Correct way to up my dosage.

[sufferinsilence798]

Hello everyone, this is my first post. Let me start by saying I am not a drug seeker, nor am I chasing a high. I am a Legitimate pain sufferer seeking quality of life, nothing more. I was diagnosed with what was classed as "mild" scheuermann's disease when I was 17 after subsequent tests were conducted to investigate my chronic chest wall/back pain. Since then I have had a 6 year history of taking tramadol (150mg sr x2 daily) Never abused It and I was always up front with my doctor. We had a excellent relationship, he actually cared and wanted to help me. Recently I have moved state and as a result, had to find a new gp. He has taken me off of tramadol( at my request) as I wasn't happy with the side effects. I couldn't perform my job properly. Hes got my on 5mg oxycontin twice daily. It is not controlling my pain near as much as the tramadol did. Ive been on this dosage fro 3 weeks and I see him again in a weeks time. Is it too soon to be asking for a higher dosage. Do I even use those words? I can tell this guy doesn't like prescribing narcotics but I deserve some quality of life. I am only 24 years old. Without the medication I would not be working, I would probably be scoring heroin living in the gutter. Please advise what route I should take to progress to a more adequate dosage,

Regards,

Zac.

[sufferinsilence798]

Seen my GP today. I was honest and upfront with him. He was dissapointed that I did not take the medication as prescribed, but I made It clear that I understood the importance of It.

He upped my dose to 10 mg sr x2 daily

The more I read on this topic of main management It becomes clear that medication is only one piece of the solution. Total body health should be paramount. I need to make a lot of changes to achieve this but It only takes a short flashback into how I felt at my worst, I realize how necessary It is.

Thanks for your imput, your advice is appreciated.

Off topic:

I maintained my 300mg/day dosage of tramadol for 4 years, never deviated and the pain was mostly controlled.

Can I expect this level of longevity from the Oxycontin or is that just wishful thinking?

Take care,

Zac.

[Weathergirl21]

Ahh...being in Australia makes a difference. Sorry, I am from the US and they only start with the 10mg Oxycontins.

Thanks for clarifying:)

It depends on whether your Dr. does drug tests or not and if they do, they will find out that you took more than prescribed.  In the US they do urine tests randomly at any time, same with pill counts.

But even if they don't do that in Australia, taking more than prescribed is not the answer. That is why I mentioned all the many other modalities used to help your pain so that when you have a pain spike, you don't just keep taking more and more opiates. Another reason to never take more than prescribed is what is happening with you and running out early. Then you will go into withdrawals which is pretty horrible when on opiates.

Believe me, I've been living with chronic pain for 11 years so I can empathize. But just like if you had heart disease...diabetes, or something else where you are on a prescription, you would never just take an extra pill.

As I said, you need to work with your Dr. and just tell him when your pain is highest and lowest, what activities make it worse, and find the best comprehensive plan to help your pain.

And as I mentioned with chronic pain, the goal is to be at about a 5 or so on the pain scale. I live with a 5-7 because I would much rather stay on lower dosages of medication than keep ramping up as I am only 43.

Just be open and honest with your Dr. about your pain and the levels and ask them to help you figure out the best way to manage this.

Good luck

[sufferinsilence798]

Thank you for your prompt replies

I'm looking at the box they came In.
OxyContin Tablets
Controlled release
5mg
28 in a box
I live in Australia by the way

I've been forced to take a extra 1 in order to get to sleep. My script will run out 5 days early. Should I come to my doctor with this or wait the 5 days? I know taking above whats prescribed looks bad but perhaps that's what It takes to get the message across?

I'm on the waiting list for a pain clinic appointment, who knows how long that will take. Just trying to get by in the meantime.

Regards,

Zac.

[Weathergirl21]

Hi there...

I think you may be confused about what you are taking. To my knowledge, Oxycontin does not have a 5mg formula. Oxycontin is Oxycodone in continuous (long acting) formula.

There is plain Oxycodone in short acting formula that is 5mg. I use them (OxyIR) for my breakthrough medication. So I would double check what your prescription bottle reads.

So only taking a 5mg pill that lasts from 4-6 hours twice a day is not likely to be giving you the same pain relief as 300mg of Tramadol that you were taking.

As mentioned, a GP is not one to handle chronic pain management as the laws/regulations are changing all the time in each state as well as the DEA rules for chronic pain management.

So as suggested, an actual Pain Management Dr. is going to be your best bet.

The key with chronic pain management is to also not rely solely on an opiate to lower your pain. You need to include many other modalities. And even with everything put together including any medication...you are looking at a 5 on the pain scale as the targeted place for CP patients.

The other modalities are exercise, yoga/stretching, physical therapy, aqua therapy, massage, acupuncture, biofeedback, injections, TENS unit, SCS, ice, heat, steroids, eating well to maintain a healthy weight, not smoking, etc.

The other medications that are used are nerve pain meds as well as muscle relaxers. An opiate only "dulls" the pain and does not target nerve or muscle pain.

Also, many CP patients are on an antidepressant to help as well.

So, it's very important that you are doing as many of these possible modalities in addition to the opiate you are taking or else your tolerance will build too quickly if you rely just on this to manage your pain. Too many people only try something once or twice and then done. There isn't any one thing that solves someone's pain. It's a puzzle with many pieces and each thing will put a tiny dent in the pain levels.

That is why a good PM Dr. will work with you to find the best possible comprehensive pain program.

So when you see the Dr., it's just about explaining that your pain is at a certain level and you want to find the best way to manage it better. It is not recommended that you ask specifically for your opiate to be dosed higher although I presume in the long run it may be tirated up a bit as 10mg a day is not much but it is normal to start this low when switching medications.

Again, double check what your prescription bottle reads as I don't think there is an Oxycontin in 5mg.

Good luck..

[Ginger077]

I agree a pain management dr would be better at treating chronic pain and not as afraid to prescribe narcotics if that's what you need. I do feel that no matter who you see it is difficult asking or getting a higher dose medication. I'm not saying you shouldn't be getting a higher dose or possibly a different med I'm just saying with all the concern nowadays with abuse and all others have ruined it for people legitimately in need of pain relief. Since your new to the area you could call your local hospital and ask for their physician referral service to get info on pain management doctors in your area.  Best of luck to you!
Ginger

[marycarmel]

You may be better off seeing a pain management doctor or a doctor that specializes in your condition.  Many GPs get nervous prescribing narcotics for long periods of time or at higher dosages.  Best of luck.