Opioids for pain management?

Lizzy, please go into Fibro 101...the first thread on the forum. There are links to good info about fibro and you will learn a lot there. Scroll down to number 16 about Serotonin Syndrome. This is something bad that can make you very sick. It is a build up of serotonin in the body caused by certain drugs and you can develop this by taking two or more of the drugs that can cause this. Right now you take four drugs that can cause this! This might be why you are feeling so badly. Yes, this can cause more pain too.

Opioids is one class of drugs that can cause this and you take two opioids...Fentynal patch and Percocet. Anti-depressants like the SSRI's and the SNRI's is another class of medication that can cause Serotonin Syndrome and you take Cymbalta which is an SNRI.

There are other medications that can cause this and one is gabapentin and you take this also! Taking one of these doesn't hurt you but taking two or more can cause this syndrome. Also dextromethorphan, which is a cough suppressant in over the counter cough medications can cause this when added to other medications. There are other things too so do read about it.

So, please read the link about Serotonin Syndrome and see your doctor. Better yet, I would get another doctor if they are putting you on this much medication. This is my humble opinion.

I use ibuprofen with food, Tylenol, magnesium malate, vitamin D3, and a muscle relaxer called Robaxin.

Sherrine

I'm glad you feel alright but combining those meds isn't safe...according to sites like the Mayo Clinic and the National Institutes of Health. We even had a member who developed Serotonin Syndrome and she became very, very sick. You can die from it.

Just be sure all of your doctors know exactly what medications and supplements you are taking and the doses of each. I typed all of my medications, supplements, and doses out one day and put it in a file and whenever I head to a doctor i have a copy with me. It's the safe thing to do.

Sherrine

Hi Lizzy 55, everything you mentioned regarding your pain is exactly what I feel. I was diagnosed about 4 years ago. I take Tramadol 50 Mgs, 2 tabs 3-4 a day. It's more on the 3 times a day side. I have been told that Tramadol is not a "hardcore" narcotic, in fact, it isn't considered a narcotic. I also take Hydrocodone, which is a narcotic, as needed. I don't take those a lot as my doctor told me that if I took too much of it, it would make my pain even worse with time. So I've cut back substantially on those. I take one a week if that when I have flare-ups. I find that Tramadol is working for me. The Hydrocodone helps for a little while; I don't find it as effective.. But we are all different..

Sadly, because some people have abused these drugs, the government is really going to get on doctors prescribing these and my fear is that they will stop giving chronic pain sufferers these pills. My doctor has not told me anything about this, but I think I will get some type of lecture when I see her in June. I only say this because it's been in the news for about a month and causing me a little anxiety as I know life will be hell without my meds.

As you know Fibro does not show up on X-rays, MRI's etc, how are doctors going to deal with all of this? How is the government going handle real chronic pain suffers and not lump us all in with "drug seekers?" Like you, I cannot get out of bed unless I take my pain pills, I would not even be able to work, or function the pain is just awful. So I know I've gone on a tangent, but I saw your question and I had to step in as I was going to ask others if they are on these types of drugs and were they as concerned as I am.

I have been told about Serotonin Syndrome, like Sherrine mentioned. I don't do well on SSRI so I don't take any, but have been told that Tramadol and SSRIs don't mix, very dangerous. Reading Fibro 101 helped me a great deal..

Anyway I hope my tangent :) helped some.

Thank you Sherrine. Yes, I guess I should've stuck to "hardcore" narcotic, at least that is what my doctor and even my pharmacist think of it. And yes, I know it is addictive if not taken as directed. I have of heard of Tramadol addicts, and if you can believe it, they take 16-25 pills a day! The most a doctor will prescribe for them is 2 tabs (50Mgs) 4 times a day for a total of 8 pills. So yes, there are people that have gotten addicted to them. I don't know how they are able to get their hands on so many pills, but they find a way.

I am very careful about taking these pills because I know that should I take more than prescribed, that would be a red flag. Thankfully I don't have that problem. But having said all this, because I have Fibro I am drug dependent. I think we all are to some degree, some may not need to take any type of opiate (lucky ones) but unfortunately some of us do. Fibro is different for all of us. The pain can be so intense for me that if I don't take my Tramadol I'd be bedridden and that is no exaggeration. Drug addiction and drug dependence are two different things. And that's what I have to understand because I think that is what the government is saying.

But I have decided this about my anxiety about the government stepping in business it shouldn't have to, like telling a good doctor how to treat his or her patient. My doctor knows me well. She knows my condition. She is experienced enough to distinguish between a chronic pain sufferer and a "drug seeker," so I need not worry. But as you know part of Fibro is anxiety, so I can see how I felt a little anxious about this.

And don't get me wrong, I know there is a problem with this, but it gets me very nervous when the government gets involved. Because the buzz word in the news about the drug problem was "chronic pain sufferers." That's us. I am just wondering what mess they are going to make of this now? Are many going to suffer because of it ? All this went through my head. But as I said, I am not going to worry about it anymore. worrying about the pain and life is enough. I'm in my doctor's hands.

Again I appreciate your input!

Shilohz
Thanks for your reply. As I have read through more posts I have seen many more people on pain meds.
Fibro is a confusing condition. I have read countless articles and postings etc about the condition and found as you did that everyone has different pain and different levels. I don't know how doctors diagnose especially when people have other conditions as well.

I have had so many conversations with myself and my doctor about what I should be on and the side effects etc. I have finally decided-- just recently in fact that I will do what is necessary today to have quality of life. I feel like I have given all the drugs usually prescribed their chance with no help. I feel that TODAY is what I will focus on. I Eat right, exercise etc-- I stay in the loop-- I do my part. I take my meds as prescribed and I don't expect complete relief.

I am not really concerned with the "crack down" I think conversations with your doctor about what is best and following correctly what you need to do will continue to serve those who are really in pain--

I do intend to speak to my doctor about the drug combo. In the past year I have had my hip replaced twice and am having trouble understanding how my internist,ortho surgeon,doctor and nurses that took care of me in the hospital,pharmacists who filled my prescriptions while in the hospital,anesthesiologists, and my pain doctor never put up a red flag.
Do they not know? Do they not want to take the time?
I will post my results. 🤔 Thanks!

Honestly if you are already on all those scripts and not having any issues, I would suggest not rocking the boat. It sounds like you have more functionality than most of us here so try to enjoy it while you can. I have tried many of the things you are currently taking. I have had some success with low does gabapenten. It sees to help with neuro pain. Marijuana (if it is legal in your state) is actually very helpful for me at night for both pain and sleeping. But at the end of the day the only thing that makes the pain go away 100% is opiates. It's sort of like a calculated risk for me because I know there will be a trade off of more pain later. So for me I use them as emergeny pills or when I have to go to a wedding or something like that. Not sure how helpful this was but I hope you continue to feel ok.

A

I forgot to comment on the marijuana. Would love to try that.
I live in Texas. Need I say more?

Thanks for the support Karen--it's not usual that people understand when they hear you take narcotics for a pain condition that they don't understand.

It is going in another direction but in case it could help thought to mention you might take a look at low dose naltrexone (LDN). Naltrexone is a prescription drug used to help people over come addiction to opioid drugs. At low doses naltrexone has been found to relieve the pain from Fibromyalgia from what I've read of late.

There are a few books on LDN. I've been reading some of them of late for another condition I have and ran across this mention of LDN helping some with fibromyalgia. Here is a study on pain reduction found with LDN.

"Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels."

http://www.ncbi.nlm.nih.gov/pubmed/23359310

Yes, that is what I read also. I read that one would not want to take opioid pain medication while taking LDN. The LDN would cancel out the opioid pain medications effect.

if it might be of assistance, there is an opinion LDN web sight. People write in and provide their experience on taking LDN. There is a section for Fibromyalgia. Looking at it some wrote in mentioning other medications taken, along with opinions on LDN's effect. The opinion sight can be seen here:

http://www.ldndatabase.com/Fibromyalgia.html

Sorry to read about the terrible time with vomiting you experienced after taking LDN. Avoiding and weening off opioid drugs is important before taking LDN. From the other testimonial web sight posted earlier it seems to help some with their condition, but not everyone. It seems to be a hit or miss medication, which all medications seem to be that way in fairness.

Did find this bit of information on another LDN sight. It does indicate LDN would not be a good fit in this case:

http://www.lowdosenaltrexone.org

"Cautionary warnings:

Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication — such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication — should not take LDN until such medicine is completely out of one's system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely."