Difficulty getting off pain meds (Oxycodone)...

[Jac074]

Hi, I am a 36 year old Aussie female who suffers from advanced RSDS / CRPS in the lower back, pelvis and both legs as the result of multiple traumas (7 knee reconstructions, hysterectomy for cervical cancer, laparascopic adhesion removal, 2 x MVAs).  I've had the condition for 15 years (the last 7 yrs with it rated as "severe") and have had a massive breakthrough by undergoing the Ketamine Infusion treatment in hospital 3 weeks ago. My pain score is now only 2-4 where it used to be 7-9 permanently. My problem is now trying to get off the Oxycodone that I've been taking for the past 7 years. It was a very good drug for me when I was sick as I had very few side effects and it was the only medication that allowed me to function on any level. I'm now completely off the slow-release and am now down to 30-40mg instant release per day (prior to the Ketamine my daily dose was around 100-120mg). I've steadily worked my way down to where I'm at now, but seem to have plateaued at this level and can't get it lower.  I don't think I have a psychological addiction as I don't have any desire to take the pills, they don't make me feel high or anything, so I'm quite certain it's purely a physical dependance.

In my attempts to get off the drug I've been using 2mg  Valium tablets, 0.5-1mg Xanax or 25-50mg Phenergan (not all at the same time obviously!). I'm also using Panadeine Extra or Nurofen Plus (both which have 15mg codeine) for the pain as needed (perhaps 4 tablets per day). I've been walking vigorously each day up to 6km to mobilise and attempt to lessen the withdrawal but I'm really stuck.  From the moment I wake up each morning, I'm shaking badly, sweating, nauseous, anxious as hell and quite unable to concentrate or do anything til I've had 10-20mg which I then need to repeat later in the day (I hold off as long as I can).  I'm quite busy with appointments and working from home so can't simply stop and then "ride it out" for the week or however long it would take. Can anyone please suggest other things I can do that may help? Exercise wise I'm limited only to walking due to 2 busted knees and the damage in my pelvis and lower back from the cancer and recurrent adhesions. Do I just try to stop stressing about it and settle on this dose for, say, a week, then try lowering it again?  I'd really appreciate any ideas as I'm proud of the progress I've made so far but now feeling like I'm a weak person for not being able to stop completely. Thanks very much :-)
Jacqui

[bigd821]

ease off slowly if you want off ! i have been on for 14 years & have gone off several times. i had to really want to get off or it would not work ! but the pain returned & before going back on i had to face weather it was pain or dependency ? its the pain cause i was off for months

[Jaybay]

Hey Jack.  You and I are in the same boat.  It's not too difficult to taper down - to a point.  The body always reaches a point of rebellion toward the end.  You can either keep on tapering and draw out the suffering or speed it up even to the point of cold turkey.  

Have you talked to your doctor about comfort meds if you speed up the taper or go cold turkey?  Clonidine is commonly used in ERs and detox programs for opiate detox.  It's an old alpha-blocker blood pressure medication that helps with the skyrocketing blood pressure and anxiety of withdrawal.  Valium is also commonly prescribed for the anxiety for a short time, usually one to two weeks.  Since using clonidine for this purpose is an off-label use, not all doctors are even aware of it and can't consult the PDR for guidance.  Some pain docs use it but not all of them.  

I do think you need a doctor's guidance on your taper and detox at this point.  Turning to codeine isn't really going to get you where you want to go since you're just changing one opiate for a different one.  Hot baths really do help with the anxiety and restless leg business, so jump in one every chance you get.  The relief is temporary but welcome.