Oxycodone

First off, let me dispel some myths that Echo and others seem to fall into. Narcotic addiction in patients with a real medical need for pain medication is extremely rare - about 5% of cases. Addiction is a problem where a person is using a drug solely for the escape of a sociological, mental or similar type problem, and has no medical use for the drug whatsoever.

Dependence with any drug, even narcotics, is very likely. The difference between Dependence and Addiction (and the reason most people shy away from painkillers to begin with) is that Dependence is caused by long term use for a specific condition. Opiates are not the only drugs that patients can become dependent on. Insulin, Synthroid, Toprol, Ritalin, and many other drugs can lead to dependence that can cause withdrawal symptoms if stopped abruptly.

As far as a "Prescription Trap", that's complete BS and is only in the mind of patients who know little about drugs in general. The only trap you can fall into is being an uninformed patient and blindly following whatever your doctor prescribes for you, whether it be treatment or drugs. While military medicine is different from civilian medicine in many ways, any Vet can refuse to take a drug prescribed, especially a disabled one since they're no longer active and under military command. Anyone who becomes a hamster does so by ignorance and choice. Just because one person or more isn't smart enough to learn about how they're being treated doesn't mean you can't learn and benefit from proper treatment yourself.

As far as most drugs like Oxycodone and other opiates not being tested long term, that's also a BS myth. I guess I'm an oddity since I've been using opiates for 12 years and I'm in my 11th year of formal Pain Management. There just isn't a lot of data because those people like me aren't large in number, and most who require the amount of opiates I use regularly are normally terminal patients anyway. I know many others who have been using opiates for a lot longer than myself.

Oxycodone is not "miracle drug" for pain or anything else. There is no miracle drug for pain as all people are different when it comes to pain. Something that might be excruciating for you is likely just uncomfortable for me as I've been to extremes of pain no one should ever have to face, so my tolerance is a lot higher than average. Also, some drugs don't work as well on some people, so what might be a miracle drug for one person is a complete failure for someone else.

The need to find something that works comes from a lack of knowledge and understanding of how pain is viewed and treated in the medical community. Having been in a formal Pain program for 11 years, I've seen many changes over the years that have made it better and easier for people to get treatment, but there are still cave-dwelling doctors out there who are still stuck in the mentality that pain isn't a problem, it's all mental. Personally, I hope they all die a very long, slow and excruciatingly painful illness prior to death since that kind of attitude violates the very oath they took to help people.

Right now your problem is that your dependence and tolerance levels have increased to the point where the dosage you're using no longer works. Pain tolerance levels are tricky things when you get to the high doses of opiates for pain that I use because there is a ceiling that all patients have where pain relief from the drug ceases to be a factor and increased side effects from the higher doses becomes a real problem. I've been there several times and it is not fun at all, to say the least. So you always want to maintain the lowest possible dose that keeps you comfortable so you have a space between your ceiling and your current tolerance level in case your pain increases and there's a need for increasing your dosages.

Dependence also becomes a factor in that you experience withdrawal pain sooner than you used to.

Depending on your problem and long term diagnosis, you might consider using a chronic pain drug rather than an acute drug like Lorcet (Hydrocodone). Lorcet is an acute pain drug, taken when your pain gets to a point that's uncomfortable. However, if your pain is chronic and constant, and the damage is long-term, then a chronic drug like Duragesic or Oxycontin is a better option. I used to use Oxycontin (time-release Oxycodone) for about a year until my tolerance level got to the point I was only getting about 7 hours out of it (it's a 12 hour drug). So I switched to Duragesic, which is a 48-72 hour pain control drug, in transdermal patch form. The drug (fentanyl) is released by body heat and absorbed through the skin. Since all opiates can be converted to a Morphine-equivalent scale, you can determine the dose you should start at (or rather your doctor can).

Since you've noted pain in your lumbar and knee area, that indicates a disk herniation at the L3/L4 level. The pain you feel is likely going down the side of your spine, around your waist, across your hip and thigh, and stops just at knee on the inside of your leg. Sound familiar?

There are 2 things you should be doing if you're not already or haven't done them. The first task is a Pain Diary - without tracking your pain and when your taking your meds, you always run the risk of dealing with a doctor who doesn't want to give you what you need. Of course if you've already got an established relationship with a good pain doctor that understands your history and works with you well, you might not need one. But most people don't have that kind of relationship with their doctors. The American Pain Foundation has pretty good Pain Diaries in PDF form online - their site is http://www.painfoundation.org. Look in the publications section.

The second task with any kind of severe pain is to find the proper doctor - either a pain specialist or neurosurgeon when dealing with spinal nerve problems. I say neurosurgeon instead of neurologist because neurosurgeons can more quickly tell from your symptoms what area of the spine your problem is located in, and can get the proper pics taken before giving you a treatment plan. In any case, surgery should always be your final option, when your only alternative is a walker or a wheelchair. Nothing else should be a reason, even extreme pain as that can be dealt with.

For the record, my pain meds are Percocet 10/325 (150/month), 100mg Demerol tabs as needed, Duragesic 100mcg patches (1 every 48 hours, or 2 when the need arises to increase my dosages). Although I've had spinal pain for 25 years, I've been in a formal Pain Mgt. program for 11 years. I've had 3 spinal operations, all multi-level fusions, over the past 12 years. Although I qualify for Veterans' disability benefits, I've never taken them because I don't want to deal with the VA. I've been retired on Federal Civilian disability for almost 10 years.

TSD -RAVEN- Category Supervisor

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Yes, they are but do not fall into the prescrition trap. Oxycodone are highly addictive and they will only work temporarly until your body gets used to them. Remember most of these drugs havent been tested long term and it seems as though we have a new drug of the month continually. I'm a disabled vet and have been on pain meds for years. I just recently started excercising and eating right, this has led me to stop taking synthetic drugs and stop being a hamster for someone that capitalizes off death. Its a tuff road but a healthy one. Talk with your doctor and tell him/her that your pain meds don't work like they used to. They will have a good idea of what the next step should be - most likely something in the oxycodone family. I agree with the above posting, a healthy diet and as much exercise as possible will always help. Also, try seeing a chiropractor for your back pain - they can be quite effective for spinal problems, and helping that may help your knee pain.