I am so very tired of reading about this. I was in terrible pain for over twenty years due to a mis-diagnosis. Please before you let anyone write about this subject, make sure that they have experienced pain on a high level. I took vicodine and many other pain meds for that 20 years and after getting a correct diagnosis and a hip operation stopped taking pain meds on my own without any, I repeat any withdrawl symptoms.
How many people have to suffer because of your honeymoon statement. You try going through pain every single minute, going sleepless, being unable to do anything for just a month not twenty years and then maybe you will be qualified to talk or write about this subject.
I am leaving my real name, this is a real subject and not something to write about to get a paycheck!
Karen L. Simon
Yes, this subject is very real and unfortunately not discussed often enough. Opioids can absolutley be beneficial in someone's life. Nothing is better that to regain the ability to sleep, to work and to live. But with these benefits come some potential consequences that need to be disclosed, discussed and revisited on a routine basis. Those who are taking opioids need to be informed and consent to the continuation of chemicals which have the potential to cause more harm than good.
In the practice of medicine, informed consent is critical to good care. The risks need to be discussed up front and periodically throughout the course of treatment. Eventually, a person may decide that this is not what he/she wants for the rest of his/her life. In that case, a divorce from the opioids might be appropriate. Other times, if a person can honestly say that life continues to be better with the use of opioids and that the benefits out weigh the risks, then the marriage can continue in wedded bliss.
Additionally, before accussing someone of lacking personal experience with these matter, you'd better know the person personally. You have no idea what I have and have not lived through.
Dr. Christina Lasich, MD
I think your comments would be better received by the chronic pain community if you DID share YOUR personal experience with this very nasty, draining, miserable condition. As one responder said, you do not seem to comprehend what it is like to live day after day after day with constant, relentless, agonizing pain; perhaps that's why your article does not elicit the response you hoped it might. If you had the choice, after 20 years of doing EXACTLY what your neurosurgeon told you to and were then considered a "failed back patient" and your choice was to use medications to WALK and lead a relatively "normal" live, you might see "chemicals" in a different light. Do I WANT to have an implanted morphine pump in my stomach that requires refills every 50 days???? OF COURSE NOT; but I DO want to be able to be halfway normal for my grandchildren, my husband and my son. I thank God every single day for a pain management doctor who CARES that MY life has meaning and is NOT defined by my pain, and who also is NOT afraid to prescribe "chemicals" to assist me in living the only life I get. It's called COMPASSION.......you might try a little of it in your next article on the difficulties of choosing to use "chemicals". Life's choices are not ever simple.
I am sorry if this subject makes you feel uncomfortable and defensive. Explaining my personal experience will not help you feel better (yes, I have explained my life experience with pain before).
Sometimes the facts about the consequences and risks of opioids are not explained at all for fear of causing anxiety. Although ignorance is bliss, this failure to disclose information can cause more harm than good.
As I acknowledged in my article, sometimes long-term opioid use is "essential for having some quality of life" (and that certainly sounds like the case in your life). But that is no reason to bury your head and be ignorant to the potential risks.
I hope that your caring doctor disclosed all of these potential consequences to you and is monitoring for these potential complications from opioid use. If that is the case, then your doctor is not only caring, but also responsible.
Dr. Christina Lasich, MD
In reference to your comments about being educated to the risks... I have noticed that the rebound from the short acting narcotics are often as bad as the original pain (ie. Taking Fiorinol for migraine causing more headaches or taking MSIR for nerve pain and dealing with migraine the next day.) The problem is I don't want to be on any long acting narcotics.
Another problem I'm finding is that insurance companies don't want to pay for some of the new alternatives to these old narcotic pain meds (like Relpax for migraines instead of Fiorinol). I have tried most of the alternative sumatriptans and nothing works like the Relpax so now I'm stuck with the Fiorinol when I get a migraine. I used to take demerol when it got really bad but Dr's aren't using that anymore. Not even the ER is giving it. They are giving a morphine type med (can't remember name right now. Starts with a "D"??) that is not nearly as effective for migraines (great for nerve pain though). My previous GP finally gave me oral demerol so I didn't have to suffer through the ER after 8 yrs. (ER visits every 3 - 4 mos.) That was 10 yrs ago and I still have some left. That Dr. closed his practice and changed specialties so I had to find a new GP. My new GP and I have developed a very good relationship and he takes care of me pretty well but is more resistant to prescribing narcotics over the last year or so. In your opinion, is that because of more government pressures? Just curious.
Amy
Dr. Christina.. I imagine you have lived through Chronic long term pain or watched someone you love live with it or else you wouldn't spend the time on this site answering all our questions. Thank You for your patience and honesty... (BTW, I'd love to read your story if you have a link to it.)
Blessings,
Amy
For me, insurance companies represent are far greater threat to my ability to relieve pain and suffering than any governmental agency or committee.
Personally, I have not experienced any pressure from the government. But, I know that am expected to act responsibly by monitoring for potential harm from opioid treatment or for misuse of opioid medications. IMO, most doctors, like me, are just trying to be responsible, objective, and caring.
Dr. Christina Lasich, MD
While I appreciate your response, I would hardly call my comment "uncomfortable and defensive". As you told another responder, don't make assumptions about a person's experiences if you know nothing about them. You are correct when you say that knowing your story will not help my pain, but it would allow me to understand that you know what it is to live with indescribable difficulty, all the while working and raising a family. Again, why would you automatically presume to believe that any of us are not already aware of the long term consequences of chemicals used for pain relief? Do you believe that the "DR." in front of your name somehow makes you more educated than we who must make that critical and yes, extremely difficult descision to medicate day after day, year after year? And no, I am not being defensive when I say that......just observant. There are many individuals in this forum, including myself, who can match you, credential for credential. This is a sacred site, where we CAN come, to help and comfort each other, knowing that our circumstances, while different, are the same. Do we appreciate your information? Certainly. Do you think you are telling us something we do not already know? Hardly.........and that is not defensive, either. I look forward to reading the articles you write in the future concerning this subject, as I know that many changes are about to occur in the medical industry, particularly, as you pointed out, as concerns pain medication.
THANK YOU!
I have to say to that this man being awful to the doctor, she hasnt assumed everyone mustnt know of the effects, as i initially mentioned that i was facing liver failure and wanted info on transfering from an opiate etc well even myself in answering this question, would do so firstly,then take any oppotunity to put as much extra info in there for other people out there that it may help or may need that info unlike your intelligent self,you should know that we are not all like you and may need this help even though you dont.go and pick on someone else not a person spending their time with the intention to TRY and help others.you would do good to take a page out of her book and make your time productive instead of destructive.....
First, I am not a man. This site took down the wrong name when I first joined. I don't think I'm being particularly difficult to this doctor at all. How long have you been a member of this site? Frankly, I'm much more surprised that the regulars didn't jump all over it way before me. I don't mean to offend anyone on a personal level; if you knew me you would know that the comment you made does not apply to me at all. I always go out of my way to help anyone in trouble and especially someone who is physically hurting. I'm sorry......the article seemed a little "preachy" to me and if I hurt your feelings then I apologize. All any of us want is to stop hurting and sometimes our individual choices are not so simply made.....even if the consequences may not be what you would choose.
Lyrica, Cymbalta, Savella are the new RX "stars" for fibro. They may or may not help but right now the pharmaceutical companies can make lots of $ because they still have only "name brand" available, no generics. Every time I look up fibromyalgia it seems the site is affilated with one of these companies.
You can look up anything negative about opioids because they have been around for hundreds of years. They may have negative side effects but they have been well studied for many years.
Most neurotransmitter drugs such as seizure, anti-depressant, and the fibro drugs, mention somewhere in their warnings that the "exact mechanism of action is unknown". Many medications used in the past 50 years or so and considered safe have after a number of years been found to have very negative outcomes.
The first one to come to mind is Tylenol. It has been pushed for so many years as safter than NSAIDS and opaites yet now we find acetaminiphin is much more dangerous than any of them. Liver damage and the highest successful suicide rate of any of the other drugs and no way to undo the damage after it has been done. Babies have been born with severe birth defects after mothers have taken small amounts of "safe" drugs.
I would much rather know for sure what I am dealing with even if it has been labeled "bad" like long term opiates, than be a victim of a wonder drug with unknown mechanism of action.
I still wonder why all the new wonderdrugs widely advertised to be safer than opioids make a lot more money for their companies when often their safety has not been adequately studied for many years of use.
Stays in the fat in your brain, may cause brain damage, causes weight gain if you want it or not. Last but not least, as with unregulated alcohol in the past, there is no standard of what is included in mj, just as no idea of safe dosage. I am not against medical mj, just want a better idea of what is actually going into my body.
Dr. Lasich, am I to take the word of a doctor who didn't know a pestcide was toxic? I have fibromyalgia, over 20 years now, and it has taken that long to obtain a modicum of relief from my pain, with a cocktail of meds. Yes, I do take an opioid, along with meds for depression, anxiety, and restless legs. I went through hell trying to find the balance of medications to relieve the never ending pain, sleeplessness, etc. that go along with my diagnosis. I actually went through
Effexor withdrawal, cold turkey, and lived to tell the tale. I am terrified to try any other drugs, or to stop the ones I do take, for fear of another event like that one. I would like your take on what a person is to do to get onto a regimine of non-withdrawal pain meds. Keeping in mind, I also have osteoarthritis, osteoporosis, and several other conditions that are not even covered here.
Ha! I guess I would not take any gardening advise from me. Silly me, I thought pesticides were only toxic to pests.
In regards to getting off the frequent cycle of withdrawals caused by taking short-acting opioids around the clock (every four, six, or eight hours), the best way to stop this roller-coaster is to use long-acting, sustained release opioid medications only.
The leading experts who set the standard for care in this nation do not prescribe short acting medications (vicodin, percocet, norco, oxycodone, etc) at all. The patients are informed that they will be placed on equivalent doses of a long-acting medication. If the long-acting opioid medications do not "work" than that is taken as evidence that the painful condition is not "opioid responsive" and that he/she should not be on opioids at all.
Changes are coming across this nation and a lot has to do with these consequences, the consequences of long-term opioid use.
Dr. Christina Lasich, MD
Yes you may chose to not use opiods or chemicals as you call them. However I think your pain level must be very very low. I can't see anyone in severe pain, as I have nonstop 24 hours a day, that could even consider not using any and everything available to combat the pain. I wish my pain level was that low!!! People like you really get me upset! Are you the mister toughman or are you just a wimp wanting to make youe self appear tough as nails?
As a chronic pain patient, this topic has been a long time concern of mine (not just with pain meds but antidepressants, nexium, sleeping pills and allergy meds too.. doesn't your body become depentant/resistant to them too?) My concern is a two sided coin. Both the resistance of Docs to prescribe for chronic pain patients for fear of losing thier liscense and the over use of prescribing. I have noticed a marked resistance to give pain meds over the last year or two. Even with Dr's who know me well and have never been suspicious of my motives in asking for them. I've referred people to these docs because they have chronic pain (other TN patients and chronic back pain) that have been treated like they are drug seeking and made to take urine tests, sign contracts and been interrogated. (which I understand but... with patients who have long documented cases like TN and my 78 yr old father who has severe osteoarthritis and several replacement joints and fusions in the spine.) This makes me MAD and confused. What do we do?
I have had Trigeminal Neuralgia for 12yrs and am on a A"cocktail" of meds to try to combat the continuous pain. They call Trigeminal Neuralgia the "suicide disease" because the pain is excruciating. Most of the meds I'm on are antiseizure(lyrica & Keppra), antidepressants(cymbalta) and muscle relaxer(baclofen) but I do have instant release morphine for flare ups that I take 1-2 times a week.
I have been thru 2 neuro surgeries with the most recent being a Motor Cortex Stimulator but have not had complete relief. (caveot.. I did know going into the MCS that it was a pain "management" device and wouldn't eliminate the pain.). I have tried several different cocktails in the past and always reach a point of them becoming ineffective even at very high doses. My GP and PM docs put their heads together about 5 yrs ago when I had reached one of those points and took me through a 5 day inpatient "withdrawl" where they lowered my doses. Prior to being admitted I did reduce methadone (the only long acting opiod I was on besides the MSIR) from 15 mg down to .25mg (over several months). Once the inpatient time was over I was reduced to almost 1/2 what I had been on and eliminated the methadone completely. I won't say it was fun b/c the withdrawls were horrific but the lower levels were more effective than the higher levels for quite some time. The thing about the inpatient reduction that I found easier was the initial withdrawl symptoms were masked by the meds he kept me on for those 5 days (IV Phenegren and an antianxeity med). It was a hassel and the 2 weeks after were still hard but it was worth it.
They inched back up over the next 5 yrs before I decided to go for the MCS. Since the MCS I have been begging my GP to do the inpatient reduction again and he is resistant. He is also resistant to giving me any additional short acting narcotics for my other pains (SI joint injury, arthritic joints, migraines and Fibromyalgia). I don't understand the resistance. Everytime I ask I get the response: "I'll think about it". I don't want to pester him about it but... I really want to lower these meds and it is tourture to do on my own.
I know this was long but I think puts my concerns in perspective... thanks,
Amy
Thank you for sharing your valuable perspective. Physical dependency and the development of tolerance are two of the major consequences of long-term opioid use. With opioid rotation (switching to a different opioid) and smaller doses of multiple different opioid molecules (not just high doses of one opioid), sometimes these consequences can be avoided.
When someone is on very high doses yet still experiencing severe 24/7 pain and is not functioning well, then a change is necessary and the treatment plan needs to be re-evaluated. Sounds like the inpatient treatment you received was a way to reset your system. Buprenorphine is another way to reset the system. Just something to consider.
Dr. Christina Lasich, MD
You are welcome. Yes, buprenorphine is used as an outpatient treatment for pain and/or opioid dependency. Only certain doctors have special license to prescribe it for the treatment of dependency. Although, any pain specialist can prescribe it for pain. It is worth looking into.
Dr. Christina Lasich, MD
But hang on as i have haD IT EXPLAINED TO ME AND THIS HAS ME IN THE STALE MATE OF NOT BEING ABLE TO TRANSFER FROM ONE OPIATE TO ANOTHER,I LIVE IN NSW THE LAW IS THAT THE NSW pHARMACUDICAL aUTH.bOARD WILL NOT APROVE AN OPIATE FOR A CLIENT WHILST THEY ARE ALREADY APROVED AND ON ANOTHER.oNLY ONCE COMPLETELY OFF AND FINISHED WITH ONE OPIATE FIRST THEN THEY WILL ASSESS AND APROVE THE NEXT ONE.So how do i transfer when this is what they have to do???This is my very problem and now having a failing liver this problem being unable to transfer may really be a killer to me....
Dr. .. Additional info.. I do understand the difference between addiction vs. physical dependency. I don't believe that mose chronic pain patients become addicted but rather dependent. I know there are exceptions but most that I know of don't want to be on any of these meds. I also was reading the article on here about the new Obama initiative to lower pain med prescribing and it really concerns me because I know that I have definitley gone "under treated" because of my regular need for opiods (especially in the ER).
Amy
I just turned 80 and have been fighting chronic pain since I was in my 50's. It started from neck problems that were subsequently corrected by having laminectomies in three joints. Then, I had severe chronic pain in my back due to a joint that was self-fusing. Surgery was unsuccessful so, in those earlier days, they often treated chronic pain with Darvocet which is no longer used because of problems with the opioid ingredient, propoxyphene.
I finally went to a pain management clinic and was first placed on Fentanyl patches which were effective until the batch I was using was recalled due to leakage. As a result, I was treated to the great displeasure of experiencing withdrawal.
Then, I was placed on Avinza which is a long acting version of morphine that was quite effective although extremely expensive. Some time later, I had an intrathecal morphine pump implanted that, after proper adjustment, was very effective in controlling my back and residual neck pains. I'm still on the pump and the morphine inside was recently replaced with dilaudid. So far, the pains are under control unless I do a lot of bending at the waist. So long as I can go on walks for exercise and perform light activities, I'm quite satisfied. Prescribed breakthrough medication is 5 Mg. of oxycodone no more than 3 times a day but I find this low dose completely ineffective so I don't use this narcotic anymore.
I'm also now on Lyrica and Cymbalta which seem to make the residual pain more tolerable but both of these medications have side effects that include constipation, occasional mild imbalance and sleepiness not unlike that which opioids can produce. I'm not sure if the long-term effects of these two medications, that are basically anti-depressants, will be any better than the narcotics but if they help keep me from taking oral narcotics, they may be a significent advantage.
I recall reading a summary of a study on the effects of long-term use of narcotic pain control medication in the elderly. It basically indicated that there were no serious problems.
Many physicians are less concerned about narcotics than with the acetaminophen contained in combination medications such as Percocet. This is because acetaminophen is also frequently contained in many over-the-counter products for colds, headaches and general pain concerns. The result is that people may overdose on this ingredient causing serious liver damage especially in the elderly. Narcotics are apparently not metabolized throuigh the liver as is acetaminophen.
I'm fortunate to be just dependent on narcotics but not addicted. The difference is that, over the years when I was taking narcotics orally, I never used or desired more medication than what I needed to control pain. Only the propoxyphene, that I took initially, caused some euphoria even at the prescribed dose.
The pump provides a relatively low dose of narcotic medication directly to the spinal cord so that side effects are quite limited although I would expect to have withdrawal symptoms if it were to suddenly stop operating. Similarly, Cymbalta and Lyrica have warnings about abruptly discontinuing their use.
You articulated your experiences very well and seem to know your medications well. My mother in law could never figure out what was what when she was your age. I feel so badly that you have had such a difficult time of it but glad you have finally found some relief. You mentioned Lyrica and Cymbalta both being antidepressants. The Cymbalta is in the antidepressant category but it used off label for pain management. Lyrica is an antiseizure med that is also prescribed off label for nerve pain patients. I am on both of these meds for Trigeminal Neuralgia (facial pain). I have used several other of the same kinds of meds over the last 12 yrs too and have had to stop one of them cold turkey b/c of a negative side effect (after 8 yrs of it) and it was excruciating until I could get on a replacement. I have also weaned slowly off of meds and even that was painful so I would warn you to take your time if you ever have to come off. Thanks for sharing your experience for all of us... You're really a trooper.
Blessings,
Amy
Thank you for the article. It was very informative. I also thank you for the part at the end where you mention that everyone must make their own choice about taking pain meds. I didn't know about the long term effects when my Dr. began perscribing me the opioid pain meds. He didn't explain any of that to me. I think you are right about not wanting to cause any more anxiety, especially since I already struggle with anxiety. Anyway, I was wondering if these effects of the opoid pain meds can be reversed if the meds are stopped. Or does a person have to live with their nervous system being overly sensitive, the metabolism changes, ect. ever afterward?
Thank you,
Rachel
Thank you for voicing your appreciation for this information. I am sure you are not alone. And you ask a very important question: Are these consequences reversible?
The human body is able return to a natural homeostasis once the external sources of opioids are removed. But that ability is dependent on a number of different factors: recovery time, health of the individual, other underlying disease processes, other medications used, age of the individual, and so on.
In my experience, the hormonal imbalances take longer to recover than the nervous system sensitivity. For example, a woman who has been experiencing extreme headaches for years finally listened to the advice of many doctors and exited off the opioids with the Suboxone program. Her nerve pain, her headaches were completely gone within a matter of weeks and she asked me, "Why do doctors prescibe that stuff?". Well, for some people "that stuff" does help help them live better lives; but for others like her, it makes matters worse in the long run.
Another gentleman called me looking for advice because he continues to stuggle with symptoms of fatigue and sweating after being off the opioids for three months. I told him that he probably continues to experience the effects of hormonal imbalances and may need to see an endocrinologist to help re-balance the system.
So, your question about the reversibility of the consequences from long-term opioid use is very relevant. Thank you for asking it.
Dr. Christina Lasich, MD
Hi Everyone, first of all I want to say I really enjoy everyone's post no matter what the opinion. Afterall, knowledge no matter where it comes from can only help us better understand how these med's affect our bodies. We are all different ,so we are all going to have different reactions to our med's,good or bad.I have been takng Either Morphine or Oxycontin for over 5 year due to a rear end car accident I was involved in that caused major back issues almost 6 years ago. Even though I have been getting my med's from a Chronic Pain Specialists, I have come to learn only the people taking the medication can truly understand and have knowledge about what these med's do to our bodies. I was given the med's for my chronic pain but to be honest with you no one inluding my GP gave me any information on any side effects let alone the many many side effects we all know are not listed in any article this side of the moon. I started having major problems with my weight just a few months after starting taking the Oxy( which I had never ever had before taking the med's) no doctor including an Internal Medicine Doctor had any answers for me which really uspet me. It took over 4 years of being on both med's at different times ,lots of research and lots of questions in my own mind to realize both Oxy and Morphine cause major problems with large weight gain once you start taking higher amounts of the long acting. I have come to realize both med's do have the same effect on my body ( yours may be different) no matter how much I move around or exercise my body doesn't realize I'm moving so I work for nothing and have no weight loss. So in other words you body thinks you are not moving and are dormant even when you are. They also cause my metabulism to completely shut down again causing major weight gain. So around 5 months ago, I started the long journey of decreasing my med's to a low enough dose that my body started acting like normal when I exercised and I finally started losing weight.So at 30 mgs of Oxy every 12 hours my body has fnally waken up after a 5 year sleep. I will also be the first one to agree that I did come to realize while I was on the higher dose of med's that they actually caused me more pain. Even though my dosage right now is around 60% lower than I ever took, my pain is under control now just as good as a much higher dosage. Morphine caused me to have severe headaches ,day in and day out.It also caused very bad skin problems on the palm of my hands to the point that my hands were so raw it looked like I had 3rd degree burns on them.Both problems cleared up with a change of med's back to Oxy. The only problem with the Oxy other than the weight problems has been my allergy to the drug at any dosage of more han 80 mgs twice daily ( which I've been on often in the last 5 years).I break out in severe itchy hives and the minute the hives hit my neck or above my lips swell and my throat closes off. ( not exactly a picnic on the beach by any means !!) As long as I'm on a dosage of less than 80 mgs twice a day I only get hives scattered over different parts of my body and it never affects my face or throat.
I'm sure no one out there has had the exact same reactions to these same medications I have ,so I hope my information can help even one person out there with questions that cannot be answered. I do hope the public continues to talk openly about their experiences with these med's and eventually we will all have the necessary knowledge to make wise decisions where these medications are concerned. Even with all the side effects I would not be able o function at even close to a normal basis. I have a 14 year old to raise these med's help me do that so I'll live with the side effects as long as my son is a happy teenager,life does go on even with the pain.Colleen
Colleen, thank you for sharing your valuable information. I am sure it will help one if not more people out there who like you received little or no information from their doctors about the side effects from opioid medications. As you have discovered, more is not better, less is better in the long run which is why adjunctive therapies like accupunture, QiGong, exercise, meditation, nutrition, hypnosis, etc all need to be utilized as part of a pain management treatment plan.
Again, thank you for sharing your experience. Hopefully, this information will help someone else make his/her personal decision about opioid use.
Dr. Christina Lasich, MD
Christina...where are your bumblebees, ladybugs, and butterflies? 
Pesticides kill all insects not just the ones we think are pests. It is a difficult choice when our end goal is beautiful flowers(I love to garden.)
The herbicide 24-D did terrible damage to our bird populations and the idea was to increase our production of food crops by killing weeds that crowded them out.
Most insecticides are neuro-toxins and now carry as many label warnings as our medication labels.
All our chemical use, including medications, often carry a great burden of benefits vs. detriments. The problem lies in the balance of the importance of the need for its use, or replace it with something deemed "safer" or choosing not to use it at all.
By all the differing opinions already posted regarding this subject, it is not an easy decision to make.
Thank you for opening a channel for many people to think about and consider their options.
Skye,
I do feel badly for the other good insects in my garden. My goal of pretty flowers may not be worth the price of mass insect destruction. Admittedly, I need to change my gardening ways to be more harmonious with all creatures great and small.
Sometimes it is worth the time to re-examine our choices.
Dr. Christina Lasich, MD
While I appreciate the content of your article, for some of us, there is no getting around using an opioid if we are to have some semblance of a life. When all other treatments....nerve ablations, traction, PT, injections, and so forth, fail to bring any relief, we are left with very little choice. In fact, pain medication and muscle relaxers WERE a last resort treatment option for my pain doctor. I have degenerative disc disease in my neck, which is excruciatingly painful, yet the doctor has told me that at my age, I'm not considered an ideal candidate for fusion surgery. Because of the DDD, I suffer from horrible migraines, muscle spasms, and the majority of the time, have very limited range of motion. The pain doesn't allow me to sleep, pick up my 2 year old son, or live a normal life. I don't take a high dosage of pain medication, nor do I take it on a daily schedule, however, I do take it when I absolutely have to. Marijuana isn't an option for me either. I live in a small Ohio town where even the possession of a very small amount is enough to get you arrested because there is zero tolerance here.
Before I started with my pain doctor, I was on Oxycontin for almost 7 years. Never in that time did I require a dosage increase, and it worked just the same in the end as it did in the beginning, probably because my doctor had me taking it "as needed" rather than on a set schedule. Not the typical way to take it, but it worked for me, and he was happy with the results. Now, with the development of the so-called "drug task force" developed here (where they are going after prescription drugs on the street and ignoring the illegal drug problems like heroin and cocaine), it's becoming amazingly hard for chronic pain patients to get treatment. They said it was a street drug crackdown, so why are legitimate pain clinic patients paying the price? However, I will keep taking pain medications as long as I have the excruciating pain in my neck, regardless of this, or any other article to the contrary. I'm not about to suffer needlessly in pain because I have a family to take care of, and my son needs me as an active participant in his life.
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dr. lasich
i am beginning to think that i may fall into this category
i take (4 )7.5 mg of percoset daily (for the past 2 years) and the dosage isn't enough for my chronic neck pain (three cervical fusions with multiple problems at every level)
how will my very caring and wonderful pain management doc approach this situation...if in fact i fall into the category of your article
beanie
I am not sure exactly what you mean by "falling into this category", but I will assume that you are experiencing some of the consequence of long-term opioid use.
If that is the case, then two solutions can be explored. The first solution is to exit off the short-acting roller coaster ride by eliminating Percocet and replacing it with a long-acting, time- released opioid. You will still be on an opioid, but at least will not be experiencing frequent withdrawls. The second solution is to exit off the opioids completely with the help of Suboxone.
Both solutions have merits and shortcomings, so your individual situation will need to be taken into account along with your long-term goals. Hopefully, your caring doctor can discuss these options with you.
Dr. Christina Lasich, MD
Hello i am on methadone for chronic p.man. due to nerve damage and several perferated disks.From this my lft side doesnt work properly still frm accident ten yrs ago leaving me the use of only my right arm.I am now being sent for my liver failing,to the liver clinic.The methadone has done some damage so i would like to find an answer.the pain clinic said i didnt have enough body muscle through deterioration to be bed ridden while they take me down to nothing before starting me on morphine.As i had asked if they could transfer me to it instead.Is there a way around this to be able to be maintained on any other pain management of some sort and a way of transition from this methadone whilst in this condition?PLEASE HHHEEELLLLPPPP>>>>THANK YOU GOD BLESS to anyone that can...kazma
If you have a wonderful, understanding pain specialist, you should consider yourself one of the lucky ones. My pain specialist always, routinely prescribes pain medication three times a day so that I am taking it every 8 hours. Instead of getting ahead of the pain, I am always chasing it. To his credit, his emphasis is on nerve blocks and radio frequency ablation. Only problem is the radio frequency injections didn't take care of the pain. So we tried a second time. To make a long story short, my sciatic nerves are now affected. OUCH is an extreme understatement, and I am still chasing pain. Either the right sciatic or the left sciatic nerve is excruciating, depending on which didn't get the last injection. If you dare get your courage up to ask about taking the pain pills every six hours instead of eight, you are told they aren't ever prescribed at 4 a day, only at 3 a day. Oh, well. My attitude has to be I will get through this as I have other things.
Hi there, I've been on long term(about 8 yrs now) Methadone for Chronic nerve pain (Sciatic,arms and the whole spine) I've been on it and others for quite some time now 25ml, 3 x a day, I used to be on 85 ml, 3 x a day, and I found it never really helped just made me a walking zombie, so I cut my Methadone dose to 25ml all by myself, and I did it in about 2 months, I suffered major withdrawls but it was worth it, I'd like to go off it alltogether but one doctor I went to see tod me there was no way my brain would let me go off it, I don't quite understand that?? I personally don't think it's true.
If I may ask, how much methadone were you taking and for how long?? What kind of liver problems arose from the Meds and did you get your liver emzymes checked frequently?? cause my dr. has never sent me to get any blood tests done to make sure all the meds I'm taking aren't killing me from the inside out.
I also take Oxybutynin 5mg/day, Nortriptlyne 75 mg/a day, Clonazepam 0.5mg/2x a day, Cyclobenzaprine 10mg/2x a day, and wash it all down with a pill ( Rabeprazole 20mg 2x a day) to help with all the acid reflux these drugs have caused.
I'm going to see my doc on Monday and I think I better get a lot of tests done!!
Thanks everyone!
Lucy