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Topic: Long-Term Prescribed Narcotic Use for Chronic Pain (Read 2582 times) |
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CHTom
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #25 on: Oct 16th, 2005, 9:52pm » |
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With some chronic CH sufferers, the length of each attack can last several hours and they can hit one after another all day long (see post by Madprof, among others). When one suffers like this, to get relief within less than an hour is a blessing.
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burnt-toast
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #26 on: Oct 17th, 2005, 6:27am » |
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on Oct 16th, 2005, 8:48am, Sean_C wrote:
The phrase "not a cluster sufferer" comes to my mind.
Opioids will not abort a cluster and thats fact. Don't spread rumors to all these newbies that Oxcy's make it go away because it won't. Any doc that gives you pain pills for CH shouldn't be treating a patient IMHO.
There is no relief in Opioids.
Sean.............................
BTW google Oxy and read the facts for yourself. I've lost 3 friends to that crap  Dependence is addiction. READ |
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Not even attempting to say narcotics of any type abort clusters. Only admitting that folks with short or infrequent attacks could possibly get relief from pain under a doctors care. But extreme caution is necessary.
I believe narcotics are extremely dangerous and in most cases the risk outweights the potential for relief if sufferers need to take them frequently enough to become dependent and/or risk addiction.
What's the difference - call it dependent or addicted - someone has reached a point where a foreign substance is needed and that risk is real for most CH sufferers when an addictive substance becomes a frequent treatment.
Tom
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CHTom
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #27 on: Oct 17th, 2005, 7:35am » |
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For "The Old Boiler" : With many people who suffer from severe, chronic CH, the attacks can last for several hours and one can get hit several times successively, without much, if any, of a break in between (i.e., the pain may decrease from a 9 or 10 after a couple of hours to a 7 and then another 9 or 10 comes along; this pattern can go on all day and all night, sometimes for weeks. With the proper narcotic medication, the pain level can drop considerably once the attack has started and so can future attacks. If you have experienced this, especially for years on end, the benefits can give you the chance to lead a semi-normal life. Once again, I stress that the use of narcotics should be supervised by a reputable pain clinic.
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| « Last Edit: Oct 17th, 2005, 7:38am by CHTom » |
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BMoneeTheMoneeMan
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #28 on: Oct 17th, 2005, 11:49pm » |
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Well, i am not an expert in some of the drugs you guys are mentioning, but i have certainly been through my fair share of vicodin and percocet. Wash them down with about 20 OTC pills a day, only to get my ass kicked hard by the beast. The more I took, the worse the beast kicked my ass.
Since i got on here and people mentioned rebounds, i have taken less than 10 pain pills in 10 months. Definately, (those) pain pills did nothing for me except make it worse.
Some of those other really hardcore drugs, morphine, oxycontin, methadone...... they might be so powerful they would numb it....i have no idea, never taken them.
But, yeah, if my only choice was taking an oxycontin and maybe getting relief in an hour, or just banging my head on the sink and getting relief in about an hour, Id stick to the sink.
PF wishes
BMonee
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #29 on: Oct 18th, 2005, 12:39pm » |
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on Sep 14th, 2005, 4:42pm, hdbngr wrote:| I used to use the Duragesic patch. I used them for a year and a half, and when the worst had passed, I weaned off of them. It wasn't fun, but it was doable. |
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I unfortunately get the wonderful dynamic duo of headaches: chronic migraines and seasonal clusters. I have used the duragesic/actiq combo for close to three years, and so far have yet to have to increase the dose. I also went off it cold turkey at one point for what turned out to be a very masochistic test, but didn't suffer any withdrawal whatsoever. (FYI 25mcg patch - 200/400mcg actiqs).
It took me from becoming completely non-functional to being the guy who never misses a day of work whom everyone can count on...am I nervous about dependence? Yes, although quitting after two years for a few months eased some of my fearts. Am I nervous about addiction? Not in the slightest, because the ONLY time I ever take the meds is when I'm in pain. Using them for anxiety or stress is what will really cause addiction. Unfortunately, everyone is different. The high risk cases are those who have high levels of anxiety and/or depression. I was fortune to be one of the rare cases who has chronic pain but does not suffer from anxiety or depression (I know...they sound mutually inclusive...heh).
Best wishes to all of you out there...keep the faith.
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CHTom
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #30 on: Oct 18th, 2005, 2:45pm » |
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Origin: I stopped using the Duragesic patch as well-200mcq-on my own (between that and the Dilaudid I was always too tired to do much of anything). I just didn't put on a new patch one day and didn't have any withdrawal symptoms and my pain was controlled just as well with the Dilaudid, taken as needed. I too was able to return to work and even had a one year spontaneous remission several months later that lasted for a year. I now use Dilaudid and Actiq (and after a DBS operation, the amount used is 1/10th of what I was using prior to the surgey). I never developed a craving for any of the drugs that I used and am once again able to lead a "normal life". Very few people who take narcotics for chronic pain (something like 1%) become addicted in the classic sense of the word and I have found that I-they use as little as possible, just enough to prevent the pain from ruling/ruining my life. I hope, with the DBS operation that I had a month ago to be able to not have to use any medications within the next 3-4 months. Continued PFDANs to you!
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don
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #31 on: Oct 18th, 2005, 9:50pm » |
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Quote:| Very few people who take narcotics for chronic pain (something like 1%) become addicted in the classic sense of the word |
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Where did you dig up that little gem of inaccurate info?
Show me that documentation.
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LeLimey
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #32 on: Oct 19th, 2005, 3:31am » |
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Oh BTW CHTom, John, Hdido, PCMCKK, John Skorohod, NYC John, Gegory P. Skorohod, DBS... and all the rest of your little handles - you've been busted on the main board. I'm sick of you trying to take people here for a ride and I will never stop busting you.
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marty
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #33 on: Oct 19th, 2005, 6:53am » |
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I just had to do the quote like Don 
[quote I just didn't put on a new patch one day and didn't have any withdrawal symptoms and my pain was controlled just as well with the Dilaudid, taken as needed.
Very few people who take narcotics for chronic pain (something like 1%) become addicted in the classic sense of the word and I have found that I-they use as little as possible, just enough to prevent the pain from ruling/ruining my life. [/quote]
Of course you did not suffer any withdrawel symptoms - the dilaudid is a lot stronger than the patch - do you inject or take the pill?
Please, if you take Dilaudid "as needed" you are, or will become addicted - or if you prefer, "dependent". Same thing as with methadone that is commonly used for chronic pain.
As to addicted "in the classical sense of the word"..? does that mean that we now have two categories: 1. addicted in the classical sense of the word. 2. Dependent upon a substance. I would love to see the criterias that seperate these categories..
There ain't no difference dude. It only makes it easier for someone who is addicted (or in danger of becoming addicted) to reason, read "hide behind" the term dependent instead of addiction.
There are times when narcotics can be used for CH but in almost all cases (I would guess) does the narcotic given at an ER turn out to be a "quick fix", leading the CH'r to do almost anything to get this quick fix instead of fighting. Next thing you know, the combination of severe pain and quick pain relief in the form of a shot may lead to the big "A".
Marty
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don
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #34 on: Oct 19th, 2005, 7:10am » |
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The defining differance between dependance and addiction is that addiction includes the phenomenon of craving.
Characteristics of addictiion include rationalizing and justifying. Much like CHTom does in this thread.
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marty
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #35 on: Oct 19th, 2005, 7:41am » |
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I stand corrected Don.
But it is a pretty thin line, wouldn't you agree?
Marty
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don
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #36 on: Oct 19th, 2005, 7:58am » |
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An extremely thin line and no one knows where it is until well after you've crossed it.
I would like to know what our learned CHTom's credentials are for researching addiction. Reading this thread I will wager he has none as he talking out of his ass and putting a lot of people in danger by promoting narcotic usage without a clue to the variables that lead to addiction.
Find yourself a street corner CHTom.
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| « Last Edit: Oct 19th, 2005, 7:58am by don » |
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Pinkfloyd
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #37 on: Oct 19th, 2005, 8:42am » |
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on Oct 18th, 2005, 9:50pm, don wrote:
Where did you dig up that little gem of inaccurate info?
Show me that documentation. |
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Yeah, it's actually closer to 2% 
Bobw
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Kevin_M
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #38 on: Oct 19th, 2005, 11:00am » |
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on Oct 19th, 2005, 7:10am, don wrote:The defining differance between dependance and addiction is that addiction includes the phenomenon of craving.
Characteristics of addictiion include rationalizing and justifying. Much like CHTom does in this thread. |
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As Hdido and CHTom, he finds and prints ONLY the articles to rationalize and justify his use. As Hdido, two by the same author.
US Govt Declares War on Doctors!
« on: Jul 23rd, 2005, 3:07pm »
on Jul 23rd, 2005, 2:07pm, hdido wrote:Does this scare you? It scares me-our government is out of control (from Today's NY Times)Op-Ed Columnist
Handcuffs and Stethoscopes
By JOHN TIERNEY
Published: July 23, 2005
(story not copied)
Posted by: hdido Posted on: Jul 24th, 2005, 12:49am
I think that there is the distinct possibility that legitimate users of prescription Oxycontin and other opiates might have to switch to buying heroin if the government threatens to or arrests doctors who prescribe the stuff for chronic pain patients. To make a point clear: there is a big difference between becoming dependent upon a drug and being an addict (see the article). Any long term use of opiates will result in dependence to control pain and higher doses will be needed as time goes by, but such patients don't use the drug to get high and don't abuse it and NEED it. (the rest not copied) |
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State of Pain!
« on: Jul 19th, 2005, 1:25pm »
on Jul 19th, 2005, 12:25pm, hdido wrote:[u]This sad, scary story is from today's New York Times
Op-Ed Columnist
Punishing Pain
By JOHN TIERNEY
Published: July 19, 2005
Zephyrhills, Fla.
(story not copied)
For Further Reading:
For more information on Richard Paey's case and others like it, visit the Pain Relief Network.
Treating Doctors as Drug Dealers: The DEAs War on Prescription Painkillers (pdf) by Ronald T. Libby. Cato Institute, 28 pp., June 2005.
Next Article in Opinion (12 of 13) >Related Articles
ESSAY; Doctors Behind Bars: Treating Pain Is Now Risky Business (October 19, 2004) $
National Briefing | Washington: Pain-Pill Policy (August 12, 2004)
New Ways to Loosen Addiction's Grip (August 3, 2004) $
Pill Thefts Alter the Look of Rural Drugstores (July 6, 2004) $
Related Searches
PainDrug Abuse and TrafficCrime and CriminalsFlorida
Inside NYTimes.com |
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Posted by: CHTom Posted on: Sep 5th, 2005, 4:32am
Quote:There continues to be a number of posts concerning CH suffers becoming addicted to narcotic analgesic medication, even after being used for only a very short time. I am publishing the following statement to try to allieve concerns that CH sufferers, who may be or have been prescribed such medications, are in great danger of becoming drug addicts. I am not endorsing the use or non-use of these medications but just hope to put some sufferers' minds at ease and also to clarify, which I think that the statement does an excellent job of doing, the difference between dependence and addiction. This statement was updated in Feb. 2004. PFDANs.
Prescribing Controlled Substances for Pain |
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don
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #39 on: Oct 19th, 2005, 12:24pm » |
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Quote:| Yeah, it's actually closer to 2% |
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Show me the documentation and I certainly dont mean clusterbuster research. Show me that evidence form someone who has the credentials to make that statement.
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Pinkfloyd
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #40 on: Oct 19th, 2005, 2:39pm » |
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on Oct 19th, 2005, 12:24pm, don wrote:
Show me the documentation and I certainly dont mean clusterbuster research. Show me that evidence form someone who has the credentials to make that statement. |
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Trust me or ignore me. I couldn't care less.
Show me the evidence that its higher than 2%
(and I don't mean based upon your circle of friends)
Bobw
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don
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #41 on: Oct 19th, 2005, 3:43pm » |
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Quote:| Show me the evidence that its higher than 2% |
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I dont need to . I'm not making claims, you are. Back em up.
I've been working in the addiction field for the last 10 years and I dont know what the % is largely because it differs from population to population, geographic regions, population dynamics, etc. etc. But I can guarantee you that you can multiply your baseless % claims by at least 40. Thats not from contrived research, thats from first hand experiance.
When people come on here and throw out whatever baseless facts suit them, especially when the subject is use of narcotics, it sets a dangerous precedant for anyone seeking treatment.
So again I ask you and CHTom to back up your claims. I dont think you can.
Quote:| (and I don't mean based upon your circle of friends) |
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My circle of friends include only those with successful recovery or those that have not, nor likely will, need it.
If you think being a shroom head is all the experiance you need then you are sadly mistaken.
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| « Last Edit: Oct 19th, 2005, 3:46pm by don » |
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Pinkfloyd
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #42 on: Oct 19th, 2005, 4:18pm » |
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on Oct 19th, 2005, 3:43pm, don wrote:
I dont know what the % is largely because it differs from population to population, geographic regions, population dynamics, etc. etc. |
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Oh bull. We're talking national averages of chronic pain patients, not the number of crack addicts on the south side of Boston vs. heroin addicts in Jersey.
Population dynamics..... 
on Oct 19th, 2005, 3:43pm, don wrote:
But I can guarantee you that you can multiply your baseless % claims by at least 40. Thats not from contrived research, thats from first hand experiance.
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ROTFFL....so, you say 80% of chronic pain patients that use opiods to treat their pain, become addicted.
We finally found the author or Reefer Madness!!!
on Oct 19th, 2005, 3:43pm, don wrote:
When people come on here and throw out whatever baseless facts suit them, especially when the subject is use of narcotics, it sets a dangerous precedant for anyone seeking treatment.
. |
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It's not baseless. You just don't know the basis. That's not my fault.
You don't know the percentages but you KNOW mine are wrong.
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kimmeesue
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #43 on: Oct 19th, 2005, 4:37pm » |
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on Oct 19th, 2005, 4:18pm, Pinkfloyd wrote:
We finally found the author or Reefer Madness!!!
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I remember having to watch that in high school. I was high as a kite and thought it was hysterical.
As far as statistics go, I majored in sociology and have a history working peripherally in the field of chemical dependency. You learn early on that numbers can be manipulated. You can get them to say whatever you want.
As far as this board is concerned we shouldn't be so concerned with who is right "statistically". According to statistics I should "be" a statistic, but I'm not. We are individuals and should treat each other with respect even when we disagree. With clusters there are no absolutes. If there were they could find a way for all of us to cope.
JMHO
Kim
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Pinkfloyd
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #44 on: Oct 19th, 2005, 5:39pm » |
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on Oct 19th, 2005, 4:37pm, kimmeesue wrote:
As far as this board is concerned we shouldn't be so concerned with who is right "statistically". According to statistics I should "be" a statistic, but I'm not.
Kim |
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Very true Kim. I would hope that everyone would do their own research and apply it to their own situation before taking the advice of anyone on the internet. I could cite 100 documents that would back my point of view. My point of view and all I use to support those views, still come from a guy that goes by the name of Pinkfloyd.
Bobw
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Kevin_M
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #45 on: Oct 19th, 2005, 6:45pm » |
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a little education
Click on this link for a comprehensive seminar about pain management.
http://www.stoppain.org/for_professionals/compendium/index.asp
Click in the light blue box on Pain and Chemical Dependency. A click-a-pic slideshow will appear, but read the writing underneath and use the up/down bar to read everything under each slide. It looks objective.
Here is an excerpt:
The existing literature suggests that the risk of abuse, addiction and diversion is relatively low overall, but becomes significant among the patients referred to pain management programs. This literature should remind all clinicians that the risk of abuse, addiction and diversion cannot be eliminated. If a clinician prescribes opioids or other potentially abusable drugs, he or she will encounter the phenomenology of chemical dependency. This justifies the view that all clinicians should have some working knowledge and skills in addiction medicine, particularly as it applies to the population receiving treatment for pain.
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| « Last Edit: Oct 19th, 2005, 7:35pm by Kevin_M » |
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Pinkfloyd
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #46 on: Oct 19th, 2005, 11:25pm » |
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on Oct 19th, 2005, 6:45pm, Kevin_M wrote:
Thanks for posting this Kevin.
Dr. Portenoy is certainly one of the most respected Dr's in this area.
Bobw
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phydeaux
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #47 on: Oct 20th, 2005, 1:16am » |
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I have chronic CH, and so far my doc hasn't found the key preventative/abortative. So when the pain is extreme, I have Actiq lollipops. And when those don't cut it, I go t the ER for morphine. They prefer to give me diaudid (spelling?), but it makes me really sleepy for a few days.
I don't feel the need to pop an actiq all the time, and don't FEEL addicted. And I know that they are not the answer for my problems. Believe me, I'd rather not take them at all. It's certainly an issue when it's a bad week, like recently when I was at the ER three nights in a row. The same Dr. was there, and I get the looks like I'm a doper trying to score.
Is there a point to my rambling here? Maybe not, other than I take what I need, when I need it. Those I know who suffer the same ailment are the same. None of us take any meds we don't need, and if we could get away with it, wouldn't take any at all.
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MJ
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #48 on: Oct 20th, 2005, 2:19am » |
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I am one who falls into the nothing works category.
Some years back Narcotics were a tried treatment for me. I dont remember the dosage but it was high. I remember my wife (a nurse) saying that what I was given over time would have killed some of her patients.
The doc at that time was so convinced he could stop the pain that he kept increasing the dosage. Narcotics did nothing for my CH.
That was not a happy time in my life due to the narcotics.
Not only was I stoned all the time but the higher the dosages the worse my CH felt. The only time I felt clear headed was when I had a good K-10 going on. Following a 2 hr attack I would go back to my stupor.
My personal experience says that narcotics are the wrong treatment.
In the nothing works category the only option for me is to treat the non attack side for a quick and positive recovery from pain. Narcotics do not allow this to happen. I believe we must remain "alert" for the battles we fight.
Its all about leaving an attack behind and resuming life as quickly as possible.
It doesnt matter if its only an hours break I prefer it to be a good quality hour. (easier said than done)
MJ
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Jimmy_B.
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Re: Long-Term Prescribed Narcotic Use for Chronic
« Reply #49 on: Oct 20th, 2005, 6:28am » |
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First off...not advocating the use of Narcotics for Cluster Headaches...although I have seen chronic use of narcotics help other types of chronic pain...cluster headaches are a different type of pain altogether. The fast rise from no pain to excruciating makes taking any pills a probable failure. But for those who believe there is not a difference between dependence and addiction, read the below site(s).
http://www.pain.com/sections/pain_resources/library/abstract.cfm?ID=5512 &next_page=1&startrec=1&RecordDisplays=20&Search_phrase=addiction
Gives you a basic definition of Addiction, Dependence, & tolerance.
also
http://www.pain.com/sections/pain_resources/library/abstract.cfm?ID=795& amp;next_page=1&startrec=1&RecordDisplays=20&Search_phrase=addiction%20to%20opioids
http://www.nationalpainfoundation.org/MyTreatment/MyTreatment_Addiction_ and_Chronic_Pain.asp
http://www.painandthelaw.org/aslme_content/24-4c/24.4g.html
"In addition, while studies report drug abuse/dependence/addiction in 3 to 19 percent of chronic pain patients,28 true addiction (psychologic dependency) is uncommon with the use of long-acting opioids for chronic pain. Tolerance is also less common with the use of long-acting opioids. The most common side effect is constipation, which is best managed with a combination of laxatives and stool softeners (e.g., senna products), exercise, high-water/high-fiber diet, and avoidance of additional constipating medications (such as tricyclic antidepressants)."
28Fishbain DA, Rosomoff HL, Rosomoff RS. Drug abuse, dependence, and addiction in chronic pain patients. Clin J Pain 1992;8:77-85.
They're long reads..but give a good understanding of the differences between addiction, dependence, & tolerance. It's definitely better to become informed before using any drug for an extended period of time. Every person is different and should make up their own mind as to what helps or doesn't help their pain...
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| « Last Edit: Oct 20th, 2005, 10:06am by Jimmy_B. » |
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