[IfItDoesTheTrick]

By posting this, I really don't want to have people that don't understand to comment as they normally do on these forums.

I have severe chronic pain and have had a spinal fusion of my lower back for spondylolisthesis (Spelling). Before surgery I saw pain specialists and was put on everything under the sun. I am pretty young, even still, and at the time was only 16. They put me on everything from actiq 1600 mcgs with patches, to oxycontin. I developed a severe tolerance to opioid therapy and finally broke down and got the spinal fusion in L4, L5 and S1.

It worked for about six months where I was on absolutely nothing, and it was great. For the first time in my life I didn't have to go to the pharmacy and the doctors every month and no medications were controlling my life.

About 2 years ago now, the pain came back. I was put back on pain meds and they needed to go way up in dosage to work whatsoever. They tried dillaudid, ms contin, they didn't cut it. Then the patches again, but I became allergic to those.

I am back on OxyContin. I started on 80mg 2Xday, but after some time it became in effective. Over the last two years the dosage almost has to be adjusted every couple months.

For me it OxyContin only lasts about six hours even at such a large dose. I kind of don't even want to say how much, because I know I am going to get posts from people just about that. Currently I take 3 tablets 3 times day and in about a few days it will probably go up to 3 tabs 4 times a day because they dont last eight hours anymore. 240 mgs really works but not for a long time. My doctor and I have been working for some time to get a dose that kicked in and lowered my pain enough so I can function like a normal 22 year old. I am in college and I really need to concentrate to pass calculus 2 and the organic chemistry courses I take. Oxycontin is the only pain med that doesn't cloud my head.

I was thinking of switching to Opana, but my doctor would have to start me off so low, that my first few months on it would be a nightmare. I can't afford to be in that state because school won't wait for me.

It would be nice to see if there are other people on these dosages of Oxy's or even other meds. I don't want to hear from doctor shoppers, drug dealers, or people who seek to just get high, for that is a waste of time and I don't want it to cloud the thread. If you take large amounts of meds it would be nice to hear any ideas you have as to what I could do to not be taking pills all day, or if you know of any new drugs coming out.

I am extremely educated in pharmacology and the human body. I am not a doctor I have just always needed to know, but I could really use some input.

[Debpurpletiger]

I suffer from Chronic Back Pain and have since November, 2004.

I have tried many Narcotics for this, including (I will try to go weakest to strongest): Vicodin, Percocet, Oxycontin, Dilaudid, and MS Contin, which I am presently on.

What worked best for me was Oxycontin...(but when the Generic went away, I could no longer afford it!!) and that is when my Dr. put me on the MS Contin. I do NOT get the pain relief I need. I take 120mgs of MS Contin per day. I take 60mgs in the morning and 60mgs in the evening. I have the 30mg pills so that is 4 pills per day - -I tried to dose it differently by taking one tablet 4 times a day...but that made no difference as far as pain relief.
I have been on this same dose since about October, 2008 and have asked about 6 weeks ago for an increase, because just naturally, we develop a tolerance and need a higher dose...but my Dr. will not prescribe a higher dose...it is VERY frustrating. I also have 5mg Percocets which I take twice per day...but that has no effect whatsoever.

Have you tried Fentanyl Patches at all? If not, I would give those a try but still have something for the "breakthru pain". My Dr. is willing to prescribe those to me, but my Insurance will NOT cover them and they, too; are very expensive.

Another option may be Methadone. That can be pretty effective for pain relief for some people. It is also very INexpensive. (120 pills per month runs about $40.) My Fiance' also suffers from Chronic Pain (3 Back surgeries) and he takes 40mgs of Methadone - One 10mg pill four times a day - 40mgs daily. He gets good pain relief from Methadone, it is actually the only Medication that works for him.

Those (Fentanyl and Methadone) are the only other Meds I can think of that you might want to try..........

Please keep me posted... OH!! You should read, under "Featured Drugs", the very first post called "Featured Drugs Index" - - - That is where all / any of us can post our personal experience and opinions on Almost any Prescription Medication. It is a VERY GOOD thread to read!!!

[Cats Meow]

I hate recommending it, but at such a high titration I think Methadone is your best and maybe only option at this point, it should do the job analgesia wise, and cloud your head less then OC.
It's very rare to be Rx'd OC above qid, I doubt you'll get much feedback.
I've heard something about Hydromorphone ER (Palladone) coming out soon, or in clinical trials, but factoring in the cost of brand new drugs, and the way insurance companies operate, good luck getting approval (same with crossing over to Opana ER), Palladone runs upward to $500/@30 days.
Cats
(edit - me)
The FDA withdrew Palladone from the US marketplace (oops).

[Cats Meow]

You may wish to consult an Anesthesiologist, this is their area of expertise and have access to lesser known more powerful analgesics, such as Levorphanol.

[mpvt]

You are a good canidate for methadone as it is a powerful agonistopiate painkiller and for some strange reason probably the cheapest. I went through some of the same experiences as you did!! I took handfuls of all opiates for 23 years before I got on methadone. My life has done a 360 as I am even back to work part time. Methadone works much better on our pain receptors then any other prescribable opaite. Heroin is stronger but it only lasts a short time. Methadone can be taken once or twice a day and controls extreme pain very well. So if I were you I wouldn't waste my time with these other drugs as they just don't work for chronic pain patients very well....Dave

[IfItDoesTheTrick]

Yeah I have tried many things over the years (it sounds strange I know, I am so young), but with me methadone did not work well I think that I was on the 10mg pill. With that I became almost fearful. I was very on edge almost scared all day long. When I switched to something else though, I got severe withdrawal symptoms, because it stays in your bone marrow for up to six months. This was the worst withdrawal I ever experienced even though I had strong pain meds in my system. I didn't like the side effects plus knowing your on something that causes such severe symptoms.. I know oxy's have a severe withdrawal as well. My doctor gave me something I am not sure what it is, I was told to give it to my fiancee in case I run out or they are stolen. When injected in your leg or arm it is supposed to give me pain relief and withdrawal releif until I can get to the doctor the next day. He isn't allowed to perscribe it on an everyday basis though, because I have a heart problem withdrawal symptoms can kill me, literally, so I have it to be covered.

I think that I am going to convert to opana though. At my last appointment we bumped up my dose for the first time in awhile. I am now at 240 mg 4x a day. He had to write the perscription for 4 tabs 3 times a day because my insurance company wont cover anything lower then eight hour intervals. Every med company thinks they have developed the answer to long acting pain meds, but they haven't quite got it. Sometimes ER release tablets wear off after an hour.

Thanks.