Opiates don't work on me

[venus12277]

I have had back problems since 2004 having a ruptured disc L4 L5 before and after surgery I was given Vicoden and morphine shots which had no effect or relief I now have herniated disc L3 L4 L4 L5 and C4 C5 C6 fell out of bed 2 nights ago and had to go to er a d was given a morphine shot with no relief I was wondering why these type of meds don't work for me and if I have some kind of resistance to opiates they never worked for my father either. Are there any other meds to help me get relief? Thank you

[Tuckamore]

Thanks for the update Missie. It's much appreciated.

What many ppl do not understand is that when we have pain (acute or chronic) and take opiates - they actually "work" on the pain.  There is no "high" - they do what they are intended to do, relieve the pain. It's my guess that's the reason you were waking and talking - and also why a mere 5mg of Hydrocodone feels ineffective to you.

Abusers or addicts often don't have pain - and therefore get that "high" from opiates that they crave. The opiate has no throbbing pain receptors to do what they were intended to do - so the addict feels a high.  I'm trying to explain this in layman's terms the best I can without going into a lot of medical jargon or detail that can be confusing.  

It's still my guess that you are not being prescribed a high enough dose of opiates to relieve your pain - hence it leaves you feeling that opiates "don't work" or are ineffective. You can probably add to that the possibility that you do not metabolize some opiates as well as most ppl do. The key word here is "some".

You are not crazy! Anyone that treats you in that manner is uneducated in Pain Management. Morphine is not a good pain reducer for me either. Like you I require higher doses than most ppl. It's been that way since I can recall - and well before I ever had chronic pain and took opiates routinely for pain control. However Demerol (which is not used in hospital settings as it once was) is effective for me - and at much lower (comparable) doses than morphine. Again It's how my body metabolizes opiates.

NSAID (Non-Steroidal Anti-Inflammatory Drugs) examples include OTC (Over-The-Counter) meds like Ibuprofen and Aspirin - not Acetaminophen (Tylenol). It also includes prescription NSAIDs like Ketorolac (brand name Toradol) and Celebrex.  Anti-Inflammatory Drugs - when taken under the direction of a medical professional can often be a good addition to your medication therapy in reducing pain. NSAIDs help control the inflammation caused my multiple conditions. The theory behind this is when you reduce inflammation you can reduce the pain.

I may be repeating myself - but 5mg of Hydrocodone is a very small dose to cover moderate to severe pain. You may do better on a 10mg dose or going to an usually more potent opiate called Oxycodone (Percocet).  

What I do know is that you shouldn't give up in your search for pain control. Find a good PMP that is willing to work with you and find something that is effective. Opiate therapy is not a one-size-fits-all. It's trial and error to find the right combination of therapies, treatments and opiates that best manages your pain.

Please keep in touch. I'll be interested in hearing more from you. If you have additional questions, always feel free to ask. We may not have the answers - but we'll certainly try. Comments or venting is also welcomed! We all do it.

My Best,
~Tuck

[venus12277]

Thank you for your reply, I looked at my bottle of Norco and it says 5-325mg
my Flexeril is 10mg, it also have never worked on me, back in 2004 they tried the Flex. and then switched me to Xanaflex which if I recall did work better. Back in 2004 when my disc ruptured my then husband and mother took me to ER and the doctor had given me so many shots of Morphine he admitted me to keep an eye on me. When I got up to my room I asked if I could go to restroom and the nurse and doc looked puzzled and said do you think you can get to restroom I said yes, so with help from ex hub I hobbled to restroom and while I was in there I guess the doctor said to my mother "I cant believe she is walking and talking, I gave her enough morphine to knock out a horse" and I have dealt with back pain since with no insurance, no meds, and no help. Luckily I now have ins. forgive me but what exactly are NSAIDs I do remember times I had to go to er over the years from back going out that shots of Torodol and I think Dimeral made feel a lil loopy and pain eased up...  Thank you so much fo the DNA thing I had no idea about that, I hate being looked at like Im crazy when I say that the Norco and Morphine dont work....

Thanks again,
Missie

[venus12277]

I think over the years I have tried just about everything I could find on Google I am on Neurontin for my diabetic neuropathy in legs and feet, and the doctor gave me Flexeril and Norco at first, then when I called to get refills (AFTER) he got my MRI results back I told the nurse I didnt want the norco because they didnt help so all they gave me was more flexeril which *****. I do go see my back surgan Jan 21st so I hope when I explain to him my opiate issues he may give me something that will work. Its just a matter of hanging in there until then which hasnt been the easiest. Thank you for replying!

God Bless
Missie

[Tuckamore]

Hi Venus,

A tardy Welcome to our community. I am so sorry to hear that opiates appear ineffective for you.

Sara has offered some good suggestions, as usual. I'll ask the same questions. What other opiates or NSAIDs have you tried.

Our individual bodies metabolize opiates differently. It's one of the reasons that some PMP are now doing a check swab. This swab checks your DNA to determine what opiates you best metabolize. It may be the answer for you. I encourage you to check on this possibility.

I do not respond well to Morphine either - unless I am given high doses of Morphine. The usual and customary doses do nothing for me. That may be true for you also. This was true for me long before I had taken any opiates for pain management.

I'd also ask what dose of Vicodin you received. If it was just 5mg - or if your pain was higher than what a dose of Vicodin could handle it's no wonder it was not effective. There are all kinds of questions that you need to ask before you determine these opiates are not effective.

That said there are a number of other opiates that a PMP may select from - often pain management is trial and error. A good PMP will work with you to find what is effective.

I recall a particularly nasty migraine that drove me to ER some year ago. I couldn't open my eyes, my head felt like a bulldozer was sitting on it - and I could not stop the nausea and vomiting. Nothing I had taken and nothing the ER MD gave me helped. I became discouraged and said, "Just let me go home and die, nothing is working." This awesome ER MD said, "See that cabinet overt there?  It's filled with drugs - and we will find something that helps you."  Indeed he did - and indeed I am still grateful to that tenacious doctor.  

The reason for my story? There are PMP out there that will work to find the right drug - or combination of drugs that will reduce your pain. There is hope. Hang in there my friend in pain. Be assertive and insist on good pain management.

Please provide us with a bit more information. We may be able to help with suggestions. I'll look forward to hearing more from you.

Take Care,
~Tuck

[saraj63]

Wow that's a serious dilemma for someone facing those kind of back problems.  They don't work well for me either but they give me somewhere between 25-50 percent relief.  Which pain medications have you tried so far?  Are you using NSAIDs, heat, ice or muscle relaxers? There are many types of pain medications on the market but they are all so similar.  Have you tried Neurontin (Gabapentine)?  Neurontin gave me more relief from my low back pain than the opiate drugs and used in combination help me.  I still can't function normally but I can at least get enough relief that I don't sit and cry in agony like I used to.
God Bless!
Sara

[ALbertPA]

Venus,
There is a well documented small population of patients who don't respond well to any narcotics. May get some relief from NSAIDS combined with Rx - Valium or Baclofen. and/or your clinician may prescribe Lidoderm 5% patches (no real systemic issues). If not covered by insurer, I've heard recently from my patients about OTC Nordic Ice pain relief patches as adjunct to oral medications.
Best-

[Chabon]

Wow, that describes me perfectly. No relief from opiates (Norco, Oxy, Morphine, Percocet, etc). Discovered Valium/NSAID/Tylenol mix and finally relief after 8 years!