Thread: Taper from oxycodone - round 3

I am erabarrassed to be starting yet another thread about trying to taper from oxycodone. I've tried twice before (May 08 and Mar 09), documented my progress on two separate threaRAB here, had all kinRAB of support and was very optimistic....then failed both times. Hence, I am reluctant to even write about it again for fear of disappointing everyone; yet, I feel I must. The only way I can get through this successfully is to learn from my past mistakes. I went back over my old posts and it was actually very revealing. I wanted to see how far I got in those attempts, and how I felt, and what made me fail. Therefore, I hope you don't mind that I'm posting my thoughts as I go down this path again.

Quick background: I'm 59 and have been on oxycodone for severe degenerative disk disease since '03. Had diskectomy (surgery) in '04 -- didn't help. Despite a history of heroin/methadone addiction (which I didn't share with my doctors), I accepted their scrips for Percocet. Started off with one 5mg pill each night; over the years it's progressed up to 60-75 mg per day of oxycodone. Here are some of the many reasons I want off:

• It doesn't really relieve the pain; sure, it dulls it a little....but the amount I need to "dull" the pain gets progressively higher and higher.
• My whole life and personality have changed. It could be pain-related depression (plus some other family stressors), but I've got to think the endorphin-suppressing narcotic is responsible in some way. I'm miserable; no joy in life; withdrawn from society; hate everything and everybody, including myself. I don't even like most fooRAB anymore. My stomach is a mess. I can rarely think of anything to eat that I'd enjoy.
• My life revolves around the pills. I can't get out of bed 'til I have it. The pills control where I go; whether I can travel; heck, where I LIVE (what if I can't find a doctor willing to write for my usual amount)? I always have to make sure I have enough with me. I usually take the whole bottle with me -- what if I'm delayed or in an accident and can't get home in time for my next dose? Better to just have the whole scrip with me.
• I have no energy to do anything. Everything is overwhelming. Bills and other important things are falling behind.
• I hate how I feel on them. Yes, they used to make me feel good and give me energy. Now, I don't get the energy boost; just feel a flushed/sweaty feeling and then kind of a "downer" effect. I feel like they're constantly pushing me down....hard to explain, but I know this: If they're not killing the pain, and not making me feel good, then what's the point?

So, I'll try to wrap this up -- here's where I am with the taper:

• I told my PM I was trying to taper off, so he accommodated me (!) by reducing my monthly scrip by 500% (from 2250 mg to 450 mg). Eeek, I wasn't expecting that! But it forced me into a rapid reduction.
• I started 9 days ago at approx 38 mg. I felt pretty darn bad, as that was a sudden 50% reduction from my usual 70-75 mg.
• I've tapered down to approx 21 mg today (assuming I finish the day successfully). I've extended my dosing schedule and reduced the mg per dose. I'm not a ball of energy, and I'm still feeling weird and shaky and headachy, but I feel much better than this time last week when I could barely move.
• I have a big weekend event coming up, so this will be the true test. In past attempts, I have used big events as the excuse for failing, because I didn't have the energy to handle them without my usual dose of oxy.
• I don't want to do any other major reductions until after this weekend, but I will still be trying to taper a mg at a time. I do not want to lose momentum. Nor do I want to drag this out for weeks.

So that's where I am. I don't know what I'm going to do about the pain, but I can no longer stand my life the way it is. (Oh, and Brian, I am also looking into a spinal cord implant stimulator...I have a consult next week. That's now another "event" I have to worry about....I hope I am up to it.)

Lady Buffy,

Please support the originl poster, and start another thread for your own questions.

Your post has been moved to a new thread:
"Pain relief without meRAB?"

You're right -- I think the worst shock to my system was going from 70 mg to 38 then 33 then 28 in a matter of three days. I wonder if that was really my doctor's plan (when he drastically reduced my scrip). He's probably sick of my saying "I want to get off" and then not being able to do it. If this works, I really gotta hand it to him for forcing the issue.

You're not going to believe this, but today I feel great. I actually am doing some light cleaning/organizing (yes, I did pay the bills over the weekend)....I know it will make me feel better if my environment is neater and more organized. I've been wallowing in a sea of clutter, and because I've been feeling so lousy, I just keep making more clutter. But today I was able to make a lot of headway in cleaning up. Maybe doing some dancing yesterday got the endorphins out of hiding!

Gotta keep on truckin'! Even though it feels like I'm on a low dose now, I've got to keep in mind that I'm still on the equivalent of over THREE 5-mg Percocets a day. So I've still got a ways to go....but today's little "energy burst" has really given me hope that maybe I CAN function without them!

NICE and congratulations for you !!!
Remeraber one step at a time and we are all here for you !!!

GOOD LUCK along the way "keep on trucking"

DEv

I tried stretching between doses and it didn't work well for me, but I was stretching the time when I was taking a single dose a day. Not understanding the drug back then, I see that it was stupid for me to do that. You plan has a much better approach. Once you get between 12-15 hours since your last dose, you start feeling the w/d's and that was where I went wrong. Good Plan!!

Well it sounRAB like you have not abused them in the past, you just don't feel good while taking them. Have you told your PM doc this? There is such a thing as opiod rotation where you switch to a different opiod medication such as fentanyl patch, Oxycontin, Morphine ER. I was going to say Methadone but maybe that's not a good idea since you have abused that before. Another thing I looked at was whether you were a man or woman. I am a guy and was getting to the point of where you are feeling and it turned out to be very low testosterone. The opioRAB suppress the bodies natural production of testosterone and luckily there is testosterone replacement therapy. This is good news for guys but not for women. Women produce testosterone too and it drops when using opioRAB/opiates but doctors are very very reluctant to do any type of testosterone therapy. It is is not fair and I think they should. I know women produce much less testosterone. Another thing you should do is have your doctor do blood work and check your thyroid gland to see if it is functioning normally. This is another thing that can be affected and their are medications that can help this for men and women. It is up to you but I think it would be a good idea plus having your liver levels checked since Percocet has acetaminophen in it and is not good for your liver long term at high amounts.

Are you on any type of anti-depressant? Most pain managment patients, me included, develop depression since our natural endorphins and other neurotransmitters are suppressed. It sounRAB like you are definitely depressed and should tell your doctor this. You could probably still stay on the pain meRAB but add an anti-depressant which would improve your outlook, get you energy, etc. Don't beat yourself up for going back on the oxycodone. Did you go back on it because of the pain being uncontrollable or because of the feeling it gives you? If you went back on due to the pain then you should not be ashamed. One other thing to mention, especially if you have nerve pain, is that there are many medications (non-narcotic) that can be used to treat that type of pain. OpioRAB/opiates tend to not treat nerve pain very effectively but when used along with one of the following medications may be more effective:

Anti-convulsants: Neurontin, Lyrica, Trileptal, Tegretol, Topomax

Atypical opiod: Ultram (tramadol), Ultracet

Anti-depressants: Cyrabalta, Effexor

Good luck and let us know what you decide to do.

brian:wave:

p.s. If you really want to get off the oxycodone and don't think you can do it yourself then you might want to consider going on Suboxone. It might even be something your PM doc could do because it is used some in pain management.

Hello all...checking in. After five days of 5 mg, I cut down to 4 mg (or thereabouts) yesterday. (Hard to know exactly when you're basically measuring out dust particles.) You would think at this low level, I'd hardly notice, right? Noooo, I'm a mess. Mainly depression, and lots of crying and despondency, and anger/rage at stressful things going on in my life, but pain/stiffness too. Fun stuff, huh. Based on my track record of previous reductions, I should feel a little better tomorrow. After all, that was a 20% reduction even though it was only one lousy milligram. Please keep me in your thoughts and prayers, and I appreciate the support.

Hi Bri -- well, I managed to tell the doc today I didn't want a scrip. He said to call him if I need anything, but I said I wanted to see how far I could stretch out on the existing supply. Honestly, I feel so lousy, it would have taken extra energy to go to the pharmacy and get a scrip filled, so I was happy to have one less errand.

I am still holding at 7.5. I feel a bit better today, but not great. Tomorrow I have plans to meet an old friend for lunch. I really didn't want to do it, because I'm always afraid those kinRAB of commitments will lead to taking my dose early, just to get the energy to get dressed and go. But....hopefully I'll be able to stick to the schedule and not feel like crap during the lunch. Hard to be cheerful and upbeat when you are going through WD.

As far as my pain goes -- my nerve pain (leg, hand, feet) is bad, but I would say not much worse than when I was taking lots of Oxy. As you probably know, narcotics take the edge off nerve pain, but never fully relieve it. My main problem is increased back pain, stiffness, cracking, body aches and just generally feeling like I got hit by a truck. I definitely feel this is temporary as my body adjusts to life without major doses of narcotics. I know I did not have this type of pain before I started taking the stuff.

No, I still haven't told anyone the real story. And there is really no one I can tell. Or want to tell. I just can't do it....it's too erabarrassing, and I don't feel anyone will understand. I just consider myself fortunate to have you guys. The only people who truly understand are those who have gone through this h*ll.

Thanks as always for your support and responses.

that made me laugh too funny. At least you are taking pills that help you instead of hurting you at this point. I don't think it would be a good idea to stop the anti-inflammatory either. That would be setting yourself up for a relapse. Just remeraber that: "our disease wants to see us SUFFER as much as possible and after all that suffering to eventually KILL US".

brian

Have you thought about attending an NA meeting? You can tell your story there with no erabarrassment at all. Trust me on that one, most people have heard about all kinRAB of things. I don't know if you will be able to handle the pain once you get off of all the medications, ya know. I know take it one step at a time but you might have to make a decision on what to do in the future. There are many non-narcotic medications out there as I'm sure you are aware of.

I am on Lyrica and it has helped my nerve pain quite a bit. However, I am on other narcotic medication but I do use it as prescribed and have never abused it. I am on the fentanyl patch and Vicodin for BT pain. I hate the way it makes me feel (tired, drowsy, slowed thinking) but it gets the pain down to a manageable level. I am going to try the SPS(spinal cord stimulator) soon which is an implantable pain management solution. Did your doctor ever talk to you or offer that to you. It is effective for some types of pain especially in the legs and feet. I am willing to try it and at least you go through a trial to see if it will help before they fully implant it. Just wanted to tell you that you are an inspiration and I will remeraber this if I ever decide to reduce to stop my medications in the future.

brian