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    jaws86-newcomer
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    jaws86 posted:
    Hi, I am a 47 male "forced" retired disabled nurse having a whole lot of pain med management difficulties. In 2009 I ruptured 4 discs in my neck requiring c3-c7 fusion and also have for bulging lumbar discs with arthritis. In January 2011 had neurostimulator placement but had to take it out 2 weeks later because of MRSA infection and waited six months to have it reinserted. Since then I have had fair-poor results for stimulator pain management and now I am on my 3rd different pain med trying to find something that lasts 2-4 hours. I am waiting on date for disability hearing and visit a pain control clinic. I have also had to be diligent as I became addiction to prescription medications. Just wanted to introduce myself. Look forward to hearing from you.
    Reply
     
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    bren_bren responded:
    Hey Jaws, I'm sorry to hear all that you have been dealing with. To me it sounds like you have tried a variety of methods to achieve pain control. Addicts typically are just in it for the pills. Are you sure that you haven't just become dependent on the medications? Do you run out of scripts too early because you enjoy the way the med's make you feel (e.g. High)? There is a big difference between addiction & tolerance. If it takes more medication to achieve the appropriate analgesic effect, it could just be a result of tolerance. I'm hoping your doc has offered other (non-narcotic) med's for you to try. Have you tried neurontin/Lyrica for nerve pain? I'm truly surprised that you went back to the neurostator after MRSA. That's mighty brave. It takes most pain patients a lengthy amount of time to find the right combination of medications. If you have a history of addiction (diagnosed) then I would look into a pain management specialist who is also an addiction specialist. Really examine your possibility of being under medicated before seeing a pm doc & spouting out that you're an addict. I also want to let you know that if you are an addict, there is nothing to be ashamed of. It's a disease, like diabetes, which requires a special course of treatment. Wishing you the best, B
     
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    jaws86 replied to bren_bren's response:
    I ad 12 years of clean time (1996-2008) when I relapsed. I do see a pm doc who is also a recovering addict, I only get my pain med from one doc and my wife picks up meds. Iam very active in NA and sponsor 2 people. I think i have found a medicine combo that seems to help: Opana 20mg ER with Percocet 10mg/325mg Thank you so much for your post.
     
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    cweinbl responded:
    The spinal cord stimulator (SCS), like the intrathecal infusion pump (IT Pump), is only for chronic pain patients who cannot benefit from the dozens of viable pain medications. The SCS success rate for patients with prior spine surgery are about 60% (see: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ). That is a fairly deplorable success rate. BTW, the link above provides the latest comprehensive research on all types of spinal interventions, not just the SCS. If I had survived an MRSA infection secondary to SCS implantation or removal, I would flee from it again with all of my ability. Even without serious infection, the success rate is very low.

    Please expand your post on "I became addiction (sic) to prescription medications." Do you have a history of addiction disorder? Have you had a history of alcoholism, drug addiction, gambling or other forms of addiction? Did you purchase your opiates illegally or with a Rx? Did you obtain opiate prescritions from several different physicians at the same time? Do you routinely run out too soon, take too many or purchase the drugs on the Internet from questionable sources? And here is the kicker... do you use prescrition pain medication to get high, rather than to reduce pain?

    If you answered yes to some of my questions above, then you might have an addiction disorder. If not, then do you truly understand the difference between addiction (a psychological disorder) and dependence and withdrawal (physical conditions that are artifacts of using pain medication, and are far less serious than addiction)?

    If you truly have a history of addiction disorder, then you might wish to ask your doctor about opiate antagonists. Suboxone and Nalaxone are examples of opiate antagonists. Sometimes patients with a history of addiction disorder are prescribed these "antagonists," because they are unlikely to be abused.

    Finally, the rate of addiction among chronic pain patients is below 3%. In fact, many new research studies peg the addiction rate below 2%. In esence, about 98% of the patients using prescription pain medication will never have an addiction disorder. I'm not saying that you are not addicted, or will never be . I'm simply repeating some very comprehensive double-blind control group research with very compelling results. read the results for yourself here: http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1 and here: http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html .

    Thanks for stopping by to introduce yourself. There are still options. Good luck.
     
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    77grace replied to jaws86's response:
    Hi jaws86,
    I am also a recovering addict and for those who are not they do not get it!!!!Its a trip with all the questions,but Bottom line We know!!
    Anyway,I am new to this site so thats why I did not get back to you sooner!I am also trying to get disability and its takes forever!I wish you Luck in that and also in your journey with pppain and recovery!!!I am happy to hear that your Dr.is also one of us!!
    My Blessings are with you ,hang in there!I would Love to stay in touch,it nice to have someone who really understands the commitee in y head1 77grace
     
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    cweinbl responded:
    Some chronic pain patients with a history of addiction disorder have had pretty good results with opiate antagonists (Suboxone, Naloxone, etc.). Another option might be the intrathecal infusion pump, as long as your physician maintains the dosage levels. It's pretty hard to cheat when you must inject the reservoir via a very long syringe. Plus, the dosages are low (intrathecal administration). And, one of the best medications for intrathecal delivery is unavailable in any other form (Prialt).

    There is one part of your post that I do not comprehend. You say that you are searching for a medication that will last 2-4 hours. Why wouldn't you want a medication that provides continual peak plasma level, such as the intrathecal infusion pump (continuous) or Fentanyl Transdermal (48-72 hours). Research shows that chronic pain patients are able to better manage their pain with long-acting pain medications, relying on short-acting drugs for breakthrough pain. Why would you only seek a 2-4 hour benefit?


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