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Nurse Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience:  RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
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Im in long term chronic pain and am wondering about online

Customer Question

I'm in long term chronic pain and am wondering about online perscriptions?
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Chip replied 2 years ago.
Hi--what exactly is your question?
Customer: replied 2 years ago.

I was unsure of what other opiate medications exist that may have slower tolerance building. The Morphine has been my medicine for over a year and I've had to increase the dose twice. Was hoping to be pointed at something that would be effective without increasing the doseage.

Customer: replied 2 years ago.
Relist: Other.
I'm quite the impatient.
Expert:  Nurse Susan replied 2 years ago.
Hello JAcustomer,

Are you looking for education regarding medication or for an actual prescription?

Thanks for clarifying,
Sincerely,
Susan
Customer: replied 2 years ago.
Yes, education only, please! I also cannot take any codene type medications because they will not work with me at all. I have fibromyalgia, osteoarthritis full body, a few bulging discs in my neck and 6 super bulges of my lower back. I do stretches and take my medicine as prescribed and have tried dietary inclusions/exclusions to help with my pain. I also have a terminator strength back brace. I lack a sense of direction on available medicines to research and discuss with my pain management doctor. Thank you!
Expert:  Nurse Susan replied 2 years ago.
Hello JAcustomer,

Thank you so much for providing me that information about your condition; it is helpful. I am sorry for the pain you are in...I know back pain all too well myself.

One of the reasons your morphine may not be as helpful as you'd like it to be is that some of your pain may be caused by impingements on nerves; you have some bulging discs. The pain that a pinched or damaged nerve produces is not conducted on the same pathway as normal pain is; thus conventional pain medications are not always the best for the special agony that is neuropathic pain. Medicines specifically designed to deal with nerve based pain are Lyrica and Neurontin. You might wish to discuss with your doctor whether or not these are right for you. These are taken daily.
Lyrica: http://www.medicinenet.com/pregabalin_lyrica/article.htm
Neurontin: http://www.medicinenet.com/gabapentin/article.htm

is also used to help nerve pain, and chronic pain as well. It is taken daily, and it does take a while to become effective. It originally was an anti-depressant, but its been shown effective on helping to lessen chronic pain. Its use for pain is considered "off label" so the information here doesn't have it listed, but it is used for pain frequently.
http://www.drugs.com/amitriptyline.html

Prescription strength celebrex may help more than Motrin or Tylenol; celebrex is a type of drug called a Cox 2 inhibitor; what it does is block the Cox 2 enzyme which may help control pain better than other NSAIDS like Motrin that do not block that. More information here: http://www.medicinenet.com/cox-2_inhibitors/article.htm

Alternatives to medications include a TENS unit. This is a device that sends a mild electric current...its not a shock though... into spasmy achy sore muscles and it has shown itself quite effective in helping to lessen pain. It is believed that the electric current "confuses" the pain signal and helps it not reach the brain. TENS units ideally should be prescribed by a doctor or physical therapist who can show you exactly where to place the electrodes.
Here is more information about TENS units: http://arthritis.about.com/od/assistivedevicesgadgets/g/tensunit.htm

Physical therapy may be something that may be of help as well. It may be able to strengthen muscles around the bulging discs so it takes stress off them resulting in less pain for you. Ask your doctor if a referral is appropriate for you.

I hope Ive given you some good places to start, and I sincerely XXXXX XXXXX feel better soon, pain is just awful.

Sincerely,
Susan
Customer: replied 2 years ago.

I took Neurontin and Lyrica AND celebrex and cymbalta etc but not all at the same time. I do have impinged upon nerves but my question was about opiate medications that have less/slower tolerance than morphine, or in any event other opiate medications to discuss with my doctor.

 

Expert:  Nurse Susan replied 2 years ago.
Hello JAcustomer,

I appreciate that information, and am so sorry you have tried so many things to no avail. There are other narcotics / opiates that have been used for pain.

Methadone is one that has a good track record for pain management. You may be familiar with it as its whats given to heroin addicts to ease the pain of heroin withdrawal. (Essentially, one addiction is substituted for another; methadone is addictive as well).
http://www.drugs.com/methadone.html

Dilaudid is a synthetic opiate narcotic, hydromorphone, and is thought to have a lower dependence potential and less troublesome side effects than morphine. http://www.drugs.com/dilaudid.html

Percoset is Tylenol and Oxycodone. http://www.drugs.com/percocet.html
Percodan is Aspirin and Oxycodone. http://www.drugs.com/search.php?searchterm=Percodan
Oxycodone is used to treat moderate to severe pain, but I have the feeling if you are taking morphine, you have tried this and it has failed for you. But in case you have not, I include it. The same is true for codeine preparations, of which there are many. Here is general information on codeine: http://www.drugs.com/codeine.html

All medications have side effects. Some side effects are not bad though; some medications act to potentiate each other when combined. Phenergan is one example. It is an anti histamine, but when its given with demoral and morphine, it helps to make the demoral or the morphine more effective. Here is information about phenergan:http://www.drugs.com/phenergan.html
Your doctor would know more about the many medications that would work well together. Phenergan is just one example; there are many.

Tramadol or Ultram is a synthetic that is based on morphine, but it is not morphine. Its called "narcotic like" but can cause dependence, and should not be taken with opiates or narcotics. http://www.drugs.com/tramadol.html

Fentanyl is a powerful and risky opiate. It is a patch, and that patch has caused problems for some people. It is used mainly for breakthrough pain of cancer, but may be used for other purposes. Information on Fentanyl is here: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601202.html

I also still suggest discussing the NON medicinal alternatives...the TENS unit may help allot. Also discuss the amitriptyline; I find it effective for my pain.

I hope I was able to help,
Sincerely,
Susan
Nurse Susan, Nurse (RN)
Category: Health
Satisfied Customers: 1084
Experience: RN, BSN, MSN-ED, Nurse Educator whose passion is helping people understand their health and wellness
Nurse Susan and 4 other Health Specialists are ready to help you
Customer: replied 2 years ago.
I assure you I have run the gamut of both medications with physical therapies, TENS unit included, also amitrip, tramadol and pretty much all the codene/codone earth hath provided except the oxy stuff, I am trying to do as much as I can to stay at or below the level I'm on. Thank you for the list and the websites!
Expert:  Nurse Susan replied 2 years ago.
Hello JAcustomer,
Thank you so much for the Accept and the bonus! I hope you find the relief that you need. I know how horrid it is to be in pain. I wish you all the best,

Sincerely,
Susan

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