pain killers?

[sexy bastard]

I have been taking Vicodin for about 6 months now for old injuries i have on my knees and shoulder, I dont take it every day or couple times a day but i go through a pain 24 hours a day, it usually goes from a annoying pain (like pressing lightly on rib cage) to I want my mommy pain (where it feels i got my penis ripped off of me) but I dont like taking it cause i know it is very addictive and dont want to get addicted to it in your opinion is there another medication i can take that does the job and is not as addicting?

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[HordeKing1]

SEXY - I'm disabled. I've had 5 major spinal surgeries. I'm no stranger to pain.

Having tried everything from Flinstones chewables to Fentanyl and Dilaudid, I'm very familiar with opiods and their effects.

ALL opiods have the potential to be addictive. Vicoden is not particularly strong, yet many get addicted to it nonetheless. This may be b/c doctors are more likely to prescribe vicoden b/c it isn't that strong - even pecocet, percodan, oxycodone and oxycontin are stronger. (Not to mention the Flintstone Chewable Morphine)!

My main pain control doctor is among the leading figures in the field. Consequentially, he's very up on the latest treatments.

Two new types of drugs are being used to treat chronic pain. The drugs themselves aren't new (in most cases) but using them for pain is. Anti-convulsants of the type taken by epileptics are very much in vogue.

Botox injections (the poison used to remove wrinkles) is also being used injected directly into the site of pain. This has yet to receive FDA approval for this use however.



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[sexy bastard]

i see what you mean, it is amazing though, I mean i for example here have my pills next to me and only take it when i am in as i said before I want my mommy pain, yet also afraid of a possible addiction though, i guess the good thing is that i am aware of a possible addcition that allows me not to abuse it

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[Michael Fury]

Sorry to hear about your chronic pain, Sexy & Horde King. I'm very familiar with this condition from the pain management pt. of view. Pain is a thief.

Just wanted to add that prescription painkillers are usually safe and effective when PROPERLY prescribed and used as directed. Your reluctance to take Vicodin on a regular basis because of concerns about becoming addicted is wise, Sexy but don't let it keep you from obtaining medical relief.

In our culture, anti-drug propaganda has been so successful in convincing people that "anyone who takes drugs becomes an addict" that pain patients who take opioids for chronic pain are typically categorized with drug abusers.

The truth is, addiction is a behavior, not a physiologic response. An addict is someone whose desire for drugs overwhelms everything they do, how they live. It consumes them. But the reality for people in pain is that once the cause of the pain is treated, most people will take themselves off opioid painkillers.

Go see a proper pain specialist, Sexy
http://www.painfoundation.org/page.asp?menu=1&item=3&file=documents/doc_020.htm They are much more knowledgeable & understanding about intractable pain than most MDs.

[HordeKing1]

FURY - You raised several issues of great importance the most important being that a great many doctors will not prescribe narcotics to people who need them.

It's gotten to such an absurd point that some doctors will not even give an effective dose of pain medication to terminally ill people b/c of fear of addiction. It's astonishing how often it happens.

Thank you for bringing up this important point.

I'm fortunate, that my main pain guy, Russell Portenoy, at Beth Israel, is a major advocate of providing whatever perscriptions are necessary to relieve pain. The problem is that in order to get a measurable amount of relief, you have to sacrifice lucidity, and I do not like to give that up.

People in chronic pain react much differently to pain meds than the general population. They can tolerate doses of narcotics that would kill someone not in chronic pain. (At one point I was taking 120 mg of morphine every 4 hours - sometimes supplemented with dilauded. Other times I was on a 300 microgram fentanyl patch (double the max recommended dose and supplemented w/dilaudid) This would ordinarily be fatal). It is not understood why the chronic pain sufferer can tolerate such high doses.

The vast majority of people in chronic pain do not become addicted to their pain medication, but they do become physically reliant on it. The distinction is a rather thin line but it is there. The addict uses drugs to get high, the pain sufferer uses it to stop hurting as much.

However, addiction is demonstrated by particular behaviors, the behaviors are produced by a physiological dependency.

When changing or adding or subtracting narcotics, even those in chronic pain must do so very gradually, or they suffer from physiological withdrawal symptoms.



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[Michael Fury]

Horde King, if you're under Russ Portenoy's care, you are in capable hands. As you know, he's highly respected in the medical profession & gives his patients the best possible pain management care.

Patients with acute chronic pain build their tolerance to opioids over time. Sometimes they're ramped up intravenously in the hospital; sometimes over time with daily meds or the fentanyl patch. You're absolutely right in saying that dependence and addiction are not equivalent to each other.

One difference between addicts & pain patients comes when it's time to get off the drug on which they're physically dependent. For addicts, this is a major hurdle. For the pain patient, it is typically an uncomplicated process.

[HordeKing1]

Uncomplicated yes, but it has to be tapered slowly to avoid withdrawal symptoms.

I'm curious, how do you know Dr. Portenoy?

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[Michael Fury]

Horde King, I work for a pharma company. I haven't met Dr. Portenoy in person. I've video-conferenced a meeting he attended this year & read several of his research papers. He's very active in the field of opioid pharmacology/pain management, something like 300 papers to his credit. The guy's a real humanitarian.

Some drugs won't take NO for an answer.

[sexy bastard]

ok cal lme a math maker
lol
just kidding
but seriously, number 1 i thank youboth for the advice... but i also believe strongly that my body will grow a tolerance to the drug and hope i do not need to rely on stronger medications, but also believe that taking it responsibly is also important, unfortunately today i took another pill and yet the pain was minimalized but not still nottolerable where i contemplated takeing another does of it...would you believe that its because my body mightbe growing a tolerance to it and or could it be that because i do not take it on a regular basis that results in it not being effective?


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[iscream22]

i take lots of tylenol.... LOL

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[Michael Fury]

Generally, the more opiate you take (both in frequency & dosage level), the quicker your body develops a tolerance. So the fact that you don't take Vicodin that frequently shouldn't effect it's painkiller effects.

Pain is a personal, subjective thing - drugs that work for some, are less effective for others. My guess (and I'm not an MD) is that if you're experiencing bad, "I want my mommy pain" then your dosage is too low. Vicodin comes as 5mg hydrocodone/500 mg acetaminophen (Tylenol), then 7.5 mg/750 mg, then 10 mg/660 mg. Again, a pain specialist is someone you would want to talk to about this. Your regular MD may have a stigma about increasing your dose.

[HordeKing1]

SEXY - Fury put it perfectly, when he said "if you're experiencing bad, "I want my mommy pain" then your dosage is too low." That sentence captures it perfectly. It alludes to the ingrained socialization of people to be so afraid of addiction to drugs that they let themselves get to that level of pain.

SEXY - Please, if you're in that much pain, you need to take the meds. Work with your doctor so that you can achieve an optimal dosage of something that will allow you to function without so much pain, while still maintaining lucidity.

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[DarkHippie]

Portnoy? isn't that the guy with the complaint? (sorry, I can't resist a good philip roth reference)

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[HordeKing1]

HIPPIE - Portnoy, yes, Portenoy, no.

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[sexy bastard]

horde did you mean port-o-pottie
lol
and i am in minor pain now like a ingrown toe nail pain..but i can deal with it now


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