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Thread: Pain doctors and meds.....

  1. #1

    Pain doctors and meds.....

    So I have a pain management doctor and for the most part he is great only because he doesn?t want to give me much and have me addicted to really bad stuff but my problem is I?m on hydrocodone 10/325 4 times a day and it really doesn?t do much for my pain if it does help it?s very short lasting. I have tried duladid not from him and that works great, but he refuses to give me anything else stronger than hydrocodone and won?t raise my script not thst I want to take more but I?m at the point to where I need something else thst works. Only thing he will do is he wants me to get this device out in my spine thst like puts electric shock or somthing but I am not interested in having something implanted in my body regardless if it work or what I just don?t like the idea. Does anyone have any other meds thst work or any advice for me to get something thst works??? He kinda doesn?t understand and since I can?t feel everything he doesn?t get how I have pain and I feel like I get treated like a druggy thst justvwants pills but all I want is to be in less pain please help as I would love to take nothing but I?m in to much pain to not take nothing... again any advice would be great

  2. #2
    Senior Member pfcs49's Avatar
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    Using increased opioids is self destructive! Becoming a junkie is virtually guaranteed if you go down that rabbit hole (I LOVE dilaudid/don't take it)

    I guess it's your choice. Live in pain or try the implant which may very well be a viable solution to a problem no amount of opioids will solve!
    69yo male T12 complete since 1995
    NW NJ

  3. #3
    I think pfcs49 is being a bit harsh there, but the evidence shows that long term use of opioids (like hydrocodone and dilaudid and heroin and everything "stronger") lowers your pain threshold and you end up with the same amount of pain, but physical dependence on opioids and even higher pain when the opioids are not actively in your system. (by long term I mean more than 5 days or so).

    There are numerous other medications you can try that are not in the opioid class:
    gabapentin (Neurontin)
    pregabalin (Lyrica)
    Lidocaine patch (Lidoderm)
    duloxetine (Cymbalta)
    baclofen (if your pain is due to muscle spasms)

    and that's just a few off the top of my head. Neuropathic pain rarely responds well to opioids in the first place, though if you take enough of them you'll certainly forget about it.

    and there are non-pharmocologic methods to help with pain
    Cognitive Behavioral Therapy
    Accupuncture
    Exercise (likely not all that feasible for those of us in wheelchairs as for our AB brethren)

    Also the half life of hydrocodone is 3.8 hours and you're taking it every 6 hours, so if I were to hazard a guess, I'd bet if you're taking it fairly regularly throughout the day (ie as prescribed) your pain is somewhat tolerable when you first take the pill, but when it's getting close to time to get that next one it's significantly wrose than before you started on hydrocodone. And if that is the case it could just be opioid induced hyperalgesia (which is the fancy name for pain being worse after taking pain pills that I described above).

  4. #4
    I do not agree that anybody taking opioid so I become addicted. I have used them for about 8 years, even prior to my accident, for chronic neck pain. I had been on methacarbinal ? as well as gabapentin
    Went off them in a weeks time with no issues. Some people have addictive genetics, others simply do not

  5. #5
    Quote Originally Posted by Lavender lady View Post
    I do not agree that anybody taking opioid so I become addicted. I have used them for about 8 years, even prior to my accident, for chronic neck pain. I had been on methacarbinal ? as well as gabapentin
    Went off them in a weeks time with no issues. Some people have addictive genetics, others simply do not
    Indeed, the problem is the only way you know if opioids are going to be a problem for you is after you've been taking them for a few week... it's impossible to know if you'll get addicted until you're addicted.

    That being said EVERYONE will become physically dependent on opioids and experience withdrawal when they stop if they take enough opioid medications regularly for long enough. No getting around that. So if you know it's not going to help your pain beyond the first few days and is actually more likely to increase your overall pain and you will become physically dependent on them if you take them long enough, in my mind it's probably not the best move to start on them... but what do I know?

  6. #6
    Senior Member Vintage's Avatar
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    I?m the same as Lavender Lady as regards not becoming addicted to opioids. Doctors had me on oxy, then hydrocodone, due to my extensive injuries and pain, for a year and a half. I couldn?t wait to get off of it...and did. Now, I take a gentle little powdered herb called Kratom. It is legal in all but two States, and can be ordered by mail, with no prescription. A site called kratomiq talks about dosage. It may seem ineffective when compared to opioids, but once you get away from opioids, this is a big help.
    Female, T9 incomplete

  7. #7
    Senior Member pfcs49's Avatar
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    Quote Originally Posted by funklab View Post
    I think pfcs49 is being a bit harsh there, but the evidence shows that long term use of opioids (like hydrocodone and dilaudid and heroin and everything "stronger") lowers your pain threshold and you end up with the same amount of pain, but physical dependence on opioids and even higher pain when the opioids are not actively in your system. (by long term I mean more than 5 days or so).

    There are numerous other medications you can try that are not in the opioid class:
    gabapentin (Neurontin)
    pregabalin (Lyrica)
    Lidocaine patch (Lidoderm)
    duloxetine (Cymbalta)
    baclofen (if your pain is due to muscle spasms)

    and that's just a few off the top of my head. Neuropathic pain rarely responds well to opioids in the first place, though if you take enough of them you'll certainly forget about it.

    and there are non-pharmocologic methods to help with pain
    Cognitive Behavioral Therapy
    Accupuncture
    Exercise (likely not all that feasible for those of us in wheelchairs as for our AB brethren)

    Also the half life of hydrocodone is 3.8 hours and you're taking it every 6 hours, so if I were to hazard a guess, I'd bet if you're taking it fairly regularly throughout the day (ie as prescribed) your pain is somewhat tolerable when you first take the pill, but when it's getting close to time to get that next one it's significantly wrose than before you started on hydrocodone. And if that is the case it could just be opioid induced hyperalgesia (which is the fancy name for pain being worse after taking pain pills that I described above).
    For the record, I tried Lyrica and gaberpentin; both caused a very disturbing change in reality-like a drug induced binge hangover. I got off them ASAP after trialing.
    I've also tried a couple mood elevators, currently Elavil, with no perceived improvement in my pain. I think my Dr is going through the medicine cabinet so he can justify and get coverage for botox to the site (my right groin, the boundary of feeling)
    I wasn't trying to be harsh, just stating in harsh terms what funklab later said: addiction is inevitable if you use enough over enough time! And addiction really sucks!
    69yo male T12 complete since 1995
    NW NJ

  8. #8
    There is a difference between addiction and physical dependence. Opioids and some other drugs such as benzos and barbituates cause physical dependence if taken for a long time, and must be discontinued through withdrawal, which ideally should be medically supervised. Addiction is a mental disorder that often results in requiring higher and higher levels of the addictive substance, drug seeking behavior, and emotional dependence on the drug.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #9
    Quote Originally Posted by Vintage View Post
    I?m the same as Lavender Lady as regards not becoming addicted to opioids. Doctors had me on oxy, then hydrocodone, due to my extensive injuries and pain, for a year and a half. I couldn?t wait to get off of it...and did. Now, I take a gentle little powdered herb called Kratom. It is legal in all but two States, and can be ordered by mail, with no prescription. A site called kratomiq talks about dosage. It may seem ineffective when compared to opioids, but once you get away from opioids, this is a big help.
    Kratom is an opioid. It's not a pure opioid as it is a plant product (much like opium is a plant product), but much of it's action is through the mu-opioid receptor (the one that gets you high and makes you stop breathing at high enough doses).

  10. #10
    Senior Member Vintage's Avatar
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    11/14/2017 08:52 pm ETUpdated Nov 15, 2017
    Last year, researchers at Columbia University published a study on mitragynine finding that it activates opioid receptors without triggering respiratory depression, the side effect of narcotic painkillers that is typically responsible for fatal overdoses.”
    https://www.huffingtonpost.com/entry...b00a6eece4c9e0
    Female, T9 incomplete

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