I think that after taking all the information on this thread and doing some research you'll be better prepared for your next appt. with your doc. I have found this site to be so helpful! The people are so caring and very knowledgable. I started out trying to find a new med because my Norco10/325 were'nt working very well any more after being on them for a year. I got lots of suggestions and researched the meds on some other sites and I felt very confident when I went in to talk to my doctor on my next visit. After discussing some meds, we decided on Tramadol (brand name Ultracet or Ultram) because it is suppose to work well for nerve damage, which is what I suffer from. (Your condition or what is causing your pain should play a roll in what kind of medication you decide on) Unfortunately I had a terrible reaction to the med and it didn't do anything for the pain,it actually kind of made it worse. So, I went back in and we talked some more and I had heard such good things about the fentanyl patch I decided to try that,75mcg every 72 hrs. At first I really liked it because the relief was constant. There were no more ups and downs/ highs and lows. Then the patch kept coming off. I had to tape it down every time I put a new one on which was very uncomfortable. Then I started to have some unpleasant reactions to the patch, so today, back to the doctor and a new med. He had suggested two times that I go on a higher dose of vicodin but I am tryin to stay away from anything with tylenol. Being on these meds for so long is bad on your liver anyway,so I'm trying to minimize the damage. So today we decided on Opana LA and a lower dose of Opana for BT. He also started me on Lyrica. I unfortunately can't find much info on this med because it's fairly new on the market I guess. So, hopefully this will be the winning combination. ;) Anyway, I've said all that, to say this...your doc should be willing to work with you and you should make an informed decision together. Also, you shouldn't feel bad or uncomfortable about asking to be able to reduce your pain to a tolerable level. If your doctor is unresponsive or argumentative, you might want to find a new PM doc.