Pain Management Community

I don't think anyone will formally answer this with regard to the medicine.

I've had all three (and more) as have my close pain friends. I can tell you that while actuary tables hold true, we are each individual chemical factories and metabelise medications uniquely. I tolerate Norco well, but not Percocet. My best freind (multiple fusions, bilateral nerve damage, arthritis etc.) is polar opposite.

I find the best advice I get is direct from my doctor and then the pharmacist.

I will tell you that these medications while sometimes necessary can be dangerous. Fentynal almost killed me.

If your situation requires such strong pharmuecuticals I recommend time with a pain managment psycologist. It was he best thing I did. Pain is so intertwined with our brain that we need to look at the mental and nuerolgical conditions along with the physical ailments in order to heal the whole body.

Best of luck and keep us posted.

Tim

We're all different. You must try virtually every opiate to determine which one (or perhaps more likely "which ones") work best for your unique body chemistry. Fentanyl is so powerful that it added nine wonderful years to my career. For those of us with very intense chronic pain, or for those of us who have a natural high tolerance for opiates, large doses of a long-acting opiate are often necessary and in combination with short-acting opiates for breakthrough pain. There are also many fine off-label drugs for chronic pain, such as anti-depressants, to inhibit the reuptake of Seratonin, anti-convulsants for neuropathic pain and anti-inflammatories for osteo and rheumatoid arthritis. It is the combination of each of these medications that is often the best tool for chronic pain.

Finally, you can use opiates for a lifetime without damaging your body in any way. They are a natural substance, binding with opiate receptors in the brain. Used as directed, there is nothing to fear and much to be gained. Best of luck.

You have the same problems I have Degenerating Spinal Arthritis and DDD. I am going to follow your progress to see what works well for you. I am living in Orlando, FL and the Doctors here will NOT prescribe opiates of any kind...it is against the law or something so I live on Motrin; which actually does NO good what so ever. I have tried pain Doctors and they also can not prescribe opiates...in fact CVS and Walgreens Pharmacies have been shut down due to over prescribing opiates to the patients (even with a full written RX!!!)

I really wish I knew where to go or what to do...I am out of my mind with pain. I exercise as much as I can, walk, try to use the pool as much as possible, stretches...I just don't think it is fair to be in sooo much pain and no one will help me.

Anyway, back to you...How long have you had your disc problems and is this the first Dr you have seen or did you have to go to lots before you finally found one who would help you? I hope this medicine helps you and please continue to write so I can follow your progress...Thanks and take care

I'm kind of sickened that it is that bad where you live as far as the medication being withheld from everyone. It almost makes me fearful that other states like mine are soon to follow. I'm in the carolinas. Im quite aware of the addiction problems we've got going on out there, but it's truely not fair to completely take away the one thing that's helping us get through our day.

So an update on the medication...I took the oxycontin as perscribed for a week, and I couldn't take it anymore. The IR oxycodone I was already taking doesn't have the sedating side effects that the extended release oxycontin has, so I called the doctor and i'm stoping the oxycontin, and increasing to 4 a day of the 10mg oxycodone.. I literally felt sick and useless when I took the oxycontin...but in doing some research, the drug company that makes oxycontin has changed its formula from OC Oxycontin to OP oxycontin, which is supposed to deter drug addicts. I dont feel like I got to truely try the medication since it's been wayy altered from its older version supposedly.

Sorry for the ramble. But the thing I'm most upset about is the amount of pain I'm still in. I'm waiting til the next appointment and I suppose we'll try something different.

And as far as doctors...I've had intense back pain since 2008, and all of the doctors i've seen since then, have all been kind of arrogant and not very helpful. I'm in my twenties which doesn't help my case...but as soon as my primary doctor decided to refer me to a pain management doctor, that's when everything turned around for me. I've been treated like a human...I finally feel like I'm with "my" doctor now.

I do have a little info on the opiate witch hunt that is going on around the country. Unfortunately, unscruplous and money hungry pain docs and some pharmacies were over prescribing these drugs during in resent years. Florida was responsible for 95% of the opiate drug scripts in the whole United States. People were driving from all over the east coast and midwest to get pain meds in Florida. It got to the point that drug seekers were having no problem getting thousands of pain meds in Florida. Many people were over dosing and dying. I live in Ohio and the pain doctors here are very leary of prescribing opiates. They will still write them but you had better have a darn good paper trail and and serious case of deginerative or chronic pain. CVS and most pharmacies are not carrying oxycotin. You have to have a written rx and then they special order them. I suggest moving to any other state than Florida. I don't know your situation or if there would be a possibility of moving. This is one resolution for you. I just wanted you to know you are not alone. We are all in the same boat. Another person on this site suggested us all to write our state representatives to stop the above metioned witch hunt. We in total agony need something to alleviate our pain. People in pain do not need pain meds to get high. Only addicts behave in such a manner. Once our pain is under control, we stop. Addicts take the meds until they are good and high. I feel so badly for you and I hope this post helps you. Hugs from Ohio.

I have read several posts that said it was against the law in Florida for doctors other than pain management doctors to prescribe opioids of any kind for chronic pain patients.

I have a close friend in Florida and asked her yesterday what the deal was. She said she didn't know because her PCP prescribed her opiates and her husband's arthritis doctor prescribed his. Both are for long standing chronic pain problems. Neither she nor her husband are terminal or anything like that.

Each doctor may decide for himself that he will not prescribe opiates, but it apparently has nothing to do with the legalities.

Take care, Annette

Read my post above to LadyofHouston.

Take care, Annette

As the others have stated, everyone is different in terms of how effective different opioid medications are for pain.

My own personal experience: I was initially started on extended release morphine. I was up to 60 mg per day before I was swiched to Opana ER. In my personal experience, the morphine didn't work very well at all to control my pain. It could be because the dose was too low or that I don't metabolize morphine well. I was taking 30-35 mg of percocet on top of the morphine to get meaningful relief.

When I was switched to Opana ER, it worked fabulously on my pain for the first 2 months and then began to fizzle out. It didn't last the full 12 hours just like the Morphine ER. After I heard about the reformulation of Opana ER and how many were getting sick by the new medicine and that it was 1/2 as effective as the original formula, I jumped ship before I was even put in a position to have to try the new formula. Plus, the Opana ER costs me $255 a month and my insurance paid 50%... when it stopped working the full 12 hours and my breakthrough pain increased, I decided it was not worth the money. The generic equivalent was worse in terms of pain relief.

I have never tried the oxycontin but my doctor almost RX'd it to me. I was hesistant to try it as it now has a known carcinogen in it called BHT. Purdue says it is in trace amounts but I don't feel comfortable taking trace amounts of a cancer causing agent over the long term just how I prefer to take oxycodone IR versus Percocet, which has tylenol in it.

We finally decided on the Fentanyl patches. I love this medication. I am on the 50 mcg/hr patch and I change it every 48 hours vs. 72 hours. The pain relief is very consistent. With the extended release 12 hour pain meds, I couldn't sleep more than 8 hours as if I slept for 9-10 hours, I would wake up in withdrawal and pain so I would have wait for the next dose to start working before I could do anything. With the Fentanyl, I don't have this problem and I like being able to less pills per day.

On ER pills there were also restrictions on when I could take my other medications as if taken too close to when I would take the Opana ER, it would interact with the Opana and I would get severe dizziness and vomiting. I ended up having to set my alarm to take some of my meds in the middle of the night so that they wouldn't interact with the Opana. The main med that didn't like to be mixed with the Opana was the Gabapentin. On the Fentanyl patch, I don't have this problem and I fall asleep pretty much instanly. The Opana caused insomnia for me.

So that's my personal opinion on the different meds. My pain levels are extremely low during the day on the fentanyl patches and I have less breakthrough pain. The pain is typically severe right when I wake up in the morning due to the nerve pain shooting down my legs which opioids don't do a great job on anyway. And, once I get moving and take some Aleve, the leg pain reduces quite a bit. Then I take the Gabapentin around noon which really helps reduce the radiculopathy.

Good luck on making your decision. My doctor has let me try most meds (that I can afford on a continual basis) to see which med worked the best. I think this is the best approach. As Charles said, you may have to try many different medications to find the one that works best for you. Doctors that only let you try one or two meds and then box you in whether your pain is controlled or not, are not taking the right approach. Some of it is due to DEA paranoia I think.

I have fibromyalgia and chronic nerve pain and muscle spasms. I have a spinal fusion of c5,6 & 7 with hardware that was done in '99. I had about one good year of pain relief in my neck and arm from the surgery, then my symptoms returned and of course, I was still dealing with the fibro as well. I had taken oral morphine about 10 years ago, but was taken off the med without notice when my pain doctor who became leery of the DEA investigating her medical practice. I switched doctors and tried cortisone injections and a procedure to burn the nerve endings in my neck (wow, lol). When nothing else worked, I was put on the fentanyl patch gradually getting to a dose of 75mcg every two days with norco and baclofen for breakthrough pain. My memory and thinking skills were terrible, so I decided to gradually withdraw from the fentanyl patch. It has taken me nearly a year, but I now am off the patch and though I had severe pain with each level of withdrawal, I prefer to live my life feeling more pain with a better mental outlook. The patch left me feeling dead emotionally with a very poor memory and bouts of depression, unable to work at my previous career in accounting. I also chose to withdrawal from fentanyl because I wanted to do warm water therapy in a pool. Fentanyl patches release all the medication at once instead of slowly if you go in a hot tub or get an elevated temperature. I hope you don't have the same side effects I experienced if you chose fentanyl. I had similiar side effects on morphine. I now take 200mg of lyrica daily, 30mg baclofen and am going to start cymbalta next week. I take norco as needed as well as mobic 10mg daily. Good luck with your pain management. Chronic pain has caused me to make some tough decisions on how to live life to the fullest.

I Think whats going on in Florida is Criminal They take the drug away from everyone so as to deny the addict,the addict will simply switch to another drug until this one is available again,a Chronic Pain Patient does not have that luxury oh geez no opiates on the street well i'll smoke a joint dipped in formaldehyde and then i will shoplift a can of compressed air and huff it that'll get me by for awhile , But you and I are left in pain with nothing to do but slowly go insane. Here in P.a. there is a problem with pharmacies getting robbed not for money they don't care about that they want drugs and cigarettes The pharmacy i use has a label for its customer walkin store but next to it is E.P.S. which is some heavily guarded bonded non descript building somewhere in the City and those three letters stand for Extended Pain Services and in this building they have every opiate in every form and anything needed to administer it and they prepare your order which is whatever your doctor is prescribing and ship it overnight ups so it get to you 3 days before you would run out, and its free and it eliminates pharmacies or their employees turning there noses up at you and it eliminates anyone targeting you by finding out when you go to get your RX of opiates and stealing them from you, so it works well for everyone the Doctor the Pharmacy and the Patient Although i must say i never had a problem with my pharmacy when i brought in scripts from my PCP .

Peace

I have had a nightmarish experience with the fentynl patch and would encourage anyone to research it before getting on it. It took me 10 months after starting it to get off. The absorption rate is not consistent, you cannot take hot baths, can get malfunctioning patches, get hot ie due to weather and have disastrous side effects. It is quite a challenge to ever stop once on.Give me a pill or tablet that I have choice over taking , or not. It is truly a "monkey on your back". Read the blogs and good luck!