Do I really need to detox just so I can lower my tolerance?

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dagogirl
Regular Member


Date Joined Apr 2010
Total Posts : 23
   Posted 7/29/2010 3:00 PM (GMT -7)   
I am so stuck. I've been on painkillers for over a decade, and my tolerance is so much higher than it needs to be. I've had my dr. change my script, I've tried to taper myself and have even tried cold turkey. So, does anyone have any advice on how to lower a tolerance? Could it be that my pain level has gotten higher, and that's the reason why the pills aren't working as well? I've been taking Percocet 5mg and Lortab 10mg. Also, if I decide to go into a detox/rehab facility, would it be helpful? If I don't disclose the name of my dr., can my dr. find out that I went into detox without his permission/referral? I just don't know what to do at this point.....
 Reflex Sympathetic Dystrophy Syndrome of the Left lower extremity


MIKEL99
Veteran Member


Date Joined Feb 2010
Total Posts : 914
   Posted 7/29/2010 3:32 PM (GMT -7)   
Hey Dago , Most likely your tolerence is higher because of your taking it for ten years , but it can be overcome I beleive . Going to a detox is probably best becauae you'll be supervised by medical and theraputic staff . Also its confidential so you don't have to tell your doctor or antbody if you prefer not to .Going to a detox they'll attend to your emotional needs that come up when going thru this as well . I'm no professionall but thats my opinion , Best of Luck . Keep posting and let us know how its going . Mikel

flower123
Veteran Member


Date Joined Apr 2009
Total Posts : 856
   Posted 7/29/2010 5:21 PM (GMT -7)   
Could you possible just need a dose increase? I don't have any suggestions, but I have heard that RSD is extremely painful!

Hugs

Flower

skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 7/29/2010 6:17 PM (GMT -7)   
Dagogirl,

Talk to your doctor. Voice your concerns about tolerance. He should be able to give you some suggestions and guidance. Drug holidays do work for some people. Or perhaps you might switch medications for a while. Maybe something new will give you better results.

hugs,
Skeye

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/30/2010 12:48 AM (GMT -7)   
Dagogirl,
Tolerance can be a complex issue. For one thing, genetics can be involved. Some people are genetically predisposed to becoming addicted to various substances, and that's nothing you can control. I'm not accusing you of being an addict or anything, but if you look around at your family tree you make get some clues if that could be a factor for you.

It could also be, as you mention, that your pain is worsening. It could just simply be that tolerance is developing normally because of the length of time you've been taking the medications, and like Skeye mentioned, talking with your PM doctor would be the best place to start. You really shouldn't try doing drug holidays or reducing doses on your own, without a doctor's oversight. If you do need a detox facility, your PM doctor could help you with that. I'm not sure why you would want to keep that from him/her, as for all of us in wrestling with pain management over time we need our team of doctors working together.

So talk with your doctor about possible options. It may also be that getting a second opinion from another PM might be helpful, if you find your own doctor is out of ideas.

Good luck.

PaLady

soupcans
New Member


Date Joined Jul 2010
Total Posts : 1
   Posted 7/30/2010 3:17 AM (GMT -7)   
nono   idea AVE PLENTY OPF EXPERIENCE IN THIS AREA, JUST LIKE YOU. I THINK THAT IF YOU CAN BUCK UP FOR about 4 DAYS AND JUST POUND WATER, YOUR TOLERANCE WILL GO DOWN SUBSTANTIALLY. PLUS "REMEMBER" TO STAY ON THAT AMOUNT AFTER THE FOUR DAYS SO YOU DON'T HAVE TO START ALL OVER AGAIN... REMEMBER, IT'S ONLY 4 DAYS (I KNOW THAT IT WILL SEEM LIKE YEARS WHILE YOU ARE GOING THROUGH IT, GET PLENTY OF IMMODIUM AD AND POUND THAT WATER HARD CORE)...
 
TIMMY
 

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/30/2010 10:26 AM (GMT -7)   
Soupcans,
I'm not sure where your experience comes from, but tolerance will not just "go down substantially" by detoxing. It is not that simple. And what you are suggesting can be dangerous. Dagogirl, please talk with your doctor(s) about this and get the help that will be individualized to your own medical situation.

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13470
   Posted 7/30/2010 11:04 AM (GMT -7)   
Dagogirl I really do not have much to offer other than by all means talk to your dr. I am amazed that you have been able to control your pain for this long on the meds you have listed. Many times just switching to a different medication can do the trick. Some PM drs do require their patients to do a "drug holiday" but it is under supervision which is the correct way to do it. I don't understand why you feel the need to hide possibly going to a rehab from your dr. If anything he would most likely commend you for even considering the idea.

You have a very painful medical condition and that is most likely going to require you being on narcotics for the rest of your life, unless a miracle happens. As rotten as life can be at times with CP we are still entitled to quality life. Taking medication for pain is another tool that we have at our disposal to help achieve that quality life.

I do hope you will talk to your dr.
 

crohns disease dx 2002 & small bowel resection, still looking for remission whatever that is, chronic pain 22 yrs, added ulcerative colitis 6-05 to the mix, high blood pressure 28 yrs, aortic heart valve insuffiency, depression, osteoarthritis, osteoporosis lumbar spine, scoliosis lumbar spine, peripheral neuropathy hands & feet, COPD & on oxygen therapy, lupus & psoriasis and psoratic arthritis. Several other health issues just not enough room to list it all. Too many surgeries to list and too many medications to list. Currently on 17 different daily medications. Intrathecal pain pump implanted June 05.


Blessedx8
Veteran Member


Date Joined Aug 2008
Total Posts : 3193
   Posted 7/30/2010 2:12 PM (GMT -7)   
Dagogirl...

I agree w/ what's been said here - I would encourage you to talk to your doctor about your increased pain, and questions re: tolerance. I'd also really encourage you to NOT go "cold turkey" off your meds... In the beginning of my CP journey, I did that a few times - out of frustration and non-acceptance of my situation. It was NOT healthy, and is really dangerous - especially when you've been on opiates long term.

In addition, I know you are concerned re: tolerance - but you've gone a really long time on the particular meds that you are on. It *could* be that they are just not working any longer, OR you could definitely just be having more pain issues w/ the RSD.

As w/ everyone, I do hope you talk to your doctor... and let us know how you are doing. Take good care --Tina
Main Health Issues: Dysautonomia/POTS; CFS/Fibro; Chronic Pain (back issues, migraines, carpal tunnel, among other things); Chronic Hypertension; Hypothyroidism and Hypoadrenalism; Mixed Sleep Apnea (on BiPap); Depression/Anxiety; Vitamin D Deficiency.

MAJOR surprise - Pregnant, w/ twin little girls (after six boys). Due Sept, 2010. Praying they are healthy. YES, you can have chronic pain AND have a successful pregnancy - not easy, but it can be done. :)

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2283
   Posted 7/30/2010 2:39 PM (GMT -7)   
I agree with the others. Going on a "drug holiday" can make a difference. My PM puts me on one once a year and it has been pretty good. There is research out there that says that many conditions can be managed by a consistent level of medication if tolerance is appropriately managed. But as PA points out, that doesn't apply to all conditions. Some actually do get physically worse & that's what contributes to needing more meds.

Also, if you are taking the prescribed amount your doctor gave you, I would suggest that INSTEAD of going to a rehab facility, that you have the holiday managed by your PM. S/he would better understand how responsible pain patients react to withdrawal. Detox centers are just used to people who are looking for more drugs (with a few exceptions). Your PM would know to give you more meds if somehow you have a horrible, horrible pain experience when cutting off or cutting down on your meds.

Also, as others have pointed out, your PM will check to make sure you are healthy enough to go off them completely. Some people (like me) have a hidden health issue & cannot cut down as quickly as others. I have an extra heartbeat. It is not really ever a problem except when I am cutting down to quickly from the pain meds. So we just go a little slower. And if needed, sometimes he will just switch me to a different medicine for a while, or just cut me down pretty low, rather than cutting me off completely.

There are responsible ways to manage tolerance & your doctor should be able to help you. Plus, there are meds to help you cope with the withdrawal symptoms.

Please do have a thoughtful discussion with your doctor about what your options are. Almost every PM out there is happy to help their patients who want to manage tolerance do so. Also, sometimes medications that have worked for years just aren't effective anymore (this happens even with anti-convulsants, anti-depressants, etc.). Maybe it's time to try a new med.


take care,
frances

PS -- Yes, they can disclose your status to your doctor in some cases. Rehab centers often assume that you are there b/c you are an addict & that informs many of their decisions. I have heard of people who are not able to get any more pain medication ever after visiting a rehab place.

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 7/30/2010 4:36 PM (GMT -7)   
Hi Dagogirl,

If I recall correctly, you have had a great deal of stress and emotional turmoil in the last several months. I am concerned for your health and wellbeing with this issue and have to completely agree with speaking directly to your doctor on this one. Detox centers may be different if you are not in the States, but here they have a rather bad reputation and are something you would not really want to do withouth a great deal of consideration. Only you and your doctor can make the decision, but I would NOT do it without discussing it with the doctor first. I honestly beleive that open communication is the best and the only way you can receive proper medical care and proper pain management.

You have had an overwhelming few months....I hope you will find the relief you are looking for!

All my best to you!
Retired Mom

dagogirl
Regular Member


Date Joined Apr 2010
Total Posts : 23
   Posted 8/1/2010 10:27 AM (GMT -7)   
Wow! I'm overwhelmed with relief. Thank you, everyone for all of your advice. Its so nice being in a place (this forum) where people genuinely care about you and your well-being. I can't say I've ever felt so. what's the word I'm looking for....... informed and loved at the same time. I can't thank you all enough! I have an appt. with my dr. tomorrow, and I will have "the talk" with him. I've also scheduled myself to be put on the waiting list at the only detox center that can take people without healthcare/insurance. That way, if and when the time comes, I won't be waiting so long to get in. I hope the dr. does work with me on this. And maybe he will recognize my need for more potent meds as what it is, and that I'm not some junkie searching for drugs. (I hate that feeling.... I've gotten that from a lot of dr.s in the past.) In any case, I think I'm ready for whatever needs to happen. Thank you, everybody. You've been the biggest help.
 Reflex Sympathetic Dystrophy Syndrome of the Left lower extremity

LLPLUV
Veteran Member


Date Joined Mar 2009
Total Posts : 1158
   Posted 8/1/2010 10:44 AM (GMT -7)   
I just wanted to pop in and welcome you to our forums. I hope you can find some good advice from all the members.

I've only been on pain meds for a couple of yrs now so I haven't had to deal with the tolerance issue yet. But I hope your doctor with work with you so you don't have to go into a center.

Laurie
Kidney Diseases and Disorders
Moderator



40 yr young female with,
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD

Also CHF (Congestive Heart Failure) and Sleep Apnea

Hopefully NO MORE........

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 8/1/2010 12:19 PM (GMT -7)   
Dagogirl,
I'm glad you've found everything here helpful and supportive. One thing I know has been difficult for me (and is for many of us) is accepting the need for pain medications, particularly as our need for more potent pain management increases. RSD (or I think it's now called CRPS - Complex Regional Pain Syndrome) has, to my knowledge, no known cure, although I've heard of some experimental procedures mostly in Germany with the use of a hyperbaric chamber (but that's a risky enterprise and I don't know if anyone in the U.S. is doing it yet). That means you're going to continue to need pain management, maybe in a variety of forms - medications, injections, etc. So I would think detox wouldn't be the direction you'd want to head in unless there was another reason your PM doctor recommended. It sounds more like you need to discuss the managing your pain better. And maybe you need to struggle with what I mentioned - accepting the long-term need for pain medications. It won't help you to go on and off pain medications (except maybe drug holidays under your doctor's supervision) on your own. Have you considered seeing a pain psychologist/therapist? That could be a very helpful piece to your overall pain management program.

Let us know how your doctor appointment goes!

PaLady

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 8/2/2010 12:07 PM (GMT -7)   
dagogirl, what meds are you taking? I too have been taking pain meds for a long freaking time. I have been on Methadone 120 mg. a day along with 30 mg. Oxycodone 5 times a day for years now...I am having the same problem with them not working anymore...I have brought up the fact that studies show there is no ceiling for Methadone use....and I could, technically, go up a lot....but I don't know what they are going to do. So? what are you taking?
Spinal Stenosis, DDD, DJD, HBP, Type 2 Diabetes

Methadone 120 mg. X daily
Oxycodone 30 mg. 5 X daily
Lisinopril HCTZ 10/12.5 2 X daily
Metformin ER 500 mg. X 2 @ bedtime
Novolin 50-0-50-50
Novolin R 0-50-0-0

That's all....but OMG!! isn't that enough?
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