New pain meds

For the last 3 yrs I've been dealing wit CRPS & 3 herniated, bulging discs L1 L2, L3, tried a few pain meds including duragesic patches, mscontin, oxycodone 20,30, with little to no relief. Earlier this week the Dr switched me to Opana Er 20's and still NOTHING except mild drowsiness! Does anyone know anything i can do to make these little green pills do what they're suppose to do??

The thing with extended release medications is that they deliver a steady dose over the course of many hours instead of hitting your system pretty much all at once. Because of this most people won't feel a dramatic relief of pain like they do with an IR.

Unlike an IR pain med which is usually taken on an as needed basis and ER pain med needs to be taken regularly. With some ER pain meds it can take a little while for it to build up in your system before it will actually start offering any noticeable relief. On the flip side of this though you need to be careful stopping them as the medication does stay in your system longer and you may notice withdrawal symptoms even if you have never had any problems stopping an IR pain med.

Thanks for sharing more...

Is there a reason why he wouldn't put you on Oxycontin (long acting Oxycodone)? It seems strange to have you on short acting Oxycodone every 4 hours....Or are you saying you were prescribed Oxycontin 6 times a day?

And I'm not sure if you are saying your dosage is only 20mg a day...(or is it 40mg ) of the Opana now...that is definitely a huge drop in meds from 180mg a day of Oxycontin...The 40mg would be closer to what is expected starting out.

Sorry for the questions...just trying to see the logic of why they wouldn't have just moved you to Oxycontin for your base med as most of us are on a long acting medication...and then have a short acting one like Vicodin, OxyIR, or MSIR for breakthrough pain as needed.

And last question...have you gone lately to a Board Certified Neurosurgeon to get a recent MRI to see if surgery is needed for any of your herniated discs? Have you had any of the injections or other treatments specifically for those?

Sorry you are hurting so much:(

Post Edited (Snowbunny21) : 11/30/2012 1:41:08 PM (GMT-7)

Atiana,

Welcome to the forum.... but I'm sorry for the reasons that bring you here.... :(

It's tough when you are on the journey to find a medication that works.... because it does come down to just trial and error. Also - it's been my experience that even a medication that didn't work at one point.... might work years later and so forth. And, it's also finding the right dosage and so forth - before completely giving up on a med....

It could be that the dose of Opana is just too low. As Snowbunny said.... it's a huge drop from your oxycontin.

When my PM doc is trying new meds/doses.... she always lets me know if something isn't working to call and come in sooner than my monthly appt -- because, as you are seeing, going 30 days is a LONG time when something isn't right. Would your doctor be open to this -- if you let him know how much pain you are in?

I'm sorry, too, you are hurting so much :(

--Tina

@Snowbunny, truthfully im not sure why they're using the meds they've given me except for insurance reasons. It was oxycodone 30mg i was on and the current dose of the Opana is 20 mg twice daily so yes i believe it is a drastic drop, which may be why im not getting any relief. I did have only 1 epididural injection and had an adverse reaction that cause lower extremity paralysis for 5 days followed by 14 of little function from the waist down. Yes, i did have an MRI done a few weeks ago and the Dr suggested surgery but im trying to avoid it if at all possible. I go back to the Dr that done the injection on Monday, so hopefully then i will be given something for BT. I was told that the Opana was stronger than oxycontin, is this not correct? And lastly, we've been going thru crap tryin to find a med that works for me and that my insurance would pay for....... For some reason most medication that I've been prescribed has been rejected by my insurance company for some ungodly reason.

I'm not sure about Opana being "stronger" than Oxycontin as those are kind of on the same level...I think it's all about what works for each person...

It still just seems strange that they wouldn't have tried Oxycontin? Was this ever suggested or did your insurance not cover this? I don't know why if they covered the Fentanyl patches or the MSContin....

The only good part with going to the Opana is that it is a long acting medication but that only matters if you are on the correct dosages...As Cogito mentioned if going by the conversion charts...the 180mg of Oxycontin is about 67mg of Opana with about a 25% cross tolerance....

That's where things get tricky with cross tolerance and metabolism and other medications added into the mix..

So...you aren't too far off for the dosages of the Opana...but as mentioned before...most of us that are chronic pain patients are on a long acting medication but also have a breakthrough medication to have around to take during the bad days.

How long have you been going to this PM? Do you think that after speaking with him that it is "final" when he said you will just have to wait a month?

Hopefully the medication will start working better these next days the more it builds up in your system....Since you were used to taking a short acting medication for so long...you are more used to a "quick shot" of medication and actually "feeling" it working for you...With a long acting med....it will just be a gradual lessening of pain...

The best that most of us get to with all the medication we take as well as all the other modalities like exercise, injections, massage, acupuncture, etc....is about a 5 on the pain scale..I live with a 5-7 depending on the day...

I would also suggest getting another Board Certified Neurosurgeon or BC Orthopedic surgeon opinion on your MRI and if you need to have surgery, then this may be something that can at least put a dent in the pain levels. I'm thankful that it pretty much got rid of my nerve pain. So yes...surgery is the last resort...but if you aren't able to live a good life with all the medication you are taking...then it's time to look at other options...

Although Opana is a mixture of MSContin and Oxycodone, it has a very low bioavail in the bloodstream, it did nothing for my level of pain at the time I was taking it, my doctor had to change my meds from the OPana to the Fentynal patch at the the time, and eventually, after taking the patch for a period of time, that stop working too, Im now on Methadone 30mgs which helped me tremendously, but Im now needing my dosage increased slightly, but pls let your doctor know and maybe he can change to something that helps, good luck.

Good morning Atiana

I wanted to say hi and welcome you to our chronic pain forum. Glad you found us but sorry you have to be here due to pain.

I sure hope the med change will be the answer for you. Like you I have had no success with medications and I have tried them all. I have been suffering more than twelve years with intractable headaches. I do hope you get some relief soon.

And congrats on getting your disability. That's a big battle won right there.

Take care and keep posting with us.

suzane