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Medications For Pain Series: Narcotic or Opiate Medication

November 26th, 2007 · 37 Comments

Updated article:  Narcotics


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37 responses so far ↓

  • Nickie // Nov 26, 2007 at 8:15 am

    I have used opioids as part of my treatment plan. Because of all of the hype surrounding them, I was really quite scared to even try them. I think they can be helpful, but for me, it’s taking a while to figure out the correct dose. We know they help me, we just have to find the correct med and dose.

    I’ve also been fortunate to not experience a lot of side effects.

  • How to Cope with Pain // Nov 26, 2007 at 9:54 am

    Thanks, Nickie for your comment. Like Nickie says, for many medications it takes a while to find the right dosage. Keep working on it!

  • Christy // Nov 26, 2007 at 10:36 pm

    Unfortunately, I look a lot more like the first pie chart than the second. Initially, that was not the case, but the only medicine that seems to make any difference is Vicodin (well, the Duragesic patches helped, but I wanted out of that). Part of it may have to do with the fact that I’ve had 9 knee surgeries so it’s a good medicine to have immediately after a surgery, but I’ve been taking it on a daily basis since 2003.

    I have no poor side effects and after taking it for so long, I can function like any normal person while on it, but the stigma that comes with it certainly sucks.

  • How to Cope with Pain // Nov 27, 2007 at 6:35 am

    If it works and you have no significant side effects, then it’s good for you. Besides pain relief, it’s important to look at if it helps you function, ,which you say is the case. Good for you!
    Many patients comment about the stigma, which is unfortunate that it comes along with a class of medication that sometimes really helps patients.

  • jeisea // Dec 1, 2007 at 6:58 pm

    I really appreciate this article as it clears up a few things for me. I took Tramel (Tramadol maybe in the US). I felt fantastic (young even) for about 6 hours. However I very quickly developed a tollerance and within weeks of first taking it my body withdrew form the drug with resultant shaking, vomiting etc for over 30 hours. In the end I felt worse than before I took the drug. I appreciate learning the difference between tollerance and addiction.

    I can not take pain meds now and consider that this is a blessing as I’ve been able to find real pain and symptom relief without the use of medications and the hell that can go with taking them. I encourage others to empower themselves by learning from websites such as yours and make informed decisions about treatment.

  • How to Cope with Pain // Dec 1, 2007 at 7:52 pm

    Yes, big difference between tolerance and addiction.
    Glad to hear this website helps a bit! Thanks.

  • bad druggy // Dec 21, 2007 at 12:34 am

    How does Jeisea cope with her pain without medicine. I have osteo arthrties in the neck. I tried the NSAI but help little. Dr gave me an Endyral patch, Morphine, Oxycontin, Methadone, and thougth hey help the pain ,the side effects are making me misarable. I am trying Oxyconting again. Does anybody there know if the side effects get better with time? I got Reglan for nausea and constipation, but what can I do about the itching and headache, and gummy groggy, tired feeling, I can’t even concentrate to read a book.

  • How to Cope with Pain // Dec 21, 2007 at 5:26 am

    You’re right… while opiates can help, they often do have significant side effects. Sometimes these side effects do lessen a bit as your body gets used to the pain.

    You might look over other posts about non-medication ways to help with pain. (You can use the search feature above to help with that.)

  • jeisea // Dec 21, 2007 at 8:46 pm

    Hi BD
    Hope you don’t mind my answering your question, “How does Jeisea cope with her pain without medicine?”

    The truth is I sometimes cope with great difficulty. The reason I can’t take medications is because I get dangerous cardiac reactions to most meds. A Vascular Physician/Cardiologist advised me never to take them, including paracetamol. This is due to dysautonia affecting my blood pressure. I had no choice but to look for alternative ways of coping and now realize that not taking medications has been a blessing.

    At first I was devastated and frightened. Faced with sink or swim, I decided to swim. I began by changing my attitude from what can be done to help me to what can I do for myself. Then I hit the internet. I looked up research. When I didn’t understand I sent emails to the researchers, and all those contacted have helped me. I wrote down what helped, eg heat packs, etc. Hooshmand’s website helped me with practical “do-able” stuff like epson salts baths.

    I discovered something Dr Lorimer Moseley had written about mirror therapy. It sounded feasible to me so I keep seeking information and research. This was about July last year. I asked my physiotherapist for help. He didn’t know anything about Moseley at the time. Also at this time, I came to the decision that the hands-on physical therapy I was having was making me have more pain. Also at the time I had been given many diagnoses of inflammation problems, eg tendonitis in many areas. I was on a downhill run.

    My new physical therapist knew about CRPS/RSD. She taught me to do whole body therapy at home. She taught me how to calm the sympathetic nervous system by activating the parasympathetic system. This reduced pain. She gave me some control. In August last year my old physio saw me in the street very excited about DR Mosely and mirror therapy. He gave me the book “Explain Pain”. I went home and worked out what I thought might work and tried using a mirror to retrain the brain.

    This is the single most effective help in pain relief I have found. However I had so much pain and all over my body that I could only do a bit at a time and an area at a time. It’s taken very hard work doing both physical therapy and mirror therapy, and more recently laser acupuncture to get me to the stage today where I am looking forward to a joyful, much less painful, Xmas. Last Xmas was very hard for me. Now I am grateful for no medications. Mirror therapy and acupuncture provided the most pain relief, but exercising yourself every day is a very important part of retraining the brain. Changing the way I feel about my pain and putting a positive spin on whatever life throws at me is how I cope.

    I hope all who read this have a blissful, joyful season. Thank you HTCwP for helping us all so very much this year.

  • How to Cope with Pain // Dec 22, 2007 at 6:58 am

    Thanks, Jeisea, for your wonderful answer! I know from Jeisea that it’s a lot of work to be in the driver’s seat of helping yourself with pain treatment. And it’s a process – don’t expect yourself to get there overnight. Thanks for sharing, Jeisea!

  • bad druggy // Dec 25, 2007 at 5:25 pm

    I want to thank How to Cope with Pain and Jeisea for their helpful information on pain. My problem with pain has led to a problem of chronic insomnia. Pain and insomnia have led to chronic depression. When I visit my doctor, he loads me up with medications, but never tries to get to the root of the problem. But I can not tolerate the stuff, especially the opiods. I’ve tried, but all I can do is take it for one or two days, and then I have to stop. Your thoughtful advise, has given me hope, and I have decided to seek other non-chemical methods of therapy to amiloreate my pain. Thanks so much. BD

  • How to Cope with Pain // Dec 27, 2007 at 3:51 pm

    I’m glad you’re seeking non-medication ways to help with pain. And you might try a pain management specialist to see if medical/medication ways might bring you some relief, as well. Often, it’s the combo that works best!

  • Suzen // Jun 22, 2008 at 8:22 am

    I have chronic pain and have tried numerous pain meds. I am on a new one called oxcycoton, not sure of spelling, anyway, I have found it helps greatly with my pain, but I itch something fierce while taking it. The itching deters me from taking it all of the time, so only when the pain is so bad, I could just vomit-that’s when I will take 1 pill. But the darn itching!!! I have Benydral but then I’m having to take 2 kinds of meds. UGH!! Is there anything to stop the itching without having to take yet another drug??? H E L P……………………….

  • How to Cope with Pain // Jun 22, 2008 at 9:36 am

    Suzen, you’re right, taking a 2nd pill to counteract side effects from a 1st pill it not fun, but if it allows you to benefit from Oxycontin, that might be worth it.

    You might ask your doctor to try another narcotic – sometimes side effects will be less with another type.

    Good luck!

  • Sara // Aug 28, 2008 at 11:27 pm

    A couple of things I wanted to mention:

    The actual percentage of people who get addicted to their pain medication is less then 1%. This has been shown in numerous studies. Most of those do have a prior addiction history.

    Also, most of the negative side effects of opiates go away with more regular usage- the exception being constipation. 🙂 That is true of any medicine, but the side effect list with anti-depressants or muscle relaxers, for example, is much longer then for my opiates. I run a support group, and I hear a lot of “Oh, I’m trying to avoid medication side effects, so I just take a lot of ibuprophen when I have pain”. After doing medication research, I ONLY take ibuprophen for fever, cycle-related pain, or pain I am pretty sure is inflammation based. I couldn’t believe how much risk there was to such a common OTC medicine. Opiates are safer then most of the other medication options for pregnancy and breastfeeding- an issue many chronic pain patients come up against at some point. Most opiates are catagory B or C- most other meds for fibro are C or D catagory.

    Also, there is a phenomenon called “psuedo-addiction” where a patient is exhibiting all the signs of an addict but in actuality inadequately treated. It’s hard to get a figure on this, but I bet it accounts for a lot of ER “frequent-fliers” and other behavior that looks like meds-seeking. People who are uninsured/underinsured and don’t have a lot of options as far as switching doctors or seeing specialists probably also fall into this group. It’s a vicious circle; places like low-income or public health clinics DO have a higher level of patients with an addiction problem, so the doctors begin to see an addict behind every corner, so legit patients go without treatment, and then maybe to deal with their untreated pain, turn to things that create addicts….

    I’ve tried almost every med out there, and my opiates are a crucial part of my treatment. I’ve found that for me, no one med is “the med”, but a combo is necessary, along with, of course, different lifestyle things I’ve found helpful. But if I had to cut down to one medicine, it would most likely be my pain meds.
    I would love to be able to control my pain with non-analegsic methods, especially because of the stigma (not only with taking opiates, but with taking medication in general- people are considered “better” if they can manage things without meds) but also because if you are in an acute crisis and already on pain meds, at least here you are often denied treatment. I was denied pain medication after gallbladder surgery; a woman I know was denied pain medication when she fractured her knee- there’s other stories I could share along these lines. You do become physically tolerant to a medication- almost any medication- that you take for a length of time (For example, I started on 25 mg. of amitryptiline and am at 250 right now) and when an acute crisis/need comes up, things need to be temporarily adjusted.
    However, my pain meds were the missing piece of the pie, so to speak, that allowed me to regain a higher functioning level as well as to try more non-medicinal methods such as exercise (I always find it amusing when someone says “Doctor, I can barely walk”, “Oh, well, then why don’t you try a half-hour a day of exercise?” It shows a big lapse in communication). I look forward to a day where I can hopefully cut down on some of my meds; but I’m less concerned with how many pills I take then with the quality of life I have.

  • How to Cope with Pain // Aug 29, 2008 at 7:43 am

    Sara, thanks for your insightful comments. It sounds like you’re a well-educated patient and an advocate for yourself.

    I think you’re right on with focusing on function, as that’s 1 of the 2 most important goals, (in addition to pain relief.)

  • Tracy // Nov 23, 2008 at 5:03 am

    I have chronic pain due to spinal fusion That did not turn out well I have neuropathy down my Left leg that goes into the left foot I do not take any pain meds at all because I am a School bus driver,But some days I find it very difficult to function Is there anything that you know of that may help me that is a non narcotic that I could take that would help with the constant pain due to nerve damage done during my surgery. I am concerned with my mental attitude some days, because I can not walk long distances or sit for long periods this makes things worse I would like to learn to cope better with the pain that I have. I would also like to know if there is any exercises I can do. at this time my exercise is limited because it makes the pain worse.

  • How to Cope with Pain // Nov 23, 2008 at 10:52 am

    Tracy, 2 series here at How to Cope with Pain which might be helpful to you are:
    1. Medications for Pain
    2. Pain Management Classes

    These are both good ways to take at look a medication and non-medication ways to decrease and cope with pain.

  • Suzzane // Dec 28, 2008 at 7:35 am

    hello. Jus wanna ask if how can we classify the effects of narcotics in our body. I mean, what are good effects and what are the bad ones?

  • How to Cope with Pain // Dec 28, 2008 at 9:22 am

    Suzzane, we generally think of pain relief as the “good” effect of narcotics, and all other effects as side effects. However, “side effects” can sometimes be put to good use. For example, the sedation that comes with narcotics is good to help people with short-term pain (eg broken bone or surgery) get extra rest and sleep to heal. If you have long-term pain, the effect of sedation isn’t good during the day, but might be helpful at night.

    Some other side effects, eg nausea, are never good.

    Hope that answers your question.

  • OA/RA- MAN // Mar 3, 2009 at 5:32 pm

    I have OA and RA. I have been taking lortab for about three years, 3 10/500 per day on average. Recently my blood work showed a high increase in liver enzymes. I am think of trying oxycodone, to eliminate the acetamitaphen in my lortab. maybe 2- 20 mg. time release doses per day.

    I function fine on my lortab, but the negative side effects to my liver are not worth the damage. Will I be able to function on hydrocodone?

  • How to Cope with Pain // Mar 3, 2009 at 5:47 pm

    I don’t prescribe narcotics, so can’t tell you exactly what the conversion would be. However, narcotics are similar, but not all the same. So you might do better with a different one, or you might do slightly worse. It may take some dose adjustment to reach one that’s good for you. But I’d agree with you that a trial of something different would be helpful. I’d suggest talking with your doctor about how to make this transition.

    There is some evidence, though controversial, that changing narcotics can reverse tolerance which usually develops with narcotics. This means that you might actually need a lower equivalent dose – and therefore fewer side effects.

  • OA/RA- MAN // Mar 4, 2009 at 2:28 am

    Thanks for the response, It’s nice to have a forum to discuss these issues with other people who can relate.

  • OA/RA- MAN // Mar 15, 2009 at 5:19 am

    Well I just wanted to give an update on my medication change over. I went from 3- 10/500 lortab per day, to 4- 10 mg instant relaese oxycodone. The oxycodone work much better at the new dose, and my liver tests have come back with much improved numbers.

    I also use 600 grams of VOLTAREN GEL per month as well. The combination of these 2 medications has been just great. I now have a handle on my arthritis for the time being, I would highly advise the use of both of these meds to anyone suffering a similar fate.

    Good luck my chronic pain companions!

  • Melissa // Oct 2, 2009 at 11:32 am

    I have to agree that I am falling into the group where the pain medication is increasing my pain and I have major side effects with very low doses, such as itching, nausea, sedation, and constipation. I have decided to forgo all the narcotics unless absolutely neccessary for actue pain. I have less chronic pain when I do not take them. I do go for epidurals which seem to help me but not for very long. My treatment does look like your second chart. I was leary of the narcotics to begin with, and was very concerned when I had tooth pain that the narcotics they had me on was not controlling. My major problem is nerve pain and muscle spasms. Md put me on low dose of 10mg oxycontin 2 times per day. Seemed to work very well except for drowsiness, but when my epidurals wore off I was in the worst pain of my life, so then they prescribe Percocet 5/325 pain and side effects significantly worse if not taken around the clock. I stopped taking in and within 3 days pain gone. I thought I was crazy.

  • Melissa // Oct 2, 2009 at 11:35 am

    Can narcotics also cause depression?

  • sparky // Oct 2, 2009 at 4:05 pm

    Unfortunately, yes. Just like other sedative medication (like benzodiazepines – Valium, Klonopin) or substances (like alcohol), opioids can cause depression.

    Of course, you have to tease out if it’s just sedation or actually depression. And if there’s depression, you have to tease out if it’s due to 1) medication, 2) the situation causing stress and depression, and 3) an underlying psychiatric disorder of depression. It can get complicated!

  • Jennifer // May 18, 2010 at 1:09 am

    I only feel normal & functional on opiates. I was on 90mg Methadone, 4-8 10/325mg Hydrocodone, 8 Tramadol 50mg each, 3 10mg Flexiril , 10 mg Valium. Now I am going cold turkey and it sucks beyond imagination. I will never go back on methadone it is the worse! However, I can’t find a dr. w/ medicare so now i don’t know what i am going to do! I want to find a hospital that is doing research on people who function better on narcotics than off.

  • oliver // Sep 8, 2010 at 6:11 pm

    Here’s my brief break down of various types of pain relief, the ‘drug’ version and the none drug ‘equivalent’, based on the effects of the drug and the none drug. Mainly for people looking for none drug alternatives, avoiding overdose or addiction / desensitisation / or minimising drug usage. It’s not complete by any means, read-up and discuss with a suitably qualified person.

    CNS depressants, narcotics, alcohol.
    None ‘drug’ versions, pain induction e.g. electrical, stamping on your foot or otherwise, stretching, bending, heat, cold, capsicum, acupuncture (doesn’t matter where they stick the pins!) etc…
    Stimulants [CNS depressants stimulate me, stimulants make me drowsy (in lowish doses)]. These also relieve pain, mental and physical.
    None ‘drug’ version, exercise, increasing metabolism.

    Disassociates: DXM (breathing suppressant), Katamine (a-typical, actually can help breathing), other veterinary not for human use, Reduce dopamine effects of narcotics, increase effect of narcotic [even below therapeutic levels], relieve pain and most notably can reset ‘false’ pain or learnt pain (both mental and physical).
    closest none drug version, distraction, concentrating and focusing on something, meditation, hypnotherapy.

    Narcotics can be cycled to reduce addiction and the de-sensitisation, this is well known to drug addicts!

    NSAI [none steroid anti-inflammatories], Asprin, Paracetamol etc…
    None drug versions, heat, increasing blood flow etc…

  • oliver // Sep 8, 2010 at 6:16 pm

    I should add, anti-histamines, reduce pain caused by histamine released as an immune response, though I’m not sure what the none-drug version is. Can cause sedation.

  • oliver // Sep 8, 2010 at 6:26 pm

    and on narcotics,
    Opoids are alkaloid base, usually given as a water soluble salt. They can turn back into base form and get absorbed by fatty tissue. Which can then be released long after the opioid has been stopped, (even years).
    Drinking cranberry juice will acidify the blood a little which should in theory keep the alkaloids in a water soluble base form [this depends on if the particular acid will oxidise the base into the salt form see Redox] and reduce the amounts that get stored in the fatty tissue.

  • Heather // Oct 22, 2010 at 9:47 am

    Hi guys. I have just recently come to relizition that I am addicted to vicodin and perocet It started when I was pregnant with my seconds child. I was having bad migraines and horrible back pain. All that was able to be prescibe was oxycodone for the pain. So that started April 2009 so i’ve been abusing since then. Then baby was born fine in October 28th 2009 with no adiction. I mean I had migraines everyday. The addiction got worse and worse as the back pain got worse an worse. No doctor wanted to figure out what was wrong with me so I was being thrown scripts for percs, vics, darvocet and muscle relaxers atleast twice a week. Mind you I pay a copayment of 40 for a specialist so I pay these doctors good money!! So I went to a walk in clinic with my husband carrying me in because my whole left was numb due to my sciatic and I was in extreme pain. They did an xray just to make sure there wad nothing else wrong or pinched. Well the doc comes in says in fine and gives me a muscle relaxers. I begged for narcos. She gave in. I went back a week later with the same problem. The doc comes in and says ” didn’t she tell you have something seriosuly wrong with your back and you need to get to an orthodopetic asap” I was dumbfounded. She had wrote it down, but never told me anything. I was so angry. So come to find out I had spondlothesis (sp?) spinal arthrithis and 2 bulging disks. So I went to an ortho. He was doing he same throwing me scripts. So I started pain mangement. I’ve gotten a series of 2 epidural injections. They haven’t done much. I have one left for the year. I’ll be getting that one soon. They also give me scripts for vicodin. I get 60 for 2 weeks but those only last me 5 days!! I’m on an aveage of 12 aday. Yesterday I saw my psych and I ask him about suboxine. So my main question here is anyone on subxone and what are the requirembt of getting on?? I go for an intake appt text Tuesday. But I’m just scare of getting turned down then it’s like I’m still on this road of vicodin and percocet addiction. Sorry I rambled I just wanted to share!!

  • How to Cope with Pain // Oct 22, 2010 at 12:51 pm

    Heather, for your health, you definitely should discuss the medication addiction with your doctor. To be able to prescribe Suboxone, doctors go through special training. If your current doctor doesn’t prescribe that treatment, he/she should be able to refer you to someone who can.

  • Angie // Mar 28, 2011 at 1:27 am

    Please Help! I have extreme “super-orbital” nerve migranes and have another month before my surgery to correct this debilitating condition. I have been living with this for almost five years now and have tried everything from new pillows, new mattress, physical therapy, chiropractic, etc… I am now in the care of a pain management specialist who has perscribed me Lyrica…which helps spread the frequency of the migranes; however, does not eleviate them once they stike. I have done everything short of begging for some relief when this happens and nothing seems to work. The doctor tried Oxycodone, but that did absolutely nothing and I ended up in the ER once again requiring a “cocktail” of medications just to be able to function. Does anyone know of an immediate pain reliever for nerve migranes that will keep me out of the ER until my surgery? Thank you in advance for your help! Sincerest Regards, Angie

  • Ted // Jul 7, 2011 at 7:21 pm

    I been itching all over for about 7 monts now , I notesed no body has any cure for it , or even talk about it, Mayo cleanick put me on gabapentin, it helps a little but still now and then it kicks in bad, I have done every test there is , I’m beeing treated for MRSA at the present is it in my blood ? nothing out side, and also my doctor says once we gat red of MRSA the itcing will go away as well, what is your input on it ?
    thank you Ted K

  • stuart // Aug 9, 2011 at 11:16 pm

    i dont know what else to say my trssures lie in heaven not here however while im here and spent all my money to diagnois disc budging and desease and have all my reports why cant some dr, help me for free, my mom did chariyty for childrens hospital and was in daghters of the nile queen and now im left broke and was on pain pills 3 years and all i want is a dr. to charity me.

  • Jaunita Guedea // Jul 26, 2012 at 11:20 pm

    This informative post was ideal for the “instructions” I was seeking.

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