I have been diagnosed with rheumatoid arthritis (RA) and fibromyalgia (FM) for more than ten years, therefore experience chronic pain which has increased throughout the years. About four years ago, I reluctantly filled a prescription for 10mg of Oxy three times a day, because I couldn't manage the pain with Tylenol#3s any more. A year ago, the pain had increased to the point where I was prescribed three 20mg tablets per day. I was so afraid of becoming addicted that I forced myself to reduce my own dosage to only 2 tablets per day, taking three Tylenol#3s at the same time to combat the breakthrough pain in between Oxy dosages. The Oxy definitely helped me feel human again. I have no complaints about its effectiveness. I do not experience euphoria either ... I'm just more myself.
I also take Methotrexate injected once a week. I'm 60 years old.
I am told by many other RA and FM sufferers that you can't be considered addicted to a narcotic analgesic unless you use it for psychological reasons rather than just enough to help with pain management. In my experience, that's pure poppycock! I had to stop taking the Oxy last year for a period of one week prior to surgery. On the second day after stopping the Oxy, I was screaming in pain! It was pain that I had never felt before; pain that was completely unlike any that I had experienced from my RA or FM symptoms. It was at that point that I realized I was physically addicted to the stuff.
Three months ago, I moved to Mexico to retire. Befoe I left Canada, I was given a 3-month prescription for 20mg of Oxy to be taken 3 times a day. Remember, I mentioned that I have never taken more than 2 tablets a day, right? So now it's four months later and I still have about 20 Oxy''s left.
My Mexican doctor says that physicians are no longer allowed to prescribe Oxy in this country. Therefore, when I went to see him to renew my prescriptions today, he told me he would have to change my pain medication from Oxy to Temgesic (buprenorphine), which is the same as Subtex.
I am terrified that I will suffer the same withdrawal symptoms as I experienced before my surgery in Canada.
How should I manage this change? Can I substitute the Temgesic for one of my Oxy doses each day, thereby using half the Oxy I usually would? Or would you taper off the Oxy altogether, first, before taking the first dose of Temgesic? I'm asking you this because I have trouble explaining my questrion in Spanish, and haven\t got any acquaintences who have attempted to do this.
Sorry this was so long. Any suggestions you may have would be most appreciated. I'm really desparate because of the language barrier down here. Thanks so much!
How absolutely awful for you! And how confusing, the interchangability of the term "addiction". Of course, those of us who take the medication legitamately (sp?) understand that our kind of addiction is OK, because it's not abusive, we don't take more than we need, we don't get hight off of it, etc., etc. But if we need to go off of it, we're not spared the horrible, painful, debilitating effects of withdrawl just because we took it for respectable reasons. When I moved to Hawaii, I had a terrible time finding a doctor to write my Rx for Oxy at first. Now I have no problem, but for a while, I had to go to emergency rooms to get my meds. Don't go cold turkey, it's too painful -- I've been there. Can't you find someone who can write morphine, patches, oxycodone (short acting), vicodin or something like that to help you titrate down and withdrawl from the Oxy? Is there a drug rehab place -- how awful at 80 to have to go to drug rehab for a perfectly legitimate condition. I'm just grasping at straws here because I don't want to see you in pain, or left to deal with this all alone!
Oh, dear, I said 80, but you're 60. Will you ever forgive me!!!!!!!! medicat I'd think you could take both at the same time (cut down on Oxy, add Temgesic in.) Just don't titrate the Oxy out of your system completely - that's just way too uncomforitable - before you start adding something in. Good Luck!
If you take these two drugs at once your going to be very ill. To even start on the suboxone you need to have ALL of the Oxycontin OUT of your system.
I would advise seeing or even calling your doctor as he KNOWS this and can help you, Do not quit the Oxycontin cold turkey, it is dangerous to do this, while your only taking 2 a day that is way it is meant to be taken every 12 hours. Some have to take three a day buy it is suppossed to last 12 hours.
Your doctor needs to go over all this with you, did he just hand you the suboxone and give you NO instructions?
When taking this medication you CAN NOT take any kind of narcotic! So if it does not help your pain you can't take other narcotic medications.
I would suggest going back to the doctor and discuss your options as far as this medication and your pain control. While some say it does control their pain it is not meant for pain control.
When a Pt is taking a medication daily and have been for any length of time it is NOT advisable to stop taking that medication abruptly. That's very reckless and dangerous.
Your body becomes accustomed to that medication and when the body no longer gets it a lot of things can happen to endanger your health. Never stop taking your medications without first speaking to your doctor at length about it.
I agree with Sandee. You need to get back in touch with your Physician so that he can go over your Meds with you. People have gone cold turkey in stopping that Oxy but it is not recommended. I am confident that your Doctor in the States will provide you with some type of relief. Is it possible that your Doctor in the States can talk with your Doctor in Mexico?? This might solve any question that the new Doctor might have.
I really feel bad for you. Please take care and I hope that you can solve your issues.
All my best,
I am so sorry that this has happened to you. You should not go cold turkey. This can be dangerous. Sandee is correct in her suggestions.
Subutex (buprenorphine hydrochloride) and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) is approved for the treatment of opiate dependence. Subutex and Suboxone treat opiate addiction by preventing symptoms of withdrawal from heroin and other opiates.
I have not heard of this drug being prescribed for pain however I am not a physician or a pharmacist. According to my research this drug is used only in patients that are addicted to opiates.
Please see another physician. I don't know where you are in Mexico but is it possible for you to go to the States for treatment to return to Canada? If this is not possible there are physicians in Mexico that speak good English. I encourage you to find one.
My Uncle retired in a border-town in TX. He and his wife have seen a physician in Mexico that speak good English.
Please let us know how you are doing and good luck.
Suboxone has been used in the treatment for pain but just recently. There are conflicting reports as to the effectivness of Suboxone when treating for pain. Some Physicians think that the drug is a good alternative for Mild pain management while others do NOT recommend it at all. If you google Suboxone you will get conflicting reports.
Like I and others have said, go back to your original Physician. It is in your best interest at this point.
Thanks so much to both of you. While you both gave me caring and knowledgeable advice, you opposed each other, so I'm a bit confused now ;-) The reason I can't discuss this with my doctor is that he speaks very little English, and I speak very little Spanish. The technical terms confuse us both. Hmmmm. Maybe when others reply, I can sort it all out. Thanks again!
The subutex is a drug that some PM doctors are using for pain management but I assume your doctor gave it to you to get off the Oxycontin.
Do not take the drugs together, if your going to take the subutex then you need to be off the oxycontin completely. When those who use subtext the doctor usually recommends the pt be off all narcotics for 72 hours. There is an excellent ask our pharmacist here at Med Help also that can answer any questions about this.
I would try and find an English speaking doctor or even hire a translator there to go with you. Call one of the visitors groups there and they can give you information on hiring a translator.
Does that answer your questions?If not please list your questions so that I can answer them properly. I believe your original question was can you alternate or take the oxycontin and subutex together and the answer is no. No you have to be off the oxycontin completely before taking the other medication. As I said most doctors want their Pt's off all narcotics for 72 hours before even taking the medication Temgesic ( subutex).
The Temgesic will block all effects of the oxycontin and will make you feel very ill.
Also as I said we have " Ask the Pharmacist" here at Med Help if you feel you need more information too.
Please let me know if this answers any questions you have.
thanks sandee. In my earlier post I indicated that I have to get off the Oxy because I am running out of the tabs that I brought from Canada and it is not available to me here. The doctor said he was prescribing the Temgesic as a *replacement* for the Oxy, because he couldn't prescribe Oxy under the new law. Hope that clears up my motives.
I too am sorry that I confused you too. I am glad that Sandee came to your rescue.
My major suggestion was to find another physician. I understand that you are in a remote area of Mexico but can you not travel to a larger city to locate a physician that can speak English? I would be very concerned in all areas of my health care if my physician and I could not communicate. The language barrier could be even more serious down the road.
According to a good source (two actually), Oxycontin is available in other areas of Mexico. Whatever you decide to do I wish you well. Please be cautious. And again I am very sorry I confused you.
Tuck gave you some excellent advice. Although you may be able to purchase the medication you need in Mexico w/o a prescription I strongly advise you not to do this as it could be packaged/marketed as a specific medication that doe not mean it is that particular drug. It could also be stronger than the dose it is labeled as. It is just extremely too dangerous to go this route.
If you contact the visitors information center they can and will set you up with a translator. This is the best thing for you to do as Tuck said it creates a huge problem for you when you can't communicate properly with your doctor and dangerous/
I'm sure someone said it, but your fears of addiction aren't 100% correct. There's a fine line, and difference between addiction and dependence. Some classify them as the same, but I do not. Dependence will happen to anyone taking these meds for any period of time, it's normal. When you're taking Oxy's it blocks the pain, and reduces your body's natural pain fighters which may explain why your pain was worse after.
I used to feel the same, worried about addiction. However, I know I'm not now. I smoke cigarettes, and I AM addicted to that. I've stopped using pain meds for days and weeks and have dependence side effects, but I don't become angry, shaky and hostile like I do with nicotine.
I'm sorry to hear about your pain but know you're among people with similar problems!
I am very familiar with Mexico, and that is a bold faced lie this doctor is telling you. Oxy is not banned in Mexico. I just don't understand if you live there full-time you don't have an english speaking Dr. Most hospitals and clinic's do have English speaking or bi-lingual staff, unless you are in a really remote area. You need find another doctor....quick.
Temgesic will take away the withdrawal, but not certain about the pain.
Muchas gracis, Amigos! I'm visiting an English-speaking doctor today. (Yaaaay! It took me a while, but I found one!) My Spanish is okay for regular, everyday communication, but not for something as serious as this. I just hope the guy takes ME seriously, and doesn't think I'm just another addict. Wish me luck.
Mindlink, I think you have made a wise decision. I am so glad that you are seeing a physician that can communicate effectively with you.
Please let us know how that goes, if you don't mind. Not only am I concerned about your pain and medications I am interested in why in some parts of Mexico some narcotics are legally prescribed and in other parts they are not.
And Thank You NautyOne for confirming what I have been saying all along. I have relatives that have retired to the area and they say just what you have said. It was beginning to worry that they may be seeing a not-so-good physician.
NautyOne: ¡Las gracias por escribir en español, pero yo tuvimos que utilizar Babelfish para traducirlo! Ahora, estoy esperando al individuo del cable que dijo que él estaría aquí mañana hace seis días. Entonces veré a un nuevo doctor.
Tuckamore: the Dr. I went to yesterday did speak English, but again, I was labelled an addict, and he told me, basically, to suck it up. I saw a great Doc in Puerto Vallarta a few years ago, so I'm going to try to get there today. I will meander down the mountain in the ancient Ford Explorer just as soon as the cable guy is finished here (he said he was coming "tomorrow" six days ago) ... I just hope he finally turns up before it's too late to go to Puerto Vallarta.
I'm not sure those who have posted before me have a full understanding of the drug you've been prescribed. Temgesic is a synthetic opoid analgesic that is longer acting than morphine. It is used for moderate to severe pain. It increases tolerance of pain and decreases perception of pain. The only thing that is contraindicated when taking this drug are other CNS depressants which may have an additive effect, and therefore overly suppress the respiratory system, as it also causes sedation. It is reported to not cause the tolerance of other opoids, preventing the need of ever increasing doses. Those with arthralgia and other rheumatic pain have reported great results. When given nalaxone - the opoid blocker, not all of this drug is blocked due to it's mode of action. I have read nothing to make it a drug that should not be taken with the other narcotics, except that it isn't ever a good idea. But it looks like it may be a great drug for you. You might give it a try. If you decide to, I'd try using the oxy until you're given the supply of the new drug and then switch. Ask your doctor ahead of time what can be taken with the temgesic, such as tramadol (ultram) and if you can get that drug, or NSAIDS, which can help with any muscle aches etc. or other drug he can prescribe and be ready. Then, if after a trial, you can't tolerate it, you'll have a few oxys left to get you to another doctor. From what I've read, however, switching to this drug has not been a problem for others. Google temgesic and there's good info. Some of what I read comes from people in Mexico, some Australia - so obviously other countries are using it more than ours. After reading up on it, I'm even thinking about looking into it due to its lessened propensity for tolerance development. You can stay on the same dose for long periods and still get relief! Sounds good to me. Anyway,Vaya usted con Dios y con permiso, deseo rezar a Dios. (spanish very rusty - no laughing pls.)
I am sorry you were treated to badly. If I ever considered living in Mexico (I haven't) my thoughts have changed. I am glad that you are still looking for a physican that can prescribe a medication that works for you. I will be watching for your updates. Good Luck!
Yes Jan, I do understand the action of Temgesic. I have no doubt that Temgesic is an effective pain medication for some ppl. I think that was not the concern for Mindlink. Just like one opiate works well for one person and not another, Temgesic was not effective for Mindlink. Oxycodone is not very effective for me. I don't take it contrary to the raves it gets. At least that it how I understood the post, unless I am totally off base. And that has occurred in the past!!
To all: "mindlink" has found a better alternative(and a better Dr).
Jan: Temgesic is just a name used in some parts of the world. In most parts it's called Buprenorphine. It's main use is as a substitute to other opiates in addiction. It is rarely used for pain management these days.
Sorry folks, I wrote privately to Nick yesterday (hence his message above), but should have posted here as well.
I went to another doctor who fully explained the Mexican Gov't's edict on the prescription of narcotics like Oxy. Long story short: Only specially certified Dr.s can prescribe higher levels of drugs. It's a very long process for the patient too, involving a battery of physical and mental tests, oodles of paperwork, and then the narcotic is flown in from Guadalajara to the one specific pharmacy allowed to dispense such drugs in the area.
However, the Dr. I saw yesterday can prescribe low-level narcotics. I was prescribed Neo-Percodan, essentially Dextropropoxyfine (65mg) & acetominophen (500mg), two tablets taken three times a day. I was so happy because the Dr. said his wife was on the same regime and we could "buddy up" during our recovery. She too has arthritis pain.
Now I'm at the 24-hour mark with the Neo-Percodan and I can't say it's much better than the withdrawal I experienced all last week from the Oxy (and didn't finish). All symptoms are lessened slightly though, except for excessive sweating and burning under the skin. I have a general restlessness and yet no energy at all. It's very uncomfortable to say the least.
I'm going to call the Dr. today to see if I can get anything else to help assuage the symptoms.
Tuckamore: I was prescribed Temgesic but never took it, after what I read here about withdrawals from it.
Jan: Thanks for your insight. There may come a time when I'll try the Temgesic out of desperation, but I'm now on this Neo-Percodan, so I have to give it the old college try. I still have some Oxy left if there's a gap in switiching meds, but I'd be damning myself if I took it ~ I just can't go back to where I started!
Thanks everyone! Gotta love ya for putting up with me.
P.S. ~~~ At least I got a decent night's sleep last night, which is something I craved last week. I took a half Gravol + one 3mg Valerian along with my night does of Meo-Percodan. Woke up very sore, but feeling alert. Yay!!
Glad to hear you found a caring Dr. I ditto everyone's sentiments that above all, it's the most important thing! Nothing is worse than a Dr. who doesn't take your pain seriously!!!!! I didn't think you'd tried the Temgesic - or I wouldn't have even tried to find anything out about it. Everyone is different to be sure and if you've tried something and it didn't work, trust me, I'd NEVER try to tell you it DID work.I can't even imagine such a thing! Also, I do know all the generic/ chemical names for it etc., as I did some research on it after reading your (mindlink) post. I'm a curious to a fault kind of gal.
I've looked into taking nalaxone to withdraw under anesthesia, because I wanted to try a trial of LDN. I keep reading such good things about its use with all autoimmune diseases, especially MS, but theoretically, also Systemic Sclerosis, and since I have both, I'd love to give it a go. BUT stopping narcotics keeps seeming impossible. I just don't know if I could ever do it. Anyway, that's why I'm more than willing to keep researching pain meds. You never know what they might come up with in the future.
Has anyone ever been approached with the idea of the pump implant? Morphine goes directly to the brain - supposedly there's less systemic effect, and more therapeutic effect. I have been reluctant due to having the box show through your abdomen quite predominantly. I guess even lying in bed miserable, I still have vanity? lol It's getting pushed into oblivion more each day though. But I don't think I'd like the feel of it anyway.
Mindlink, I wish you the best, and I hope you find a combination or drug that works for you. I have had the fentenyl patch and actiq suckers taken from me when I went on Medicaid - that hurt! And Pallidone when someone died while on it. So, I've experienced my share of being told my pain meds were no longer available - we'd have to find something new. It's always hard. Blessings to all
I have read a lot of articles on the effectiveness of the temgesic in pain control studies and to be honest the more I read the more I see that it is not really meant for pain management but for those with addiction issues.
Everyone is different though what may work for someone else may not work the same for you.
Suboxone( Temgesic) binds more strongly to your body's opiate receptors than oxycontin. That is why it helps people with addiction. Also, the Suboxone, because it has a stronger affinity (it binds more readily to your body's opiate receptors), will actually knock off the Oxycontin that is bound to it. That is why if you are not in sufficient withdrawal when you first take Sub, it will put you in to withdrawal because it knocks off the Oxycontin and attaches itself, but it doesn't stimulate you the same.
I am very glad to hear your doing better so maybe you will not need to try the it but if you do please research it and know the adverse symptoms well so you will be prepared if something does go wrong. I do know that you have to be off all narcotics before starting the drug or it will make you very ill. It essentially will send you into direct withdrawal but at a higher level.
Fortunately, we have the internet through which we can research the side effects and long-term effects of all this nasty stuff we're putting into our bodies in the quest for pain relief. And that's exactly where I spent hours and hours, even days, trying to find the truth about each of the drugs the Drs here were suggesting. When the first one prescribed Temgesic, I researched it and found very little on it's long-term effects until I came here to MedHelp and talked with folks who had experience with it.
The pharmaceutical sites don't tell you never to cut an Oxycontin tablet. They don't tell you never to take Temgesic & Oxy on the same day. They don't tell you about the rivers of sweat, the burning under the skin, the intense nausea & diarrhea, the total lack of energy, etc. one gets when switching these powerful meds. They don't tell you that ALL of the above could either kill you or send you back into the vicious world of drug dependence.
Yes, having been a news editor, I believe intensive research is the only way to the truth, but I also remind myself that often we find only partial truths, or truths slanted for reasons known only to their author. The final truth we find by further research and combining the whole.
That's why I joined MedHelp, where I found the most intelligent discussions on the 'net. No one placated me; no one sugar-coated their truth. Everyone has told the truth as they saw it.
With your help, the research has finally gelled, and I've taken the path that makes the most sense to me. The Temgesic will stay in the cupboard. I'll weather the withdrawal stoically. (When I couldn't bear the w/d symptoms any more, I slipped and took an Oxy after tapering off them last week. I've now gone 5 days completely without Oxy, and I'm starting to feel a little better.) I'm certainly not out of the woods yet, and I may well need your sage advice along the way. I'm so glad I know where to find you!
you are now through the worst of it. days 2-5 are usually the worst. it's all better from here. but we're still certainly here if you need us. a week from now you may wonder what all the fuss was about. although you still may need to find new ways to deal with the pain. wishing you all the best,
Let's here it for research on the net!! What amazes me - beyond the truths you already stated so well, is that the entire pharmaceutical industry is so ___ bent on profit (nothing wrong with making money!) that they refuse to research treatments that don't have the propensity to bring a profit. There are so many things we aren't told, simply because the info hasn't made it to a press conference, or major medical journal. When a substance is found to help a condition - eg. tryptophan for depression - they feverishly go to work producing a chemical cousin that's marketable, accomplishes a similar enough result, and causes the least possible harm. What we aren't told is about the original substance (usually). Hydrogen Peroxide has many health benefits, even though still controversial, but it isn't marketable. It's a naturally occurring substance. I'm interested in it for lung cleansing. But, you get my drift.
My own anecdote that illustrates this well, is my recent trial with Copaxone, the MS drug. I researched it prior to taking it, and everything pointed to it being the least offensive of the MS drugs, and to it's side effects being mostly, and even almost always, local, at the site of injection. So, off I went. I don't mind needles or shots so assumed I'd do great. Even when it hurt like heck after injecting, I didn't flinch. But the first couple injections I did were followed by a day of severe nausea and malaise. I took it in stride but when I was called about my well being, I told the nurse, and also the Copaxone representative, and I was told by both that it WAS NOT a side effect of the med. I said, but, um, it says right here in the prescribing info that it IS a possible side effect - to which I was told - those side effects happen in such small numbers that you can't really consider it to be caused by the drug. WHAT? Now - every flyer, every pamphlet - lists it in a list of 5 or so side effects! Right there at the TOP. Their marketing is so dependent on the SE being only local, which separates it from the others, that they can't even be honest with the patient! Other things happened further down the line and I finally had to stop the treatment, but trying to get honest answers out of anyone during the process was always biased due to the extreme manner in which the drug was marketed.
Anyway, I agree with you totally. Combining info and people's experiences etc. - is the only way to arrive at any semblance of a "true picture".
Yeah, Nick ... going back to Square One after taking that one extra Oxy sure sat me back on my butt. But without your encouragement from the other side of the world, I wouldn't be looking at the light at the end of that long dark tunnel today.
Bok, I had the same experience with Methotrexate (used to slow the progress of some cancers and rheumatoid arthritis). It's taken once a week, and each time I took it, I would be useless the whole next day. It felt like there was a war going on inside my torso. Neither my Dr. nor my pharmacist mentioned it, and there was no little slip detailing its uses and instructions inside the bottle. I come to find out that it's an old drug that was used in chemotherapy! No wonder cancer patients tell us that chemo is such hell! My hair fell out, my eyes dried up ... Oh gosh, there were all kinds of side effects that not only scared the daylights out of me, but my whole family too!
I think nowadays, doctors rely too much on the fact that some of us do our research. Or they rely on the pharmacist to tell us, which, fortunately, many do. But not all the time. Rarely are we fully informed about the stuff we put into our bodies. Nor are we informed about the stake each player has along the path to get it there!
I took methotrexate for a long time for my systemic Sclerosis. 8-10 pills/week From what I've heard, that's more than most take. But other than losing a lot of my hair and it not helping the disease and it can cause lymphoma later on, as well as liver failure - gee - I'm sure it was good for me!? Doctors want to help. Mine especially, since I'm so untreatable and progressing poorly, but I don't want to take something just to be taking something!!!! Especially when there are so many side effects. I had been on Prednisone for a long time without knowing anything about it (in my 20s) and I lost bone and who knows what else. Now, I steer clear. I don't want to be a lab rat - I want to be informed of my choices and all their consequences, Good thing we're on top of things - but think of all the millions who are popping needless pills, thinking they're helping, just to make a Dr. feel like they're "doing something". And, believe me, I realize this all sounds like it's painted with a very broad brush. There are good doctors, and there are good meds, but you know of what I speak! lol Sounds like you're hanging in there. How is your pain? What joints are involved? My first dx was RA, and I still think I may have it, but I have so many other things as well, it's hard to sort out.The neurologist who dx me with MS threw up her hands and said "you need fairy dust - I just don't know what to do". Oh my.
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