Tapering Opioids

[CancerSignFibro]

Hi
I lost my doctor due to cancer and then the back up doctor due to retirement. The new person at the clinic is tapering me off opioids since they apparently
lost their effectiveness over time and risk of overdose (although I have taken them for years and never been close). Anyways, I was on both a long acting
and short acting one and she converted it all to short acting and now I am leveled with massive pain, weird hot flashes, stomach issues, and feeling extremely irritable and cannot sleep. The first couple days I was merely uncomfortable but now am feeling horrible. Since the short acting should be making up the difference of the
long acting upon converting to all short, what could be happening here? I thought I would research before calling my new doctor. I think it was likely a mistake to
completely stop the long acting without a taper of it. Maybe the formulation is different so the analgesic qualities are different versus short?
Any help appreciated. Tim

 

[sunkacola]

Hi Tim, From what you describe (and note I am not a doctor so this is only an opinion) you became addicted physically to the opioids, and you are now going through classic withdrawal symptoms. It is highly unpleasant, to say the least, but it is temporary. Once you get past the withdrawal period you will be fine. And getting off all opioid medication is an excellent idea, precisely because the body becomes addicted to it and it has terrible long-range effects on the body.

Hang in there. You might google "how to ease withdrawal from ___" fill in the medication you have been taking, and see if you don't get some good suggestions there.

And, if you have any energy for such things, you might check out my advice post for things you can do to help manage fibromyalgia now that you won't be taking the opiates.
Best of luck!

My advice for managing fibromyalgia (especially for newcomers)

I am not a doctor or anything, just a person who has lived with fibromyalgia for several years now and has done a lot of research and trial and error experimentation. What follows is just basics. There are a lot of variations. You will find your own versions of everything I say, as this is not a...

www.fibromyalgiaforums.org

 

[MikkiD]

Hi Tim. Sorry you are struggling so. Why must the patient suffer just because the doctors change? I have experienced that myself. First of all, sometimes you have to be your own advocate. It sounds like pain medication worked for you well for years without problems. For a new doctor to reference abuse is really premature. It sounds like a script they follow. They can switch pain meds to another for a bit since our bodies do acclimate to one, as a sort of reset. There are many opioid options. A good doctor will look at your past and listen to you.

Also, you may be physically dependent on opioids without being addicted. A small distinction but one that sounds much better. I hope you are able to feel better soon. If not, do that research then go in and have a two-way conversation about what has been working for you.

 

[CancerSignFibro]

All the PCPs are tapering people off here. I don’t know how I go to zero after 28 years being on them. It is going to be hell. Not fair! I never abused them at all.

 

[sunkacola]

All the PCPs are tapering people off here. I don’t know how I go to zero after 28 years being on them. It is going to be hell. Not fair! I never abused them at all.

While I fully understand how you feel, I also know that opioids are addictive even if never abused. If that were not the case, there would be no withdrawal from them.
Going to zero should be a process that takes about a year, so as to avoid the withdrawal. If you go ever so slowly it will not be hell at all.

And, one way to look at it is that this year while you are tapering off you have the opportunity to explore all of the non-medical things that will potentially help you in working with and managing the pain. If you want help with that, let us know, because many of us are using non-medical ways of managing fibro.

 

[Sibergirl]

@CancerSignFibro
Tim,

Hi. I’m so sorry you are going through this. I take Tramadol 1 50mg tablet when I wake up and 1 before going to bed. I had a doc who wanted to take me off the Tram and put me on Gabapentin. Holy hell, it was awful. The gabapentin worked for my pain so we tapered off the Tramadol. The Gabapentin had to be increased, after being off Tram for a few days. During this time my mood dropped into the blackest depression. I cried every day for 6 months. A psychiatrist figured out that it wasn’t the tramadol, it was the gabapentin. Gabapentin helped the pain but ir can cause severe mood changes. It totally screwed up my mind and mood. I became disassociated from reality sometimes. It’s rare but it happens. It’s terribly scary, because even though it is a rare side effect, doctors tend not to look for it or to overlook it, as it was done in my case.

Please watch your psychological state of mind. It anything changes, severe mood shifts or suicidal ideation, tell your doc. I don’t know which meds you were switched to, but here Gabapentin and Cymbalta are highly prescribed for Fibro. Both made me feel and believe that I was losing my mind. That’s not me, so it was awful. My docs couldn’t figure out what else to try for my pain since I couldn’t tolerate actual opioids, Gabapentin or Cymbalta. So, went back on the Tram and that’s that, at the moment.

I know exactly what you mean about the pain coming back and it’s awful. You feel it roll in like a storm, you see it on the horizon and know it’s coming and there is no where to hide. I’ve been there. My heart goes out to you. It’s sucks losing not one but two good Dr’s who you trusted.

Are you in America? If so you can just go see someone else? Pain Management docs here in the States can be real jerks to people who are going through pain, because the government has been scaring the poop out of them since 2016. Then the govt regulated who could prescribe them and how. So for years people in real pain that didn’t respond to non narcotic methods just lived in pain. Heck, I’ve tried the legit codeine and morphine derivatives and they make me too sick. I can’t handle them. Tramadol is the only thing that allows me to live a normal life.

Recently, the FDA finally loosened restrictions on opioid prescriptions. Now, in many states, any doctor (not just pain mgmt) can prescribe opioids or synthetic opioids (Tramadol). Well, Americans made their voices heard and the FDA rolled back the restrictions.

As for the sleeping I highly recommend getting some Delta 8 CBD gummy’s or tinctures. If you’re in the United States there’s this great website called The Calm Leaf. It’s a Father-son business and they know everything about CBD. Delta 8 knocks me right out. No more insomnia, afrer suffering from it for years.

~Rachel

 

[JayCS]

cried every day for 6 months. A psychiatrist figured out that it wasn’t the tramadol, it was the gabapentin.

Similarly my pain docs prescribed me tilidine & amitriptyline altho they increases seizures. My neurologist pointed me to that.
Since then I double check anything for side effects as soon as any come up, & try to keep the nocebo effect down by not doing it too much before I take them. But also I just stay clear of most meds, as most were poison.

 

[fimi]

there’s this great website called The Calm Leaf. It’s a Father-son business and they know everything about CBD.

Thanks @Sibergirl, looking this site up as we speak!

 

[Nan]

Hi like you I have been on opioids for a number of years. I take 10mg am and 20mg pm with Oxycodone 5mg for extra help if needed. I have never craved more and more as most seem to think especially doctors. I was referred to pain clinic where the specialist immediately withdrew my meds. I was given nothing to help my fibromyalgia, widespread arthritis etc etc. i immediately returned to my family dr who re prescribed my opioids. I find I have a good pain control on opioids despite what everyone says. Most pain medication contains some amount of opioids so we sufferers of chronic pain mostly take some form of this medication. ?????
I prefer not to suffer too much pain. Nan

 

[Drummer76]

I went through withdrawals so many times when I was on them. I was addicted to them badly and woke up one day and decided no more and stopped cold turkey.
After about 10 days,all symptoms were gone and I have touched them in 4-5 years. I have done my own research and opiates really aren’t the answer for people with fibromyalgia. Yeah,they take the pain away but then you need more or higher doses to maintain that level of comfort.
That said, everyone is different and it’s very difficult to stop cold turkey and I don’t really advise anyone of doing it.
I recently lost my doctor who prescribed klonopin to me and the new one wouldn’t listen to me. As soon as I said I have chronic pain, she automatically started saying opiates and klonopin don’t mix and I had to cut her off 3 times to remind her I don’t take opiates. Needless to say I changed doctors when she said she was taking me off klonopin eventually. Not just for that reason,but she made me sound like a junkie looking for drugs. Not once have I abused the klonopin and I’ve been on it several years. She wanted to try different medications in place of it and I refuse to go back to the Guinea pig stage now since I have heart problems.
I have found that Zanaflex (muscle relaxer) has helped me more then opiates have.
I hope you figure something out with your medications. It’s not easy to maneuver through the health care system.

 

[Nan]

Well done coming off opioids I know it is very hard but as I was stating in my post rightly or wrongly I think I am helped by them and have never felt any uphoria or needed to take more and more. I am coping being on a relatively small dose. All the very best Drummer. Brilliant. Nan

 

[Drummer76]

I don’t disagree that they help and very few can do what you are by not over using. That was my problem and I knew it was time to stop.
Wish you all the best with this terrible health condition

 

[Nan]

And the very best to you also. Nan

 

[CancerSignFibro]

I am really feeling down as the pain is awful. It feels like acid all over. How I go to zero is beyond me. I need to find a new doctor but how?

 

[Drummer76]

Another thing about opioids that most people overlook is rebound pain that they can cause.
My pain level has actually been more manageable after getting off them and staying off them and letting it fully get out of my body.
I still have pain,but it’s not as severe as it was when being on them or I’m just getting used to the pain. I know it does help some people and some can control their usage and not get as dependent on them.
It’s a shame that the people who abused them has made it so hard for those who really need them to be able to get them. Not just for fibromyalgia,but other health issues. But look at what it has caused,a heroin epidemic and all first responders to carry narcan. They even have machines in my city that have free narcan in them. 10 years ago,it sure as heck wasn’t like that.