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opoid resistence?

tarheelgirlttarheelgirl Posts: 473
edited 06/11/2012 - 8:47 AM in Pain Medications
Hi guys,
Someone mentioned to me regarding my recent pain increase and unability to control it with my oxycontin 60mgX 3 day plus 20mg IR oxycondone X 4 a day, that perhaps I had hit opoid resistence. I did a little research on it and I get it...I can see that it could be the issue. I also found where many people on narcotics for long periods change their regimens around every 6-12 months to keep this from happening. My doctor is on an extended vacation of 10 days and while he's been gone (get's back on the 20th) I've been taking one extra oxycontin at night when I'm woken with horrible pain and have to wait about an hour and a half for it to really kick in to go back to sleep...then a couple hours later it's time to get up with the family. I don't know about all of you, but without enough sleep, it's much harder for me to deal with the pain and it's harder for the pain meds to work. So, I've been doing some thinking about what I want to do when my doctor gets back...I will be calling him when he's been back a couple days....

He has mentioned a pain pump, but that is far out, b/c I haven't been worked up for that and all.

I've been on fentanyl patches before, but hubby didn't want me to ever use those again due to overdose potential with defective patches. Someone mentioned they no longer make the ones with the resevoir of med and the med is in the adhesive, so that problem has been elimenated? So, I think I can throw the patches back into the pot.

I was on Kadian before my current regimen of oxy...but if I went back to it, I believe I'd need the highest dose of 200mg twice a day...I was only on 100mg twice a day before.

So, I feel these are my only two options. I don't think my doctor will go for me being on oxycontin 4 times per day. The Patch is starting to sound more appealing to me. I don't know what I'm trying to get at...I know you guys can't tell me what to do. But, is there anyone who rotates regimens due to opoid resestence???

Also, of those of you on the patches...do you like them? Do you get good relief? Do you change them every 2 days or 3 days? Last time I was put on the patches, I was yanked off percocet for suspected headaches and put on the patches...well being different types of meds...I went thru a pretty hard withdrawl period! So if I go to the patch, I will insist to keep my oxycondone IR for breakthru pain and probably take it on a semi scheduled basis for a while. I don't ever want to withdraw again like that!!

Well, thanks for helping me brainstorm!

oh, one last question...how many of you on oxycontin takes it 4 times a day? I know that isn't as common as 2-3 times a day...but my 3 times a day is not covering me.


  • Many folks are afraid to answer your question as to whether or not they take Oxycontin 4 times a day. If you were to take someone's answer and use that as a basis for your own decision to go ahead and take it 4 times a day when it is not prescribed to you in that manner, it wouldn't be fair to them or fair to you. I hope that makes sense because I am having a difficult time trying to explain this.

    The only one who can advise you legally as to whether or not you can take Oxycontin 4 times a day instead of 3, is your doc.

    Are some folks opioid tolerant, absolutely. Can a drug holiday or change in meds help keep them effective as well as keep you comfortable, in my experience it can. I am on a 3 month rotation cycle for muscle relaxers in order to keep them effective. I rotate through 3 different drugs for 3 months each. So far it has really made a big difference for me.

    If your pain is to the point where you are taking an extra dose in order to sleep, I would encourage you to see another doc since yours is on vacation. Even if they don't change the dose, they can at least annotate your increased pain levels in your records for future reference.

    I use a couple of OTC meds to help me get a good night sleep. My PM doc recommended them and I find it works quite well.

    I hope that you get something resolved soon.

  • If I took extra meds without the consent of my doctor he would drop me without giving me a second chance as would most doctors who prescribe pain meds. Most of us have signed a contract as well.

    I wish you luck but careful for two reasons. 1. An overdose and 2. Getting dropped by your doctor and being labelled an addict.
  • I have been reading multiple post lately, by you regarding medications. I am curious why medications are the only thing that can be used to help aid in pain relief. It has been my experience that it takes a combination approach to help with the pain cycles. I don't expect my pain meds to take everything away, at all. I also found that using such high of pain meds also covered up some other issues on pain, that I would have normally felt and now will have to be surgically repaired. I am just suggesting that medications are one part of the plan and you have to be doing other things as well to ease the pain.
  • Tarheelgirl, I'm still concerned about your increasing your medication levels without discussing it with your doctor. I understand that you're in a bad place right now, and hurting, and just want it to stop. But I just don't think taking extra pills is the answer.

    What if he does drop you as a patient? How would you manage then? I know he said that he'd take care of you if you took extra, but I think he meant a little bit extra, not these amounts.

    And what if he just decides not to refill your meds early?

    So many ways this could backfire on you, because although you're positive he will take care of you, really that's not what he is supposed to do. He is supposed to require you to take the medications as prescribed, and could lose his license for doing anything less :(
  • I guess I'm so focused on pain medicines lately b/c mine are not working properly and my pain levels are very bad. I have tried many treatments for my pain in the past, PT, Chiro, accupuncture, tens unit, massage, trigger injections, epidural injections. I do what all of you do..I didn't expect to get jumped on for asking what you guys think. this is the last thing I need as I'm so emotional and I thought this was the one place I could come where I would be understood.

    I wasn't asking if people took oxy 4 times a day so that I could up mine, but wondering if it would be an option that I could discuss with my doctor when he gets back.

    I've never taken extra meds except this month...I've been treated for years. This is the exception for me, not the norm. And I know my doctor well enough to know that if I'm up in the middle of the night in horrible pain, he'd tell me to take an extra dose. He has been my doctor for a long time and I've never refilled early...he will not drop me for this one incident of about 6 days that I've taken an extra dose. I'm sure I'm not the only one who has taken an extra dose before.

    I'm sorry for posting my issues. I'm so hurt and disappointed...I guess there really is no one who understands me, I am alone in this journey. Thank God for my wonderful husband...he's been telling me I've been spending too much time on this site lately, but I keep saying that it's just nice to have others who are like me...he was right.

    God bless you all.
  • That's why I'm trying to make it clear that I'm worried, not judgemental. I hope your doctor does understand, but the ambien thing freaked me out. I just wish he was there to monitor things, so that the pain didn't make you do something crazy.

    Being up in the middle of the night and in pain does not always make for the best judgement. Having someone making sure you're not going overboard is good sometimes.

  • You asked for our help and everyone is giving help in the manner that they each feel they can contribute something. No one is attacking you or jumping all over you. People are definitely concerned. Don't condemn a person for trying to help you out.

    Do we see things differently from others on the forums? Certainly we do. That's just part of being human. Being willing to set aside potential differences and disagreements in order to help someone out is what Spine Health excels at.

    It's really a shame that you are going through a tough time at the moment. I know there are many here that wish you well. There are many who have risked ridicule in order to try and help you.

    We really do care, maybe too much.

    Good luck to you

  • Tarheelgirl,

    I've been reading both of these 'medication' threads and I think "C" hit it correctly. People on here (myself of course included) post replies based on what a member posts. Remember, we can't "see" emotion many times in ones words, so we can only go "on the words"... That sometimes translates into some hard answers, maybe answers we don't want to hear.

    We've all been there with something in our postings on here. It is hard I know when you're hurting or down when someone picks you up, shakes you back to reality, and it hurts. From what I've read most have posted with their hearts and knowledge, and yes like you, emotions. Please try to reread your posts and the replies....I think you will find that people care A LOT. You just need to look at it as though a third party? I hope you stick around personally. Take care. *HUGZ*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • I will only state that one-sided increases, by a patient, falls onto all of the rest of us, who use our meds, just as they are prescribed.

    When I go the get my meds refilled, I get to hear about what dumb thing someone has tried to pull on my Dr. And because he knows that I quit stuff that does not work, and we have worked on communicating for 4 years, He and I can be honest about what is going on.

    Have there been times, when I thought I needed to increase things for myself, heck yes! But I told him and then told him to wait 30 days, and let me see if I could modify things to improve how I felt about things.If I could not, we agreed to increase things as needed, no more issue about it!

    I am sincerely glad I have done this because I know that I could be on any dose that my body could stand, but I would have been out on LTD, and not working for the rest of my life, at the level of meds that I was on for periods of time.

    Whether I hurt, because I did too much in the morning, or I was pain-free for a few minutes and pulled something, the answer is never as cut and dried as I always wish to present with the written word here.

    Besides - You cannot see my smile, nor my low voice and gentle touch.

    You cannot know that I am concerned, when I see someone ONLY FOCUSED on the meds. To me - they are part of the plan, BUT THEY ARE NOT ALL THAT THE PLAN CONSISTS OF.
  • a moderator here. I have found that some members post a question asking for support fully expecting total agreememtn with what they type. The minute you disagree or give an opposing view it is viewed as an attack. The result is either an attack back or the 'poor hard done by', "I should never have posted because no one understands."

    In fact we understand all to well. We are ALL here for the same reasons. Back/neck pain and treatments.

    Tarheel, I am sorry you feel you are not getting the support you want and think you are being attacked but you posted a subject many of us deal with all the time. You come across as someone justifying abusing your medications (WHICH YOU ARE BECAUSE YOU ARE TAKING MORE THAN PRESCRIBED). You are also acting like meds are the only answer. You did not give information at the get go about other treatments you tried and only stated a justification of taking more meds than your doctor allowed and seem he/she will be OK with that. Doctors are rarely OK when a patient screws with their DEA license.

    I don't mean to come on so strong but give it a rest....don't ask a question in a forum if you can't accept the answers.

    My previous screen name was paulgla. As you are aware I have always been a huge advocate of yours. Especially when you were applying for SSDI.

    take care...............Paul
  • I don't if Tarheelgirl will be returning, and since the other thread that went down this path was closed down, I would respectfully ask that this one be closed down as well.

    I think enough has been said.

  • :( I hope she comes back.
  • My understanding of forum rules is that we are only supposed to offer information based on our personal experiences. I know everyones intention was to help but unless you have broken your contract and been dismissed or have increased a serious med like this on your own it would seem that every post here is out of line. It also hi-jacked her post by turning it into a drug abuse thread.

    Tarheel asked two specific questions. She wanted to know if anyone was on a prescribed dose 4x a day and she asked if anyone had alternated their meds to avoid opoid resistance.

    None of us know what is truly going on in her house or for that matter in anyones life. We have to take at face value what they say and offer the best advice that we can based on our experiences.

    So Tarheel here's my answer. I have been given Oxycontin on a 6 hour dosing schedule after surgery. It was only for a week and he expected me to decrease to taking it as needed(meaning I didn't wake up at night to take it) which I did after about two days. As far as rotating drugs I will be talking to my doctor tomorrow about changing my neurontin since I do not think it is effective at this point. Hope this helps and I hope you get to your doctor as soon as possible. Any chance they have someone covering who you could talk to before next week?
  • I totally agree. I miss her already.

    In my humble opinion as a newbie (compared to many on this forum), I feel that no matter how strong our convictions, we have to find a way to express them with compassion. Just to be perfectly clear, I am not directing that to any specific individual. It's just a general comment about what I feel should be a mutual aspiration for this community.

    Have a wonderful day!
  • dilaurodilauro ConnecticutPosts: 9,833
    The tone of this thread went beyond what
    tarheelgirl asked.
    We may not agree with everything that was asked, being done, and some of the responses.
    But I and my team will not allow threads to become open targets of other members
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
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