I'm not sure if this has been previously discussed, but my last trip to my pain management doc revealed something I'm NOT looking forward to: opioids won't work forever, and actually make the pain WORSE!
My doc said, forget tolerance and the need for increased dosages. They've learned something new. Opioids are known for "breaking" the connection or pathways the brain uses to sense pain. While opioids work well in the semi-long term, like for cancer patients who are expected to live 10 years, longer usage results in the brain learning NEW PATHWAYS to sense pain. It gets better: doctors don't know how to relieve pain once those new pathways are established.
This discussion seems to be a recurring theme. I visited a Psychiatrist to learn pain-coping techniques. Since Fibro sufferers are usually in constant pain, the usually pathways the brain uses to sense pain are well established. Apparently even the slightest pain can be amplified along those well traveled paths. She taught me exercises geared toward breaking those pathways.
After explaining this to my sympathetic and very supportive neighbor/friend, he asked "WHAT are you going to do?"
my reply was, "guess I'm going to have to die in 10 years
Post-traumatic Fibro onset after accident 10/05, diagnosed end of 8/06
Total right hip replacement due to osteoarthritis 8/1/06
Extra Hemi Vertibrae on top of T1 and below C7 (call it C8??)
resulting in scoliosis, last measured 40+ degrees.
meds: Cymbalata 60mg twice daily,
Lyrica 150mg 3 times daily
Oxycodone 10/325 up to 6 times daily, usually 3 or 4
Fentanyl patch 100mc 1 per 48 hours
Provigil 200 mg once daily