Opioids for Neuropathic pain?
 

Maybe? As an adjunct to other meds some find opioids helpful. I'm not a big fan of pharms but we all use them at times so it's helpful to do your research and find what is best.

Here's an interesting article I came across while researching pain meds.
http://care.diabetesjournals.org/content/28/2/485.full

After trying everything under the sun over the last 19 years (some helped for a while, others could not be tolerated or didn't help), I am now using the Fentanyl patch for both my neuropathic pain and joint/inflammatory arthritis pain...successfully, I might add.

Fentanyl patch works better on nerve pain than other opioids. I don't know the reason behind this, but the doctor told me of this when prescribing and sure enough, it was true after just the first few weeks of treatment (compared to other opioids I used before). However, I personally find that Fentanyl does not work as well for joint/bone pain.

My doctor had mentioned Methadone as an option for neuropathic pain, but side-effects are high (according to him) and Fentanyl was a better option for me with severe gastroparesis, which causes GI absorption problems. The Fentanyl, of course, is transdermal and doesn't rely on going through the GI tract.

Don't you have to be opioid dependent for some time before they will give you Fentanyl?

They won't use fentanyl on opioid naive patients...they must be opiate tolerant.

I had taken other opioids before the patch. They also worked pretty good on the neuropathic pain, but after trying the patch I must say it is noticeably better for this type of pain.

I don't remember if you mentioned it but have you used methadone? How did it work for you if you did?

No, I have not tried it. The new pain mgmt doctor I saw mentioned it as an option but said the side-effects were more problematic than other opioids. We decided to try the patch to bypass my GI problems. It ended up being the best choice for me and has worked out well. This is very new (only second month on the patch) so we are still working on finding the right dose/strength.

I also receive IVIG monthly and although it doesn't make a huge impact on my permanently damaged nerves, it does help some. I know this because after 3 weeks, my nerve pain is much worse when the IVIG wears off (half life of only 21 days).

When I was having radiation treatments I was on pretty constant oxycodone. The last few weeks it wasn't sufficient so I also had a Fentanyl patch. All I remember of it was that it really zoned me out. Would hate the thought of using it over a long period of time.

Know I've discussed this here, maybe with some of these same posters in fact, but kratom can be very effective for pain.

I've used kratom in the past but my condition was mild then.

Everone is different. I actually have NO side-effects at all from the Fentanyl patch...NONE. No tiredness, no zoned out, no skin irritation from the patch, no high.

That's pretty awesome.

What Icelander said. Good for you!

Well I used to have a little addiction to Kratom and I finally kicked it. It turned out to be pretty easy compared to any other opioid. Long story short I got out my supply tonight. Haven't used any in many months. I took a teaspoon of Malay and I been having the best evening and night I've had in many months. I'm fairly pain free and very little buzzing. The last few nights have been pretty intense so this has been a very welcome and pleasant event. Thank you so much for the reminder and that little push in that direction.

Methadone, MContin and Dilaudid
 

I have used MSContin, and dilaudid for breakthrough pain, for approx. 13 years now. I could not have survived the discomfort without these meds. I had already tried many, many meds and combinations thereof.

I did try methadone. I could not tolerate it for even 3 days. I had severe side-effects.

I had also tried a couple of types of pain meds. I had chosen MSContin because it worked and I did not feel high from it. I do not enjoy feeling high.
Same goes with dilaudid. While I can feel a bit high on IV dilaudid at the hospital, I do not feel high at all on dilaudid taken orally.

I am starting to look for another approach and have heard so many pros and cons for the fentanyl patch, yet, I keep coming back to it. I appreciate your feedback, EnBloc, regarding your experience with pain medications. Bypassing stomach issues would be very helpful to me at this time.

Will see what my doctors say soon.

:grouphug:

DejaVu

Hi DejaVu :)
 

I'm not where I want to be as far as pain control but for the moment I'll stick with it.

I'm on the BuTrans pain patch, 20 mcg/hr and 3 oxycodone 10-325 a day. 20 mcg/hr is the max he will allow. I have seen other users whose dr's allowed them to go higher. I have not requested an increase in the oxycodone because it gives me that 'high' feeling that like u, I don't like. I do have extra oxycodone's from previous prescriptions and if the pain is really bad I'll take 1 and a 1/4 pills and just that little extra really helps. This is the only thing I've tried so far after being on hydrocodone originally. Of course I've only been dealing with this since May 2013.

When I first went to my pain mgmt dr he did suggest Methadone but said I would have to have an EKG or something similar to that every 6 months. As I have already had heart ablation for excessive PVC's I decided not to go that route.

Not sure why he chose BuTrans over Fentyal patch but I love the ease of using a patch. Mine stays on 7 days and I think the other is only 2 or 3 days and u have to change it. My patch works better if I cover it with a Tegaderm transparent dressing.

Just wanted to give u this info from my experience in case it helps u any.

Take care :)

Debi from Georgia

Thanks, Debi!
 

Hi Debi, :)

Thanks so much for sharing with me. I honestly have never liked feeling "high." I am glad you understand. Many look at me with an odd look when I say this. :)

I will look into the BuTrans patch as well as into the fentanyl patch.

I have been leery of patches as I had a friend use them and she was so erratic with her pain management and her overall stability. On hot, humid days, her fentanyl patch seemed to give her too high a dose too soon. I don't want to get higher than a kite simply because I am sweating. Exercise, showers and/or swimming also did a number on her.

I like things to be as stable as possible and consistent. I also like to feel I am in control of my meds and not vice-versa. ;)

I enjoy the illusion that I have more control than I truly have. Lol. ;)

Thanks again, Debi. You and your family have been on my mind and in my prayers. :hug:

Warmly,
DejaVu

My husband has had Idiopathic SFN for 13 years now and after the Gabapentin (3600mg daily) and Hydromorph Contin (90mg daily) stopped working he was put on the Fentanyl patch.

He started at 75mcg/h and is up to 125mcg/h now, with very little side affects. He sweats excessively at times, but he did that previously. He has less dry mouth than before. But no "drugged" tired feeling, no high, he can function normally and drives (safely!).

He still occasionally takes Oxycondone HCL 5mg as needed, so it is not a "magic cure" but compared to how he was 5 months ago it's 500% improved. So please don't fear the opoids. Yes, there are probably long term affects but honestly if this option wasn't there I don't think he would be here. The pain was so excessive and constant that he couldn't have carried on like that.

Linda

I totally agree Linda. Unfortunately, this disease is one that seems to put us in a constant state of figuring out and choosing "the lesser of the evils"