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pain medication

Hello Everyone, I am new to this sort of thing, although found it very informative. I was in a auto accident which I am the only surviver out of 6 people. I now have degenerated disc disease, severe neck and back pain, and I also have arthritis. I take the fentanyl patch 100mcg every other day and if needed nucynta 100mg for pain. Does anyone know what I can take for inflamation for my arthritis? I cant take the NSAIDS like Mobic, Motrin etc etc due to I have Gerd and those drugs tear up my stomach. So is there anything out there that will not upset my Gerd and ulcers, hopefully Generic???
Also my doctor is talking about back surgery to me because I want to get off the narcotics. I know getting off Fentanyl and nucynta can cause seizures. I heard of a new way some doctors and hospitals are detoxing people off these narcotics by putting them into a comatose stage for a few days. Does anyone out there ever hear of this method? Or what is the normal procedure for detoxing off this stuff? At one particular time I was getting my fentanyl patches through a mail order pharmacy and due to some mix up I ended up without my patches for 9 days and had 2 seizures due to withdrawl. I do not want to go through that again. I know I wrote a lot here but I am new to this and really need some info from people who been there done that sort of thing. Any advice or feedback will be greatly appreciated.


  • LizLiz Posts: 7,832

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • i'm confused, when i first started with chronic pain meds 13 years ago they put me on the patch, 100 micograms, the patch is supposed to be on for 3 days and then replaced with another one they are made to be worn 3 days. how to you wear the patch every other day? that does not make sense. no doctor would have you wear a new one every other day. they do not work that way. are you sure you heard or read the directions correctly? if not, you and your doctor could have some issues. the 3 days is also the manifactures directions. i would ask your doctor to repeat the directions. 100 mics i believe is the strongest or next to the strongest strength made. you could get an overdose if you are changing the patch too soon, please look into it and ask you doctor.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • sandisandi Posts: 6,342
    edited 06/25/2014 - 6:52 AM
    Who is providing your pain medications? I hope that you are seeing a pain management doctor locally and not securing medications through an online pharmacy...
    Why are you on two long acting pain medications? Nucynta is a long acting opiate, and so is fentanyl.......but your doctor can provide you with a tapering plan to slowly reduce the dosages over a period of time.
    The overall dosage of both medications are slowly reduced, until you are at the lowest possible dose, then they are stopped.
    Fentanyl withdrawal does not cause seizures if stopped suddenly.....Nucynta, however can.
    As far as what you can take for arthritis, you also need to discuss that with your doctor. We can't make medication recommendations. With GERD and ulcers you may be limited and not able to take anti inflammatories but there are other medications that may be okay.
    As far as Rapid detox goes, there is no need to undergo rapid detox, a simple taper, for someone who is using the medications as prescribed is far easier, and gentler than putting someone into a suspended animation state and using narcan to kick all of the opiates off the receptors. Being sedated for a prolonged period of time can be dangerous and life threatening and is not something to consider doing except in extreme circumstances.
  • I don't have any conditions, ulcers etc but I was concerned about long term use of antiinflamatories for arthritis. I'm on a prescription arthritis med with a special coating that's supposed to make it much gentler on my stomach. Have a talk with your doctor & he can tell you the best one for your conditions.

    I was on fentanyl & neucynta (not together I think) many years ago. I remember changing the patches more often than the manufacturer stated...this was the old style patches & I had all kinds of problems with them. I had to stop using them in the end. It's not unheard of. The neucynta was 'as needed' not a extended release one. I'm remembering back to my 'dark ages' of spine care!

    I've titrated up & down with many medications over the years. I've stopped taking narcotics completely on a couple of occasions. (pregnancy etc) I've always followed a taper plan & I've never had any problems at all. It's very common & your doctors should be used to doing it. Those detox programs aren't necessary for chronic pain patients like us. As long as you do exactly what you're told you should be fine. ;-)
    Osteoarthritis & DDD.
  • regarding the Nucynta........based on the dosage, I believed that the dose was extended release and not the immediate release version of it. When I was on the old style fentanyl, I also was on a differnt dosing schedule than the traditional 72 hour schedule. When they changed the base and the delivery mechanism , instead of the alcohol base it was in, to the adhesive, I went back to the 72 hour dosing schedule and found it much more consistent in it's delivery.
  • I have been following the thread on Nucynta and Fentanyl. Just curious, I thought Nucynta only came in caps of either 75 or 150mg????

    ACDF 3 Level 5/28/2014
    PLIF L4/L5/S1 4/2013
  • sandisandi Posts: 6,342
    edited 06/25/2014 - 7:48 AM
    The extended release versions come in 50 mg, 100 mg, 200 mg and 250 mg versions......they are oval caplets. The maximum daily dosage is 500 mg per day.
    The immediate release version dosing is 50 mg, 75 mg and 100 mg doses. The maximum daily ongoing dosing is 600 mg per day on the immediate release. The immediate release version is tablets.
  • i take nucynta er, 150mg every 12 hours.
  • Do you find Nucynta particularly effective for you? I have a friend who was recently prescribed it for migraines & back pain. Her doctor told her that he doesn't want to start her on 'real' narcotics because of 'addiction risks'. This has completely confused me! I thought that it is a 'real' narcotic & I remember the listed side effects, particularly seizures terrified me. Can anyone shed any light on his statement for me? Does Nucynta carry less addiction risks than other medications?
    Osteoarthritis & DDD.
  • Englishgirl, yes it is effective for me, i have been on it for over a year now, along with gabapentin, and celebrex, if you read up on it, it will say it is opiate like, so i asked my pharmacist, he confirmed yes it is an opiate. as far as the seizure thing, i am sure i read about the warnings when i first started taking it, but i completely forgot about it, until reading your post. i do several things to take care of my pain issues, such as do stretches every morning, and i mean every morning, even on vacation. i also sleep with a pillow under my knees when sleeping on my back, or between my legs, when on my side. i do not sit for long periods at all, i either stand or lay, also drink plenty of water.i work a physical job, try to lift correctly, or ask for help. good luck to you.
  • Nucynta is very , very similar to Tramadol or Ultram/Ultracet in how it acts in the body. It also has anti depressant properties and interferes with the norepinephrine reuptake in a person's body. It's a synthetic opiate . Many people that use it have found that the medication lifts their moods as well and provides a sense of well being, similar to tramadol's effects in some patients.
  • To add my 2 cents............I have been on Nucynta 150 for several years first as a post op pain med, since I have big time GI problems. One of my surgeons came up with the idea of trying it as I was having trouble with most other tablet, or capsule forms of pain medication. We even tried Stadol, which is a nasal spray. Hard to find, though. Anyway, I now have my PM doc using it and getting good results with it.

    ACDF 3 Level 5/28/2014
    PLIF L4/L5/S1 4/2013
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 06/30/2014 - 12:22 PM
    Thank you guys! My only remaining question.. Is it considered to be a lower addiction risk than other narcotics? That's what my friend was told...

    I was prescribed it for a while, many years ago. At the time I had a very, very prescription happy PM. I was on so many medications at the time that I honestly can't remember which ones but my list included Nucynta, Oxycodone, fentanyl, Cymbalta, Lyrica, Savella, Gabapentin, the list goes on & on (some high doses) I bacame very sick both mentally & physically. Lost a huge amount of weight to the point that size 0 jeans were falling off of me. I was just under 5ft 9" at the time & looked anorexic! High blood pressure, palpitations my list of medical issues was nearly as long as my prescriptions. I learnt one lesson very well...when it comes to medications less is most definitely more! My fentanyl alone was a higher dose of narcotics than I'm taking now (ER & IR combined) & I was in far more pain. I was an uneducated pain patient, just desperate for some relief. This experience is why I often say, "There is no quantity of medications that will take my pain away!". We live & learn ;-)
    Osteoarthritis & DDD.
  • tran92ttran92 Posts: 183
    edited 06/30/2014 - 2:52 PM
    i've been on antiinflammatories for a bunch of years now. Also have severe GERD. usually get 8 months to a year on something and then Wham... my stomach decides to revolt, and i'm pulled off for a year or so. I've taken naprosyn, mobic (aka meloxicam), arthrotec (which has a secondary med built into the pill to reduce stomach acid), voltaren, ibuprofen, etc.

    the last med i was given, by my rheumatologist because it was supposed to be one of the least acidic NSAIDs was relafen. its an older drug, so was pretty cheap through my insuance. it worked fairly well for me for a little over a year.

    unfortunately as i usually have happen, my stomach revolted. chronic stomach pain and chest pain. so that was the end of that one, but i did get a good year on it. now i'm on Dexilant for my stomach. its a timed release of an omemprazole type med. not sure if its omeprazole, or pantoprazole, or one of the other variants. but its working pretty well.

    i'm also now on plaquenil to help reduce inflammation. its an old school anti-malarial drug sometimes used for rheumatic diseases. it works well, just have to see the eye doc more often to get checked due to possible side effects.

    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • EnglishGirlEEnglishGirl Posts: 1,825
    edited 07/01/2014 - 5:30 AM
    I'm on initinflamatories. I don't have any other conditions but I was very concerned about future stomach problems so my doc gave me Diclofenac with Misoprostol for arthritis. I've tried not taking antiinflamatories but it does make a difference & I need all the help I can get at the moment. I hate the risks that come with these meds. I really like my doc & his view is "you don't have any problems 'yet' so take the meds". I dont know if I'm over concerned or just careful...ugh!
    Osteoarthritis & DDD.
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