic pain management and addiction. If you have any questions/topics you'd like to be included in that, please PM me and let me know.
 

muvolution

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Alright, I got transferred from Opana to Suboxone for the management of my chronic pain and dependence on my pain medication. Very excited. At the same time I can't believe I gave up a script for the best "dope" money can buy.
Anyways, I am starting with it today, I will keep everyone updated on how it works for chronic pain which would otherwise be treated with heavy full-agonist narcotics.
The appointment went very well, it seems as though psychiatrists who are registered to dispense subutex/suboxone are more than happy to work with CPpatients even though those two formulations are not yet approved for treatment of pain (in the united states).

(I know this wasn't a question, but some useful information, and I will keep everyone updated)

If anyone is interested in going this route for any reason whatsoever, PM me and I will tell you my opinion on it/
 

Cane2theLeft

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^It doesn't matter if subutex/suboxone are approved for pain management (but I don't think that matters, buprenorphine IS indicated for pain and they are all bupe products) doctors can prescribe anything off-label. Any doctor can prescribe sub products for pain anyway, you don't need the certification to do so.... I've talked to many people who've been prescribed these preparations for pain by doctors who don't have the bupe certification or license which is only required to prescribe the medication to addicts as other medications are illegal to be prescribed for maintenance purposes.

What were your doses and RoA(s) of opana and what is your dose and RoA of bupe? Definitely do keep us updated... in its heyday, the CP mega thread was more akin to the bupe mega thread where lots of CP patients checked in regularly to discuss how their treatment was going and get support. I'd love to see this thread (and the comprehensive CP FAQ I'm working on) restored to that.
 

muvolution

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Anywhere from 30mg/day oral to 60-80mg per day insufflated (always IR's) obviously that felt great but I wasn't really leading a normal or healthy life.
Moreso it was just the attitude of the PM doctor who i got switched to at the only practice available to me. And a little bit of a grey area as this is Colorado and when I started PM, I had my MMJ card, they knew, inducted me into therapy with no problem, i never signed a contract, and then I was surprised when on my first UA (which i thought was just to check that I was taking it???) i listed Cannabis as one of my medications and she was just like, I'm not even going to bother sending this in. So I guess I have a red flag on my file now, not for diverting or abusing my medication, but for smoking pot? Anyways I wanted to stop going to that practice, for said reasons, and others. I guess that's some shit the states are going have to work out with the FDA, the DEA is already respecting states' rights on this one. Who would've thought?
Anyways sorry for the rant, but in alot of western states there is now the possibility that you will run into this as a legitimate CPP, so be warned.
I was prescribed 8mg of bube (in the form of suboxone)/ day, up to 2 times a day if i want, but he gave me enough for 3...? whatever. I'll probably start at like 2mg twice a day, maybe less. I think that's a good idea from the consensus on the boards here.
 

HT harm redux

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Doctors and tolerance

This may have been answered many times before if so im sorry for asking again. I am prescribed 100mg MScontin twice a day and roxycodone 15mg 1 every 6 hours. What will my doctor most likely do if I tell him that Ive built up a tolerance to the oxycodone? Ive been on and off it legally for about 5 years now, so tolerance is expected. What are some of your experiences? and how do you think he will react? and info will greatly be appreciated.
 

HT harm redux

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I just hope he doesnt want me to go back to hydrocodone. has anyone else had to do this? how did it go for you?
 

Captain.Heroin

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I just hope he doesnt want me to go back to hydrocodone. has anyone else had to do this? how did it go for you?
I would be shocked if that's what he expected you to do, and you could always try going to another doctor if that's what happens.

It would be one thing for the doctor to say no I won't give you more, but to give you LESS would be really horrible; I doubt they are going to do that.

No one can know for sure, but I wouldn't feel guilty or scared at all to bring this up to your doctor. Let them know this. You deserve to live a close to pain free life, at least enough so that you are functional and don't suffer in a major way. :)
 

Cane2theLeft

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If you have legitimate pain and your pain isn't being relieved, tell him that that. Don't go in saying "my tolerance" is growing and I need more. You can imagine how that looks.
 

THunder MuFF

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Hey guys I'm a pain management patient, I have herniated discs in c4,c5,c6 and also severe muscle and nerve damage. I take 3 30mg roxi's a day and 3 40mg oxycontins. I have been lucky up until now to have been able to get the ethex oc's so I haven't really been effected. Before finding out about them though I used a compounding pharmacy and got oxycodone SR's from them they formulated and put into caps. I'm not sure what the deal is but I'm pretty sure I started having a reaction to the SR's. When I took them I would feel really weird like shortness of breath and they even made me kind of panic a little messing with my heart rate and like I said making me feel weird in general. I refuse to take OP's, they don't work for me plus my insurance isn't that great so they're way expensive for something that doesn't work. The roxi's have been my saving grace but I am having surgery again next friday. I go back to the Dr. on wed and I know I will get my Roxi's refilled but I am going to ask to get switched to something else because I am going to need a long acting pain reliever. I know he wont put me on Opana's, so I guess my real question here is what else is there that is a long lasting pain killer out there? I mean am I just spinning my wheels here trying to switch to something else and just ask for more roxi's and just be done with it? They work well but hell I hate having to take them so often because they barely last two hours. Thanks for the advice ahead of team fellas.
 

volp

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This may have been answered many times before if so im sorry for asking again. I am prescribed 100mg MScontin twice a day and roxycodone 15mg 1 every 6 hours. What will my doctor most likely do if I tell him that Ive built up a tolerance to the oxycodone? Ive been on and off it legally for about 5 years now, so tolerance is expected. What are some of your experiences? and how do you think he will react? and info will greatly be appreciated.
When I talk to my doctor, I don't raise my tolerance levels or anything that can be construed as addict behavior. And I say that as a chronic pain sufferer who hates the stigmas placed upon people. But I'm aware they exist and I sidestep them when possible and appropriate.

Therefore in your case I would tell him simply that you are not getting adequate relief from the current medications. Let the doctor be the one to bring up higher doses or stronger meds. Always let the doctors think it was their idea to prescribe you something.

It's sad that in many cases we can't just be honest and say "I have a high tolerance and I believe that X amount of oxycontin will provide the proper relief." But we generally can't say stuff like that. So be honest, but in different terms.
 

HT harm redux

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Thank you all for your advice. its much appreciated. I will approach him as stated that im not getting relief from my medicine. i was going to tell him that i think after being on oxycodone so long i developed a tolerance and need something different for breakthrough. but i see now that that would appear to be addictive behaviour. thank you all
 

Captain.Heroin

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How could one go about asking to switch to methadone for long lasting pain relief and then continuing to have breakthrough meds as needed as well? I take Opana ERs and IRs but the ERs, especially these 15 mg'ers (compared to three 5mg pills), don't really work. The short half-time bound to that "ph dependent" mix of gels doesn't seem to reliably work for me. Is there any chance of getting pill form methadone for extended pain relief?
Yeah, I know doctors are happy to rx methadone in pills to pain patients. Most pain patients prefer shorter acting stuff, but methadone works well for some people.

It won't hurt to ask. :)
 

sebastianbell

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i get frequent migraine headaches (1-2x a week, each lasting an avg of 2-3 days). i know the issues that arise with opiates and migraines (cranial pressure), but my Dr prescribed opiates anyway. his credentials from a podunk med school tell me he isn't that great of a specialist, but opiates worked to manage the pain so i kept going to him. he prescribed 7.5mg vicodin per month and injectable dilaudid for severe breakthrough pain.

my employer cut their health insurance so i can't see any doctors or buy scripts. i'm forced to turn to legal alternatives, namely kratom and tea from poppy seeds. has anyone had positive experiences treating pain (of any type) with poppy seed tea? what dependency can i expect from daily usage of 6-8 oz of poppy seeds per day?
 
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abracadabra girl

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Switching from MS Contin to Kadian, due to insurance issues. Do they work equally well? Any problems to be on the lookout for, or to refuse to switch entirely?

Also, how to find a pain mgt doc in the SF Bay area?
 
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Tunnelfission

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I was recently taking codeine and occasionally dilaudid for my mangled back and my frequent headaches.

but after a really horrible experience with codeine and a flu coming on later that night i'm deciding to live with the pain and work on it with yoga/ meditating/sleeping instead of pushing myself harder than the body wants.

I kicked the junk... no matter how mild it was, I feel spiritually higher when I'm not numbed out and chasing a "concenhate" (CWE codeine)

That is all :)
 

Beerman

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I have renal colics and buprenorphine (i'm on ORT) seems helps a little but I think a bit of morphine woudn't be bad... >_< I'm suffering one right now... hope a lil bit more of bupe helps...

Sometimes when I have a colic I go to ER and they IM me some Metamizol or Diclofenac but it don't do shit...

Is someone treated with opiates/oids for that crap?
 
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