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In chronic pain but refuse to take pain pills


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Old 04-06-2018, 07:18 PM   #1
atra6
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In chronic pain but refuse to take pain pills

Hello,

I am new here and writing because my father has been struggling with chronic pain for years and years and it has been getting progressively worse. He has severe pain in his arms, legs, and back due to degenerative nerve damage. He says he has sharp pain 24 hours a day and has stopped doing many things he enjoys because of the pain.

His doctor prescribes him oxycontin but he refuses to take it because he doesn't want to get addicted to the pills. I am on here because I refuse to believe that there is nothing that can be done for the pain other than taking opiates that will just build a tolerance and he will need more and get addicted. He also refuses to get surgery because surgery is a risk, no matter how basic/routine it is. H

Would taking the painkillers automatically get him addicted? What else can be done because I want him to be able to enjoy life again. Thanks.
-Amy

 
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Old 04-07-2018, 03:46 AM   #2
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Re: In chronic pain but refuse to take pain pills

Amy, all pain pills are addictive; however, when they are used correctly under a doctors care- and not abused- patients can take them and successfully STOP taking them when they are no longer needed.

The bigger picture is how long will your dad need them for? You are right that the body builds up a tolerance and eventually more and more are needed.

What about Physical therapy or some sort of chiropractic care? Would either of these things help your dad?

Have you looked into natural or holistic treatments like accupuncture?

There are different things you can try...even meditation, yoga and stretching help some with chronic pain.

Good luck!
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Old 04-07-2018, 07:32 AM   #3
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Re: In chronic pain but refuse to take pain pills

What about gabapentin or Lyrica?
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Old 04-07-2018, 07:43 AM   #4
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Re: In chronic pain but refuse to take pain pills

Dear catra6,

I can relate to your father because I have severe chronic pain and will not take pain meds (except only if I have surgery, then am off them just as fast as possible). I would rather have pain than how pain meds feel to me. NO thanks! Just reading up on the side effects of drugs is enough to keep me off them.

The issue with pain meds is not so much psychological. They are physically addicting, because a very steady amount has to be in the body system or the pain comes back or increases. Your whole life becomes centered on getting pain med exactly at the right time or the pain increases.

The worse experience I had on pain med was after I had a very serious break in my ankle. I'm not one that enjoys being drugged. I like to be alert. Some people like the drugged feeling. Not me at all. Probably not your dad, either. Pain meds are not a natural physical need. Be glad he isn't a medication seeker.

You can look into studying what foods/supplements feed the nerves. Father may need a diet change and to cut way back from salts and salty foods. Take him to a Naturopath doctor. Check for good ones by using Yelp. Like all doctors/people they are not all equal.

I suspect his diet is not great, and that he may need B vitamins to feed his nerves. Nerves need proper nutrition to be calm, too.Brewer's yeast in orange juice (because it tastes so bad on it's own) is full of balanced B vitamins and made a load of difference for me. I need to get back on it, myself.
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Last edited by YaYagirl; 04-07-2018 at 07:44 AM.

 
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Old 04-07-2018, 12:10 PM   #5
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Re: In chronic pain but refuse to take pain pills

There are many natural routes you can try to take (your dad can). Both magnesium and turmeric are all natural and have been shown to help some with pain and inflammation.

There's also meds specifically for nerve pain like lyrica and gabapentin that aren't addictive the way opioids are. As well as many physical therapy type options. Traditional pt, water therapy, yoga, chiropractic, tens units, massage therapy. And there are minimally invasive procedures to consider as well. Depending on the cause of the pain there are nerve blocks, epidurals, nerve ablation, etc., etc, etc....
I do not want to preach at you or your dad, and I completely respect anyone's choice of what to or not put in their body, I would like to say that there's a very large difference between dependence and addiction. Most boils down to behavior. An addict takes their drug of choice to get high and continues to do that drug despite severe consequences to their health, jobs, family, their very life. An individual who is dependent on their doctor prescribed, therapeutic dose of medication takes that medication in order to bring back their function and to again be able to contribute to their jobs, their families, their life.

A pain management patient, taking their prescribed medication at their prescribed dose is no different than a diabetic who is dependent on insulin to sustain their life and health, an epileptic on seizure meds, a heart patienton beta blockers. No one would call them addicted to their meds despite their need to use them to maintain a normal and productive life and that's no different for a chronic pain patient. And on a personal note, I have been on the same pain med, same low dose, for almost ten years. I do not need an ever-increasing dose.

I use many other modalities when my pain spikes (ice, heat, stretches, epidurals, etc.). I do not take more medication. But because of this medication I'm actively involved with my family, I work more than full time hours, and I'm able to live life within my limits. Without pain relief I know my life would look very different. I completely understand the fear of addiction, but when monitored and taken correctly, it can be safe and effective. All these options would be best to talk over with a pain management doctor, as they have a great deal of knowledge and a host of options to help relieve chronic pain.
Just my opinion of course. I wish you, and your father, all the best in whatever he chooses!

Last edited by Administrator; 04-07-2018 at 04:09 PM.

 
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Old 04-07-2018, 09:42 PM   #6
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Re: In chronic pain but refuse to take pain pills

He has tried the various meds out there but none have worked, plus even if they did, he does not want to take Lyrica, Nuerontin, Topamax or any of the other drugs out there because they make you stupid (short term memory loss, cant spell things, loopy feeling). He functions very well mentally and can not beE to lose mental functioning in addition to physical functioning.

He has tried accupuncture, electric shocks, nerve blocks, patches, and supplements. The doctor said If he gets surgery theres 33 percent chance only of getting better...33 chance getting worse and 33 chance of staying the same..so what's the point of that?

What is the difference between addiction and dependence when it comes to opiates?! He may have to keep taking more and they work and doc prescribes them but eventually he will require too large of an amt to control the pain and wouldn't be able to take them for overdose reasons...so I disagree on the idea that it's not wrong If he needs them and dr. Prescribes them because also if some point doctors stop writing the script, then the dependence turns into addiction and withdrawal etc. Plus who wants to be all loopy and dazed all day? He lives a normal life, just doesn't go out as much as he used to or do things he enjoys like walking etc. The trade off of less pain just isn't worth it yet.

I told him about vitamins B6 B12 E and some others that may help. His diet is not good so maybe that can help. He has been to a ton of pain doctors who just do nothing but prescribe cocktails of meds that dont work for him..he seems treatment resistant.

I just dont get how in 2018 doctors still dont know how to treat pain PROPERLY without creating either drug addicts or people who suffer severe side effects from drugs where hot cant even remember what you ate yesterday or boost the brain into early dementia. I don't blame him in rather having pain than these things...I just hate to see him suffer and stay in bed alot more and not be able to walk the dog, etc.

 
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Old 04-09-2018, 09:38 PM   #7
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Re: In chronic pain but refuse to take pain pills

Dear atra6,

I personally do not like feeling drugged or being in lalaland. I can understand some wanting to be on drugs, not being bothered, but I hate how I feel on modern pain meds. Except for right after surgery, I always refuse them and self-treat with overthecounter meds. Yes they have side effects but I can tell when I am feeling better and stop them without withdrawals. Some people don't mind the dependence that the modern pain meds cause. I dislike and refuse it.

The drugs out now cause instant dependence we call addiction, but the fact is as a pharmacist friend kindly explained to me, the moment we take an opiate we get relief but then begin to go into withdrawal so that the med has to be taken again at exact intervals or the sweats and agony take over. There is no 'getting used to' that process. The drug itself demands taking it again. None of the pain meds I had taken 40 or more years ago caused those symptoms inbetween doses. I was able to stop those drugs with no side effects as soon as I could bear the pain level. It was easy to stop the old-type of pain meds.

As soon as I learned the side effects of modern pain med, I said I am not taking it again. My pharmacist friend warned me not suddenly stop, but to cut the dose down and down extremely slowly.

However, I was not going through that cycle again. It was worse than having the pain. I did stop the pain med, and began using overthecounter pain solutions. The withdrawal agony and sweating was very harsh but with each hour and day I kept my face toward freedom and I got there in a month.

All that to say, I know first hand why some of us don't want to deal with the modern pain meds. And, I also know doctors get beneficial kick backs form pharmaceutical companies to keep them pushing those drugs on us. Maybe there is a cartel behind it, I don't know. I know all doctors are not bought off. They can be good people but have been sold a bill of goods (lies). Probably the sales people don't even know how bad the modern pain meds can be.

We have to trust that everyone is not indecent just to be able to get along in life. I think it's often difficult to see the line between beneficial and damaging...each of us have to make our own decision.

Your dad seems to prefer to have his mental faculties than to poison himself so he can walk the dog. I made that decision too, so hubbie walks our dogs. I pet them at home. I'm fine with it.

When you find some interesting, possibly effective info, just print it and share it with your father, but trust his own decisions and keep showing how much you love him...that's the best medicine you can give him.

If he wants he can try something. It seems like dad is accepting of what line he wants to cross or not. Trust him about that.

You're a good daughter.
Love,
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Last edited by YaYagirl; 04-09-2018 at 09:46 PM.

 
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Old 04-10-2018, 07:12 PM   #8
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Re: In chronic pain but refuse to take pain pills

I also wanted to chime in about the use of opioids for chronic pain. There are common misconceptions. From everything I have read and my own personal experience, taking opioids long term as prescribed for severe chronic pain has a very low risk of psychological addiction (in contrast to taking them for acute pain, such as after a surgery, and especially, recreationally). When taken for severe chronic pain, many (like me) don't get any euphoria type side effects, just pain relief (but also unfortunately side effects, like constipation). I actually think much more clearly when on opioids, as otherwise the pain prevents me from being able to focus.

Sometimes folks have euphoria in the beginning (first couple weeks), but that can be a sign that the dose is too high. It is also more likely to occur with short (vs. long) acting opioids. Oxycontin is a long acting one by the way, the same as Oxycodone, except Oxycontin is time release. Opioid addiction is most commonly seen in folks who have struggled one or more other types of addiction in their life (like alcohol, gambling, etc).

The goal with opioids is not to take away 100% of the pain, but to help manage it, such as with 50% relief. Chasing 100% relief is likely to cause rapid tolerance and subsequent dose escalation, as well as more side effects. So, if your father was feeling overly medicated when he has tried opioids previously and was getting very good pain relief, he may want to try half that dose (or even less) to test if that would have a better result. Each person also responds differently to each med, so some meds may be a better fit for pain and/or side effects.

Also on this note, medications all have different conversion rates, so 10mg of one med may actually be equal to 50mg of another med or similar. Some meds are perceived by the public as being “stronger” than others, but in fact the dose should be converted such that the result would be equivalent. That said, if your father is against trying Oxycontin specifically, asking his doctor about something less potent is an option, especially if it would make him comfortable with the idea. For example, there is now a long acting form of Hydrocodone/Vicodin, Zohydro ot Hysingla

Tolerance to an opioid medication builds over time, meaning you need a higher dose for the same effect. However, this often occurs much slower in older patients (vs. younger patients). There are reports of seniors being on the same dose for 10 or 20 years, and sometimes even needing to decrease their dose as they aged as it became too strong. Sometimes rotating to an opioid when tolerance begins to build is sufficient to get the same pain relief again. Therefore, tolerance may not be a significant issue, and at least shouldn’t be what prevents someone from trying opioids if they are their best option.

There is also a unique med which is primarily for addiction but being tried more for chronic pain that patients don’t build tolerance to, Buprenorphine. It is FDA approved for pain in the form of a patch, Butrans, but it is more common used for addiction in a much much higher dose in the form of an oral strip, Suboxone.

A good pain management doctor should offer multiple pain treatment options, discussing pros and cons of different forms (such as patches vs. oral meds), and ensuring that all non-opioid options have been tried before resorting to opioids. Often just seeing a different doctor opens up some treatment options as not every doctor will use every method (they have their favorites). Often a combination of therapies is used to maximize relief.

There is a big difference between physical dependence and psychological addiction. Dependence means that if you don't take the opioid medication as scheduled, you would go into physical withdrawal (gastro issues, anxiety, trouble sleeping). Dependence happens to nearly everyone who regularly takes an opioid medication (several times a day for a couple weeks), but a small percent of folks don't get it for whatever reason. Addiction is when you want to take the medication for reasons other than pain, such as to get "high", will do things to get more meds that a non addicted person wouldn't do (like fake pain or steal money to buy pills). In some cases dependence can mimic addiction, as a patient will be asking for a dose increase and may seem desperate, but in those cases, the dose increase and subsequent pain relief would stop those actions that appeared like addiction.

Long acting meds are known to be less likely to cause tolerance, side effects (including euphoria), and addiction, as they release a steady dose over a period of 8 to 24 hours (depending on the med). So, until recently they were widely used for chronic pain that didn't respond well to other treatments. However, in the last few years, opioids are being prescribed less - fewer patients are started on them, and patients are having their doses decreased or even cut off completely.

Therefore, opioids are not an option for all pain patients now. Unfortunately opioids are the best pain treatment we have right now; although other treatments are effective for some folks, it can take a lot of trial & error, and combining multiple treatments together. I have hope that things will improve though. I have to, after having this constant severe pain for 12 years.

I'd encourage you and your father to have a sit down with his doctor and discuss your concerns.

It is actually very important to be clear with the doctor that he is not taking the Oxycontin, as it is common to need to take a urinalysis to verify the meds are being taken as prescribed. If he isn't taking them, be sure to bring in the full bottle if it was filled or the script if it wasn't, as without that evidence, not having the med in his system could cause them to put a red flag on his record against future prescribing for any reason.

If the doctor isn’t offering other options, then see another one. Just be sure he doesn’t get medications for his pain (especially opioids) from more than one doctor at a time. Although it sounds like he has tried the major stuff, there are always more things to try; they just may be similar to what was already tried. Starting multiple treatments at the same time may also be beneficial even if by themselves they weren’t. I had to visit several pain management doctors to find a good fit to treat my chronic pain, and that was after having seen dozens of other doctors over the years. Best wishes.
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Old 06-28-2018, 02:28 PM   #9
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Re: In chronic pain but refuse to take pain pills

Has you father tried pain and nerve meds or are you responding to things that you have read or heard in television? I have DDD, herniated and ruptured disks with nerve involvement and have taken low dose pain and nerve meds for 5 years. I have a career with a major bank that requires clear thinking and reasoning and the ability to make informed decisions based on data and financial analysis. I donít feel loopy, foggy or out of it and I donít suffer from dementia. I am able to work, play with my grandchildren, cycle, garden, travel, all of the things that I would be unable to enjoy without medication. I also swim, do yoga, stretch, use analgesics, heat and ice and a tens unit to help manage flares. I have never asked for an increase in my medication nor do I seek drugs in the streets. I would suggest that your father try pain and/or nerve meds, as well as some of the other modalities I mentioned. He may change his mind.

 
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Old 06-28-2018, 02:37 PM   #10
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Re: In chronic pain but refuse to take pain pills

I do not believe that you can go into withdrawal after ONE dose of an opioid.

There are many people out there who have been on the same dose for years. You are correct, opioid pain medication should not be stopped suddenly and should be tapered over time after prolonged and continued use. You pharmacist friend should not be spreading misinformation and should have the knowledge to separate fact from fiction.

Last edited by Administrator; 06-28-2018 at 10:40 PM.

 
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