Am I a drug addict?

[Hopejoy777]

I have had 2 spinal fusion and laminectomy with instrumentation surgeries  to L345S1  7 years ago and now have severe degenerative disc disease with spondylosis. I have numbness to both feet and some in lower legs now. I am prescribed Oxycontin 40 twice a day and Panadeine forte BT and Oxycodone 20mgs 3rd hourly. I have worsening pain to the area of surgery and now can only find pain relief laying down. If I go walking or standing for too long the pain is unbearable. Am I on a very high pain relief regime? I don't want to go on stronger meds at tall as when I have to be hospitalized I am treated like a substance abuser yet I take only what is prescribed for my severe back injury. Sometimes I feel as if I am withdrawing on the meds then other times I can go 8 hours with nothing. Pain is my major symptom. My neurosurgeon says I should try a morphine pump however I am refusing to go down that path. Fentanyl gives me migraines as I suffered severely post op the only time I had fentanyl. Does methadone kill the pain? I am financially struggling so I need to reduce the cost of meds. I worry so much about being an addict. I am an RN and it is surprising how many nurses treat CP people like addicts. (I was injured originally by a patient attacking me while on duty.) I have even been refused prescribed pain relief post op by an RN for 8 hours whenever she was on duty and she would only give me panadol. It was terrible post spinal fusion and knee replacements. I am terrified to go back into hospital. Has anyone experienced this? I cannot get into the Pain Management specialist as it is a very long waiting list. I have insurance as well. What pain management med works best and cheapest? I also try to keep being active and push through the pain. Can there be any light at the end of the tunnel? I despise taking these meds!

[philnoir]

I know this argument, and I have to say that it's a red herring.

Chronic pain patients who are maintained on opioids do not need to detox from their medication -- we're in for life due to our chronic pain conditions. There is no cure for people like me.

Besides, there are ways to manage detox from methadone. I used it for almost 12 years, and I had no withdrawal at the end -- my pain doc just rotated me to the proper dose of an alternate opioid analgesic.

People with non-chronic pain syndromes should never be given methadone -- it is not a substitute for some long-acting medication formulation like OxyContin.

OxyContin and other ER/LA pain medications like the Contins, Exalgo, etc. are actually short-acting opioids put into a tamper proof, time release capsule.

Methadone, as you hint, has the longest half-life of available opioid medications sold in America. It can run anything from 24 to 72 hours depending on dose and an individual's metabolism. I could go for over 2 days without a dose without feeling any difference in my pain relief or any hint of withdrawal syndrome.

Methadone is also a highly effective pain medication because it is both an opioid and is an NMDA antagonist so it affects two very important classes of neuroreceptors that govern the perception of pain.

But it should only be used with the opioid tolerant, chronic pain patient population, and it needs to be prescribed only by an experienced prescriber, like a pain specialist. One reason we've had a 4-fold increase in opiate Rx deaths over the past 10 years is due to physicians improperly prescribing this medication as a substitute for OxyContin in the opiate naive populations in doses far exceeding safe levels.

Best wishes.

[Lilly1955]

Methadone is the hardest drug to withdraw from. It took 8 months of tapering and horrible withdrawals. Mental spiritual and emotional death. Please reconsider taking that devils brew.takes about 2 years maybe longer to get methadone out of your bone marrow. Withdrawals are long slow painful and could affect you the rest of your life.

[philnoir]

No, you are not a drug addict -- you have chronic pain and you are not getting the right kind of medication.

People in chronic pain react differently to traditional opioid pain medications than those in acute pain.  We become tolerant to pain medication, and require more medication to achieve the same analgesia.

Methadone is an excellent pain medication -- it may help. However, opioid medications like oxyContin, oxycodone, codeine, and methadone sometimes do not work well for chronic back pain.

Your best bet is to try to expedite entry into the pain program where they can offer you alternative treatments.

In the mean time, research chronic pain as it applies to back disease. See spineuniverse.com or spine-health.com for more information on diseases and treatments.