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Pain medications????
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<blockquote data-quote="Marguerite" data-source="post: 155957" data-attributes="member: 1991"><p>OK, I'll try to keep this one shorter.</p><p></p><p>Because I've done some digging on the topic over the years, mainly to assure myself that I'm on the right track as well as to have the information I need for anxious relatives, I can assure you - if you are taking the medications correctly, to treat pain, and not taking them because you enjoy some degree of euphoria on them, then if/when you ever can stop taking them you shouldn't get craving for it. </p><p></p><p>Withdrawal symptoms don't last more than a few days, with acute withdrawal. You don't HAVE to step down. It helps if you do, it cuts withdrawal back to practically non-existent. But you're not going to have a life-threatening crisis if you suddenly decide to permanently flush all your pain medications.</p><p></p><p>The withdrawal symptoms described on websites apply mainly to addicts, who take a great deal more and who also take widely varying amounts. </p><p></p><p>And the list is:</p><p>Abdominal pain</p><p>Agitation</p><p>Diarrhoea</p><p>Dilated pupils</p><p>Goose bumps</p><p>Nausea</p><p>Runny nose</p><p>Sweating</p><p>Vomiting</p><p></p><p>The most I've had is diarrhoea, with maybe a little associated abdominal discomfort. And it makes sense - if you take opiate medication of any kind, it slows GI motility. You get constipation, developing from that point until you stop the medications (short course). But if you stay on the medications for any length of time, your body adapts. So the constipation eases and you go back towards a more normal pattern.</p><p>So it stands to reason - you've been on them for, say, a fortnight, and then stop the medications. Your body simply is reacting back the other way - diarrhoea, until it adapts back to a normal gut motility again.</p><p></p><p>I'm now on fairly high dose levels (well, it HAS been at least 12 years!) so I can begin to feel withdrawal if I'm a few hours late for my next dose. Sometimes, because the pain isn't too bad to remind me, it's the beginning of mild abdominal discomfort that reminds me I've not taken my medications for the day. No big deal. On days when I'm in less pain and I decide to take a lower dose, I get no withdrawal just from cutting back.</p><p></p><p>I think if your body has become accustomed to a stable, consistent dose, then it has been able to adapt back to a normal pattern while taking the effect of the medications into account. Addicts, on the other hand, are unlikely to be maintaining fairly stable blood levels. If they were, they wouldn't be enjoying any high from the drug. To get a high, you need to spike your blood levels much higher than your base level. And the amount you need for the high increases dramatically, with opiates because your body adapts to them so fast. But there is a big difference between getting high, and getting pain relieved.</p><p></p><p>But if, let's say, you are one of the unlucky ones who is withdrawing and experiencing a lot more of the symptoms on the list - there is good medical relief available to ease it right back. The short-term solution is to take just enough of the drug to ease the symptoms to a bearable level. This will be lower than your therapeutic dose. So as you can see, it is much easier to come of this (when taken for medical reasons only) than for addicts.</p><p></p><p>Without any psychological component to the withdrawal, most of the problems addicts have to deal with are just not an issue.</p><p></p><p>To summarise - over time, your body WILL become habituated to the drug, as it adapts to compensate for the other effects it has on your body. Also over time, the dose you need is likely to increase. But unless you find yourself chasing the drug for its euphoria (assuming you experience it) then you are not going to get addicted. The same goes for heroin - when used (as in Britain) for long-term chronic pain only, patients are able to come off it as soon as their pain is relieved. Again, they have to deal with any physical withdrawal, but there are no cravings. What is craved, is the euphoric high. Where you have no high - you have no craving.</p><p></p><p>You know the really crazy thing? The reason I am on this particular medication regime, is - it's the safest, the gentlest on my shattered system, the one which will do the least damage to my body. There is nothing else that even comes close.</p><p></p><p>Crazy, isn't it?</p><p></p><p>The pain management specialist will definitely be the way to go. They can cut through so much red tape. For us, a GP may prescribe a small amount every once in a long while, but will get into trouble if they give you any more. As soon as a pain specialist is known to be involved, suddenly doors open.</p><p></p><p>Strong recommendation though, from my bitter experience - once you're settled into a system that is working and a dose that is keeping everything well controlled, get a letter from your pain specialist to carry with you, that specifies your medication, your dosage and your diagnosis. If he includes his 24 hour contact details then kiss the ground he walks on. But it still may not be enough in a crisis - I was on holiday in an area noted for its attraction to addicts, when I became really ill. They dismissed my doctor's letter as a probably forgery and chose to not call him. They didn't give me any opiates at all (I was in more pain than usual plus I had been without morphine for 48 hours by this stage) but at least they got the other symptoms under control so I could keep my own pills down when I was finally able to take them. I suspect without the letter they wouldn't have even done that much.</p><p></p><p>However, most of the time the hospitals are really understanding. The letter is a big help there.</p><p></p><p>Seriously, Linda - once you get your pain under control you won't know yourself.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 155957, member: 1991"] OK, I'll try to keep this one shorter. Because I've done some digging on the topic over the years, mainly to assure myself that I'm on the right track as well as to have the information I need for anxious relatives, I can assure you - if you are taking the medications correctly, to treat pain, and not taking them because you enjoy some degree of euphoria on them, then if/when you ever can stop taking them you shouldn't get craving for it. Withdrawal symptoms don't last more than a few days, with acute withdrawal. You don't HAVE to step down. It helps if you do, it cuts withdrawal back to practically non-existent. But you're not going to have a life-threatening crisis if you suddenly decide to permanently flush all your pain medications. The withdrawal symptoms described on websites apply mainly to addicts, who take a great deal more and who also take widely varying amounts. And the list is: Abdominal pain Agitation Diarrhoea Dilated pupils Goose bumps Nausea Runny nose Sweating Vomiting The most I've had is diarrhoea, with maybe a little associated abdominal discomfort. And it makes sense - if you take opiate medication of any kind, it slows GI motility. You get constipation, developing from that point until you stop the medications (short course). But if you stay on the medications for any length of time, your body adapts. So the constipation eases and you go back towards a more normal pattern. So it stands to reason - you've been on them for, say, a fortnight, and then stop the medications. Your body simply is reacting back the other way - diarrhoea, until it adapts back to a normal gut motility again. I'm now on fairly high dose levels (well, it HAS been at least 12 years!) so I can begin to feel withdrawal if I'm a few hours late for my next dose. Sometimes, because the pain isn't too bad to remind me, it's the beginning of mild abdominal discomfort that reminds me I've not taken my medications for the day. No big deal. On days when I'm in less pain and I decide to take a lower dose, I get no withdrawal just from cutting back. I think if your body has become accustomed to a stable, consistent dose, then it has been able to adapt back to a normal pattern while taking the effect of the medications into account. Addicts, on the other hand, are unlikely to be maintaining fairly stable blood levels. If they were, they wouldn't be enjoying any high from the drug. To get a high, you need to spike your blood levels much higher than your base level. And the amount you need for the high increases dramatically, with opiates because your body adapts to them so fast. But there is a big difference between getting high, and getting pain relieved. But if, let's say, you are one of the unlucky ones who is withdrawing and experiencing a lot more of the symptoms on the list - there is good medical relief available to ease it right back. The short-term solution is to take just enough of the drug to ease the symptoms to a bearable level. This will be lower than your therapeutic dose. So as you can see, it is much easier to come of this (when taken for medical reasons only) than for addicts. Without any psychological component to the withdrawal, most of the problems addicts have to deal with are just not an issue. To summarise - over time, your body WILL become habituated to the drug, as it adapts to compensate for the other effects it has on your body. Also over time, the dose you need is likely to increase. But unless you find yourself chasing the drug for its euphoria (assuming you experience it) then you are not going to get addicted. The same goes for heroin - when used (as in Britain) for long-term chronic pain only, patients are able to come off it as soon as their pain is relieved. Again, they have to deal with any physical withdrawal, but there are no cravings. What is craved, is the euphoric high. Where you have no high - you have no craving. You know the really crazy thing? The reason I am on this particular medication regime, is - it's the safest, the gentlest on my shattered system, the one which will do the least damage to my body. There is nothing else that even comes close. Crazy, isn't it? The pain management specialist will definitely be the way to go. They can cut through so much red tape. For us, a GP may prescribe a small amount every once in a long while, but will get into trouble if they give you any more. As soon as a pain specialist is known to be involved, suddenly doors open. Strong recommendation though, from my bitter experience - once you're settled into a system that is working and a dose that is keeping everything well controlled, get a letter from your pain specialist to carry with you, that specifies your medication, your dosage and your diagnosis. If he includes his 24 hour contact details then kiss the ground he walks on. But it still may not be enough in a crisis - I was on holiday in an area noted for its attraction to addicts, when I became really ill. They dismissed my doctor's letter as a probably forgery and chose to not call him. They didn't give me any opiates at all (I was in more pain than usual plus I had been without morphine for 48 hours by this stage) but at least they got the other symptoms under control so I could keep my own pills down when I was finally able to take them. I suspect without the letter they wouldn't have even done that much. However, most of the time the hospitals are really understanding. The letter is a big help there. Seriously, Linda - once you get your pain under control you won't know yourself. Marg [/QUOTE]
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