I'm currently seeing a Pain Management doctor for my chronic back pain. I was researching long-acting opioids and opiates and have only found a few i.e; Oxycontin, MS Contin, Methadone, Fentanyl Patch and Oxymorphone (which my insurance doesn't cover). I think I'm going to ask to try a Fentanyl patch if my doctor will let me. I know that MS Contin is the Gold Standard but I just want everyone's opinion. What about breakthrough pain? Does anyone without cancer use Actiq for breakthrough pain or any other short acting drugs? Please Help. Thanks :)
I'm starting opiate/opioid therapy for chronic back pain. What's the best long acting narcotic?
Added 1 Feb 2010:
Thanks you everyone. I have decided that not one narcotic is the best for an individual person. People differ from one another and don't respond the same as others do to the same drug. I have therefore decided to try what ever narcotics that I discuss with my doctor to see which works best for me personally. So far the Fentanyl patch has been working great. The only side effect I experience is sweating which is not that bad. However the sweating causes the Tegaderm patch that covers the Fentanyl patch to bubble up do to the sweat that accumulates under the patch. It only seems to work for 2 days as well because the third day I experience withdrawals. I will talk to my doctor about this and will probably try an oral long acting narcotic such as Morphine Sulfate (MS Contin most likely.) I'll keep you all up to date on what happens. I see my doctor on the 8th. Thanks for all the comments.
31 Jan 2010
I too have chronic and terrible back pain. I've used the basics: hydrocodone 10/325, Fent. patches 50mg, Oxycontin 60-80mg per day (180mg in the past per day), and briefly tried methadone for pain.
The fent. patches were the only meds that made me feel sick. The generics would fall off, and didn't to work. I went to the Duragesic brand patches which are much better for sticking and pain control. Though as I said, they made me feel sick and ill.
I find low dose oxycontin to be most effective. I prefer to take 1 20mg pill, 3 times per day, or 2 in the morning, 1 at night. Keeping another instant release med around for bad BT pain is also a good idea. I'd reccommend hydrocodone 10/325. Percs. are too much to add with ER oxycodone.
Also be sure to check the medication interractions as narcotic anelgesics do interract with some other non-opiod meds.
Good luck. Chronic pain is difficult to deal with, and takes it's physical and emotional toll. I also went through a shoulder surgery in Sept, and I still havn't recovered. It was and still is very difficult to manage both bad back pain and shoulder pain (after 5 months, my shoulder still kills- much worse than before surgery).
31 Jan 2010
I should also add that Methadone is a good pain control drug. You only need to take it 1 time per day..generally. As you may know, the Germans in the last 30's new war was coming. They were concerned with the supply of raw opium from the east and middle east. As such, researchers were tasked to create a synthetic opiate anelgesic which could be used for battlefield casualties, and treatment of long term injured soldiers. It did work well for the German needs during the 2nd World War. It was later named Dolphine in the United States..not after the German dictator (a common misconception). Anyway, enough history lessons for today, it works quite well.
My understanding is that suboxone never was approved by the FDA for pain. perhaps something changed. I don't know. Not too interested in trying it..but would if I knew it would relieve my pain.
Fent. patches are indeed used for chronic ortho conditions. Alot of docs like them because there is lower abuse potential. I've read on other pain management forums about patients cutting the fent./alcohol mixture out and either eating it, smoking it, taking it rectally, etc., for pain which they say they would otherwise not be able to control. However I suspect that's HIGHLY DANDGEROUS.
Anyway, you may just want to try them all until you find the one which works best for you. It's a hit and miss process. Watch the tollerance thing. It happense to everyone. Resist the urge to take more to control pain as it's a slippery slope and people get themselves into very bad situations needing more and more and more, and thier respective phys. know they have developed a problem. Use what you're prescribed, and if you're having pain issues and tollerance issues, back off some of the meds if you can. Substitue 1 pill for 2 Motrin, or 1 stronger pill for a weaker pill like a Hydrocodone.
Geezzz..my post script comment ended up long. Yikes.
Again, good luck and hang in there. Pain sucks but it can be controlled.
3 Mar 2012
I have taken just about every opioid legally available. Started with Tylenol 4 up to Vicodin, Lortab, I liked those since they were easier to get from your PCP and they can be refilled without a Doctors visit every time you need a new RX.
They also do a job on your Liver and Kisneys because of all the Tylenol or Aspirin in them. My PCP felt it would be better to just take straight Pain Meds. OxyContin is not control released so hits you fast but leaves you after 4-6 he's. MSContin lasts 8 hours unless you chew it which hits you immediately and when taken as you are supposed to it will release over 8 hours. Once you get to Sched2 drugs you cannot get refills and also beware PCP's will write them, but the majority are not certified to detox you. Pain clinics limit amounts, watch you and treat you totally as a drug addict.
I am now on 120mg Kadian, which is a capsule form of MSContin (Morphine Sulfate). but it lasts 12 hours a dose. It is easy to quit if you have a suboxone Dr. near you. It will take care of withdrawal but has no effect on your pain receptors
I have taken all of these with Xanax with no problems. Just be sensible. After feeling like a dog on a leash, and am just using Xanax and 800mg Ibuprophens. I just get 4 blood panels and an MRI every year to check my liver and Kidney's. You will need a special Doctor for the suboxone if you want to quit. Good luck. Do more Rehab and less Pain Meds. you will have to keep increasing your doses until they won't give you any higher. That leaves you with an addiction to drugs that don't even stop your pain. Not worth it.
18 Feb 2010
Dear mitjason, I saw on a website that and older drug called demarol works very well. It worked fro me when I had my appendix out about 23 years ago! I was in intense pain and it worked! Although it was intravenous at the hospital,but even the pills helped tremedously. This website that I can't remember gave it a 9. 5 out of 10.
13 Mar 2012
"Best" depends on what works best for you. The patches are great, so is MS Contin and Oxycontin, and I agree Methadone is also very good although it's not a time released med, it's dirt cheap even without insurance. Oxycodone IR is very good for breakthrough. As it goes you and your Doc should be able to figure this out based on what works best for you. A program that will help with the pain yet not make you drowsy or drool at the dinner table (and sleep well).
21 Jul 2012
If you keep taking these extremely strong narcotics you're going to be addicted like no ones business. I've taken suboxone for 18 months because I got addicted to opiates. I wound up trying heroin and it worked very well. Clearly it was illegal but God it was the strongest narcotic available and killed all my pain. Now I have a super sensitivity to pain. Everything hurts all the time.
5 Jul 2010
i was on morphine in different grades and types ms contin, kapanol ect, adjusted by the doctor and worked well, VERY important fact here my well being was good on these meds going through cancer for the second time at 21. Detox hard but ok.(by the way every human who has opiates for over 7 days will have w3ithdrawl symptums if they suddenly stop , so were all going to gain an addiction)
At 30 put on methadone for pain , it stole my sole, stigmatised me and jadgement will come from everywhere. And if you detox which i did compared to morphine it was 100X worse , im still suffering and would like to die.
18 Jan 2010
I have RSD and was wearing 2 fentanyl patches and taking morphine(ms contin) and it didn't take the pain away ,it did at first but then my body got adjusted very quickly and i needed higher doses of morphine for break through pain. i take suboxone and tramadol this combo. has been working well for 2 yrs. now i take other meds. for my condition as well.i don't think doctors prescribe fentanyl patches for back pain even severe back pain. this type of medication was only approved for patients with cancer or RSD and maybe in other extreme cases but not for severe back pain.i'm not a doctor but this is what i was told and read,do you take any muscle relaxers? maybe you should consider a muscle relaxer with a pain med. again i'm not a doctor but i have severe back pain as well b/c i have full body RSD. and have taken many combos of meds.
i use to take oxycontin for years before fentanyl but again even though the meds are long acting your body starts to adjust. when i was taking oxycontin i would have break through pain as well and then i was prescribed methadone with the oxycontin.it's just a cycle of more meds. and never ending pain. so i've found that a long acting med. like suboxone and tramadol as needed with a muscle relaxer seems to work well for me but everyone is different.
1 Feb 2010
fentenol - patches/morphine patches 4-8 hours relife... Oxycodine more of a heroin fix but will last -days-at least 2 days per pill 20mg to 80mg if takin in quarter chunks weight is a player in this drug also so the bigger u r the more u'll need at first... morphine pills will work for a bout 2 ta 5 hours but can upset yer stomach so eat light and drink light... there are alota pills n drugs u can get rid of yer pain w/ mi friend ed has the same problem he uses fentenol patches (chews on them but can go on your skin) and takes sereqil i cant spell it & mi other friend tawney has a slipped disk she takes vicodine (weak)2hour affect w/darvocets(weak)1/2 hour affect but good luck to u hope this was some help 2 you pCe-A
22 Jan 2010
i am a paraplegic,from a car accident at the age of sixteen it will be 35 years next month. I had harringtonrods with spinal fusion after my accident, I got married and had a son at 23 and had many years without pain until the rods starting topoke through my skin so they were removed and the dr, did not put anything back to keep my spine stable.After years of the wear on my spine my spinal cord had gotton so bad my disc were shot DDD 2006 had anterior posterior fusion with cadaver bone and still having severe pain, my back is full of hardware and very ridgid, I have been on fentanly patches oxycontin, hyro, so may I can't even remember, The fentanyl was by far the worse med I have ever been on, I could not stay awake eat or did I care I lost so much wieght and I am a short small framed girl to begin with, I stopped the patche cold and had bad w/d this was before you heard of meds that would help with the w/d and a poor excuse of a dr. didn't help. Now I am in pain mangt.
and just this week asked to be changed from hydro. for a while they helped for a while but just wasn't helping, Now I on percocet 7.5 4xday and xanax and it helps if I take half of xanax with the perk, I have very strong muscle spasms so that helps to control them. I don't want to get high I just want to have a little slice of life. I know alot of you guys understand and I have found this site to be very helpful. My prayers are with all of you and I would not wish this type of pain on anyone.
11 Nov 2010
I have suffered with severe nerve damage and RSD for 15 years. I have been through trials of over 40 drugs. From Advil to massive injections of Botox to Morphine. I have tried methadone, it did not work very well and there is a real risk of heart failure with this medication. Hands down, Oxycontin with three 5% Lidocaine Patch's works the best for me. The Lidocaine Patch can burn the skin for about 10 minutes but the added pain relief lasts for about 12 hours.
While Oxy is addictive. You just have to manage your activity around your pain level. When your done, put your feet up and call it a day. Chronic pain is life changing and can sometimes seem unbearable. Work with a good pain management doctor until you find the medication that works for you.
Good luck and keep fighting.
27 Feb 2010
If I could tell the horrors of my story both after my back surgery and my wife's constant migraines after her father's death all I can tell you is that we are now both on suboxone to kick this insidious lie that doctors perpetuate on unsuspected pain filled people's lives under the guise of "pain Management" they came very close to killing my wife of 30 years, cost me my job as a minister, went through over 500k in family savings, and lost a once wonderful friend filled life. It started with fentanyl and ended with Lortab and no there was no illegal drugs in the process. These pain clinics are absolute jokes, The Doctors even long term personal family ones like mine are pitifully under educated about addiction, and the list goes on. I also found that over time they all made my back pain significantly worse due to constipation and weight gain around my middle (from steriod injections to begin with but then mainly from opiates.
MAKE NO MISTAKE THIS STUFF IS FROM THE OPIUM POPPI FAMILY AND HAS DESTROYED PEOPLE LIKE YOU AND ME FOR CENTURIES.It may be packaged differently and prescribed by a "doctor" but it is as bad or worse the meth or any other street drug in my opinion. I would rather be in a wheel chair completely paralyzed or in writhing pain than to go back to lortab,percecet, norc, fentanyl, vicoden, vicoprofun, tylenol codene, oxycodone, oxycontin. DO NOT LET THESE IDIOTS TALK YOU INTO DOING THIS< I say this because I wish someone would have talked to me 5 years ago when I was in your position. I would have done anything personal trainers, accupunture, you name it I would have done anything but taking pain killers. It is ultimately up to you but YOU WILL LIVE TO REGRET IT IT YOU LIVE> Go on the suboxone site and read peoples stories like mine and you will have serious pause about getting hooked on opiates. I just went through watching my sweet Christian loving faithful wife go through the most hellish withdrawal you could ever imagine and If I could have filmed it for you and posted it on youtube to help others I should have... Please stop while you can... God Bless.
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