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Old 12-10-2010, 10:57 PM   #1
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chronic severe daily headaches...

For the last four years I have been having daily headaches that are very severe. I am fairly young and didn't have insurance when this started, so I began self mediating with opiates. I obviously fell in love, and before I knew it, I was taking 80 to 100mg a day of oxycodone.

Fast forward to now: I finally have insurance and I was able to see the doctor. CT and mri shows nothing wrong, so I am given an array of medications for tension headaches, migraines, and more (non opiates). Finally I am prescribed 5mg ir oxycodone.

My question here is: I have a giant tolerance, I don't feel pain relief, nor the euphoria with under 80mg. Then the rebound headaches are just as severe if not worse. What do I do to get any relief from these headaches? No dose of oxy or hydro does it. All the other meds (relpax, furinol, furinol with codiene, etc...) don't provide relief, and there is no way I'm going to get more than 150mg a month of oxycodone, and that won't even provide relief for more than two days aT best...

What now? I'm tired of living in pain. I'm too young for this.

Thanks for your help...

 
Old 12-11-2010, 12:37 AM   #2
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Re: chronic severe daily headaches...

Have you tried amitriptyline/nortriptyline/anticonvulsant drugs such as divaprolex or lyceria?

Its extremely unlikely that any doctor is going to give you high doses of opiates for headache, as it is generaly beleived that they feed rebound headaches.

I think referal to a pain clinic at a major university hospital would be a wise move, you might have luck with "end of the line" therapies there (such as opiates) than with a neurologist in private practice.

The drug buprenorphine might be worth loooking into (in america it is mostly used for drug addiction, but in the rest of the world it is widely used as an analgesic) - it is very long acting, and so less likely to feed rebound headaches.

How quickly did your dose escelate to 100mg/day? Have you ever had any other problems with drugs or alcohol?
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Last edited by jonnstar; 12-11-2010 at 12:50 AM.

 
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Old 12-11-2010, 03:42 AM   #3
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Re: chronic severe daily headaches...

Hey, thanks for your reply...

I have tried amitryptaline and various beta lockers. Haven't tried the one you mentioned (the anti-convulsant). I have tried buprenorphine/naloxen (suboxone) but only one 8mg sublingual tab a few times throughout the last few years. Mostly because its not readily available on the "street" in my area. So I haven't had any long term trial with it, and I don't recall what it did for my headaches, as I was taking it to ease other withdrawal symptoms. I suppose it worked, made me feel better for the day anyway.

Yes, I have had addiction/drug abuse issues before. Not out of control rehab status, but heavy use until about two years ago. My deal is that while i was into drug experimentation (in high school) I never liked opiates. I'm not going to deny that I do like the euphoric feeling I get, but I have a child now and I only started seeking these out for relief, not recreation. I am passed my days of abuse. However I am only 23 so my doctor is very weary about giving me any narcotics. As stated before, I have had every blood test, ct scans, mri's and they can't find anything. With nothing to show they don't want to hardly give me anything. It sucks because I'm in a lot of pain daily and everytime I go to see my doc I just get the vibe that they think I'm lying. If I start saying things like, "maybe some buprenorphine would work" they are going to see it as drug seeking behavior. I have to play stupid when I go there as to not seem like I'm a junkie.

Maybe I should see a pain management clinic, however the nearest ones are three hours away. I don't know what to do. How do I talk to these doctors and get them to be on my level and not just think I'm a drug addict?

Also...it didn't take long for that tolerance to build up. I've always been not very sensitive to opiates. I feel I can just pop them over Nd over and not get relief. This is why I got the oxy ir's with no acetametaphen because I take way too much tylenol into my system with percocets or vicodin. Anyway, I appreciate your time! Thanks.

 
Old 12-11-2010, 02:13 PM   #4
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Re: chronic severe daily headaches...

Divaprolex is commonly known as Depakote, and would be well worth a trial.

I would definatly go to the university hospital pain clinic if there is any way at all you can - there is so much they can do, both with drugs and with other procedures like nerve blocks etc, it could certainly make your pain more managable.
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Old 12-14-2010, 02:52 PM   #5
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Re: chronic severe daily headaches...

This might sound kind of crazy... but perhaps you need to see a dentist.

They say that up to 80 percent of people suffering from headaches actually relate back to their occlusion. Do you know what your TMJ is?

Do you grind or clench your teeth at night?
Do you have any pain or stuffiness in either of your ears?

Patients very often will self-diagnose, especially strong, chronic “bad” headaches as “migraine,” usually without the diagnosis of a neurologist. The typical headache TMJ patient’s exhibit is temporal headaches. The reason TMJ patients most often suffer from temporal headaches is because the temporalis muscle, which is located at the sides of the head, is the positioning muscle of the mandible, or lower jaw. If the teeth clenched together place the mandible at an unfavorable relationship to the head and neck complex, the temporalis muscle is overactivated and goes into spasm. Overworked muscles of chewing, like overworked muscles in any sport, can fatigue, be filled with toxins and cause pain perceived as headaches. Clenchers and grinders often wake up in the mornings with temporal headaches. This misalignment of the mandible is an orthopedic problem which can be corrected, thus eliminating temporal headaches related to the bite or occlusion.

I urge you to look into neuromuscular dentistry if you feel you may have a problem with your TMJ. Hope this helps.

 
Old 12-14-2010, 07:23 PM   #6
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Re: chronic severe daily headaches...

To be totally honest, you're going to have a very difficult time finding a doc who believes you really need treatment for headaches and aren't just wanting drugs, due to your years of self-medication. Having said that, docs don't generally treat chronic head-aches with Opiates. I have Cluster Migraines, they last anywhere from a day to 13 days....and my PCP & Neurologist have never prescribed a narcotic for them...the main reason they don't work. I take Topomax daily as a preventative and Axert at onset, which is a migraine med. You need to see a neurologist and get on a migraine/headache regimine, something that is designed specifically for headaches. These meds work by affecting the blood vessels in your head and around your brain, which are what generally cause the headaches. I also take Morphine and Percocet for Chronic Pain and they never effect the pain of a migraine.

Good luck, let us know how it turns out.

 
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