What is Chronic Pain
Chronic pain becomes chronic when it persists longer than 6 months and is resistant to medical management. Millions of Americans are chronic pain patients and some exper...
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Has anybody else been put on the slippery slope of being on pain meds (narcotic type pain meds) by your GP only to have them want to take them away?
I recently had this experience with my doctor. I had just come to terms with needing pain meds after 6 months of being on them and trying to come off and then realising I needed them again etc, etc. Now my doctor, who won't even be my doctor 2 weeks from now as I will be released from the military and will have to find a civilian GP, is stating that she may want to hospitalize me for "detox". I have been having a horrible month for headache and that has flared up my other chronic issues, and I have ended up in the military version of the ER many, many times this month. I end up there when I my dosage of "at home" meds are no longer working and I need treatment. Well of course my tolerance has gone up for the ER treatment and of course they are getting sick of me being there. The other day my doctor told me that I can't keep coming for treatment. She also told me last week that she wanted hospitalize me for the migraine that wouldn't cease so that I could get treatment in a regular hospital that they could not give me at the military hospital. I never did that hospitalization for the migraine or get any other form of treatment for my migraine other than the usual I.V. narcotics. I had brought in other suggestions such as magnesium, and a letter from my neuro with his thoughts on my issues. So it wasn't like I was just going there for the I.V. treatment....I just wanted my migraine to go away. Yet the doctor says she wants to put me in a hospital for drug detox. She did also contradict herself by saying that I should "stay away" from the base hospital treatment and try taking REALLY high doses of my at home meds to equal what they give me in the military hospital. These dosages are not reasonable for me to take at home....there is not a chance I will take that high a dosage at home........NO WAY! How can she say she wants to put me in hospital for detox in one breath and then in the next tell me I should take really high doses of narcotics at home and to stay away from places that could treat me? What is going on? I never wanted to have to resort to these types of pain meds and I did take myself off of narcotics a couple of months ago but then quickly realized that I still needed them to control my pain to have ANY quality of life. AT that time, doctor said that she was never worried about me abusing drugs and that if they provide some relief I should not feel bad about needing them. I finally came to terms with all of that last month. Then this month hit and my migraines and other pain has been totally out of control and I did NOT want to just start popping high doses of pills. I wanted to get my migraine under control and get back to my "normal pain" that I know how to deal with...if that makes any sense. Now, it looks like the doctor is getting ready to totally take me off all pain meds....even though she wants me to take such high doses at this moment to keep me from going to the base clinic for treatment. My doctor put me on this slippery slope and now it appears she is going to abruptly take me off all meds and she still has not dealt with my other issues. My headache, has finally started to ease on its' own (after a MONTH) but I am still left with the after math of that on top of my chronic pain. If she takes me off all meds, what will there be left for me. I will now have to find a civilian GP and that GP will see that this other doctor has taken me off the other pain meds and I will have to start the whole cycle again from scratch. Has anybody else had to deal with a doctor doing this to them. Meaning putting them on meds and then taking them away? I know I will deal with it if I have to, but I finally was okay with myself for having to take these pain meds. Now, I don't want to say that I "want" to still be on them because that may look bad on my part but I also don't want to be pushed aside and minimized like this. I'm sorry this is so long, and I am sorry to those that read most of this in my journal already, but I just don't know what to do. I also want to add that I NEVER ran out of pain meds early and I NEVER asked for additional pain meds, or "lost" prescriptions....nothing like that. I have been very careful to only take them when I need them....but unfortunately because of my migraine this month my tolerance to I.V. stuff is through the roof...and I know my visits for that treatment are beginning to look bad...but I really needed help. (and even though my tolerance for the I.V. treatment went up, I still have not increased my "at home usage" that much....any increase was first discussed and O.K.'d with my doctor) Is there any advice out there on how I should proceed? Anything? Anybody? Posted on 11/02/07, 12:11 am |
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hi. i don't have advice, but i wanted to let you know i really feel for you. 
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I suffered from migraines for nearly 10 yrs and was NEVER given narcotics to treat it. My dr said narcotics did nothing to help migraines and caused rebound headaches instead. Oddly enough, when I ruptured a disc in my neck that required surgery, my migraines stopped and have never returned. I looked at your profile and you are taking some really strong narcotics and the rebound theory could be why you are headed for the ER more often now. You might want to post this in the migraine community to see what suggestions you get from the members there.
Good luck to you.
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Rebound depends on how often you use it. Gold standard by headache specialists is no more than 2 days a week. (And that is for any med, triptans can cause rebound too)
Your doctor is covering her ass. If she suggests detox, then she can write down in your file that you refused it. Make sure you get copies of your other neuro's notes on other things she wants to try, and have it included in your medical file over at the base. That way you have something to point to. And keep trying to get them to try the other methods. Narcotics for migraines/chronic migraine need to be an option in limited amounts, when all else is failing. But, rebound from medication isn't the only issue here. The longer your brain is caught in a cycle of nerves firing in pain, the more likely they are to become trapped in that cycle. (The harder preventatives will have to work to get you out.) Pain meds are great, but we gotta solve the issue at the same time. Plus, opiates lower the bodies natural endorphins, which mean the eventually the pain you do experience feels worse - because you have none of your own natural painkillers to fight it off.
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I don't know hwat to tell you. But I want to say we're here for you. Come and vent to us as much as you need. And good luck finding a solution.
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Before you get out of the military, be sure to check out your records and make a copy of your complete medical file, since that will not be going with you, unless you take a copy of it. In civilian hospitals, they usually give you a non-narcotic pain reliever when you go in for serious pain. It is an IV medication that they give you, but it won't be a narcotic like they do in military hospitals. Ask your doctor for the non-narcotic pain meds like ultram or methadone, and only use narcotics for short periods of time (3 or 4 days), just long enough to break the pain cycle, and then go back to the non-narcotic pain meds. Good luck to you.
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Ultram and Methadone are both narcotic pain meds. Just for everyones infromation. So for the thread starter, dont start taking those thinking they are non-narcotic and that you will have no withdrawal or anything from them, because you definately will. Ultram (tramadol) is a very weak opioid and it acts differently than most opioids, which is why it is considered to be less addictive, however people do still get dependent on it and addicted to it. Methadone on the other hand is a very strong narcotic. It does have less addictive potential than some of the other strong narcotics because it has a slow onset (no rush, which is one of the main things drug users seek). Methadone though can be very hard for some people to detox from because its detox can last so long (up to a month for the physical withdrawals, compared to a week for most other opioids), but the withdrawals are also less acute apparently. Just thought I would clear that up.
Also I hope everything works out for you WhiteRose. You seem to having a rough time. It could be rebound headaches, that is true, I would think about that possibility. I also read your profile and it says you are on the fentanyl patch. You might want to consider seeing if you could switch to a different long acting med. Something like Methadone which I mentioned before, it has done wonders for me and my headaches/migraines, and my headaches were chronic at a pain level of 7-8 ussually. The methadone also does not cause a fog or anything like that I feel very clear headed on it. There is also MScontin (Morphine Continuous release) and Oxycontin(Oxycodone Continuous release), as well as the new med Opana (Oxymorphone continuous release). It just seems like the patch is not working very well, I have read before that fentanyl is not a very effective painkiller for headaches, compared with equianalgesic doses of other pain meds. So I would definately recommend trying a different long acting med. Good luck and I hope everyone has a pain-free day, Circa
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And, hon...get an appointment with a civilian GP now - because you know it might take awhile to get in as a new patient somewhere. Two weeks might come up faster than you think. And once it is here, you'll need a GP for referrals to go see your current neuro. (Or at least that's how it works in this country for insurance)
Make sure that is in place. And make sure you have meds in place for the gap. I would suggest tapering off the meds slowly now, too - because there is the chance that a new GP will be uncomfortable prescribing such meds to a new patient. Pain is horrible enough without adding withdrawal into it. (And if they give you Ultram, don't take it within 4-6 hours of an opiate. Ultram/Tramadol is an opiate agonist, not an opiate-opiate. If you take the two at the same time, you stand a good chance of feeling really ill.)
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No ultram should be ok to take. It is not a mixed agonist/antagonist. It is a full agonist, just like morphine, diluadid, or codiene. You may be thinking of butorphanol, which is in stadol nasal spray, it is a mised agonist/antagonist, and suboxone has naloxone in it which is an antagonist. If you take either of those while you are on opioids and dependent on them, they can precipitate (cause) withdrawals to start, and they will be very severe. Ultram however should be safe, in terms of causing withdrawals.
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Please check the American Pain Foundation out, http://www.painfoundation.org/
they have some great resources!
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Thanks everyone for your replies. I was on the fentanyl patch but removed myself from it. About a two months ago I did a full self imposed Detox. My doctor wondered why. However this past month, for whatever reason, the pain had been horrible. I have been very careful not to take too many meds at home and I always tell someone when I do take something. I know at this point I have some physical dependence. I know that I will have to deal with withdrawal once again.
I was just pissed off that my doctor wanted to point such a nasty finger at me after I resisted pain meds for sooooo long and even took myself off of them. I couldn't believe she was saying I was "drug seeking" as I have never run out of meds early. Celtic was right she is probably just covering her ass because I am releasing from the military soon and she wants to look good...even though she is the one that put me on the path of the pain meds.
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