Help/Advice neededASAP -Fentanyl detox, pain pat. abused meds will need meds in futre

[emsmom]

I agree with Reach and feelbad. Listen to what they're telling you. You really need to get to your doctor, tell him/her everything and work together to figure out a good plan.

Using "used" Fentanyl patches is extremely dangerous regardless of your tolerance.

You're in my thoughts a prayers. Keep in touch and let us know how everything goes.

Love emsmom

[Confused089]

Hi, I just logged back in.

The last time I checked no one had posted a response. I am, of course, still struggling with what to do and read the posts with a lot of sadness. I am scared to death of telling my PM though I could tell he was already suspicious when I saw him for my monthly appt - I have now been in this mess for 6 weeks. Before I go on, I read everyone's posts and just felt truly sad and more hopeless since I so want a solution that doesn't carry lifelong consequences.

I want to thank everyone who responded. I really appreciate it. It's true, it's NOT what I wanted to hear - I wanted to be able to solve this myself. I don't want a mistake like this to have the ramifications that it does and I have been trying to figure out some other way. I really want to hear from chronic pain patients who have had done something similar - who were in too much pain, scared they wouldn't be able to to their jobs/work and took more meds than they should have. If it hadn't been Fentanyl I guess it might not have been so bad. And, I wouldn't have even gotten into the used patches if I had known that I was about to make my problems so much worse.

I just couldn't get my work finished with the pain. I can't do normal things like clean or household things without stirring up severe pain that lasts at least a day. It completely screwed up my return to work b/c I couldn't perfom in the way I did before I became injured and my boss did not care why I couldn't perform, he just cared that I wasn't performing as well. So, the more trouble I had, the more he upped his demands for me to perform. I am revealing a lot more of the details, but I'm still afraid that pms may read these boards. I've probably given enuf details at this point to be recognizable to my PM.

I know I screwed up and am continuing to screw up but how, honestly, how does that make me an addict? I have never used the meds for getting high. When I first took fentanyl I felt high and I took off a patch for a day until I felt normal again. I feel like I was arrogant [thinking I could swap F for for my other meds using conversion tables and then go back to my regular regime when I ran out of extra patches] and that I made a bunch of cognitive errors as I tried to figure out what to do -- with more arrogance b/c I knew that if I was in extreme pain, I would not OD on the meds.

[I know I repeat this many times! It's my greatest fear, I think] I cannot see how the PM or any other PM would ever want to treat me again -why in the world would they take the risk of treating a patient that put their license at risk? I haven't been able to get my pain adequately treated yet [except for the brief period of 8 months. Why would someone actually "believe" me in the future when I tell them I am in excruciating pain and can't afford to pay several hundred dollars/wk for acupuncture to keep the pain under control? I haven't known this PM long - perhaps if I had been his patient for years he might be less inclined to show me the door and blacklist me, but I don't know why he would help me now.

From the person who said she was a chronic pain patient and was carefully monitored, what does that mean? I have no extra money, just lots of debt from my accident. This is not something I would do again - I didn't do it because I lost control or because I craved the drug. I think as I said earlier, I was arrogant and under incredible pressure to perform as if I didn't have any problems w/ chronic pain - In some ways I have had to prove that I am as fast or better than someone w/o chronic pain at work.My entire career has been on the line since I started again after my accident but the last 3 months and the next 6 months are critical and basically determine my career trajectory for the rest of my life. Right now, that is not looking great. Since I have been dealing with this, I have made the situation far worse since I have not worked much - at the time, of course, relieving some of my pain seemed like a good thing and I was so focused on work that I truly did not think through the possible consequences of my actions. I feel like lots of people make mistakes [like this?] - patients often don't completely comply with their doctor's orders and people make cognitive errors and mistakes because they don't think about the consequences of their actions] you just don't get to make a mistake like this w/ chronic pain, and my entire focus was on my pain and my work.


At any rate, I do not feel like I know more than the doctor when if come to pain meds, esp. Fent. - I may understand that fentanyl is far more effective for me than than the other pain meds I was taking but I don't know anything about how my body is responding to all of this - in theory, and it was stupid not to check, I should have been able to switch back from 50 mcg of Fentanyl to more other meds. Maybe it is b/c Fentanyl is in a different class and affects different receptors. I honestly don't know. I do know that I seem to have blown my tolerance for Fentanyl now though and that I am not EVER going to do something like this again. Given the number of patches I am having to use to stay out just a little out of w/d, I am virtually certain my GABA levels have been affected - so I think that a taper from Fentanyl would be risky in the same way that Cold Turkey from benzos would be. If anyone [lay] can confirm this, [if that is allowed], I would be grateful. But, I can't imagine that it wouldn't. Even if I tapered down on the Fentanyl I might go too fast for my GABA receptors. For a while I was having wd symptoms and could not tell whether or not they were similar to benzo wd or opiate wd - I realized some of them were benzo symptoms [tight band around my head, blurred vision - this was def. worrisome since I took my benzos as prescribed [I might have taken less while I was taking the higher dose]. At any rate, my pain levels are going too high again as I am trying to taper down on the patches.

But, yes, I feel incredibly guilty. I like this PM and I feel incredibly crappy about lying to him. Either way, I am probably going to lose everything I have worked for over the last 10 years -- I'm under incredible pressure to finish "work" by mid fall - I'm still sort of paranoid?? about posting here and am concerned that someone - my doctor?? who knows might read my post and recognize me so until I feel more comfortable, I don't feel like I can say more about what I am losing b/c of my mistake [and now continuing mistakes]. I worry that I am putting the doctor's license at risk by not using the meds correctly; I worry that if I were in an accident, he might get sued; I also feel like I am screwing over other pain patients. I used to feel incredibly pissed off at people who abused opiates b/c they made it hard for pain patients to get medication. This is not a mistake I would make again. I have gotten through my head that I may know more about small pieces of medicine than many doctors but that I am not a doctor and do not have the big picture. And I am not going to do something illegal and buy off the street. I wouldn't even have a clue as to where to go.

I don't recall what I said in my original post, but I have considered trying to slowly taper down but it seems like it would probably take a year since my tolerance went up so fast. And, as I said, my pain is a problem.

I have also considered getting detoxed somewhere and then coming back and going back on the meds very slowly - but of course, that is more of the same. I would be self-medicating and I wouldn't have a clue as to my tolerance. It could easily be far riskier than what I am doing now. This plan also bothers me because I would have spent a ton of money to get detoxed [I can't very well tell a detox place to stop at my normal dose - my tolerance is screwed up anyway so my pain would probably be out of control at a normal dose] of course. If I'm going to detox, I want to try to get off or way down on these meds. I don't want to be up at the high med dose I have been at in the past. I don't have the money in the first place,so If I'm going to borrow money to do this, I would really like something good to come out of it.

Ironically, all of this means that my job/career are most likely history. Everything I have been working 12 + hrs. a day to recover since my accident is going to be lost, which is incredibly depressing.

I heard people telling me to tell my PM, I would really like to hear stories of people who have serious chronic pain that prob. has to be treated w/ narcotics [I'm hoping maybe there is another way but every doctor I have seen [pain, anyway, has said I am stuck with the meds for the rest of my life - I am too screwed up to not have pain meds].

I would really really like to hear from anyone who has done something similar OR who talked to their PM and what the reaction was. I have read the chronic pain boards though and people have been dropped for having their meds stolen or for the slightest infraction. I am in a ton of debt b/c of injury and I have to be able to take care of myself and work and I really cannot see why a doctor would take me on after this. If they did, I assume that they would want to do a urine screen or whatever frequently and I have SO little money.

The only thing that seems remotely plausible, and this is a *big* stretch is to wait a month or two and tell my pdoc that I want to get off the meds [I do - I don't think I know any chronic pain patient who wants to be on this stuff] and what would he think if I did a detox and tried to get my tolerance down and try alternative pain control methods? If anyone has any thoughts on this particular pipe dream, let me know. I would still be using more patches for several months than I am supposed to - I am basically putting them on and not taking them off for a week and then supplementing with a used patch if the pain or w/d gets really bad. My current plan is sort just to wear the patches I am prescribed ALOT longer than normal until I figure out what to do.

I talked to a dr. who would taper me down to suboxone, which he said would work fine for pain. I've read enough to know that there is a really good chance sub would not cover my pain. I would have a break in my pain management that I wouldn't be able to explain as well. Plus, if I put the sub on my insurance or took sub, I think I would be part of a database right?

I am just really scared of not getting adequate treatment for my pain since that is what started this in the first place. I really do not see myself as an addict since I am not using the meds to get high. I see myself as someone who made an arrogant and stupid mistake and is scared. I take the meds so that I CAN function not to avoid life. I feel a little frustrated that I can't post to the pain management board. Addiction is a pattern - I guess I getting into a pattern of misuse but it isn't to get high, so??

At any rate, I would really really like to hear from people who have debilitating chronic pain and may have made a mistake like I did. I feel like I have to know that my chronic pain will still be treated if I confess. For teh PM, wouldn't it be better if I simply left teh practice and went to an addiction specialist who prescribes sub? Then his records don't get screwed up and he also isn't more suspicious of his pain patients -- ie I don't want my mistake to have repercussions for him or his other patients. On the other hand, I know I am not being fair to him right now. I know I have an insane tolerance-- I can't even feel [before] a 25mcg patch and 50 mcg. made a dent in my pain but still didn't get it under control the way it was before. Nor did I feel a "high" when I added the 50 mcg this time.

Ok, would love to hear more, especially from chronic pain patients who have to take meds to function. The best possible outcome of all of this would be to find out that I don't need meds for my pain but I really think that's pretty unlikely given my fusion, disc disease and pain.

And, btw, how likely is it that pm doctors read these boards?

Thanks for the support. Still trying to find a way out without paying a huge cost for my mistake. If anyone thinks I can slowly detox tho, pls. do tell. Of course a drug test will be the end of the story as well.

I know I'm in denial one day and then out the next and then back in denial. I don't know what is left to treat my pain anyway,auge ,etjpdpme I haven't even fully accepted that I am "disabled" tho enuf time has probably passed since the accident that I should be in the acceptance phase - it's just that I don't have money and my career has been going downhill because of my pain...Ok well, enuf rambling. Obviously, I'm still on the fence. If I tell my PM, all he needs to do is give me meds for 30 day detox [which would be pretty horrendous given the amount i'm on] and show me the door. Oh, and blacklist me as well. Why in the world would he help me when I have put his career at risk AND lied to him?! And why would another doctor help?

[Still] confused...And far far more confused now cause the withdrawals are back. .. .Not too horrible yet, jus cannot think or spell very well. Gotta go...sorry if ay of this is unintelligible - I had such a hard time writing the last part while in w/d.

[Confused089]

Hi, this is really to everyone

Just wanted to say again that I am listening even if my post sounded like more of the same. Physically, I am feeling mild wds. I think I just don't want to face this and I really really need to hear from someone who has serious chronic pain and used meds for pain and didn't lose their PM. I feel frustrated that I can't talk to people in the chronic pain forum now.

I haven't seen any posts from someone who was in pain and misused or abused their meds for pain. I really want to hear from someone who has gone through a similar experience. I agree that others in pain must have taken more meds than they should have but I haven't seen any posts. In chronic pain I see posts about one mistake and you are finished.

I have suddenly gone from being a legit. pain patient to an addict (?) in one attempt to reduce my pain? I guess I feel frustrated that not following the doctor's instructions [patient compliance is an issue for all doctors] somehow has these incredible ramifications that it wouldn't in any other medical situation. So many people with other diseases do not follow their doctor's orders to the letter and don't get labeled an addict, don't have to go to a treatment program for not doing exactly what their doctors said to do, and don't have to be monitored for the rest of their lives. I'm just not ready to be labeled as a "bad" patient [again, if you read my earlier post though I really do think this doctor is far better than the other doctors I have had in the past].

I'm angry with myself, and feel guilty, but I am also very frustrated by what chronic pain patients have to go through to get treated and function. This is not directed at you or anyone who is reaching out to help and offer advice to talk to my PM. I simply have a lot of feelings about all this and while I do not blame anyone for addiction or think that addicts are "bad," I do not feel like what I did makes me an addict. If the system were not going to label me as an addict and if I didn't feel like being able to take care of myself were at risk here, I would have talked to the doctor immediately. It's so different with chronic pain - you can't make ANY mistakes. I think the system needs changing so that it is easier to talk to your doctor if you mess up. I feel like I am risking everything! And yes, of course, I should have thought of that at the time but I didn't.

If a diabetic doesn't comply with her med regime, she doesn't have to go to a treatment program and no one questions her need for medication in the future; she probably gets a really strong reprimand from her doctor. I understand this is NOT the doctors' fault - they are under serious scrutiny and have to protect themselves and their practices. But, I am truly frustrated by the whole experience. I hate having to take meds and be dependent on doctors so that I can function like everyone else - or not anywhere close to everyone else... I would have talked with my doctor immediately if I had not been so scared of the consequences. I have followed instructions to the letter until 6 weeks ago. It's just a really crappy disease or problem to have. I so wish they could make painkillers that weren't addictive, stigmatized, dependency forming and that the DEA wasn't involved in patient care. I realize that people DO get addicted from these medications and that it is a huge problem but I'm just really frustrated that trying to get enough pain control so that I can actually support and care for myself has huge consequences. This just wouldn't happen with any other disease. I don't crave opiates or anything. When my pain control was good I didn't even think about them. I just took them. It only became a problem when I discovered that I could relieve my pain and function more like a normal person because the fentanyl actually worked. I should not have played doctor and shouldn't be doing it now. I'm not going to say that I am "forced" to play doctor b/c that isn't true and it would be irresponsible of me to say that. I'm really frustrated though by a system that takes one mistake and makes it a lifetime problem. I know that someone said she was glad her doctor checked her meds. I don't care one way or the other. I am not going t abuse the medication if my pain is under control. I didn't abuse it when it wasn't [tho that probably had something to do with the fact that abusing it would not have helped my pain since I have always needed a lot of medication to keep the pain under control. Doctors get nervous when they are prescribing such high doses to a patient like me and they undermedicate b/c to really take care of my pain would put them under higher scrutiny from the DEA. I guess this is a place where I want to be able to express some of my feelings about what it means to be a chronic pain patient and how screwed up it is. I realize I raised a red flag by asking for a drug that worked for me - in what other disease would a patient come under suspicion for asking for a drug that seemed to be working better than another for them? I would LOVE to be off all this stuff and have no pain. I'm venting and I'm sorry....There has been a lot of support and kind words. I'm angry, sad, scared, frustrated, confused and a little hopeless right now. I'm literally upset that I can't post on the pain management board. Anyway, that's it for tonight....I will check back...thanks again to everyone for their support and their thoughts.

Hmm, one more thing - I presume that detoxing from Fentanyl and the seizures are from raising GABA levels too high b/c of Fentanyl potency? Or do you know [again, this is a post to everyone]? Also, I had not heard about the chemical changing in Fentanyl [I have tried to do as much reading as possible in med journals etc.] - could the person who mentioned that be a bit more specific? I am wearing patches for a week - Impossible to tell right now if all teh med is gone after a week. I'll only know after I start taking some off. Still adding one or two old ones to keep w/d to a minimum. BTW, you might ask why I kept the old ones. I was terrified of ever losing my prescription and thought I should try to have some kind of back up supply. I wasn't planning on using them like this tho!

[reachout]

Hello Confused

All these thoufghts are tormenting you and I am sorry for the emotional upheaval. I don't know whether or not you are an addict. There are some addictive behaviors showing.... self-medicating, misusing prescribed meds, crossing lines that should not be crossed.

I recognize these things because I am also a chronic pain patient who has displayed the same behaviours. I took it a step farther and crossed the line into using pain meds for emotional as well relief and that is where I probably crossed into addiction fully.

I think as chronic pain patients, we are always in danger of addiction. I believe that part of it comes because after long term use, we become unable to deal with any degree of pain. That was sure true of me. I reached the point where I was taking pain pills by the clock, not by the pain. This happened early on. It was so easy to just pop a pill and not take the time to use resources like heat, cold, massage and rest. It was so easy to anticipate pain and try to prevent it with the pills. I pushed my body to perform by disguising the pain, hiding it, stuffing down my body's signals to take time out when my brain said "You have to go to work."

Well, that worked for a long time.. quite a number of years. I worked and caused more and more damage to my injured leg because I pushed way beyond the limits of what my condition was by disguising all the symptoms I could. I worked. And eventually that was all I did. Work. I used pain meds during work to keep functioning and after work, I took to my bed and used pills to escape the physical and emotional pain it was causing me to live like this. ANd I continued to ignore the signs of my falling into addiction.

Two years ago, it all came to a screeching halt. I was experiencing excruciating pain physically and emotionally. And the dam broke when I fell into a total breakdown physically, emotionally and spiritually. Total eclipse of the mind, body and soul. I couldn't work anymore. Actially, I could not function anymore period. My fight with pain turned into a fight for my life.

I couldn't hide from my use, misuse, abuse and addctive behaviours anymore. I was self-medicating beyond reason. I went to my doctor (family) in a sobbing mess and spilled the guts. We developed together a plan to taper down from Oxycodone and then from Xanax. It took me nearly a year to accomplish. And during that time, I discovered that my life was much more than just working and hiding.

I did have to retire. And today I am on Disability. It sure was not the plan I had for my life, but it is what life brought to me. I have learned to deal with life on Life's terms.


I am happy today. Poor, but happy. Smiles. I do not use opaites or benzos anymore for pain relief. I use rest and ice and heating pads and sometimes Aspirin. I can think straight again and I am calm. I am participaing in Life again at a much slower pace that my condition demands.. at Life's pace for me. I am no longer licving a life of torment and angst.

So, there are no covert messages here for you. Just a sharing from another Chronic Pain Patient, my own story.

I am hoping the best for you in whatever your own story is meant to be.

With all good wishes and hope
reach

[Executor]

I'm very sorry to hear about your troubles. You have gone to great length to talk about your feelings & etc....Which is good. However, to be very candid and honest, you seem to be talking in circles, even rambling. I don't mean to be critical, but rather honest in my assessment as a way to help.

Before I, or probably many others, can help, we need to know what happened. If you don't want to go into a lot of detail, then don't....But please give us a general idea what happened and how. Have you been fired by your Doc? Are you going back to see him at some point? Do you have another appt.? All of these questions are very important. I, for one, cannot give advice on what to do until I know what happened. You've talked very candidly about your pain, and the root cause....And, I believe you are in pain....But, what has happened to get you in this state of partial WD? How bad was your screw up?

I look forward to hearing from you and I will help as much as I can.

Regards,

Ex