Hello Confused

All these thoufghts are tormenting you and I am sorry for the emotional upheaval. I don't know whether or not you are an addict. There are some addictive behaviors showing.... self-medicating, misusing prescribed meds, crossing lines that should not be crossed.

I recognize these things because I am also a chronic pain patient who has displayed the same behaviours. I took it a step farther and crossed the line into using pain meds for emotional as well relief and that is where I probably crossed into addiction fully.

I think as chronic pain patients, we are always in danger of addiction. I believe that part of it comes because after long term use, we become unable to deal with any degree of pain. That was sure true of me. I reached the point where I was taking pain pills by the clock, not by the pain. This happened early on. It was so easy to just pop a pill and not take the time to use resources like heat, cold, massage and rest. It was so easy to anticipate pain and try to prevent it with the pills. I pushed my body to perform by disguising the pain, hiding it, stuffing down my body's signals to take time out when my brain said "You have to go to work."

Well, that worked for a long time.. quite a number of years. I worked and caused more and more damage to my injured leg because I pushed way beyond the limits of what my condition was by disguising all the symptoms I could. I worked. And eventually that was all I did. Work. I used pain meds during work to keep functioning and after work, I took to my bed and used pills to escape the physical and emotional pain it was causing me to live like this. ANd I continued to ignore the signs of my falling into addiction.

Two years ago, it all came to a screeching halt. I was experiencing excruciating pain physically and emotionally. And the dam broke when I fell into a total breakdown physically, emotionally and spiritually. Total eclipse of the mind, body and soul. I couldn't work anymore. Actially, I could not function anymore period. My fight with pain turned into a fight for my life.

I couldn't hide from my use, misuse, abuse and addctive behaviours anymore. I was self-medicating beyond reason. I went to my doctor (family) in a sobbing mess and spilled the guts. We developed together a plan to taper down from Oxycodone and then from Xanax. It took me nearly a year to accomplish. And during that time, I discovered that my life was much more than just working and hiding.

I did have to retire. And today I am on Disability. It sure was not the plan I had for my life, but it is what life brought to me. I have learned to deal with life on Life's terms.


I am happy today. Poor, but happy. Smiles. I do not use opaites or benzos anymore for pain relief. I use rest and ice and heating pads and sometimes Aspirin. I can think straight again and I am calm. I am participaing in Life again at a much slower pace that my condition demands.. at Life's pace for me. I am no longer licving a life of torment and angst.

So, there are no covert messages here for you. Just a sharing from another Chronic Pain Patient, my own story.

I am hoping the best for you in whatever your own story is meant to be.

With all good wishes and hope
reach

My pain became much worse over a year ago when I had an interaction between two meds - before that I was on a constant dose of oxy that worked exceptionally well. I actually felt close to "normal." I had a different PM then in a different city - he told me he understood the interaction but I later learned that he did not understand it. When I talked about my increased pain from the interaction [my understanding from reading med. jounrals is that is raised my dose by 10-15x - I had mini-withdrawals as the med left my body for close to two months [it had a very long half-life]. This is really when the pain problems got terribly out of control. Since that time, I have struggled a lot with pain and with work. I'm not sure how much I'm going to be able to type right now b/c my pain level is pretty high - it could be the withdrawal or it could be going down on the meds - really no way of telling right now except that the pain is only in the area that I usually have it - I don't know if that means it's w/d pain or not.

I have tried oxycodone, which, as I said worked well before I had an interaction. After my accident I was able to control the pain with relatively low doses of oxy - I'm pretty afraid of surgery again since my pain went way up after my fusion, which was to stabilize my spine and [the doctor did not tell me this] apparently to treat my pain as well. I needed a much higher dose of meds after the surgery. I know the fusion is putting pressure on the discs below - I did not know [tho I knew I had a lot of back pain before my accident] that I had degenerative disc disease in my c-spine until they did MRI's and cat-scans when I had my accident.

I really do not believe I have become addicted but I understand I was not thinking responsibly or about the possible long term effects of my actions on myself or others when I took my meds into my own hands. I was thinking about money problems and the need to perform at work so that I do not lose my job and have a financial crisis [I already have a financial crisis with my debt]. The pace has been relentless and I have worked 12+ hr days since I returned. I have felt like I was fighting for my survival. I think this is my explanation for what happened tho not an excuse. The PM has recognized this and has been very respectful of my financial constraints as well as the pressure on me to perform. Lack of money and no time off [tho I have essentially taken the last month off w/o permission since I have not been in any condition to work] is one of the reasons we haven't changed any meds or tried anything really different. The hope is that if I can just get through this period at work - which lasts roughly thru the fall, I may have more flexibility afterwards.

The in my PM,considering the contract i signed when i started there and my past addiction issues,i would most likely be terminated if i decided to change my own Rxing schedule. its just not acceptable in the PM world to even go there,which i know you do realize now,but you had to have a clue that this was not the norm in what you decided to do back then either ya know?

My new PM was quite relaxed and I didn't actually sign a contract. I have had one urine test and no pill counts since I started PM two years ago. But he does have a contract now and pill counts and UA's. This means I am actually short two patches, which is serious problem since we now need to bring unused meds to each appt. This wasn't in effect [tho of course I knew that wasn't something I should do, when I used extra patches. And, of course, my greatest fear is that I will be terminated and blacklisted. I definitely had a clue and have tried to do everything by the book up until now. I don't think I would have crossed the line w/o all the pressure but I am definitely not trying to excuse what I did - explain it would be more accurate.

Not until this month did he implement pill counts, a contract and UAs. But, of course, I understood those were the terms and that I needed to abide by them. May I ask why you are under a bit more scrutiny?

i am under a bit more scrutiny and have no problem if my clinic calls me up and asks me to bring my meds in for a count or ask me to pee in a cup within the next 24 hours. this just is part of the program in most PMs. over the past four yaers since i started there,i have never gone out of my PMs guidelines with out being okayed there first for whatever reason. i just have that responsibility to my PM and his other patients if i should decide to create my own dosing schedule. hon,this IS why those rules are in place to begin with,so peole do not do what you decided to do and end up where you are right now. whether you were in just alot of pain or whatever the reason,a phone call should have been made to your PM at that point and a plan discussed as to how to go about getting better relief. that is where you made the bigger mistake.

I really was honest w/ my PM about my pain problems and I think he was trying to address them. But he didn't have much room to manevuer with my financial and work stituation. When he upped my morphine dose by a very small amt., I felt kind of hopeless b/c I knew morphine wasn't making a big diff. for me and that a small increase wasn't going to make any difference. I could not even "feel" the difference with a patch increase.

I would much rather be approaching my pain from a multi-disciplinary approach - my insurance company will only pay for the meds. I have a huge deductible to do anything else. In addition, there has been *no* time as I have been working constantly.

I think I'm going to have to finish this later b/c my pain is really getting to me and I have some mild nausea as well right now. This is day two of my 2nd [small] taper and I suspect things are just going to be worse tomorrow, but we'll see. I am trying to at least stop using any old used patches tho I am still way way out of bounds on the amt. of meds I am taking since I am leaving the new patches on for a week. I have to be at more than double my correct dose. I am kind of hoping that the patches just don't give anymore after 5 days but I really don't know. The fact that I now have to come up with two patches I don't have is going to make this a lot more difficult. I was at least trying get on a stable dose so that my body is not constantly adjusting to different amounts of medication and so that I am not using old patches with absolutely no clue as to the amount in them. So, thank you very much for responding. I'll be back on tomorrow and respond more, provided I am doing well enough to sit at the computer. I expect tomorrow to be tougher. I am now wearing only one used 50 mcg patch [in addition to all the new ones I have left on]. For myself at this point, I really want to stop using the used patches which is why I am doing this taper. After that, I need to assess the situation again, especially given the fact that I am short two patches from last month [not this month - honestly, it depends on how far back he is counting - I may be short a lot more.] Good night and happy 4th...thanks again.

there is just a reason,many reasons why,espescially fent is not up to the patient to decide how to dose,and you are finding that out right now unfortuently the hardest way possible. knowing just what other methods,meds,modalities you have actually tried would help alot in seeing the whole picture here. and the possibility of a surgical intervention that could at the very least,lower your actual pain to some degree. for me, i am never ever pain free or in some areas,very intolerable levels are there that my brain has thankfully started to kind of accomodate since my original spinal cord injury created not only RSD but another nasty pain syndrome called central pain. its an actul compenasory thing that your brain does when you experience something 'noxious' that is continuous and non stop 24/7. but my other pain is very wide spread from many different injuries and a kidney liver disease that is creating huge ass kidneys for me an adding to my already severe c spine pain. this is what my oxycontin responds to the best. six surgeries later,things are still not good,but the ones i have had have also helped reduce at least some of the intensity of them. i am just wondering about that herniated disc and how much a possible surgery could realistically help you.

Sorry, read some more and your injuries/disease is far more extensive than what I am dealing with.....As far as surgery, I know a surgeon might promise that by fusing another level [which would reduce my mobility substantially] and perhaps by dealing with some of the herniated discs, I might get better, but I am really wary of the cost and the possibility for even greater pain from surgery. I really do not want another surgery nor do I have any idea how I could afford it given my current levels of debt. Ok, *now* I am going to bed...It's quite late!

One last comment, I really was upfront about the pain...it's just that he is a new PM for me and I am already on high doses and he has to work within constraints that most docs. don't have because of my work and financial situation. In a way, his hands were a bit tied.

when i really started looking for bettter ways to manage my pain using therepies and other modalities,i didn;t feel so afraid of the next pain flare since i do now have many other options to try before ever going to the only two alloted BT meds i have during the day. simply trying to manage very severe pain only using narcotics really does not work for most peoples pain. its a combination of things that really gives you the best coverage and management. instead of having to keep raising your intake or the strength of the narcotics,it helps alot to reduce the level of tolerance too. narcotics are simply another adjunct to manage pain. part of your pain plan and should never be totally relied upon for total pain control. it just creates alot of problems that would not be there if other methods were also being used. one BIG problem with fent is that delivery system that cannot be altered or cut in half or taken as needed,its a whole nother ballgame that just come with its own types of problems,that are just not really there as much with most other meds.even the LA narcotics.