Opioid Dilemma

[GeoffL]

I suffer with Chronic pain due to Bulging Discs, Nerve Pain, Knee Pain and Arthritis. I was on Oxycontin for some time with NO addiction or dependence issues however I was referred to a pain specialist who took me off the Opioid medicine and put me on Methadone.

I had issues with the Pain Specialist and was on the methadone for some time however I still had to be under a Pain Specialist to continue this medicine. The new pain specialist that I said that I was going to be taken off the methadone and given nothing for my pain.

1 month later I was off the methadone and back on Tramadol which is not helping with the pain. So what do you do when you have pain specialists, doctors and governments who are paranoid about Opioid medicine because Addicts are stealing and abusing this medicine and Chronic Pain sufferers such as myself are left to deal with our pain in a measure of excruciating circumstances?.

[Kai--]

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If haven’t seen already, GeoffL, this conversation ( healthunlocked.com/nras/pos... ) may be of interest? 🤔

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[Nicole2000]

Hello GeoffL,

Like you together with my PsA, I am also a chronic back pain sufferer. There was no pain tablet, liquid or patches that I had not tried in the past 10-15 years. I too was a pain clinic visitor and even with their interventions there seemed to be no end to my agony. I for a very long time was housebound and was on long term sick leave. In 2015, I hit rock bottom, my fentanyl patches weren’t working and it was the very first arthritic flare I ever had. If the truth be known I wanted to die. The pain was indescribable, all of my joints in parts of my body I didn’t know existed and in my spine with constant sciatica I was in pain 24/7. I woke up (in pain) one morning and managed to get a GP appointment (this is like gold dust where I live), lucky for me he was one of the more senior partners. I sat next to his desk and quite calmly said ‘ I can’t do pain anymore, help me’. The 10 min appointment lasted close to an hour. We made a plan for me to come of the opioids, tried to speed up my very first Rheumatology appointment and sorted my work out by increasing my sick leave time. To cut a long story short, I now take cocodamol, naproxen, pregablin, nortriptyline for my back pain and diazepam when I am having spasms and the rest of the meds are for my PsA.

The best thing I did was to get off the opioids. I was functioning in a fog, it made my daily living experiences a complete blur and I had great difficulties going to the bathroom (you know what I mean). At the time of taking the opioids I couldn’t see any of this happening, all I knew is that I was pain free, but wasn’t living. My rheumatologist was also adamant that the opioids was masking my PsA symptoms.

I am now working, looking after my girls, doing housework to some degree and can hold a conversation and stay in the moment. Don’t get me wrong, I have had my medication changed from time to time as my body gets use to the levels of the drugs, but I say better this than opioids any day.

I have also tried pilates, acupuncture and mindfulness. Don’t listen to individuals who knock alternative therapies, if it works, use it. Some exercise, eating well and resting helps me too. I don’t go jogging, but I do go walking when I’m not having an arthritic flare up.

I hope my condensed story helps in some small way. Please feel free to message me if you have any questions. I am well versed on chronic pain but on arthritis I am just a novice.

Take care and be kind to yourself.

All the best,

Nicole x

[nomoreheels]

My, you've plenty to be dealing with haven't you? You don't mention which type of arthritis you have alongside your other problems but if needed pain relief med should be prescribed, over & above your arthritis meds, that's just good med management. Opioids are unfortunately associated with the potential for misuse & addiction, there's no getting round that it's as it is but the prescriber should differentiate between need & possible misuse with each patient. OxyContin (oxycodone), like any other opioid med has the potential to be addictive, you probably realise that it's sustained release & as such it contains 20 times the active ingredient. They're on the controlled drugs list, both Class A Schedule 2 drugs... oxycodone is a semi-synthetic opiate whereas methadone is a synthetic opioid & isn't usually prescribed unless oxycodone has become less effective & no longer controlling your pain. Was it your GP who initiated oxycodone & you were then referred to the Pain Clinic who stopped it & prescribed methadone?

I take it you'd been prescribed tramadol prior to oxycodone & methadone? It's just it seems poor management if you're being prescribed (in your case) inferior previously prescribed pain relief when historically oxycodone or methadone helps ease your pain. Was there reason was given for not represcribing methadone, or is it the general dependence/addiction concern? If it is maybe you can express the need for appropriate pain relief & break it down for each symptom, if it isn't to be methadone then address each symptom individually. For the neuralgia possibly amitriptyline, duloxetine, gabapentin or pregabalin, for the knee pain could it be your arthritis meds could be amended then for the disc pain maybe once the others are controlled you'll be able to manage on less 'addictive' meds, it could resolve the issues your Pain Clinic doctor has in prescribing for your chronic pain.

These are all just thoughts that might work round the basic issue, don't know if they're workable you'd have to discuss your options with the appropriate prescribers but I hope you can find a suitable way to control your pain. I have RD & OA, my pain relief consists of co-codamol, pregabalin, amitriptyline, Butec transdermal patch (buprenorphine) & morphine sulfate.

[LizzieR]

Hi Geoffl,

I can't add much beyond the wise words of the others, but wanted you to know you are not alone. Many of us have and are experiencing the balancing of pain medication/ side effects and the worry of addiction. It's been in the news recently and I think Docs have been given 'advice' to beware of 'accidental'opiate addiction. I hope you find what you need x

[Hidden]

Hi Geoffl, Frankly, I think they have got an absolute cheek to suggest you are an addict because you need pain meds. Surely they have copies of your MRI Scans of your disc problems and X-rays of your arthritis? An addict is someone with a particular type of personality. I met a lady on holiday who had been addicted to food and had a gastric by-pass. She had lost over 180lbs. and was looking quite glamourous and I was interested in her story. I noticed her partner looked very stressed. Then she was missing all the time so I asked the partner where she was. He said since she'd stopped eating, she'd taken up gambling! She won loads of money on the slot machines on the ferry on the way home! If you were an addict by nature, I am sure YOU would recognise that fact and there are things that give a much better high than a few old painkillers. Since they cannot cure us lot with bad discs, (I have six prolapsed discs,) I can't see why they should worry whether we are addicts or not. I have Fentanyl patches, but often stop them and take another medication, if I get too sleepy. I don't drink or smoke either, so I don't suppose I have an addictive personality trait. Now if you were swigging the Oxycontin down with a bottle of whiskey every day, that might be cause for concern!

[Jay-bird]

At the risk of being stuck off the chat room may I suggest something that a couple of friends with MS have recommended to me. Smoke a little dope at bed time. It should give you a good sleep and make you better able to cope with pain. But to avoid problems, only keep enough on hand for your immediate requirements. The active ingredient in weed is also available on prescription if you prefer. For many MS patients it's indispensable and for people with chronic pain doctors don't mind prescribing it.