Painkillers  − 4 April, 2008

So I was reading an interesting article yesterday about painkiller “myths.” I have been on painkillers of one sort or another for most of my life, for the myriad orthopedic problems I have. Both the joints and the spasming muscles have caused me pain from as early on as I can remember, and there is no good reason to suffer in pain if there are medications to help it.
I can honestly say I have never had a pain-free day in my memory. Even being on serious painkillers, I am still in pain to some degree – I have never been on a medication that has totally gotten rid of the pain – they simply “take the edge off” or make not care so much about the discomfort. And I also do not let the pain rule my life – I do what I want despite it.
Of course, I frequently “pay” for my overdoing it – increased pain that even doubling or tripling the painkiller dose doesn’t help much. I have found other substances that help “potentiate” the drugs – things like caffeine (a mild analgesic itself, it seems to make the meds more effective) and alcohol seem to catalyze the drugs I am on, making a lower dose work stronger.
A lot of the drugs available for chronic pain are Opiates (Morphine derivatives) and I tend to be quite ill on them. I do better on Opioids – drugs chemically similar to Morphine derivatives – without too much of the side-effects, like nausea.
The drugs cause nausea, but the pain does, too, so sometimes I can’t tell if it is the drugs or my pain causing that queasy feeling.
Anyway, when I first started on the “heavier” drugs, like OxyContin IR, I was concerned about addiction. Word on the street has it that such substances are highly addicting. Well, that is, apparently, one of the “myths.” Certainly if I was an addictive personality using the drug to get high, it would be an issue, but as a patient who needs the drug for pain relief, my risk for getting addicted is minimal. Unfortunately for me, my body also tends to develop a “tolerance” for the drugs I take after a while, so I need to “switch out” my meds every 6 months or so. I have gotten into a routine of rotating them throughout the year to keep them effective.
I also have to take, on occasion, what I call “support” drugs – like Compazine - which helps mitigate the nausea side effect. This will be an absolute necessity if I decide to try Fentanyl again, as it made me terribly ill. At this point, though, with my recent “setback” the drugs I am on now are not really helping all that much. Fentanyl comes in a patch, which is convenient, however, I can’t “halve” the dose and it takes a little while to get into and out of your system, so if I have another bad reaction, I have to wait longer for it to subside than if it were a pill.
I will freely admit I think being pain-free is addictive. Again, I have never been totally pain-free, but when it is controlled, it is a liberating feeling. When you are in terrible pain, that seems to be the only thing you can think about. Like right now… I overdid it last night training dogs and my left hip muscles are spasming fiercely (hence the inspiration for this blog). I am sitting in an odd position to try to minimize the discomfort, but I have already popped some muscle relaxers in an attempt to be more comfortable. Though I am focused enough to do my work (like writing this) the back of my mind is screaming from the pain, and I am impatient for the drugs to kick in so I can sit back more comfortably. Well, I have another doctor’s appointment today… maybe he will have a suggestion for me…