Re: Oxycontin medication

Message

Posted by John Kramer on December 21, 2000 at 11:43:35:

In Reply to: Re: Oxycontin medication posted by PatG on December 19, 2000 at 20:16:54:

Brad, I've been practicing pain management for about 2 decades now. Opioids like Oxycontin are perfectly fine, provided certain criteria are met:

1. They work. This means no need to go to the ER or see other doctors or have further treatments.
2. Minimal side effects, including sedation and constipation
3. Medical compliance- the meds are taken as prescribed and refilled per schedule. Running out or last minute refills means in my mind that mental status is affected, and I stop them
4. No tolerance- if the dosage increases or the drug efficacy decreases in the absence of progression of the condition (i.e.- your back condition remains stable and no new fractures, etc.), then it's time for an opioid holiday, and the patient roughs it for a couple of weeks before the original dose is restarted, if it's restarted at all. Otherwise the dose can escalate to a point where nothing will work, ever.

Good luck on this-

: : Hello-

: : I have been taking oxycontin and vicodin for about a year now for pain in my hip due to an auto accident/sever injury (and a bit of a botched surgery).

: : I dealt with the pain for about two and a half years before finally going to my doctor who referred me to a pain clinic. They were really wonderful there and did several things; the first thing was to get me to a really great physical therapist who did some soft tissue work on me (he loosened up some knotted muscles and such which allowed me to start strengthening the affected area), the clinic gave me cortizone injections along with a long-term steroid that was intended to loosen any nerves that might be caught in scar tissue, etc... that may haven been contributing to the pain, the third thing they did was to start prescribing me pain medication - 20mg oxycontin 3 times a day with 6-5 mg vicodin a day for breakthrough pain. Initially this was AMAZING, the combination of these three things seemed to change my life almost back to normal and most importantlty, allowed me to start towards walking normally again (I'd walked with a pretty bad limp up until that point, due to the auto injury).
: : However, after the amount of time I've been going to the clinic they have stopped the injections, for now anyway, they only want to do so many injections for "x" period of time and after several months or so the injections may be resumed but I'm told that these injections constantly, every month, can be a bad thing. Also, I feel like I've really developed a tolerance to the pain medication. I've, since I started going to the clinic, went from 6 vicodin a day down to three but continue to max out the oxycontin. In fact, I prefer them because they are time release and seem to be easier on my stomach/digestive system. The doctors, though, don't like the idea of increasing my dose on oxycontin. I would think it'd be better to increase the oxycontin dose and reduce the vicodin dose as I don't feel as disoriented mentally with the oxycontin as compared to vicodin and with the higher tolerance combined with the cessation of the injections the pain seems to be creeping back.

: : I have a surgery coming up this spring that will hopefully cure the pain all together, but until then I would like to get a higher dose of oxycontin with lower dose of vicodin to help me keep the pain off my mind and continue my life as normally as possible. The doctors, on the other hand, don't seem to warm to this idea. I'm not sure what to do but I'm considering switching clinics.

: : Does anyone have any advice on this topic?
: : Any suggestions would be much appreciated.

: : Regards,
: : -Brad
: Dear Brad: I take Oxycontin, too. To me, it has given me my life back. The clinic you have been going to sounds excellent. I really hate to see you switch clinics, as this one sounds really good. Plus, Oxycontin is a Class Schedule II Drug. The DEA classifies the narcotic drugs and Class I is heroin and marijuana, which are deemed to have no medical use at all. The DEA can give doctors a real hard time, especially when they are prescribing schedule II drugs. Vicodin is Class Schedule III. If you try another clinic, looking for more narcotics, it could put up a Red Flag, such as addiction!!!! That COULD be why they don't want to increase your dosage any more than 3 a day. Since you are having surgery this spring, if I were you, I'd just stick with it the way it is. You really don't want any red flags popping up on you. I fought long and hard to get my Oxycontin; I suffered 8 years before finding a doctor to give it to me.

: I don't know if you are working or not. However, you may have to lie down a little more during the day, if the pain gets too intolerable. Since you have cut back on the Vicodin, you could possibly increase them again, if your doctor is willing.

: Brad, this is my opinion only. I know being "spacey" is difficult, but you are very fortunate to be getting the narcotics you are getting. I am sorry for your pain. I have low back problems and neck problems, surgeries have been done on both. I know what that unrelenting pain can do. I just hate to see you lose the meds that you do have. Take care of yourself and happy holidays to you. PatG

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