Chronic Pain/Narcotic addiction

[kjstupid54]

I've been a chronic pain patient for several years. I've taken just about every kind of narcotic known to mankind. Of course, even those stop working and so I ended up from taking for example 2-Vicodin 7.5/750 to up to 6 or 7 a day, on top of taking 20-30mg Oxycontin and Valium 10mg up to 5-7 a day. Quite a load and still have pain. My Dr. now is giving me Cymbalta to try. He is unaware of my overuse of the narcotics. I go for sometimes up to 2 weeks w/o pain meds and am in living hell w/withdrawls. Should I go ahead and start taking the Cymbalta 30mg 1 day? I'm running out of pain meds again and am scared. If I tell my Dr. I'm sure he'll dismiss me as a patient. I don't get drugs off the street, but if I knew how, I probably would. Can you help me? Karen (Oh, btw, my dosages are suppose to be 1-10mg Oxycontin every 12 hrs, 1-2 7.5 Vicodin twice a day, and 1-Valium 10mg 3 times a day. Haven't started the Cymbalta yet)

[femmy29]

I think Tangle and Mary provided some really good advice!!  I couldn't have said any of what they said better.  :)

I would also like to know what is causing your pain.  Is it back pain? Neuropathy? Arthritis? Muscular? or a combination?

I also think Oxycontin 10 mg every 12 hours if it truly extended release oxycodone is an extremely low dose.  I take a 10 mg oxycodone immediate release twice a day along with Morphine.

It is really important that you try to get back to taking regular doses of pain medication.  This my own opinion and it is not the right thing to do, per se, but I have read from others here on medhelp about how quickly they were booted out of their doctor's office after telling the doctor that they have been taking more than prescribed and ran out 1-2 weeks early every month for x number of months because the regular dose wasn't controlling their pain.  The goal was for the doctor to be understanding, respect their honesty, and increase the regular dose so that they would have better pain control and not have to take more than prescribed.  However, more often than not, the doctor red flags them and dismisses them from pain management for noncompliance.  Every once in awhile I hear good outcomes from patient honesty but most of the time the end result isn't pleasant.

So I do believe you need to tell him that you still have pain after taking your medicines or that your pain relief lasts only an hour when it is supposed to last 4 hours, whatever the real situation is tell him.  But I wouldn't tell him that you have been taking 2 to 3 times the amount prescribed.  Hopefully, he will increase your pain meds so that you will have better pain control.  After that, it is up to you to be compliant from there on out.  If the increased dose still isn't cutting it, tell him but don't take more without his authorization.

I truly agree with Mary that it may be a case of psuedoaddiction such that once your pain is controlled, the addictive type behavior will stop.  But it is important to keep in mind that your pain has to be managed.  Most pain management patients still have some pain that has to dealt with in different ways than just taking another pill.  100% pain relief is rarely if ever achieved.  There are good days, good moments and bad days, bad moments as pain levels go up and down with or without triggers.

Good luck to you and definitely visit the substance abuse community.  They can help you with this next round of withdrawal.  If you have a loved one that you trust that can hold your medications and give you only what you can have at scheduled periods of the day, that may be very helpful as only your loved one will know where your medications are.  It is somewhat a forceful approach but you will have medicine through the entire month again versus just for two weeks.  

femmy

[tanglewood]

Cymbalta helps me. I would ask the dr to increase the pain meds; maybe tell the dr that you've had to take more breakthrough meds, and take your regular meds before the 12 hrs is up. To me, 10mg oxy every 12hrs is a low dose. I was taking 30mg oxy 4 times a day, but recently switched to opana er.

Good luck

[marycarmel]

I was on a ton of narcotics and at very high doses.  I also was taking prescription medication for sleep.  I tried Cymbalta for pain a couple of years ago and it was not a good fit for me.  I also took Ativan as well for anxiety.  A lot of people have success with it.

It would help to know what kind of pain you have and who treats you for it.  Do you see a pain management specialist or some other kind of doctor?  Pain management doctors/clinics, as a rule, use other things as well as medication.  You may benefit from some type of procedure.

Sometimes people aren't truly addicted but instead are pseudo-addicted.  It's when your pain isn't well controlled and you start increasing your medications on your own.  (That's it in a nutshell, but, of course, there's more to it.

It's never a good idea to increase our medications ourselves.  You risk being dropped as a patient, and you could find it very hard to find another doctor to treat you.

I've never misused my medications.  There have been times, especially post-surgery, where my pain was hard to manage but I always would call and talk to the doctor and let them tell me what to do.  Only you really know if you're addicted or if you're pain is just under treated.

I decided to taper down on my medications to see if there was a difference in my pain. It's not an easy thing to do as at times pain will increase temporarily when you taper down or stop.  For me, I have found that taking a small dose of a narcotic, along with Neurontin, is doable.  I still have pain, but most chronic pain patients have to live with some pain.

I stopped the Ambien and have been taking Melatonin and/or Alteril, which are non-habit forming sleep aids.  I've found them to work as well as the Ambien did.  I also stopped the Ativan and now use Valerian Root, which also works equally well for me.

It's unlikely that I'll ever be able to stop all narcotics, but I'm on a very low dose.  I do have flare-ups but I use other things to help.

You really need to talk with your doctor and be honest about what you've been doing.  Better they hear it directly from you than to find out in another way.  This way you can work together and find the right approach for your pain.  If you truly are addicted, they can help you get off the addiction cycle and come up with a plan to manage your pain.

Addiction is a progressive disease.  You can find a lot of support on the Substance Abuse Forum here on MedHelp.  Not only will you get the support of the members, there are ways to help with withdrawal symptoms.  It sometimes happens that people with chronic pain who use narcotics slide into addiction.  There's no shame in it, but if that's where you are, you need to face it and make changes.

I find great support here and on the SA forum, even though I'm not an addict.  I found great support during my taper and found some of the things to help withdrawals really work.

[littlebit667]

What is your pain level  and why are you taking them??  Often your body will manufacture more pain than you actually have to get you to take the meds.  Many had gotten off the pain meds to see where their pain level is.  What many have discovered is that it is less then they thought and had been able to manage it with OTC non narcotics.  They felt that their pain meds actually made it worse in the long run and found they were able to deal with the lowered pain levels.