Addiction...

[crpsSucks]

Let's talk about the big elephant in the room when dealing with pain and pain meds.. The fear that we're all going to turn into drug addicts!!

There's always stuff in the media, the BBC have just done another documentary "Heroin Town". As soon as I saw the title I knew how it would play out. Louis Theroux goes to a run-down town in the US. Where he meets people who got addicted to prescription meds & then cut off (rather than sensibly taper), often by their own Dr who was treating them for pain, so they had no choice but to turn to street drugs. Plus I knew Fentanyl would be featured, how it's 100x stranger than Heroin, who are now OD regularly.

I'm interested in how others have been treated, if you have become addicted/ dependant yourself (or someone close to you)?

For me (UK): I find it annoying as I am prescribed Fentanyl patches, (big difference to the s**t coming out of China) been struggle with pain for months (it was effecting my mental health). Desperate to see a pain specialist only to refuse any stronger meds (even for breakthrough pain), criticise my current dose and roll her eyes at me when she said how addictive they were. I stopped wearing the patches for 9 days to prove I wasn't [that was hell] as the alternative was an overdose. Thankfully my GP made an exception and since prescribed stronger pain meds (I'm not pain free but feeling much better).

[Bananas5]

Interesting post and one subject that has been covered here many times. Addiction or dependency?

Of course these TV programmers do nothing for those who need regular medication for whatever their conditions. It wouldn't get good ratings if they showed 'normal' people who suffer chronic pain doing daily chores. Everyone would switch off. Sensationalize is the key.

The other side of the coin and this is now coming out more and more is that ever stronger meds do not work.. It has been researched for many years and at one time it was thought just an excuse for GP and pain consultants not to prescribe due to costs.

The amount of pain meds an average patient takes would fell an elephant at least. David was on Fentanyl for 12 years and found it very good. After those years the increased dosage was having less effect but he could not function mentally on any more.

So he changed to Oxycontin 80 x twice a day. Just 6 months ago his consultant said she wanted him to reduce. He did and slowly we have got down to 40 x twice a day and still coming down.

Result? No more or less pain so what did those high doses do? Nothing apparently but if you keep on taking more and more hoping for some relief you will be disappointed and may resort to anything you can get in the vain hope.

x

[crpsSucks in reply to Bananas5]

I don't like the term dependency to describe drug addiction myself, the difference is that; If you give an addict loads of drugs, they'll take as much as they can. I'm dependent on [prescribed] drugs/ meds to manage pain, have meds around me that I have no urge to take (even for a sub average day), the reminder to change the Fentanyl (50ug) patch went off over an hour ago and haven't applied it yet as I plan of going swimming tomorrow morning (should have gone tonight).

Like you, I much prefer the longer lasting medication, so you avoid the ups and downs (they just turn the level of pain down). Being able to sleep is one of the most important things for me, so is work (software engineer). I still get bad days, and flare-ups, but you have to roll with the punches (I try not to book meetings/ appointments early in the morning as I often don't know how the night will go.

Even though they doubled the dosage, I felt virtually zero side effects (less drowsy as I was sleeping better). I realise the Opioids aren't a silver bullet (buying time at best), and only part my pain treatment. I think it's a shame Medical Marijuana isn't used in the UK, especially for breakthrough pain (one day..). I just want a grown-up discussion with doctors, developing a dependency is a possibility - but is it the most pressing issue, what are the options?

Oh, the most dangerous medication I've taken so far is Naproxen (a NSAID), it's caused serious stomach & intestine damage and I'm now a coeliac (my immune system went after the wrong target).

[etheral in reply to Bananas5]

I was up to 5 80mg oxycontin tabs for neuropathic pain and continued to develop tolerance. It took 4months but with the help of pregabilin, valium and medical marijuana I was finally able to get off the opiods completely. The withdrawal was worse than the pain. Don't know if everyone experience such a degree of tolerance but beware if you find you need a higher dose of narcotics to maintain pain control.

[Raboo]

And being in that constant pain keeps the fibro in constant aggitation. Im so sorry. Are you also taking a daily medicine for the fibro? I take savella daily. Before they put me on the savella the pain was constant. I pray you find some rest and peace.

[Jonimo]

I have chronic back pain due to a number of conditions that have no cure or surgical option. I was on opiates for 13 years, first to be able to function at work. Eventually couldn't work any longer and got on Disability. Weaned down on the opiates somewhat. Finally weaned off opiates completely this summer. I was surprised that the pain isn't much different without any pain meds. Did have considerable misery during withdrawal, but got thru it. I'm really awake for the first time in over a decade. I still struggle with depression but pain is tolerably low.

[Matt8394Alien]

I’ve been on Fentanyl patches for 6 years now and have had no bad affects on my life. I also take Lyrica, 30/500 solpodol and Robaxin for my spinal condition. Some days I take no robaxin or solpodol when the Fentanyl is kicking in. Even on all this I’ve managed to do university and work full time. Things I would not be able to do without the medication.

I was on higher Fentanyl dose but asked for it to be reduced and my pain level is the same on the lower dose. I get blood work every 6 months and my liver and kidneys etc are all perfectly fine and my doctors have even pointed out how they are in better condition than others my age (early 30’s) who go out drinking weekly. That alone sort of shows the overhype and lies about long term paracetamol use.

I do worry about the stigma but I don’t tell people in work that I’m on all this nor do many others know. When the Fentanyl patch starts wearing off by half way through the second day I do feel withdrawal pains. Or perhaps it’s just the nerve damage showing through. I don’t know.

Either way, for me these medications have been a life saver from age 27 when I was medically discharged from the military.

[crpsSucks in reply to Matt8394Alien]

Hi Matt, I believe we're a similar age.

I recently started taking Gabapentin, and it has made quite a big difference to the acute pain, and I'm interested in Lyrica. Have you noticed any side-effects, such as weight gain? (Not just being vane, as a crutch-user excess weight is an issue.)

I've never heard of Robaxin before, but it does look interesting (as muscle spasms are a big problem for flare-ups). I read it doesn't last long, so I'm guessing you take it every 4 hours (when you need it). How fast is the onset time? I'm scared to fly (love flying) as there's very little I can do if I'm stuck on a plane. Thinking of trying diazepam (only for big flare-ups), but I don't really want to be on my own when you take as it doesn't just relax your muscles!

I was chatting to a friend of mine who has had chronic pain for nearly two decades. I was surprised to hear that he wasn't on any opiods, he's been on benefits for nearly all of that time as he is unable to work. It begs the question: What is better, being able to work/ function (and run the risk of becoming addicted) or being opioid free?

When I doubled the dose of Fentanyl to 50ug, I wouldn't of said it feels like double the pain relief. More like 50% at best (pain is so hard to gauge as there's so many internal & external variables). Bananas5 has mentioned deminissing returns and I tend to agree. My lived is better now that when it was 10 years ago (I was working in the pub trade), I was surprised!

I'm not ashamed to tell people that I'm on Fentanyl (et al), it is a medicine after all. I don't think hey-fever sufferers are ashamed about taking antihistamines (which can also be abused).

I do find the 3 day of wearing the patch is noticeably less pain relief, but don't take anything for it (I don't have to work normal hours, just when I can). I just accept it as a con of the medication, although I do vary the length +-12 hours depending on the pain. I try to get ahead(1.5 days now), I think the mini-detoxs are a good thing.

[Matt8394Alien in reply to crpsSucks]

The military had originally put me on gabapentin but I did not find it much use. Then Lyrica came along for me and it works way better. I’ve not gained weight on it. Biggest issues at first were dry mouth and short term memory issues. Lyrica really helped with the weakness in my leg from nerve damage and the nerve pain has greatly reduced.

Only reason I’m on Fentanyl etc is because the damage in my spine can’t be fixed with operation and it will only get worse as I age. So I’m this for life apparently.

I don’t take the robaxin or solpodol every 4 hours. I usually take one solpodol before leaving for work and then at lunch one robaxin and then same in the evening. Some days I take way more but it all depends on the muscle tension and if any of my damaged discs move out of place. Which happened recently leaving me in severe pain and in bed for a week.

The muscles tense up so bad in my spine that it pushes on the discs and nerves according to spinal surgeon. Robaxin has really helped.