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Old 04-19-2008, 02:10 PM   #1
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pain and meds making me ill!

Hi everybody I have been on pain medication for about 2 years now, i have a muscle in my bowel which does not relax, the proffesionals seem to be as clueless as me as to finding a solution to it. It gives me a great deal of pain and the only meds that have helped have been narcotics-tramadol which i think is called ultram on your side of the pond and dihydrocodeine which is codeine tartrate i have not come across anyone on this board taking this drug, it has a street name of DF118 on the UK.
Is this the same drug as oxycodone? You dont hear of this drug in the UK, the drug comes in 30ml tablets which i know are stronger than 10ml oxycontin.
Any how my PM has took me off the dihydrocodeine in weekly reductions which i'm finding hard as i had been overusing anyway (not for a high, although i do get a high). I have quite a long history of substance abuse (heroin and methadon) which has kept me from telling the pm that i'm over using for fear of stopping my medication altogetherreally I'm now really fed up of the pain and the medication, i feel ill, tired and emotionally numb.
The pain does not seem to be showing any signs of going away but i dont feel that narcotics is the way forward for me!!!

 
Old 04-19-2008, 05:53 PM   #2
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Re: pain and meds making me ill!

Hello Hapy Jack.

You don't go into specifics about your prior substance abuse, only to say that you have a "long history." I'm guessing that long term exposure to heroin and methadone have significantly increased your tolerance. Thus, you are probably under medicated....Maybe significantly so.

The million dollar question is whether to tell your Doc or not....And, I don't have an opinion. Depends on what kind of Doc you have, and the rest of your medical history and current situation.

Ex

Last edited by Executor; 04-19-2008 at 05:54 PM.

 
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Old 04-19-2008, 06:48 PM   #3
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Re: pain and meds making me ill!

Hi executor, my addiction problems with opiates started in 1991 with heroin but i switched to prescription methadone from drug services and was succesfull in abstaining from heroin for many years until 2003 when i came off all substances (yes everything) and went into treatment. It was when i was detoxing that i started to notice the pain and thought it might just be my body adjusting and would clear in a few months. Anyway after 2 years abstinence from all drugs my doctor started me on opiate therapy. which was relatively successfull in alieviating alot of the pain which made life more comfortable, bear in mind i was 2 years clean and had no tolerance to narcotics. Over the last 12 months i have developed tolerance to the meds and try to use just what i need for pain relief, i do try to be carefull knowing that there is an addict in my personality. I dont expect total relief but my current dose is severly inadequite, as you say the big question is do i tell my consultant this, i just feel that my past is stereotyping me as patient, i fully understand the dr's must use caution but i'm in pain alot and i'm always worrying about running out of meds!! I really dont know what to do next!!

 
Old 04-19-2008, 08:07 PM   #4
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Re: pain and meds making me ill!

So, If I understand this correctly, your regular Doc knows, but your PM Doc does not? Sorry, but it's not quite clear. Also, did your Doc send you to PM or did you go on your own?

Ex

 
Old 04-20-2008, 01:12 AM   #5
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Re: pain and meds making me ill!

I know exactly where you are at since I am a recovering addict myself. I really can not believe that the doctors were putting you back onto opiates after 2 months of being clean. I think what you need to try is something called Suboxone/Subutex (it is buprenerophine). I don't know what it is called in the UK but it is specifically designed for opiate addicts and also has the benefit that it treats pain. I would ask your doctor about this. I know that when I told my doctor about my addiction, he immediately stopped what I was taking which was Oxycontin & Percocet which are both oxycodone. I am currently back on the narcotic medications but the good thing for me is that I NEVER ABUSED my pain meds, it was something else. Therefore I have never been considered an opiate addict. I know it's hard to believe but true. I saw an addictionologist(doctor specializes in treating addiction & pain) and she was going to put me on the Suboxone until I told her everything. However, I think the Suboxone would be perfect for you. The drawback initially is that you MUST BE COMPLETELY OFF ALL OPIATE/OPIOD medications, be in withdrawal, before they can give it to you. I believe you have to be off 24-48 hours, then they start it, and the withdrawals go away pretty quickly after they start it. You don't want to be on any opiates or it will send you into SEVERE WITHDRAWAL. But I do know the struggle of being a recovering addict & needing pain treatment. Before I found my current doctor, they would only give me tramadol(which didn't do much more than ibuprofen&acetaminophen) but gave me some bad side effects. I am off that drug for 9 days now . Good luck and keep posting.

brian

 
Old 04-20-2008, 05:02 AM   #6
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Re: pain and meds making me ill!

Neither my doctor nor my PM know i'm overusing. i asked my GP(doctor) to refer me to PM because he didn't want to give me anything stronger than tramadol and dihydrocodeine and i would say my GP has been brilliant through all this, many doctors would probably have said "cant help you or it will pass in its own time". I was rather hoping PM would be able to help me and would give me something stronger which is what i felt i needed. As for your suggestion BRIANPAIN i'm unsure wether they use suboxone for pain here in the UK but i have been on this drug they used it to help me detox off methadone 5yrs ago and i started to feel the pain when i started on suboxone so i dont think it would help me, also i know some friends in recovery who tell me they have some very long lasting deppression after withdrawl from suboxone, why is it all these so called safer options ie ultram, suboxone turn out to be harder to kick than good old morpheine. There's one consolation though i can come on the board and share with you guys and get some empathy and understanding as well help which is a big help and i don't have to feel alone with my frustrations THANKS GUYS

 
Old 04-20-2008, 10:50 AM   #7
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Re: pain and meds making me ill!

Happy Jack,
first of all I want to say that you are in a great place; people here can offer you a lot of support, they can share their own stories and I have it will make you feel much better.

I don't know much about addictions, but Brian can share with you his own experience, he is a very nice person and he is trying to help others a lot.

I can't give you advice regarding your Drs - it's totally up to you. Just make sure you don't put yourself in trouble if your Dr will find out the truth somehow.
When I had sign a contract with my PM Dr i had to answer the question if I ever been treated for any addictions. I had to give my urine and blood speciments before i got prescription from his first time.

Good luck to you! I wish you the best

 
Old 04-20-2008, 04:26 PM   #8
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Re: pain and meds making me ill!

Thanks MOL I really appreciate the support that we give each other here. I do speak to my friends who give me support but what i have found is chronic pain is a very lonely buisness the only people who really undrestand are those who have been through it and fortunatly i can come here and people say "yeah i understand how you feel" which i dont really get anywhere else. I enjoy coming on the boards and some of the senior memebers are fantastic.

 
Old 04-21-2008, 02:39 PM   #9
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Re: pain and meds making me ill!

hapy jack,

Dihydrocodeine isn't used much here, except in a couple of preparations. It's not oxycodone. In potency dihydrocodeine falls between codeine and hydrocodone (Vicodin). Oxycodone is significantly more potent, about 50% stronger than morphine.

I know this sounds "off the wall," but would methadone treatment for pain be totally out of the question? I can see it almost killing two birds with one stone so to speak. I found it to be the best pain med I ever used. And if it can serve to keep you off of street drugs, or even overusing your scripted meds, then so much the better.

Just curious...

steve

Last edited by forginon; 04-21-2008 at 02:51 PM.

 
Old 04-21-2008, 04:05 PM   #10
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Re: pain and meds making me ill!

Hapy Jack: I have just read through your thread and I can't offer any advice on the addiction side, but I did want to offer my support and let you know that I do understand the frustration that goes along with chronic pain. It is significantly more difficult when you can't get any help finding out what is causing the pain.

Have your doctors ever done any testing to see what is causing the bowel pain? Maybe a colonoscopy? Or an MRI? I was just curious, as you weren't specific. My sister-in-law just had emergency surgery for a bowel obstruction and they initially thought it was a result of constipation or impacted stool. When they opened her up, however, they found it was scar tissue. They still don't know why, because she has never had any bowel surgeries, but it was there anyway. I'm not saying this is what is happening with you, I just thought I'd throw that out there as a possibility.

I also can't tell you what to do about telling your docs about the over-using, but I know if it were me, I'd feel much better coming clean and getting it off my chest. Maybe if you just explain that you found youself despeately needing pain relief, but not craving a "high", they might understand. I wish you the best of luck, whatever you decide. I hope you can get this resolved so that you can feel better both physically and emotionally.

Take care and keep us posted. cmpgirl

 
Old 04-21-2008, 06:12 PM   #11
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Arrow Re: pain and meds making me ill!

I know this sounds "off the wall," but would methadone treatment for pain be totally out of the question? I can see it almost killing two birds with one stone so to speak. I found it to be the best pain med I ever used. And if it can serve to keep you off of street drugs, or even overusing your scripted meds, then so much the better.
Yes i think i would be be better on methadone or possibly slow release morpheine but again i dont know if they use methadone over here for CP. I have had xrays and MRI's and all that has showed up is a muscle not relaxing. I think the doctors are no better informed than me, i would even say i'm more in touch with the problem than they are because i feel the pain and although scientific evidence is not showing much i know something is definately not right! Its very clouded for them to prescribe because when they see my notes for 12 years the list reads= heroin addiction, methadone addiction, detox,......detox.....methadone and on and on....
On my last PM consultation i saw a new guy, my usual's on maternity leave, any how he asks me tell my pain story so i tell him i was on drugs for x number of years and i stopped and then noticed this pain. So he goes on to say " not much has come up on the x-rays, i want you to stop taking 1 of the drugs either tramadol or dihydrocodeine because I DONT WANT TO HARM YOU"! I thought this guys showing me no mercy he does not believe me, so i said "i'l stop the tramadol", he replied "i want you to stop the dihydrocodeine"!!! Basically he did not give me any choice which ****** ME OFF!!
Without going in to detail he reated me like i was mentally ill and i felt patronised and insulted by the way he spoke to me. He procceded to put me on neorontin which has had a minimal effect on the pain.
If i wanted to just go on to methadone it would not be hard, its very easy to access drug services in the UK, it would probably take a month or two to get a methadone prescription.
I dont think its right i that to have to go through drug servives to get pain relief, for gods sake i volunteer as a drugs worker i live my life right and i hope to get full time job in drug services i enjoy my work and my studies (i am doing a degree). My pain is the only negative thing in my life and i have had it now for nearly five years! i dont know where it will end, cant the DR's see if i wanted to just get drugs from them i would have used a much easier tried and tested route....................

 
Old 04-21-2008, 09:53 PM   #12
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Re: pain and meds making me ill!

hapy jak:
there are no majic answers and yes there are going to be many, many doctors that treat you bad because you are a recovering addict. if they do not know anything about addiction, then they are going to think that you are merely there to get the drugs to get "high" or to sell them on the street. I am sure that you are doing neither. I wanted to bust my head against a brick wall when the PM doc that I was seeing would only give me tramadol(Ultram) for the pain. I kept telling him my pain is averaging 7 or 8 and sometimes shoots up to a 9. He was trying me on Cymbalta which did not work and tried several epidural injections which did not work.

Here is a question, do you seriously think that you can take the methadone without abusing it? If not then absolutely do not go on it. I know how frustrating it can be and I was using drugs because I was trying to self treat my pain. I will go ahead and tell you that it was crack-cocaine that I was using which was actually making the pain worse I found out. I finally found a doctor that is willing to trust me and give me the meds that I need for pain relief. Maybe you can ask the doctor about the fentanyl patch and see what he says. Here is how it helps me. It can not be abused as easily, it is a steady dose of narcotic medication(fentanyl), I don't have to take pills, I only change it every 2 days. The steady dose is absolutely necessary for a recovering addict, which is why the Vicodin(hydrocodone) and Oxycontin(oxycodone) are two of the most abused prescription drugs here in the US. I do know that Methadone is a LA(long acting) drug too but since you have abused it in the past, it would be nearly impossible for you to be on it again without abusing it. Are you also in Narcotics Anonymous for support. If not, then I would highly suggest you get involved. Keep posting alright, we do care what happens

brian

 
Old 05-05-2008, 09:28 AM   #13
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Re: pain and meds making me ill!

Hi brian i no you will see this; i got emergency appt with PM last week, and he just wont budge on the meds, so i said i,ll refer back to GP. i am having and epidural in june and he's put me down for another MRI.
I went back to see my GP two days later and told him the story and he seemed ok with things and scripted me some codeine which is better than nothing.
I'm getting very worried now as the meds i'm on tramadol, codeine, amitrptylene and neorontin are not not giving me the needed relief most of the time, i'm thinking is it me? whats wrong with me? I hate going to my doc and saying i'm struggling with my pain even on all these meds!

 
Old 05-05-2008, 03:25 PM   #14
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Re: pain and meds making me ill!

hapy jack,

In a way it is you. Unfortunately, because of your past use of very strong narcotics, you have a high tolerance for these meds. Your system probably laughs at codeine and tramadol. So, that's one challenge.

The other challenge is that your condition may be getting a bit worse. This happens to a lot of us. Our pain level shoots up and we kinda automatically think it's tolerance to the meds. But sometimes it's our condition that has worsened.

You may have both things working against you. I think primarily you are not receiving anywhere near the amounts of opioids you need for pain. This happens to a lot of folks who have a history with opioid abuse or are actively using. They simply have a higher requirement for opioids. Doses that would kill me might be just right for your pain.

The problem is finding a doc willing to prescribe the level of narcotics you need. And there's always the trust issue. Docs find it awfully hard to trust ex-addicts enough to prescribe opioids. There is some good news. There are now drugs on the market, and many others that are soon to come out that are more tamper resistant or have a delivery system that makes them less likely to be abused. The fentanyl patch is one of the best. Duragesic is a patch loaded with a matrix including fentanyl that is applied to the skin and slowly delivers the drug through the skin and into the bloodstream over 48-72 hours. Of course, it could be abused by breaking open the patch covering and consuming the contents. But, the matrix is very toxic if injected and also if swallowed. There are other meds coming that are mixed with anti-opioids that if injected bring on immediate withdrawal.

What level is your pain at? On a scale of 0-10 where 0=no pain and 10=worst pain you can imagine?

 
Old 05-05-2008, 03:52 PM   #15
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Angry Re: pain and meds making me ill!

Thanks J that makes lots of sense the ex-user tolerance issue.
I would say an average day i start with zero-1 on awakening which progressess to maybe a 3 or 5 at dinner, the meds are kicking in at this time but so is the pain and i would say slowly moves towards a six in the evening. Evenings usually hover between 7 and 8.
Stress seems to agravate my condition, i used to live a pretty active life but i do less these days and do try to relax as often as possible. I'm on my first year of a degree and i hope i can cope it means alot to me to try to live my life as best i can and i do have ambitions and goals, mentally the pain and the meds seem to be slowly wearing me down. I think any hope i have of drug free normality is vanishing, i'm really finding life hard and i'm starting to feel like burying my head in the sand and i think pity is rearing its ugly head.

 
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