Silk Road forums
Discussion => Drug safety => Topic started by: Tunbear on February 28, 2012, 07:38 pm
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Hello folks i was wondering if i could get a little help about my medication
A year ago I damaged my back in a work accident, after an absolute nightmare time with my doctor (awesome guy, he will prescribe pretty much anything I ask for but his diagnosing is ridiculous, when I started getting psoriasis as a kid he didn't know what it was and looked it up under S) I seen a proper specialist and have found out the problem.
Basically my spine is screwed and I've got 3 years of treatment ahead of me. Now the problem is my pain management. I have a screwed up body somehow, basically I have a high tolerance to practically any chemical (first time I took ketamine I remember it taking me 2 or 3 times as much as other people to get me going for example) and because of this it's hard to find a suitable painkiller.
At the moment I don't take anything for the chronic pain, I deal with it (it's about a 3 or 4, I'd say equivilent to a sprained ankle, or a bruised rib) but as it flairs up often I'm having trouble finding the right meds to treat it.
I used to take dihydrocodeine, but was taking 300mg just to bring it down to bearable. Then he diagnosed me morphine sustained release 10mg, but I'm taking 10 of these which brings it down to about a 2 (stubbed toe maybe ?) but I'm worried about the sort of damage this is doing to my liver.
My doc has advised me to take the morphine every day instead of just as needed as this will help me build a baseline to treat chronic pain but this doesn't sound right - won't this both A) make my tolerance go up quicker and B) for me to get addicted easier ? At the moment I've been taking morphine for 3 months but I ran out a month ago and didn't feel any withdrawal from it.
For these sort of situations do you guys have any advice ? I've got BuTrans buprenorphine patches but the dose he's given me is for people without an opioid tolerance so I don't think these will help.
He said I can have oxy if I really want it but checking the opioid comparison chart its on 2x stronger than morphine, and isn't oxy much more addictive ?
Any advice about best way to manage the pain will be appreciated, it's only recently I've found out it's a 3 year recovery so I want to make a plan now.
I'm assuming I'm going to come out of the end of it with a pretty strong opioid addiction but part of my settlement with work will include any sort of detox treatment I need at the end of it.
Sorry for the long post thanks for reading.
TL:DR chronic pain sufferer with really high tolerance;
morphine not helping;
3 years of pain planned with a lot of peaks in pain;
ideas to treat it ?
O also, I don't get high off any of the stuff, could there be something wrong with my body not processing the opioids (can you even have defunct opioid receptors?) ?
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I had a pallet of frozen foods fall on my back over 10 years ago and started on the opiate
express,first for the pain then It made me feel much better,more made it better.
Started on soma,xanax,vikes,loratabs,oxycontin 40s,morphine,roxi 30s and the huge settlement I received
was gone between Dr.s appointments,meds both legal and illegal.
It's a fine line between using your meds responsibly or justifying
your use/abuse due to the pain.Only you know if you can control your med use
I sure couldn't to this day and still take a ride down to Miami for the 10 bag for $80 specials
GOOD LUCK
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Hi,
I would strongly advise you to try Levorphanol(generic name: Levo-Dromoran), especially since you say your doctor is open to suggestions. What you need is a medication that is more potent than morphine (mg wise), but not excessively so (to prevent rapid tachyphyxia) and which allows for convenient dosing due to high oral bioavailability. Most importantly, as a chronic pain sufferer you'd want to have a drug with quite a long half life (this can also help with managing tolerance). Levorphanol fits perfectly plus you and your doctor won't have to deal with the current oxycontin hysteria.
Also, your type of pain often responds well to multiple treatment strategies. Again, Levorphanol does the trick since it's also active as an NMDA antagonist, which was proven to be of great benefit to pain patients.
EDIT: One more tip (in case your doctor hasn't come up with this already): The idea with chronic pain management is to cover most or at least a good part of your pain with a long acting base medication (see above, though many doctors now use methadone or buprenorphine which I'd advise against for various reasons). Use a second, short acting medication for any breakthrough pain. It's a much more efficient regimen and will be easier on your tolerance in the long run.
Regards,
strike
Disclaimer: I'm not a medical professional and any advise in this thread is merely personal opinion which cannot substitute for the qualification of a doctor.
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GORDENRAMSEY:
Ah see I've got a bit of a leg up on the chance of addiction front - I get no euphoria or nice feeling of opioids whatsoever, it's freaky-deaky and has in the past pissed me off because I wanted to feel that feeling everyone raves about, but now with such a long road ahead of me on them I'm glad of it.
But the physical addiction is still going to take hold after that many years on it.
I've noticed that with this BuTrans patch on the pain is actually quite manageable, but I've not strained myself in any way since applying it.
strike:
Ah that sounds brilliant I'll have a look at it, see if it can be prescribed here. With it being the UK, strong painkillers are an absolute nightmare to be prescribed. The Surgery I go to (Surgery is what we call the doctor's offices, don't know if you use that term) has 3 different doctors on staff and if I go to any of others all they will prescribe is co-codamol.
I understand their concern because so many people can be addicted and abuse them but it feels like I have to prove to them I'm not a junkie just so I can be treated.
The doctor I see though all he cares about is that I'm working and paying for my prescriptions, he's seen me enough times (and with big breaks in between so he knows I'm not jonesing) to trust me.
He has been wary about putting me on oxy and to be honest I don't think it will help as much as I think it would, it's not much stronger than morphine anyway.
In the morning I'm going to go for a long walk and see how I am after that, if this patch holds up with that then we could be onto a winner and if not I'll ask him about Levorphanol.
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Bupe patches can be an option, it all depends on how you tolerate them and how your pain levels change throughout the day. If they are mostly constant then the patches could be all you need.
I was in a similar situation years ago (chronic back pain after weight-lifting injury) and would have terrible pain spikes at night, not catching any sleep. Patches would have been quite useless, since the dose needed at night would be overkill for the rest of the day, thus screwing your tolerance. The actual problem with bupe is that taking any other opiates "as needed" doesn't work, since it blocks most receptors due to its agonist-antagonist properties. I was lucky to quickly end up with a knowledgeable pain specialist who got me on levorphanol (I'm pain and drug free now). It must be the most underappreciated and forgotten opiate of them all, so don't be surprised if your doc hasn't even heard about it. Like I said, if you find the bupe lacking, just pretty much tell your doctor what is written above and make sure he feels that you care and do have a plan (seems like he doesn't?).
Regards,
strike
P.S. As for the prescription: I'm in Germany, but seems to be available and listed Class A in the UK. So in this respect it's no different than the morphine you had or oxycodone. It boils down to whether the doc thinks it's appropriate.
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strike you hit the nail on the head - these patches were great up until around bed time last night. Getting up, sorting out some stuff gave the pain spikes you know so well. And sleeping is a nightmare on these!
But after a walk I was alright - I'd say it's about a 2-3 (dull ache, a minor sprain feeling) which I'm ok with normally it's about a 6 after I do something.
And you're right about the as-needed, took 100mg morphine and didn't do much at all. I've got an appointment next week I'll ask him about levorphanol.
He does care about my pain as every time I've asked for something stronger he's bumped me up when the others wouldn't. He was the one who made me try tramadol because they don't like prescribing codeine. Had a seizure on them (was taking them like sweets, they did absolutely nothing) so he put me on codeine. Came back only 3 days later and said they weren't working so put me on dihydrocodeine 10mg and a box of 30mg too to let me judge my own tolerance. He was wary about doing more than that but still let me try morphine..in the UK getting a doc to prescribe morphine is practically impossible.
And it was him who suggested the patch because he said my pain management was a bit backwards so let's try his way for a bit, which I am doing as I at least owe him that :)
So hopefully he'll let me keep trying my way after I run with these for a week and ask for that levorphanol. Thanks again strike, what you went through is damn near identical to me so I reckon your method will work the best!