Johnny and Phil,
I believe TN is one of the states that avoid prescribing OxyContin at all costs. I know a PMP just relocated from TN and he would/will not prescribe it - accept in terminal cases. The same is true in FL.
It's my guess - and I have been told that it's from the abuse of the older version. Also to blame is all the Pill Mills that existed, especially in the FL Panhandle and Miami area - OxyContin was the preferred drug - unfortunately it got a bad name. It is an effective opiate. Many ppl from surrounding states can to FL for pain mgmt, both true chronic pain patients and those that abused and diverted opiates. KY recently printed another article regarding our (FL) pill mills and how they are/were responsible for addictions and death. We're close to TN so I assume the same may be true. Fortunately Pill Mills no longer exist in FL.
I have found it greatly depends on the state "climate" (sometimes the physician) as to what they prefer to prescribe. In WI long acting opiates are preferred for pain management - as you said Phil. They don't like prescribing short acting opiates. That doesn't hold true in all states.
Who can guess what you'll find. I encourage you to be open to all forms of PM. Again, good luck.
Pain management today frowns on the use of short acting medications like Percocet 10 for chronic pain.
If you are using this medication every day, multiple times a day, you might do better with a long-acting formulation, OxyContin.
However, if you are using it PRN, only when needed, then there are options.
Morphine, while the 'gold standard' of pain medication, has many unwanted side effects.
Perhaps a better drug for you to take prn for severe pain may be hydromorphone (Dilaudid), which is stronger than oxycodone, but has less toxic metabolites.
Also, if you respond to oxycodone, but are tolerant at that dose, this medication does come in 15, 20, and 30mg strengths.
Because Percocet contains acetaminophen, it is wise to choose a plain formulation of oxycodone, without acetaminophen, when higher doses are needed.
Unfortunately, acetaminophen is more damaging to your liver than any opioid medication. A dose as low as 4 g / day (2 - Extra Strength Tylenol, 4 times a day) can be toxic.
Talk to your doctor about either upping your dose of oxycodone without acetaminophen, switching to a long acting formulation like OxyContin, or to another opioid like hydromorphone (Dilaudid).
By the way, quitting Valium cold turkey was quite risky. Abrupt withholding of the medication in benzodiazepene dependance can cause seizures and death.
Please, do not simply quit any medication you are prescribed without first consulting with your physician. While withdrawal is difficult, some consequences are deadly.
Best wishes with your pain control.
As always, Tuck has some valuable advise and I can add to it.
I feel that you need your own Doctor to call the insurance co. and override the orders. I have had this done a few times when my insurance co. will not pay for the specific drug. I would talk to the Doctor that prescribes the medication for you.
Welcome to our Pain Management Community. You accident sounds horrific. I'm sorry you had to experience it and continue to have pain.
Opiates can change our personalities, indeed many other medications have that effect on our systems. You may find that any "Big Dog" med will do the same. Don't fear, there are alternatives.
Are you being seen by a knowledgeable PMP? If not I encourage you to do so. I've seen three with that title and the difference between each one is unbelievable - not just in personality but in attitude and knowledge.
I don't believe in recommending a specific medication as we are all very different - and our pain is different. A good PMP should be able to make adjustments in your medications.
Do you have nerve pain? I wasn't aware of how much nerve pain was a component of my pain until a PMP prescribed a medication to treat nerve pain. It has been extremely beneficial - but it's a bit pricey! It's not an opiate which makes be extremely happy. But yes I do take an opiate also.
It's possible that your system may be a bit tolerant to the oxycodone (Percocet). In some ppl their pain is actually becoming worse and the opiates are no longer effective. Only a physician can determine if you are tolerant or your pain is worse or poorly controlled.
In short acting opiates oxycodone is one of the stronger ones that most physicians are willing or able to prescribe. You may be looking at adding a long acting opiate (slow release) for better pain control. Was the morphine you were taking a long acting like MS Contin?
There's also a well accepted theory that many chronic pain patient have Opioid-induced hyperalgesia - which simply put means our body become overly sensitive to stimuli and we feel pain when there isn't a reason for pain - or we feel a much greater degree of pain than the a non-opiate treated person would experience. I don't totally buy that theory, especially in all ppl. I do think it may occur on occasion but I have trouble believing that it's the norm.
I know I didn't suggest a specific medication - but again that's because I think your pain needs to be evaluated. It make take some trial and error to find an effective med regime. What works best and effective for one person may not be right for the next person. Working closely with your PMP should find you better pain control.
Please let us know how you are doing. Thanks for posting. I'll look forward to hearing from you again soon.