Can I get some advice - it's critical?

[RaleighGuy83]

I am 33 years old and have a great job, wonderful wife, and a lot of things to look forward to.  Unfortunately I am also a chronic pain sufferer with several very painful and debilitating spinal injuries.  I have had these conditions since age 18 or 19...so 14 years.  In these years I tried every drug, alternative medicine, procedure that was suggested.  I am now taking:
75mcg Fentanyl patch every 72 hors
3-4 8mg Dilaudid tablets per day
1-3 2mg Ativan per day
1 50mg Trazodone for sleep PRN insomnia

PRN Adderall 20mg 1-3 times daily (this is used infrequently)

In the last 3 years is when I began using Fentanyl - it's very helpful with the pain.  My tolerance to opiates is very, very high.  I worry about what would happen if the doctor stopped prescribing or laws changed.  

What do I do?  I already feel bad enough with everyone giving me looks, judging me, thinking that I'm some dishonest dope fiend.  Well I'm not, I'm actually a successful insurance agent that is able to live s normal life because the sharp edge of chronic pain is softened just enough.  

Do I need to get off these meds and onto Suboxone or Methadone?  Does that mean any doctor looking in my file will assume I was an addict?

How do I or should I get off the Ativan?

Any advice would me most welcome.

[Dee1956]

UH Oh, welcome to the forum! This is a really nice place to obtain help, support and friendship.  I wish you well, Dee

[Dee1956]

Hi there, I am sorry you are so worried.  If you are in pain this decision should be between you and your doctor.  Unfortunately the CDC has decided to get involved.
if I were you I would try to be prepared for the day your medication is reduced or completely cut off.
With the new CDC guidelines there is a world of hurt coming.  There is a petition now to congress asking them to give pain patients their rights back.  Many people are on high doses of opoids and the CDC is saying no one needs more than 90 mg or equivalent of morphine. per day.They are saying for new patients, try not to give them an opoid, if necessary 3 days is all that is needed. This is ridiculous.  It is like a witch hunt.  40 people a day are overdosing so "someone" has decided if they cut the chronic pain patients medication that will solve the problem.
It is ludicrous to me that this is happening!  While I am not a pain patient I have family members who are.  I fear for their future.
Most pain patients I know are required to lock up their medications so it isn't their medication getting out there.  I have read about pharmacies missing thousands of doses of medication in Florida.  what a nightmare.

I am wondering what all of these pain patients will do.  Perhaps the powers that be want everyone on subxone?  I don't know, that drug is stronger than anything in equivalent dosage.

Sorry I know you did not ask for all of this.  I am extremely worried about the future of people who have been on high doses that are suddenly dropped with no warning.  What will they do? Where will they go?
Then there will be many other problems to contend with suicide, street drugs, hospital over crowding as people go to the ER in agony.

You have nothing to feel embarrassed about, you are in pain and you are on the correct dose per your doctor.
Take care everyone

[fntn]

Keep in mind many here have been using opioid based medications, for many years. So each will have a story. We are often treated as criminals along the way, even if we follow the rules perfectly - which most do. Just keep in mind that simply following the rules doesn't mean you will not have issues. Most will run into trouble and it can be a battle to find the correct course of action.

I have been a very complicated case, and my doctors know what is going on. They find they hands tied wrt therapy. I understand and work with them the best I can. At the the end, you may likely find yourself as your own best consult wrt the correct path to take, be it traditional or alternative.

[MareRN]

Oh and stay w the Ativan -- it's not the sneaky one. It's addicting however the dilaudid and fentanyl is heavy duty

[MareRN]

Hey listen it's terrifying when faced with any change in pain medication.  Pain is awful but addiction is not for the weak either...its devastating and though you don't feel the dependency forming, it is in fact rapidly changing you.  Opiates just do.  Fact.  No arguing that.  Now I'm speaking both as a nurse and a recovering addict who is just trying to open people's minds to the fact that long term opiate use of this caliper is not gonna end well.  You're young...maybe just try one thing at a time; one less pill, maybe 50 of fentynl ?

I don't care about what ppl think and you shouldn't either.  You should however consider the future.  I'm not dismissing your pain...I promise...just advice.  

[Ptawillis61]

Ps. I am in the Medical field as a health provider. Studies are finding that once narcotic use goes over 30 days it doesn't help you very much. Why many are being cut off narcs completely after weining down. I disagree with these findings bur Dr's wont. Don't be surprised if your cut off in a,few months to a year.

[Ptawillis61]

Good lord man how do you function on all that crap. Fentyl and diludid plus others. Who the heck is prescribing you all this?? 75 Fentyl patch plus the 8mg delaudid q4h. I am surprised your breathing right now.I was on 300 mg of MS Contin q8h and 2mg Dulidud q4h and can't remember a whole year lol. I have a rare pain disorder that's bad as cancer and don't get what ur taking. Now I get MS Contin 60mg q8hr and that's its. If you keep this up your going to accidental overdose and die. Be careful man.

[TxAli369]

You are lucky that you are able to tolerate Pain better than others.  Nerve pain is extremely difficult to control. (Y, most pain is nerve pain). Pain from spinal problems is horrible. Since you are also someone who suffers from severe pain, maybe try not to judge.

[Crohnsareus]

Having a list of chronic issues has led to being on major pain medications for over 20 years. I have a medical history sheet (it's up to three pages now} that gives all my medications, allergies, surgeries as well as who prescribes the drugs I am on. I too have a high tolerance to pain medication. Being open and honest about what and why I'm  on that has worked for me. I do understand how you feel about people thinking your a doper. I have too much pain and health issues to worry about peoples opinion that know nothing of what I go through on a daily basis. The laws are getting stricter, I understand you fear on that note but I don't expect any doctor is going to just take your medications away for no reason. Note..methadone has it's own set of issues. I was on it for an extended period. It caused an issue that could stop my heart. I was weened off it and put on a different drug. My rule of thumb is to try taking the least amount of drugs possible to treat the illnesses and pain. I don't give a rip what anyone thinks but me, my family and my doctor. Neither should you. I wish you the best of luck.

[remar]

I'm sorry. I just reread your post and you did not mention having children.

[remar]

Please don't worry about what other people think because it doesn't matter. What matters is that your pain in under control so you can enjoy your wife, your children and life in general. Without your medications you probably wouldn't be able to be a productive member of society. With your medication you're able to work and provide for your family.
I'm sure you've had a lot of testing done. CT scans, x rays and so on. Any Dr can look at those tests and see what's going on with your back.
I have back issues myself and I fought taking pain meds because I worried what people would think of me. I would skip doses or just not take my meds at all. My husband would ask me, why in the world are you not taking your meds when I can clearly see how much pain you're in. He was right.
Think of it this way. If you were diabetic and needed insulin you would take it and not worry about what people thought. You have back issues that you did not ask for. Without your meds you would be in so much pain, needlessly. You're taking your meds as prescribed, right? You are a dope fiend. You're doing what you need to do to take care of yourself and your family.
If the Ativan helps you sleep then you should probably stay on it. Sleep is extremely important for our health.