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Long Term Narcotic Use

deggeddegge Posts: 5
edited 06/11/2012 - 8:45 AM in Chronic Pain
52 yr old male with failed surgery at L4-L5 and L5-S1. I have been on narcotics for about 4 years. Mostly oxycodone (7.5mg x 4) with lyrica. I've recently been having all sorts of other aches and pains - shoulder, hips, knees, etc. I was told by a doctor brother in law that long term narcotic use will actually eventually make you more intolerant to other pains - that it is well known by pain management docs that this is an eventual drawback as well as the eventual tolerance of the narcotic.

Good news is my doc just took me off oxycodone and put me on avinza (30mg x 1 per day). This has been a fantastic drug helping my back (sleep through night now) as well as many of my aches and pains seem to be going away.

Question is, has anyone heard of this - long term narcotic use leads to intolerance of pains besides the one being treated?


  • Yes, it can happen. It is called hyperalgesia.

    But it seems the problem you're having is more tolerance, as you're being treated with another narcotic and feeling better. That's also a known issue :)
  • My doc switched me from lortab to percocett and I can tell a big difference. It's too bad they don't last longer tho.. Nothing seems to work more than about 4 hours..
  • thanks much happy. Now at least have a name for it if it occurs again.

    What happens when you've gone through all the pain meds and built tolerance to all? Can that happen. Hate to think that oxycodone is a non-starter for the rest of my life. It worked too well at first. Now, with the avinza, I fear the day that stops working.
  • Have you tried longer lasting meds like Oxycontin? My PM doc put me on that 30mg 3times per day with Norco as break through pain it seems to work pretty good. The other meds by themselves didn't last very long....just a thought.
  • Avinza is a long lasting med, it is actually once daily Morphine! I really should ask about it, I am liking the MS-contin but the 3x a day is getting me down.

    You've a long way to go before you've used up all there is ;) I think we all worry about that, as well as all of the "long term narcotic use" issues. But opiates are really the only thing there is out there for our type of pain, so that's what we use.

    If you read the wikipedia article on opiate medications, it has a blurb about hyperalgesia, I think, as well as a bit about tolerance, etc. It's a good article.

    But back to the tolerance issue, there's now a long acting version of dilaudid. I figure if I ever get there, I'll know I've REALLY become opiate tolerant ;) Right now I'm on MS-contin 15s 3x/day, it's baby meds.

  • that if you switch back and forth, your tolerance goes away. like I was on lortab for years, now on percosett and if it quits working well, she will go back to lortab.
  • that you've grown tolerant of the medication. Let's face it -- ain't any of us getting any younger. My back was feeling lots better when my shoulder started popping and really hurting. I just had to have a rotator cuff repair, debridement, and resection of my collar bone to clean that up. If it's not one thing, it's another!

    Linda (AKA Roseanne Roseannadanna)
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I have had 5 l-4- 5 surgerys i had failed scs,failed fusion 4-5 i have been on percocet since 1993 i take 3-4 a day, it still helps leg pain some lumbar pain,i am trying to get a pain pump i would like info on that where i live they do not put them in,so i would have to go to Hershey pa or pittsburg,pa Rick in ncpa
  • Backman, is Percocet the only pain medication you have been taking? I believe that doctors try long-acting medications before they install (lol, can't think of another word) a pain pump.

  • if you haven't tried the long acting medications, perhaps this is something you need to speak to your doctor about... :-C there is quite a difference between short acting and long acting medications... this is surely something you would want to try before a pump.. good luck to you and let us know what you decide with your doctor! Jenny :)
  • Indeed, the long-acting meds have been a godsend to me, quite an improvement!
  • Before my doc put me on long acting meds my meds would stop working before time for more.with my long acting I don't have that time where you're waiting for them to kick in again.Indeed a godsend!!
    Be good to yourselves,
  • I have been on perc since 93 with flexeril since09
    the pain is nerve damage from fusion nothing they can do,what are long lasting meds?ill ask the doc about them Rick
  • backman01 said:
    I have been on perc since 93 with flexeril since09
    the pain is nerve damage from fusion nothing they can do,what are long lasting meds?ill ask the doc about them Rick
    Long acting or Extended Release medications are numerous. Oxycontin, Methadone, MS-contin, Oramorph, Kadian and Avinza to name some of the oral narcotics.

    Nerve pain can also respond to anti-seizure and or anti-depressant medications.

    Going from Percocet and Flexerill to a pain pump, is like giving a 15 year old with a learners permit, the keys to a tractor-trailer with and oversized load and split-shift.

    However, your doctor is the one who best knows your case and drug situation. If you go to the web sites for any of the companies who make pain pumps, you will see their list of criteria for someone to be considered a candidate for a pain pump trial. It may help clear a few things up for you and better prepare you with questions for your doc.

  • Of all people to recommend medication, my Acupuncturist said that she feels that "Methodone is a wonderful medication". I thought that comment was odd, if not inappropriate given her qualifications. Is Methodone considered in Opioid? I know that it is used for heroin addicts to wean them off.

    I'm trying to wean off of hydrocodone/oxycodone, but like many people in this thread, I've been on it for 15 months and it barely gives me 2.5 hours of relief out of each 4 hour period. Meanwhile, my doctor wants me to reduce to 1 pill every six hours despite the fact that my pain is worse than ever.

    I was especially curious about a medication that could provide long-term relief that also helps get away from the opioid class of meds. Any more insight on Methodone?

  • It's my understanding that Methadone can be very effective, but it needs to be prescribed by a PM doctor very versed in its use, as it has a long half life and can build in the system.

    I think you need to find a new PM doctor anyway if they are trying to wean you off while your pain is getting worse. You're not having trouble weaning off of narcotics, you're having trouble weaning off of pain meds while you're still in pain. Big difference.
  • I want to thank you for your comments, especially about my doctor. He has added so much anxiety to my life because he is treating me like a first-time surgery patient who is no longer in pain. In fact, this is my third back surgery and the second one was a failed discectomy and the third is arguably a successful fusion that didn't address the root problem. Thus, I'm no better today than I was after the failed discectomy, except that I'm still healing from the fusion!

    I found an awesome PM doctor, but he only does injections and non-narcotic meds. I would be willing to commit to him to get off of all narcotics if he could help make me feel better. I don't see him again until mid-August, but I may ask him if he would take over my meds since he is doing epidural and SI injections over a period of time. I don't know if he would be willing to also help me wean off of narcotics during that period of time where I'm getting injections. It won't hurt to ask.

    Thanks again for your support!
  • Yep, me too - thank goodness for long acting or SR (slow release) stuff. I had not had more than 2-3 hours sleep then waking up, taking more and waiting for the meds to begin working again before getting another 2-3 hours. I was constantly exhausted until my doc put me on SR meds so at leastt I can get about 5-6 hours now. But to keep to the thread, I've alwasy wondered that how come when we are taking mega strong painkillers, you can still get a normal headache!? I mean, that always seems odd to me and that then 2 paracetomol will cure that headache, despite already having the worlds supply of Tramadol in my system 24/7. I wonder if that phenomena might get misinterpreted as the intolerance of pains sometimes? (not to say the condition does not exist, it does) - I mean where a pain which would be considered much "less" than the one being treated is still felt despite the presence of strong meds?
  • I have been taking Methadone for a couple of months now for pain and it helps me better than anything else I have taken. I was on oxycodone and various other meds for a few years,"failed back surgery". Now all I take is Methadone and Oxycontin for breakthrough pain. It works great for me.
  • Reformed,

    I don't understand why your doctor would want to take you off of pain medications if you're still in pain. Do you take a long-acting medication? Can you find a PM doctor that does both medications and injections? I would be upset if I were still in pain and my doctor wanted me to taper! Maybe you can ask your PCP for a referral. Sometimes it's good to ask a friend (if you know any nurses), or do a lot of research before you choose a PM doctor. I think it's good to have a PM doctor that treats pain using a lot of different things--therapy, medicine, anti-depressants, tens, etc. Just my opinion...I don't work in medicine (obviously, lol)

  • Hello,
    It is counter productive not to be taking proportionate medication when we are in pain although many aspire to be reducing the overall intake and free from the imposition of medication use, we need to be realistic with ourselves and balance desired performance with quality of life. PM here encourages the reduction of medication, never were we asked to be taking none and the strategy of taking medication by the clock, increased the dosage for some rather than reduced it. The emphasis was on taking the medication before the pain arrives and so increase the overall threshold and ease those peaks and troughs, rather than chasing the pain for some reduction.

    I have been taking medication for twenty years, we are correct in being cautious and initiate a periodic review of what we are taking, and the possibility of an alternative, in knowing that this would be a lifelong venture my doctor has tried to protect and reduce the impact of continuous medication and potential dangers. The rate of addiction is low and we have to make a clear distinction between our usage and that ascribed to us in the media, by association.

    Medication is only one element of the pain management strategy and the most effective way of managing pain it is to use a array of simultaneous concepts, none of those in isolation will be as effective when used together and we have to find out as individuals what works for us and what does not and use more of those beneficial things.

    It is questionable if in taking medication alone we could ever ease our plight overall and many reach that ceiling of functionality before any max dosage and that is no way to live or exist. Some establishments do have a policy of trying to assist patients off medication and this is sometimes a pre-requisite for any potential treatment. Getting that balance between function and adequate pain relief is a life long goal and when the pain is severe we are mandated to rest, that and time may bring some relief and even at its most simplest it is problematic in trying to compress our healthy lives into those windows of opportunity when the pain is not as severe.

    An extra pill does not always equate to increased function or one that could be quantified or replicated, they come with associated side effects, going up the volume medication route does have its pitfalls and anyone who can attempt not taking medication should be given all the support and encouragement we can muster.

    Change is never easy, even with our acceptance, practitioners do what is possible to meet our expectation of reduced if not manageable pain and we need that faith and belief when the impact of change brings associated doubts.

    Perhaps you could ask your PM why they prefer reduced medication and talk to someone who he has treated with the same strategy.

    Take care and be kind to yourself.


  • But sometimes it does. Sometimes better function can be as simple as changing meds.

    So important to have the right doctors! Because without the right doctor, you are never going to get to try the good medications.
  • You're right HBmom. A simple change in my medication (not even a big change at all) made me able to function significantly better.

  • You've been on percocet since 1993? Wow That's a long time suffering and dealing with pain.
    This bout for me is 18 months with no clear end. Had micro-surgery L4-L5 but it just changed up the pain areas?? Anyway dealing with it OK with Narco. I do hope you some how get better but ....
    C3-4-5 fusion 2005
    C-5-T-1 disk bulged
    L-4-5 bulge to the right, with Microdiscectomy, failed
    L5- Bi-Lateral bulge
    Pain in right foot -loss of feeling
    Left butt, hip and front thigh pain with bad shooting pain into inside ankle sometimes
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