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Old 12-19-2011, 02:45 PM   #2
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Re: Pain managment of an Opiod addicted person

Hi Reed, You may have better luck on the adiction board, Certainly their are other addicts that have pain issues and their advice will cetainly be more suited to your situation. Honesty is the best policy but you have to be honest about everything.

I know enough about addiction to know that there is no difference between injecting, snorting or smoking H,meth or any other drug. I have a dead brother, a dead uncle, a dead grandfather and a father in recovery. If your still trying to minimize your heroin use it by saying I never injected it and dont look like a street jumkie than it sounds like you still have issues to deal with and any doc that deals with meds with the addictive nature of 300 mgs of oxy a day also knows it doesn't make a difference if you snort smoke or inject. An addict is an addict is an addict no matter what bow you wrap around it or how functional you are as long as you have your drug of choice.

Dont get me wrong, I dont believe someone should suffer because of their past, but when you do find a doc willing to help, expect to take UA's , Only get weekly supplies, have pill counts every week or month and sign a contract so that you know the minute you screw up and use some exceuse he;'s already heard a thousand times like they fell in the sink, my dog ate them, a rooom mate stole them it doesn't matter. The bottom line is you are responsable for your meds. My doc doesn't replace lost or stolen meds, Anyone can call the police and say someone broke in and stole my meds. IT actually happened to me, My bnext door neighbor got me and took half mymeds along with a couple credit cardds. I knew what the answer would be if I called my doc so i sucked it up for a couple sweeks and reduced my dose. Then I bought a floor safe and installed an alarm and monitoring sytem so no junkie ever got me again.

Someone in enough pain will jump through any hoop they have to to manage that pain, otherwise your letting your addictiion set the rules and you can always justify taking an extra pill or suplemetning with what you find on the street.

I have to flollow all those rules, they do random UA's at least twice a year, they do pill counts at every apt. I went through 3 spinal surgeries over a 6 year period the last was a 6 level fusion of my entire lumbar spine that failed and left me bed wridden for a year before I was offered long acting painmeds. We have an amazing ability to endure a tremedous amount ofpain. I have broken 3 sets of hardware and had my firstheart attack from the high BP caused by pain before I was offered treatment with no personal history of addiction or abuse, but I still have to play by the rules or I will be dismissd and my pump will be turned off.

I am in enough pain that I do play by the rules. In any PM docs mind, if your in that much pain you will jump through every hoop set in front of you if the potential to reduce your pain is their and if the doc suggest you try acupuncture you will try avupuncture to supplement the suboxone. The only meds I recieved for 7 years during those surgeries were 6-10 weeks post op. I never turned to heroin, I went to pain clinic after pain clinic trying anything and everything they suggested would help with my pain. Only through trial and failure of very non opuate method you can name was I given the meds and eventually the pump that I have now.

I did the injections, learned bio feedback, self hypnosis, guided imagry had nerves burned and blocked and epidurals, botox, trigger point injections. Anything and everything my docs suggested. My willingness to try anything is what justifies my present med use now. If the DEA ever asks my docs how can I be on this dose of medication, He has 18 years of alternative therapies, treatments and failed surgeries documanted to show them.

Dont expect to find immediate relief. Your back may be so bad that no amount of medication will allow you to work with concrete or do carpet work or any tyoe of job that is particularly bad for a bad back or simply allow you to stand on your feet 40 hours week. That's what I live with. If a doctor said it would help, I tried it. If you go into pain management telling the doc what dose you need and what med you want you wont find someone to help you other than a quack that is already on the DEA's radar.

If you have found humility in your quest for sobriety then you wont go into a docs office thinking you know more than he does about treating your pain. If you haven't tried it, try it and you may find that adjunct methods combined with the suboxone or some other med, just like this doc is trying now with the injections, may be enough. You don't know what you need. I have a contract with my PM doc, I do randonme UA's twice a year, They do a pill count at every apt, their is no such thing as an early refill for any excuse. All of which I have no problem complyng with beause my pain is that severe.

Their is a history of adiction in my family and i know that without rules and the ability to self medicate it's tough to determine when enough reief is enough. You have to turn that over to the doc. You may never get 300 mgs of oxy a day, but you can and will be offfered other options and tools to manage your pain. I'm disabled by pain and Heroin wouldn't allow me to return to work, no amount of pain med would mask the amount of pain I still have to live with even with an implanted pump that deliivers dilaudid to my spine. The goal ofpain anagementis just that, tomanage, not toeliminate sothat your not inconviencd and have to change jobs or restrict your workload. If your in enough pain to need that kind of dose, you will still have to learn to live with some degree of pain and even more on bad days. How you act on those bad days will determmine if you traetment continues

Something like an implanted pump you can't tamper with may be the right device once they have ruled out every other option and show that you are willing to do anything they suggest and will remain completely compliant even when you have your worst pain days. I have never abused any med or substance or taken more than prescribed, becaue I know the conswequences if I break the rules as laid out in a pain management contract.

I also know Texas has one of the best indegent healthcare programs in the country. I had an uncle that became disabled by Crohns disease, lost his job in VA and moved to Texas less than 8 months ago to become part of a pool of patients with pre-existing conditions that would otherwise be uninsurable. In order to aford the thousands in meds it costs to manage chrohns every month. Oxycontin isn't cheap, even when obtained legitimatly. So you need tolook into that health pcare program so that you can afford the injections, the counseling and possibly surgery to correct. If their is an easu solution, why would theylet an addict choose not tohave a disc trimmed to be out of pain because he wants 300mgs of oxy a day. How are you going topay for that prescription, it would cost between 800 and a thousand a month if you went to a pharamcy and paid cash. Pain managemetn is trial and error, if it's walking into a doc n the box that wont be their in 3 months, your not doing anything diffeent than before. Just because a doc prescribes it doesn't mean you can't become addicted, wont sell it for money or abuse it. Soif your serious, Then go to themajor universitieies and find the best PM docs and surgeons and find out what all your options are. If you can tolerate the sickness of withdrawal, you can tolerate whatever it takes to get to where you need to be, whether it takes 3 months or 3 years. Just knowng their is light at the end of the tunnell if you jump through all the hoops is more than some people have had to live with. OxyC has only beed around for 14 years. Prior to that it was antidepresants, PT and relaxation techniques for everyone but the terminally ill.

If you look for a quick fix, Some quack that prescribes to anyone that complains" rather than see this as tryng to find a lifetime soluton to lifelong problem, which you dont know it will be if you havem't tried surgery to correct your problem, you will end up right back where you were.

Start with the insurance issue. Otherwise you wont be able to fill that script for 300 mgs of oxy a day.

Good luck, Dave