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Old 12-05-2010, 09:21 PM   #1
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Painkiller Tolerance

Hello all, sorry if this has been posted before, but i searched and could not find anything. I have been on pain meds for a long time, to manage my fibromyalgia. I was on 15mg hydro-codone pills. My tolerance started getting higher, and I started taking more, and to be completely honest I went through a bad breakup and abused my prescription for about 6 months. I know this was a bad call, so spare me the whipping. I realized the terrible decision i was making, and decided to deal with the situation differently...So:

my question is this, if I were to stop taking my pills for 6 weeks, a month, two months, will my tolerance go back down? Is it possible for my tolerance to go back down? If I stop taking them for a period of time, can i got back to taking one 15mg pill and have it be effective once again? Thanks so much!

 
Old 12-05-2010, 10:18 PM   #2
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Re: Painkiller Tolerance

Yes, your tolorance will go back down if you stop them for a while. A month would probably do it, cut them down slowly, suddenly stopping could be extremely unplesant due to withdrawls.
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Old 12-05-2010, 11:41 PM   #3
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Re: Painkiller Tolerance

Thanks for the reply! I appreciate it, i'll ween down slowly, before stopping. Thank you again.

 
Old 12-06-2010, 03:16 AM   #4
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Re: Painkiller Tolerance

Hi Ape if you did a search and found nothing you didn't use the write terminiology. What your proposing is a medicatin holiday. I just did a search and got 5 pages of posts.

Bottom line is a medication is holiday is about as contraversial as using opiates to treat chronic pain. One theory suggest it's an effective way to manage tolerance when done corectly , another suggest you will reduce your tolerance for a3-6 weeks before your right back where you started. I big factor is what dose you take and how long. If 15 mg at a time is what your supposed to take but you blew that number out of the water during your break up, It's even less likely your going to find stability at this dose for any length of time. If you were taking double that, quitting for a month may give you a couple weeks, but 15 mgs may not be enough for more than a couple weeks if the dose you created yourself was much higher.

Anyone in CP can always find a way to justify taking more medication. If you thought a break up was bad, wait till your 10 years down the road on opiates requiring 10 times the dose your on now, that's pretty dang depressing too. If you use the same rational simply wanting to feel better after a decade or two of chronic pain. Opiates can mask the emotional and psychological issues associated with chronic pain short term, just like the can mask the emotional pain of a break or any tragedy short term. It's something you will have to be ever vigalante of, especially once you have slid down that slope and found the relief you wanted. It makes it that much more tempting to fall back too when something else goes bad or you just get weakor weary of of your situation. Yes it seems to help short term, but Ive also seen getting out of a bad relationaship reduce the need for pain meds entirely in some people.

Since you seem to have this covered and don't want to hear all the nagatives involved in that activity I won't beat a dead horse other than say pain alone is enough reason to abuse meds, after 17 years I would about kill for just one pain free day but I know abusing my meds isn't going to make me pain free and I know the potential risk and cost.

My personal opinion on medication holidays are they are worthless unless done for several months, like 4-6 months for your body to truly reset. A month simply isn't long enough to get a sustained results once these meds have been taken for years or abused for months. You can't undue the changes that took years to occur physiologically in 30 days and you can't untrain your mind that these meds can bring relief to other issues short term too. You will have a short honeymoon when you restart and within weeks you will be right back where you are.

You might want to consider adding other modalities to your treatment plan and finding a pain management psychologist if your looking for more relief. They can teach you other ways to deal with emotional and physical stress and pain, aside for reaching for the little brown bottle with the child proof cap.

Good luck, Dave

 
Old 12-06-2010, 12:37 PM   #5
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Re: Painkiller Tolerance

I have struggled with this in the past as well. But like Shoreline says, your tolerance will indeed "reset", only to quickly rise back to the previous tolerance.

When my tolerance went from 10mg being able to control my pain to requiring 15mg after a year or two, I wanted to bring it back down. So I took a medication vacation of sorts and quit taking anything but OTC pain meds like Tylenol and Ibuprophen for a month. For one thing, it was a LONG month. Heh. For another, the reset tolerance only lasted a week at best, if that.
It wasn't long at all until I needed that extra 5mg again.
The nice thing was that I had an extra month worth of medication saved up, but ultimately it was pointless, as my tolerance just zoomed right back to where it was.

One suggestion that I will make is perhaps switching medications for a few months or so. Instead of taking your current medication, you could talk to your doctor about switching to another - for instance switching from Oxycontin to a morphine like MS Contin or even Embeda.
Now, I'm not sure that would exactly lower or reset your tolerance since you'd still be taking a narcotic, in which case you may even want to do away with all powerful narcotics and try something like Tramadol or something similar to that?
I dunno. Talk it over with your doctor though. You can get some decent advice and insight here on the forums but your doctor still remains your best and most knowledgeable source.

Good luck.

 
Old 12-06-2010, 01:53 PM   #6
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Re: Painkiller Tolerance

Ape-

You say 15mg of Hydrocodone? Not all in one pill I assume because 10mg is the highest available dose in a combination drug.

I've heard, as the others have said, that tolerance can be reset to some degree by several methods. I've heard that for some people they just trickle down, not completely off, for a week or so .... And even that method will help.

The problem you have, in part, is that Hydrocodone is a fast acting drug that comes on with a rush in 15 minutes and lasts only a few hours at best. Now, you are chasing the Dragon.

You may need to look into a long acting med that gradually relieves your pain and lasts 8-12 hours. Long acting meds tend to have a lower abuse profile because the 'Rush' is blunted and the effects are long lasting which keeps you from counting hours and counting pills.

I hope this helps.



 
Old 12-06-2010, 04:06 PM   #7
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Re: Painkiller Tolerance

I don't have any scientific knowledge of this, but my experience would mirror what shoreline and brokend have described. I had a brief holiday, and when I started with the same dose, I thought "hey this is great, I can get by with less again" but in a few weeks I was back up to my previous dose.

 
Old 12-06-2010, 05:12 PM   #8
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Re: Painkiller Tolerance

Quote:
Originally Posted by Isotope View Post
The problem you have, in part, is that Hydrocodone is a fast acting drug that comes on with a rush in 15 minutes and lasts only a few hours at best. Now, you are chasing the Dragon.
Really? That must be nice.

Do you have a low or high metabolism, Isotope? I'm asking because it seems to be that people with a high or low metabolism experience different "release" and duration of short acting medication.

For example, I have a very high metabolism. My doctor says that the reason for the short acting meds lasting less in duration for me as compared to other people is due to my metabolism. Being as high as it is, short acting medications rarely last me for the entire 4-6 hours that they are supposed to and diminish rather quickly; most of the time within 3 to 4 hours max, though at other times it can and does last me anywhere from 3 to 6 hours...

He says that my metabolism processes the medication quicker and it is in and out of my system much faster than someone with a low metabolism may experience, and he also points to my metabolism for the reason that my tolerance is higher than a lot of people's when it comes to an effective dosage. I have always required a larger dose than most folks, as when I just started taking pain medication 5mg didn't cut it and I needed 10mg instead. As I have been on it for several years now, it takes 15mg, and often times even that seems to be lacking. I get much better relief and much longer duration from 20mg.

The release, though, always seems to take me longer than other people for some reason, which doesn't make sense to me in terms of my higher metabolism being a factor. My current medication, Oxycodone, takes anywhere from 30 to 40 minutes to begin taking effect. Hydrocodone on the other hand always takes much longer, usually anywhere from 45 to 65 minutes.
When I was on Oxycontin it always took between 1.5 and 2 hours to start working, where the average (from what I have read) is about 1 hour for most people.

It's interesting that you begin to notice the release of the Hydrocodone in 15 minutes or so, as I have personally found it to be the slowest of the short acting medications to take hold. I would consider that a benefit rather than anything negative, imo.

Also, according to a pharmacist in my family, Hydrocodone has a longer half life than Oxycodone, which makes it last longer in effective duration of controlling pain. I have found this to be true when comparing the two, for me anyway. While the Oxycodone works better and releases quicker for me, the Hydrocodone does indeed always last longer.

Anyway, I'm rambling. Just thinking out loud I guess. Interesting though.

 
Old 12-06-2010, 05:27 PM   #9
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Re: Painkiller Tolerance

that's really interesting. I, too, have a fast metabolism, but it takes about 45 min to an hour for my percocet to start working. My muscle relaxer starts working within 5 minutes, but usually I have a good hour before I'm feeling relief from by break-through medication.

 
Old 12-06-2010, 05:32 PM   #10
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Re: Painkiller Tolerance

Yes, everyone has different reactions to various meds. I can feel a Norco in 15 minutes, in an hour it feels like it is at full strength, and I can feel it gradually going away in 3 hours..... My point was, that for many people in Chronic Pain, a short duration window of pain relief like that causes anxiety and it tends to make one reach for another.

Studies show that long acting (Controlled Release, Extended Release.. etc) pain meds cause less anxiety and less dose creep.



Last edited by Isotope; 12-06-2010 at 05:36 PM. Reason: Clarification

 
Old 12-06-2010, 07:02 PM   #11
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Re: Painkiller Tolerance

Dose creep? lol... I've never heard that term before. That's funny.

Good points, though. I have from time to time had that urge to take another half pill when my pain is significant enough that it seems like the regular dose isn't working as well as it should. However, I rarely do it, and when I do I always wait at least 2 hours. For whatever reason there are times when the medication takes longer than it should to get to full effect; sometimes as long as an hour and a half or so.

 
Old 12-06-2010, 08:22 PM   #12
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Re: Painkiller Tolerance

When I was asking the Pharmacist all of my various questions about Opana, metabolism was mentioned. From what I understand, drug effects are dependent on a specific aspect of metabolism relating to how we process various enzymes and compounds in any particular medication. It is not exactly the same type of metabolism that most people are referring to when they say "I'm thin, I'm a Fat Burner, I have a fast metabolism..."

Drug Metabolism is not the same as Coloric burning Metabolism.


Last edited by Isotope; 12-07-2010 at 12:31 PM. Reason: More Clarity

 
Old 12-08-2010, 12:10 AM   #13
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Re: Painkiller Tolerance

It's the little blue pill. with the M on one side, and either the 15 or 30 on the other. I suppose my terminology is incorrect? Is it percocet?

Quote:
Originally Posted by Isotope View Post
Ape-

You say 15mg of Hydrocodone? Not all in one pill I assume because 10mg is the highest available dose in a combination drug.

I've heard, as the others have said, that tolerance can be reset to some degree by several methods. I've heard that for some people they just trickle down, not completely off, for a week or so .... And even that method will help.

The problem you have, in part, is that Hydrocodone is a fast acting drug that comes on with a rush in 15 minutes and lasts only a few hours at best. Now, you are chasing the Dragon.

You may need to look into a long acting med that gradually relieves your pain and lasts 8-12 hours. Long acting meds tend to have a lower abuse profile because the 'Rush' is blunted and the effects are long lasting which keeps you from counting hours and counting pills.

I hope this helps.



 
Old 12-08-2010, 12:14 AM   #14
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Re: Painkiller Tolerance

Um, what does it say on the bottle?
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Old 12-08-2010, 12:32 AM   #15
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Re: Painkiller Tolerance

Umm good question, let me check. I've never really read the name before, my doctor calls it percocet, or endocet, but the bottle has the technical name, or pharmaceutical name...(is that correct?), "Oxycodone Hydrochloride" is what the bottle says.

And thank you to everyone who has replied thus far. I know abusing your pain meds is bad, but truly having your heart ripped out for the first time by the girl you were set to marry does funny things to a person's judgment and view of right and wrong. It's far worse than any physical pain i've endured in my 27 years on this planet, (and i hope to keep it that way.) But long story short, after picking up the pieces I just want to got back to eating 15mg every so many hours, and not make this mistake again!

 
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