How long before pain stops during opioid withdrawal?

[MeaganFox]

I got in a really bad car accident when I was 19, I broke my spine, really messed up my leg, mild traumatic brain injury the whole nine, and I have been on pain meds ever since (Nov. 13, 2007). I have been prescribed just about every narcotic pain med there is morphine, dilaudid, fentanyl, percocet, vicodin, etc. For the last few years I've been taking the fentanyl patches (50 mcg) along with percocet (10mg x5/day), back in Nov I started weaning myself off I cut the fentanyl first, then went from 5 percs a day to 5 vics a day, and have stayed there for the last few months. Well last week I decided to try and quit cold turkey, and right now I'm right around day 7. The first two days were by far the worst, now I just kinda feel overall crappy, but the thing I'm having the most trouble with is my back pain, and I'm just wondering if this is just part of the withdrawals and will eventually get better over time or is it my actual back pain?

[philnoir]

Tuck is correct and offers good advice. Let me just add that the hyperalgesia you are experiencing is normal.

The length and intensity of opioid withdrawal symptoms are directly proportional to the dose and length of time of COT.

You were on an equivalent dose of about 80mg of morphine / day. This is a moderate dose -- not too high, but not for the opiate naive.

You were also on opioids for approximately 8 years. Somewhere between then and now, your body became tolerant and dependent on opioids. This causes certain pain regulating mechanisms in the central nervous system to shut down. It is theorized that the hyperalgesia of opioid withdrawal is caused by the shut down of these natural pain regulating (down regulating) mechanisms.

Some day, these mechanisms will return, although I can't say when.

As for day 7 -- that seems to be a major milestone in the withdrawal process. GI symptoms, runny nose, and other nuisances disappear by day 7.

It is important to start eating and drinking healthier than you ever have. Natural fresh fruit and vegetable juices are an excellent source of vitamins and minerals. Eat high protein meals -- protein helps reduce pain. Keep your carbohydrates moderate to low.

Some people say that going gluten free at this point really helps. While I don't agree, I don't argue with success, so you may consider a gluten free diet and see what it does for you.

Finally, exercise in the fresh air is an excellent way to work off the emotional stress of withdrawal. Make sure you get an hour of exercise a day, outdoors if possible (but don't give yourself heatstroke!)

Support groups are quite helpful to prevent relapse. While 12 step programs like AA and NA have good track records, some aspects of these programs don't fit everyone's personality.

For example,  I never liked claiming that I was an addict -- yes, I was dependent and still am, but my so-called drug seeking behaviors were actually pain relief seeking behaviors. I never felt comfortable with that aspect of NA.

So, if AA/NA is not for you, find other groupps. They're out there.

Online recovery groups are proving to be effective.

Counseling may also help. CBT (Cognitive based therapy), a commonly used psychological tool, is being applied with success to recovery.

We're primarily a pain forum -- you'll get much better information from some of the recovery forums here on MedHelp.

Of course, you are always welcome here.

I wish you the best in all your future endeavors, beyond recovery.

[Tuckamore]

Hi Megan,

Welcome to our Pain Management Community, I am very sorry to hear about your pain. It's called rebound pain.

There is opiate induced pain that's known in the medical community as  hyperalgesia. Hyperalgesia literally means “more pain”. It is believed to be fairly common in patients that are treated with long term opiates.

There are two kinds of opiate induced pain. One is immediate, and the other may be gradual. Neither one is psychosomatic. They are both very real pains with very real causes. Once a person stops the opiates it can take several weeks before hyperalgesia eases significantly.

The pain truth is you had pain before you were prescribed opiates. You may very well be experiencing the return of that pain. I applaud you for your strength and courage to discontinue pain management (PM). It's what most of us wish we could do. I'm so very tired of being treated like a second class citizen because I require opiates for extreme pain.

You didn't share with us why you have chosen to cease PM. I hope you are doing so under a physicians care. There is no shame in requiring opiates for PM. You may find you can do with less - or there are other non-narcotic medications available that do help ease pain. Please consult your PMP.

I hope you will let us know how you are doing. I'll look forward to hearing from you. I wish you the best of luck in your attempt to discontinue opiates.

Take Care,
~Tuck