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-   -   Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc. (http://www.healthboards.com/boards/chronic-pain/842474-question-regarding-changes-meds-fentanyl-dilaudid-opana-norco-etc.html)

FemmeVA 03-30-2011 10:59 AM

Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
I've been living with chronic pain since a car accident in 2004. In 2006 I was diagnosed with Ulcerative Colitis (UC) and due to the disease I'm not supposed to ever take and NSAIDS again. Prior to that, I was doing OK on Mobic and muscle relaxers. Since the UC diagnosis, narcotic pain relievers are one of my only options due to allergies and the no NSAIDS thing. It started with Vicodin and progressed on to stronger medications. I want to make it clear that I only use my medications as prescribed and my doctors all know everything I take, how much I drink (less than one drink per day), etc.
Recently, my UC has experienced a flare-up after 2 years in remission with Remicade. With the flare-up, my overall ability to deal with the pain has decreased and there is the pain with the bleeding ulcers as well.
So....after a very long background, I was wondering what I should expect. I saw my pain specialist today and we changed me from Norco (hydrocodone 10mg. Tylenol 325mg) 4x/day along with 75mcg/hr of Fentanyl to Dilaudid 2-4mg. 4x/day along with the same dose of Fentanyl. Previously, I was on Opana 10mg. 4x/day along with the Fentanyl but the Opana didn't seem to work well for me so I went back to the Hydrocodone. I am wondering what to expect with the Dilaudid. My only experience with it has been in a hospital via an IV and that was usually for post-procedural/surgical pain. The first time I had it in a hospital I knew I still had pain, I just didn't care about it or anything else.
Has anyone on here taken Dilaudid orally while on the Fentanyl patch? If so, please let me know your experiences. Also, please let me know how the Dilaudid orally compares to orally taking Opana, Norco, Oxycodone, etc. as I've taken all of those in the past.
Also, while I personally do not have any history of drug of alcohol abuse, it runs in my family - my Mom was a heroin addict in her late teens/early 20s as was her twin, another uncle was a cocaine addict. My doctors know of my family history, but Dilaudid is a medication I've heard compared to heroin and I want to know the risks of getting addicted to the medication. I know that by now, I have a physical dependence on narcotics as I haven't gone a day without them in a few years, but I've never experienced withdrawal symptoms if I've changed meds or run out of meds for a day or so - just a lot of pain as the narcotics weren't in my system to block my feeling the pain. So, what should I be looking for and what should I expect with these medications?
Thanks for your help!
FYI, I also take muscle relaxers (Flexeril and Baclofen) and use Lidoderm patches for my pain.

Boxerluver 03-30-2011 05:19 PM

Re: Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
Hi, I am on the fentanyl patch and years ago was prescribed Dilaudid. I had just gotten out of the hospital with kidney stones and had Dilaudid through the I.V. Which worked great. My doc warned me that the Dilaudid by mouth would not have the same effect and I said that I figured as much. I was given 4mg, every 4 hours and it did absolutely nothing. I had another break through med so when the Dilaudid didn't work, I did have something for BT, but I did give it a good try to see if it would work. For whatever reason I got no pain relief from it. I told that to my pain doc when I went back the next month and he just left me on the other BT med I was taking.

I would definitely try it because we are all different and react differently to the meds, but I have read a lot of people do not get enough relief with Dilaudid by mouth.

FemmeVA 03-31-2011 08:44 AM

Re: Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
Thanks for letting me know your experience. If you don't mind, would you please let me know the medication that's working for you for breakthrough pain? I'm only 1 day in, but I've noticed it's very short-acting in the pain relief (my pain specialist told me that I could take 1/2 of a pill (2mg) every 3 hours if needed instead of 1 pill every 6 hrs. but was hoping 1/2 of a pill every 6 hrs. would be enough. It's definitely not like the IV stuff, but if I recall correctly, the IV stuff lasted less than an hour per dose.
My body is strange with some meds - when getting my wisdom teeth removed I found out I had absolutely no reaction to nitrous oxide, oxycodone doesn't work well for me and the Opana - which should be 3x the strength of morphine didn't seem to do much either, but I was only on that while overdo for steroid injections, so I really am not sure.
It scares me how it seems like I'm just getting more and more drugs in my system as I build up a tolerance, so I'm scheduled to discuss other options, such as nerve blocks next month.

jonnstar 03-31-2011 10:22 PM

Re: Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
Oxycodone is another opioid similar to Dilaudid that is highly active by mouth, very well adsorbed. It is also somewhat longer acting.

It is avaliable by it self as Roxicodone, or with Tylenol as Percacet

It is one of the most commonly prescribed strong painkillers all over the world, and has been in use since the 1920's, so we know that it is safe and it works.

FemmeVA 03-31-2011 11:27 PM

Re: Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
Johnstar- for some reason, Oxycodone in all it's forms doesn't seem to work well for me - Roxicodone, Oxycontin, Percocet, Concentrated Oxycodone liquid, etc. - Just the way my body is made up I guess. 20mg. of Oxycodone provide me with less relief than 7.5mg of hydrocodone (Vicodin). I also have other health problems so my medications are sometimes a juggling act - Ultram caused seizures, the Fentanyl combined with Verapamil (which was prescribed to help prevent migraines) made me go crazy - as in, I packed a bag, was taken to the ER and admitted to the psych ward by request as I didn't know if I could keep from hurting myself and I was VERY verbally abusive to others (luckily, I had a lucid moment and remembered reading they might interact so I mentioned this to the psychiatrist who doubted it was that particular combo, but I had him check and 24 hours after my last Verapamil I was back to being my "normal crazy" and back home.
The Diluadid is the first medication that's really scaring me as I've heard it compared to heroin many times and my family has a history of drug addiction and I don't want to follow that path.
My level of tolerance to pain meds over the past few years has really been bothering me and in another post I'm asking about other treatment options - various injections, blocks, possibly burning the nerve root & such.
I really appreciate everyone's thoughts and suggestions. This seems like a really great place to converse honestly about pain treatments and not just finding people looking for ways to get high.

Joebizz 09-28-2011 09:53 PM

Re: Question regarding changes in meds-Fentanyl, Dilaudid, Opana, Norco, etc.
 
[QUOTE=FemmeVA;4719145]I've been living with chronic pain since a car accident in 2004. In 2006 I was diagnosed with Ulcerative Colitis (UC) and due to the disease I'm not supposed to ever take and NSAIDS again. Prior to that, I was doing OK on Mobic and muscle relaxers. Since the UC diagnosis, narcotic pain relievers are one of my only options due to allergies and the no NSAIDS thing. It started with Vicodin and progressed on to stronger medications. I want to make it clear that I only use my medications as prescribed and my doctors all know everything I take, how much I drink (less than one drink per day), etc.
Recently, my UC has experienced a flare-up after 2 years in remission with Remicade. With the flare-up, my overall ability to deal with the pain has decreased and there is the pain with the bleeding ulcers as well.
So....after a very long background, I was wondering what I should expect. I saw my pain specialist today and we changed me from Norco (hydrocodone 10mg. Tylenol 325mg) 4x/day along with 75mcg/hr of Fentanyl to Dilaudid 2-4mg. 4x/day along with the same dose of Fentanyl. Previously, I was on Opana 10mg. 4x/day along with the Fentanyl but the Opana didn't seem to work well for me so I went back to the Hydrocodone. I am wondering what to expect with the Dilaudid. My only experience with it has been in a hospital via an IV and that was usually for post-procedural/surgical pain. The first time I had it in a hospital I knew I still had pain, I just didn't care about it or anything else.
Has anyone on here taken Dilaudid orally while on the Fentanyl patch? If so, please let me know your experiences. Also, please let me know how the Dilaudid orally compares to orally taking Opana, Norco, Oxycodone, etc. as I've taken all of those in the past.
Also, while I personally do not have any history of drug of alcohol abuse, it runs in my family - my Mom was a heroin addict in her late teens/early 20s as was her twin, another uncle was a cocaine addict. My doctors know of my family history, but Dilaudid is a medication I've heard compared to heroin and I want to know the risks of getting addicted to the medication. I know that by now, I have a physical dependence on narcotics as I haven't gone a day without them in a few years, but I've never experienced withdrawal symptoms if I've changed meds or run out of meds for a day or so - just a lot of pain as the narcotics weren't in my system to block my feeling the pain. So, what should I be looking for and what should I expect with these medications?
Thanks for your help!
FYI, I also take muscle relaxers (Flexeril and Baclofen) and use Lidoderm patches for my pain.[/QUOTE]
Fentanyl & Dilaudid are narcotic pain medicines & do have an dependency issue. Once (if ever) you no longer need pain management, your doctor will ween you off of them so when you stop taking them, you won't suffer symptoms of withdrawl.


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