Chronic Pain, Maximum quality of life

[exitwound]

I'd like to talk here in this thread about anything and everything that can improve quality of life for people with chronic pain.

Obviously opiates play a big role. It's basically impossible to properly manage most kinds of moderate to severe CP without them.

Oxycontin was (and for many still is, or at least should be) a wonder drug. Fentanyl similarly can do wonders when used properly. But these are both being held back from many CP patients in this "brave new world" of paranoia about getting in trouble with the DEA.

Long-acting morphines such as MS-Contin, Avinza and Kadian are now the top choice for many docs who are willing to treat CP with pain medication at all. Hydrocodone is usually the weapon of choice for breakthrough pain or other short-acting applications.

This is the combination I am prescribed. I supplement with poppy pod tea, and I grow my own poppies as well as medical marijuana to round out my arsenal of tools in this struggle against CP.

So.....other CP sufferers, or those who'd like to discuss related topics, please -- join in!

[caesee]

My doc is the same way no oxys, but he will give fent., personally I didnt care for it..(I had a horrible rash where the patch was, that was itching like a mother fucker) My monthly is 60mg ms-contin (80 count) and 10/325 percs (100 count), plus I have the "watson connect" which has unlimted hydro and he will trade them for herb good backup. I normally grap about 1, 500 count bottle from him. I was also on hydro but my doc finnaly dedcided to give me percs. I also have a medi-marijuana card, which helps me. Although I do smoke 70% of the time, I have found that eliables (homemade) and hash pills (cannabrex system) work really well when a longer effect is needed. I have wanted to grow poppies for awhile, but dont have the space right now.

[alowishus]

I think it was around or just before the turn of the millenia the maker of OC's was pushing hard on all the Dr's in their pocket to give out oxycontin, and boy they did, there was a flood of OC's scritped out; many did see it as a wonder drug. 9 times out of 10 it was giving to the elderly for a myriad reasons, you name it....you got it.

Well 2-3 years later suprise suprise there was created a whole generation of elderly junkies, freaking out cuz the Dr's were cutting back the meds, going through hard W/D's. Most had NO IDEA what was going now, being the generation that grew up well before the drug culture (40's) Besides Dr's were like gods to them, what they say was law so if this little pill was harmless....it was.

Once the medical community started to see what they were doing, they did the thing that is best for them, stopped scritping OC's and hushed up, if you don't talk about it it's not real. So this nation wide group of old junkies were swept away w/ a brush of the Dr's hand and never really talked about in the media.....

Never researched fent so I can't tell you any stories about it. But it's not the DEA, I mean they're "jonny come lately" to the OC's ban, it's the Dr's themselves, it's the act of addiction which they feel is worse then the cause of the original ailment; and to "do no harm" means helping people from themselves. Hey we've given these guys that power over us....right? (That's another thread)

But for any GOOD Dr's too have the means to help a person in real pain, and doesn't ....well.....find another one.

[exitwound]

To the best of my knowledge I have the best doc available to me. I just have to provide for myself, whatever he is not able to give.

[thanatos]

I suffer from chronic pain, I was run over by an 18 wheel truck. Many broken bones, crushed disks in back, etc. At first it was Morphine and then they tried to say Vicoden. I went ape shit. I was not going to go from Liquid Morphine, Dilaudid and valium to Vicoden. So it titrated down to OC's and Fentanyl and Percodan and Valium. Then I had a problem and all my OC's for the whole month got snorted in the first week. I was scared as shit. I doctor shopped a bit. Had to find alternate sources while I considered how to approach my doc. Finally we agreed on Methadone and some occasional OCs and Valium, but not much really. I am very happy with the way Methadone handles my pain, actually. I did the research on what the hell I wanted to try, and it seems in a reasonable % of patients methadone works well for chronic pain, and it handled my withdrawl issues. Now I guess I am best described as a maintance addict, or chronic pain sufferer, or something. I have a legitimate physical problem, and am fortunate that my doc understands the balance of pain, reasonable compassion, drug balancing, and understanding my needs while being able to feel okay about the ethical implications of the situation.
Thanatos

[exitwound]

I suffer from chronic pain, I was run over by an 18 wheel truck. Many broken bones, crushed disks in back, etc. At first it was Morphine and then they tried to say Vicoden. I went ape shit. I was not going to go from Liquid Morphine, Dilaudid and valium to Vicoden. So it titrated down to OC's and Fentanyl and Percodan and Valium. Then I had a problem and all my OC's for the whole month got snorted in the first week. I was scared as shit. I doctor shopped a bit. Had to find alternate sources while I considered how to approach my doc. Finally we agreed on Methadone and some occasional OCs and Valium, but not much really. I am very happy with the way Methadone handles my pain, actually. I did the research on what the hell I wanted to try, and it seems in a reasonable % of patients methadone works well for chronic pain, and it handled my withdrawl issues. Now I guess I am best described as a maintance addict, or chronic pain sufferer, or something. I have a legitimate physical problem, and am fortunate that my doc understands the balance of pain, reasonable compassion, drug balancing, and understanding my needs while being able to feel okay about the ethical implications of the situation.
Thanatos

good to have you with us man! hopefully you can share a different perspective with us. i know that i am struggling with a lot of the same issues as are many others here...

[elegua]

To be fair, while of course there are all sorts of personalities represented in the profession known as 'physician,' I should also point out that there are many 'watchdog' organizations in the United States that can permanently ruin a physicians career if that dr. is perceived as being too 'free-wheeling' in regards to how they prescribe certain medications. Despite the fact that several studies have indicated that withdrawl is less of an issue when pain is severe, still we have many, many non-doctors second-guessing the professionals in regards to how they practice medicine. Sure, there are doctors who are major pricks and won't give a pain patient the benefit of the doubt...but there are also plenty of doctors who would be willing to write the prescription but second guess themselves just because they don't want to be dragged in front of some inquiry board or get a notice that they're under investigation for writing 'excessive' pain reliever prescriptions...considering 'excessive' is a completely subjective term, it doesn't feel good to be stuck in a world of constant paranoia, stuck under the thumbs of the whims of bureaucratic types.

[oc80tn]

It really pisses me off that oxycodone gets such a bad rep concerning its abuse liability and dependency. Sure, if you suddenly stop taking oxycodone in any form (Percocet, Percodan, OxyIR or the dreaded OXYCONTIN), your ass is gonna get sick, especially if you've been taking a high dose and/or you've been taking it for an extended period of time. The same is true with hydrocodone, hydromorphone, morphine...whatever.
My point is this. I have been noticing a lot of people on the boards here who have had their doctor switch them from OxyContin over to other extended release drugs like Duragesic or MSContin because of the fear of addiction to Oxy. Let me tell you, I have gone through withdrawals from Fentanyl and Oxycodone. If I had to do one or the other, I would take oxy wd's any day of the week! I was sick for a good 8-10 days coming off Fentanyl...and I mean throwing up, diarrhea, worst flu ever sick. I refuse to ever take it again just for that reason.
The Oxy withdrawal was just as bad with one exception. After about two days, the worst of it was over. It took about 5 or 6 days to completely get over it, but I turned a corner after day two, going into day three. With the Duragesic, it was rubber room time for over a week.
My buddy, SWIM, has a similar experience with morphine. He agrees that oxycodone withdrawal is a whole lot easier than hydromorphone, fentanyl or morphine withdrawal. For some reason, they just seem a whole lot more severe, especially in their duration.

[exitwound]

you couldn't be more right, oc80tn. I have often been told (by experts other than my prescribing doc) that fentanyl patches and perhaps Actiq for BT would be the best choice for my kind of pain condition. but aside from the huge cost for an uninsured person life myself, it can have a profound effect on some people's emotional stability (can cause anger, depression, irritability, over-emotionality, etc in a fair % of patients) that morphine usually does not.

of course, high dose morphine can definitely mess with people. and even in mid or low doses it certainly causes intense nightmares; i wrestle with them almost every night. but i've heard more reports of day to day psychological difficulties from oxy and fentanyl for some reason.

i think i would be a lot better off on oxycontin, probably 3 80's per day (every 8 hrs) with up to 3 30mg Roxicodone for breakthrough. but my doc is into low-dose breakthrough, emphasis-on-long-acting regimens so i have to get my extra meds from ROP's which means more hydro.

oxy and oxy, or perhaps oxy and hydromorphone, would be the most effective for pain and probably the easiest on me in terms of side effects, tolerance etc....but oh well. politics dictate otherwise, and the supplemental medications i can get my hands on are either expensive, hard to produce, or both.

[halfalien_s4]

my doc wouldnt do oxycontin just because of the bad wrap, and explained that he wanted to but he was afraid to...but he did give me 2 bottles of oxyfast for BT pain along with 30mg of avinza 5 times a day at first along with 60 norco 10s. i love my doc to death hes so cool! he recently put me on actiq (instead of oxyfast) 4 x a day, & methadose 40mg twice a day, and at that point i still had atleast a half bottle of 150 avinza left and he said i could go ahead and take it too along with the others if i needed it. so far im in less pain than ive ever been i think even tho i still have my bad days and flare-ups, but he has been so helpful and compassionant. hes the first one ive gone to thats been this good (ive been to several pain specialists) and ive been with him for about 3 yrs or so now. altho i certainly know what its like to be accused of it "being all in ur head" or "being an addict" and all that bullshit you get from other people/docs that dont understand that ur in a lot of pain and why you take those meds! i just want to strangle people sometimes! people can be so close-minded sometimes! you just want to stick ur foot up their ass and tell them the way it is. thats why i like coming to places like this where others r on the same meds i am or are also CP patients like myself....

[exitwound]

you're a lucky one, HA. I finally got put on Oxycontin, but it seems like my doc is always one step behind my real pain levels. That actiq must be great! I'd kill for a few of em to have on my really bad days.....I have a couple of Methadose diskettes but I never touch them, they make me too nauseous and zonky relative to the level of pain relief.

I take a little bit of my leftover MS Contin but it's not nearly enough by itself.

[bronyraur]

i certainly know what its like to be accused of it "being all in ur head" or "being an addict" and all that bullshit you get from other people/docs that dont understand that ur in a lot of pain and why you take those meds!

I can agree with that completely. That is one of the worst feelings in the world, to be in constant pain, and not have anyone believe you.

That being said, I too am CP sufferer. I was recently switched to MS Contin 15mg 3x daily and Percocet-5mg 5x daily for nasty back problems. While I'm not on as high of a dose of opiates as some folks, it's a great relief to finally have a good doc that understands that I'm in pain! It also helps that my doc is a CP patient too. All I can say to those who don't have adequate pain control is to keep trying, no matter how hard it seems. I was sent to 6 different docs before they found out what was wrong with me (ankylosing spondilitis-basically arthritis of the spine).

As far as the OC stigma, my doc said he doesn't have a problem Rx'ing it, but he saves it until patients get up around 180mg of morphine or more per dose. So I've got a ways to go.

[PRIZEFIGHTERINFERNO]

Well i too am a Chronic Pain patient. I have a bone disorder that tears me up a little each day. Its mostly my legs one worse than the other but my back is messed aswell. The Oxycontin i am prescribed is a miracle for my life. Without it i would be screwed right now, unable to walk and unable to enjoy my beautifull wife and child as much as i now can. My doc just adjusted my dose from 40's to 80's. I always take hydro but it just wasnt cutting it (50+mgs a day) so the Oxy has been a life saver. No more waking up in the middle of the night in agony...and when that does happen i have relief now that actually gets me back to sleep. I use a crutch most of the time but when i take the oxy i can actually walk without the pain to stop me...im not really supposed to go without the crutch or cane but sometimes like when im going out with friends i dont like to use it and now i dont have too. Besides opiates i get the most out of life from being with my baby and wife...but there are a few hobbies that really help. One of them is just being able to come here and talk with people that know what its like to go through all the medical and opiate related shit that can go on. I love all you Ophiles even the haters (they make me laugh). The GUITAR is a major form of relief for me...just being able to play and let everything fade away is key. No matter how i feel i can just channel it through my guitar. Music is my life...like Bob Marley said "One good thing about music when it hits you feel no pain" (especially after 80+mgs of oxy LOL). Spirituallity is also a release for me...a time were i can just forget about everything and try to feel peace for a few moments helps alot. Reading is also a good way to increase the quality of life for me...whether its learning about the middle ages, politics, religion, philosiphy or even reading a good Graphic Novel or comic and just enjoying the art and story. So i dont know theres alot of ways i try to cope with all the shit and pain that goes on in life...coffee in the morning is also a normal thing for me...me and the wife going to the coffee shop sitting back outside reading the paper and just talking. Again this site is a great way to get a release...talk to people about there problems hopefully help out alittle here and there and get shit off my chest aswell. Alright im sorry im rambling i admit i am blasted right now, way way way opiated. But thanks all you guys for letting me get this shit out on the board. peace.

[DaOxyMan]

you couldn't be more right, oc80tn. I have often been told (by experts other than my prescribing doc) that fentanyl patches and perhaps Actiq for BT would be the best choice for my kind of pain condition. but aside from the huge cost for an uninsured person life myself, it can have a profound effect on some people's emotional stability (can cause anger, depression, irritability, over-emotionality, etc in a fair % of patients) that morphine usually does not.

of course, high dose morphine can definitely mess with people. and even in mid or low doses it certainly causes intense nightmares; i wrestle with them almost every night. but i've heard more reports of day to day psychological difficulties from oxy and fentanyl for some reason.

i think i would be a lot better off on oxycontin, probably 3 80's per day (every 8 hrs) with up to 3 30mg Roxicodone for breakthrough. but my doc is into low-dose breakthrough, emphasis-on-long-acting regimens so i have to get my extra meds from ROP's which means more hydro.

oxy and oxy, or perhaps oxy and hydromorphone, would be the most effective for pain and probably the easiest on me in terms of side effects, tolerance etc....but oh well. politics dictate otherwise, and the supplemental medications i can get my hands on are either expensive, hard to produce, or both.


have you ever tried hydromorpone ? oddly enough, i found it to be quite inneffective as far as pain relief- iwould have chosen one of those roxi 30mg any day of the week. what i'm sayin is, i would test drive it before ya try and by it for a month, cuz ya might get stuck w/ a low like 2mg dose, just the .02

[halfalien_s4]

Well i too am a Chronic Pain patient. I have a bone disorder that tears me up a little each day. Its mostly my legs one worse than the other but my back is messed aswell. The Oxycontin i am prescribed is a miracle for my life. Without it i would be screwed right now, unable to walk and unable to enjoy my beautifull wife and child as much as i now can. My doc just adjusted my dose from 40's to 80's. I always take hydro but it just wasnt cutting it (50+mgs a day) so the Oxy has been a life saver. No more waking up in the middle of the night in agony...and when that does happen i have relief now that actually gets me back to sleep. I use a crutch most of the time but when i take the oxy i can actually walk without the pain to stop me...im not really supposed to go without the crutch or cane but sometimes like when im going out with friends i dont like to use it and now i dont have too. Besides opiates i get the most out of life from being with my baby and wife...but there are a few hobbies that really help. One of them is just being able to come here and talk with people that know what its like to go through all the medical and opiate related shit that can go on. I love all you Ophiles even the haters (they make me laugh). The GUITAR is a major form of relief for me...just being able to play and let everything fade away is key. No matter how i feel i can just channel it through my guitar. Music is my life...like Bob Marley said "One good thing about music when it hits you feel no pain" (especially after 80+mgs of oxy LOL). Spirituallity is also a release for me...a time were i can just forget about everything and try to feel peace for a few moments helps alot. Reading is also a good way to increase the quality of life for me...whether its learning about the middle ages, politics, religion, philosiphy or even reading a good Graphic Novel or comic and just enjoying the art and story. So i dont know theres alot of ways i try to cope with all the shit and pain that goes on in life...coffee in the morning is also a normal thing for me...me and the wife going to the coffee shop sitting back outside reading the paper and just talking. Again this site is a great way to get a release...talk to people about there problems hopefully help out alittle here and there and get shit off my chest aswell. Alright im sorry im rambling i admit i am blasted right now, way way way opiated. But thanks all you guys for letting me get this shit out on the board. peace.
i play guitar also...its really relaxing....

[jerzyjunk]

growing poppies i must say is the most rewardind thing and the skill to grow them out of season is even more rewarding anyone in nj ny pa take advantage we have 3 chances to get as manny in if you are a beggininer try and try you will succeed

[renton]

With all the news it the media about the medical uses of marijuana do any of you think it's a better alternative for chronic pain than opiates? From personall experience weed works well aslong as it's used sparingly, too much and your too stoned to funtion. But in small doses it seems to reduce pain and anxiety and best of all it isnt addicting for the most part. Whens the last time you saw a guy giving blowjobs to pay for his weed habit? hehe

[dorje]

Opiates are the way to go for chronic pain. Nitrous works for a few minutes, LSD used to be given to cancer opatients before the government got involved.

[Maksene Delianan]

I just finished a book about President Lincoln's melancholy. I found it interesting that opiates were prescribed to him for depression, as it was a common treatment before the days of SSRIs and Tricyclics. Also, the leading mental health doctor at that time was himself depressed for about a year after losing his family in a fire. He found that opiates were the only thing that got him through, and was able to quit after a couple years by willpower. He was a strong supporter of opiates for depression for the rest of his life.

My opinion about why doctors are no longer engaging in the process of prescribing opiates is the issue of drug companies losing their patents. When drug companies lose their patents after a certain amount of years (and opiates have been around for soooo long), such drugs are no longer pushed on doctors to prescribe. Drug companies are in the business of making money, not neccessarily truly helping people. Newer drugs are always better in the minds of not so savvy doctors, despite of how unhealthy and risky they are compared to opiates. The only problem with pure opiates (ie, no tylenol etc. added) is that they are addicting. Which leads you to the question of whether addiction in itself is really a problem if it adds to the quality of one's life and does not do any known biological damage.

And yes, I agree with LIPTONBUDDY that it is true that withdrawl is hard and tends to loom about. The only thing is that one should not have to withdraw unless they want to. They should be perscribed as easily as Paxil or Effexor is (although I do think that SSRI's are prescribed a little too easily), as a daily medication, on a lifetime basis and on a medical, monitored, logically acceptable need-based regimin. Paxil etc., have awful withdrawls, but they are totally actually pushed on people. Anyway, this is just an observation of mine of the all too common practice of hypocrisy.

The second opinion I have regarding this issue is that it has been proven that only 10 percent of the population is able to feel better from the use of opiates mentally. Therefore, the backlash currently going on against the use of opiates may very possibly be a case of the many against the few. When people don't understand something themselves, they become afraid or weary of it. Because most people don't get anything out of opiates, they figure why should anyone else be allowed to, and that it must be a negative thing, whether they actually know it is or not.

For example, it is known but seldom mentioned that SSRI's damage the mind's ability to think creatively. Not to mention the suicidal side effects that have been noted in teenagers and children taking them. The drug companies simply play this down by saying that an increased rate of suicide is only applicable to young people. I have no idea what is so very different about a teenager's brain and an adult's brain that would cause suicidal effects only in one but not the other in every single incident. Chemistry is so complex that one cannot simply explain away a higher rate of suicide in someone who is 17 but not in someone who is 22. Not to mention all of the other factors, including that drug companies explain the difference by saying that after someone is 20 they commit suicide due to depression itself and not the drug. Rather fishy.

All I know, is that SSRI's have never done a thing for me except give me some pretty nasty withdrawls. Why is it okay to take these but not opiates when the withdrawl is truly just as bad and the side effects are worse? Because they are newer, and newer is always better (sarcastic tone). My doctor put me on Lexapro, a new generation anti-depressent and 2 days later I was convinced that the police must be after me over something bad I had done in my past but had forgotten about. It was a horrible time, and I can guarantee you that if I had been put on tramadol or hydro instead of Lexapro, instead of major paranoia, I would have been feeling a sense of well being and perspective.

Anyway, that's my 2 cents. I think it's important for people who understand these indescrepencies to educate the educated sometime; when the educated are ignorant regarding an important issue and beleive something just because it is a popular belief at the time, it is a very scary situation.

[alowishus]

2 cents...? dude that's a fifty dollar bill!!!:p

[Fifteen]

What happens when you know you are an addict from other behaviors when it comes to drugs and you also are a chronic pain patient, where does that leave you? do you not get high?

[orangejuice]

What happens when you know you are an addict from other behaviors when it comes to drugs and you also are a chronic pain patient, where does that leave you? do you not get high?


Well although not being a cp patient, thank God, from what ive heard, and experienced living with a cp sufferer, SADLY many do not get high. I mean sadly if one wanted to get high, of course. Usually, depending on the case, a pain sufferer may be on a whole array of strong meds, and not only will they get little relief, they will not, if searching, get a buzz. I guess that is what you asked, im not sure lol kinda late. just my 2 cents, been out for a while, just tryin to get in the mix again....peace

[HeidiW]

To comment on Exit's point, I somewhat control my chronic pain with 120 mg. Methadone/day, 90 mg. Morphine Sulfate IR/day, 350 mg Soma 3x's/day, 1mg Xanax twice a day, .5 mg Halcion at night for sleep.
Most of the time, I'm in bad pain. All of this crap just barely takes the edge off.:mad:

[nick]

Does anyone know anything about relaxation techniques for chronic pain patients on opiates?Any personal experiences or even a reference.I have already tried the search here and googled this ,to no avail ANY help would be greatly appreciated

[scarlett44]

I cant remember who wrote about the SSRI's making a person less creative, but can you send me a link or tell me where to find some more info? Anyone else that wants to tell me their opinion on anti-depressants would be great. I am about to taper off hydros, (I want to at least) but I know I can't do it w/o being on an anti-depressant. I just tried effexor for a few days and I wante dto crawl out of my skin. Wht do you guys think is the best?

[alowishus]

I just tried effexor for a few days and I wante dto crawl out of my skin. Wht do you guys think is the best?


I can tell you that you will need to be on them for at least two weeks to start, a month is when you can tell if you need to up the dose, change to an other, or what have you, a few days is nothing. The drugs have to build up in your system. The internet is FULL of stuff on SSRI's.









:rolleyes: Good & bad.:p