stopping percs

so i'm getting a bit ahead of myself as my Crohn's disease is still keeping me in pretty bad pain...

but as my dose is increasing from time to time- currently 10/325 6 times a day I'm beginning to wonder how hard it will

be to stop the percs when they are no longer needed.  I don't THINK i'm dependent on them but that throught is starting to cross my mind as the dose gets higher and higher...what do i have to look forward to?  i'm getting a bit nervous thinking about withdrawal...do they taper the dose down for a while?  how do you stop taking narcotics when you're done after you've been on them for a while?  thanks so much!

         Good morning mgtman!

              I have to agree with flower123 here, but wanted to add my own personal thoughts to this.

     One thing I have learned is that sometimes we suffer a sense of guilt (Not saying this is your case)...because of the public's view on pain med's....but I have come to realize that it is quite all right to take them when hurting. There is no need to suffer trying to please a family member or the general public.

      If indeed you find yourself able to reduce you're med's then do so a little at a time. Everyone is different in regards to withdrawals, but if you have a good Dr as flower123 says, then it will be much easier.

     Take care,

  SE

Hi mtgman!

I do understand your concern about how much pain meds are going through your body. I have had the same concerns.

One thing I want to add is the use of the word 'dependent'. Dependence is when your body is used to getting a certain amount of medication on a regular basis. It depends on it continuing. If you stop the medication you will go into withdrawal which is not a pretty sight. A lot of medications cause dependence...like antidepressants, sleep medications, and even things like insulin. I'm what's considered IDDM... insulin Dependent diabetes myelitis. In other words I'm diabetic and take insulin. If I stopped my body would have serious issues!

I think what you are worried about is addiction! Here's a boring definition for addiction:

The American Society of Addiction Medicine has this definition for Addiction:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. The addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction can involve cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

And what I think is a better one:

"Historically, addiction has been defined as physical and psychological dependence on psychoactive substances (for example alcohol, tobacco, heroin and other drugs) which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain.

Addiction can also be viewed as a continued involvement with a substance or activity despite the negative consequences associated with it. Pleasure and enjoyment would have originally been sought; however, over a period of time involvement with the substance or activity is needed to feel normal. Some psychology professionals and many laymen now mean 'addiction' to include abnormal psychological dependency on such things as gambling, food, sex, pornography, computers, internet, work, exercise, idolizing, watching TV or certain types of non-pornographic videos, spiritual obsession, self-injury and shopping."

The rates of addiction for chronic pain patients is less than 1% per a National Arthritis Foundation study. Should we still concern ourselves with it?? You bet! You or I may be that 1%. But excessive worrying over it isn't necessary.

I've offered way more than you asked for but hopefully someone who reads it will find some helpful information.
Chutz

Hi Mtgmn...I really wouldn't worry about your body becoming dependent on the medicine...a good Dr. will always tirate someone down if/when you would need to go off the medicine so you wouldn't have any negative side effects...

This only applies to someone who is abusing their medication and would take too much and then run out...and then keep having the actual 'highs' and then the lows (withdrawals)...

One of the ways to keep your tolerance low if you are on a narcotic long term is to always be using other modalities to help with your pain...for me...I use exercise daily, PT, acupuncture, yoga/stretching, injections when needed, aqua therapy, muscle pain medicine, sleep medicine, eating all Organic, not smoking, etc...So whatever else you can do to help with the Chron's..

As well as making sure that not just your Dr. is part of your team...but your Pharmacist...I have used the same one for 10 years...and I always chat with them...ask about their family....and they are in a big box store...the good part is that not only do I know them...but they know me so if there was ever a mix up with something...they would call me and know what I'm on the medicine for...

And if the Dr. decides to keep you on an opiate long term...since you are taking up to 6 a day of 'short acting' medicine....it may be time to move you to a long acting med...So..since you are taking 60mg a day of Oxycodone...you could take an Oxycontin 10mg and a 20mg in the AM....then repeat 12 hours later...(don't think they have a 30mg pill)....

So this would be the exact same medication and dosing as you take now....but it would be released more smoothly throughout 24hours...instead of the ups/downs with the Percocet that hits the most at 45minutes in...then goes down from there...so you are chasing the pain more...as well as you could add either Acetaminophen or even an Ibuprofen if needed but not having it every dose...I actually like the ability to choose..

It all boils down to making sure you have a good Dr. that is working with you...(don't know who is prescribing the Percocets)...and if you need to stay on them...then so be it....or if going down or off them...they will taper you properly...no sense worrying about something that isn't even happening!..LOL..

And hope that you can also add the Humira or Cimzia!!!

Post Edited (Snowbunny21) : 6/17/2011 5:48:24 PM (GMT-6)

Ahh...that makes sense with the Crohn's and the long acting...duh...my brain was not working with that..lol...I am glad to hear you are seeing a PM for the medicine as they are very knowledgeable with their Anesthesiology background..and working with you on different one's if you need...and yes...if you have to go to the patch...there are many of us that can give you some advice on our experiences as well to discuss with him...

But one step at a time..right:) It sounds like you are in good hands..

Hope you are able to have a good weekend and doing something that makes you smile and release some endorphins!!

SS..I wish I could have a pain free hour each day!! LOL...but mostly as you said..it is about Pain Management...

A narcotic is a small piece of the puzzle...and even with that, and other modalities...most PM Dr.s shoot for a 5 on the pain scale...So if people are that and below...that is great:)...I have between a 5-7 depending on activity...but I take a lower amount of medicine than my Dr. wants me to take but I want to keep my tolerance low as well as I am used to this level of pain but like to stay more alert each day...

Some days I will take my higher dosage prescribed...and add a muscle relaxer to help like this weekend...and get to a 4 or 5...

SS...as I just was reminded because of Mtgman's Crohn's...he can't do the extended release medicines....

I think you are on the right track Mtgman:)

MTG, I totally know where you are at dealing with CD. My first kidney stone was a few short years ago, I would compare that pain to the complete blockage pain. I saw every color in the rainbow at 2:00am when I passed that thing and nearly passed out I was in so much pain. Yes, it is wonderful that your dr has some first hand knowledge of kind of pain CD can cause a person. Many drs just don't have a clue about that kind of pain.

Have you started Humira yet or not? I hope if you are getting ready to start it soon that it helps. You know when I first started Remicade infusions it really did help me, but as time went on it lost its punch. I went every 4 weeks for my infusion as that schedule worked the best for me. Then I started getting so sick after each infusion and they did some testing and found it had induced Lupus. Humira can do the very same thing so the drs just keep me on Lupus medication.

It is scary when tampering with our meds, not knowing how we will react to a new one. I have Dilaudid in my pain pump, it is a very old drug that is effective on pain and has few side effects like so many of the newer pain meds today. I do not tolerate medications well at all and usually end up having severe reactions or allergic reactions, either way, I normally get shot in the foot, lol.

hey straydog- i've been on the humira for approx 3 months now...it's so up and down it's hard to get a read on its effectiveness- i had to bump up the prednisone for a while unfortunately. right now i'm feeling pretty good so i hope it stays that way. i've been doing a lot of travelling for work which is always fun and exciting with crohns...just a ton more anxiety for me to deal with haha.

snowbunny good idea about keeping the doc apprised of what's going on...