How fast do you become 'immune' to pain meds?

I almost feel ashamed to be posting her after reading some of the posts and seeing what other people are dealing with!  I first hurt my back in '87 and spent years in PT and on pain meds and muscle relaxors.  Over time, I did have some progress and was able to finally stop all prescriptions when I became pregnant in '96.  The pain was still there, but I was able to deal and manage with OTC pain reliever.

However, after falling on ice last winter I herniated a disc and when that pain became absolutely unbearable I went to the doctor.  He prescribed Vicodin and Flexeril 2 x day, no more than 2 per day of the Vicodin.  At first, 3 days on the meds and I would be OK and could stop taking.  A month's RX would last about 6 months.

When I took my daughter to DisneyWorld last month I took them every morning about 10 am as a precaution.  I didn't want to ruin the vacation by being unable to do anything. Every night I needed only Advil to sleep. 

The first week we were back I was still fine.  Now it seems I need them every day because the pain gets so bad I just can't stand it.    I'm not having that real relief after 3 days of the pills + rest when I'm not at work.  Sometimes the pills don't seem to give me any relief from the pain at all.

Could this be because I took them every day for 7 days?  Did I make myself  immune to the drugs?

At this point I am considering surgery because I just can't live like this.  From what I've read, the surgery may not take away my pain anyway, but when the pain is bad enough I'm willing to try.  For me, that's a lot of pain!  Just thinking about someone elses pain can make me sick to my stomache with anxiety!  When ever I read about the surgery I get ill. 

I'm used to being in some pain or discomfort every day since I first hurt my back in '87, but this is way worse than I've ever experienced.  I would compare it to the last hour of labor before the birth happens - only difference is that it doesn't end.

I am tired - can't sleep without taking something - either the RX or some OTC sleep aid, so I try to take something every 3rd night, but I don't like taking anything at night because a drug induced sleep makes mornings difficult for me.

I am irritable, prone to angry outbursts at my daughter - my patience level is way below 0 these days and I know it's because of the pain and lack of sleep, but I am hesitant to ask the doctor for anything stronger.  I am terrified of becoming addicted and have heard horror stories of Vicodin addiction!  Am I becoming immune and in danger of addiction if I continue to use Vicodin for pain relief.  (not that I have any idea what to do instead!)

Any opinions would be most appreciated! 

Hi, Gypsy,
Welcome to the chronic pain forum of Healing Well. We're always sad to find another person in pain, but glad you found us as IMHO this is the best support group on the internet. We aren't doctors, however, and can't give medical adivce, but can share our experiences.

You describe having done a lot of activities which may have worsened something with your spine, or rekindled old problems. I think your first step is to go to your doctor and get a good evaluation of the condition of your spine, and what may be causing the increased pain. There are lots of options, some of which you've used successfuly in the past, so don't jump to surgery so quickly. That doesn't always resolve things, as I know firsthand.

Once you get a diagnosis (and this may likely require a specialist visit but I wouldn't jump to a neurosurgeon - maybe a neurologist or ortheopidist) you can ask about your options. Perhaps going back into PT for awhile will help. As our backs age, they do degenerate normally, but that doesn't mean surgery. I have been in and out of PT for decades and although it doesn't always resolve things, it has definitely helped.

I think what you mean by "immune" is really developing tolerance. The body will normally become phsycically dependent on many substances over time - everything from caffeine to narcotic medications. Sometimes, but not always, an individual develops a tolerance to a certain medication, and a dosage increase may be needed. Or a change to a different medication. Sometimes combinations of medications - which can include anti-depressants (which also help with pain), muscle relaxers (that you already know about), and many other medications can be used. If you are at that point (but you really need a good diagnostic evaluation first), a pain management specialist is the best doctor to do with, although that can have its complications, too! (like some pm specialists don't do medications, but just high tech procedures, but some of those can help).

Anyway, I'm just trying to say you need to talk with your doctor, and be honest about your pain in order to figure out what's going on, and your options.

Others will probably be along to add things I've missed. Hope this helps a bit.

Again, welcome!

PaLady

Hey there and welcome!

First of all im so sorry u hav a reason to be here, cuz pain just sucks... but i did want to point out a few things that hopefully will help u!

First of all there is a HUGE difference between Addiction and Dependance, which should help u to kno cuz of ur worries with becoming addicted (and dont worry- i was so there at the begininng of all my pain issues too!) But addiction is a psychological need for the drug, and they may think or say they hav some physical pain, but it is reallly a mental addiction-they think they cannot live without the med. A good story is lik an alcoholic or any kind of addict really, who can watch everything falling apart around him- his family and friends can leave him, he loses all his possesions and/or sells them for money for the drinks or pills, he can be living on the street- just everything around him is falling apart, and he just cannot stop, he only thinks about his next fix or pill or drink... that whole story, whereas Dependance is a physiological dependance on a medication; its where your body becomes used to having this certain med, and when it suddenly stops, your body is confused, leading to withdrawl symptoms...(and its just a physical reaction, you really hav no control over this)  My pain doc always tells me that the people LEAST likely to become addicts are people who hav real pain! esp people who are worried about becoming addicts because we only take these pills because we MUST to just live, and normally people lik this will take only what they need and no more! (and i kno this is true for me but i hate the fact i hav to take these pills, and i hate them, i kno it sounds odd, but i really do, but i kno it lets me live, so i take them...) so honestly i really think you are fine on the whole addict thing...

As for your pain med situation, i kno the frustration of that, ive been there as well, and i hate "asking" for something stronger, although you never want to ask for a certain pill or med by name or say i need more or stronger... My first thing i would STRONGLY suggest u do is get a pain management doctor/specialist! I kno its a hard step and it can be difficult at first (and sometimes, its hard to find the right one) but for me, it was the best move i made! They think differently, because they deal with pain day in and day out, and i kno u mite think, well, this is only a temp increase in pain, so theres no need... but from what u said, even if your pain goes back to "normal" you still hav some daily pain, and a pain doc mite even hav ideas of how to make even that better! but he would always be there if it increases lik this ever again, and they know A TON more than any other doctor about pain meds, and can give you many more options and will work with you to figure out exactly what works for you! Either way, if u go to a pain doc or just ur primary(and i think u should talk to ur primary anyway, so that they kno wats going on and can help u before you get in to see a pain doc) you dont need to say u need something "stronger," what i always do when im in this situation, is say my pain has been much worse lately and the meds are not helping either at all or very very little; just being honest telling them whats happening with the pain and how much or little the meds are helping is the best way to go about it, that way ur letting the docs figure out where to go, what to do from there...

Ok, sorry for my frazzeled order here but also about the tolerance thing, everyone reacts differently so no one can tell you exact timelines for tolerance and stuff lik that, but im pretty sure it cant be in a week   But im thinking wat ur noticing is lack of side effects maybe that you could always "feel" when the pills kicked in before? this is always what happens with me, when i change meds, but thats not tolerance, that is just ur body becoming used to the pills- actually i see it as a good thing cuz i hate those side effects- but it is not the same as tolerance! and i kno a big part of this worry is also that the pills are just not helping with the pain anymore, but i would think that is the pain- i mean that the pain has just gotten worse... And i kno toooooo well about the lack of sleep and all the pain, and its perfectly normal that u hav shorter patience than usual! i would really call ur primary tell her wats going on, how bad the pain is, and (i hope u would) ask her/his opinion on a pain doc... if u hav an appt coming up that would be handy but calling works great too- but if u are talking to them about a pain doc, id also make it clear that u need to do something in the meantime!

Sorry this was so so long, i just had too much to say! But really talk to ur doc, investigate pain docs, and dont worry about addiction or tolerance! is the short version....haha but i hope something in here helped, i hope u get some help and once more    WELCOME TO HEALING WELL!!!  (and btw- when ur feeling really down or u just get time, feel free to come chat in the chat rooms, it helps me a lot when my pain sucks, and we all understand what ur feeling!)

Take care and have low pain!

Katherine