[MikeB]

I have severe peripheral neuropathy.
I take lyrica, 200 mg. 3x plus an extra at bedtime. Gabapentin 600mg. 3x. Essentially, "maxxed out" on both of them. I also take vicodin, about 1-1/2 hour before bedtime.

Recently, I tried something different with my doctor. We weaned off both the lyrica and gabapentin while starting on the Fentanyl Patch. (synthentic morphine.) Once weaned off of those two, the pain was terrible while on 25 mcg/hour patch. I had to start taking some low dosages of lyrica and gabapentin. Then my doctor took me off of the Fentanyl Patch, and started me on MS Contin. (morphine sulfate - 30 mg.) up to 3x. Still pain was so severe that I stopped it and went back on my regular dose of lyrica and gabapentin.
I go to a monthly "Pain Support Group". Our speaker was a Pharmacist who has specialize in Pain Medicine.
Long story short, Morphine, Fentanyl, Oxycontin, all "opioids" do NOT work for nerve pain.
As a matter of fact, they make it worse.

(When I came off the trial of fentanly and morphine, which was almost 7 weeks, I couldn't understand why my pain was worse, even though I was back up to my normal dosage.)

He told me that although the vicodin is in that same catagory, and it works for me, I should keep using it for breakthough pain and at bedtime.

Bottom Line, Opioids will make your pain worse.
(They cause your nerve receptors to increase, which will make you feel more pain.)

Hope this helps some of you folks.

[aussiemom]

I'm not on daily pain meds, can't take lyrics, cymbal ya or neurontin daily. I use Vicodin when it's really bad, and it helps.

[en bloc]

Mike,

Some people find opioids help. So the idea these do NOT work or make pain worse is just not the case IMO and you even proved it yourself.

I think it all depends on what is causing the PN (whether known or not). I know for me it (percocet in small doses) does not completely take the pain away, but it takes the edge off and that makes life easier. I've tried lyrica, neurontin, cymbalta, ...the list goes on. They didn't help or side effects were too great.

Keep in mind that some have improvement just from increased B12. It really is an individual condition and each person needs to find what works for them.

[ginnie]

You may be on to something. I gave up morphine, and percocet. My pain got BETTER after I was off those medications!!!!!!! I don't understand it, just grateful I got off those meds. ginnie

[Neurochic]

It's just not correct to say that opioids don't work for nerve pain. They provide excellent pain control for many people. They don't work for everyone and people have to have sensible and have realistic expectations of the amount of pain that they will still have to live with when's hey take theses drugs for neuropathic pain.

One of the big problems is that people are allowed to take multiple opioids together along with all sorts of other drugs. This causes all manner of interactions and complications. Another issue is that as people keep increasing the doses because they want to be pain free, they require greater and greater amounts of medication because their body becomes increasingly tolerant. Opioid induced pain is another significant issue, increasingly being recognised by pharmacists and doctors and that also increases pain levels. Basic paracetamol can do exactly the same thing.

For anyone whose pain levels reduce when they simplify their drug regime and remove opioids, that is great. However, for those of us who have a sensible and realistic approach to our chronic neuropathic pain management, opioids are an excellent (and necessary) addition to the tool-kit of medication and other interventions.

[Susanne C.]

Originally Posted by Neurochic

It's just not correct to say that opioids don't work for nerve pain. They provide excellent pain control for many people. They don't work for everyone and people have to have sensible and have realistic expectations of the amount of pain that they will still have to live with when's hey take theses drugs for neuropathic pain.

One of the big problems is that people are allowed to take multiple opioids together along with all sorts of other drugs. This causes all manner of interactions and complications. Another issue is that as people keep increasing the doses because they want to be pain free, they require greater and greater amounts of medication because their body becomes increasingly tolerant. Opioid induced pain is another significant issue, increasingly being recognised by pharmacists and doctors and that also increases pain levels. Basic paracetamol can do exactly the same thing

For anyone whose pain levels reduce when they simplify their drug regime and remove opioids, that is great. However, for those of us who have a sensible and realistic approach to our chronic neuropathic pain management, opioids are an excellent (and necessary) addition to the tool-kit of medication and other interventions.

This was said so perfectly I can add nothing. My quality of life would be far lower without opiates. I am not pain free, but I am able to function in spite of increasing disability.

[Neurochic]

I do think that all chronic pain patients deserve to be told right at the outset that they need to set their expectations sensibly. Too often doctors are full of nonsense and tell patients that they are 'very optimistic' about their outcomes instead of being rather more honest about what a chronic neuropathic pain condition actually means. It would make life for these doctors much easier in the long run too - instead of having eternally desperate patients who keep seeking more and more medication or interventions, they might have more accepting patients.

There is a place for all forms of relevant medication in pain management but setting realistic expectations right from the outset is what patients deserve.

[ger715]

Susanne,
The same could be said for me as well. While I still have quite a bit of pain; without the Oxycontin , as well as Oxycodone(percocet) for breakthru pain, my life would be intollerable. I had been given, a while back ago, Cymbalta and lyrica which both proved to be useless.

Gerry