Ask Me Help Desk - Percocet switch

Hi, I am new here and just had a question. I am a 27 year old male that had the unfortunate luck of blowing 5 confirmed and 1 unconfirmed discs out of my back. 2 lower, 3 in my midback and one possibly in my neck. I am prescribed to 180 percocets a month and was just wondering if asking to switch to methadone would be a wise choice? The pain is unbearable at times and I have also read that methadone is used to curb opiate addiction. So my logic in this matter would be that methadone would be the wiser choice, because it is used to wean people. Any input would be greatly appreciated.

Quote:

Originally Posted by jonathan_1980

Hi, I am new here and just had a question. I am a 27 year old male that had the unfortunate luck of blowing 5 confirmed and 1 unconfirmed discs out of my back. 2 lower, 3 in my midback and one possibly in my neck. I am prescribed to 180 percocets a month and was just wondering if asking to switch to methadone would be a wise choice? The pain is unbearable at times and I have also read that methadone is used to curb opiate addiction. So my logic in this matter would be that methadone would be the wiser choice, due to the fact that it is used to wean people. Any input would be greatly appreciated.

Hi Jonathan, you said that you have a bad back and you take 180 Percocets a month. Are you going to a pain MGMT Doctor? If so, I would talk to your Doctor and explain that the medication that you're taking is not helping and your pain is unbearable. Methadone happens to be a very good Pain med but I 'am curious why do you want to be on Methadone? Have you ever taken it before? They're a lot of good new pain medication on the market,albeit, Methadone happens to be very cheap medication! Methadone is also used to Detox Patients from Opioid/Opiate Drugs and Methadone also happens to be a Opioid and it's an agonist Medication which is different to Suboxone which is an Agonist/Antagonist Med.
My best advice, would be to discuss with your Doctor about if he/she would prescribe you Methadone. I take it for back Pain and I also take MSIR for breakthrough pain and I also Take MS Contin. Hope all works out! LI

No I don't go to pain mgmt doc. That was denied by my work comp (gotta love the ol' work comp lol). I am prescribed by my neurosurgeon. I just wanted to change because I feel like I am beginning to get addicted to the percs and was hoping that the methadone would be a wiser choice. I wasn't sure if the methadone was a stronger pain reliever, but I have read that you can be "weaned" off the methadone. Now don't get me wrong, I don't think that I will ever be taken off the pain meds due to my back. Also please don't think that I am a druggie just looking for a better high. I was just thinking that my doctor may look at me like that if I go in asking for a different med. But I would like to be on something stronger so I don't have to be on so many pills. Any thoughts on how to even approach my doctor with the issue? Thanks for any input

Addiction is less likely when you are taking the medication for real pain.

Tolerance is likely for any long-term user of pain medications.

Jonathon had some issues with my post and it's nice that Jonathon commented via PM.

Johnathon:

I too am in chronic intermittant pain and I kow first hand about addiction and tolerance and I am taking medications that are usually used for acute pain for chonic pain including Percoset and Oxycontin.

From your description You are in pain. I wanted you to knpw about the differences between addiction and tolerance. Taking pain medications for pain, won't ,in theory, get you addicted. Talking them continuously will eventually require more and more of the drug. This is not addiction. Taking pain medications for the purpose they are designed for will not lead to addiction. That's what I was try to say. I hope this clarifies things.

I would be concerned with taking Percoset because it contains Tylenol. Tylenol has been associated with liver damage and in my opinion it may not be the right medication for chronic pain. Tylenol does is an alalgesic that helps reduce inflammation which is something you need too. Vicodin is a very similar medication.

That out of the way, I'd ask for the possibility to combine some non-narcotic meds to the regimin. Two, in particular come to mind. Soma which is a muscle relaxer and Neurontin which will help deaden the nerve pain. With these, you may be able to cut back on the narcotics.

It's important to take the pain relievers early in the pain cycle, otherwise they will have a reduced effect.

Now if your doctor would agree, you can combine oxycontin with Tylenol and "ADJUST" your dosage of the particular components.

For stronger pain relief there is the Duragesic patch which requires extreme care not to cut. Lidederm is also a patch.

You can also ask if TENS therapy might be effective. Electronic pulses from electrodes tend to short-circuit pain.

Do, som research and use terms like "Duragesic physician Prescribing Information" to get some decent hits.

I'll give you a reference to TENS. Transcutaneous Electrical Nerve Stimulator - Wikipedia, the free encyclopedia

Keepitsimple, I do have REAL pain. Forgive me if that is not what you were impying. But as you say, tolerance is likely for long term users. What options do I have? Like I said I am only 27 so I have a long road ahead of me. I don't want to keep becoming tolerant of every medication that I may be put on in the future. Any suggestions? Oh, and I only take as prescribed. Sometimes I make myself suffer so I don't build up a tolerance to soon. Hope you have a good suggestion because I am at a loss. Ty

Thanks keepitsimple. I think that I may discuss some other options with my doctor. I am just afraid of looking like a drug addict. I have read forums on chronic suffers that say when they go in to there doctor informed by research that the doctor treats them like an addict. And that is one thing that I do not want to be looked on as. I understand addicts have a hard time with addiction, but they don't realize how hard they make it on people like us that rely on our doctors for relief. It almost doesn't seem fair to those of us that hurt. Ty for your input. Oh yea. Do you think that it would be wise to start a conversation with my doctor or just wait and hope that he realizes that I am in a tremedous amount of pain?

I did. Check out Vicodin, Soma, Neurontin and TENS. The latter three are not analgesics.

Yes, you do have real pain. My mom has severe degenerative arthritus of the spine.

If your supporting the back on your own, don't consider getting fitted for a corset or whatever the medical term is.

You said you were prescribed these by your neurosurgeon. Have you had surgery on these discs yet? If you have not had surgery - there are new techniques out there to relieve the ruptured discs and accompanying pain. Did he suggest surgery to help you? I don't think you should just take Percoset like that either. That is a very addictive rx in my opinion. Sometimes you can actually get into a viscous cycle of pain, take a pill, get relief, then get rebound pain even worse than before. I have 3 in my lower back, 3 in my neck, and two discs in my thorax that have been "out" for years. I take nothing rx wise now and have so for years. The pain is not from the discs but from the surrounding nerves radiating the pain into the spinal cord. I opted for no operation on any disc. The one in my neck is at C-2 and is too high up to safely operate on.

How long ago was your injury? That could also indicate your pain level.

December of 07 was the original injury date. I haven't even considered surgery. That's a road I do not want to go down unless absolutely neccasry. I was referred to pain mgmt but work comp turned it down. They were going to give me some kind of injection in my spine but that got totally denied. I can't afford to go on my own considering what work comp gives me is barely able to keep a roof over my head and diapers on my 7 month old. I am just at a total loss, sometimes I just feel like giving up. The days hardly ever get better. Wait a minute, that sounded totally selfish. I don't know how I could even think of giving up when I have a baby depending on me. Sorry about that, didn't mean to get down and out. I don't know what to do though, like I said in the previous message, I am afraid my doc will think I am an addict. But something has to give. Thanks for talking with me though. Just to have someone to talk to really helps. Thanks a bunch

Quote:

Originally Posted by jonathan_1980

Hi, I am new here and just had a question. I am a 27 year old male that had the unfortunate luck of blowing 5 confirmed and 1 unconfirmed discs out of my back. 2 lower, 3 in my midback and one possibly in my neck. I am prescribed to 180 percocets a month and was just wondering if asking to switch to methadone would be a wise choice? The pain is unbearable at times and I have also read that methadone is used to curb opiate addiction. So my logic in this matter would be that methadone would be the wiser choice, due to the fact that it is used to wean people. Any input would be greatly appreciated.

Hi J;
I also have basically the same issues... boy do I sympathise... it hurts like heck, and because you "look" normal, people forget that you are sick! I am on pain management with my doctor. I take Hydrocodone with APAP 10-500. I also take Robaxin (a muscle relaxer). I think that you should speak to your doctor, voice your concerns, be your own advocate. I also find that a neck brace works wonders, I also use a back brace. I wonder if you were denied by Worker's Comp if you have either the basis for a law suit, or maybe you can call your pharmacy and see if they are aware of any programs to help you with cost. I was out of work, and it cost me over $600.00... which was crazy! Now I know that they have some new ideas for helping people with meds. Don't ever feel like a drug addict. If you take your medication for a certain condition, prescribed by a doctor, you have every right to your meds. Doctor's don't want you to hurt either! That is what the drugs are intended for... to help. I know how hard this is... so please don't give up! It isn't easy dealing with chronic pain... but there are a lot of avenues that you can take... even online self help groups... sometimes just talking about it helps. I will keep you in my thoughts... I hope that you feel better! (gentle hug!)

Hey, you don't ASK for a medication. You don't say "Can I have X".
You so it in a way of suggesting. More like. I've done some research on back pain and I was wondering about these drugs and these treatment options.

With a little peamble like "Dr x, the medications that I have been taking for pain don't seem to allow me to function and I'm still in a lot of pain. I've.....options.

Get it.

They make the decision, they create the dosage.

Heck, I've only seen a doc twice and she suggested that I do some searching for medications in this class on the inernet.

I've gotten turned down a few times too. That's a doctor problem. Sometimes their philosophy is down right wrong. Sometimes it's very good.

Remember, "The doctor is your employee". You can generally hire and fire them.

Quote:

Originally Posted by jonathan_1980

No I dont go to pain mgmt doc. That was denied by my work comp (gotta love the ol' work comp lol). I am prescribed by my neurosurgeon. I just wanted to change because i feel like I am beginning to get addicted to the percs and was hoping that the methadone would be a wiser choice. I wasn't sure if the methadone was a stronger pain reliever, but I have read that you can be "weaned" off the methadone. Now dont get me wrong, I dont think that I will ever be taken off of the pain meds due to my back. Also please dont think that I am a druggie just looking for a better high. I was just thinking that my doctor may look at me like that if I go in asking for a different med. But I would like to be on something stronger so I dont have to be on so many pills. Any thoughts on how to even approach my doctor with the issue? Thanks for any input

Jonathan , I know very well about workers Comp, I've been on it since 1999. I hope you have a good Lawyer! You should ask Neurosurgeon to write that you need a Pain Mgmt Doctor and have your lawyer bring it up at your next WC Hearing. I see a Pain MGT Doctor,Neurologist, chiropractor and Physical therapist and all is approved by my Workers Comp so you should speak to your lawyer. So you're getting the Perc' from a Neurosurgeon... That's OK. You must be open with your doctor and if you're still have unbearable pain, YOU MUST tell the Doctor!! Your doctor is there to help you. I'd tell the doctor that you still have a lot of pain and the percocets are not helping you. You see, I don't know how long you've been taking the perc. After awhile people get a tolerance to these medications. Addiction & Tolerance are different. You will be dependent on it but it doesn't mean that you're an Drug addict! Now I don't know where you are from but they're a lot of Doctors that I call Addictaphobic or Narcophobic and do not like to write narcotics even if people need the medication, and Methadone is very stigmatized but if you find a Good pain DR you shouldn't have a problem. I believe when people are studying and go to medical school to become a doctor, they DO NOT spend much time studying how to treat chronic pain. For Instance, I'm on a very high dose of Pain medication and I am scared to death if something were to happen to me and I had to be Hospitalized. The doctors would not believe what kind of dosage I'm on, at one time, I was on 400 MGs of Methadone a day Plus Morphine Sulphate 30 mgs 4 X a day Plus I take the highest dosage of Xanax and some and other med's If I told the ER doctor that I was on 400 a day, they'd think I was crazy and wouldn't give me that dosage until they spoke to my Doctor, which could take possible a few days and I would suffer and go into WD, and even after they had spoken to my Pain DR, they still would be apprehensive at giving me my dose. In the PDR Phyician Desk Reference, the dosage for methadone I believe says 2.5 mg to 10 mg 3 times a day. If you're not opiate tolerant, 50 or 60 mgs of methadone could kill you. In the news recently , I've read a lot about methadone Deaths. I know that I am getting away from your topic but when a Teenager or anybody gets methadone on the street and they have never used it, They might try a 40 mg Discet and after 45 minutes , they won't feel it so they might take another one and then they OD and die. It takes about an hour to start to feel the effects of methadone, and it is very long acting. OK Jonathan, Back to you're problem, You wrote " Please don't think of me as a druggie" and I do not, and I understand that you might need medications the rest of your life, but you think that asking your doctor for another medication will think he/she will think that there is something wrong with asking... Well it's not at wrong at all. Most of the time It Takes different medications at first to see if it will help you. IMO, Perocets are not very strong for me but as Keepitsimple said the Percocets have a lot of Tylenol which is not good for your Liver. You might want to ask the doctor about an extended Release medication that you would either take every 8 hours or 12 hours. Some medications like that are Oxycontin, Mscontin, Opana, Durgesic(Fentyal Patch) which you keep on 72 hours, I'm not crazy about that, Dilauid, Fentenyl Lolly pops,Avinza,KADIAN® which are (Morphine Sulfate Extended-Release) I would ask your doctor about the drug Soma (Carisopridol) it's a very good musscle relaxant and it helps me sleep,I have very bad insomnia, probably because I've been on sleeping med's 18 years and when you stop taking the meds, you get a rebound effect and you cannot sleep at all. I once detoxed off because one night I couldn't sleep and I was taking my Xanax, Soma, Restoral but in the morning, I took my methadone and it kicked everything in and I kept falling so my mom took me to the ER and when I was coming to, they said that they had an inpaitent program, I figured if I didn't agree to go I would have been committed. I said I would go as long as I got my pain Meds andXanax, they told me I would but I never got my XanaX, they lied to me and I didn't sleep the whole 2 weeks I was in a inpaitent program. I wanted to get out and I told them that I was going to go back on the Xanax as soon as I left the place but they would not release me because I was on a Phenobarbital taper.They did give me my Methadone and Dilauid but they didn't give me my soma or Thorazine, which I take a very small amount at night to help me sleep. When I was there, twp people climed and jumped over the fence. If I was physically able to, I would have done that. Back to Soma, it is not a controlled substance, albeit, I think it should be.Now about pain relief, Medication is not always the answer! You can go for trigger point injection, that's very simple, they inject a lidocaine solution in the area that's Painful but doesn't last very long. Also you can go for epidural injection, and they inject a steriod type of medication which I think will give you longer relief. There are minimally invasive procedures like I had which was called a disectomy, they need to do a discogram ( a test) to cause you pain to see if it's positive so you can get the disectomy. Also someone mentioned a TEN Unit, Electrical nerve stimulater and now they implant a nerve stimulater in your body and they can adjust the setting to select different places on your body where the pain is. I've been sitting a long time already writing this and I'm in a lot of pain, So Just Talk to your Doctor and don't worry what He or she is going to think. Best Wishes Limo;)

I think that everyone has really good information... you might want to try :
CreakyJoints.org - Your Arthritis Homepage as well... it is an online group with a lot of information about different types of help... whether you are into herbal or etc... It is basically a forum for arthritis sufferers... but they delve into other questions as well.
I just thought that maybe it would help.
:-)

Quote:

Originally Posted by Inpain1

I think that everyone has really good information....you might want to try :
CreakyJoints.org - Your Arthritis Homepage as well...it is an online group with a lot of information about different types of help...whether you are into herbal or etc.... It is basically a forum for arthritis sufferers...but they delve into other questions as well.
I just thought that maybe it would help.
:-)

Hi Inpain1 This is the 3 RD time I tried to post and I lost it, so here is my last time.
On the AOL Message Boards they have some pain Boards. AOL used to have Moderaters of the boards but AOL got rid of them. There is a board called Back Medication, Treatment and procedure and this Woman Lippy used to Moderate the board, her link are Lippy

Lippy's Spine Line

Spine Links Galore

Former Community Leader, still volunteering

Back Pain: Medications, Treatments & Procedures - AOL Message Boards and the other Board, which might be empty now is

Pain Relief & Management - AOL Message Boards

There is also a Workers Comp Boards

Perhaps this might be helpful to Jonathan and inpain1

Workers' Compensation Issues - AOL Message Boards

Limeolene, thanks for the input. You know what, I am going to go to my doctor and tell him that I know my body and I know the amount of pain that I am in. I forgot to mention he is a really great guy. But I am also going to go on the point that someone made about the tylenol being bad for the liver. This is just something that I am going to have to do. I am thankful for the help that he has given me and he is very cooperative with my lawyer as far as that goes. He has put in a second request for pain mngt. The thing that kills me is I have never done drugs, and that is my main concern is to be treated like one. But I feel that if I don't ask then I will never know. So I think that is what I am going to do. One other question, I just went Apr 22. Should I try to get an earlier appointment (my next is not until May 20th) and just try to cope or should I call and try to get in. I don't want him thinking that I am eager to get powerful narcotics. What do you guys think?

Thanks to all, and if anyone has anymore advice let me know. You guys have been great.

You can ask " I would like to come in if there is a cancellation. I can usually be there within x time".

Cool deal, you have been a great help, along with everyone else. I believe that I have the confidence to go and talk to him man to man and just be honest. Whatever happens will happen. Wish me luck and I will keep you guys posted. You have all been great. And thanks to all for not calling me a "seeker" like I have seen so many others called on differnent threads. I just hope this all works out. Im hurting so bad now, I may have to go to the E.R and see if they can give me a shot of something.

It's how you ask that matters. Be sincere. Do your homework and ask questions. Don't dictate. Don't go there like a dog with your tung hanging out and you'll be fine.