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    Dextromethorphan (DXM) for pain management
    1IDArmyVeteran posted:
    I hurt my back and left knee while I was serving in the military in 2007. I have been on nearly every narcotic and non narcotic pain reliever you can imagine.

    I read some studies about DXM used in patients with neuropathic pain and pain from diabetes. The dosing was 960 mg/daily.

    I have tried using it myself at a lower dose of 300mg with almost complete pain relief.

    I was wondering has anybody tried this themselves and found the same symptom relief and also does anyone know of any more studies on this medication for pain control?

    I've only found two short studies with no long term information.

    But this drug is almost a wonder drug as it nearly knocks out my pain for 8+ hours on that dosing. Better than any narcotic I have used, but I know DXM is a NMDA antagonists and doesn't work like narcotics.

    bj1208 responded:
    hi and welcome to the support group -

    I don't know anyone on this board that has tried this nor would I suggest it for pain relief -

    you should be seeing a spine specialist (Orthopedic Spine Specialist or Neurosurgeon Spine Specialist) for your back and an Orthopedic Surgeon specializing in knees -

    for pain management - you should be seeing a PHYSIATRIST Pain management clinic -

    cough suppressants are not good when they are abused and this is what is happening as you are taking it for something else.

    please let us know what you find out - take care - Joy
    1IDArmyVeteran replied to bj1208's response:
    This is not abuse. I don't appreciate you saying that to me either, as I clearly stated the reason I have used it, which is clearly not abuse.

    I do not take this medication to get 'high' nor dose that low does make you anything near that. There are studies showing DXM helps with pain, especially nerve pain.

    I don't think it's very fair for you to post that because someone uses a medication off label then that means they are abusing it. If that was the case, you might want to fire about every doctor you ever met for prescribing off label medication uses.

    Trazodone wasn't made for sleep, but I sure take it for sleep, should we get the firing squad because I'm taking it for something other than depression?

    Get off your high horse ma'am.

    "you should be seeing a spine specialist (Orthopedic Spine Specialist or Neurosurgeon Spine Specialist) for your back and an Orthopedic Surgeon specializing in knees -"

    Been there done that, and still see VA docs.

    "for pain management - you should be seeing a PHYSIATRIST Pain management clinic - "

    I think you meant psychiatrists - see one they are very aware of my problems.

    "cough suppressants are not good when they are abused and this is what is happening as you are taking it for something else."

    Are you as doctor or a research scientists (I know some studies that say otherwise)? How do you know what is and is not good for a person? You make foul judgements on people, that is for sure and you crossed the line.

    Thank a veteran.
    southgirl67 replied to 1IDArmyVeteran's response:
    good for you on speaking up, and suffering from back,both legs pain, after having a spinal fusion in 2002 after suffering for five years after a car accident, I would love to read those studies and Im running out to get this medication ASAP. I would also like to thank you for everything Youve done for us, being an american. My daughter is in the military, she just finished 7 years and signed up for seven more, she loves it. Thank you
    my email is southgirl
    1IDArmyVeteran replied to southgirl67's response:
    Thanks for the post southgirl67.

    I don't know if posting links is okay but here are the links to the studies.

    You can Google "dextromethorphan research study" for more information.

    I do want to warn that DXM comes in pure form through medication like Robitussin cough gels, but if you are to try this medication to start off on a low does and slowly go upwards. Please do not buy anything else like cough medications with out inactive or active ingredients.

    People do abuse this medication to get high (people will abuse anything), but I have found it to work wonders.
    1IDArmyVeteran replied to 1IDArmyVeteran's response:
    I meant to say..

    Please do not buy anything else like cough medications WITH inactive or active ingredients other than DXM HBr.

    Robitussin cough gels are best.

    The packaging looks like this..

    And a bottle of 20 gels (300 mg) will run you about 5 or 6 bucks depending on the store.
    dianer01 replied to 1IDArmyVeteran's response:
    Dear Veteran,

    Wow, you come to a public board then lash out when someone says something you don't like?

    Take a deep breath!

    There is a big difference between a physiatrist and a psychiatrist. The physiatrist is specially trained in pain management. They may use many different techniques and medications to put a holistic plan together. There are also neurologists who specialize in pain management.

    Please talk to your case manager at the VA. They have many great doctors and may be able to find more help for you.
    Anon_1421 replied to 1IDArmyVeteran's response:
    Dear 1IDArmyVeteran,

    First of all, thank you for your service to our country and to all American citizens-my dad was in the army for 20 years, my sister was in the air force, her husband was a marine, and my other brother in law was in the navy-thank God for folks like you that make sacrifices for America! I am deeply grateful.
    Actually Joy DID mean a physiatrist, not psychiatrist. A physiatrist is a different kind of pain management doctor that if I have this right doesn't just treat pain but looks into the causes of it and uses many different approaches to try and treat it. She went through her own pain hell with regular pain management doctors until she found a physiatrist that helped her in ways that the regular pain docs didn't. She was lucky to find a decent doctor, many of us here haven't been that lucky! Again, thank you so much for your service.
    1IDArmyVeteran replied to Anon_1421's response:
    I stand corrected.

    DianeR01 - "Wow, you come to a public board then lash out when someone says something you don't like?"

    Yes, when you come here and call me a drug abuser, I sure will lash out. Would you like it if you said you take a medication for off label use and because of that I start calling you a drug abuser? I'm sure you wouldn't. What gives that person the right to name call and point fingers? Maybe it's the military side of me, but I try to respect everyone's point of view, without name calling and finger pointing and judgmental outlook.

    Anon_1421 - I can only take what the VA gives me, after all it is FREE health care. They don't always staff enough doctors and always seemed overwhelmed to me. I don't have public health insurance. And thank you.
    bj1208 replied to 1IDArmyVeteran's response:
    Hi - sorry for the statement of abuse - I stand corrected -

    However, PHYSIATRIST is a specialized pain management profession - see link

    so this time you need to get off your high horse Veteran -

    so NO I am not a doctor or research scientists but have had back problems sicne I hurt my back as a child and have had all treatment options done (click my name or pic and read my story) -

    I think you have had too many NO's thrown at you regarding your pains - I don't know if you have had any MRI's, CT Scans etc., done but it would be nice if we knew what the findings were (what does written report state).,

    I do apologize for making the statement - we do pride ourselves on being a great support board and was only looking out for your best interest - taking a cough suppressant, possibly on daily basis, may not be good going thru your system like that and again NO I'm not a physician but even with medications, you build up resistance and would have to take more to get the feeling of comfort (pain relief) so do be careful -

    please let us know a little more of what is going on - we can direct you to some research sites etc.,

    Respectfully, Joy
    Chris_WebMD_Staff replied to bj1208's response:
    Good Morning,

    I just wanted to jump in here and remind you all that we can be argumentative, but never disrespectful to each other here. Members come here for support so please know that is the tone whether giving advice or getting advice. We don't diagnose, we can only share our experiences.
    Attacking or a disruptive post will not be tolerated.

    Thank you all for understanding.
    Chrissy~ WebMD Staff

    Confucius Say;
    Our greatest glory is not in never falling, but in rising every time we fall.

    Anon_160307 replied to 1IDArmyVeteran's response:
    I would also like to thank you so very much for your service to our country.

    I read through this entire thread and its clear that your post was taken out of context and perhaps caught others off guard because I have never heard of a cough suppressant having the pain relieving properties you speak about. However, I am extremely interested in learning more about the research studies you posted links to and from your initial post. From your initial post, I never believed that you were abusing the cough suppressant medications let alone soliciting others to join in on the "abuse". With most any type of pain medication, over time more is needed to get the same initial analgesic effects whether the medication is a cough suppressant or an opioid...doesn't matter. Many medicines used for pain cause a tolerance when used over an extended period of time.

    I'll be honest with you, I tried the physiatrist route and the one that I saw did not prescribe medications, only offered recommendations so it wasn't a one stop shop as it is often advertised to be. I still had to seek out and find a primary care physician to manage my medications. Now I do go into the physiatrist for injections but don't be surprised if they don't do everything, especially medications. However, I have a belief that some of them do as a few here have testified to that but I didn't get those services offered when I went to see one at a world renowned teaching hospital.
    dper2000 replied to 1IDArmyVeteran's response:
    I take 1200 mgs of gabapentin (nerontin) a day. It is not for back pain, it is used for people like epileptics. I'm new on here today, I have had 2 failed back surgeries and am sick of the pain. I was not happy to take the drugs at all. If you were a drug abuser you would be going for the good stuff. My doctor wants to put me on a long acting drug, but I do not want to get into all that and end up like my husband on fentanyl who has extreme withdrawals if he does not change it on time. I take 10 mg hydrocodone, 8 pills a day. I like my liver so I am exploring other options such as the pain pump. I tried the spinal cord stimulator and hated it. My husband has one and i see how they do not work.

    I am very sorry about someone calling you a addict. If you were an addict you's be looking for morphine or some other drug. I want a drug that my body won't become addicted to. Every so often I grin and bear it and take no pain pills so I wont be physicall dependent. I really respect our service men and women and hope the reaction to your post will not chase you away from this community. I have had so many operations due to work that I need places like this. I thank you from the bottom of my heart for your service to this country.
    Anon_1112 replied to 1IDArmyVeteran's response:
    Being a veteran, I just wanted to mention that I had to do 4 yrs of active duty to be entitled to medical care at a VA hospital. I wouldn't call that free health care- otherwise, anyone could use the VA hospital. I also pay to see the dr and also for my meds.(and I'm service connected- 0% compensated).

    I'm sure it wasn't meant the way it was said. In regards to the rest of the conversation, respect is most important. Good health to all.
    latem responded:
    Hello all &1IDAryVeteran

    I'm from New Zealand and I'm currently tring this meds for back pain management myself as I had a accident at work in 1996 that damaged my L5 S1 disc. Now in 2006 I had surgery on it which I have to say was the sillys thing i've ever done as it just made the problem worse and the block used for the fusion only lasted 16 weeks before having to go back into Hosiptal for a second operation to replace the block and to also complete disc replacement on L4 disc as the old block was moving 1mm side to side which damaged the disc above the the fusion.

    Now like you 1IDAryVeteran my pain spealist tried me on everything normally used for back pain without any luck and this DXM was my last opition and I've only been taking it for a week now and I'm a new man as I can play with my kids and do the things i love without the pain stopping me.

    The biggest thing for me is it looks like i'm finally going to get by to work after 6 years and that's great as the biggest thing that hurt me was the feeling of note being able to support my Family over that time.

    I just have one more step before I can going back to work and that's funding for this meds as they are not fully funded here in New Zealand and (ACC) Accident compensation corporation here deal with work place injurys here are real a pain in the butt to deal with and the paperwork just to get these meds funded is just over the top 14 pages just to appile for funding.

    I leave it there for now and i'll keep everyone here on how things go with this meds for my pain problem.


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