Jules Galen
Banned
- Joined
- Jun 17, 2013
- Messages
- 3,726
Does Canibus help with the pain?
-
Security incident: ISF was recently accessed by intruders. Please change your password, and change it anywhere else you used it. Read more
Chronic Pain and Opiod Addiction
- Thread starter Magrat
- Start date
-
- Tags
- addiction chronic pain opiod
Does Canibus help with the pain?
My wife has had chronic pancreatitis for about 16 years now. She has continuously been on opioids for that time. She also functions completely normally: keeps a job, etc.
For those who have chronic pain, opioids (morphine. vicodin, etc.) don't produce the "high" that recreational users experience. This is because they are taken at regular intervals and a tolerance develops.
There are several reasons doctors are hesitant to prescribe opioids on a long term basis.
1) They come under government scrutiny. In the past, there have been several doctors who essentially became dealers by writing prescriptions to anyone who came in complaining of pain. Professional licenses are at stake. There have been times when our doctor was out of the office and it was hard to find another doctor in his office willing to write the prescription.
2) Opioids are considered a medication of last resort. They would like to find the least "heavy" medication that is effective and opioids are the big guns.
3) Doctors are very wary of drug seekers. The stories of people going to the ER to try to get a prescription are very true. Because of this, my wife has a pain contract that says she will only take the amount prescribed, and only go to one pharmacy to get the prescription filled. (Can't go to CVS one time and Walgreens the next.) There was one time when we couldn't get a new prescription because the the doctor was out of town. The ER doctor would not write a prescription until he was able to talk directly with her doctor.
4) If they think you are depressed, drink, or take other depressants, they are going to be very hesitant to prescribe an opioid for obvious reasons. This may be why the clinic mentioned will do opioids or cannabis, but not both.
While her medication works great, and it's kept her out of the hospital, my wife would prefer not to take it if she could. There are side effects. Constipation is one of the worst. Also, her energy level is affected. Because she has a legitimate prescription, she passes pre-employment drug tests, but it takes longer because the lab's doctor has to contact her for documentation. And it's a good thing she's not a bus driver or pilot. (Although no driving restrictions or anything.)
The high end opioids are a pain in the butt. Pharmacies don't usually keep large amounts of them. They can't be phoned in or faxed to the pharmacy, so I have to pick up the script from the doctor's office and take it to the pharmacy in person. Vacations are a pain because you generally cannot fill the prescription more than a few days early.
For those who have chronic pain, opioids (morphine. vicodin, etc.) don't produce the "high" that recreational users experience. This is because they are taken at regular intervals and a tolerance develops.
There are several reasons doctors are hesitant to prescribe opioids on a long term basis.
1) They come under government scrutiny. In the past, there have been several doctors who essentially became dealers by writing prescriptions to anyone who came in complaining of pain. Professional licenses are at stake. There have been times when our doctor was out of the office and it was hard to find another doctor in his office willing to write the prescription.
2) Opioids are considered a medication of last resort. They would like to find the least "heavy" medication that is effective and opioids are the big guns.
3) Doctors are very wary of drug seekers. The stories of people going to the ER to try to get a prescription are very true. Because of this, my wife has a pain contract that says she will only take the amount prescribed, and only go to one pharmacy to get the prescription filled. (Can't go to CVS one time and Walgreens the next.) There was one time when we couldn't get a new prescription because the the doctor was out of town. The ER doctor would not write a prescription until he was able to talk directly with her doctor.
4) If they think you are depressed, drink, or take other depressants, they are going to be very hesitant to prescribe an opioid for obvious reasons. This may be why the clinic mentioned will do opioids or cannabis, but not both.
While her medication works great, and it's kept her out of the hospital, my wife would prefer not to take it if she could. There are side effects. Constipation is one of the worst. Also, her energy level is affected. Because she has a legitimate prescription, she passes pre-employment drug tests, but it takes longer because the lab's doctor has to contact her for documentation. And it's a good thing she's not a bus driver or pilot. (Although no driving restrictions or anything.)
The high end opioids are a pain in the butt. Pharmacies don't usually keep large amounts of them. They can't be phoned in or faxed to the pharmacy, so I have to pick up the script from the doctor's office and take it to the pharmacy in person. Vacations are a pain because you generally cannot fill the prescription more than a few days early.
ponderingturtle
Orthogonal Vector
- Joined
- Jul 11, 2006
- Messages
- 54,796
There is the other thing that over time opiods make people more suseptible to pain. Opiod Induced hyperalgesia is a problematic responce when one wants to manage pain
Magrat
Mrs. Rincewind
It would probably, but it is too limited and impossible for me to get. There's not even doctors within an hour of me who prescribe it.
Magrat
Mrs. Rincewind
All correct and my basic experience. I stopped taking oral pain killers about 18 months ago, after 3.5 years taking tramadol and norco.
I don't get high from pain killers. I had IV dilaudid in the er Saturday for my gall stone, I was very surprised to find I felt almost nothing.
That's part of why I had to stop taking them. I am 38. If I am completely tolerant of norco, then they move me up to the next thing after my next surgery. (My medical device gets replaced every 5-7 years). So say, that's vicodin. Couple years later, I'm tolerant of vicodin, so next step up...won't be very long before I am tolerant of every major pain killer. Especially since I can't take morphine.
Good luck to your wife bro, pancreatitis sucks, my son was hospitalized for that a few years ago. Acute, not chronic, he got better after six weeks.
Eta I wonder if the butrans patch would help her? It doesn't make you as tired, or constipated.
Last edited:
Shadowdweller
Graduate Poster
- Joined
- Mar 22, 2008
- Messages
- 1,509
Indeed; as well as potentially dangerous respiratory depression. Over prolonged opioid (i.e. opium-like, based on the neuroreceptors that these chemicals target) usage, the brain reduces the amount of endorphins secreted - the chemicals the brain normally uses to control pain (and stress). These are amongst the primary reasons physicians are reluctant to prescribe too much.
(After a period of time without opioid use - withdrawal - normal endorphin secretion returns, but during that time the brain cannot turn off aches or stress as normal)
That would actually be a step down. She has been on morphine ER for 8-10 years. It doesn't lose it's effectiveness.
Prior to that, she had fentanyl patches. They worked, but patches suck. When she switched doctors (her previous doctor moved) the new doctor switched her off of the patches because the oral meds give you better control. Patches don't deliver medication in a uniform manner. There is a ramp up and a ramp down. In theory, a patch lasts three days, but in practice it is not as effective at the start and end. So she would have to overlap the patches putting a new one on after two days and removing the old after the third. If you lose track, a new patch takes longer to take effect. With the oral, it's much easier to manage.
Also, for chronic pain, things like vicodin and norco, in my opinion, suck. Plus they are bad for your liver because of the tylenol in them. People usually are given these with instructions of "as needed." This makes them much easier to abuse (I need more) or run out early. Time release pills are much better. The idea, according to her doctor, is to keep a constant level of medication in her system. You don't want peaks and valleys, but a constant level.
In all this time, she has not had a problem with medications losing effectiveness. There are a number of other things she takes, but just the one item for pain. It's really not that bad. When she misses a dose, she can still function. if she misses a second, she'll notice because she'll feel a little under the weather. She regularly takes Mirolax for the constipation. She's also on Ritalin for ADHD, which helps with her energy level. (For those that don't know, Ritalin is not a depressant that dopes people up. It's speed.) Unless they are told, know one knows my wife has any problems. It doesn't affect her work and I doubt anyone there even know she's sick.
Magrat
Mrs. Rincewind
I don't have those issues with the patch, and I had the exact opposite issue with the oral meds. I take about a dozen scripts though, because my pain is entirely neurological, so it would obviously cause a different result.
I use Linzess for the constipation, but mine is more from being celiac than the meds. I'm not on Ritalin yet, but that's likely where the road will lead. I have ADHD pretty bad (as do both my kids) and it is exhausting!
I am honestly curious if this increase represents:
1. young people prescribed opiods for medically related pain, who then become addicted, or
2. young people who find a sleazy physician to prescribe them opiods for the money, who are previously or later addicted, or
3. young people who have no prescription for the drugs, but buy them on the street from a black market of opiods diverted from the legitimate medical market.
Obviously the problems and solutions would be different. My understanding is that when the drugs are prescribed correctly there would be relatively few cases of #1. But I could be wrong.
I don't know if pot relieves pain- but I imagine it could be a very useful general distraction for people going through medical traumas. A way of distancing themselves mentally from their physical problems. With fewer concerns as to CNS depression than when people use alcohol as a distraction. This is based on memories of pot experiences when I was young and healthy, so I don't know for certain. Any insights?
Magrat
Mrs. Rincewind
Steve
Penultimate Amazing
Pain control seems to be less of an issue here in Canada. My wife has had several spinal issues including a shattered vertebrae, 5 vertebrae fusion, and an infection that resulted in the loss of several discs. Chronic pain is a way of life for her, but she has no difficulty obtaining the meds that help. She currently has renewable pain prescriptions for:
- buprenorphine patches
- long acting hydromorphone caps
- quick acting hydromorphone caps
- nabilone (synthetic cannabinoid) caps
She may well have a level of addiction to these meds but, as she will be on them for the rest of her life (she is currently 66) this is not an issue to either herself or her doctors. The meds keep her comfortable and able to function fairly normally.
Hope more sense prevails in the medical field in your neck of the woods before too long.
Magrat
Mrs. Rincewind
I am in so much pain it is hard to exist. I hope something changes soon too.
arthwollipot
Limerick Purist Pronouns: He/Him
I think I went to Woodstock aboard the Canibus.
arthwollipot
Limerick Purist Pronouns: He/Him
The one time I was given morphine, I said that it didn't make it stop hurting, but it made me care less that it hurt.
But my experience is very limited here, and I would not presume to speak for others.
Magrat
Mrs. Rincewind
That's true of many pain medicines...generally, if you're give something after surgery or in the er, that's what it will do. Acute care. The butrans patch I wear (buprenorphine) blocks the pain receptor in your brain, so you're still in pain, your brain just doesn't know it. Better for long term use.
arthwollipot
Limerick Purist Pronouns: He/Him
Without going into details, I did have surgery in the err....
Magrat
Mrs. Rincewind
Exactly. So they make you space out directly after, when the pain would be unbearable. For obvious reasons that's not feasible for chronic pain.
The drugs they use for long term pain block pain receptors or inhibit the nerve impulses, which means you don't necessarily get "high".
arthwollipot
Limerick Purist Pronouns: He/Him
Actually I was given morphine before the operation.
Magrat
Mrs. Rincewind
point is they let you go away for a while.