I have to come down with Pete on this on. When the constricting and "bone crunching" pain kicks in my feet, only a combination of Xanax and OxyContin/oxycodone makes the pain bearable.

That of course is not to say that Physical Therapy hasn't recently done wonders for my spasms, concentrating almost exclusively on repeating an almost hour long set of "nerve gliding" exercises, for which I had been previously dependant on Baclofen (which wasn’t enough) and on my worst days, Marinol, which took care of the cramping nicely but left me too looped for my taste. And a home ultrasound machine which can be purchased on-line for about $110 really helps as well, for about half an hour. That and mindfulness can allow me to side-step the pain, but I'm not (yet?) at the point when I can do that while chewing gum and walking, so to speak. For reasons that should be obvious, a peaceful environment helps a great deal in maintaining the level of concentration that’s required for that one.

Sure, it’s possible to go into hyperaesthesia from narcotics, and it happened to one of the dearest friends in my life, after over 30 years of intractable pain, a dozen failed back surgeries and an implanted morphine pump that almost killed her (discharging a 30 day supply in 36 hours), when she finally developed metastasized ovarian cancer, and faced the worst pain of her life, she was given a Dilaudid pump! And that put her over the top. She was in fact more comfortable once she was detoxed, and more comfortable still when she was put back on a reduced level of opioids, where she spent the final months of her life.

And yes, I know that some of the old guard, along with the University of Washington Medical School - which has basically hijacked the state with the odious new law that will take effect in the middle of next year – are constantly bleating about people developing “tolerances” on account of which they require ever increasing amounts of the medication, just to stay in one place. And perhaps that was true of my friend, but if so it was only because her doctors were cowboys, ever willing to push her into something stronger, and she was compliant. Of course, nowadays too many doctors rightly live in fear of the DEA, which is why I would guess that KyMarie’s doctor told her the narcotics don’t help with RSD/CRPS.

Of course it’s rubbish, everyone would agree that they help – at least in the short run – but I suspect what she heard was spoken less out of conviction then self-preservation. And sadly, this is largely a regional phenomenon, especially in the Southeast, where doctors and at least one patient have been put away for what many would assert was objectively reasonable conduct. Whereas, to come to the attention if the DEA in California, you must either run a good size marijuana plantation, be prescribing and dispensing thousands of doses to any given new cash patient in a single office visit [true story] or be responsible for the death of a celebrity, or so at least so it appears.

In my case, my doctors have been much more cautious. I must have graduated from Vicodin to oxycodone six or seven years ago, but I can truthfully say that my consumption of OxyContin and oxycodone has remained unchanged to the last four or five years, except for a disastrous month in with my pain specialist tried me out on Methadone and I couldn’t keep my eyes open. Perhaps I’m just genetically lucky in that regard, especially where two of my first cousins were heroin addicts who died of AIDS in the 90s. And yes, if I haven’t taken the meds for a while, I can become agitated for a few hours, but that’s what Klonopin is for. And when I go to a weeklong mediation retreat, I’m off them almost the entire time: sometimes the pain is bad enough by dinner time that I feel I “have to” take a single 5 mg. oxycodone, but then I wind up sleeping through the dharma talk!

So do narcotics ease the pain of RSD/CRPS? Yes, without a doubt. But neither are they the be-all-end-all. But they can make a huge difference in the meantime.

KyMarie, I apologize for going on so, and hope my comments are useful.

Mike