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Discussion:
Do you take narcotic pain meds?
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For your RA? And if so, for what specifically?

This might seem like a strange question, but I am just dumbfounded.

A few years ago, I had a shoulder impingement. It was BAD. And having 3 little ones and no ability to get surgery (though I did have the cortisone shots) the orthopod I saw put me on hydrocodone and meloxicam (ibuprofen/nsaid). 5mg hydrocodone was not enough so he pushed it up to 7.5mg. The impingement gradually got better on its own and he moved me back to 5mg (4x per day as needed).

Long story short, I have essentially been taking narcotic pain relievers since 2007, minus the time I was pregnant with my daughter.

In a day and age where this is such a taboo topic, I feel a little skeevy even talking about it..... but I know that's because of the people out there who have abused these medications and the stigma these meds now carry.

Anyway, the thing with the narcotic pain relievers: THEY HELP ME!! I do not get "high" off them, I don't get dizzy/sleepy (except for maybe the first day of taking them?) They are effective for me and they work. They help me get around without feeling achy. Even though I no longer have the shoulder impingement... the "RA" makes me achy ALL THE TIME. I used to think it was fibromyalgia, but regardless, for me, these drugs WORK. They help me tremendously.

Since I no longer had a shoulder impingement, I was referred to a pain management doctor in my orthopod's practice. She has tried everything from lyrica to electrical shock/stimulation. Almost ALL of what she wants me to try freaks me out or I can't do it for one reason or another (for instance NSAIDS, apart from otc ibuprofen, don't mix well with me). This electrical stimulation... NO. I'm sorry, NO. I feel that THOSE methods are far less conservative than pain meds. But, because I live in a state where pill mills and addiction to these drugs is an epidemic, I think its caused doctors to shy away from these meds. And this doctor is like, anti-pain meds (mind you, she is pain management!!) She currently has me on a prescription of hydrocodone 5mg, up to TWICE per day. That's it. I told her it helps me more to take it 3-4 times per day. She refuses. I'd like to switch doctors, but then I worry I'd be seen as "doctor shopping?"

My rheumatologist said (at my last appointment) that she would have no problem prescribing them, but for whatever reason, FL is now not allowing her (or rheumys in general?) to prescribe narcotics??

Anyway... I guess this is a "question/vent/advice needed" ramble instead of just a flat out question. Sorry about that. Anyway, do you take pain meds for your rheum? And is it for a specific area or is it for the achiness in general?
Posted on 01/10/12, 01:00 pm
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Reply #1 - 01/10/12  1:26pm
" I personally do not take narcotics for my RA, but I have been fortunate enough not to need them. Yet. I say yet because I recognize that even though my pain is well controlled with a combination of MTX, Humira, and Celebrex, I understand that there could (and probably will) come a time when I need something else to keep things under control. At that time I will do whatever I need to do (including taking narcotics) to improve my quality of life.

This is a touchy topic - you're right about that. So many rotten apples have spoiled it for the rest of us by abusing pain meds. Doctors have been made very suspicious of anyone who appears to be "doctor shopping" and really, who can blame them? It's very easy to become jaded in a field where people malinger or outright lie to get pills. It's a very sad situation for everyone involved.

I know I didn't really answer your question. I hope you are able to get the pain relief you need. Quality of life is key. I hope your doctor is able to see that, and if not, that you can find one who can. "
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Reply #2 - 01/10/12  2:03pm
" I have them on hand just in case I do really need them and on a rare occasion when I have tried other things first and gotten no relief, I will take one then (actually, I cut them in half--if half doesn't work, then later I will take the other half). I try Naproxen, alternate heat and cold therapy, meditation, rest. Fortunately, I have been able to control my pain most of the time this way. My doctors have all told me that it is all right to take them when I need to, but I put off taking anything that strong.

I think it is an individual decision. Only you know how much pain your body can endure. "
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Reply #3 - 01/10/12  2:34pm
" I don't take narcotics - pain relief is absolutely needed, but with RA the best medication are DMARDS...I assume you are on your share of RA med too.
I guess if I had to use a narcotic, I would. I hope you feel better. "
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Reply #4 - 01/10/12  2:37pm
" Are you not taking any RA meds? RA meds should be taking care of some of the pain (the joint swelling IS so painful). I would think you would want a dmard or biologic to prevent future joint erosion and deformity.

On the hydtocodone, I take when needed. In the past year I have taken it about five times, when my shoulders (me, too!) would not work. But the Plaq and Mtx seem to be preventing the pain/swelling. "
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Reply #5 - 01/10/12  3:11pm
" I was on hydrocodone/apap 5/500 1x every 6hr and recently switched to nucynta ER 100mg (12 hr). I can usually get by with 1 nucynta a day, but I'm also dealing with daily migraines.. probably due to a bad RA neck and sinus infection. I've taken 1 dose of MTX and got sick, hopefully will start it up here again in the next few days so I can reduce or eliminate the narcotic use.

It's hard to imagine in FL they're not letting RA patients take much narcotics... especially considering the damage it can do. That's crazy, it really lowers the quality of life for a lot of pain patients in a state known for it's older population. Did your rheumy tell you that or...? I'd call another rheumy office, tell them your situation and ask them flat out.

I don't know what else to tell you. I've been very straight forward with my doctors about narcotic use. I switched doctors when I started suspecting RA because I didn't trust my current office with something serious. My new doc didn't like it, but he prescribed until I could get into rheumy, who was not a bit hesitant to prescribe and even encouraged me to go on something stronger until the MTX does it job. Currently I'm on a prednisone burst, which helps a lot. I hope you find relief soon!! "
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Reply #6 - 01/10/12  3:55pm
" I too take the vicodin. No other pain meds have helped and my new biologic hasn't started to work yet. My rheumy at first didn't like the fact that I needed them but then when he was assured I wasn't abusing them he was much more comfprtable. I try not to take them but on a bad day I I take 2 and usually thats all I need for the day. "
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Reply #7 - 01/10/12  8:58pm
" Narcotics make me so SICK, but Tramadol does help me. I take four to six Tramadol a day, and have for a year, slong with 400 mg of Celebrex, Humira and MTX. Tramadol also seems to help with my fatigue. "
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Reply #8 - 01/10/12  10:14pm
" I am not sure that the issue with narcotic pain meds is about a few people who "choose" to abuse them. The reluctance in some doctors prescribing, likely has to do with the real risk that your body/brain will become physiologically dependent on them. I would never say never to taking these meds, but appreciate that doctors prescribe these meds with caution. Narcotic meds are risky in dealing with chronic pain. "
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Reply #9 - 01/10/12  10:16pm
" I take vicodin. When I started out it was one pill every 6 hours when needed. I cut this back my self. When the RA meds work, I don't need to take any. But I'm down to almost no meds left and on Enbrel which is working about 1/3 of what it use to. Now I need the Vicodin a lot of the time. I take one half a pill every 4 hours as needed. It works best for me when I'm in awful pain to not have the jolt the first hour and nothing the last 3 hours as it wears off. It sort of works like a pain released pill this way.

I have been on the pain patch at times but it is a dangerous drug and if you aren't careful where you wear it, you can get an overdose. It releases by the heat of your body so for me the best place is the top of my shoulder where I wouldn't be sitting against anything and producing extra heat.

I do watch that I take the Vicodin with milk because it can be hard on your tummy. My RA doc has no problem writing the script for me. Without killing the pain I wouldn't have a life, be productive or enjoy living.

Now here is the REAL touchy topic...POT...and yes, I have grown it , dryed it and smoked it. It works as good as Vicodin without side effects! So there, I said it. Not only that, smoke 1/2 a joint and it holds you all night...what a shame to exclude this from people who could benefit because of addicts selling and buying it on the streets. "
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Reply #10 - 01/10/12  11:20pm
" I live in Florida and my first Rheumy gave my hydrocodone 7.5mg and it was causing me some reactions so my PCP gave me Morphine and said I could take up to 20mg every day. It is a 24 hr time released dosage and it has worked for me when I am bad. I dont take it often like I did before my meds started working, but I am alos now taking Cymbalta and that really does help me with the everyday pains and aches I have from the RA and the damage it has done. Only when I am in a bad flare will I take the Morphine too. "

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