Pain Management Community

In my experience all opioids are pretty much the same, I feel any difference is dose related.

I take methadone for a long acting drug and oxycodone for breakthrough pain. Hydrocodone worked fine but I was tired of taking all the acetaminophen along with it. I have noted no mental strangeness with the oxycodone, it helps some with my pain, as it should.

Of course, there are abusers, as there will be when the hydrocodone is widely marketed without any added acetaminophen or ibuprofen. Dilaudid is widely abused when folks can get it. It is just the flip side of the coin, any opioid drug that helps with pain will have the potential of being abused, until they come up with some that do not have any euphoric effects at all. The sad thing is that most abusers are just looking to stay "normal" after a few weeks or months, they just do not want to go into withdrawal. Addiction is a sad and pathetic illness.

Take care, Annette

PS - Darvocet has been withdrawn from the market for awhile now.

i'll tend to agree with a fair amount of what you said. i do know that whether it is 15mg,40,60 or 80, it only will last 2-3 hrs at the most, short term such as after a major surgery ok, tolerance build-up happens quickly also so it takes more to get 2 hrs. of relief. For me long lasting pain relief came with the methadone. I am on methadone 10mg qid and 10mg of oxy for breakthrough pain which has worked quite well. I have weaned down from fentanyl 75mcg every 2 days and 40mg oxy. it was nice to wean down and control. I am limited on med choices because I am in the VA system and have been happy with them. Had i not been eligible for the VA, I would have been in a world of crap. I see by the results of the poll there are a lot of people you refer to. Take care

Hello and thanks for the reply. I can tell by the way you explained it, you ARE a patient that uses OxyContin the CORRECT way. I totally agree with both of you as well. Have you seen some of the people on the news that are on OxyContin Only? Because of THIER "Pain" ? These people are in great shape, working, young, athletic, have tons of energy, run, play basketball, football etc... This is the person that does not need OxyContin for a pain medication. I knew a guy that was in his mid 20s and sprayed his ankle while playing basketball. He went to the doctor because he thought it was broken, well it wasn't, just a arranged ankle. The Doctor gave him 80mg of OxyContin for the pain ! What ! For a ankle that's not even broke! This is the beginning of an OXY addict. Young, given a high dose for a minor injury. This is where abuse starts. Doctors use this medication far to much. This medication is for the HONESTLY CRONIC PAIN PATIENT. Not someone who fell off a bike. That's what upsets me... Oh and as for the basketball player with the bad ankle, he didn't use the entire script that the doctor gave him and I think(99.9% sure) he sold the rest. Not positive, but he doesn't have emand just seems a bit shady, can't prove but I told him that if he got caught he would be in for a serious crime of selling a schedule 3 drug. Now I don't want anyone getting me or what I'm talking about confused with "OXYCODONE" that's a tottaly differant medication. Thanks again for your time. I hope some others reply that are on OxyContin that know they are abusing it, so I can hopefully help the,... Bless all of you, thanks... Mjc...

I do thend to agree with you about the opioids, the reason I chose OxyContin as a big time culprit is the strength that you can get it in 1 tablet. 1 OXY @ 80mg is EXTREAMLY strong, and these kids, people that get ahold of these are overdosing the first time they take them. They (on our local news)would say "I've taken 4-6 Vicodin at a time with no bad side effects" so what's wrong with only 2 OXY?". The abuse is running rapid and I don't think there will be an end to it unless someone can control the doctors that are prescribing this EXTREAMLY effective, but super strong pain reliever. You are the kind of patient that this drug was meant for, not the guy that twisted his ankle down the street. I see it all the time and it worries me to see doctors giving this out to certain patients, esspesally how addicting it is. Yes all opioids are addictive, but after you take 1 -2 OXY compared to 2 Vicodin or Dilaudid, there's no comparison. I just hope the "abusers" help so they don't end up overdosing or killing someone while driving...

Hope all goes well for you.. PS;, may I ask what happened to you to cause your pain?

Sincerely, Michael...

No one can know what another person's pain is. It's a very subjective thing.

I wonder why you are so concerned about meds that other persons take for their chronic (spelled correctly) pain.

With the newer version of OxyContin, the active metabolites become inert if it is crushed.

It still should never be prescribed for a sprained ankle or as a post-op med. None of the long-acting opiates are meant to be used for acute or post-op pain.

Dilaudid is much stronger than Vicodin, it is just that for whatever reason doctors do not use it as often, so it isn't out there to be abused. Back when I worked in the ER, people would come in and say that the only drug that works for them was Dilaudid, these folks were 18-9 years old. Many of them were addicts looking for drugs.

I think one has to separate the two problems, addiction and pain management. Doctors must be aware and they have to be able to trust their patients not to divert the drugs to street use. Unfortunately, there is no test to check for chronic pain, so a patient and a doctor must have a trusting relationship.

I am so glad I have chronic pain rather than addiction as my health issue. I have worked in addiction treatment as a RN and the successful treatment percentage is very low.

I have a triad of health problems causing my pain, Fibromyalgia, degenerative disc disease in my neck, and migraines. The FMS makes the pain from the others much more difficult to control.

Take care, Annette

Dilaudid 2mg taken orally from what I've read so far is not as effective as oxycodone because of the way hydromorphone interacts with the stomach and intestinal linings. From what I've read so far, Dilaudid 2mg orally is perhaps 20% of the effectiveness of the same dilauded taken IV which is MUCH stronger then hydrocodone then.

I'm still working through the proper medications and lifestyle changes necessary to treat my pain (CRPS). Dilaudid does very little for my pain. Its been wrecking havoc though on my memory. I am loathe to even take it except in the most extreme cases (those 10 moments), because of the memory loss I encounter while taking it.


Also remember each pain medication affects each patient differently. For one person oxycontin might be a lifesaver, for others it will do very little.

I understand where you're coming from with people demanding oxycontin for fractures and such. The stigma that those of us living with real pain every day for years must suffer is causing us all more harm than it is doing us good.

I agree with what Anon_57995 said. Pain is very subjective and even then, many doctors won't treat a patient's pain until they have a diagnosis. I am grateful to have a diagnosis that explicitly tells me where my pain is coming from and why but it took many years of tests, x-rays, MRIs to come to a diagnosis not to mention, botched treatments.

I also wanted to post some corrections to some incorrect statements made about opioid medications.

Dilaudid is stronger than both hydrocodone and oxycodone/oxycontin mg per mg. Hydrocodone is actually a weak mu opioid agonist that isn't much stronger than the opiate codiene. Opioid medications affects everyone differently so even if dilaudid is much stronger than hydrocodone based on pharmacology, a patient may state that the hydrocodone works better for his/her's pain. I know many patients that say hydrocodone works better for than pain than oxycodone, even though oxycodone is stronger based on pharmacology.

Now, oxycontin is simply oxycodone in extended release form. Oxycodone is not a completely different drug from oxycontin. And in fact, oxycodone in immediate release form is more easier to abuse than oxycontin as there is no timer mechanism to break down. The DEA is watching the 30 mg roxicodones like hawks because all you have to do is combine 3 of them and bam! you have the high that an 80 mg oxycontin tablet from the old formula used to give you. The newly formulated oxycontin makes it harder for abusers to mutilate the medication to get a high but from what I have read online, they have found a way around it.

Oxycontin is formulated to lasts 12 hours. For many people (including myself) extended release medications formulated to last 12 hours only lasts 8 hours and sometimes less than that, which has to do with how their bodies metabolize medications.

I have recently been switched from Morphine ER to Opana ER which is oxymorphone. Oxymorphone is 2 times as strong as oxycodone and it has a new TimerX formulation that Endo pharmaceuticals claims makes the pill effective for 12 hours for almost everybody. I have been on this new medicine, 30 mg twice a day (equivalent to 120 mg of oxycodone/180 mg morphine), for 2 weeks and this medicine has been a God send for me! NO PAIN!!! I only have break through pain in the morning 3 hours before taking Opana ER and I take two 5/325 mg of Percocet and that is it. I no longer need 7 percocets a day!!! My new physician said we would try oxycontin next if Opana was not effective but no need for that! Opana ER has given me the best pain relief out of all of the 12 years I have been experiencing chronic pain with and without treatment with medications. No more epidural steroid injections for me! The Opana ER gets rid of all of my pain and I haven't had an injection since Sept so I was really hurting and the Opana ER took all of that pain away! I am so happy to have found such a compassionate physician that has decided to treat my pain AGGRESSIVELY instead of undertreating my pain. The Opana ER takes 3-4 days to reach a steady state level in the bloodstream so it was seeming like it wasn't as effective as the morphine but once it reached full strength, it was MORE effective than the morphine and percocet combined!

Due to the media hype and other issues surrounding oxycontin, many doctors are forcing patients to swap their oxycontin for opana ER. In my state, we don't see any loose prescribing practices for oxycontin. That is more seen in states such as Florida and it is typically fueled by the immense profit brought in from the drug such that it is a cash cow for greedy doctors. Those are the doctors that will prescribe oxycontin for a sprained ankle...I have never heard or seen any of that happening in my state. So depending on the state in which chronic pain patients live, they may find it easier or more difficult to get treatment with opioid medications based on the level of ongoing abuse of prescription drugs.

Where is it that ":greedy" Dr.s make any money off of prescribing medications for patients??? I think it's terrible for people to judge Drs. concerning medications that are prescribed or even to judge if others have pain or not-oh, I guess I''ve done that, too, in the past, but in my area it doesn't seem like too many Drs. overprescribe. It's difficult to get Drs. to prescribe enough meds to take care of real chronic pain. In the past few yrs. Drs. have been told to really listen to their patients and the fact that we can't feel anyone else's pain. Now, it's really tightening up on wanting to prescrible pain med. cuz of overdoses in ER's, so it's hard to know what to do. I don't know about your area, but in most of the US, Drs. write prescriptions, but then it's the pharmacy and drug companies that get paid for the meds. The regulations and standards are so high here that it costs skads of money to get any new med. on the market, but if anything does go wrong, the companies are sued for so much and have to reup those costs somewhere. I was an RN for 25 yrs in the hospital and did a lot of lifting of heavy patients through the yrs. I had to quit 11 yrs ago due to almost crawling up the stairs every nt. in pain. Then I caught a patient falling dead weight and didn't let her hit the floor but pushed her back up in bed and just ripped something in my back. After much rehab., I had to go back and was told they coouldn't do anymore., I went back to work with even worse pain and finally had to quit. I had 3 kids who all wanted to go to college. I started on methadone 11 yrs. ago and have had pretty severe pain every day. I had my 3rd fusion a month ago. In 2005, I had L-4/L-5 and L-5/S-1fused in Mar. .In the end of that yr. the next vertebra was sliding over the next and had to have L-3/L-4 fused and laminectomys were also done. I had major surgery in Dec./2011 and they had to rebuild the original fusions since the screws were loose and I could feel bones move, I also had spinal stenosis-central and foraminal btw. L-2/L-2 now with disc pressing on spinal chord. Pain! I had 68 staples in my back. I have to say, I'd rather have a Doc overprescribe than underprescribe when I'm in terrible pain. I'm just saying. Lol!

I just wanted to correct that I also had new fusion from L-2/L-3 to T11( I think that is the right number for the lowest thoracic level). I put the part in about I had 3 kids wanting to go to college, but the reason I did was to show how hard it was for me to quit work. I worked until I couldn't walk, stand, or sit more than a few min at a time. If I totally wrote too much it's because I spend almost all my time alone. I also have quit smoking but it's harder than other times. I've said it's really hard to get through the withdrawal part, but it's the emotions that I've always slipped over and gone back. The Dr. said he would n't do the surgery if I didn't quit. My kids-2 of them were with me in the hospital for 6 days due to high fevers, loss of blood and transfusion, etc. The next week at home all 3 took care of me. They've been disappointed so many times when I've quit smoking and went back to it or saying I'm going to. and not giving it a good shot. By the way, all 3 of my kids graduated from the University of Iowa, and my 2nd son just got his 2nd Master's Degree and they all have good jobs and doing well which is all a mom can wish for.

I can't believe an addition I wrote just disappeared. I wanted to add that it took everything I had to stop working when I had 3 children who wanted to go to college. My husband at that time was able to get overtime and all 3 graduated from Iowa and my 2nd son just received his 2nd Master's Degree from the Dominican Republic in Chicago. Also, I had a new fusion and laminectomies like before from L-2/L-3 up to the bottom thoracic vertebra-T-12, I believe. Thanks for listening