Are some people 'resistant' to opiate medications, and find no relief from pain?
Hi, I have been having a lot of problems finding a drug that will relieve my back pain. I have 2 herniated discs in my lumbar back, but a new disc in my cervical (C6) back has left me totally overtaken by constant severe pain in my neck, back (at C6) and my right shoulder, bycep, forearm and hand. It is constant stabbing, throbing pain that starts in my neck and moves outward through my right arm. Nothing stops this pain. NOTHING. It doesn't matter if I am standing, sitting, lying down, using Ice, or heat, day or night, or what medications I take. I have been given Gabapentin, Prednisone, Cyclobenzapr, oxycodone, dullaudid, MS Contin, and Fentanyl patches. It doesn't matter how much of the opiate drugs I take (within reason, I'm not out to OD) I simply have no response to the medications. Now I'm 48, I understand drugs, getting high, etc. and I know what high feels like. I feel nothing. with the dullaudid, oxycodone, and morphine I feel no effects at all, no dizziness, lightheadedness, uphoria, drowsiness, nothing, let alone relief from my pain. I have taken up to 10 4mg dullaudid at one time with NO effects whatsoever. My oxycodone dosage is 10 MG every 4 hours and it takes care of my lumbar pain fine, but does nothing for the nerve pain in my C6 no matter how much I take. I did however find some relief from pain with Fentanyl, but it was suckers given by a friend that he uses to treat cancer pain but it's dosage was strong enough to put an oxen to sleep. I do NOT advise or suggest that anyone take these drugs in these amounts, I am simply at my wits end trying to find relief, and cannot find any. My question is this: are some people by the shear nature of their chemical makeup resistant to the effects of pain medications? If so, how do these people get relief? Could the reason simply be that because I take oxycodone 10 mg every 4 to 6 hours for the past 6 months built up a tolerance to opiate meds? I am so worn out from being in severe pain 24 hours a day, I am ready to do anything. Please help, Thanks..Tommy
Yes opiate resistance does occur (unfortunately). Check out the below link for a paper on opiate resistance in AIDS patients. This physician reccomends continuing to use opiates but boosting their effectiveness with other agents. He does not believe that long-term use of opiates causes tolerance. The problem may very well be genetic; researchers are beginning to disentangle genetic differences in fibromyalgia patients, for instance, that cause some of them to respond to one type of pain medication better than another.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1275976
You really need to find a really sharp specialist to address your pain. Some hospitals have special pain management centers.
Check out this article that suggests that opioid resistance is common in fibromyalgia patients. The presence of an injury does not mean you might not have FM as well which is characterized by widespread pain. FM is treated differently than other types of pain. You might want to check out the FM section of this website.
http://www.medpagetoday.com/Geriatrics/PainManagement/tb/6811
http://www.healthcentral.com/chronic-pain/fibromyalgia.html
This is going to take some research. Good luck!
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Yes. As well as making folk sick (as in my own case) opiates sometimes have absolutely NO effect at all on some. My own Dr told me of anothr of his patients who is absolutely unmoved by opiates in any way. She is,apparently, doing very well on Prialt(Ziconitide). Unfortunately it is VERY expensive. I tried it to no availe, it made me sick, just like everything else.
Mag1
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RickJay
Saturday, May 23, 2009 at 11:26 PM
I really feel for you! I have been seeing a pain doc and many other docs for a year now with a torn and leaking disk, siatica, and for some reason yet desided- missed periods or periods that last 20 days and give terrible pelvic pain. i have been on several different opiates, norco (stopped working after 6 months), percocet only works well with another long acting medicine too), fentantly patch (left me with open sores and did not help), opana (helped!!! but i couldn't pee!) and now oxycotin (seems to be helping a bit with the percocet as well and gapabentin. i am also complelty resisitant to morphin. i always tell my docs that- i have had 3 surgeries where i came out of them on morphin screaming like hell and they kept giving me more, finally they believe me and switch to something else- the last time i ended up in the hospital after a outpatient surgery for 1 week just to get on top of the pain. don't give up!!!! you are not abnormal. one thing that has really made a difference for me is getting a full nights sleep every night- and i understand that may not seem possible, my pain is at its worse when i lay down too. but i fianlly was prescribed a sleeping med- ambian cr. it really works and i never feel groggy when i get up! it has taken my pain level down to a 6!
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I feel your pain! (Sorry couldn't help it)
I have this spinal weirdness going on that is a real combination platter. L-3456 screwed up - then a fracture of C-11 I think- mid back where it is actually leaning on the spinal canal. My doctor is a champ but at a loss what to do . The theory put forth was functional stenosis, with several other terms- point is I never know when the little monster is going to put me down. Point is I took tylenol 4 for two years and alternated it - with Tramadol 50 mg. X 8 a day. The tramadol beat out the tylenol 4 and even the vicoden he put me on just recently. Problem is the tramadol you must watch since it takes more for the effect so to speak, over time. But if it's in your system it seems to help (the pain is always there) and it numbs me some from throat to groin and feet somehow. I was so pissed off at one point I took 6 tylenol 4 in front of my wife and all I got was this bloated feeling, trying to make her understand something was wrong with the meds or my body- I do believe that some of us are imune to certain drugs. I believe that somehow the body percieves it as a threat and runs it right threw intact so to speaak on a moleculer level. The switching back and forth was my own attempt to keep from addiction since I have 21 years sobriety so to speak and I am angry since the whole scenario has me feeling threatened. I did however see a phsychiatrist to oversee me since I was really getting depressed etc... but for the most part to oversee my behavior becuase of my compulsive nature. I still have horrible insomnia from the pain and general malaise - but try tramadol and alternate aproaches - I am trying to figure out how to clean out the old thinking and go for acupuncture or an alternate- wich generally doesn't sit well with the crusty single headed establishment but my doc is cool with it.- good luck -B
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Just to add to the discussion, opiates do not and have never had substantial effect on me. I've never had chronic pain issues, but on maybe half a dozen occasions in my life have been prescibed opiates for temporarily severe problems - a bad root canal, hopsitalized for migraine, a temporary back injury, stuff like that. They had no more effect on me than, say, a couple of Advils.
Conversely, my father, if he takes something like that, can barely stand up thirty minutes later. Go figure.