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Are oral pain meds ineffective for anyone else?

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Posted 12/28/2013 3:48 AM (GMT 0)
I've known for several years that oral meds in general aren't very effective with me. When I had a root canal in college, the percocet did absolutely nothing.

So since I got CD 3 years ago, we've found that oral pain meds have no effect on me whatsoever. It didn't matter much at the beginning, but last year with the pancreatitis, c. diff., and flares, and now this year with the thrush, mastitis, flares, c-section, etc., it's gotten a little disheartening.

When I take oral pain meds - dilaudid, norco, percocet, lortab, etc. - absolutely nothing happens. No pain relief, no loopiness, no exhaustion. As a result, I've developed a pretty high pain tolerance. I came home from my c-section and just sucked it up.

This last week though I've had a lot of rectal pain in the seton site and am just waiting to get in to see my CR surgeon. My PCP in the meantime gave me norco at a 10/325 dose. That's the really crummy part about getting new doctors - they all insist I "just try it." As a result, the top shelf of my bathroom closet looks like a drug dealer's with tons of bottles of pain meds that I tried a few times and didn't work.

Anyway, I took a norco over an hour ago when my pain hit about a 5 (I normally would just suck it up, but I thought I'd try it before it hit a 7 or an 8 and was too out of control). Absolutely nothing. No dizziness, no pain lessening at all, absolutely nothing. I played a sudoku game in under 3 minutes and am still pretty awake.

I think it's just because of the CD and my body's quirks that these don't work. Does anyone else have this problem? I just think that maybe my body doesn't absorb the pills well. Any thoughts?
Posted 12/28/2013 3:58 AM (GMT 0)
That's pretty crazy! (No offense!) maybe you just have some kind of resistance to narcotics? Have you tried dissolving the pills under your tongue to bypass your stomach? Under the tongue would go straight into your blood stream and also works faster. Just an idea.
Posted 12/28/2013 4:06 AM (GMT 0)
Yeah, I've tried that. We actually even tried patches, like fentanyl patches, and it just doesn't work. I think it is a resistance that I've always had a bit (the root canal thing was years before I got CD), but that all the IV stuff from all of the hospitalizations has made it build up more. I was just hoping that since I went my whole pregnancy without IV meds that the resistance would have died down or something, but after the epidural wore off from my c-section, the oral pain meds they gave me had no effect at all. So after 12 loooong hours of trying different ones, they let me have IV morphine the whole hospital stay and then I just sucked it up when I got home.

It's just so expensive to have to pay the ER copay of $100 every time pain gets out of control. Plus I don't want them to think I'm a druggy. They already give me funny looks when I can walk in and say that .5 of dilaudid isn't strong enough and that I need 50 mg of benadryl or I'll itch like crazy and 25mg isn't strong enough.

I can get 2 mg of IV dilaudid with phenergan for nausea and 50 mg of benadryl and STILL be awake and fairly coherent.
Posted 12/28/2013 4:07 AM (GMT 0)
And I should mention this also happens with all meds - cold medications don't help much, or allergy meds. Pred takes longer to be effective (when I first got on it with getting diagnosed with CD, it took 10 months of 40 mg plus imuran plus mesalamine to get me into a half-remission). My migraine medicine only works if I take double the dose, and even then it only dulls the pain.
Posted 12/28/2013 5:56 PM (GMT 0)
Wow! That's such an inconvenient "resistance" to have! Geez! And I get it that you don't want the hospitals to think you are a drug seeker. Maybe your doc can put something in your chart. Surely you can't be the only person who has this kind of resistance, even if it's rare. I wonder if there's a name for it. The worst part is, what in the heck do you do for pain relief then? Do you just cross your fingers and hope you get through it? And you can't be dropping $100 every time there's a flare..... Not an easy situation, that is for sure!
Posted 12/28/2013 10:13 PM (GMT 0)
I too have a high tolerance to all the pain medications, after so long fighting my CD they seem to have stopped working on me... Infact Dec 2010 during a massive attack they had such a hard time maniging my pain while in the hospital they overdosed me on Dilaudid and I woke up three days later in ICU after having my pulse oxygen drop to near zero, aspirating vomit and a major heart attack due to the heart racing to pump blood to my brain I pretty much quit taking any pain meds and just try to deal with the pain..... It has been a long hard road for me as well, since 2004 I have had 3-5 major attack per year requireing hositalization, not to mention all the other attacks I just sucked up and fought with myself... I am just lucky not to have had any major surgeries...

34 Yr Male
Chron's Disease 2004, Fistula, 2008 Osteopenia
Current: Humira, Vit D & Calcium
Previous: Remicade, 6MP, Prednisone, Imuran, and
Asacol (Allergic)
Posted 12/29/2013 10:45 AM (GMT 0)
Yeah, I usually just curl up in a ball on the bed, and when it's hit a 7 or an 8 for more than a couple of hours, then I go in to the ER.
Posted 12/30/2013 1:32 PM (GMT 0)
I sort of have that resistance. For me, some things either don't work at all or I have the most extreme reaction. When I had the nerve pain due to back issues, I was taking 5 pills intead of the 2 recommended and it never touched a thing (I even drove which I do not recommend). Most pain killers do nothing for me unless it is IV. Give me an IV sedative and I am whacked out or asleep by the time the needle glances the IV...oral sedatives seem to do nothing. I had my husband confused when I went from tears to "Wheeeeeeee let's go home" in literally two seconds on morphine.
Fortunately, Prednisone was always an quick worker for me. It seems anti inflammatories my body likes. Heck even Advil always worked fast when I used to take it.
My sister has the same pain meds issue as you---nothing gets through on her.
Posted 12/30/2013 2:46 PM (GMT 0)
That is an unfortunate resistance to have. Have you ever though of meeting with a pain management doctor? They may be more educated in this area and have more ideas to get you pain relief at home. It definitely stinks having to go to the hospital every time your in pain from a chronic illness - those visits can accumulate fast!
Posted 12/31/2013 1:09 AM (GMT 0)
I was put on Olfen injections,. diclofenac, twice/day for max 3 days only when needed. I take it only when curling in bed can't take away these intense throbbing pulses in the intestines. May they can relieve your pain. Ask your GI as these are NSAIDs and might trigger a flare up. I take them only when I can't bear pain and it's an 8 or 9.
Posted 12/31/2013 10:37 AM (GMT 0)
@habs - lol, yep, that sounds about right! IV dilaudid is my friend when it's all hurting. And you never realize how badly you're hurting until you get it and the pain goes away. Then it's like, "oh WOW!"

@minnie - that's a good idea. My PCP gave me a shot of something when I was there last week, but it only lasted about 15 hours (it was supposed to last 24), and I don't think they'll give prescriptions of that. He didn't suggest it. None of my drs have.

@Myrne - I did last year with all of the pancreatitis and c. diff. problems, but we never really had any success.
Posted 1/1/2014 7:40 PM (GMT 0)
hello, i came upon this site an hour ago. Glad to see it. I have the same concern. My oral pain meds no longer work for me. I do see a pain management dr., and he has me on 60 mg of straight oxycodone along with 10 mg of methadone every 8 hours. I have been on oxy for about 10 yrs now off and on. This stretch has been going for about 3 yrs of oxy. The only relief I seem to get is from IV dilaudid. I am allergic to liquid (iv) morphine, oral morp does nothing for me. Oral dilaud does nothing for me. Seems that only the iv dilaud helps. What am I to do? I too go to the ER when I can no longer stand it. You are correct, they tend to catagorize you as some kind of druggie. I have been turned away from my ER more than once cuz I went to the ER more than once in one week. Could we, someone, exchange email or facebook info so we can talk to one another.? I am Lana Jean Fisher Holden on facebook, or [email protected]
Please advise me as to what to do next. I am in my late 40's, female, Massachusetts, USA. thank you.
Posted 1/3/2014 2:43 AM (GMT 0)
Wow, sounds rough! I am actually not very comfortable giving out personal info or contacting individually, but I am happy to talk via this forum!
Posted 1/3/2014 6:34 AM (GMT 0)
well, idk about oral pain meds in general, but opiods completely shut down my digestive system. but only the muscles; the microbes keep doing their thing, so all the food that got stuck in there continues to digest, generating gas... which has nowhere to go. causes immense bloating and abdominal pain. the gas would press against my diaphragm if i sat up, making it difficult to breathe. it became impossible to eat. worst pain i've ever felt.

first time it happened was last august, after my iliectomy. nurses thought it was just part of the recovery. then it happened a few months ago when i took vicodin for some pulled molars. figured it out myself, since that was the only new med.

as for what i do for pain relief... well, my tolerance is high, so for day-to-day stuff i havent needed more than the occasional tylenol. for major things, i guess i'll let my doctors figure it out and try not to be conscious for the worst parts.
Posted 1/5/2014 3:09 PM (GMT 0)
I'm so sorry your going through all of this. I don't have a resistance to pain medications. But instead I just have bad reactions to medications. Many medications they have me try I'm the one that has all of the side effects. I always have. Doctors keep saying we'll try this or that's then is have a bad reaction and they have me try something else. I'm always scared to try a new medication to see what problem I'm going to have next.
Posted 3/19/2014 1:30 AM (GMT 0)
Just an update on this: I saw a pain management doctor today. At first when he'd seen my records, he was concerned about me being an addict (so many scripts for pain meds plus tons of IV dilaudid during hospitalizations), but when I told him that I don't even fill most of the scripts anymore because my body doesn't absorb them, he understood! He said he knew EXACTLY what I was talking about and that he has tons of Crohn's patients who have the same problems. When I told him that this hospitalization was a new, additional diagnosis of gastroparesis, he said, "Wow, no wonder nothing gets absorbed."

So it was just nice to have what I suspected all along be verified by a pain management doctor. We're going to experiment a bit with patches and dissolvable pills. I've tried them before but didn't have much success with them because it was through the hospital doctors while admitted; this is my first time actively trying to meet with a pain specialist outside of the hospital.

But even if nothing works, I feel validated!!! :)
Posted 3/19/2014 2:13 AM (GMT 0)
I hope they find something that will help. I am allergic to almost evey narcotic with the exception of fentanyl and plain oxycodone so I am not a good person to say how good or bad the rest are. The fentanyl comes in a patch so maybe they will have you try that. I didn't have any side effects from it and it helped me with the pain more than anything when I was in the hospital.

Hope you can beat that pain soon!
Posted 3/19/2014 5:24 AM (GMT 0)
Thanks! I've tried the fenanyl patch before (didn't work) and then they gave me another one today - waiting to see if it kicks in or not. I also was given something that dissolved in my mouth between cheek and gum (begins with F, can't remember name) that not only didn't work at all, but burned the skin that it dissolved against.

We did find a couple of weeks ago that Norco 10-325 is a bit effective if I take 2 pills at a time on an empty stomach, but I'm not sure I want to go that route for pain control on a regular basis.
Posted 3/19/2014 6:35 PM (GMT 0)
I have a pretty high resistance to pain meds also. Anything less than Percocet level might as well be baby aspirin for all the good it does. There are notes in my chart I think about it. Luckily, I can still have relief from the Percs- as long as I take a few of them at once (usually about 20mg of the Oxycodone is necessary for pain relief). Meds have always been a little weird on me- they usually take twice the expected time to work. Also, things like Benadryl and other allergy meds do not make me sleepy and caffeine does not wake me up. This may be a metabolism thing as well as an absorption thing. I was almost OD’d on meds in the hospital after my proctectomy. I was on a Dilaudid pump (morphine is less effective and makes me barf rainbows of ick) and was apparently still in enough pain that they were supplementing my pump with additional pain meds and gave me too much. They had to use Narcan to get me back. I have almost no memories of this time, but there are some fun stories from my family about them trying to keep me awake while I was drugged out and the crazy stuff I was saying. Apparently I know a lot more than I thought I did about the building of the Pyramids at Giza!
Posted 3/20/2014 4:30 AM (GMT 0)
I feel your pain... literally! with almost no intestine, I absorb very little. if its not IV it wont work and even then it has to beat max dose that they allow. are any of you redheads? known studies have said that redheads are naturally more resistant to pain meds and should be given a higher dose to start with.
Posted 3/20/2014 7:38 AM (GMT 0)
I do have a bit of red in my hair, actually. Especially when the sun hits it just right.

Here is the article talking about how redheads have a genetic mutation that might cause why they are more prone than others to have pain medication not work as well for them. I also wake up a lot during surgeries or procedures when given just the standard anesthesia dose.
well.blogs.nytimes.com/2009/08/06/the-pain-of-being-a-redhead/?_php=true&_type=blogs&_r=1
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