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  • Taper from oxycodone - round 3



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    Old 06-18-2009, 03:16 PM   #1
    NotPerky
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    Taper from oxycodone - round 3

    I am embarrassed to be starting yet another thread about trying to taper from oxycodone. I've tried twice before (May 08 and Mar 09), documented my progress on two separate threads here, had all kinds of support and was very optimistic....then failed both times. Hence, I am reluctant to even write about it again for fear of disappointing everyone; yet, I feel I must. The only way I can get through this successfully is to learn from my past mistakes. I went back over my old posts and it was actually very revealing. I wanted to see how far I got in those attempts, and how I felt, and what made me fail. Therefore, I hope you don't mind that I'm posting my thoughts as I go down this path again.

    Quick background: I'm 59 and have been on oxycodone for severe degenerative disk disease since '03. Had diskectomy (surgery) in '04 -- didn't help. Despite a history of heroin/methadone addiction (which I didn't share with my doctors), I accepted their scrips for Percocet. Started off with one 5mg pill each night; over the years it's progressed up to 60-75 mg per day of oxycodone. Here are some of the many reasons I want off:
    • It doesn't really relieve the pain; sure, it dulls it a little....but the amount I need to "dull" the pain gets progressively higher and higher.
    • My whole life and personality have changed. It could be pain-related depression (plus some other family stressors), but I've got to think the endorphin-suppressing narcotic is responsible in some way. I'm miserable; no joy in life; withdrawn from society; hate everything and everybody, including myself. I don't even like most foods anymore. My stomach is a mess. I can rarely think of anything to eat that I'd enjoy.
    • My life revolves around the pills. I can't get out of bed 'til I have it. The pills control where I go; whether I can travel; heck, where I LIVE (what if I can't find a doctor willing to write for my usual amount)? I always have to make sure I have enough with me. I usually take the whole bottle with me -- what if I'm delayed or in an accident and can't get home in time for my next dose? Better to just have the whole scrip with me.
    • I have no energy to do anything. Everything is overwhelming. Bills and other important things are falling behind.
    • I hate how I feel on them. Yes, they used to make me feel good and give me energy. Now, I don't get the energy boost; just feel a flushed/sweaty feeling and then kind of a "downer" effect. I feel like they're constantly pushing me down....hard to explain, but I know this: If they're not killing the pain, and not making me feel good, then what's the point?

    So, I'll try to wrap this up -- here's where I am with the taper:
    • I told my PM I was trying to taper off, so he accommodated me (!) by reducing my monthly scrip by 500% (from 2250 mg to 450 mg). Eeek, I wasn't expecting that! But it forced me into a rapid reduction.
    • I started 9 days ago at approx 38 mg. I felt pretty darn bad, as that was a sudden 50% reduction from my usual 70-75 mg.
    • I've tapered down to approx 21 mg today (assuming I finish the day successfully). I've extended my dosing schedule and reduced the mg per dose. I'm not a ball of energy, and I'm still feeling weird and shaky and headachy, but I feel much better than this time last week when I could barely move.
    • I have a big weekend event coming up, so this will be the true test. In past attempts, I have used big events as the excuse for failing, because I didn't have the energy to handle them without my usual dose of oxy.
    • I don't want to do any other major reductions until after this weekend, but I will still be trying to taper a mg at a time. I do not want to lose momentum. Nor do I want to drag this out for weeks.

    So that's where I am. I don't know what I'm going to do about the pain, but I can no longer stand my life the way it is. (Oh, and Brian, I am also looking into a spinal cord implant stimulator...I have a consult next week. That's now another "event" I have to worry about....I hope I am up to it.)

    Last edited by NotPerky; 06-18-2009 at 03:22 PM. Reason: added something

     
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    Old 06-18-2009, 04:38 PM   #2
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    Re: Taper from oxycodone - round 3

    Well it sounds like you have not abused them in the past, you just don't feel good while taking them. Have you told your PM doc this? There is such a thing as opiod rotation where you switch to a different opiod medication such as fentanyl patch, Oxycontin, Morphine ER. I was going to say Methadone but maybe that's not a good idea since you have abused that before. Another thing I looked at was whether you were a man or woman. I am a guy and was getting to the point of where you are feeling and it turned out to be very low testosterone. The opiods suppress the bodies natural production of testosterone and luckily there is testosterone replacement therapy. This is good news for guys but not for women. Women produce testosterone too and it drops when using opiods/opiates but doctors are very very reluctant to do any type of testosterone therapy. It is is not fair and I think they should. I know women produce much less testosterone. Another thing you should do is have your doctor do blood work and check your thyroid gland to see if it is functioning normally. This is another thing that can be affected and their are medications that can help this for men and women. It is up to you but I think it would be a good idea plus having your liver levels checked since Percocet has acetaminophen in it and is not good for your liver long term at high amounts.

    Are you on any type of anti-depressant? Most pain managment patients, me included, develop depression since our natural endorphins and other neurotransmitters are suppressed. It sounds like you are definitely depressed and should tell your doctor this. You could probably still stay on the pain meds but add an anti-depressant which would improve your outlook, get you energy, etc. Don't beat yourself up for going back on the oxycodone. Did you go back on it because of the pain being uncontrollable or because of the feeling it gives you? If you went back on due to the pain then you should not be ashamed. One other thing to mention, especially if you have nerve pain, is that there are many medications (non-narcotic) that can be used to treat that type of pain. Opiods/opiates tend to not treat nerve pain very effectively but when used along with one of the following medications may be more effective:

    Anti-convulsants: Neurontin, Lyrica, Trileptal, Tegretol, Topomax

    Atypical opiod: Ultram (tramadol), Ultracet

    Anti-depressants: Cymbalta, Effexor

    Good luck and let us know what you decide to do.

    brian

    p.s. If you really want to get off the oxycodone and don't think you can do it yourself then you might want to consider going on Suboxone. It might even be something your PM doc could do because it is used some in pain management.

    Last edited by brianpain33; 06-18-2009 at 04:41 PM.

     
    Old 06-18-2009, 07:03 PM   #3
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    Re: Taper from oxycodone - round 3

    Hi Brian, and thanks for your response and advice. I'll try to address your Q's:
    • I am female.
    • I am on oxycodone (not Percocet). I started on Perc but the PM switched to oxy IR (no Tylenol) because of the liver concerns.
    • I have apparently a very sensitive "system", because many many medications cause side-effects that I'm not willing to live with -- mainly stomach problems that make me completely miserable (even moreso than now).
    • I have been on Wellbutrin (anti-depressant) for years. I'm not on a high dose, but I can't increase the dose (I tried) because it affects my stomach.
    • I have no doubt I'm depressed -- I have all the symptoms. However, this has been building up gradually over the past few years, and it coincides with my use of oxycodone.
    • I've been on many meds for nerve pain -- Cymbalta, Neurontin, other stuff....none of them helped the pain but I couldn't stick with them very long because of the various side effects.
    • I've been on other narcotics -- Kadian (morphine, which makes me nauseous)....low-dose OxyContin (didn't help the pain and didn't get the "high").
    • I'm on a prescription anti-inflammatory.
    • I get my bloodwork done every 6-12 months (due to high cholesterol)....no thyroid or liver issues so far.
    • My PM dr. cannot write for Suboxone, and I don't want to go that route for the reasons listed in my other post.

    Finally, the reason I end up going back "up" on the oxy is that I become incapacitated without my usual dose. I need it to just achieve a feeling of "normal"....to get the energy to do anything....and the more I take, the more I need. I'm just plain tired of the merry-go-round. I want to see what my pain is like without it. I believe it's not even helping the pain much, because it is nerve pain that shoots down my leg. So we'll see how it goes....

     
    Old 06-18-2009, 07:25 PM   #4
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    Re: Taper from oxycodone - round 3

    Oh, also I realized I didn't talk about methadone, Brian. I didn't abuse methadone -- I was on a maintenance program for heroin addicts back in the '70's. Had to go to the clinic every day after work to get it. If I had to work late, I'd start sweating (literally)....it was a lovely sight. After my experience detoxing from it, I wouldn't go on methadone again for a million dollars. I guess that's where my feelings about the Subuxone come from. I never ever thought I'd be in a position again to experience WD symptoms. Narcotics are not the answer for me. I've got to get off them and figure something else out to deal with this pain.

     
    Old 06-18-2009, 10:07 PM   #5
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    Re: Taper from oxycodone - round 3

    Your story is mine. I could be you. Every aspect of your life, energy, events, travel. I use hydrocodone: 10/325. I feel like I could take 100 hydros a day. Sometimes I wonder how many I really could take. I had surgery a couple of years a go and it really helped as I was really almost a criple. I am way better but still have the pain and it gets worse. My tolerance is almost a joke. I'm with you on so many levels. Torn between functioning and pills. I want to be strong for you notperky but hopefully someone who relates can be helpful. Let's be strong together. I'm with and for you. You are my hero right now tapering and doing what is best for you even though your brain is screaming to take more. I am trying to taper too. Hang in there. Let's try not to think to far ahead.
    XXX
    RR

     
    Old 06-18-2009, 10:38 PM   #6
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    Re: Taper from oxycodone - round 3

    Redrock, thank you so much for your message. It means so much to have others who understand and can relate to my suffering. A few weeks ago, honestly, I was at the depths of depression, and my thoughts were not good ones (if you know what I mean). Who wants to live like this for another 15, 20, 25 years.... OK, but at least I'm over that! I feel a hope now....like, wow, wouldn't it be great to not have these hot flashes/sweats/chills....wouldn't it be great to travel to (anywhere) and not have to count pills....hey, maybe I could even move to (insert state) like I've wanted to do....maybe I'd be happy again, not so snippy, able to go out with friends, enjoy my family despite their quirks....blah blah, you know, just fantasizing about a pill-free life.

    But you're right -- we can't get ahead of ourselves. That's why I'm not projecting my taper timeline beyond a day or two at a time. Anyway, my pain is bad but I believe my body is so used to the narcotic, the pain level is aggravated until it gets used to not having it. So I'm not freaking out about it. This is a huge challenge and my desire to see it through is incredibly strong. Well, the good news is -- since I've been blathering on, I managed to go an extra half-hour without my dose! And I didn't even notice. Sort of shows me that a lot of this is psychological....with no other distractions, I sit there and watch the clock....start to sweat, then get chills, etc.

    OK, well, thanks again for the support and I will check in again tomorrow....have a good night (and I do love Red Rock Country!).

     
    Old 06-19-2009, 08:00 AM   #7
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    Re: Taper from oxycodone - round 3

    Notperky don't beat yourself up! You are human and frankly, doing the best you can. I wonder how it must be to be in constant pain and addicted to what helps you. I understand the merry go round. I am like you when you take the pills with you, contantly figuring out how many you'll need, etc. I started to take them myself because of an injury and like so many others, I continued to take them after I have healed. I never anticipated how my spirits would "lift" when I was on them. But now, like you, I take them to just feel "normal." It sucks. Honestly now i notice that I'm just a moody Bi*ch regardless. I am on Anti-Depressants (Zoloft 100mg) And they used to help a lot better on lower doses of Opiates. Is there anyone you can trust that you can give your pills to and have them dole them out to you when its time? I was wondering if I should do that as well. I simply can not trust myself to be disciplined enough to taper correctly. Sometimes it helps to have a trusted individual help you on your journey to recovery. And I would also be honest with your PM dr. I know it is easy to give advice and not take it yourself so I feel like a hyprocrite. But deep down, we ALL know what the right thing is to do. Its hard and it is a struggle....sometimes minute by minute. I often wonder how I got to this point. Addiction is cunning and sneaks up on you. Before you know it, years go by. I'm still a bit baffled myself. Good luck on what you decide to do. And take it day by day, second by second if you need to. We are all here in support.

     
    Old 06-19-2009, 10:04 AM   #8
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    Re: Taper from oxycodone - round 3

    Thank you for your kind words. I am getting ready for a 10 day trip California and Oregon. I don't even want to go. Same with me, can I stand my friends and family? I do not have enough because I abused my dosage and I knew this would happen, I told myself over and over and yet, the pain comes and I take a pill or 1 and 1/2. Then night comes and I can't sleep because I've taken too many and that's what happens. I'm snarly to people and so emotional and weepy to others. My PM has upped my dosage and what do I do? go right on up too. I am suppose to take 3 and I take 6 I am suppose to take 5 and I take 10. No real help with the pain but honestly if I don't take them at all then I'm in real trouble. I think the advice about finding someone to help hold the pills is a good thing and just when I think I have someone they say or do something I think will be judgemental. I'm not even sure how to do it. Everyday, I go over and get my dose? I feel like a weakling and a child. You sound so much better today NP. Hope you have a really good one. I will be thinking about you and sending you the good juju as I like to call it. You are right this just stopped me from taking another pill.....off to pack.

    RR

     
    Old 06-19-2009, 10:40 AM   #9
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    Re: Taper from oxycodone - round 3

    Redrock, well I hope at least your trip is for pleasure and not work. I went to CA last year to visit a friend, and I found myself aggravated with everything she said or did. By the end of the trip, I said to myself "I'll never stay with her again!". Now, I've been friends with her for 10 years and stayed many times with her -- why suddenly does she get on my nerves so bad? Oh that's right -- everything and everyone get on my nerves now. I am a mean, miserable wench. Gotta think, what's the difference between now and a few years ago....hmmm, taking a lot more of an endorphin-suppressing narcotic.....as the dose goes up, I become more of a b*tch.

    I don't have any friends that I'd trust to tell, much less hold the drug and dole it out to me (besides the obvious logistical problems with that). I was going to ask my son to do it -- until he told me a few months ago HE was hooked on heroin and had raided my pills occasionally. He's living with me and off drugs (as far as I know) but I'm trying to hide my continued use from him. I don't want him to know (for sure) that I have anything in the house. Which means, I also can't tell him I'm tapering, and going through WD symptoms, and that's why Mom is pretty much incapacitated these days.

    So you guys are IT -- my sole confidante! And really, it's more meaningful to have you guys because you all have been there...or are still there. No one who hasn't been through this can understand. My one girlfriend had Percocet prescribed after surgery; she took one and "didn't like the way it made me feel"....she knew I took pain pills so she gave the rest to me. The only snippet of information I might share with a couple friends is that I'm cutting down on the pain meds and that's why I'm not able to do much lately....though it doesn't explain why half the time I don't even answer their calls.

    Well, gotta stop blathering and get something accomplished around here now that I've taken my noon dose. Isn't it sad that I have to rush to "do things" before the drug starts wearing off. Pathetic....hate it. Anyway, Redrock, I hope that you are able to enjoy your trip and I will look forward to giving you positive news upon your return -- fingers crossed!

     
    Old 06-19-2009, 08:21 PM   #10
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    Re: Taper from oxycodone - round 3

    Hi NotPerky
    Wow!! . . . . . I think you are an exceptionally strong woman to be dealing with everything you are going through!! Take it easy on yourself though. Youve got a lot on your plate right now - the effects of tapering, the stress of keeping it from everyone, finding out about your son - i think your dealing with it better than what your giving yourself credit for! Give credit where credit is due. I think your amazing
    Im sorry i cant be more helpful where meds etc are concerned as i dont know what they are (apart from Effexor which im on) but know that im here when ever you need to vent, ***** or need a shoulder.
    I hope you have a great day
    Rach xox

    Last edited by rksn; 06-19-2009 at 08:23 PM.

     
    Old 06-19-2009, 08:56 PM   #11
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    Re: Taper from oxycodone - round 3

    Well, I think I'm now at approx 19 mg. This has always been my breaking point in past tapers....and I can see why. My body is stiff as a board. The pain is bad, but not a whole lot worse than usual. It's just the stiffness, occasional hot flashes and clamminess, and general weird feeling. I don't know how I'm going to gear myself up for the event I have to go to on Sun. I don't know how I'm going to find the energy to get all dressed up, do the hair and make-up. Most days lately, I look like a pitiful wreck....and this is coming from someone who was really into my looks, clothes, accessories, shoes. My skin feels so creepy-crawly. I'm sweating a lot of the time....yuck. The event starts 90 mins. before my afternoon dose. Can't you just see me in my get-up all antsy and sweaty? In past tapers, if I had an event to go to, I'd always bring more than my taper dose -- just in case. God forbid I'd get sick during the event....how would I explain that? And then, of course, I'd wind up taking the extra pills and blowing the taper. I do NOT want to do that this Sun.

    I wanted to go for a swim today....the sun was finally out after being MIA for pretty much the whole month. Thought it would help with the stiffness. I couldn't do it. Too much energy to go to the pool. The water would be freezing. I'd be freezing when I got out. I'd probably do less than one lap and be a mess. I feel too weird. I did manage to do a few errands and walk the dog around the building. Poor dog....needs more exercise than I can give him. I still haven't gotten around to doing my bills. Things are so overwhelming....even just routine things. Cleaning? Lord knows when/if that'll ever get done. I'm lucky I unload the dishwasher once in awhile and put the dirty stuff in.

    Well, the laptop hurts my leg, so I'll sign off now....please keep me in your thoughts....it's getting to crunch time.

     
    Old 06-20-2009, 07:51 AM   #12
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    Re: Taper from oxycodone - round 3

    Hello Notperky

    Friend, you are very much in my thoughts. Our stories very much parallel one another. Oxycodone, without a doubt, brought me way down into depression. I also fell apart over the years and whoever I was became a long ago memory.

    It is good that 'crunch time' is recognized. Recognizing it allows something to be done to prevent it from letting the drug win. Take only the dose scheduled to the outing. No more, no less. Easy safeguard to keep yourself on top of any crunch time failures. You will deal with any uncomfortable symptom because of putting yourself in the position of having to do so. When the occassion is over, you will look back with relief and think, "Good, I was able to do that."

    Notperky, I know that tapering is very hard. It is not symptom free as some seem to perceive. However, for me, my own experience tells me that one of the best things is that the depression slowly passes as we taper. There was no huge episode of depression at the end.... it had all resolved itself throughout the taper.

    As far as finding the umph to get things done, I found it best to break it all down into pieces. Quite frankly, put the cleaning last and do the bills. One day, write out the bills. Find a bit of glory in the accomplishment. If you walk the dog in the Am, then don't demand anything else of yourself until later in the day. Baby steps.... a tiny bit at a time. The steps will become larger when the time is right. The biggest priority for now is the taper. Whatever gets waylaid is okay because you are continually accomplishing something each day, each hour, that you remain consistent in the taper. When it is done, and yes, an end will come, there will be plenty of time for all other things.

    Wishing you well
    reach

     
    Old 06-20-2009, 11:03 AM   #13
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    Re: Taper from oxycodone - round 3

    Reach, you are a doll, and an inspiration, as always. I think what I am going to do is hold at my current dose for today and tomorrow. By tomorrow (event day), my body should be a bit better-adjusted to this new dose. With me, there's a big psychological component -- I'm sure I will feel worse, or imagine I'm feeling worse, even if I drop down only one mg. So I'll hold today and tomorrow. I promise I won't bring more than my taper dose.

    Love ya!
    NP

     
    Old 06-21-2009, 07:32 AM   #14
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    Re: Taper from oxycodone - round 3

    Hey There

    Sending some spiritual strength your way today. All will be well. Try and keep the thoughts on enjoying the occasion.

    Hugs
    reach

     
    Old 06-21-2009, 09:17 PM   #15
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    Re: Taper from oxycodone - round 3

    Quote:
    When the occassion is over, you will look back with relief and think, "Good, I was able to do that."
    Good -- I was able to do that!!! :-)

    Woke up this morning and did some stretches while still in bed so I wouldn't be so stiff when I got up. I managed to get showered etc. but then I ended up taking my noon dose a half-hour early -- I was sweating and it was interfering with doing my make-up. So I get to the event, and I managed to get back on schedule with my next dose. At one point, I started to have a little one of those dry-cough fits and I thought "oh crap" because of course, that was when it was supposed to be quiet, but fortunately I got it under control. Tonight before my 9 PM dose I was still there, and feeling the usual hot/sweaty feeling plus a little sneezing fit, but managed to not take my dose early.

    Soooo, I am so thrilled that I was able to go, have a great time, and not have to think too much about WD or watching the clock. Tomorrow I will be trying to cut down another 2 mg.

    Thank you for giving me the confidence to get past my worries and "just do it".

     
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