Isnt 2 weeks to stop pain meds after 14 months too quick?

I had shingles oct  2010 and developed phn from that, extremely painful constant back pain.  Started going to a pain management doc and have been on oxycontin extended release 40 mg 3x per day plus oxycodone 15 mg 4x per day for 14 months.  Consistantly take the er, but only take 15's as needed.  My visit last week, the dr.  says out of the blue i have to stop and has me decreasing the 15's daily for one week then totally stopping and decreasing the 40's over 2 weeks then stopping.  I told the dr.  that i thought this was very drastic and i was very concerned because i am going to be away for 2 weeks for the holidays and he said if i was so concerned i should not go, like i can cancel christmas!  this just seems wrong to me.  I know my body is addicted to the meds because i have had nerve block injections that temporarily stopped the pain and i had to take a pill anyway because i started to feel withdrawals.  I had told him about this and he said that was the right thing to do.  I just dont understand how someone can be expected to stop in 2 weeks after 14 months not to mention that the pain is unreal without the meds.  I have no prior experience, so any insight would be appreciated.

[femmy29]

Hi and welcome to the community!

I think you are confusing addiction and dependance.  Addiction is when after you stop taking the medication, you crave the drug or you have a very hard time stopping the medication even when you want to.  Within addiction, includes also taking the medicine more frequently and at higher doses outside the prescribing limits set forth by the physician to obtain a state of euphoria or high.  Dependance simply means that if you stop taking the medicine, you will have withdrawal symptoms because your body is dependant on the medication.  Addiction has many psychological components and dependance has primarily physiological components.  From what you described in your post, I have no reason to believe that you are addicted.

I think you have been taking a high dose of oxycodone over the past 14 months such that I believe 2 weeks to taper is too rapid.  I have been hearing a lot posts like yours and I believe that it is linked to the media hype about oxycodone and how many are abusing it and have abused it.  The media portrays the drug as legal heroin and continually boosts about how many people have died from drug overdoses on it.  The DEA is very involved and focused on monitoring the distribution of oxycodone both legally (as in your case) and illegally from pill mills spread out all over the south.  Because of this, some doctors are switching patients to other pain medicines and others are halting prescriptions entirely to pain patients (in which I believe this is the scenario you are in).  Oxycodone is a safe and very effective medication when taken as prescribed.  I also take oxycodone for pain within a combo medication called Percocet.

I am very sorry that you are in this predictament, especially around Christmas.  I know the withdrawal symptoms are very painful and makes it hard to do just about anything until they subside.  I have heard from others that the worst is over within a weeks time.  

There are a couple of alternatives.  First one is you could ask your physician to switch you to a different medication such as morphine.  If he refuses, your other alternative would be to seek out a new pain management physician as quickly as you can so that you can hopefully get your same medications from a different doctor and save Christmas.  In the meantime, I would recommend starting a taper of your own, beginning with cessation of your breakthrough meds.  If you feel the taper that your doctor provided is too rapid, try halving the taping amounts he provided to you.  I think there will come a time that you will be uncomfortable from the withdrawal symptoms but a slower taper could minimize your discomfort.  My hope is that you will be able to find another physician that will prescribe your medications before this happens.  So, starting Monday I would start setting up appointments with other doctors.  Set up at least 2 or 3 appointments within a week.  If you find a doctor at the first or second appointment, you can cancel the rest.

I will look forward to your updates, and I hope that you will be able to find a doctor soon so that you can continue your plans for Christmas.

femmy

[Thedomina]

Thanks for your thoughful reply. I have been unsucessful in finding another pm dr. I can get an appointment with but i will keep trying. I was uneducated when i was at his office last week and did not know if such a rapid withdrawal was normal.  I do not believe i am an addict.  Dependent yes. I have actually alot of the breakthrough meds stocked up because i find it hard to function mentally on those and take only half at a time.  I get so much pain release from the medication and dont understand why i need to be off them if i am not abusing them.

[femmy29]

You're very welcome and I appreciate your kind feedback.

Please understand that it is not your fault.  Not your fault at all.  You did nothing wrong. You are not an addict and you have been taking your medication as prescribed.  You also have a documented medical condition that protects you and the physician against DEA prosecution.  I hate to say it as bluntly as this but your doctor is the one who is a coward.  It could be that he had one bad apple within his practice and that pushed him to not put forth the risk.  It doesn't make sense to stop helping many with legitimate pain just to prevent one or two bad apples from trying to beat the system.

I am very glad to hear that you have a stockpile of meds.  This is very good.  I am also stockpiling my meds as well as I will also be looking for a new physician in January due to a insurance switch.  I plan to start scheduling appointments next week when my new insurance cards come in.  

If you can use half of your stock pile to taper down a bit then have the remainder during Christmas to help with your pain, that may also help.  I know that you may experience more pain than you would like but it is better than nothing.  Another option would be to stockpile the oxycontin for Christmas and use breakthrough meds every 4-6 hours for a few days prior to your trip since you have a stockpile of those.  You may have more pain during these days but hopefully you can get what you need done for the trip in advance and just relax at home those days.  That way, you will be sure to be covered with the oxycontin over Christmas.  

I wouldn't give up hope on finding a physician.  Try to stay optimistic and positive and things should fall into place.  Just simply tell the new physician what you are suffering from and what meds you have been taking to manage your pain effectively.  If he asks you why you switched doctors, just tell him the honest truth.  There are many doctors out there that are not afraid of the DEA mostly because they know they are prescribing the medicines properly to their patients.  

I will look forward to more updates from you.  I want to help in anyway I can, virtually.  :)

femmy

[Thedomina]

Thanks again. I am going to pick up my records from the dr. tomorrow and hopefully get better insight. I appreciate your kindness and support

[Thedomina]

So i tried this tapering as prescribed but was starting to get bad headaches and nausea at night. Called dr and he said to come in today. I told him that when he first gave me the schedule last week that i was very unfamiliar with tapering process but that from reading and from what my body is telling me this is way too quick for me. He took my vitals for first time ever, said i was showing no signs of having withdrawals. I said of course not, i took my meds today...he started saying that something came from the city about high doses of meds for non malignant cases....and he wouldnt prescribe more...so basically my health issues are being governed by the government...he had no answer for that and i got up and walked out. Only good thing is that i am not an addict and have enough medication stockpiled to do a slower taper...but the inhumanity is unbelievable...and can drivemone to be an addict!

[femmy29]

I have read a lot of articles on this very thing that your doctor talked to you about at your appointment.  There are a lot of new laws that many local governments in certain states are trying to get passed.  I haven't heard of anything related to your state (NY), however.  The state that is really being hit hard is Washington state.  They have passed a new law that goes into effect in January and it is causing many doctors to throw their patients out in the cold because there are so many loopholes in the new law that lawyers can easily target and file lawsuits against the doctors.  It is a long laundry list of guidelines physicians must follow per governmental regulations.  It used to be that physicians were able to make their own decisions with the patients concerns/desires taken into consideration.  Now the government in Washington will be dictating what doctors can and can't do regarding prescribing pain medication.  

For pain medication over a certain amount, they will have to have taken additional training and will need to consult with a government representative for approval to prescribe an opioid medication over a certain amount.  Additionally, certain medications are being outlawed if they don't contain nalaxone (an opioid antagonist, that reverses the effects of the opioid medication when the delivery system is altered - i.e., crushed, chewed, melted).  People caught with medications such as Oxycontin or Fentanyl will be charged with a felony offense as those two medications don't contain nalaxone.  

Oxycontin has been reformulated to have different binders that makes the pills not injectable when melted but because they don't contain nalaxone, they won't be allowed within the state of Washington.  These new regulations are tying the doctor's hands behind their backs and many doctors have decided to completely stop prescribing opioid medications or they will only prescribe below the limit to avoid a consult with a government representative.  

They are doing this because of the many deaths in Washington state attributed to opioid overdose.  The new laws are harsh and will hurt the patients that live in that state.  There is talk that more states are considering enacting these new rules and regulations.  I don't know if you have any specific information about new NY governmental regulations on opioids but if you do, I would love to hear more about what's going on there.  I am so sorry you are in this predictament.  

They are beginning to tailor laws to prevent drug abuse by the addicts but are going about it the wrong way.  Instead of targeting the diverters, dealers, and drug addicts, they are targeting the doctors and the patients.  It is easier to do that as they can easily be found in doctor offices during the day versus having to go out in the field with guns at night trying to catch the dealers, diverters, and drug addicts.  It is so unfortunate as many patients will be suffering in Washington next year because of these new laws.  I hope that this is not going on in your state.  Continue doing your slower taper and searching for a new doctor.  There are still doctors out there that will prescribe opioid medications but they are beginning to be a needle in a hay stack in some states.  

I will look forward to your updates.  

femmy

[allmymarbles]

It would seem that the two terms addiction and dependence are only used to make a distinction between addicts and people with severe pain. Getting off the stuff is hard, no matter what you call it. The question is how is your doctor going to treat your pain once he gets you off your present pain medication? He he just going to allow you to suffer? Is he treating you as an addict rather than a person looking for relief from pain? And, yes, two weeks is too short a time an will cause needless suffering. Maybe you should find another doctor.