I sympathize with your issues. I've been using opioids for about
6 years to deal with hip injuries from a car accident and scoliosis in my upper back.
I was very reluctant to use any opioids, even with the severe pain following the accident. I finally gave in about
4 months after the accident as I was basically stuck in bed. I started with darvocet, willing only to take the weakest opioid, but it didn't help. The doctor then moved me to tramadol, which did. I have since been on Ultram ER (tramadol ER) and use hydrocodone or oxycodone for break through pain.
When I first started hydrocodone -- about
5 years ago, I was prescribed 7.5mg pills and typically took 1 1/2. So that's 11.25mg. My PM now gives me 10mg pills and I take either 1 or 1 1/2 depending upon how much pain that I'm in. So, the effective dose for me has not changed much in this time. I would say that 11.25mg then has the same effect as 15mg now. So in 5 years, that an increase of 33%.
Tolerance is inevitable and I think I'm seeing it in particular with my daily ultram dose. I don't think it is nearly as effective. But breakthrough meds, the change is less drastic.
In terms of "addiction", I don't want to be dependent on any meds. However, without them, I'm in too much pain to work. As I see it, if you limit your use to when that use will productively improve your quality of life (i.e. allow you to work more, concentrate better, be there for your family, etc.), the reliance on the meds is better than losing out on life.
Like many others here, I am dependent upon pain meds to function well. But I don't look for the "high" for its own sake... even after 5 years. When the weather is good and I don't over do it, take breaks and lie down, etc., I can go a week or so without taking a breakthrough med. But when it is cold and damp, when I have to be at my desk for hours, etc., 10-15mg of hydrocodone will allow me to continue working through the day; and/or 5-7.5mg of oxycodone will allow me to make it through dinner and spend time with my wife, rather than having to leave mid-meal and lie down.
If you need to take opioids and are concerned about
the pathologies of addiction, I recommend you keep meticulous track of how many you take per day/per week/per month. And, whenever you are considering taking one, ask yourself whether your pain level warrants it or if you could just take a hot shower or lie down for a spell, or something else that might help instead of the dose.
Overall, if you think you'll need meds permanently, then work out the balance between your immediate pain issues and your goal of slowing tolerance as much as possible.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.
Post Edited (cogito) : 1/18/2011 1:03:16 PM (GMT-7)