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Pain is worse...

aviator24aaviator24 Posts: 9
edited 06/11/2012 - 8:50 AM in Pain Medications
Hi, I have been on this forum before.
Long story short, had spine fusion surgery nearly 2 years ago. Pain was much less after recovery. Was taking 4 40MG oxy for pain still (120 a month). I could get by usually only taking 3 per day. This was down from three times what I was taking. I was slowly trying to get down to less but 3 days ago I hurt my back again, same location. Not sure what I did? It went from a pain level 2 up to a 6. Current 40 mg oxy is not giving me any relief.
I am going to my Pain Dr in a couple hours. He is great but now I am upset as I know I need to up my pain dosage! I was trying to get it down and was proud I was doing so.
Just getting the 120 40mg Oxy's filled is a chore. Most pharmacies do not carry that amount. Now I am super worried I am going to be spending all day trying to find somewhere to get my script filled as I need a stronger dose. Sorry, just venting. Anyone had any luck with a stronger pain med other than Oxy?
Thank You all. Love this site...


  • Wow, that is a lot! Anything over 200/250 mg a day of morphine equivalent is considered a "high dose" in some areas. According to University of Alberta's conversion chart, you're taking closer to 500 mg/day! (12 mg of oxycodone = 30 mg oral morphine).

    You could ask whether they could switch you to a fentanyl patch or other long-acting with oxy only as a breakthrough? But I don't think there's any way to skirt under the radar, people are going to take notice and comment at that dosage, and your doctor may have to defend the medical necessity.

    Have you asked your doctor about ways to manage the drug tolerance?

    There are several drugs out there that would reduce the number of pills you'd have to take, but since it's all based on morphine equivalent, you would not escape the issue unless the drug is more effective and you can reduce the equivalent dosage.
  • Rather than traveling to multiple pharmacies every month, select a primary pharmacy to fill that prescription. I don't take as much oxycodone as you, but the quantity and mg I'm prescribed is difficult to obtain. My doctor gives me my scripts ahead of time so I can give the pharmacy at least a week to fill my prescription.

    On a side note, according to the The Clinician's Ultimate Reference, 12mg of oxycodone is equivalent to 18 mg of oral morphine. Based on my calculator, your taking 240mg equivalent to oral morphine.

  • I was getting 120 60mg Oxys and 100 10/325 percs each month. I went down to 120 40 mg oxys and no percs. I always had many pills left over at the end of each month. I know this is a lot but without these pain meds I could not work full time and go to school full time as well as being a single parent full time.
    I do not abuse my meds and keep them locked in a safe.
    My pain Dr. has enabled me to have my life back. As far as I amm concerned, he walks on water. I have been to several and all made me feel horrible for needing these meds to function.
    And yes, I did P.T. three times.
    I am tired of trying to justify my scripts. I was just looking for a little advice...
  • No justification needed. I gave you what I thought was the best advice under the circumstances you are in. Find a pharmacy that will work with you on this. You already have the doctor. I've been doing this for 3 years now and only have had only one snafu.

  • I hope that your PM doc was able to do something for you today. Let us know what the verdict was.

    I used to be on large amounts of oxycontin, oxycodone and percocet. What helped me out, was that the prescribing doc worked in a fairly large hospital that had a pharmacy review board. This board made up of doctors and pharmacists reviewed the cases of those on higher than normal doses of narcotic pain medications. They also helped each other try to figure if there were better medication choices for some of these patients.

    At one point they recommended I be tried on Fentynal patches so I was switched over for not quite 2 months. We were unable to obtain good pain management with the patches so I went back to the oxycontin, oxycodone and percocet. We discussed trying Methadone next, but it never got to that point before I had surgery and no longer required the heavy pain meds.

    Anyway, the jist of what I'm trying to get at, is that I had no problem with getting prescriptions filled for large quantities at the hospital pharmacy. They were set up to handle large volumes of drugs, unlike many local town pharmacies.

    There are other meds that can be tried, but that's where the skill and experience of your doc comes in. Have you asked your doc if there are alternatives you can try? Most docs have their list of "favorite" meds they prefer to prescribe. Sometimes it takes a little advocacy on the part of the patient, to get the doc to venture outside the "favorite" zone.

    Best of luck and welcome back.

  • My pain dr said I should be back to normal in 3 weeks. It has been only 4 days and it still is the same pain level. He kept my script the same but added some percs for the added pain.
    I HOPE he is right, the pain is almost as bad as before my spine fusion surgery...
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