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Pain meds/ long term affects
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RaiderRip posted:
Hello,

Just joined the site and have a question…well, I have a bunch but I will stick with one at a time. I have back issues (I'll spare the sob story) and have been on pain meds for about 2 years now. I have been taking oxycodone twice a day and just recently my doctor switched me to oxycotin (sp?) twice a day and the oxycodone for any break though pain. I am not sure what the difference is but the oxycotin doesn't really seem to help as much.
Ok…getting off subject here…. My question is, are there people out there that have been taking pain meds for extended periods of time? I mean, can I take this stuff for years and years without worrying about long term affects?

Thanks guys,
Roger
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ahrenberger25 responded:
There is not as much data on the subject as there should be, but I recently read a study of legitimate, male CP patients receiving 10 years of opiate/oid medications have shown a significant increase in the development of hypogonadism.

But, if your physician prescribes you narcotics for years and years and you take them AS PRESCRIBED, other than one heck of a opiate/oid tolerance you should be OK. However, chances are that your doctor will try other methods of pain relief rather than just narcotics (unless your condition is terminal).
 
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Anon_231249 responded:
am not a dr but that drug scares me, this is so tricky cause how do you know if you are dep cause you need it or is the drug you need? i would try to move to something not as stong, if you can ultram? oxcotin is one of the most addicting drugs i have heard about. i would look into it, learne verything about the drug from experts
 
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RaiderRip responded:
Yeah, oxycotin worries me too. The oxycodone definitly helps with the pain but, my problem has been that I have a lot of pain at night and, my understanding is that oxycotin is more of a time release type of thing which should help me at night. My back is all screwed up and after 2 surgeries I really don't see it getting any better hence the question about how long can I take this stuff.

Its really scary because I have seen people who can hardly walk after back surgery and they will tell you to never let them touch you because you will never be the same. Well, I have been through 2 and I can still walk and do some things but, even simple tasks like mowing the yard (riding lawn mower) and some simple woodworking will put me flat on my back. I want to avoid another surgery as long as possible.
 
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Anon_160307 replied to RaiderRip's response:
Oxycontin is a good long-acting opioid medication for pain. It has been reformulated to be 100% extended release versus the old formula was 40% immediate release and 60% extended release. This medication as well as other long-acting opioid medications do not release much euphoria if any at all. You shouldn't be fearful of it. The media has exaggerated the abuse potential based on many in Florida that were obtaining prescriptions for this medication at the pill mills with the intent of abusing the medication.

Opioid medications are safe to use over an extended period of time. They do not damage any internal organs and typically have mild side effects like constipation and low testosterone (sp?) levels.

Personally, I think you should fear the potential detrimental results of multiple back surgeries more than addiction to Oxycontin. As long as you take the medication as prescribed, you shouldn't fear addiction. Now, most chronic pain patients do become dependant on their medications such that stopping them cold turkey will produce unpleasant withdrawal symptoms. If or when you decide you know longer need the Oxycontin, it is highly adviseable that you talk with your doctor as he/she will be able to help you wean off of them slowly through a medically supervised taper which will minimize unpleasant side effects.
 
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RaiderRip replied to Anon_160307's response:
Thanks Anon, that helps explain things a little better. Man, I am at a loss. I am just tired of living with it all the time. I am will be 50 this year and I wonder what will I look like in 10 years, heck, what will it be like in 5 years for that matter. I wonder if I should try to retire so I can at least take things a little easier and maybe last a little longer. But, I can't afford to with a son in college and another 10 years of house payments.....geezzz, can't win for loosing...
 
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annette030 replied to RaiderRip's response:
Oxycodone and Oxycontin contain the same drug in different forms, the first is immediate acting, the second is long acting.

I have taken opioids for over 15 years, with no apparent addiction or organ problems.

Just follow the instructions the doctor/pharmacy gives you. Do your own research on medical treatments and surgeries, but I would advise you to use appropriate sites with evidence based research on them.

Take care, Annette
 
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jpinmiss responded:
OXYCOTIN is long release med.
OXYCODONE is faster .
been on one or both for 12 years.
goog luck
 
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jpinmiss replied to Anon_160307's response:
I have been on opioids for going on 13 years, am 72.

You have to train yourself to ask a question before taking every opioid med. AM I TAKING THIS BECAUSE MY PAQIN LEVEL REQUIRTES IT ??? , OR BECAUSE MY BRAIN SAYS IT TIME FOR A HIT.
I have been up and down the addiction road and the dependency road twice. It is easy to get lost in addicition, but life really is better if you understand the difference betwee acciction and dependency.
good luck on your pain issues.
 
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RaiderRip replied to jpinmiss's response:
jpinmiss,

That is a great question to ask yourself everytime you are about to take a med. I also agree that there can be a fine line between taking a medication for the pain and taking it because of an addiction but, is it not the case the some of these meds need to be taken on a regular basis for them to be affective?

Thanks for all of the responses guys.
 
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annette030 replied to RaiderRip's response:
I too ask that question every time I take an opioid pain pill, regardless of what it is. The long acting ones generally should be taken on a regular schedule to be effective. I still ask the question, for my own peace of mind. If it were ever for other than pain (or as directed for the long acting pills), I would make an appt. with my doctor to discuss it. With the short acting meds, I would just not take the med until I really hurt, and discuss it with my doctor ASAP also.

I have never had an addiction problem, but I did work with addicts when I was much younger, I do not want to go there.

Take care, Annette
 
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dfromspencer responded:
RaiderRip, from what i have been reading from your responses to these answers, you will be just fine. I have been taking morphine now for two years, before that i was taking methadone for my severe nerve damage. I was on the methadone for about three years. Along with these drugs, i was also, and still am, taking oxycodone for fast relief from sudden spikes in pain level. I was once addicted to alcohol. So, i know the difference between needing relief, and just needing to get high. You will too, if you feel yourself slipping, call your Dr. right away! I have never had a problem yet, so, i do believe from your answers, you too will be just fine. I hope that someone can fix your back for you, pain like that just never goes away! I will be seeing my surgeon next week about fusing another set of vertabrae in my neck. Dreading this, this is the second for me also. Well, good luck in the future! Dennis
 
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cweinbl responded:

You have no reason to fear. Many of us have been using narcotics for chronic pain for 40 years or more. Opiates are a natural substance in the body. They bind with opiate receptors in the brain to reduce the effects of pain. You can use narcotics as directed for a lifetime without damaging your body's organs or functioning.

Addiction is not an issue. If you have not had an episode of addiction disorder in the past, your risk of becoming addicted in the future is below 2% (see the latest research here: http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html and here: http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1 ).

Your Oxycontin is Oxycodone in a timed release format (long-acting). It makes sense to use it also for breakthrough (BT) pain, as well.

Research shows that chronic pain patients who use long-acting medications (Oxycontin) report them to be more efficacious than short-acting drugs (Oxycodone), which work better for BT pain. If you are not receiving enough pain relief at your current level of Oxycontin dosage, just tell your doctor. The dosage can be adjusted.

It is also useful to remain cognizant that we all become tolerant to medications over time. If you stay on one medication over a number of years, you might easily reach the maximum safe dosage. When that occurs, your doctor can have you rotate to a chemically different pain medication for a couple of months. After that, you should be able to return to the original medication with improved performance.

Good luck!
cweinbl
csw2@bex.net
 
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cweinbl replied to Anon_231249's response:
Anon, Oxycontin is NOT particularly addictive. Nor is any other opiate or synthetic derivative of an opiate. Less than 2% of all chronic pain patients using narcotics become addicted. If you want to "look into it," here are two recent major research studies on opiates and addiction:

http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1 .

http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html .

As you can see for yourself, the addiction risk is indeed TINY. It is important to access valid (double-blind, control group) research, rather than believe what you read in newspapers, magazines or on Internet web sites not under the auspices of the pharmacological or medical community.

You use safely narcotics as directed by your physician for a lifetime as long as you have no history of addiction disorder. The risk for those of us without a history of addiction is under 2% (see research studies above).
cweinbl
csw2@bex.net
 
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David Maine, MD responded:
That is a great question. Opioids (such as oxycodone/Oxycontin) while very effective for pain do have a number of side effects. When first starting an opioid potential side effects include sedation, nausea, vomiting, constipation, and cognitive impairment to name of a few. In regards to your specific question - long term risk include hypogonadism/sexual dysfunction because of testosterone suppression (this can typically recover after 1 month of ending use or can be treated with testosterone replacement). Testosterone deficiency can also lead to decreased bone mineral density which can cause an increase in fractures. There is also the development of tolerance over time and concerns with dependence and issues of abuse. All of these issues should be discussed in detail with your doctor to determine the best treatment and course of monitoring. I hope that helps. Good luck.


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David N. Maine, MD is the director of the Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore. Maine graduated with a degree ...More

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