Posted 5/2/2008 12:28 PM (GMT -7)
absolutely. Having tried almost all the opiates/pain meds out there (including almost all of the classic "cop-out scripts" as I call them, like Cymbalta) I was just trying to share my perspective & experience for whatever it was worth.....Opana is great medicine, IMHO. Pretty much the best of the "traditional" opiates.
After the "traditional" opiate hierarchy, there are two other classes of opioid pain medicines:
1) Fentanyl family, which is so potent by weight that it is dosed in the micrograms rather than milligrams, and though it is very short-acting (about 2.5 hours), its receptor binding affinity is extremely high and cannot be blocked by other opiates -- even methadone tends to yield to Fentanyl, which is what makes the combination of methadone with Fentanyl as a breakthrough pain medication such an excellent one.
2) Opioids which are related to unique compounds such as DXM (dextromethorphan, the main ingredient in cough syrups, Nyquil/Dayquil etc) and which act via several routes other than just opiate receptor binding -- though they both have a very high binding affinity and tend to take priority over just about anything except possibly for Fentanyl-class molecules.....
-- 2a) Methadone ~ NMDA receptor antagonist, reuptake inhibitor for Serotonin, Norepinephrine, Dopamine, very long duration of action and often works where traditional opiates fail to control severe pain of certain types while helping to flatten out the tolerance curve over time to keep the medication working properly to control pain for much longer at a stable dosage than one could with other straight-up traditional opiates.
-- 2b) Levorphanol (Levo-Dromoran, an extremely close relative of DXM) ~ very potent NMDA antagonist, opiate receptor affinity nearly on par with Fentanyl and superior to that of virtually all others.....very well known to control pain that is insufficiently managed otherwise. 2mg dosage, lasts longer than any other non-time-released opiate except for Methadone -- an average of 5-7 hours instead of 4-6.
Conditions: Reactive Arthralgia/Reactive Constellation, Chronic Pelvic Pain Syndrome, Sacroiliitis, Costochondritis, widespread Tendonitis, severe back pain & spasms with numerous spinal problems, barely able to type anymore due to severe full-body runaway inflammation, and on and on. Typical daily pain levels exceed 8.5(!)
Medications: Methadone, Dilaudid, Oxycodone, Marinol, Cesamet, Lidocaine Patches, Flexeril, Zanaflex, Soma, Desipramine; many herbs & supplements.
Previous medications: Oxycontin, Opana, Fentanyl patches, Kadian, Avinza, MS Contin, Lortab, OxyIR, Baclofen, Testosterone (oral, patches, gel), Cymbalta, Lyrica, Neurontin, Amitryptyline, every NSAID known to man, Prednisone....and many, MANY more.