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Louise Sivak, M.D.
Louise Sivak, M.D., Doctor
Category: Medical
Satisfied Customers: 3499
Experience:  Pediatrician, Board-certified in Hematology/Oncology
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I have been taking (2) Oxycodone 15MG every 6 hours for pain

Customer Question

I have been taking (2) Oxycodone 15MG every 6 hours for pain for about 6 months now. I would like to back away from them to be sure I'm not developing a tolerance or addiction. Unlike a lot of people I read about, I do not take them to get high, just for pain. I know this kind of drug has screwed up many lives, so I want to be careful. How long would I have to stop taking this drug to eliminate any tolerance that has developed?
Submitted: 7 years ago.
Category: Medical
Expert:  Louise Sivak, M.D. replied 7 years ago.
I am sorry you have had this degree of pain and I applaud you for wanting to wean off this highly addictive and potentially harmful medication.
I would ask: why were you prescribed this medication in the first place? Do you have a positive professional relationship with that physician - what has s/he recommended for a taper schedule?
Thank you.
Louise Sivak, MD
Customer: replied 7 years ago.
I was prescribed this medication after two separate surgery's. The first was to remove built up scar tissue from a previous injury that was strangling my ulnar nerve and creating sever pain and numbness in my hand and last two fingers. The second surgery actually relocated the nerve because after the first surgery we learned I build severe scar tissue and that was now pressing on the nerve causing more inflammation and pain. I have a very good relationship with my doctor. She's not concerned at all with weening me off this medication slowly when we get to that point. I still need and can't live without the pain medication today. I have developed severe hand muscle atrophy with noticeable wasting of my hand. After trying many other class II pain killers, Oxycodone 15mg, (2) every 6 hours is the only thing that has worked and the dosage has been increased. Originally I was on Percocet 10/325 (2) every 6 hours but she wanted to get me away from the Tylenol. My last surgery was 7/17/09 and I'm still in very bad pain 24 hours a day because as my doctor suspects, the nerve is still severely inflamed. I'm told my pain could last 1 year or even 1 1/2 years as the nerve and or pain pathways rejuvenate. I'm concerned my current dosage will increase due to tolerance building up, the length of time I will need to take them, and ultimately end up with a real strong dosage that have caused trouble for others after long term usage. So, summing it all up, the Oxycodone 15mg I need to continue to take because I can't function to even do daily home tasks, without this pain relief. My concern is the need to increase dosage as time goes on. My doctor will do that without an issue I'm sure, but I'm concerned about going stronger and want to try to eliminate tolerance build up if possible now. I have gone, and suffered badly just lying on the couch and also getting virtually less than two hours sleep nightly, a full 5 days cold turkey without this medicine. I was in severe pain in my hand, forearm, and elbow but didn't seem to notice any withdrawal symptoms. 20mg Percocet dosage use to barely take the edge off but I could live with that. Now it takes 30mg worth of Oxycodone. I would like to eliminate tolerance and get maybe to 15mg total dosage or go back to the 20mg. How long will it take to eliminate my tolerance and what's the best way to go about it, cold turkey for a specific time?
Expert:  Louise Sivak, M.D. replied 7 years ago.
Thank you for the helpful additional info.
There is no way I know to eliminate tolerance - it's a biological phenomenon.
I would recommend your and your doctor's taking a broader view and trying to get your pain better controlled first, then wean off the medication slowly. Has your doctor ever discussed your trying other types of pain medication, such as amitryptilene or gabapentin? These are sometimes very helpful for people with chronic nerve pain and have fewer (but not none) side effects than narcotics.
When you pain is better controlled, then I would recommend you decrease your narcotic dose by 5% every 5-7 days, going back to the previous dose if you get withdrawal symptoms. Your doctor should agree with and know of your plan.
I hope this helps and please tell me if you have more questions.
Louise Sivak, M.D.
Customer: replied 7 years ago.

I have tried Gabapentin, Lyrica, Morphine IR, Dilaudid, Vicodin HP, Tylenol #4, Motrin 800mg, Relafen, Prednisone, and several others without any relief. Only (2) Percocet 10/325 and then later (2) Oxycodone 15mg take the edge off. I have not been able to switch to another drug as a substitute. My doctor wanted to switch me and then go back, but we could not find another drug that works. I have not tried fentanyl, which would probably work, but I'm affraid with screwing with a drug that strong. So, my options are limited and I either suffer with pain or become more medicated and dependent to Oxycodone. I feel no withdrawal symptoms after 5 days cold turkey, so I probably have no issues today. I was thinking I need a few weeks away from it to reduce tolerance but theres no way I can go that long. I suffer very bad without the medication and get virtually no sleep. What is your understanding of nerve pain and the time to heal. Do you agree it is a slow process and could be over a year an my doctor and hand therapist both tell me? What is your personal experience?

Expert:  Louise Sivak, M.D. replied 7 years ago.
You are clearly motivated and intelligent and have researched this issue, plus you know your own body.
Amitryptilene may still help you at least reduce your narcotic dose - potentially worth a try.
Fentanyl is not "stronger" than oxycodone and the timed-release skin patch may help you a lot - just worth consideration.
Yes, in my limited experience nerve injury / pain can take a long time to improve and sometimes never heals completely.
Wishing you the best,
Louise Sivak, M.D.
Customer: replied 7 years ago.
Again, I have no desire to be high on drugs and/or sit drooling on my couch all day like many pill poppers seek out. I hate taking any medicine or having to process it in my body unless absolutely necessary. I have read that Fentanyl is 100 times stronger than Morphine. Also, there's been several documented cases of death from respiratory failure due to defective patches. This makes me fear this drug. I believe Fentanyl is also an opiate derivative am I correct? With that being said, it would not help me away from the Oxycodone since it is also an opiate, do you agree?
Expert:  Louise Sivak, M.D. replied 7 years ago.
You are correct that both oxycodone and fentanyl are narcotics (opiates), and that fentanyl is more potent.
I understand your worry about defective patches, but when used correctly, low-dose patches can be helpful in weaning off a drug. It would (if it helps you) help you get away from having to take oral medication.
Just a suggestion to discuss with your doctor.
Customer: replied 7 years ago.
Thank you for your time and advice with my medication problems. Please answer my question at the bottom as your best guess and/or opinion, knowing it's not an exact science. I'm still not sure, but I understand they make a fentanyl berry flavor sucker for break through pain, that may also be a temporary answer for me. Do you feel if I can make it to two weeks cold turkey without any Oxycodone, any tolerance that may be there could be gone?
Expert:  Louise Sivak, M.D. replied 7 years ago.
Yes, I think two weeks may be enough time.
Best of luck and health,
Louise Sivak, M.D.
Louise Sivak, M.D. and 4 other Medical Specialists are ready to help you
Customer: replied 7 years ago.
Expert:  Louise Sivak, M.D. replied 7 years ago.
You are most welcome and I wish you the very best!
Louise Sivak, M.D.