Painkiller tolerance?

[Guest niall]

Hey guys,

 

I don't consider myself a medicinal user, but some of you guys really know your stuff re: painkillers so I'd love to hear any comments you have.

 

I had a really nasty soft tissue tear in my back over 3 years ago, wasn't able to move for a week and ended up on Valium when I finally got to the doctor. It was only 200mg from memory, maybe that's wrong it was so long ago. It's never really healed and I'm starting to think it never will. I'm doing all sorts of rehab and abdominal strengthening etc. but one thing I noticed over the last few months has scared the shit out of me.

 

I've been using Ibuprofen as needed, not often and not until it becomes unbearable, as directed with food etc. and the last month or two it hasn't done a thing. It's always worked, but now nothing. My back goes into spasm and if I can't keep a lid on it then I'm fucked for the rest of the day. I was using them almost daily for the first year or two, but haven't had them more than a few times a month over the last year.

 

It couldn't compare to most of the spine problems some of you guys have had, and I can take the pain fine - it's scary how you build up a tolerance, it just scares me how this particular substance doesn't work anymore. I haven't increased the dosage as I don't want to be using them in the first place, I know they're weak as shit but I still don't like the idea of using painkillers.

 

Pot does help my spasm, and like someone said in another thread it distracts you from the pain moreso than actually reducing it significantly, but again I don't want to become dependent on something for pain relief. I'm working in rehab quite hard and I'm sure I'll beat this or at least manage it in the long term.

 

Just curious if anyone has had this experience with something as impotent as Ibuprofen? Any comments or recommendations?

[pipeman]

My recommendation is to go see a Doctor and let him suggest an alternative pain killer or way to manage the problem. As well as that you can try pot obviously, no one can tell you how effective pot can be for pain, it works well for some people and doesn't to do shit for others. I find for migraine type headaches it works really well for me, almost instant relief, but for muscle tension type headaches like from sleeping in a bad position or wrenching your neck it actually makes the pain worse. Also, I sometimes get ear infections, and I find getting stoned makes that pain worse as well and my infected ear really starts to throb.

 

I have found Panadeine, or Panadeine Forte to be the best pain killers. Works for almost anything I get, which is usually nothing too serious, but the only reason they work is because I don't take them all the time. Taking codeine or any panadeine long term makes them almost useless, plus they're addictive, which makes them evil.

[white_cluster]

I dunno why, but panadiene forte knocks me out, like smoking 300 bongs and end up snoozing all day when on em, I got a really low tolerance to legal drugs, but illegal drugs I'm good with.

 

Anyway I find them Tramal are better than forte, same amount of pain relief but no real fucking with my head.

[Luke Skywalker]

I too suffer from some pretty nasty back pain, as well as sciatica after I do any heavy labour. Lays me out for days afterwards, if not weeks, so I have to be careful how active I get.... particularly during summer for some reason...

 

There's not much I can tell you about the effects of cannabis on muscular pain other than some strains work for me, others don't do much. Usually the heavy indica stones are the ones I get the best relief from back pain and my sciatic spasms, but it never completely rids it. And I still use neurofen gel every now and again... (great stuff that by the way, although if you have serious inflammatory pain they'll prob put you on higher doses)

 

I found if I was taking the high doses of ibuprofen tho, that it tended to become ineffective after a short time, and my body just upped the ante as it were.... I ended up on 2 1000mg slow release tabs a day, and me and my doctor gave up... it was just going to be a pointless exercise... I've seen many, and they've all said three things... 1... opiates... 2.... anti-inflammatories 3... exercise and walking. Well, the first is right dangerous, as I've been down that road as well... nuff said. The second I just explained, and the third is something I do every day. So I'm sorta in a catch 22... I'd love to see some serious medical research on the muscle relaxant qualities of individual cannabinoids as well as strain comparisons... Although I think we'll find a lot of variation in the population, there may be enough of a general response crossover within the population to warrant the development of such drugs...

 

I've heard cannabis can be absorbed dermally, so I think that could be an option... I've also read that cannabis root is known to be effective on inflammation and localised pain, although I have no back up for that. I'd say try some of the menthol or similar heat gels when it's mildly painful for ya, and then move on the scale to the neurofen gels... Although I imagine that if this is a problem you've been treated with medication for these aren't going to do a lot. Try a couple different strains if you can, they may be the way to treat... and maybe look around for a topical MJ recipie... you never know really....

 

Other than that, yeah, you should be discussing the use of MJ for your back with a doctor... You should be able to find one with an open enough mind around major cities nowadays. They should be able to advise you a lot more accurately about things than we could....

 

I hope this helps you out mate, I know how crippling back pain can be, so my sympathies and Force go out to ya...

[RobbieGanjaSeed]

Depending on just what "soft tissue" in your back has been ripped, you could be in for the long haul or not.

 

It can be difficult to get any doctors to back you up with these kind of conditions, for some reason they have a horrible time believeing people are sincere about debilitating pain at times.

 

I have several MRI and CT scans that show a three teir disc prolapse, with stenosis, with thee major nerve roots being compressed. But still, I have "experts" look at the pictures and play the whole affair down.

 

While at other times, I will get a doctor who will look at the very same pics, and find it hard to eblieve I can stand.

 

It's all subjective, their understanding of the pain caused by the damge they can see on film. You're the only one who knows what pain you have, and if you aren't getting succes with any doctors on the matter, keep moving around from doctor to doctor until you do. You will find one that cares. Ask around the community, ask other doctors, what GPs they can reccomend that will be able to prescribe help.

 

I've found the best doctors to be Gov. docs. the ones the gov. calls out to affirm deaths in the community and so forth. Specialists in spinal injuries are very good also. They are used to seeing xray evidence suggest one thing, then cut a person open, only to find things far worse than they were prepared for.

 

But pot for pain is ok. It helps me to relax at night and drop off to sleep, even if for just a few hours.

 

I started using panadiene forte many years ago, then went onto oxycodone 5mg (endone). Then Prolodone (30mg oxycodn IR suppository), to Fentanyl (40 times stronger than heroin weight for weight), to now on 1300 mg+ a day of oxycontin. Which is insane. I use dilaudid as well, which is like a legal heroin. I used to use methadone, but became allegic to it.

 

Just telling you this, so you can watch out for that slippery slide down hill on pain killers. I never thought I'd be doing narcotics at this rate, but am presently using enough to kill several people a day that have no tolerance.

 

Having said that, if the soft tissue tearis rubbing against a neve as you move, (the scaring will rub on neve roots), you wont have any choice but to one day use some kind of narcotic.

 

I'm as strong a proponent for the medical use of marijuana in the country, but still, there is no replacing opaites for total pain control. it's just gonna come down to how bad it is, and how much freedom pain killers will give you.

 

Mind you, I can't drive a car anymore., as I fall asleep in just a matter of minutes of a car moving along, even if I'm driving. So there's serious draw backs, but remember, a usual dose of oxyconitn would be maybe 20 or 40 mg twice a day. I'm using 1300+mg a day. Thats what tolerance will do over a number of years but.

 

Sorry to rush this, I'm in a hurry.

 

take care mate. I sincerely hope you get well soon.

 

rob

[pipeman]

It can be difficult to get any doctors to back you up with these kind of conditions, for some reason they have a horrible time believeing people are sincere about debilitating pain at times.

Its because drug addicts often fake pain, or sometimes even injure themselves on purpose to get the prescription they want. And, as you point out, there is no way to diagnose pain, its a matter of patient credibility and the Doctor's judgement. Its can be frustrating for legitimate sufferers, but the Doctor is only trying to do what is right and ethical to prevent too many people unnecessarily falling down the slippery slope into chronic addiction. In Rob's case I'm sure its legitimate, but if you need to go down that path, you should be doing it due to the pain, not because the patient is a drug addict. This is the difficult judgement that all Doctor's face.

[Chev]

Just telling you this, so you can watch out for that slippery slide down hill on pain killers. I never thought I'd be doing narcotics at this rate, but am presently using enough to kill several people a day that have no tolerance.

That's the scary thing. No-one usually ever thinks that using painkillers could really amount to that much of a dependence on them. I won't even take panadeine forte anymore. I started using almost half a pack a day so I could go to work, and I nearly fucked myself right up. And tramal, and various anti-inflammatories.

Now, I won't barely touch panadol. ::

[RobbieGanjaSeed]

That's right pipeman, doctors are always put in a horrible position, where they on one hand have spent a long time learning how to relieve the suffering of the sick and injured, and on the other hand, due to the complex situation of drug addicts searching, and gov. authorities holding GPs by the nuts, they have to act like cops.

 

Some doctors, well it just seems to suit their nature to do this, they seem uncaring and arragant, but I've had doctors squirm wondfering if their lisence is worth believing me or not, even when I've had letter sof refeal from pain experts from other states.

 

If you live stable, and go to the one GP over your life, it wont be a problem, the doc will come to know you, and trust you (or not), and go from there.

 

This is how I started. My doc was advising me to get out of manual work and get a degree or something, that my back couldnt stand the abuse. I was always getting him to "put my back in". He was magic at it. Then when my discs fnally blew apart, he was there, and knew the story. Without him being there, and knowing me before it happened, I would still be stuffed today.

 

But since then I've had to move countless times, and every new move is an experience in withdrawal, pain and shit fighting with doctors.

 

Fortunatley I went through the pain clinic this time. They approved all my case, I have collected all the details of my case for years . Something some doctors stand in the way of by not allowing the patient a copy of various reports. But I've managed to get them every time one way or another.

 

Anyway, in Qld. a patient has to keep going back to the pain clinc to see that the narcotics are still required, sometimes every 3 months, sometimes every 6 months, and so on; even for cancer sometimes. Or else they have no approval, and hence, no GP can prescribe to you anymore.

 

I fortunately have a life long approval here. Well, they told me I never have to be reviewed, but policies change, and who knows what the future holds.

 

But pain patients by and large are under-treated. Not me as it turns out. Thank goodness.

 

I usually hang out at poppies.org a bit, and have over three or so years that site's been up and running, I've made many friends there. The last 6 months or maybe not that long, I haven't been there, or here for that matter, very much.

 

When I returned the other day, I was keen to catch up with a guy that is of all things a doctor, and a young fella that has way too much knowlege for his age, amongst others. but particularly the doctor. Both are dead.

 

It really knocked me. Going to pain forums, and so on, you kind of get used to the members dieing, that's the nature of the site to a large extent. But when they take their own lives, it really hurts. Steve, (the doctor), killed himself because he couldn't get enough pain relief. I'd say there were other factors in his life that went into that, but that's what did it in the end. He just couldn't go on with insufferable pain, and no relief.

 

He, even being a doctor, was reviewed, a judgment was made reagrding how bad his damage is and it was obvious by MRI and nerve conduction tests, things which can't be "bunged on". but what level of pain a person feels from a certain injury can vary wildly. They figured he didn't need as much as he was using, and took his authority off him, well reduced it at any rate. He was called in for an interview to be told, and he killed himself that night. He was alrady in a lot of pain on the dose he was taking.

 

But the yanks are mad on this issue, as much as illegal drugs. They are just rabid on the subject. They cant even buy codiene over the counter there. And when they do get prescribed stuff like we can get over the counter, it's often mixed with herendous amounts of asprin. The narcotic wont hurt a person, so long as they dont OD. The body gets rid of opaites very readily. But asprin is another story. And they put insane amounts in, so it acts like a deterent to junkies, or would be junkies. It's like trying to stop a kid eating lollies by putting arsnic in them. Their approach to legit drug prescriptions really is close to ther attitude to pot and such, they're mad.

 

The young fella I can't be sure why he killed himself, if that was pain relief trouble or not.

 

But just at my own Gps office, two pain patients have killed themselves in the last year. One was a result of spiralling debt, with no way to provide for the family. I go through this depression too, and is the number one killer of suicide pain patients. He couldn't handle sitting on his arse, smashed out of his brains, and unable to care financially for his family. His wife was suffering stress trying to pay the bills, as my wife also strugles, and he just couldn't go on.

 

The other guy couldn't cope with the disbelief. He had seen a lot of orthopedic doctors, and no one would support his case. Just the same, the GP was treating him with suffficient narcotics, and taking a stand for him. But the embarresment of being dis-believed sent him over the edge and he topped himself too. He was a strong bloke that worked hard all his life, and apparently it was difficult for him to complain about his pain. Believe it or not, this os often a problem.

 

You go in, and through all your life ya taught to not bitch and complain, so you try to stick to the facts, and leave out the theatrics. But doctors often read this as if you have no pain. I myslef have sat in a seat with so much pain I just wanted to collapse, but because I just played it straight, the guy wrote me up as having nothing really wrong with me. It's terrible when your word is worthless.

 

You can't get much more embarrised than to strip naked, stand on one leg and do all these outraegous manouvers, and then be told there's nothing wrong with you.

 

Anyway, I don'thave to go through that anymore, like I said, the gov. has taken my side in so much as the pain clinic has rubber stamped my case, and now my GP can prescribe without fear of being arrested.

 

Having drawn close to my GP ( I see him 3 times a week), he's told me that some surgeons get bad results in certain operations. My type of surgery is often a failure. So when it comes to report on the case, and his findings, he's faced with either writing "this is beyond my scope of ability",. or" there's nothing wrong with him". Guess what they write.

 

Another guy told me this too. A proffesor on spinal injuries. He was outraeged when he read a report made by an orthopedic surgeon regarding my back. It was simply a case of self defense; vanity.

 

If a GP prescribes narcotics to a person that it later turns out to be a ruse, the GP can be kicked out of his profession, and even arerested. It does happen too.

 

The problem here is that GPs aren't trained in the crazy world of pain treatment. They are trained how to do a lot of things, but mainly when something has gone past the take two asprin and call me in the morning routine, they have to refer it on to a specialist. There just isn't any good system in Qld, and many states, to fill this gap. Tasmania has pain doctors, where a gp prescribes for a short while, then refers you on to the pain doctor, who has a lot of training in narcotics and such. Pain doctors are typically anesthetics (them blokes what knock ya out for an operation).

 

Anyway, that'd make a better system. These guys know a lot more about narcotics, both the dangers, and at the same time not deadly afraid of the stuff,like some GPS are. A GP that has no training in the subject , that takes the responsability on to control the amount of narcotics a person should take has taken on a big thing.

 

I'd like to see somethinglike the TAs. system, and have specific pain doctors. Guys who understand the medicines, and the injurues.

 

Anyway, a lot of rambling, and not much point to it really.

 

Take care all.

rob

[Guest niall]

Thanks guys, this has really convinced me not to become dependent on these things. I'll talk to my doctor next visit for an alternative. I've got Ibuprofen gel and this is fairly good but it's not very convenient if you're out and about. It's not too urgent, I'm so used to the pain now it's just a part of life, and I'm doing a lot of deep abdominal, hip flexor strengthening etc. for stability and to protect it, but I do think I'll have this with me the rest of my life.

 

But pot for pain is ok. It helps me to relax at night and drop off to sleep, even if for just a few hours.

 

This just amazes me, I haven't fallen asleep on pot for over a decade now - maybe all I'm getting is sativa dominant, it'd be nice if I could find a confirmed indica one day to be sure. When I smoke I'm awake for 10+ hours every time, no chance in hell can I get to sleep, no matter how late I smoke.

 

Cheers

[syk613]

As was stated above anti-inflams or NSAID non steroidal anti-flammatory drugs are the best drugs for this situation besides narcotics but as your doc will tell you there are 2 classes of NSAID I don't know what biochem changes have taken place to produce this tolerance but perhaps using aspirin may help, as this is a different class of NSAID that works pharacodynamically in a very similar manner BUT I STRESS DO NOT MIX THESE DRUGS OR PANADOL IE PARACETAMOL and I would suggest you wait until you see your doc before doing anything unless the pain is really bad. Watch out for a problem with your blood clotting and if you get a serious cut be exteremly careful because these drugs produce there effect by decreasing the clotting agents and thining the blood meaning less inflammation and pain at any damage area but also this means you won't stop bleeding as quickly if you have a large dose which could obviosly be very serios. But this is just my 2cents you can't see my degree from the Doc NICK RIVIERRA (spellcheck)UNI of Springfield .... So if I was you I would leave the decision making to my doc and if he/she isn't helping grab your medicare card and go and see another one. Good luck also lots of info comes with the drugs, so you'll probably find a few answers and it may raise a few questions, with the product brochure

 

 

 

 

 

 

 

and WC pannadeine forte is almost like having a tab heroin that is my it knocks you out i suspect you don't shoot up so even that small amount of codeine lowers your respiration, heartrate etc it activates your parasympathetic nervous system and puts you to sleep)

[RobbieGanjaSeed]

Smoking pot will make you drop off to sleep fairly quick if you already have the nod from having large amounts of narcotics in ya. I haven't had a "clean" system from narcotics for so many years it's nuts, and I remember when smoking pot was fun all night long. But I live on the verge of sleep all day and night as itis, and a smoke relaxes me just enough to put the lights out.

 

Mind you, I'm wide awake within a couple hours . But that's a couple hours closer to death, and ultimate freedom, so what the hey..

 

NSAIDs are ok, and some of the modern ones are actually able to do what they have always claimed they should, reduce pain. But after 10 years of using them, I developed ulcers in my gut, had to have an edoscipy (camera down the guts); I think thats what they call it. Anyway, I can't take them anymore, because of the damage they've done to the lining of my stomach. I vomitted blood for hours every night for months before that settled down, so go easy on those too.

 

Watch ya weight, exercise lightly, do ya physio if it helps, and stay as fit as possible. That really is the best thing you can do. I lost the battle a long time ago. My weight has got me down now, the experts have all advised me to not do any exersize, not even physio, ( I hate it when lounge chair doctors tell me walking is what my back needs). But then my case is extreme, and it's degenerative. It sounds like yours is a "one of" accident, a tear that is. Where-as I have a degenerative condition, where it's gonna get worse no matter what I do. Aggrevating it just causes more need for pain relief, and round around it goes.

 

So we're kinda diferent patients.

 

Good luck to ya mate. I sincerely wish you well.

rob

Edited October 3, 2003 by RobbieGanjaSeed