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PostPosted: Sat Dec 26, 2009 12:45 am 
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Hi everyone. so glad to have located this forum.
I have been on sub almost two years now and have been on 2 mg daily for 4 months now.
Tried 30 hours with zero and started to get eebie-jeebies. decided to go down to 1mg daily
and taper to 1 every other day prior to really stopping. It looks like the WD can be as bad as
the dilaudid detox I did a few years ago.
So I am just wondering... say 2-3 days into stopping what does anyone think of using a couple of Norcos
to take the edge off? Like just using them to ease the way a bit.
OK I am ready- I know you're going to rail at me.
I am honestly considering switching back to full on pain meds as I am suffering brutally at the hands of
degenerative disc disease. Hurts like hell just to walk.

Thanks.


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PostPosted: Sat Dec 26, 2009 12:51 pm 
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Hey thespaw -

No railing here. Sounds like you are in the famous category of chronic pain to me.

I totally understand your desire to get off opiates! Still, it seems to me that medicine is not that advanced far enough yet in how to help chronic pain patients.

Let's say you use ANY method and taper off the suboxone. Will your back then hurt only bad enough that a couple of ibuprophen will do the trick? If not....

Then you are in a really tough spot. Are you at a "pain clinic" where they have other potential medications for your back (like blocks, and other things)?

I'm all for your support. I understand - hey a norco here or there will help break the fall. Maybe. I'd just start back up on the norco's if I did that (that's me).

There is other medication your doc can prescribe to help - clonadine seems to be the most prominent - to help.

I believe you may be posting about a much larger issue though... your back! What will you do when you are opiate free? Will the pain be OK? I really feel for you!

If I were in your shoes, i would consider seriously going to a pain clinic to help with your back. Anyway my - non-railing - 2 cents.


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PostPosted: Sat Dec 26, 2009 1:44 pm 
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lathe-
Two issues: pain and being an addict in recovery.
Hard to reconcile the two, but you know I really am not willing to go through life suffering.
I have two small and beautiful sons and want to share life with them. The other night they wanted me
to play with them and my sciatica hurt so bad I couldn't. That just sucks. The suboxone is not
getting the job done with my pain so I am thinking I need to switch back over to real opiates.
I was addicted to oxys (160 mg daily) before the subs- pain was absolutely no issue then.
Now I am feeling truly trapped- Gosh you know this sucks so much. After fifty years on the planet I am realizing
that the truth of life is that it's not gonna be easy. It also can be just wonderful too.

Thanks for responding.
Spaw
:)


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PostPosted: Sun Dec 27, 2009 1:22 pm 
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Hi Spaw -

I can speak from family experience.... choices about pain control (tolerance) and all of that is a very personal decision. This is one area where one size DOES NOT FIT ALL!

Our family made a conscious decision for pain control when the rheumatologist could do no more for pain relief.

The result?

Methadone.

Is it perfect? No. Is it addicting? Yes. I don't fight that battle my wife does but I will say this in defense of methadone -- because of the pain clinic the boys have a mom back. Measured in 'hours' a day of quality - we went from maybe an hour (1) to 4-5 hours. That is huge, and only those who experience chronic pain can really understand what it means to get 5 times as much time with your kids - without wishing you were in a not tub, or just dead so the pain would go away.

Tolerance is an issue. So is your addiction. Still - if you are open and honest with your doctors as you are with suboxone, you may be a good candidate for methadone. I hate to say that here on this board, but like I said - I believe short of a miracle from God, we will be on that for the rest of her life. It's better than being the 'tough one' and having no quality of life.

I wish you well if you go that route. I would guess you already know that methadone is often used for Heroin addiction, but is also very good at pain control (over time - no buzz according to her).

Happy New Year - and I wish you all the best. The decision you face is larger than you... It includes your spouse (if you have one), and your kids.... Whatever you choose, if communicated well, will be the right one. PLEASE KEEP POSTING so we know how you are and if you switch, etc.


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PostPosted: Sun Dec 27, 2009 1:52 pm 
Hi Spaw - Lathedude gives good advice and has good insight into your situation. He's right when he says you probably need to be under the care of a pain management physician. Before taking that step, though - if you haven't already, you most likey need a current, complete work up of your specific back problems before starting ANY new medications. I would suggest a NeuroSpine doc as they have more specific training and expertise when it comes to all things "back". Your family physician or orthopedist with a copy of your back Xray or MRI in their hand is worth about as much as having your veterinarian look at it when it comes to something as specialized as the spine!!! lol - sorry, couldn't resist!! Degenerative Disk disease is just kind of a catch-all term for a lot of different potential diagnoses, and frankly it seems to be handy terminology to throw around to get your pain pills, kind of like fibromyalgia. Now, before anybody gets all mad at me - I am NOT saying these disorders are a bunch of bunk! I believe they're real. It's just that these diagnoses have been thrown around for a lot of years and gotten a lot of people dependent and/or addicted to opiates when there's little evidence to back up the diagnosis or the need for such heavy prescription medications. Okay enough of that before I piss somebody off.
Spaw - Do yourself a favor and get a comprehensive work up done. Find out what's going on - is it arthritis, is it bulging or ruptured disks, is it stenosis, is it scoliosis, is it spondylithesis.....? There are so many possibilities. You mentioned sciatica which is usually caused by compression or irritation of the very large bundle of nerves that run down the middle of the butt cheek and down the leg to the foot. It is quite painful (been there, done that...started my relationship to opiates). Often the pain originates in the lower back because of a disc problem but it can actually also be caused by an entrapment of the nerve in the muscles of the butt.
Why I think it's important to know the cause is this: Opiates are just going to mask the pain, you won't be able to escape tolerance and dependence and you are an addict = nothing good willl come of it. Physical therapy along with NSAIDS may alleviate your pain enough to allow you to function. Your condition may warrant surgery - if so, that may alleviate your pain after a time on opiates, go back on Sub and do okay. You may benefit greatly from a disc decompression procedure I've been hearing more about. You may be a good candidate for epidural steroid/local anesthetic injections, or even a spinal cord stimulator implant (those are supposed to be best for nerve-type pain and there are no narcotics involved). Also drugs like Neurontin and Lyrica are not opiates and work for this type of pain as well.
Those are some things for you to consider before you give up the sobriety you've worked so hard for. If your plan is to go back onto full agonist opiates, then I guess there's no reason to suffer through withdrawals coming off Suboxone, but know that that's what you'll be doing - restarting the motor of your addiction. If I were you, I'd just stick with my 2mg of Sub and take ibuprofen or naproxyn with it until you get a full work up with a good neuro spine guy and find out what you're up against. If it looks like there's nothing to be gained by surgery - get referred to a pain management doctor. Be completely honest with this doctor about your addiction and exhaust every possibility for pain management outside of opiates before you get back on that train.
I know you're suffering I'm so sorry. I know how much sciatica hurts and how much pain interferes with everything in your life, but talk about interfering with life.......opiate addiction interferes with life and pretty much steals your life!! Please take care of yourself and take your time in figuring out what you need to do next.
I've carried on long enough....maybe gave you a little food for thought at least.
Let us know what you decide!


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PostPosted: Mon Dec 28, 2009 2:14 am 
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Wow amazing guys-- so much excellent stuff in your answers. Thank you so very much.
I am going to see a physiatrist on Thursday and will be referred to a specialist. As for NSAIDs I cannot take them.
They are verboten for people with colitis like me. My last major flareup was triggered by using ibuprofen. No more for me.
I have worked very hard to get to where I am clean and sober yes, but I have decided I am unwilling to tolerate this pain and will indeed go the route of opiates if that will stop this suffering. It is ruining the quality of my life. This pain has lasted four months and is worsening. Not likely to go away on its own. Sucks as I have been a serious athlete (cyclist/climber/skiier, etc etc). Rheumatologist tells me some of my pain comes from using my body so hard over the years. And that I am 50 now. So goes it. I'll let you guys know what I find out and will keep this thread updated. Again I really want to express my gratitude for your help.

Spaw


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PostPosted: Mon Dec 28, 2009 10:59 am 
Glad you came back and read your replies Spaw! I'm with you. You have to find some relief - living with constant debilitating pain is not living! Having a gut that will not allow NSAIDS really throws a wrench in things too!
Please hang in there and stay on your Suboxone and try to stay away from the opiates until you are definitively diagnosed. As I said before - there are many disorders that can cause this sciatic pain and some of them can be treated to the point that you will NOT need long-term pain medications. That is my prayer for you.
If indeed it looks like long-term pain management is the only answer - make yourself accountable to your physician by telling the truth about your history with opiates and make yourself accountable to your significant other in helping you monitor your pill counts.
Hoping the best for you and keep posting. I'm interested to hear what you find out.


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PostPosted: Tue Dec 29, 2009 1:01 pm 
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Hey Spaw!

What a great reply by setmefree! Sounds like you are taking the next steps for help.

As I re-read this thread - I realize that we are simply saying .... Go into this next phase "with your eyes wide open."

You know what the 'opiate' route - tolerance, more opiates, tolerance, etc... will do.

What may turn out, exactly as setmefree said, is that as you walk this path - ask EVERY QUESTION you can think of, and look EVERYWHERE for relief before you take a full opiate again. Great advice. You know your system.

Here's the scoop. Guilt and Shame.

You have chronic pain in the back - apparently discussed by a rheumatogist.
You are a mom with little kids with addiction/dependence on opiate issues.
You have other health conditions that limit your options for systemic meds (like NSAIDS).
You desire to have a quality of life for you and your family.
You know there is no silver bullet for this, but you are not just going to crawl inside of an oxycontin and pretend nothing is wrong.

Seems like you are on track to me. These decisions - with all the information you will obtain through spine specialists - will give you what you need to make future decisions.

What you don't need is anyone (family/friends/acquaintances) giving you any grief as you walk this path. Perhaps it's suboxone, and spinal decompression, and heat/cold. Maybe it's a pain-management clinic.

IT IS WHAT IT IS.

We all care about you here! I know what our family chose. In many ways - that feels different than someone like me who didn't have any real reason (just a line of excuses to use) opiates past my knee surgery date. I believe you need to be sure to include all significant others in your life with this. If you wind up on other opiates - then it's good to have someone else understand EXACTLY what you are prescribed and that you follow that routine. We do it rigorously.

Hope this helps some. EYES WIDE OPEN... and ALL THE BEST! Happy New Year.

Any my 2010 saying... "It's complicated"... LOL


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PostPosted: Tue Dec 29, 2009 5:22 pm 
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Well, there ain't much that I can say that wasn't already said better than I could say it. I agree with above lathe and setmefree. Good advice and good luck!

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"The past is finished. There is nothing to be gained by going over it. Whatever it gave us in the experiences it brought us was something we had to know."----Rebecca Beard

"Have no fear of perfection - you'll never reach it." ---Salvador Dali


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PostPosted: Wed Dec 30, 2009 11:50 pm 
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Only one thing to correct... I am not a Mom- I am a Dad.
:roll:

Going for my physiatrist appointment tomorrow. Pain is pretty much constant now.
Really hoping there is some sort of mechanical adjustment possible to fix this.
Downside here is my osteoporosis- developed after five years on prednisone.
I'll post and let you guys know what I find out.


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PostPosted: Fri Jan 01, 2010 12:01 am 
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OK- today I saw the physiatrist. The medical group was top-notch and I really lucked out getting a great doctor!
He did a full analysis of all my syptoms and we came up with a pinched nerve between L4-L5. I go in for an
epideral injection next week. No drugs needed. After that we'll initiate a physical therapy regimen. I am
a really happy camper tonight. Sure do hope this will work- based on his troubleshooting theory I have every
reason to think it will. He nearrowed it down really fast. This is the first time I've gone to this kind of a doctor
and man am I glad I did.
You guys were right!


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PostPosted: Fri Jan 01, 2010 2:37 pm 
spaw, I'm glad everything is looking better and glad you feel good about your doctor. Pardon my ignorance here, I probably should know this but I don't. A "physiatrist" as I understand it is a rehab type of doctor, working with you to improve functionality and diminish pain through various modalities, and most often efforts are to avoid surgery. Is that correct? So, does the Physiatrist do everything that what I would refer to as a "Pain Management" doctor would do? I'm thinking the answer is 'yes.' Like a pain mgmt doc can do your epidural injections and such. Will it be your physiatrist who will do your injections?
So how did your doctor feel about your Suboxone? Any concerns in that regard? It kinda sounds like you'll be trying treatments that do not involve opiates anyway, so the Sub shouldn't be an issue, right?
Again, I'm thrilled you've gotten in with a good doctor. I hope his/her diagnosis is spot-on and that the treatments prescribed provide you with good relief. Remember, though, that back issues can be so very complex. So if you do find that you're not pleased with your initial results, don't jump to pain meds. Rather have them keep investigating, testing, treating, etc to find what is wrong and treat it appropriately.
Thank you for updating us on your progress!


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PostPosted: Fri Jan 01, 2010 2:53 pm 
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setme-
Yes, you described it to a tee. That is the physiatrist definition.
He found that I have reduced flexibility in the lower back, and that my lumbar curve is pretty flat.
He wants me to start physical therapy to inccrease range of motion and flexibility, which he believes
will help with this recurring problem. I tend to agree.
And we barely talked about suboxone or opiates- he discussed other types of pain medication but at
this juncture we're focusing on the injection and the therapy. I am hopeful this will get the job done.
Thanks so very much for your input. It means a lot to me.

Spaw


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PostPosted: Sun Feb 14, 2010 1:27 pm 
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Hi Guys...
Hey I got an epidural for L4-L5 and L5-S1 in early January.
The pain left for about 5 weeks, but is creeping back. I start physical therapy tomorrow.
We'll see how it goes. I'm down to 1/2 a 2 mg sub avery day. Next month I go to 1/2 a pill every other day.
We'll see how it goes. So far so good. Amazing how willing I would be to take an oxy right now after all the
difficulty I went through getting off them.

Spaw


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PostPosted: Mon Feb 15, 2010 12:55 pm 
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Hey Spaw -

Wow- you are fighting a double battle. Please be careful (I know - DUH)...

I understand the feeling of 'I can't believe I could just pick up an oxy'... really. Somehow - you will need to be realistic as you taper - pain control/management with your back - and tapering.

Sounds like you have a plan. Stay strong.


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PostPosted: Mon Feb 15, 2010 1:19 pm 
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I just wanted to say to that I too have degenerative disc disease also between L4 and L5. I have even had a spinal fusion and yet I was still in extreme pain. Eventually I ended up in a treatment center and although my back was literally killing me after about a week it was hurting a little bit less. I know it sounds impossible but I've talked to others too who's pain subsided after they stopped using opiates. The mind is a VERY powerfull thing and I'm not sure if that's what was causing the pain but that was my experience. I would describe myself as being well educated and very rational and I was completely convinced without a shadow of a doubt that the pain was from my back but after my experience it really wasn't. Don't get me wrong it gives me trouble a fair amount of time but I'm able to live with it after being forced to deal with it without opiates. As far as using norco/hydro to taper off the last stretch of Suboxone withdrawal would seem like a terrible idea to me. I know at least for me (remember I'm only speaking of my personal experience and opinions) that while I could really, really, really want to just use just a few hydros to taper off of lower doses of Suboxone I ended up on Suboxone in the first place because I was unable to taper off abusable opiates...... I think even with the best intentions I could end up using again. The worst part I think of opiate addiction for me is realizing that as an addict I have a completely distorted reality for others (when I was still using I mean) but after starting Suboxone it's helped alot andI actually feel like I can make rational decisions based on reality rather than my altered perspective of reality when using.

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PostPosted: Mon Feb 15, 2010 8:38 pm 
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Yeah my reality was skewed too.. and I would just get pissed off without any warning.. anyone could say anything and I would snap... I really hated being like that...

Though my first few days off suboxane I had some really odd thought processes and I felt like my world was changing in front of me.. but I think that was just my body fighting the fact that it didn't have opiates.

Luckily this time around I was able to taper using suboxane and that was actually really nice.. when I went cold turkey off of oxy I would have severe leg pain and other pains through out my body.. but this time around I honestly havent.

I've been taking clonidine which has been a life saver... and today I felt pretty sluggish but drank a 5 hour energy cause there is less caffeine then energy drinks and that helped get me energy...

but other then that, tomorrow is day 4 for me.. and I think I'll be alright... 4mg for 2 months, then down to 2mg, then 13 day taper to .25mg


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PostPosted: Mon Feb 15, 2010 8:39 pm 
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Oh and I walked 2 miles too, which helps..


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