How Many Milligrams Are You On?

[Eddie G]

Thanks! Percoset are bad for your liver long term....

Anyone else taking opiates here?

[jsewell]

I recently cut back, i was taking 20mg of percocet every 4 hours during the day. Also had dilaudid which was sporadic as to when i used it.

Now i just saw a new pain management doctor today. He gave me MsContin 30mg twice per day and allows one percocet daily. He is worried about the possible liver or kidney damage and is sending me to a lab to have it checked. I had been on the higher dose of percocet for about 4 years. 15 surgeries in 4 years.
I sure hope the mscontin works well.
Judy

[Maria]

I take 10mg of Methadone/day. Same dose for about 11 years now.

[Eddie G]

Thanks Maria. Anyone else on opiates?

I cant take Oxycontin anymore since they changed the formula, the pill is 2x as big, full of polymers. Same reason I cant take generics from all the side effects. It was easier taking an 8 hour pill than a 3 hour Roxi pill too.

[mmglobal]

EddieG,

The most I've ever been prescribed was 80mg/day. That was my first oxy prescription and after taking the first pill I called the doctor's office and told them it was way too much. I've had many clients who take much more than that.

Except for that one scrip (and during the 3 weeks following my L4-S1 ADR in 2002), the most I've ever taken was 60mg/day. I always try to reduce my meds when I can... then if I have to go back up, it's that much more effective.

Because of the experience with a client of mine, I'm currently trying to reduce... maybe to zero. I'm down to 2 x 10 = 20mg/day. Oxy does not last 12 hours for me. The 2 a day dosing is very hard because there is not even coverage. I much prefer to be on 3 a day dosing. I get more benefit from being on 3 x 10 instead of 2 x 20, even though it's less overall, the coverage is smoother.

My next step is to leave the oxycontin and replace with oxycodone or hydrocodone.

Call me if you want to discuss. I have some other issues that may be relevant for you too.

Mark

[Eddie G]

Liberty Mutual claims none of their pm doctors will treat me unless I go to a 10 day detox first. They are looking at my chart that says 90mg Roxi every 3 hrs. Im actually on 15mg. every 3 hrs and thats as low as I can go on my own. Im off my Lyrica (since the judge said its widely abused and I'd have to come off that too) I never even bothered to bring up cannabis at that point. (Im mean LYRICA? Really? addicts have stolen my Morphine, Oxy, Roxi, but they always left the Lyrica & Gabapentin. I dont think they're trading Lyrica for sexual favors in the hood! Such misinformation....)

I cant imagine a week of this "recovery room" pain but maybe they have some good restraints & straight jackets for me to wear...

I found cannabis to be helpful during this adjustment/detox time. I have a feeling thats going to be an issue with this new pmd even after I get my card.

[Maria]

As far as I know my PM's office isn't in favor of one utilizing cannabis for spine pain and his PM is limited to treating spine patients.

Re Lyrica being abused ... really? I'm surprised and don't really get the abuse aspect unless it's being sold on the street for neuropathies for those that cannot obtain it otherwise which would probably not be happening as it's costly enough either way if one has to pay cash.

hmm.... I must really be out of the loop.

[Ringo]

Mark,

I like reading your posts. They are full of meat and potatoe's : ) I worked in a methadone clinic part time for about 2 years. Plus I deal with pain and I take pain medication (hydrocodone). I avoid taking it on a regular basis if at all possible and I try to control my pain levels with activity control. I try to stay in a swimming pool and just move my body (the parts that still work).

I have talked to hundreds, maybe thousands of people using pain meds. In general I think that people sort of get the impression that weaning narcotics is a linear event. But, it isn't. If taking fairly large amounts of opiates, you might be able to wean fairly briskly in the begining. So, you can decrease dose by regular amounts and you can do it at regular intervals. But, as you get down to about 50% of the maintance dose (as I recall) you sort of had to slow the taper both in dose and time interval. This is were all sorts of things come into play. Very often coping mechanisms deteriorate, people don't handle stress as well, anxiety rears its head and generalized pain increases. Sometimes people would panic at this point and give up and say "I failed." Typically, even if done slowly you will experience varying discomfort that might last a couple weeks and mess with your sleep (badly). And this will repeat itself everytime you decrease your dose. If weaned to aggressively, people described it like having flue like symptoms x10. I have to add that all this gets complicated when you have had multiple surgeries, unknown pain generators and/or known pain generators that have no treatment. Normal no longer exists and it will never exist.

The problem with pills is that they are usually short acting and they don't achieve the steady state in the body and instead creat a peak and trough situation. This is probably the most difficult way to wean if a person has been taking opiods long term. It actually probably leads to people taking higher and higher doses longterm. The theory behind methadone is that it is long acting and creates a better chance of creating a steady state. But, coming off high doses of methadone is no walk in the park either. How ever a person weans (if they have been on this stuff long term), they need to create a steady state and very slowly decrease the dose letting the physiology of the body change and the psychology of the mind adapt. I suspect you know a lot about this and I might just be preaching. But, I saying it for anyone out there that needs the support. I also really believe that the same should be done with psychotropics but you never or rarely see that happen.

I am aware of extended release pill and patches but I don't have personal experience with them. So, not sure how they would be incorporated into a weaning schedual. Also, there are implanted narcotic pumps and spinal stimulators. I don't have any experience with them but I might eventually.

Another area that is worth appreciating is how the body just naturally rewires itself. It is believed that chronic pain sufferers actually develope a larger pain perseption center in the brain. Sort of like a muscle getting stronger from exercise. People get better at perceiving pain. Then there are people that seem to get a mix of fibromyalgia like symptoms mixed into their pain. Arachnoiditis is a possibility of being mixed in there as well (not fully appreciated with chronic pain suffers) and can be related to spinal injections. I personally don't know how to describe my pain to doctors any more. My body aches and burns. Is this my new normal after 4 back surgeries and 52 years of age and mulitple spinal injections? Is the outcome of multiple injuries and surgeries on the delicate and exquisitely designed machine called the human body? I just know that it hurts a lot and I think its going to be that way from here on out.

Peace, Terry

Just remember that your body isn't a 4 speed transmission that you slam shift when you adjust your medications.

Originally Posted by mmglobal

EddieG,

The most I've ever been prescribed was 80mg/day. That was my first oxy prescription and after taking the first pill I called the doctor's office and told them it was way too much. I've had many clients who take much more than that.

Except for that one scrip (and during the 3 weeks following my L4-S1 ADR in 2002), the most I've ever taken was 60mg/day. I always try to reduce my meds when I can... then if I have to go back up, it's that much more effective.

Because of the experience with a client of mine, I'm currently trying to reduce... maybe to zero. I'm down to 2 x 10 = 20mg/day. Oxy does not last 12 hours for me. The 2 a day dosing is very hard because there is not even coverage. I much prefer to be on 3 a day dosing. I get more benefit from being on 3 x 10 instead of 2 x 20, even though it's less overall, the coverage is smoother.

My next step is to leave the oxycontin and replace with oxycodone or hydrocodone.

Call me if you want to discuss. I have some other issues that may be relevant for you too.

Mark

[ajspine]

Hi Guys,
Just came across this as I spend most of my time on the iSpine forum. First, Eddie, Congrats on coming off the opiates, this is great. And I have heard some wonderful things about medical maryjane. I am currently going through hell with the VA because they switched me from 5mg Oxycodone HCL 2 every 6 hours(40 mg a day) to 10/325 Hydrocodone one every 6 hours. The Hydrocodone does NOT work for me and from what I have been reading the dosing is way off. I have to take 2 to almost get relief but I can't do that because that is not what I am prescribed. it also has APAP, which makes me worry about my liver and kidneys.
I tried this for 8 days then called my Dr to switch back and he was gone on Vaca until today(I have an appointment this afternoon) and I had to go the VAMC 2.5 hours away to have the Chief of Staff fill my meds because no one else would fill them while my Dr. was gone.
This med change left me crying in bed for days and I have had to take an incomplete in both of my Grad school courses. I have finally pushed for approval for treatment at a Civilian Pain clinic in the town I live in. I should not have to beg for pain relief but the VA is on tear when it comes to opiates and true chronic pain patients are losing their meds. It is unbelievable what they put us through.
I wish I had the option to try Mary jane for my pain but the VA is federal and if I get caught I will loose all of my benefits. Once again, Congrats!
AJ