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Old 08-23-2009, 01:06 PM   #1
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Question Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

It seems that once you tell them yes I use to abuse alcohol, but no longer they think I will abuse pain meds. I am a 33yr old disabled veteran I had a hip replacement 3yrs ago and have been on pain meds for about that long. Every time I go to the doctors office any time I ask about changing my pain meds they give me a hard time, I put myself in a Rehab program for alcohol and weed 6mo ago been sober since but I have chronic pain issues and need to take pain meds for my neck and back. I want them to change my pain meds but i think they will tell me no. I also seek treatment at the VA and in the private sector what should I do. I also give them random Urine screens when asked and never refuse I do not have the urge to drink or smoke pot but once you admit you have a problem it haunts you for every. I am know on 30mg morphine 3x times daily for long acting which I would like to switch to oxycotin because i take 5mg oxycodone for breakthru pain which works great.

 
Old 08-24-2009, 02:57 PM   #2
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

I have been in a similar situation as you. I am in recovery and am a recovering drug addict. Once I got clean, I went to a pain management doctor and he would not prescribe me anything stronger than Ultram(tramadol). I hated the way that it made me feel and he was prescribing me the max that he could. I asked for something to treat my pain better and he kept telling me no and made me see an addictionologist (a person that specializes in treating people with addiction and other medical issues).

I quit going to that doctor and started going to a doctor recommended by my sponsor. I was honest with the doctor when I first started seeing him and he just had to get my medical records. He then put me on the fentanyl patch with Vicodin for BT pain. I would just be honest with your doctor and tell them what your pain level is on avergere (# out of 10). Tell your doctor that you would like to be able to do more but your pain inhibits you. Ask your doctor what is a reasonable goal (like a pain less than 5/10). Say something like "would it be reasonable to have my goal of pain be less than a 5. If the doctor says yes, then tell him how much you are currently suffering, that you just want better pain relief and that you do not abuse your medications.

That is really all that you can do. If the doctor is not helping you well enough then try to find another more caring doctor. If you attend 12 step meetings maybe ask people there about pain issues or maybe which doctors they see for their issues. That is another option. Good luck and I know exactly what you are going through.

brian

 
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Old 02-18-2010, 11:25 AM   #3
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Hello and congratulations on getting sober! The reason why NA and AA programs require complete abstinence is because once you become an addict, you know that you can remove yourself from difficult situations, self-doubt, loneliness and all types of emotional pain by getting high. Once you cross over from assuming life's problems must be coped with to knowing you can use a substance to escape, you are in serious danger of becoming addicted to any mood altering substance.

This is hard to accept, because once our drug(s) of choice are no longer an option, we don't have that escape hatch ready and waiting anymore!

I am a fibromyalgia patient who has had multiple abdominal surgeries and severe G.I. health problems for all of my adulthood. I have endured terrible pain on a regular basis, and I do understand what it means to suffer.

The significant dangers of opiates are starting to be widely known in the medical community. Most people with opiate addictions started out using the meds for legitimate reasons, following their dr.'s orders for dosing. They don't start out taking handfuls of meds and going on pleasant mental vacations. They start with good intentions and a real need for pain relief.

Herein lies the problem: When you are an addict, you are highly susceptible to transferring your addiction from a substance you used in the past (but now abstain from) to a new substance. This doesn't happen occasionally--it happens so often that an addict must have great vigilance to avoid starting a new addiction.

This new addiction will start the same way they all do: you can control your intake, you may not take it every day, and you don't crave or look forward to the drug. This honeymoon phase is the time you look back on once you are hook, line and sinker addicted to another substance, and you say to yourself, "Why can't I just go back to how it was before?"

Addiction to opiates is becoming such a huge problem that dr.'s guidelines for prescribing them are only going to get more restrictive. The fact is, opiate addiction overwhelmingly originates with a dr.'s prescription for legitimate pain. What are the alternatives for managing pain without narcotics?

Your first line of defense against pain are antidepressants. Medications such as Elavil and Pamelor have been proven to prevent and control chronic pain. Often, these meds are effective in much smaller doses than those needed to control depression, and are tolerated well in the low doses needed to treat chronic pain. They take time to become effective (4-6 weeks, on average), and should not be discontinued before they can start to work, just because they do not provide instant relief.

Another option? Anticonvulsant medications, such as Neurontin, Tegretol and Lyrica. These meds are effective in controlling nasty nerve pain (among the worst type of pain) without using opiates. A note about Lyrica: It can make some people feel woozy or unsteady, possibly mimicking a drunken feeling, which can be an issue for someone who is an addict or alcoholic. These effects are short-lived at prescribed doses and will recede on their own once your body gets used to the medication, AS LONG AS YOU DO NOT CONTINUALLY INCREASE YOUR DOSE TO RECREATE THE INITIAL FEELING.)

Cymbalta and Milnacipran (Savella) are two new antidepressant meds that show great promise in controlling chronic pain, and they can be an excellent alternative to traditional pain meds for many!

Exhaust all of your other options for pain relief before going on opiates. Rx opiate addictions can easily lead to overdoses, seizures and liver damage. Tolerance to these meds means ever-increasing doses are needed, which in turn causes more harm to your body and less pain relief.

The gold standard for chronic pain relief is quickly becoming daily administration of antidepressant and/or anticonvulsant medication, with NSAIDS for breakthrough pain relief. Physical therapy, hot and cold compresses, (Rx) local anesthetic gels, exercise and holistic medicine techniques such as acupuncture and meditation can also be helpful.

No, not everyone becomes addicted to opiates. But the dirty truth is coming out: plenty of people are, and you would never know it because it is a secretive addiction that people can keep even from their own family members and their doctors. Opiate addiction is exploding, and it is every bit as difficult to stop as alcohol or any illegal drugs.

 
Old 02-18-2010, 06:16 PM   #4
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Actually, most pain patients, who have not had a prior addiction, will not become addicted to their pain meds. I just saw something the other day that said it was less and half of one percent.

Since you have had a prior addiction, you just need to be very careful. There is no reason why just because someone is in recovery, that they should have to suffer. You just have to find a really good doc to work with you.

 
Old 02-18-2010, 06:30 PM   #5
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Who are you hope4thefuture with one post? I don't know what you know about pain management but there are plenty of people who are just in pain and need to be treated with respect. Some may abuse the med's but it soon becomes obvious to their doctors and they will be refused opiates. But there are many genuine pain sufferers that these people have given a bad name. Give patients the correct treatment as most are in desperate need of help, I know. There are only a small percentage of addicts here abusing their med's.
Allan

Last edited by allanbruce; 02-19-2010 at 05:52 AM.

 
Old 02-19-2010, 01:48 AM   #6
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Quote:
Originally Posted by allanbruce View Post
Who are you? I don't know what you know about pain management but there are plenty of people who are just in pain and need to be treated with respect. Some may abuse the med's but it soon becomes obvious to their doctors and they will be refused opiates. But there are many genuine pain sufferers that these people have given a bad name. Give patients the correct treatment as most are in desperate need of help, I know. There are only a small percentage of addicts here abusing their med's.
Allan
Thats right,a lot of us are suffering for no reason.I hope the dr will realize he needs his medicine,other substances should not matter when you are in pain.
I think the age of the person has a lot of pull,hence all drs give old ladys anything they want.Good luck my friend.

 
Old 02-19-2010, 05:50 AM   #7
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

I was on tramadol for many years before I could find a doctor who would prescribe the medication I needed. It can be a long road before receiving the appropriate meds and a trial of finding the right med for you individually. I know my battle would have been a lot easier if I was treated with respect in the first place but we are presumed guilty before they realise we just need the right help. It can take a long time also to find a doctor who you can relate to and speak with honestly and be listened to with respect but because of the people who try to manipulate the system we suffer. In a dream world we would all be believed but as far as others go you are guilty before proven innersent.
I hope all of us will one day be given the chance to show we only want to be able to live some sort of normal life and not be in agony for the rest of our lives.
But because you are an addict usually you are judged by your past behaviour as most will return to that life as they don't know any different. Good luck, I hope you can find the right treatment for you.

Allan

Last edited by allanbruce; 02-22-2010 at 08:01 PM.

 
Old 02-19-2010, 11:13 AM   #8
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Quote:
Originally Posted by ermitch View Post

I also give them random Urine screens when asked and never refuse I do not have the urge to drink or smoke pot but once you admit you have a problem it haunts you for every. I am know on 30mg morphine 3x times daily for long acting which I would like to switch to oxycotin because i take 5mg oxycodone for breakthru pain which works great.
Congrats on being honest and open. Trust me, you are a much better person for it. Not only is telling the truth very important, but it removes the burden of being dishonest.

I know it's tough to understand right now, but the Doc is only looking after your best interests. Many in situations like you can't get any access to PM, much less, good PM. I'm obviously not your Dr., but my guess is that they have you on the specific meds for a reason. Oral morphine doesn't exhibit the euphoria, nor does it energize the excitement pathways like some other meds. Hydrocodone and Oxycodone are the two most likely to do so. I'm guessing they have you on the lowest dose Oxy for a reason.

In terms of Oxycontin, not only has there been a lot of press about the addiction and abuse, but it is 100% Oxycodone, so it wouldn't surprise me if they don't feel it's just too much risk right now since it's only been 6 months. I would be a bit careful about pushing too hard...It may backfire. Irregardless of the abuse past, Docs usually don't like making wholesale switches in PM regimens....They'd rather tweak it and move slowly. Thus, I'd try to maybe gently persuade them to increase the BT med and leave the morphine alone....That type of thing.

As a person who has taken both OC and oral morphine, I can tell you that oral morphine does a much better job of holding one's long acting pain in check....OC seemed to always run short on me and I needed more and more. Thus, that may be contrary to what you need right now. A lot of people who take OC and can't get the med to last end up on oral morphine. My point is that the grass isn't always greener on the other side of the fence.

Please realize that I only want to help and am only trying to give you the Doc's perspective. Best of luck to you.

Regards,

Ex

 
Old 02-22-2010, 06:43 PM   #9
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

My post offered a host of suggestions for non-narcotic pain relief. Feel free to confirm the information I included in my post. Antidepressants and anticonvulsants are the future of pain relief. The addictive nature of opiate/opioid meds means they present a real risk of addiction that cannot be summarily dismissed. Beyond the dangers of addiction, the ability to control pain with narcotics diminishes with repeated, daily use. These meds often work best used on a prn basis, rather than an around-the-clock application.

 
Old 02-22-2010, 07:03 PM   #10
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

The oxycontin I take saves me from so much pain, I don't know what I would do without it. Saying that an anti depressant would give the same relief, I doubt it. I am happy to use these types of medication and I don't believe you become addicted or have to increase the dose very often at all. I may have to increase the dose down the track and after that I will just change to another type. Narcotic medication should not be neglected and I hope it will be used for years into the future. I am hoping that after surgery I will not have the sciatica and maybe even reduced pain from the disc's and facet joints so I will be able to decrease the meds as I am able to. I am not addicted to the meds but certainly rely on them. I have done so in the past as when I went off the durogesic patches I was on 2x 50mc/gr/hr every 3 days. Down to tramadol again but that was not enough pain relief so I went to the Oxycontin I use successfully now 2 x 40mg a day plus paracetamol and endone if I need it.
My opinion after many years of chronic pain. Allan

Last edited by allanbruce; 02-22-2010 at 07:37 PM.

 
Old 02-22-2010, 07:25 PM   #11
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Plus I've got news for you. After you've been on the meds for a couple of years, there aren't any more "mental vacations". Allanbruce, I'm not referring to what you said, but to hope4thefuture.

Dave

Last edited by dmarcus48; 02-22-2010 at 07:30 PM.

 
Old 02-22-2010, 07:36 PM   #12
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Sorry what do you mean when you say mental vacations?
I understand if you mean to get high. I have never been high from my medication as it usually is only just enough to get me through the pain. I never take any more than I need because I get very few short acting tablets so I have to make them last. So no getting high for me. I would have to take probably double what I have now to get any sort of high and all I want is some pain relief not to be off my head. If that is that I wanted I would be swallowing a bottle of rum.
I tried Tegratol for 3 months and it did nothing. I was on Lyrica as well and I may as well be drinking water neither helped me a bit. Maybe I needed a stronger dose? Oh well Just use what I have.
Allan

Last edited by allanbruce; 02-22-2010 at 08:01 PM.

 
Old 02-22-2010, 08:16 PM   #13
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

Sorry I knew that was going to happen. It wasn't directed at you allanbruce but at hope4thefuture's original post. They mentioned mental vacations from taking the pain meds

 
Old 02-22-2010, 08:21 PM   #14
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Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

No worries

 
Old 02-24-2010, 12:48 AM   #15
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Talking Re: Im in recovery for Alcohol and mairjuana, I have a Pain Management Doctor

How's this for ironic? (Hope you see the humor in it, but please delete if anyone finds it offensive.)


So I'm going through Vocational Rehabilitation through the states services... basically an offshoot of their Department of Workforce Services. Anyways they tried to find a psychologist who specializes in Pain Management. Guess what even though I'm one of those that doesn't have an addiction to his pain medications, his office is at the University Alcohol & Drug Rehab Clinic.

Kind of a reversal of roles... I'm going to Alcohol & Drug Rehab for my Pain Management... Not to minimize all your accomplishments in your Rehab but I just found this incredibly ironic and wanted to share a laugh...

Or maybe the meds have just twisted my sense of humor.

 
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