Hi. My pain doctor said the pain dose is at least 1800 up to 3200. I am on 1800 right now. I don't know what the long term issues are as that has never been a concern from the doctors I have worked with. If you are going to go off I would not just stop that can be dangerous. For me the cause is unknown. I have been to almost every specialty,multiple opinions,and so many diagnostic tests so for me now it is just managing the pain. I am a young case to as I developed this at 28. Hang in there