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    Old 05-21-2009, 04:56 PM   #1
    lemonflavor
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    Pain Med/Tolerance Questions

    I had a microdiscetomy L4/L5 and it helped but I can see that I also have degenerative disc disease and arthritis with pelvic floor pain ("butt pain" or "sitting pain" i call it). I also have fibromyalgia (probably) and a host of mental illness stuff.

    I take Percoset 3-4 days a week as needed, 7.5-10mg oxycodone per dose, usually a half a day when I do. I'm slowly building a tolerance despite those days in-between. Does anyone have a strategy for keeping the tolerance down? I really want to go 3-4 days without to try to get it down, but pain comes up for one reason or another and I just can't do it. Will switching back and forth to Vicodin help or is that like switching benzos which is the same thing?

    Hope this hasn't been brought up before. I'm new and did some searching. If there are other helpful posts feel free to provide a link.

     
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    Old 05-21-2009, 08:37 PM   #2
    lemonflavor
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    Re: Pain Med/Tolerance Questions

    I hope this questions wasn't out of bounds. It's hard to tell. I'm not taking more than the doctor would want me to and I will be asking him these same questions in the future but I would like to hear others' experiences also. He knows I've built a bit of a tolerance. If I need to rephrase anything let me know.

    I'm not writing because nobody answered yet. Just a little paranoid. I don't like breaking rules.

    Last edited by lemonflavor; 05-21-2009 at 08:38 PM.

     
    Old 05-21-2009, 10:48 PM   #3
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    Re: Pain Med/Tolerance Questions

    Quote:
    Originally Posted by lemonflavor View Post

    I take Percoset 3-4 days a week as needed, 7.5-10mg oxycodone per dose, usually a half a day when I do. I'm slowly building a tolerance despite those days in-between. Does anyone have a strategy for keeping the tolerance down? I really want to go 3-4 days without to try to get it down, but pain comes up for one reason or another and I just can't do it. Will switching back and forth to Vicodin help or is that like switching benzos which is the same thing?
    Hello and welcome to the boards. Many here have a wide variety of experiences, thus, can offer lots of support and guidance.

    Unfortunately, "tolerance" is an inevitable part of PM. However, most PM Docs understand the concept and make allowances for it accordingly. Tolerance most often increases the quickest early on in the PM process, and then slows over time.

    To answer your question, the only way to slow tolerance, or to stop it, is abstinence. Switching to a lower strength med will help a little bit, but I'm not sure the net effect is worth the effort. This would only help if you dropped down from a strong med to something much weaker. The difference between the two meds you list isn't that great. There is a difference between them, but over time, the difference is diminished.

    If keeping tolerance as low as possible is your primary goal, then the best way to do this is to simply wait as long as you can between doses. However, you have to keep in mind that the trade off to that is that your pain may become worse and thus, require even more med than otherwise.

    It's quite known in PM that it's best to stay ahead of the pain....Meaning, trying to nip it in the bud early and not wait until one's pain is full blown. Otherwise, the meds aren't as effective and you spend all your effort trying to play catch up so to speak. Thus, if you wait too long in between doses, then you might actually require more med. So, there is definitely a trade off.

    Is there a reason why you are so concerned about tolerance? The reason I ask is because if your condition has been deemed as "chronic" and you'll be on some sort of med indefinitely, then a good PM Doc will take tolerance into account and manage it accordingly. If you do some research on long term PM, you'll find that the most advanced researchers have found that there is basically no ceiling when it comes to PM treatment. Granted, one doesn't get to the super high levels overnight as it takes many, many years to get there. However, my point is that there is no reason why one should suffer in an attempt to keep your tolerance minimized. While such a strategy is valiant, it really is unnecessary.

    Best of luck with this, and please let me know if I can hep further. Please feel free to PM me as well in necessary.

    Regards,

    Ex

     
    Old 05-22-2009, 08:32 AM   #4
    lemonflavor
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    Re: Pain Med/Tolerance Questions

    Quote:
    Originally Posted by Executor View Post
    Is there a reason why you are so concerned about tolerance? The reason I ask is because if your condition has been deemed as "chronic" and you'll be on some sort of med indefinitely, then a good PM Doc will take tolerance into account and manage it accordingly.
    I'm not that well versed in PM yet. My pain is tolerable on days when there isn't a random flare-up, when I'm not especially tense (although I have anxiety disorders so I'm always somewhat tense) and I'm hoping to get some relief in a couple other things my psyiatrist is going to try. I also don't want to take anything ER because I want to be able to drive even though that's only about once a week.

    I suppose I've always had the idea that more tolerance = less effect which it looks like isn't necessarily true. Also if I would want or need to come off, it would take a lot longer. I have terrible withdrawal effects and have had more experiences that I can count with psych meds.

    Quote:
    If you do some research on long term PM, you'll find that the most advanced researchers have found that there is basically no ceiling when it comes to PM treatment. Granted, one doesn't get to the super high levels overnight as it takes many, many years to get there. However, my point is that there is no reason why one should suffer in an attempt to keep your tolerance minimized. While such a strategy is valiant, it really is unnecessary.
    Come on, what's wrong with valiant? I'm a tough guy. Seriously, when I'm almost in tears and can't concentrate enough to do anything I suppose pain relief is something I should take advantage of.

    Quote:
    Best of luck with this, and please let me know if I can hep further. Please feel free to PM me as well in necessary.

    Regards,

    Ex
    Will do. Thank you very much.

     
    Old 05-22-2009, 01:44 PM   #5
    brianpain33
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    Re: Pain Med/Tolerance Questions

    Hello,
    Welcome to the pain boards. I was asking similar questions a couple of years ago when I starting taking pain meds every day. I also have "mental" issues and was worried that the doctors thought I was either, "making it up", or "the pain was all in my head", or "I was exaggerating how much pain I was in". However, none of these things were true. I also was concerned about tolerance and I still do but not as much these days. I have been on the same dose of meds for a year now without an increase.

    I would think your anxiety is being made worse by taking the Percocet for a couple of days and then going without for a couple of days. When you do this you are going through withdrawal during those off days. Even though it is not as bad as someone who has taken them long term, it still is withdrawal and ends up increasing anxiety, causing upset stomach, etc. The goal of pain management is to KEEP YOUR PAIN UNDER CONTROL. So if this is the goal then you need to do whatever it takes to meet that goal. The one thing you could do is take 1/2 a pill at a time. Maybe you could take 1/2 pill every 4-6 hours each day. That way you would be taking 2 or 3 pills per day but having a constant amount of medication in your body. The more constant you keep the amount or blood plasma level, then the better your pain will be controlled and the less anxiety you will experience overall. That sounds like a good plan to me.

    brian

     
    Old 05-22-2009, 05:56 PM   #6
    lemonflavor
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    Re: Pain Med/Tolerance Questions

    Hi Brian (Mr. Pain?). Two problems I would see with taking a half pill per dose everyday:
    -half of a pill (2.5mg oxycodone) doesn't do anything
    -then I can't drive--it's illegal here as far as I know

    I don't seem to have any withdrawal effects taking it every other day but if there are, they're minimal.

    If I needed something all the time, I'd probably want to ask my doc about something ER and take Percoset for breakthrough pain. But I'm still a rookie at this so feel free to comment on what I'm saying.

     
    Old 05-22-2009, 06:01 PM   #7
    lemonflavor
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    Re: Pain Med/Tolerance Questions

    Forum hiccuped.

    Last edited by lemonflavor; 05-22-2009 at 09:15 PM.

     
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