As the subject indicates eliminating my opioid pain meds is not my choice. I am not an addict or someone who has abused their meds. I follow my doctor's instructions and that where I'm having a problem.
I have chronic neck and back pain, which started to become persistent starting in 2006. I have degenerative disc disease and arthritis. I was sent to pain management where I was started on opioid pain meds. I started out taking Vicodin 7.5mg and when I left the practice due to losing my health insurance at the end of 2011, I was taking Kadian 50mg twice daily and Oxycodone 30mg 4 times a day. I was also taking Lyrica and muscle relaxers. The dosage increase was probably due to tolerance and slow worsening of my spine.
Being a Veteran, I was allowed to enroll in the VA heath care system for my medical care. Immediately, my 75 year old PCP said my opioid dosage was excessive in a very demeaning way. Another time he arrogantly asked how long I had been an addict. An MD had prescribed all my pain meds, not me. Each doctor that I saw spoke badly of opioids for pain. There was so much negativity.
In January of 2012, I had my first pain management appointment. I asked if my meds were excessive. She said yes and no, but decided that the nasty opioids should be eliminated from my daily regimen. She told me that too many Veterans have been dying in their sleep from their opioids. She quoted that I had a 6% chance of dying in my sleep. I'm pretty passive and non-confrontational and was glad that she would prescribe me anything. She prescribed Morphine SR 75mg 3 times a day and Oxycodone 5mg 4 times a day. I was given a place to reduce my dosage of Morphine by 15mg each mo.
I'm only able to be seen every 6 to 8 weeks, because of the doctor patient ratio. At my next visit, I discovered I had a new regular doctor, who was also going to follow the taper plan. I actually did OK until I started drifting below 45mg of Morphine SR. Then the pain slowly started to increase. At 30mg of Morphine SR, that seemed like the lowest I would say I could live with. Every time I explained how I was doing to my PM doctor, I was met with resistance. Especially since he discovered I'm depressed, even though I've had that since I was a teenager. He said we would control my pain with non-opioid pain meds, specifically Meloxicam, Tylenol and Capsaicin cream.
A month ago, he read my sleep study report. One bad or good thing about the VA is that all my doctors have access to my records. He wasn't the one that requested the sleep study. The Nurse Practitioner that I see at the Mental Health Clinic suggested it after I told her I didn't sleep well. I figure on account of my pain, because it's really bad when I wake up. It reported that I have severe sleep apnea and mild central sleep apnea and suggested weaning off my narcotics and other CNS depressants. Well, that just reinforced his idea that I eliminate my opioids I was instructed to eliminate taper off all opioids in 2 weeks. That's 30mg of Morphine SR and 5mg of Oxycodone 3 times a day.
I tried my best to follow his plan, not in 2 weeks, more like a month and I'm down to 15mg of Morphine once a day. I try not to take any Oxycodone, but the pain will get so bad, I give in and take 2.5mg. It's only been 2 days that I've been take one Morphine SR a day and today the pain began increasing all day to the point where it was more than I could stand and broke down and took a second Morphine SR and 2.5mg of Oxycodone.
I only want to use the opioids because the of the pain. The other stuff he has prescribed doesn't help at all. I'm also on 1,200 mg Gabapentin 3 times a day for a year and Methocarbamol. The problem is that I don't understand what's happening. I had a lot of pain back in 2006. I don't know if the severe nerve pain I'm experiencing is simply from opioid withdrawal or I have a lot of pain that's been helped by the opioids.
I should also mention that the VA will send me to an outside facility for ESI's. The last cervical ESI I had late summer helped modestly for a week. I was supposed to have 3 in a row, but was unable to get a ride for the last 2. I plan on asking him to request a new authorization as I think I can get a ride.
Any suggestions will b appreciated. I can provide more information if requested.