Very "Opioid Tolerant" person needs help - Pain Management Message Board

brentskib · 10-04-2007, 12:19 AM

I've been taking some form of narcotics for over 13 yrs now.

*I've had 3 lamanectomies, a fusion as well as Microvascular Decompression surgery for Trigeminal Neurailgia. I now need another fusion.

I've been very lucky when it comes to pain management Dr's,having 2 Dr's. during the past 10 yrs. (5 yrs. in Fla, and the last 5 in San Diego)
They've never been judgemental, always understood my pain and always provided me with whatever pain medications I needed.

So, I've been taking some form of pain meds. for the past 10 yrs. During that time,I've seen my pain Dr. every month and always used the same pharmacy in each city. ( 2 pharm. in 10 yrs.)

I tried the pump many yrs ago but it broke twice requiring 2 surgeries to fix it and finally had it taken out.

To say the least,I've grown extremely "Opioid Tolerant".

My current current meds are 80 mg. Oxycontin 2 x day,20 mg. of methadone 3 X day,8 mg. dilaudid every 4-6 hrs. as needed for btp.

I've been on this regimen for at least the past 2 yrs. I really need to switch my breakthrough pain meds as the dilaudid doesn't help as needed anymore.

I know that switching pain meds. helps from developing tolerance, and I plan to talk to my Dr. about switching my pain meds.on my next visit.
My pain Dr. has always been very open to any suggestions re; my pain mgmt. and medications.

I not only need to change my BTP meds but I'd also like to decrease my overall meds. so that when I have my surgery, my pain mgmt in the hosp. will be more effective.

I went through hell during my Trigeminal Neuralgia surgery 4 yrs ago due to the high doses of pain meds that I was on at the time, and continue to be on now.

Any suggestions would be greatly appreciated.
Thank You.

Fabrashamx · 10-04-2007, 12:28 AM

Cold you make a lateral move to something like the patch or methadone? You may not even have to raise your dosage, sometimes a new medicine will work where another has stopped being as effective.

I know some people in pain management switch meds around every 6 months or so, it keeps their tolerence down, but it doesnt work for everyone is what I have heard.

I think switching to another med is worth a try, even if it doesnt work out, maybe a short break from what youre on now will be enough to make them be more effective for you.

Good luck, I'm sure others will have more advice for you.
Your Friend, Fabby

whitfield · 10-04-2007, 05:20 AM

I would suggest that you ask your doc about the Duragesic Patch--I have been on the 100Mcg patch for several years and find that it provides relief without the hassle of taking a lot of pills--One note, the Mylan brand does not work for me or many others--If you decide to try it, use the name brand (Janssen) or the generic Sandoz (which is identical to name brand)--They are expensive and some people have problems with them sticking etc.--I do not--provides excellent relief and only need breakthrough meds on the third day--Some docs prescribe it to be changed every 48 hours rather than 72--My doc does not--prefers what manufacturer suggests--every 72 hours--Just a thought--Good luck--whit

jodom1979 · 10-04-2007, 06:20 AM

Whitfield,

Well said on the patches. I loath the Mylan brand and think they are junk. I wish i knew about that when I recieved my first script... Since then I have bought the Sandoz and they have worked like a charm.

BrittleBones · 10-04-2007, 07:46 AM

Hi Brent! I am suprised that your doc has you on two long acting meds: the oxycontin AND methadone. I haven't heard of that before. I was on methadone for about 3 years before deciding that the pain relief I was getting wasn't worth the many hours I that I was spending staring off into space. I'm currently on the Duragesic patch 100 with oxycodone 30mg for breakthrough. I'm not getting the pain control from the patch that I was when I first started using it and I'm waiting to talk to my new PM doc on October 25th to see what can be done. I have found that the oxyccodone works the best for my pain and am hoping that the doc will take me off the patch and put me on long acting oxycontin with the oxycodone for break through. All the best - Memere