one a day?

[rtg1015]

Okay, no abuse here but I do have a question.....I have had MS for over 23 years and recently was prescribed percocet for the pain.   Directions say to take every 6-8 hours for pain.  NEVER even need close to that amount, but I do usually take 1/2 to 1 a day.  The dosage is 5-325 (can anyone tell me what that means??).

Chances are that I may be on this a while.  Some people are on pain meds their whole life and I'm worried that I very truly may need this med for years, but it scares me.  Scares me because IT HELPS SO MUCH!!.  I just am amazed at how much more fluid my walking is and how easy!!  You have to understand that this is coming from a girl who has lost a large part of her ability to walk.
I am currently on disability due to this.
I am seeing a chiropractor for this, and will very soon be on a new IV MS med.....very hopeful for this new med.

Bottom line is that I am so grateful for this medication and I want to know if I have anything to worry about in taking 1/2 to 1 a day, and what if I actually need to take 2 a day at some point?

[Tuckamore]

First here's the link to MedHelp's MS Community:
http://www.medhelp.org/forums/Multiple-Sclerosis/show/41

You'll find others with MS on that Forum who can relate to your experiences first hand..... Just please don't leave us. :o)  

Here's also a link to my journal entry that Mellie mentioned regarding Addiction vs Dependency.  It contains Facts not just my opinion.
http://www.medhelp.org/user_journals/show/138942/Addiction-VS-Dependency?personal_page_id=14686

Also as Melli said you are doing nothing wrong! You are on a very small dose of Oxycodone (Percocet). 2 1/2 mgs is almost nothing.

You've asked a great question regarding the effect that an opiate has on the CNS. Opiates bind to specific opioid receptors in the nervous system and other tissues. They suppress many of the functions of the nervous system such as respiration.... and the reception of pain signals. If this has any effect at all on action that MS plays within the CNS a question I cannot answer with any great accurately. It is my guess that it doesn't play a significant role.... but I'll bet the MS Forum has better information on this subject.

Please don't be overly concerned with your requirement for opiates. I understand the fear of addiction and the stigma often attached with opiate use.... BUT remember you are not abusing. You are not drug seeking. You require these/this medication for several good reasons.

So glad you are maintaining contact and sharing with us how you are doing. I'll look forward to hearing more from you. Together this journey through Chronic Pain is a bit easier.... a bit more manageable.  :o)

My Best to You,
~Tuck

[rtg1015]

WHOA....took a whole percocet (5-325) and won't make that mistake again!!  I think 1/2 is as far as I can go as long as I take a xanax with it.  Yep, Neurologist has put me on xanax 3x a day.  At the most I've only taken it once but I'm starting to see the need for it more often.
Obviously you can tell from all my posts I get pretty over anxious about meds and maybe i am just an over anxious girl in general....    :((((

[mellie4]

You're not doing anything bad!!!  And if it helps your MS symptoms even if you don't have pain, then how can that be bad?  You're not treating yourself, you're not misusing your meds!!

Even if you had to take one day forever, so what?  If you were diabetic, you might have to take insulin everyday, right?  CP is chronic, which usually, for most of us, means you will have to take and/or do something for it every day.

Again, dependence is far different than tolerance!!!  Your body may become physically dependent on something but that doesn't mean you're an addict.

Check out Tuck's journals.  She has some great information there that is based in fact, not opinion.  Even one whole pill a day is a tiny dose (though you could still wind up dependent on that.)  But, again, dependence is far different than addicted.

It can be hard adjusting to the mental aspect of taking a narcotic every day, even if you don't have addictive behaviors.  It was for me.  Educate yourself, keep your relationship with your physicians open and honest, and when something isn't working right for you, always talk to your doctor about it as opposed to medicating yourself.

It is, in my opinion, important to be self-aware but to worry needlessly, sometimes due to outside influences, doesn't get you anywhere.  I've been down that path and I did myself a disservice.

[rtg1015]

Again, than you so very much.  My script says to take 1 every6-8 hrs for pain.  I usually only take 1/2 of one.  It is 5-325.  I just don't know if I dare take a whole one.
And what happens IF I end up taking this dose (a whole pill) once a day for the rest of my life???  Would I seem like some kind of addict???

Here is the wierd thing......It must have some effect on the central nervous system, the main focus of MS.
Hate to even say this, but even if I don't have absolute horrible pain, or much at all, I find that when I have this in my system, I am able to walk SOOO much better, get up and down from chairs with relative ease, able to walk up and down the stairs to the laundry far better than without.

Do any of you know why this is, and am I doing anything bad by this.  I do not want to be!!
And yes, please give me the info about the MS forum for sure!!

thanks again!

[Tuckamore]

Hi rtg,

Welcome to the Pain Management Forum. I am glad that you found us and took the time to post. I hope you will be active in our community. You've already learned how compassionate and supportive our members can be. They are wonderfully caring ppl and I am hoping that you have joined us.

I admire your courage. MS can be a difficult disease to deal with and the journey is sometimes challenging. My heart goes out to you!

I see that Mellie has done a good job of explaining the contents of Percocet or Oxycodone with Acetaminophen. It's a popularly prescribed opiate for ppl with chronic pain and even acute pain.

Don't be concerned with the long term usage of opiates. Most of us Chronic Pain patients require them just to function daily and obtain some kind of rest or sleep. You are taking a very, very low dosage. At any rate I have provided a link to an article you may find useful in my journals regarding long term opiate use. There are other articles that address such things as addiction vs dependency n the same location but this may be a good place to begin. So here's the link:  

http://www.medhelp.org/user_journals/show/141662/Long-Term-Opiate-Therapy?personal_page_id=14686

As already said, what you require to control your pain is nobodies business but yours. No one in my family, other then my husband know exactly what I take for pain control. I don't think I have even share it here, among my friends in pain. It's your business and never be ashamed of it.

Don't let the fact the Percocet helps you be of concern. This is actually great!  All of us are delighted when we find something that controls our pain. I am very happy for you!! I wouldn't be concerned that you may require more medication at one point. This is something you'll just discuss with your physician when the time comes. It's usual and customary.

As you may know we have a MS Forum, one of the leaders is Lulu. She's a very knowledgeable person and may have additional suggestions for you. If you are not familiar with the forum or can't locate it please let me know and I'll direct you to it. But Please don't leave us at the Pain Management Forum. Although most of us don't have MS, we do have Chronic Pain and can relate to the challenges of the journey.

I'll look forward to hearing from you often. We're here whenever you have a question or concern... or if you just want to chat or vent. We're here!

Best of Luck to You,
~Tuck

[sweetlilbj]

Mercy, u hv been prescribed a script for your pain by your doctor. The amont perscribed was due to obviously how u described your pain to your dr., your rx background, your ms, and your drs knowledge of you. If it helps, you are lucky that u hv found something that gives u the relief. Obviously u r lower dosing yourself, and if u r pleased with results frm lower dose, thn stick with that, but nxt dr visit be sure dr is aware that u are lower dosing yourself, as he could be reported by pharmacy if by accident due to your not follwing directions and he is unaware that u r not taking as prescribed, and he overprescribes, or it could just mess him up bad if he is unaware, ur not dosing as stated on bottle. Thats a controlled substance and am pretty sure fda has these types of pain meds under a microscope as to who what where when how & why. And at some point u need the two a day, thn take 2 a day, but make the dr aware, jst dont take more than directed, and should some day u might need mg upped, or even ur body might gets resistant & might even need to try a diff drug all together, just dont drink alcohol , dont mix any street drugs, & there should b no prob. Just b sure ur dr is aware of how ur doing ur dosing. Good luck, be careful, glad the med is helping! take care!

[mellie4]

I just want to add something.  This may not apply to you and I hope you have wonderful support in your life.  I have always been one of those people who are an "open book;" "what you see is what you get;" "just ask and I'll tell you."  I was very open about my medications.  And I was cautious.  I never drove on a new med or on an increased dose until I knew how it affected me.  I had asked my doctors if it was legal for me to drive while I was on the meds (and was told it was.)  (I had also asked if I could drive while my arm was casted ... different opinions on that one!)  But my sister got it into her head I was an "addict."  Even though she's seen me after my 9 surgeries and seen pictures of my hand, she refused to believe I needed meds.  I offered her to come with me to my surgeon's office, my pain clinic appointments and my primary care appointments.  She refused but still made my life miserable.

She told my kids I had a problem.  She told my  83-year old dad the same.  Mind you, she smokes pot daily and drinks a large bottle of wine every night.  In her mind, that's okay.  Because of that, I made some very bad choices and hurt myself.  I thought maybe I should get off my medication and I tried to do it too fast and without supervision.  Not smart.  (And normally, I'm a fairly smart woman.)

I have always talked openly with my doctors about my fear of addiction/tolerance/dependence/withdrawals and none of them ever thought I should give it a second thought.  I always was compliant, until I started tapering off.  I wound up in withdrawals and it was not pleasant.  I also was on a roller coaster with my pain.  I wound up with nerve pain and RSD after so many surgeries.  I didn't have to cause myself so much pain.  And it could be why I've had trouble with controlling my pain; because I let someone else think they knew more than my doctors.

This is really just a reminder that your medication is between you and your physician and who you CHOOSE to share it with.  It doesn't need to be shared with anyone if you choose not to share it.

Now my medications are between me, my pain management physicians, and my primary care doctor.  I'm getting a little better pain control and I'll never just go off something on my own without some medical supervision.  I  put my trust back in my physicians and told my sister it was a closed subject.  (And I got great advice here when I struggled with this.)

Hope you'll let us know how things are going.  This is a great forum with some really great people ... it helps when others know what you're going through to a degree.

[rtg1015]

I have absolute tears in my eyes......You have all been so supportive and gentle to me.
I can't tell you how I appreciate your kindness, and your recognizing my concerns.
Thank you all for helping to put my mind at ease and giving me support at allowing myself to take this med, and ENJOY the fact that it is working for me, and not not beat myself up over taking it.
What an overwhelming sense of relief you have given me in so many ways.
Thank you so much!

[Ghilly]

There is a HUGE difference between being dependent on a medication and being addicted to it.  As pain management patients, we are ALL dependent on our medication, meaning if we suddenly stop taking it, we will experience withdrawal symptoms.  The difference is, we take the medication AS DIRECTED and are not taking more and more just to get a high from it.  When you are addicted to a medication, you are no longer taking it as directed and you just take more and more to reach that high as your body becomes accustomed to each new level of medication.

PLEASE, if the medication helps you to lead a more functional, productive life, DO NOT LET THE STIGMA OF TAKING AN OPIOID RUIN THAT FOR YOU!  I cannot stress that enough.  You have an incurable disease.  You are not taking the medication for fun and you are not taking it for the high.  Society today has made it very difficult for chronic pain patients to be able to take our meds without worrying about being labeled, but you need to realize that by taking your meds as prescribed, you are doing nothing wrong or illegal.  You are helping yourself.  

We get one life.  It is not reasonable to be expected to live it in chronic intractable pain, and especially not when relief from that pain is a dose of medication away.  When people have to live your life in your shoes, then they can pass judgement on what you do, and not until.  In the meantime, don't sentence yourself to a life of misery by worrying "what if" when it comes to your meds.  If they help you that much, then be grateful that the smallest dose does so much for you.  Over time you WILL need to increase your dose, and so what if you do?  If you end up having to take two or three or four a day, as long as you are not chasing a high and take your medicine responsibly, that's all that matters.

Meanwhile, if you need moral support, these forums are the best place in the world to find it.  

Ghilly

[mellie4]

Five is the milligrams of oxycodone and 325 is the milligram of acetominophen.  You are on, I believe, the smallest dose.  I also believe that even if you only take a 1/2 or one a day, eventually your body would become dependent on it.  Some people take much more than that.  You are wise to be cautious, but some people need narcotics to manage their pain.  Tuckamore has a great journal on dependence vs. addiction.  I was on very, very high doses at one time and tapered down and now on a small dose of another narcotic.  I'd like to think I could someday be off it all but it's unlikely.  I've struggled with taking it and worried about it.  I've never ever misused any meds in any way but I still let outside influences worry me.

It sounds like this is a necessary medication for you and it's helping you live a functional life.  I think the most important thing for a pain management patient is to have a totally honest relationship with their physician.  If your meds aren't working, you can't just dose yourself.  You need to call or see them and explain things, and you work together.  And most pain patients, like you, use other things in addition to pain meds.  It may be procedures or other types of medications, chiropractors, massage, therapy ... the list is long.  But sounds like you're a smart woman who educates herself about things.  That goes a  long way no matter what medical issue you have!!!

Hope you'll continue posting here and let us know how you're doing with things.