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Weaning off oxycodone-need advice

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Posted 4/8/2015 4:10 PM (GMT 0)
Hi everyone,

It's been awhile since I posted. I was in a terrible car accident on Dec 2013, a little over a year ago. Broke my back, crushed my heel bone, broke 3 toes, broke leg, broke knee and broke nose. I have been on 10/325 oxycodone for the whole time. My pcp wants to wean me off the pain med cause he said that I can't be on them for the rest of my life. He said we would do it very slowly. I have been on 7.5 for 5 days now. I hurt a lot more and I have been waking up at night hurting.(I never did that before the lower dose). My question is this: is my body withdrawing because of the lower dose? And if anybody else has been in this situation, do you still hurt when you get off the pain meds? I got off them once by myself about six months ago for 3 weeks and I continued to hurt so I got back on them. I am so scared of hurting. I am also on Celabrex and Gabapentin. I would welcome any advice.

Jodi
Posted 4/8/2015 4:30 PM (GMT 0)
Hey Jodi...Firstly, I'm no medical professional.  I am a student of life with a PhD (pain has debilitated).  I can only offer my experience with Oxycodone.

I enrolled in PM in January 2014 for a multitude of health issues that cause constant pain.  I am 14 months into this chaos, with no solution yet.  I have GI issues that preclude PM trials.  I have mal-absorption issues due to a surgically altered stomach.

Oxycodone was the 3rd medication that I tried.  I had ALL of the extreme SEs due to being "opiate naive".  It caused the lesser GI issues, so I was hopeful. However, I found that this med caused extreme rebound pain like I had never experienced.  I prefer the stimulant vs. sedative type of meds I've done trials with.  

I cannot function if my mind is blurred, and thinking impaired.  I had hoped it would relieve my pain and allow me to be productive again in my life. It may have done so, but the IR form could not keep serum levels steady.  I had too many ups and downs, as well as (I felt) an increase of pain when it left my system.  I stopped the 15 mg 3xday, as I started the Fentanyl patch trial in February of this year.

BTW...I've weaned off the patch, too, after agonizing through 6 weeks of major SEs, sedation with no relief.  I'm unsure where I go from here.

Your doctor should be your guide in weaning off any opiate IMO. I just wanted to let you know that I understand your need for pain control, but perhaps an ER would provide a more steady relief.

Dixie

 

Posted 4/9/2015 1:55 AM (GMT 0)
I understand being scared of pain. Maybe ask your doctor to go slower and/or switch you to Hydro of some type. It's less strong than oxy but still works.

I think it's your right to disagree with your doctor's plan if it is to eliminate all opiate use.

Often doctors are more receptive to long term use if you pursue other avenues of pain relief, such as acupuncture, massage.

Your car accident sounds horrible.

I have a lot of fear of pain too.
Posted 4/9/2015 5:24 AM (GMT 0)
Dear Jodi,
I'm sorry you are having to go through this! I, too, was involved in a serious MVA (back in 08) which involved many surgeries and almost an amputation of my foot which they ended up reattaching. I did not stay on oxy as long as you have. They backed me down pretty quickly, and truthfully, I think it was to my advantage. I still take an occasional pill PRN, but they are much more effective when it is a rare occasion. I hope you can wean very slowly if you do continue to go off. I know your body is used to it, and it is not the easiest drug to come off of. I would let your doctor know it is giving you trouble - maybe you can go back and forth between dosage for a while until you are able to handle the 7.5 all the time. I don't know when your worst times are, but you might ask if you can take the 10 during that time and 7.5 the rest of the time. Of course I am not a medical professional, but I have had the experience of being the patient. I also recommend adding the non-medical treatments. I really like acupuncture and massage (I used to be a licensed massage therapist). I also recommend breathing techniques and meditation to help you relax your muscles. I'm so sorry you were in the accident and that you are suffering so! Prayers for you and I hope you are able to find a good solution to coming off the medication! Cindy
Posted 4/9/2015 7:08 AM (GMT 0)
Sorry your having a difficult time and first if you are not satisfied with the Dr's decision and your still having a great deal of pain lowering your dose just remember that you can find another Dr. Your body took a beating that likely left permanent issues and you CAN be on them forever if you are in pain forever, thus why we are all here and why chronic pain is a acceptable diagnosis that requires the use of opiate treatment long-term. I do support trying to get down and off if only temporarily to get a adequate take on your actual pain levels med free but if it's still debilitating don't allow yourself to suffer just on the basis of one Dr's opinion. By the way what kind of Dr are we talking about here?

Withdrawal can and almost always does cause rebound pain and even going slowly can cause aches and pains in muscles and joints and adding a non narcotic med may help some but there's several prescription drugs available for helping alleviate the discomfort and talk to your Dr if you start feeling lousy. IIt's important to stay hydrated, eat healthy, exercise and use diversion techniques, something you enjoy like music, reading, puzzles, also lot's of warm baths are great.

Good luck and keep us updated and I will watch for more information from you.
Posted 4/9/2015 1:49 PM (GMT 0)
When you stop amy opiate after being on it for an extended time period, you are most likely going to experience some "rebound" pain.
Think of it this way, your body has become used to having a regular level of opiates in your system. Your body will attempt to get you to give it what it has become accustomed to, which is the amount of oxycodonr that you have been on, so your brain will interpret those attempts as "pain"....Your doctor only decreased your dose by 2.5 mg, which is the next lowest dose. Your body should only be experiencing minimal withdrawal symptoms, if any, and will quickly adapt to the lower dose, after three days or so. You may continue to experience what feels like increased pain because your body will attempt to convince you to take the old dose, but you can manage the increased pain in other ways, ice,heat, topical pain relief creams, stretching, even Epsom salt baths can all ease the pain. Motrin ,advil, naproxen can all be great help in handling increased pain, when taken in between doses as you reduce the oxycodone.
Posted 4/9/2015 7:22 PM (GMT 0)
Thank ya''ll SO very much for the replies. Your advice has really helped me. Day 6 of being on the lower dose and its better but I still hurt. I think I do want to see if I can do without the oxycodone. I need to have a sub talor fusion and the surgeon said that it would be hard to control my pain because I was already on pain meds. BUT if I can't stand it, I guess I will have to go to pm, because my PCP does not like to write narcotics because of all these new regulations.


Jodi

P.S. what are the dosages of oxycodone?
Posted 4/10/2015 3:37 AM (GMT 0)
Jodi, your surgeon is correct about controlling your post op pain. We have had several members that had surgery & because of the prior meds they were on before surgery they had a very difficult time with the post op pain. The surgeons are not comfortable writing scripts for strong narcotics. This results in a patient possibly having to deal with a lot of extra pain.

Good luck on your pending surgery.
Posted 4/13/2015 1:01 AM (GMT 0)
You shouldn't notice a significant difference in your pain between the 10mg and 7.5mg dosages. You should only notice a small decrease in the effectiveness of the medication, but over time, it should work just as well as the 10mg did. However, I have to start with your trial without the medication for 3 weeks. That isn't anywhere near long enough to know how you'll feel without the medication. It typically takes 3 months for your body to return to normal after taking opiates for a significant amount of time. Personally, I'm a person that much prefers quitting cold turkey to the slow increase from slightly worse pain to severe pain that comes from weaning off the medication slowly. I take 100mg of oxycodone to get any kind of significant pain relief (on top of my long-acting meds, which are also high dosages). But 18 months ago, I was taking THREE TIMES what I do today, and my physical problems have only increased. Yes, I'm in more pain, but I've been in severe pain for so long I know how to manage it very well, and taking 1/3 of the medication is WAY better for my body long-term.

I know it's hard, but my best advice for you would be to quit cold turkey and see how you feel in a couple of months. If you want to wean off the meds instead, then stick with what your doctor is doing and keep lowering the total daily dosages by 10% a month.
Posted 4/14/2015 1:51 AM (GMT 0)
Just wanted to add that if a CPP on pk meds is to have surgery, sometimes it makes sense to discuss the post operative pain management/relief plan BEFORE the surgery is scheduled. No shame in having been on meds long enough, so that the standard amount of pm relief does not suffice.

I think if we (CPPs) are outspoken about our post-operative pain fears, surgeons understand and script accordingly, albeit for a short time, which is fine. Now if one is on the highest possible level of meds already, sure that will complicate pain mgt.

But lots of us are one lower doses, but still need that little pm bump post surgery. I have only had 2 surgeries but fussed both times. Worked, got what I need to stay ahead of surgical pain. On the day of check-in at the hospital, I must have made the point again, a zillion times.

Gotta make sure it's written in your chart too. In fact, my hyster turned into an overnight stay, just for that reason. Gotta love that pain pump!

Post surgical pain when not controlled can get in the way of healing. JMO.
Posted 4/14/2015 2:31 AM (GMT 0)
Hello,
I have noticed it takes longer for the med to work. I've been on 30 mg a day for 1 year and three months. Next month I will go down to a 5. I tried going cold turkey 6 months ago and had horrible withdrawals. But I was off of it for three weeks and I hurt a lot, so I went back on at 5mg and went quickly up to 10mg. Soooo, I don't know about this time......If I still hurt, I will have to go pain management.

Thanks for your help.
Jodi
Posted 4/14/2015 11:37 AM (GMT 0)
Have you ever tried any of the medications that help with withdrawal like thorazine or anti-nausea meds? Robaxin, flexeril, or other muscle relaxants? Thorazine, a muscle relaxant, and an anti-nausea med is a great combination to help. It takes up to 3 months (or more) for your body to produce its natural pain medications/hormones so it's perfectly normal to have pain until that happens. There's no way to know how much pain you'll be in without the opiates until your body fully gets back to normal, which like I said could take 3+ months. It certainly won't happen in 3 weeks; at that point you'll only be through the worst of the withdrawal but still have increased pain from any chronic sources.

As for post-op pain, you're not on a high enough dosage that it should be terribly hard for the anesthesiologist to control it, but it's always harder to control when somebody already takes pain meds before surgery. Every case is different. My only advice is to take as little as possible because there's no difference taking the pain meds for post-op pain versus chronic pain when you're a chronic pain sufferer. The more you take, the harder it will be to stop, and the longer it will take (unless you're willing to go cold turkey like me, which I really have to say after 20 or 30+ withdrawals and trying lots of things is the best way to do it).
Posted 4/14/2015 1:35 PM (GMT 0)
In stronger than pain,

Ty for all the advice. It really means a lot. I will probably be weaned off by June, so after 3 months, I will know what my true pain level will be. Hope I can stand it that long. 6 months ago when I was totally off of the oxy for 3 weeks, nothing helped.

Jodi
Posted 4/17/2015 8:51 AM (GMT 0)
Yes I had to go through the same thing and I told my doctor and he ask me why I would do that . He said if you're in pain when you try to cut back then your not ready , he said that's what they make them for and don't worry about getting addicted because you probably already are , just be patient and let the meds do their job and in a while we'll try it again and guess what he was right . He said we can lower the dose slowly or I could go to a methadone clinic and be done in twenty one days I chose the clinic and that was it . Plus if you're not an addict , this won't make you one . Good luck to you .
Posted 4/18/2015 9:39 AM (GMT 0)
Ty Wesley59. I will have to go slowly. Don't want to be away from family AND home for that long. Lol.
Jodi
Posted 4/18/2015 10:46 PM (GMT 0)
I tapered down on meds a couple years ago after a stimulator. My dr gave me a couple meds (chlorodine? and one other) that helped a lot with the "withdrawl" symptoms. It was not fun but bearable and feel much better afterwards. I dropped approx. 90% of what I was taking, btw.
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