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Alternatives To Oxycontin?




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10 replies to this topic

#1 hipcrip

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Posted 25 December 2008 - 04:23 AM

I'm US-based, and take 80 mg of Oxycontin twice a day, plus 20 mg of Oxycodone every three - six hours, as needed.

Even though I have a Medicare Part D Prescription drug plan, my O/contin is getting to expensive to afford -- it's $751/month during those months when I have to pay the full cost until I've spent the out of pocket limit ($4500 this year), when the catastrophic level of coverage kicks in.

Even though it's only that price for 3-4 months, I just can't afford that anymore, and am hoping there is a cheaper long-acting opiod that I could switch to.

I've been told by friends that use them that the Fentynal patch is quite effective, but I have very touchy skin when it comes to adhesives so I'm a bit leary of that option.


Any recommendations?

Also, does anyone have experience with weaning off Oxycontin and on to another drug? I just have no idea how that would work.

#2 n0f34r

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Posted 13 January 2009 - 02:07 PM

Oxy IR's r prob cheaper

#3 Nichole

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Posted 14 January 2009 - 02:57 AM

Holy crap dude! Thats a hell of a lot of pain medication you are taking there. Not to mention you are taking one of the most highly addictive prescription drugs out there. Oxy is SO bad, its pretty much medical grade heroin. I'm not at all trying to imply that you are abusing this drug, but just in my opinion you should try to find another way to control your pain. Cost aside, what this drug is doing to your body and your brain is horrible. You are most likely physically dependant on this drug by now if you've been taking that much for any measurable amount of time. I really suggest you research what this drug actually does to your brain. You will actually stop producing the chemical that your body would naturally release in response to pain, cause you to becoming physically dependant on it. I was on this for about a month when i was in the hospital. They gave the 80mg version once, and I literally had hallucinations. I was basically tripping on this shit. They actually od me, I was pretty sure my dad was going to kill a doctor that day...They started giving me a smaller mg, but I don't even see how you can handle what you are taking. It made me so sick, I ended up going from 115lbs to 85 (mind you I'm 5'7). As soon as I got out of the hospital my parents started helping me detox from it. I had to cut doses down gradually. You cant just drop it all at once. I still went through withdraws, even though I did the gradual thing. As far as symptoms of the withdraw go; anxiety, sleeplessness, muscle pain, nausea, fever, crazy itching feeling, nervousness...its completely horrible.

Do yourself a favor and kick this drug. Talk with your doctor, find alternative ways to manage your pain. I don't know what to tell you there because I dont take anything for pain at all. Maybe an over the counter advil or excedrin once or twice a week if anything. There are a hundred other things you can try though that aren't such a hazard to your mental and physical health. Remember, don't try to drop it all at once either, if you decide to that is, it can actually land you in the hospital.

Good luck in whatever you decide.

http://www.webmd.com...=OxyContin Oral

#4 hipcrip

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Posted 17 January 2009 - 10:49 PM

Nichole, your concerns are understood (and shared).

Due to the nature of my spinal cord damage (multiple surgeries to remove a cancerous tumor that was intertwined with the cord from C2-T4, radiation, cervical and thoracic cord tethering, and syringobulbia), and the degenerative nature of my conditions, I can assure you that there are no other effective options for managing my pain that I have not already tried in the more than 30 years that I have dealt with chronic pain.

Despite all of the downsides to taking this level of opiods, they offer me a chance to have a life, something no other treatments have been able to do. My dependence on them is, IMO, no different than being physically dependent on baclofen, oxybutin and other drugs taken long term that give people with SCI a greater quality of life.

Thank you for taking an interest. :-)

#5 AndrewB

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Posted 17 January 2009 - 10:55 PM

Some call it tampee..

Some call it the weed...

Some call it Marijuana,
Some of them call it Ganja

Legalize it... don't criticize it

Legalize it and i will advertise it.
Prison bars imagined are no less solid steel

#6 kewlcatkez

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Posted 17 January 2009 - 11:45 PM

Holy crap dude! Thats a hell of a lot of pain medication you are taking there. Not to mention you are taking one of the most highly addictive prescription drugs out there. Oxy is SO bad, its pretty much medical grade heroin.



I think its also important to realize that Oxycontin is "hillbilly heroin" in the US and really frowned upon to the extent that if yo are taking it - whatever the reason- people presume that you are a recovering drug addict. HOWEVER, here in the UK METHADONE is the drug of choice for those doing drugs detox a medicinal drug which is used for pain control in other parts of the world including the US....its a lot about stigma and misinformation and confusion.

The truth is that I am 'reliant' upon them for some sort of lessening of my pain. I would say relief, but to be honest I don't get that. Research has shown that those of us who take Opiates for valid medical reasoning do not have the same dependency as those who take it purely for recreational reasons. Yes, its possible to feel like you 'need' to take some medication, but I like the studies suggest, do not get 'withdrawal' symptoms, nor did I when dropping dosages dramatically. this would be less important to me if I didn't have young dependent children and probably if I wasn't used to looking from the other 'side'.

I was a RN prior to all of this. I have a complex situation, Paralysis and also a every joint widespread, multiple dislocations every day which has worsened since I had children. I have chronic neurological, joint dislocation, widespread pain syndromes and all sorts going on, all interweaved... I too am taking oxycontin and oxynorm (the slow release and the normal one). I used to yake a lot more than I do now, but I have weaned back some since I just didn't get any more relief from a higher dose, just had more drowsiness etc. I have two lil ones and I didn't want to be out cold when they need me.

Due to the fact I need to be alert etc, ( for the kids and for driving) I take a baseline lower dose of the Oxycontin ( 40mg twice a day) and then take 10mg Oxynorm every 2-4 hours when required. It says to take every 4 hours, but I do know that in hospitals it is an as needed drug, and I only do this with the full backing of my specialist. Also I am 5'3 and petite-ish built, female if that helps. Did take 60mg o/contin and 10mg oxynorm prn a while back..as reffered to above.

Sometimes I will take it every 3 hours, but if I need to be driving more I will space it out more etc.

I get some relief, but not neuro pain relief. I also dislocate very easily and it helps a little with the pain from that as well as my pain issues regarding the paralysis etc. What I would say is that it just takes the edge off, doesn't really do much more, but it is better than no help whatsoever!

I was very very reluctant to take a controlled drug, but I really didn't have anywhere else to go in terms of analgesia. I also take the tabs/capsules as my skin tears with the opiate patches (such as fentanyl) which some folks use.

Of course everyone is different and their tollerence for opiates is too. What I would advise is that folks only take meds on the advice of their dr and at the spacing and dosages they reccomend.

Like I mentioned in another thread today (re neuro pain) I tried extra hot Tiger balm and didn't help.... neither does aversion therapies and Acupuncture (in my case) nor deep and targeted thinking etc.. although some things have distracted me momentarily, nothing has allowed me to escape...I try and keep my mind as busy as I can.. We are leaving it a while ( and trying other things) before trying the Lyrica® (Pregabalin) again b/c as like I said,I have a connective tissue disorder as well as my paralysis ( which means I dislocate many joints, many times a day) and Pregabalin can cause loosing of the joints.

Gabapentin and pregabalin both belong to a group of drugs called "anti convulsants". These are more likely to be of use for your nerve pain than other pain types/analgesia. There are of course many drugs in the anti-convulsant group, several of which have been shown to be effective in treating chronic neuropathic pain. Pregbalin ( Lyrica┬«) and Gabapentin (neurontin┬«) are similar that they both work by binding to the α2δ subunit of the "calcium channel" in the c/nervous system.

I have tried Neurontin® and Topamax® Prozac® etc (along with my opiates) for my Neurogenic pain. It was even suggested that people with nerve pain could try Zacin® (made out of the stuff Chillis are made out of and is meant to kill like crazy, but block pain receptors) we are just not sure if it will be that useful. All of these are thought to act better on Nerve pain. As the Opiates work well on your pain I am thinking that you have non-neuro pain also. It doesn't hurt to look up pricing for these and talk with a pain specialist if possible.


~~Back to your other q re weaning. Firstly pls do not stop your opiates suddenly. This can elad to some nasty cardiovascular and other side effects. The correct and safe way to wean from opiates is to do so very slowly and under the direction of a dr/practitioner. It basically means that instead of taking 40mg O/contin M/r twice a day and 10mg of O/norm every few hours, I would take 30mg in the morning and 40mg at night and keep the other dosages the same, then after a few days ( or when dr advises) I would decrease the evening dose of O/Contin M/r. I can clarify further if required,

Hope this helps,

Take care,

K
Ex Nurse (med retired)
Connective tissue disorder & associated paralysis.

#7 hipcrip

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Posted 18 January 2009 - 02:52 AM

Kez,

I can't thank you enough for your informed, detailed reply! Your points about stigma and presumption of abuse are right on the money.I appreciate you telling your story for a number of reasons, not the least of which is that it made me feel less alone.

Except for your Ehlers-Danlos, it sounds like you and I are soulmates who have rolled down a remarkably similar path while trying to manage pain. Reading about everything you've tried was like looking at my own treatment history, albeit written much more eloquently than I could muster up right now. I do have non-neuro pain as well, including a shoulder that is not permanently dislocated and back pain at the point where my scoliosis and kyphosis overlap (right below my C2-T4 posterior and anterior fusions). As with you, the opioids do not cure my pain, but they take enough of an edge off of it that I can have some good days now and again.

My question re: weaning is not so much how to stop taking the Oxycontin as it is how to transition from the Oxycontin to a drug like methadone. Is it going to be necessary to be completely off of one before starting the other? As you (better than most) can imagine, the weaning process will take a while to accomplish safely, and I honestly don't know how I'd cope being in severe pain for the length of time I would be on the reduced doses before being able to start a different pain med. Still, I may not have a choice -- paying for the Oxycontin is becoming incredibly hard.

Thank you again for your contributions, in this thread and throughout the board. You're truly an asset to the community.

--HC

#8 kewlcatkez

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Posted 18 January 2009 - 04:57 PM

Kez,

I can't thank you enough for your informed, detailed reply! Your points about stigma and presumption of abuse are right on the money.I appreciate you telling your story for a number of reasons, not the least of which is that it made me feel less alone.

Except for your Ehlers-Danlos, it sounds like you and I are soulmates who have rolled down a remarkably similar path while trying to manage pain. Reading about everything you've tried was like looking at my own treatment history, albeit written much more eloquently than I could muster up right now. I do have non-neuro pain as well, including a shoulder that is not permanently dislocated and back pain at the point where my scoliosis and kyphosis overlap (right below my C2-T4 posterior and anterior fusions). As with you, the opioids do not cure my pain, but they take enough of an edge off of it that I can have some good days now and again.

My question re: weaning is not so much how to stop taking the Oxycontin as it is how to transition from the Oxycontin to a drug like methadone. Is it going to be necessary to be completely off of one before starting the other? As you (better than most) can imagine, the weaning process will take a while to accomplish safely, and I honestly don't know how I'd cope being in severe pain for the length of time I would be on the reduced doses before being able to start a different pain med. Still, I may not have a choice -- paying for the Oxycontin is becoming incredibly hard.

Thank you again for your contributions, in this thread and throughout the board. You're truly an asset to the community.

--HC


Hiya again HC,

Thank you for the kind words. I just hope that you will find a suitable alternative or the money to continue with Oxys if they are the only therapy which is working.

I mentioned the generic names of the drugs I have tried above so that you can ensure that you are paying the least amount! Quite often the generic is a lot cheaper ( thats why the NHS uses them!!) and yet it is the same content (however some will argue the toss that a certain brand gives them a different effect, and (not discrediting this at all but) this is a so far mostly uncertain anecdotal findings.

Like I said above I was very very reluctant to take Oxycontin, even though in the UK it is little known of in the general population and so doesn't have the same stigma that Methadone for eg has or that Oxys have in say the US (and prob other countries). As I was a Nurse I was wary if addiction, but like I explained above, research has shown that folks who take Oxys ( or any opiate) for pain relief are less likely to form a true addiction. That said OF COURSE someone can become adddicted. That usually happens when someone is prescribed the drug for an ACUTE stage of their recovery/injury or for another similar episode, but remain on it when they have no more or much less pain. In my opinion, there is nothing wrong with prescribing Opiates when they are needed, but they should be limited and be under the careful glance of an experienced Physician or practitioner ( a pain clinic or pain liaison in a hosp or sci unit for eg). It is then important for the drug to be weaned after the acute phase has ended or addiction MAY occur.

HOWEVER, in some cases individuals will not experience acute pain but CHRONIC pain. In those/these cases, Opiates are a very useful and VALID treatment. Of course they should never be taken lightly, but they shouldn't be discounted eeither ( IMO lol).

The difficulties with people getting addicted to pain meds is often because sometimes it is difficult to know if their pain is returning when Opiates are weaned or if there is a withdrawal reaction. An experienced pain specialist will look for the signs of true pain. If chronic pain isn't present, and the opiates are weaned and noone can interpret if the person is withdrawing or in true pain -often a person will be put back on the drug and be on it for the wrong reasons.

More frequently though, because of fear of addiction, sometimes cost etc etc, a person is weaned when its not appropriate - when they have chronic pain.

LOL just my little rant about opiates..lol..

Back to your q..yes you can switch over from one opiate to another. A Pharmacist would have to advise the drs on the amount which is right for you to switch right over to. For eg, you can't (most times) switch from 80mg of Oxycontin to 80mg of something else...The pharmacist/dr/pain specialist works out how much you are taking over 24 hours and works out the "like for like" of the new drg ( for eg 80mg of Oxycontin could be equal to 50mg of NEW DRUG etc)..This MUST be undertaken by a dr to avoid overdosing. I have seen it done many times and people have entered hospital to ensure it is done with the least risk and then others have been under the care of a dr but remained at home...

I hope this helps..Gonna go now as I think I am not making sense. LOL..I will try and think of how I can explain it better! HTH a little though,

Take care,

Ps glad you feel less alone xox

Edited by kewlcatkez, 18 January 2009 - 10:18 PM.

Ex Nurse (med retired)
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#9 twisted_ophelia

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Posted 25 January 2009 - 09:23 PM

Have you tried codeine-contin? I currently take 100mg at night, it's 12 hour time release stuff and I find it works better than any other painkiller I've tried over the years--and I've tried a lot of them while searching for something to help with the pain in my spine including oxycontin. I also find that as far as side effects go, they are minimal (can cause constipation so make sure you take in enough fluid). Codeine-contin is good for long term use because it's less hard on the organs and body as well. Not sure how much it will cost you in the US since I'm in Canada but it might be another option for you.

Edited by twisted_ophelia, 25 January 2009 - 09:24 PM.

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#10 Lucky

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Posted 04 February 2009 - 12:13 AM

I take 240mg of Oxycontin + 30ml of Oramorph / day and personally couldn't be without.

Just slowly taper if you want rid but personally I'd rather be addicted than in pain.

We're lucky we have the NHS even though most moan about it.

was 57 a typo Nichole ?

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#11 HandicapHero

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Posted 22 February 2009 - 06:39 PM

In my opinion, methadone would be a good alternative to oxycodone. Maybe not a complete substitute but when used in conjuntion with a low dose of oxycodone, methadone can be kept at a relatively low dose and still retain much of its analgesic (pain killing) properties. This works very well for me right now. I've had to increase the amount of oxycodone over the years, but the amount of methadone I am taking has not changed for over 2 years. I am very happy with methadone as my main med for dealing with pain.


Spinal Cord Injury & Cauda Equina Syndrome Support

This website is a way for those with spinal cord injuries and cauda equina syndrome to share experiences and advice. Any medical matters, treatments or alternative therapies discussed on this website should be thoroughly reviewed by a medical professional or therapist before being acted upon. Under no circumstances should you alter prescribed medication or a medical care plan without consulting your doctor or care plan supervisor first.