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    I want to quit Narcotics !!!
    channah posted:
    I don't know what to do ! I sooooo desperately want to get off the pain pills but I am really scared ! I have experienced withdrawal 3X in my life and it was HORRIBLE ! Each time, I went in a hospital facility, and they PROMISED to keep me comfortable ! B.S.!!!!!! I suffered sooooo much.
    I asked my present pain clinic to give me Klonipin or the like to help me through it, but NO! That means they'd just let me be miserable OR get back on them!
    What can I do? I have detoxed at home, too, which is what I'm going to do. Shalom
    ctbeth responded:
    Are you prescribed opiate meds for pain management?

    If so, the question is why you want to stop taking medicines that help relieve your pain.

    If you're prescribed opiates and do. OT want to take them, ask you prescribing MD to assist you with at it rating down schedule, rather than just stopping, the doses are slowly reduced in hopes of discontinuing the med without experiencing withdrawal symptoms.

    Good wishes,
    77grace responded:
    Hello and Welcome !
    channah,I have felt the same way at times in my life !So if I can be of any help I need to know why you want to get off of the meds and a little bit about your story !Where is your Pain ?
    I have detoxed many ways !
    Let me know !
    Take care 77grace
    annette030 responded:
    I think you are thinking of Clonidine, Klonipin is the brand name of clonazepam, a benzodiazepine that I ended I up hooked on and required medical intervention to wean off of.

    If you require help getting off of opioid pain meds, tapering VERY slowly as an outpatient should work. Clonidine might help you.

    Take care, Annette
    Anon_1379 responded:
    PS-You will probably have whatever symptoms you had that you were treating with pain pills, and will still have to deal with those.

    Take care, Annette
    channah replied to ctbeth's response:
    Yes I am on chronic pain management w/ a pain clinic. I have chronic pain from a previously broken hip, a shoulder replacement, back issues, and a wrist surgery back on 9/18. They had to cut the bones, put in a graft and a plate. It is STILL very painful and keeps me from doing a lot of things. I have asked to go back for more therapy.
    Right now, I am having too much pain to stop the meds., and I keep thinking that anytime now it will stop hurting. I made an appt. w/ my Orthopedic doc next Fri. Pain Clinic is on Monday, 12/23. At this point, I need at least a change from the MS Contin 30mg 2x/day., and 10mg Percocet 4x/day. The detox will have to come later.
    cweinbl responded:
    Shalom Channa and (tonight) Shabbat Shalom.

    1. Are you saying that you no longer have moderate to severe chronic pain? Yes? Or, your pain medications aren't working? Why else would you want to stop. Most of us here need powerful pain medication. If we stopped, our pain would be out of control. You mentioned that, "they'd just let me be miserable OR get back on them." If you no longer need opioids, why would you say that?

    2. I know this is picky, but physicians and pharmacists no longer use the word "narcotic" to describe these medications. "Opioids" is a better word today. I mean nothing negative towards you in saying this. Most people use the same word.

    3. Klonopin is not the best medication for someone dealing with withdrawal from opioids. Naloxone and Suboxone were designed to treat addiction disorder & opioid withdrawal. Ask your physician about them.

    Good luck!
    channah replied to cweinbl's response:
    I want to quit the "opioids" only because of their side effects.
    #1. NO appetite .....this is my main complaint! (I am 5'4" 96 lbs.)
    #2. the constipation; even though I am Vegan!
    #3. I feel like it's affecting my skin, my hair, my teeth??, etc.
    #4. I don't think they are even working!
    But w/ out the medicines I'm not sure how bad my pain will be since I've been taking them for 2 yrs. now; since I broke my hip.
    And this wrist of mine is ALWAYS very painful since my surgery back 9/18/13 and I have to do stretching exercises w/ it daily that really crank it up!!
    Please keep in mind that I have ADHD & Dyslexia so my thoughts & writing may, ahem, seem a bit scattered and incoherent. I hate it!!!...and I am also hyperactive!
    brokendownat45 replied to channah's response:
    I am sorry to hear about your concerns & realize that what you focus on are true concerns.
    I am a Chronic Back Pain Patient that has been seeking treatment of my BACK for the last 14 years. I have had the following procedures performed in hopes to alleviate if not end the back pain that I cope w/daily:
    Epidural Injections
    Corti-Steroid Injections
    Bursa Injections
    Removal of a portion of the Nerve Bundle @ Pain Site
    Lamininectomy (twice)
    Discectomy (twice)
    More Steroidal Injections
    Another portion of nerve removal
    More Epidural Injections
    Latest procedure: CortiSteroid Injections

    I am on Pain Management and have been for the last fourteen (14) years. I've taken just about every type and strength of medications that are viable for Pain Relief and Anti-Inflamitory drugs from Tramadol to OxyContn 90 mg,
    Your fears are warranted. I've taken myself back down the Pain Management Chart and have been holding steady for the last five (5) years on Oxycodone 30 mg 4x per day & Morphine Sulfate 15 mg Extended Release 2X per day. I suffer with Insomnia and Restless Leg and are showing markers of Parkinson's & Alzhiemer's Disease.
    A the current time I am trying to regain movement after I had a nasty spill outside on the sidewalk.
    But to address your concerns.... Yes, there are other parts of your body that the medications affect you. They are as follows:
    liver; kidneys; eyesight; teeth (i the last 3weeks I have lost 4 teeth and they are hollow, the nerve or root is non-existent and the tooth itself is just a I wasn't eating anything crunchy, I was eating oatmeal with the first loss; mashed potatoes & gravy for the second loss & nothing when Iost the third tooth). It's embarrassing because I am a nut when it comes to my teeth. All of our friends make fun of me because I carry a ttoth brush & toothpaste in my purse. I brush my teeth about ten tines a day. It is ironic that I take such good care of my teeth, for them to be falling out of my head.
    The IRONY....I have no other options than to be in severe acute back pain & miserable all day & night, or take the medication and continue to encounter problems w/my teeth.
    My Family Doctor, Pain Magement Doctor & Dentist are all in agreement that the problem stems from the medication that I take so that my life if bearable and I can function to do at least the bare minimum to live.
    So continued to be concerned and do try anything that is an alternative, Accupuncture..whatever,I would give it a try. You never know.... It might be what you are looking for to replace the Narcotics in your life.
    I wish you all the luck in life & hope you find happiness.
    cweinbl replied to channah's response:
    You have a very simple solution. Stop all of the opioid medications. Determine how/if you might manage the pain. If the pain is not burdensome, if it does not prevent you from doing what you like to do, from working , etc. then be happy - you don't need the opioids.

    But if you stop the pain drugs and your pain becomes intolerable, then like millions of others, it's better to have manageable pain and deal with the drug side effects.

    With that in mind:

    1. You can take appetite enhancers and dismiss that condition. One such appetite enhancer is called Marinol (designed to treat the weight loss and appetite loss associated with chemotherapy). Ironically, Marinol is also used off-label for chronic pain. The active ingredient is THC.

    2. Everyone who uses opioids regularly must deal with constipation. Over decades of such use, many of us have discovered that the daily use of a stimulant laxative is efficacious. You must understand that opioids decrease bowel peristalsis, right down to almost nothing. You can take massive amounts of stool softeners and laxatives and they will have NO effect. You must use a laxative that says, STIMULANT on the box. With regular experimentation, you will discover the precise amount of stimulant laxative necessary to stay regular. Believe me, this is a battle easily won.

    3. "Skin, hair & Teeth?" OK, I don't doubt your comments. Opioids can dry out the skin, resulting in itching. Daily use of a good skin conditioner can greatly help. I'm not aware of any compelling research that shows opioids connected to issues with teeth or hair. But if I did, it would not be a major factor. I would much rather have tolerable pain than lose my hair or teeth, assuming there is any veracity in that postulation (and I haven't seen any). If I had such a huge amount of pain on a daily basis, I would be delighted to purchase a wig and dentures, if only I could manage that horrible pain with medications.

    Your only other alternative is to deal with chronic severe pain that's left untreated, day after day, month after month and year after year. That's no way to live. Give me the medication side effects... please. For without that medication, I cannot deal with the chronic severe pain!
    ctbeth replied to channah's response:
    Hi Channah,

    The reason that persons who take an opiate, and this is also the case with many other drugs, may have dental issues is related to the adverse effect of anti-cholinergic action.

    In simple terms, the mouth produces less saliva and the drier environment can cause dental caries.

    If you keep your water intake high, this problem becomes easily managed.

    Increased fluids will also help will the constipation.

    Of course, you must be aware of adding fiber to your diet.

    If you are constipated and increasing your fruit and vegetable intake doesn't improve it adequately, you can ask your pharmacist about some of the natural vegetable laxatives.

    I agree that constipation is a rough adverse effect, but it can be controlled.

    Since your orthopedic surgery (called an ORIF, or open reduction internal fixation) was done just this past September, it's not unusual that you'd still have some post op pain three months post op.

    Since you state that your appetite is quite poor, this would also indicate that your nutritional status is compromised.

    Poor nutrition would definitely exhibit itself in the condition of your hair and skin. Since you're vegan, this indicates to me that you do care, and are attentive to matters of nutrition.

    I think that you might consider consulting with a registered dietician and discuss strategy for assuring that your intake is adequate. Supplements in pill form (vitamins, "nutricuticals") are not going to provide you with the protein. Carbs, and lipids that you need.

    The first signs of one not having adequate lipids in the diet are constipation, dry brittle hair, and dry flaky skin.

    Please let me know what you think.

    ctbeth replied to ctbeth's response:
    I should have made this clear:

    cweinbl replied to ctbeth's response:
    Actually, adding fiber and water won't resolve constipation secondary to chronic opioid administration. The reason it won't help much is because opioids reduce bowel peristalsis significantly. Having fiber and water in your bowels makes little difference when the bowel is not pushing food and stool along normally. No amount of fiber, water, stool softener or "natural" constipation remedy" will restart bowel peristalsis. This must be accomplished with a stimulant laxative, such as Dulcolax or Alophen. If the box says, "stilmulant," it should work. I've tried virtually every prescription and non-prescription remedy over the past 40 years. I can guarantee that the only way to restart an opioid-stalled bowel peristalsis is with a stimulant laxative. Frankly, I'd much rather be able to manage my pain and deal with constipation than to stop the medications that manage my pain and live every moment in agony.

    BTW, there is a product that you can use to stimulate saliva for patients whose medications result in dry mouth. It's called Salagen. Another option is Biotene. Ask your dentist or physician about it. I believe that it is OTC.
    ctbeth replied to cweinbl's response:
    Greetings, Charles.

    I was thinking of Senekot, which is the med of choice of my pain management practice.

    I really don't want to discuss poop, but non- soluable fiber and increased liquid, albeit probably not enough for many, will keep matters softer.

    As with all medical treatments, most practitioners opt to begin any treatment with the least possible effective intervention.

    My practice has a protocol that all of the MDs follow.

    The Stage 1 med is propylene glycol and Doscusate, Stage 2 is Lactulose and bisacodyl, with the highest intervention being the mu blocker by injection- the name escapes me right now.

    Opioid-induced constipation seems to be an adverse effect that is bothersome to many persons on opiate therapy. I'm fortunate that my practice is aware and helpful.

    Unfortunately, it seems as if many pain management MDs leave patients out in the cold, in parlance, on this one.
    ctbeth replied to ctbeth's response:
    Sorry, I posted incorrectly:

    Phase one is the prop and Doscusate

    Phase two is Senekot-S. The protocol commences with 1 daily. If that doesn't work, the dose is increased by one tab each day, with BID dosing.

    The max for Senekot-S is four tablets twice a day.

    The bisacodyl is Stage 3, provided the four Senekot-s is insufficient.

    The sub-cutaneous injection that blocks the mu receptors I the intestine is brand named Relistor.

    Sorry for the wrong info of yesterday.

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