Oxy holiday, withdrawal and pain control

[Guest guest]

Both you and Karyn, as well as a friend through a private email,

made some very valid and interesting points.

Karyn pointed out the benefits of taking a drug holiday and

reassured me that opiod withdrawal is relatively successful.

However the questions that come to mind is how do you detox

successfully while still maintaining adequate pain control. I have

to admit that the thought of keeping off from the oxy scares me to

death. While i am in better health now than I have been in five

years, my " black hole " of despair is still recent enough for me to

dread sliding into it again....and having to spend tough mental

and physical time getting out of it. I am also scared of not having

any pain control during the detox period and worry about going

through the withdrawal symptoms. I recognize and accept that

the body has become physically dependent on the meds, and I

regret that there is no doubt that it is a paradoxical reaction - that

by taking pain pills we actually become more sensitive to

" normal " stimuli, but I wonder if that is just a natural give and

take for making hard decisions - something that everyone has to

endure no matter what meds are being taken. Karyn's point is

also well taken about not feeling like a failure for needing the

meds. It is not that I necessarily do for the most part....but I have

to admit that there is a small, gnawing sense of it just not being

right......that I am somehow deluding myself into thinking I need

them. I have reconciled my earlier concern about believing deep

down inside that I want to be sick.....I have successfully

completed my experiment that proved to myself that this just isn't

so.....that I am not somehow unconsciously willing myself to be

sick as compensation for some social or psychological lack in

my life (the comment made by Sandy comes to mind - the whole

" you are just a bored middle-aged woman looking for attention "

attitude that many doctors have towards me).I am thoroughly

convinced that this is real....and not just in a sense that whatever

we perceive is " real " to us...but that this is a real disorder with

real ebbs and flows that is not controlled by my mind or attitude.

So this is a big accomplishment for me over the last year!

I am interested in learning how Karyn goes about detoxifying and

how interferring with her life it is.....

's comments are so on point. - you especially nailed the

dilemma over taking the meds before things get out of hand vs

toughing it out. And the reminder (also conveyed in the private

email) that CP pain occurs in a different time frame as opposed

to withdrawal pain is also something that finally clicked with me.

I was also glad that you reassured me that my variable usage

could indicate that I am responding more to " real " pain rather

than physcial dependency. What you describe occuring to you

with Oxy is exactly what happens to me with Neurontin. Even if I

take just 300mgs, I get so dopey, unbalanced and muddled that I

cannot get beyond 600 mg at night - and even that tends to affect

me well into the afternoon hours of the next day. And the eye

problems it causes.....not something that I enjoy, both the blurred

vision and the outright eye pain itself. I am positive that I will

never be able to tolerate dosages that in the therapeutic range

and am tapering off of them in response to the recent posts here

concerning edema, etc. The symptoms that I wonder that may

be indicating that I am treating withdrawal rather than pancreas

pain is sometimes it is the nausea and a general " ickky " feeling,

not necessarily the groaning pain of CP. However, I find that this

is not always in the timeframe of 12 to 24 hours after my last pill.

And the days that I feel really good.....I can go 12 or more hours

between pills without that ickky feeling. I just seem to have a

heightened fear of appearing weak to myself...that to gain back

my life I have to prove that I am strong in every way....physically

and mentally.

I need to learn more about why oxy is one of the most physically

addicting pain med...is it more than morphine? of dilaudid? Why

do you think it is one of the first, stronger meds to be offered

then? Whenever I was dilaudid, the doctors were uncomfortable

about it and even made an anesthesiologist sit with me for an

hour or so when I was in the hospital on the 4th of July Holiday,

in order to " wean " from it to be replaced my morphine. They

acted as if dilaudid was the more " scarier " med. I know that IV

wise, dilaudid was more effective than the morphine.......

As far as the tolerance issue...I was told something similar to

you...that any drastic increase of use was usually the result in

worsening pain. However the formula that PM docs use is that a

person is expected to need 5-10% more a year of the drug in

order to get the same pain relief, basically treating a " stable "

condition. In my case, I haven't experienced that.

I also concur that you were not advocating not using oxy....I was

just soliciting your opinion on a subject that causes me to feel

caught between a rock and a hard place. And I guess I need

periodical reassurance and reminders that there is no perfect

answers, or concrete ways to determine the " whys? " and

" what-ifs? " and " now whats? "

Laurie

[Guest guest]

Laurie

you crack me out up with your delusions of a bored housewife hahhaa

I dont think you need a holiday from these drugs. I too went through

this lol, but I know I have real pain, and yes fear of the full swing

of it back at me is enough fo rme not to play to much with my meds.

I am constantly monitorinh myself whether I can decrease my dose. I

started out 6 yrs ago on 80 mg a day and now take 40 mg so what they

syay about tolerance isnt true.

I always have pain and it varies, I do this as I cant stand the brain

fog associated with these drugs.

I dont think one has to go off it to see if they still have pain

merely reducing it shows that,

debs

[Guest guest]

Drug Holiday? Why would you do that to yourself if you are in pain and need them

to function? I had this EXACT argument with my old beloved GI professor one time

(boy do I still miss him), after being sick for about a year. Doubled over,

vomiting and not good. He told me once that sometimes the pain meds can cause

pain in themselves due to constipation and a slowing of the system. Perhaps if I

stopped, we could see. I couldn't believe what was coming out of his mouth when

he said that. I presented my side and he finally chuckled, agreed and never

brought it up again. My point was/is, you are in pain or you are not in pain.

The fact that you are on pain meds does not cause the pain. I started the pain

meds because I was IN pain, alot of it. Not the other way around. Yes the pain

meds, at times, can cause constipation which can INCREASE the panc/SOD pain,

but it already existed. When you go thru withdrawals (if you have been on the

narcotics for an extended period of time) you do not

get the panc/SOD pain if you are fixed. You get the horrible flu feeling, where

you ache everywhere, you get the tickles/restless feeling in you limbs and body,

you get sweats, nausea, diarrhea and you can't sleep for days. If you taper,

very slowly, it makes the symptoms lighter but they are still there. It takes 12

Hrs off the vicodin/norco (that's what I was on for 2-1/2 year) for it to start,

at least for me. By 24 Hrs you are really into it. So pain is pain and

withdrawals are withdrawals. Yes we may be afraid the pain may come back or

still be there after we are done with withdrawals. But you will know fast,

either the pain is there or it is not. If you are having panc/SOD pain, you will

be in pain when you withhold your pain meds. You will know, don't doubt what you

are feeling. Don't doubt your body. You know better then anyone and your body

speaks load and clear when you are having problems. Hope you are having a good

day and will talk to you soon.

Love,

w

---------------------------------

Yahoo! Mail for Mobile

Take Yahoo! Mail with you! Check email on your mobile phone.

[Guest guest]

Dear ,

I hope your appointment goes well today. When I was real sick, I also

started seeing a Pain management MD. She adjusted my meds so I got adequate pain

relief. She also helped me get off the pain meds when I was better. I hope they

are able to get your pain under control quickly. Let us know how your

appointment goes. Talk to you soon

Love,

w

---------------------------------

Start your day with Yahoo! - make it your home page

[Guest guest]

,

I started out taking Darvocet, which was really like taking nothing! I was

suffering greatly and losing so much weight from not being able to eat that my

docs finally sent me to ton. When I went to ton and they put me

on oxycodone my pain level finally started to be under much better control

Then I had surgery 2 months ago. That didn't work like they wanted it to and so

I

just went to my first pain doc. I wish I had found her 2 years ago! I would

not have suffered like I have. She was wonderful. So compassionate and

knowledgeable about cp and the pain. I am now on oxycontin 20mg. twice a day and

5

mg. oxycodone as needed. I cannot tell you how much better I feel. I am sleeping

better too. Not waking up in pain every night. I feel like a weight has been

lifted off of me! I see a light at the end of my tunnel now instead of hitting

brick walls all day! I would talk to my doc if I were you and see if there is

a good one in your area. Where do you live?

If I had known what relief was out there for me, I would have grabbed this

bull by the horns a LONG time ago!

Angie in SC

" The happiest of people don't necessarily have the

best of everything; they just make the best of everything that comes along

their way. "

[Guest guest]

I've been trying to follow this thread and have heard excellent

comments by Karyn, Chrissy, Laurie, and K as to the pros and

cons of Oxy use, drug holidays, withdrawal and the need for pain control.

My personal conclusion is that pain medications have such different

and obvious side effects on each individual that there isn't any right or

wrong answer to this debate.

Using myself as an example, I can go for a week or two without taking

any of my BT oxycodone, with no ill effects, withdrawal or problems. The

following week I may need to take up to 45 mgs. a day each day to handle the

pain, then drop to none three days later. My daily use of a 50 mcg.

Duragesic patch negates the philosophy of being totally drug free, yet it does

prove that my pain is determining my use of the Oxy, not the Oxy itself.

At the time I entered the hospital in March '03 with my DKA, I was

using a 50 mgs. Duragesic patch every 48 hours and taking 60-80 mgs. of

Percocet 10/325's each day. When I was released I was drug-free, apparently

having gone through withdrawal while hospitalized, though I never realized

it or felt it as such because I was so sick with the DKA and dealing with having

type 1 diabetes. Immediately after that, I went without any pain medication at

all for 8 weeks, so I guess that was my " Drug Holiday " .....lol!

It wasn't until my pseudocyst started to flare up again 8 weeks later

that I had to go in to my new GI and ask for help with the pain, and that's when

I started again on the patch, with Percocet for breakthrough. As soon as my

new doctor realized that the need for breakthrough meds was going to be a

continuing necessity, he insisted that I get off the Percocet. He didn't want

me

to develop any liver problems by the frequent use of tylenol. He

sent me to a Pain Mangement specialist, and we started a trial of all the

different pain meds to see what would work best for me. What I learned was:

* Oral Dilaudid that's so successful for makes me have

hallucinations during the day and violent dreams at night.

* Dilaudid via a PCA works successfully for me and was an appropriate

therapy while in the hospital.

* Oxycontin, (MS Contin), which is so effective for and many

others, didn't give me enough pain relief, even at double doses.

* OxyIR was not effective as a break through med.

* Morphine also wasn't effective for breakthrough.

* The Neurontin that Laurie has had such problems with has been my

most successful non-narcotic medication, so successful that I now take

18,000 mgs. of it daily, and by doing so, have been able to reduce my BT med

dosages by two-thirds.

* Percocet will wire Sandy up so badly that she hates to use it, but

when I took it, it worked effectively and quickly to ease my pain with no side

effects.

* The Duragesic patch, which makes so many people drowsy and then

many others have to discontinue its use because of excessive itching, made

me drowsy for the first week or two and then stopped, closely following

the expected side effects as listed in the manufacturer's warnings. I've

not had any itching problems with it at all. It has continued to be the most

effective narcotic I've used, and I've been able to maintain or decrease the

same dosage of it for the past 3-1/2 years.

* Oxycodone has remained to be the most effective BT med that I've

used, and causes me no side effects or unusual behavior, (to the best of my

knowledge....lol!) That's what I was taking when and Chrissy came

to spend the weekend with me, so ask them if it weirded me out! And, as I

said earlier, I can go through a week or two without using it at all, provided

that my pain cooperates. I only take it when the pain interferes with my

normal activities.

Based on these facts, I don't think any of us can depend upon each other's

results as an accurate assessment guide for any narcotic. Our individual

physical reactions are so varied that the best way to assess the different pain

medications is through professionally supervised trial and error with our PM

doctor. As for side effects or what to expect, it should be the responsibility

of

each patient to utilize the excellent medication guides, such as rxlist.com or

drugdigest.com, that are available on the internet, to research any medication

that has been prescribed for us. Since many doctors don't seem to know all

the expected side effects, the correct dosing requirements, or even know

whether or not a particular medication causes pancreatitis, I check these

guides first BEFORE I accept any new medication. This way, I know what to

expect and what type of side effects are serious enough to merit immediate

notification of my doctor. I like to know what other people's experiences with

any medication has been, but I certainly don't expect that mine will be the

same.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

SC Rep

SE Regional Rep

PAI

Note: All comments or advice are based on personal experience or

opinion only, and should not be substituted for consultation with your

medical professional.

[Guest guest]

K,

I'd recommend mine, but you have to be a Kaiser patient to see them and

I can't remember if you are a Kaiser patient or not.. I go to the

Oakland Kaiser Pain clinic and they are very good.

Kimber

--

Kimber

Vallejo, CA

hominid2@...

Note: All advice given is personal opinion, not equal to that of a licensed

physician or health care professional.