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Crohn's Disease Forum » Treatment » Pain medication and addiction in Crohn's Disease


 
10-22-2014, 03:49 AM   #391
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Going to try to have a codeine-free day today.
10-22-2014, 05:53 AM   #392
goofyrn2
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Good luck UnXmas
10-22-2014, 05:54 AM   #393
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Good luck UnXmas. I have not had problems with addiction.
10-22-2014, 11:32 AM   #394
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Didn't manage it. I think I could have if I wanted to, but I didn't want to. I wanted to take my dog for a walk because I love the grey miserable English weather (seriously! I love Autumn and Winter - just wish it was colder!) and I was all achy and had no energy. I took some codeine and felt well enough to go out and not just force myself to, but actually wanted to and enjoyed it.

Edit: Trying again today.

Last edited by UnXmas; 10-23-2014 at 05:53 AM.
10-24-2014, 05:57 AM   #395
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Yesterday was better! I've taken some today, but less than usual - enough to prevent withdrawal.
10-24-2014, 06:17 AM   #396
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One day at a time......
10-25-2014, 12:40 PM   #397
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Today's been better.
10-27-2014, 09:40 AM   #398
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Glad to hear it. Hang in there and keep us posted.
10-31-2014, 06:25 AM   #399
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No codeine at all today. Might take some later when withdrawal symptoms start. Yesterday that's all I took too - none until early evening, then moderate dose to stop withdrawal. I'm using Modafinil as a kind of substitute: http://www.crohnsforum.com/showthread.php?t=67990

I'm also very aware that I've gone through a lot of my codeine prescription that's supposed to last me a couple more weeks yet. Last prescription I ran out too early and don't want to repeat that. But why did I wait 'til now to try and moderate it?! Why was I too stupid to do that from the start? It's the same with my weight - I know my doctors will hospitalise me if I don't gain enough weight each week, but I spent a while faffing around before I actually realised I have to force myself to eat more. I guess I always want to see what I can get away with.
10-31-2014, 06:36 AM   #400
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Keep up the good work UnXmas. Hang in there. It's a hard road but I'm sure with time you will get there. Thanks for the link about Modafinil.
10-31-2014, 11:44 AM   #401
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Late afternoon now, and I'm still doing ok!
10-31-2014, 11:48 AM   #402
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Cool. Glad to hear it.
11-01-2014, 05:47 AM   #403
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I'm worried that I'm dominating this thread. Does anyone mind or should I start my own thread?

Edit: I think I will stop posting about the codeine on this thread, and post about it on my Modafinil thread instead ( http://www.crohnsforum.com/showthrea...d=1#post826484 ), since the two relate to each other. It seems more appropriate.
11-28-2014, 06:25 AM   #404
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I , personally, don't have a problem with it UnXmas but lets see what other folks say. I have not had any problems with addition so I wish I had suggestions for you. Hang in there.
12-30-2014, 08:59 AM   #405
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Been a while since I last posted on this thread. I've had many codeine-free days recently, and my overall consumption is down quite a bit. The doctor's prescription now lasts me a month like it's supposed to. I still take it all at one time though, I don't take the 30 to 60 mg at a time like I'm supposed to, I take, at the moment, usually 180 to 240 mg in one go, though that's lower than my average dose was a couple of months ago. And I still take over the daily limit often. It's just not effective to take 30 to 60 mg at a time and never go over 240mg in a day. Much better to have 240mg in the morning followed by another similarly large dose later in the day and have a really good day. If I took 30mg and then a few hours later another 30mg and so on, it would just waste it because I'd still get through a lot of it but not feel any benefit other than staving off withdrawal.

And withdrawal is a funny thing. One thing I've found that's helped me to cut down is that sometimes I feel awful withdrawal and sometimes it's not that bad. (And the reverse is also true: sometimes a high dose makes me feel so much better, and other times only a bit better - but always at least a bit, it never fails to make me feel a bit better and I always feel better taking some than none.) So I try going without, and if the withdrawal's awful I take some, if it's not, I keep going without.

And I'm still using it in the way it's of most help: if I feel awful, physically, mentally, for reasons nothing to do with codeine withdrawal, a big dose will calm me down and steady me a bit.
12-31-2014, 06:35 AM   #406
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Hi Unxmas

Have you considered Methadone? I have no idea about how withdrawal works but perhaps you can work with a withdrawal clinic but they would require you not to take your script. Just something I am throwing this out there for your thoughts.

Happy New Year.
12-31-2014, 04:19 PM   #407
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I don't think codeine is strong enough to warrant methadone. Codeine withdrawal just feels like having the flu, getting over-emotional, and really wanting to take some codeine even though I'm not quite sure why I want it. Taking methadone would cause more problems than carrying on taking codeine. Thanks for the suggestion though. Happy New Year to you too!
12-31-2014, 04:36 PM   #408
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Unxmas

Are you in a state that offers medical marijuana? Again I am just racking my brain to help you. It is not offered in Virginia. Very conservative. Well, that is all I can think of at this point but I feel your frustration. Take care and thanks for a Happy New Year. They, being Christmas and New Years comes faster and faster the older I get...LOL
01-01-2015, 05:12 AM   #409
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I'm in the UK, where medical marijuana is illegal everywhere.
01-01-2015, 08:44 AM   #410
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But don't worry about me, goofy. I don't intend to stop codeine completely. If I did want to do that, I'd just ask my GP to stop my prescriptions. You can't buy codeine here, you can only get it if you have a doctor's prescription (well, you can buy codeine in very small doses that also contain paracetamol. The reason for the paracetamol is that it makes you sick if you take too much, so you can't take any more than the very small amount of codeine - I know, I've tried it and I can't stand feeling nauseous, so I won't do that again!). If the GP stopped my codeine prescription, I'd go through a few days of feeling like I had bad flu, but it's not dangerous and it's not terrible - I've done it many times, voluntarily. But what I'm trying to do at the moment is cut my codeine use down, because it was getting out of hand, but not stop it.

Maybe it would help if I set myself definite limits to stick to. I have been cutting down, but when I feel bad I take more. Maybe if I set myself a specific number of pills to take, and maybe another specific number for when I feel very bad, it would be easier than just having the undefined idea of cutting down. Guess I could also ask my doctor to reduce my prescription? except I need to have control of it myself.

But anyway, codeine addiction and withdrawal are nothing compared to strong opioids, I'm sure other drug addicts would not be impressed by the amount of fuss I make about it. And codeine withdrawal isn't dangerous, which is another critical difference. When I was in hospital, I had oxycodone - I posted about it on this thread - and the withdrawal from that was something else - and I'd only been on it for a few days! That withdrawal was awful, and there was no way I could have done it by myself. I was begging the doctors and nurses for more.... if there'd been any way I could have got someone to sneak it into the hospital for me, I probably would have, I was that desperate for it.

A nurse told me that if you imagine a scale of the strength and withdrawal of opioids, heroin would be at the very top: the strongest effects and the most terrible withdrawal. She said oxycodone would be right up there just below heroin, though the withdrawal after just a few days of use shouldn't have been anywhere near as bad as it was for me. I think for some reason opioids just do it for me: something in my physiology just responds to them and taking them makes me feel so well, and my body just hates it when they're taken away. And the nurse said codeine is right down at the bottom of the scale. In fact, once I was off the oxycodone, the doctors were fine with letting me have doses of codeine higher than the recommended maximum. I think they felt that, compared to oxy, codeine addiction wasn't worth worrying about.

From that experience I learned never to try another opiate: pain is better than withdrawal. But also that codeine addiction isn't terrible.
01-01-2015, 08:50 AM   #411
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Btw goofy - do you have pain? How do you manage it? (A lot better than I do obviously. ) I saw on your profile you have fibromyalgia, and am I right in remembering your take Elavil? I take it, but for pain but for sleep and as an antidepressant. Have you joined the support group for it?

http://www.crohnsforum.com/showthread.php?t=47926

(Elavil's a brand name for Amitriptyline.)

Last edited by UnXmas; 01-01-2015 at 09:09 AM.
01-10-2015, 07:47 PM   #412
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I've read through this thread and I've noticed that a lot of you talk about taking Dilaudid. Are you taking it at home, in pill form? I've only ever gotten that in the ER by IV. When I need pain meds at home, I've only been given Tramadol (or a few days worth of Vicodin if I'm being discharged from the ER). I was just curious because I've never heard of docs prescribing Dilaudid pills for home (which would seem like a life changer!).
02-07-2015, 06:30 AM   #413
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I pulled a muscle or something in my leg the other day. Codeine stopped the pain like magic. There are definitely benefits in continuing to take it.
03-17-2015, 10:06 AM   #414
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Hi UnXmas. I didn't kow there was a group for fibro and those taking Elavil. It really does take the pain away at night time and helps me to rest. One a new note....I tried the new drug Entyvio approved by the FDA for Crohns and after the fourth does I had an anaphalysis response and off to the ER I went. I looked like a burn victim. It was all over, hurt like being a burn victim and had respiratory involvement. Now my GI guy is sending me to medical centers to see if they have any studies going on. The only thing I am on now is steriods and that aint cutting it. Hope all is well with you and hope others have more success with this new drug. It is a great hopeful drug for so many that struggle with remission.
03-17-2015, 12:00 PM   #415
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Goofy! That sounds awful! Have you had reactions to other meds before?

Amitriptyline (Elavil) still works very well for me at night. I've been trying to find alternatives to codeine; my doctor prescribed me tramadol but I'm not sure the benefits were worth the side effects, so I'm still in the same situation with painkillers, trying to make my prescription last longer, but my doctor isn't concerned and tells me to take codeine if it makes me feel well, which it does.
03-17-2015, 12:07 PM   #416
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Hi UnXmas. I have tried so many drugs including all the TNF drugs. I have had anaphylasis to liver failure. Some of them have latex in them or in the vials they are in and I am anaphylatic to latex as well. Sorry my spelling is not my forte. I do take narcotics for the pain and the doc tells me to take them but I don't have any problem with lowering the dosages or taking the full amount as perscribed without any addiction symptoms. My heart goes out to you. Crohn's is just so complicated in itself and then the meds with their side effects complicates things even more.
04-09-2015, 04:54 PM   #417
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I am so blown away, hurt and angry!!! I've said before on this page that I've been on and off narcotics for years and with in the last 2yrs i've been able to stay off them. I'm having a bad spring (my crohns seems to flare in spring and fall), and needed some pain relief. I went to the ER, as I have been told to do in the past, and was denied pain meds unless I submitted myself to a CT scan and scads off other tests to see what was causing the pain. I told him I know what is causing the pain and I see my GI in two days and would rather have him call the tests due to expense. He told me due to having signed a substance agreement he cannot give me meds. I said this makes no sense, the contract is to make sure I stay within my Docs not ER, besides, I said, I have pain meds at home that are not working, I don't want to leave with any, just need a break from all this pain. He looked at me like I was an idiot and seeking out medications. I left AMA, crying for being accused of doing that! He was so cold and mean, and has no clue how to deal with a chronic pain patient. Sorry had to vent. I hate this disease!!!!!
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diagnosed: Crohn's desease 1988, Hiatal hernia, reflux, chronic pain syndrome
surgeries: 2 bowel resections(removed ilium; approx 2 1/2-3ft of small bowel and some of colon) 4-5 rectal fistula repairs; gallbladder and appendix removed
Current medications: Immuran(azathioprine)100mg, nexium 40mg, alprazolam, wellbutrin, lexapro, lomotal, donnatol, monthly B12 injection

In the midst of my first flare in 13yrs
04-10-2015, 02:01 AM   #418
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I'm sorry long time crohnie. Do you have a copy of the contract? The hospital must have records of your ER visit, you could find out who this doctor was and get his superiors to educate him. If you don't have a copy, it sounds like it would be a useful thing to have should you ever need to go to the ER again.

Why on earth would a doctor only give you pain meds if you have a scan? If you were drug seeking (which is a possibility the ER doctor did have to consider), why would it then be ok to give you meds after the scan?! Or did he mean only if tests revealed a legitimate cause of your pain to prove you weren't just drug seeking? Did he not even offer you non-addictive pain meds? I know they're often useless, but things like paracetamol may have helped you a bit.

Again, I'm very sorry this happened to you. You're doing so well staying off pain meds, you don't deserve to be treated like this for something in your past when you've moved on.

Can I ask though, if you were to take painkillers again now, do you think it's possible you'd have difficulty getting off them again? If you're pretty confident it wouldn't be a problem, maybe your usual doctor could give you an emergency supply to keep at home so as to eliminate the need for ER visits.
04-11-2015, 01:24 PM   #419
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UnXmas, Thanks for your reply and support. I cannot find my copy of the Controlled Substance Contract and have asked my doc for a copy. It is my understanding that you must sign this if you have been given any controlled substance within the ProHealth doctors. I signed one for my psych doc due to being on xanex for anxiety. It is standard practice. So yes, I do have an emergency supply, why one of the two contracts I've signed, for oxycondine. Unfortunately these meds were not helping, which is why I went to the ER. I explained what happened at my GI appt yesterday and my PA was appalled.

Im well aware of people drug seeking, which is why they implemented this contract. To ensure you stay within the providing physician and not dr hop. He meant that he would not give me any pain relief unless they found a problem via cat scan. My GI agreed that I should not have had to have one. He offered my nothing but accusations that I was a seeker. I haven't been to the ER for pain relief in 18mos!!

Re taking pain meds now, I try and not take them daily and if need be, only 1-2 a day. I know all too well how fast our bodies can become addicted, Ive cleaned my self up 2x in the past 20yrs (on my own knowledge of being on too many and not knowing my pain levels any more). I believe that addiction is a chronic issue w this shitty disease, and as long as I am open and honest to my docs and make sure they monitor me, I'll be ok. Thanks again
04-11-2015, 01:55 PM   #420
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I believe that addiction is a chronic issue w this shitty disease, and as long as I am open and honest to my docs and make sure they monitor me, I'll be ok.
This is how I think about it too. I know I'm addicted to painkillers, but I also know I have legitimate pain. But since secrecy is meant to be a major sign of an addict, I make a point of not keeping anything from my doctors, including telling them I'm addicted and that I take more medication than I should (which they know, since they prescribe it all).

I haven't heard of contracts before, maybe we don't have them in the UK or maybe they don't have them for codeine, which is the only addictive painkiller I take when not in hospital.

I hope your pain is better and you can avoid the ER and its less-than-helpful doctors.
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