I am a 60 year old retired teacher. I have multiple spinal issues. I've actually been taking Opana close to 2 years. With the exception of one anxiety attack, I've tolerated the drug. My Doctor likes Opana because ( his words ) it has no peak .... It provides a steady stream of pain meds 24/7. ( although I beg to differ) ..... Now ( April/2012 ) I find myself with 2 major problems.
1. I want OUT of the opiate pain med business. 2. The drug is hard to find. Last month , I went to 7 pharmacies ..... Felt like a street user .....begging for drugs.
I have a appointment next week with my Doctor..... I have no idea what to say to him ......oh, btw .... I take Percocet 10/325 for Breakthrough pain.
Guess my question for this forum is .... " is there a drug out there ( for pain ) that rivals the effectiveness of Opana ? What about withdrawals ? OH GOSH , I just hate all of this. Thanks for reading my first
Hi there! You definitely have options. It is normal to build tolerance to a narcotic and have it last for less time or not work as well over time. Tell your doctor the med isn't giving you stable and sufficient relief. They should either increase the dose or switch you to something else. Morphine, Dilaudid, Oxycodone, Methadone, and Fentanyl all come in extended release formulations. With the right dose and dosing schedule, its very likely you can be doing better. It can take some time to switch meds or get a dose right, but its typically worth it.
Never ask for a med by name though...just be honest and tell them why it isn't working. Your pharmacy should be able to order Opana for you. Talk to the head pharmacist in person and set up something such as you calling a week before you are scheduled for your script and remind them to order what you need. They may tell you they can put in on their order schedule, but even if they do, if they don't set it asside for you, that doesn't mean much. Definitely call monthly, giving them enough time to order it. I was also on Opana once and attest it was tough to find. Many doctors request you only use one pharmacy, so that can put some patients in a pinch.
I definitely recommend talking to your doctor and seeing if you can get a dose increase or med switch before considering going off the pain meds...most folks start on them for a good reason...nothing else works for them. If you really wanted off, a slow taper over several months if needed should minimize withdrawal symptoms. Sometimes taking Clonidine or a similar adjunct med can help any symptoms too.
If they end up switching you to a different med, keep in mind to be safe they need to drop the dose, as you won't have as much tolerance to the new med. Sometimes they calculate it too conservatively and you can have increased pain or withdrawal. If its too bad, definitely call your doctor. They are available for a reason, and you don't need to be miserable.
I don't see any reason why Opana is better than any other long acting narcotic. If anything, its more expensive (as its brand only). Thats why its so hard to find (pharmacies don't stock expensive meds that aren't requested much). I've actually heard of a lot of folks who don't like it. It works pretty ok for me as a short acting med, but like everything else, I quickly became tolerant. There are many other meds doctors would probably like better as they have a lower abuse potential, such as Nucynta or one of those formulations that can't be crushed. Best wishes.
I took Opana for quite some time. I found it overly expensive and a bit redundant since the principle narcotic (Oxymorphone) is naturally long acting (5-7hrs). The Opana release mechanism added maybe an hour or two to that.... I found I had more control with generic immediate release Oxymorphone that I could break up and dose as needed. Also, it is very hard to do any weening of Opana because the tabs can't be broken into smaller doses.
If you are still out there. I reread your post. Don't be scared. You CAN get off of Opana. You will need to switch to the generic immediate release pills, match your dose and take at the same time you do Opana. Begin dividing the pills in quarters. If you take a quarter less than your usual dose each week you will drug free in a month. I recently dropped from the equivalent of 50mgs of Oxymorphone to 10mgs in one day! -No, it wasn't very comfortable for a few days but I did it and you can too!
I gave up on the extended release mechanisms, I wanted control over how much drug and when.... You mention also the idea of switching? Your predicament will remain the same essentially with any of the Narcotics. I've found Opana/Oxymorphone perhaps a bit more benign than some I've tried. For example -for me, Hydrocodone was pleasurable, Oxycodone was pleasurable AND made me want more AND made me an anxiety wreck. Morphine seemed to set off every immune response in my body and made my skin flake off and hair fall out. Hydromorphone (Dilaudid) was probably my most recent mistake, very short acting in a sort of vicious way that made me feel like a junkie. Thankfully I have no interest in going anywhere near a Fentanyl patch. I think Levorphanol is the chemical sibling to Oxymorphone so that would be my next best choice, long acting, pharmacies order it in, it's cheap, but rarely prescribed these days for some reason. But, for now I'm trickling out, I'm on the bench.
Bottom line, YES you CAN get off Opana, and it may be easier than if you were taking Dilaudid or OxyContin.
Thanks so much my friend .....I appreciate your ideas for my " battle plan " ..... Also , I've been trying to explain this situation to my wife. She's thinking , " if Opana is helping you, why change ? " ...... While she may have a point ( to a certain degree ) I'm thinking long term ..... I'm only 60 years old ( yeah, I know, in many circles , that IS old ..but I'm hoping to live another 25 years ..... I'd love to enter my 80s with my brain, liver and kidneys in good working condition !!!
Thanks again ..... I meet with my Doctor on May 2 ......
There are several good LA meds besides Opana, it's just Oxymorphone. You have Oxycontin, which comes in several varieties and Morphine which comes in several varieties. These are all 12 hour meds that work on the same principal as Opana, steady pain coverage, no peaks and valleys. Morphine is the least expensive and easiest to get at a pharmacy. Oxycontin was very good until Purdue switched it's formula a few years ago to make it harder to abuse, whatever they did it cut the ability of the drug to actually control pain. Most of us who were on Oxycontin at that time jumped ship to a different LA Med, as our 12 hr med was no only controlling pain for 4 - 6 hours, major problem. They're are also Fentanyl patches, they are also a LA med. I can pretty much guarantee you that you doc will not move you down to just a SA med when you've been on a LA med for 2 years. And I can warn you that if you request that change you may find yourself in the position of being labeled a drug seeker, your doc may question your true need for pain meds, as most people who are in pain don't want to decrease their meds. As someone who's been doing this for a long time I get where your coming from, not wanting to be on drugs forever, I've been in Pain Management since I was 17...I'm 43, I've had to accept the fact that if I want to walk, and live some semblance of a live I'll be on pain meds. Have you talked to your Dr.'s about surgical intervention or other therapies that might take the place of medications? Steroid shots, epidurals, PT, etc. As for withdrawals, generally when you switch from one narcotic to another you don't suffer withdrawals, your body doesn't seem to mind as long as it has some form of narcotic or opiod to replace what you were taking. If you do decide to get off LA meds, your Dr. will taper you off slowly, it will be done over several months, you can't just stop these meds quickly, that can be fatal. Your Dr. will probably stop your SA meds as well, since they're not made to control that kind of pain, and the normal dosage won't be able to and that's when people get in trouble and start abusing them because they get desperate and take more and more to get the pain to stop. When you think about how awful it seems to be on meds for the rest of your life, make sure you figure in all the remaining facts, living in constant pain is not much of a life.
Is true what you say? "you can't just stop these meds quickly, that can be fatal."
My understanding was that the Benzo drugs were not to be abruptly stopped due to potential seizures? Or, at least that was the wisdom from veteran Shoreline, he said in a post something to the effect that 'nobody ever died from opiate withdrawl', I paraphrase from memory (which is sketchy at best). Let me know your thoughts on this Kat -I respect your knowledge, thnx.
Iso, depending on what your daily dosage of Opiods is, yes people can die from stopping their meds. Some of us who have been on these meds are on pretty high doses and your body adjusts to these drugs and has to have them. My Dr. tells me repeatedly, "If you ever get stupid enough to decide you don't need the pain meds and stop them, get your *** to the ER before your heart stops beating!" LOL...I tend to get irritable and threaten to toss 'em every few months! And of course with Benzo's you have Grand Mal Seizures, Seizures can be deadly. I have a Seizure Disorder, typically death from Seizures is from asphyxiation, choking or injuries incurred while having a seizure. Strong meds aren't made to be taken lightly, when your on high doses of this stuff, or multiple meds, your body get used to it, it adjusts to running with those substances in it, you suddenly stop them and its not a good thing. And you have folks with multiple meds for multiple disorders, I mean I take 13 meds and 1 injection a day, those include high dose pain meds, anti-seizure meds, anti-depressants, anti-psychotics, mood stabilizers, muscle relaxers, blood pressure meds, Antihistamines, sleeping meds and anti-inflammatories. It takes some work to get all that stuff to work and play well together, it doesn't happen overnight, and once your body adapts to having synthetic substances (non-natural) doing it's jobs for it, you can't just take it away, not without serious problems.
Now having said all that, your on a low enough dose at 10 mg, that if you stopped your pain meds tomorrow, you probably would be just fine, except for some really nasty withdrawal symptoms.
Sounds logical that each individual, their opiate dose, their other meds and their other conditions et, would dictate their plan. Aubrey doesn't mention his dose.
Other than my disintegrating gut and my rapid cycling brain I'm otherwise in good shape so, I had no doubt I would survive my moderately low dose being cut, lol. Tonight I'm in pain, so I remind myself yet again that I won't be functional at my job if I exceed 10mg, so this is the way it is. That be the gist of it.
Thanks ....again , for sharing ......I really appreciate you.
BTW ...... I take Opana ER 30 ( every 12 hrs ) ...Celebrex 200 mg ...... And Percocet 10/325 ( with Acetaminophen) ..for breakthrough pain.
( while I have your attention ) ...Kat mentioned " surgical alternatives " ?? Well, honestly surgical repair would be more than I could handle.
After speaking with 2 Orthpedic Surgeons , repairing my damaged body would be quite a chore..... 1. A FULL spinal fusion ...with associated hardware ..2 both hips = total replacement, 3. Left shoulder = total replacement ....presently bone on bone 4. I have a suspended perineum ....making it nearly impossible to sit ( max 30 mins) 5. I also have a very rare condition called " Pudendal Nerve Entrapment" ( Google it ) 6. Arthritis has taken up residence in my pelvis .... AND , just throw in Severe Obstructive Sleep Apnea for good measure ....I'm also a certified Insomniac ......averaging hummmmmm about 19-20 hours of sleep PER WEEK ..... So , while I haven't had any surgical interventions, you can hopefully understand why I'm hesitate to jump aboard this surgical roller coaster. Even if every surgery went perfectly, I would probably spend the rest of my life in " recovery mode " ..... IN CLOSING , I'm just not sure what to do .... My doctor seems to think I need to stick with Opana .... But he's not the one driving 40 miles to get the hard copy of the script, then feel like a street user when I stand in line at the drug store , praying they have my drug.....the last 2 months, I've had to drive all over the city , trying to find Opana .... I've had it !!! Enough is enough ..... I see my doctor on May 2. Thanks again everyone
Last edited by Aubrey3611; 04-24-2012 at 11:30 PM.
It is a hard decision, and you just have to consider all the options and do what works for you. You've got a lot going on, the lack of sleep alone can ramp up chronic pain. Your doc's concern is most likely that if you stop your LA meds your going to have incredible amounts of uncontrollable pain and at your age that can be a health risk all in its own.
Believe me I understand where your coming from, I've had 30 plus surgeries in the last 25 years, most in the last 13, I see my pain doc once a month, every month, I also see ortho docs and neuro docs every 3 months, and my psych twice a month, every month. The only removable organs I have left in my body are kidneys and lungs, technically you can live with one of each, but my kidneys are diseased and full of stones and have been cut into several times so they aren't that great. I take so many meds and injections and vitamins it's a full time job just trying to keep it all straight.
But it's all I got, I could give up and just wither away, but I don't think my sons would be to happy with me. I can't really say I "live" life like most people, I think it's more about surviving, but, hey if everyone was normal, it'd be downright boring!
It all boils down to you have to do whats best and right for you. If you don't want to take the meds and you have some other way to control your pain, go for it. But if you can't control your pain, and your considering quitting the meds just because of some stigma attached to them....it's just not worth it to suffer that much.
When I took my first Opana script to my mom/pop Drugstore they had 5's and 20's on the shelf but no 10's. They ordered in 10's just for me, they arrived the following morning. My pharmacist told me to give him a heads up whenever possible as to any changes so that they could make sure to check their stock -and said that they were glad to order in anything I needed. I did end up switching around several times and they accommodated every change. A good Drugstore will provide you with that kind of customer service.
1) Have a chat with the pharmacist at your preferred drugstore about your needs.
2) Ask for assurance that they will always have your meds in stock.
3) I don't recall the rules, Kat would know -Can these Cll scripts be faxed?
4) I don't recall the rules, Kat would know -Can a Doctor write for a 90 day supply?
Nope, Opana scripts have to be turned in, in a hard copy, by the patient.
And I've never had a doc that would give over a 30 day supply, I don't think a doc would give a 3 month supply for this class of narcotics. The DEA just regulates this so much, they can't let patients go for that long. That can be a lot of trouble waiting to happen.
No they can't fax or write more than 30 day supply or refills on a CII. Best they can do is in some cases they will write post dated scripts, but more often, they have you pick it up at the office (without an appointment; you call in advance). No matter what assurance I got that they would order it monthly, as often it can take several days for an order, I would call a week ahead each month. If I got a dose change, then I may have to call around to find someone that had it if they didn't. It sucks, but so is our life. We're truly dependent on these doctors.
I once was driving a four hour round trip to get my meds each month! I'd have to leave in time to get there when they opened at 8am and be back for my college classes lol. Didn't do that too long thankfully. Scares me if there was a disaster and I couldn't get to the doctor or pharmacy so I have built up extras. Hate not taking meds I need, but its for a good reason I think. Best wishes.
Aubry, if you've gone to the same pharmacist all along to get your meds, he can probably work with you. Most of PM'ers are locked into one pharmacist for clarity. If you go to a small mom and pop type you may need to move to a larger chain type. I've had the same pharmacist for 13 years, I'm on every type of med you can name, and I've used every SA and LA narcotic and pain patch there is, my pharmacist at Rite Aid has always been able to get my meds. I don't call and bug him, he orders them every month if need be, I don't have to babysit him and he's 15 minutes from my home. I've never missed a day of meds, and never gotten them late or had to go somewhere else to find them. Just do some checking and see what needs to be done.