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Coming Off Narcotics

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Chronic Pain
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Posted 5/21/2013 11:28 PM (GMT 0)
Hello all! I am new to the CP board. I am on Healing Well's Ostomy board and have some questions about coming off narcotics.

I have had 3 major abdominal surgeries in the past 6 months. In December 2012, I had a rare emergency surgery to remove part of my colon that had twisted into my intestines and caused a blockage. After the surgery, I had complications and had to be reopened and they left the incision open due to infection. The end result was a foot long incision from my lower abs to right below my chest. I was also given a temp ostomy. After 4 months of healing, I had a 3rd surgery 3 weeks ago to correct the ostomy and also had a plastic surgeon come and close the incision that had been left open.

I have had severe pain at the incision site since the original surgery in December and have been using narcotics to help deal with the pain. I've been on opiats for close to 5 months. I am currently using Oxycodone 15 mg every 4 hrs as needed. I am ok for 4 to 5 hrs.

I would like to come off of the pain meds and I wanted to ask some general questions:

1.) How long does withdrawal last? I made it 24 hrs last night with no meds and I couldn't make it through the night. My main withdrawal symptoms were sweats, could not sleep and at some point the pain just overtook me. It was a very difficult night.

2.) Do opiats effect your perception of pain after taking them for longterm? I have severe pain at the incision site and do not understand if the pain is 'really' that bad or if the withdrawal of the opiats is tricking my mind into thinking that. I am not an expert but have read that after being dependent on opiats, the body loses the ability to cope with pain and has to be retrained after withdrawal has taken place.

I see my PM tomorrow and wanted to get a game plan in place so any advice would be appreciated.

Thanks all!
-mossmi33

Post Edited (Mossmi33) : 5/21/2013 9:16:32 PM (GMT-6)

Posted 5/22/2013 1:04 AM (GMT 0)
1. Considering you have only been on them for 5 months at a low dose, the W/D should not last past 48 hours, 72 hours maximum. It helps to drink water, get some Immodium, and anything that may help you sleep (Ambien, xanax/valium, etc, muscle relaxers, OTC). Other than that, not much else you can do. You should not go cold turkey and should talk with your doctor about going off them. He/she should ween you down slowly so the W/D aren't as bad or not there.

2. It depends. If you have chronic pain, then it will be there for a while, until you can find a way to help fix it. The W/Ds will definitely make your pain worse, but after the W/Ds are done the pain should subside. If you still feel the pain and it is that bad after getting off narcotics, then you have a problem and should get it looked at further.

Good luck.
Posted 5/22/2013 1:11 AM (GMT 0)
Thanks for the response.

I have spoken with both my PM and my surgical doctor about 'why' I am having so much pain and they cannot give me a medical answer except to say it takes everyone different amounts of time to deal with the trauma involved with surgery.
Posted 5/22/2013 3:25 AM (GMT 0)
welcome, moss

you have been through a lot. I went through Ostomy surgery myself in 2010, and ended up with an Urostomy. It was a difficult surgery, and even a more difficult recovery. It was part of the reason why I ended up with CP.

Based on my post-Ostomy surgery, you aren't that far out of surgery, and some of the pain you are still feeling very well might be related to the surgery, and not the coming off the meds.

I agree, that a short time use of something like Ambien, might help your through the process. As far as the pain meds, you would need to wean off them under the care of your doctor.

There was a lot of trauma with your type of surgery, so don't beat your self up, it will take time to really totally heal from that.

Good luck, and never give up hope, sounds like you are on a good path to eventually recovery.

david in sc
Posted 5/22/2013 3:43 AM (GMT 0)
Thanks David, It helped me to hear your story because I feel like I should be able to get over the pain and it's hard for me to give things time.

My PM has given me Adavan to help with anxiety/sleep. I haven't been using it but I now realize I'm going to need it if I plan on tapering off.

I also am the type of person that has an all or nothing mentality. I feel like it would be easier for me to stop cold turkey instead of tapering from a 15 mg dosage to a 5/10 mg dosage but I might have to do that if I can't handle the pain.

Thanks again

Post Edited (Mossmi33) : 5/21/2013 9:47:39 PM (GMT-6)

Posted 5/22/2013 4:00 AM (GMT 0)
Glad that helped.

Tapering off is far more effective than the cold turkey methods, easier on your body too, and most if not all doctors would agree with that.

Use the Adavan and see if it helps with the sleep issues, but sleep can be disturbed by unresolved pain too, so it can create a vicious circle if both sides are not being controlled.

It took me 6 months to recover from the basic Urostomy surgery, but a full year to feel better from it, and then of course, if you have a stoma, its a serious learning curve in learning to live the life of an Ostomy patient. Finding the right device/appliance, even with my wife being a nurse, it was still hard on both of us for at least a year.

Good luck ahead,

david
Posted 5/22/2013 4:36 AM (GMT 0)
Also, from what you said earlier, your WDs are not too bad. If you just have sweats at night, thats not bad. Its when you get RLS and hot/cold flashes. When you are cold then are hot on and off over and over with nausea and vomiting, you are really in WD. What you felt was probably 15% of a WD. I'm sure if you had waited another 8-12 hours you would have been fine. Just an FYI.
Posted 5/22/2013 4:40 AM (GMT 0)
Thanks, I was kicking myself in the morning because I gave in but I just have to be stronger next time. My pillow got to the point that it was soaked. I think that freaked me out and was the turning point. I had the hot/cold flashes as well. Felt like a really bad flue. No throwing up though so that's a positive.

This experience was still good for me. It showed me that I can definitely stretch my dosage a lot farther than I thought I could. Even now that I am using oxy again, I am trying to stretch the dose instead of just taking it at a time on a clock.

Post Edited (Mossmi33) : 5/21/2013 10:54:40 PM (GMT-6)

Posted 5/22/2013 7:16 PM (GMT 0)
What you can do if you struggle is to change your meds from tablet to liquid. I can't remember if there's a liquid oxycodone but there's definitely a liquid morphine which could be used for this purpose. A conversion from oxycodone to morphine is easy, it's just converting the dose. The idea is that you can drop it very very slowly and only drop the dose when you're happy you've adapted to the new one. As it's a liquid you can go as slowly as you need to.

Don't just stop taking them, it's never good for you.
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