I would love to be sleeping right now, but instead, I’m trying to distract myself from insomnia by discovering websites where I can find the stories of other pain patients (survivors).
Patients on this Reddit thread are discussing their current difficulties because of the opioid war, and it looks like a know-it-all pain doctor felt compelled to add his “expertise.”
ityprpain doc, 1 day ago
Opioid-induced hyperanalgesia is not rare at all. It happens to almost all chronic pain opioid users… Disclosure: I am a pain dr…
If your pain doctor has this kind of strong belief in hyperalgesia, I would start looking for another pain doctor right away. Because hyperalgesia is rare, at least according to pain patients. Your doctor’s belief in this unproven theory just means he has an excuse to cut you off. Or force you to again try other, more expensive treatments.
There is nothing that “happens to almost all chronic pain opioid users,” except maybe poverty. Oh, and of course, almost all chronic pain patients taking opioids obtain some level of pain relief. A small percentage of this patient population will suffer from addiction, but no one knows exactly how much. Most would say it’s around 5%, which is lower than the addiction rates found in the general public. But, as this Reddit poster (orangesunshine) said:
Though I thought we had decided that worrying about this risk of “addiction” made little sense in a population at significantly higher risk of suicide …
Mr. Pain Doctor has more to say (of course):
In proper opioid pain management, once short acting opioids are tried and the pt is in need of around the clock pain management, you switch to a long acting opioid to cover your “baseline” pain and then use prn IR opioids to control breakthrough pain, hopefully less than twice a day. I say “proper opioid pain management” because most drs, especially PCPs do not properly rx opioids to chronic pain pts.
Yes, this is the current thinking on opioid treatment, but I don’t think it works with the new CDC rules. And I’m not sure this theory works for most pain patients, either. You won’t know which drugs will help until you try them. Unfortunately, as can be seen in this Reddit thread, doctors are forcing patients off of opioids, and replacing them with drugs that are ineffective and have worse side effects.
Or replacing pills with patches. I tried fentynal patches a long time ago, and I don’t think any drug made me as nauseated as that one did. I laid on the couch for hours and hours, waiting for the nausea to subside and the pain relief to arrive. Unfortunately, that never happened. I tried one more time, with the same results. (Yes, I’ll say it again, doctors suck.)
Mr. Pain Doctor says the future in pain medication lies in Ketamine, which may become more available in 3-5 years. I’m not sure I agree, but I don’t know if my disagreement lies in my dislike for Mr. Pain Doctor or not. LOL. Any doctor who says that hydrocodone and oxycodone don’t work for long-term chronic pain doesn’t know what he’s talking about.
Mr. Pain Doctor’s view of the future in research:
ityprpain doc, 22 hours ago
“Also if you’re going to publish something it’d be nice to see someone do a review that looks at which opioids have the best efficacy in the treatment of long term chronic pain.”
There is nigh zero chance of that happening.
Melting_Phoenix, RA/failed back surgery/nerve damage, 9 hours ago
My neurosurgeon was prescribing my pain medication after my failed spinal fusion (this was 2 years ago) and he referred me to a pain clinic that was willing to do anything but prescribe me meds. I have spent that past two years trying every non-opioid med, nerve blocks, epidurals, CBT, facet injections, PT but nothing helped. I wish my brain chemistry was different and something like gabapentin actually helped me but it did nothing. The only way I was able to manage the pain and keep working was by taking pain killers and I honestly didn’t have any side effects except occasional constipation. Every doctor I have seen I have been totally honest with. I give them my medical records showing I have nerve damage and showing that I have tried everything and only painkillers helped lessen my pain. Apparently saying pain killers help my pain means I’m a drug addict.
I used to do bio-med research and I try to keep up with recent research. I’m sure there will be better drug options several years from now but I’ve been to the ER 3 times in the past two years wanting to kill myself from the pain so I don’t know if I can wait that long.
I know it’s hard for doctors because they don’t know who they can trust to be honest, even with drug tests people can still be selling some of their pills on the side. And I know they consider people with depression at a higher rick for overdosing so I do regret admitting that the pain made me depressed.