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Thread: Alternatives to Opioids?

  1. #1
    Moderator Top User ddessert's Avatar
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    Alternatives to Opioids?

    With the "opioid epidemic" in the USA news so much this year, I am wondering what are the pain management alternatives?

    I listen to opioid addiction experts in these news stories that say the only role for opioids is:
    a) for a few days after surgery
    b) stage 4 terminal cancer patients

    That has left me wondering what the alternatives are for all the others with chronic pain conditions. The only plan I hear from these experts is to wean everyone off these pain medications and they will all feel better.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
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    Oct 2011-Sep 2012 - shrinking tumor
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    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
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    @pancanology

  2. #2
    Moderator Top User jorola's Avatar
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    I work in a job where I deal with this as well. I work with injured people. It is to the point they even are saying Tylenol #3 should only be given for very short periods of time. I have been told, by medical professionals, that pain medications are designed for short term use only and that after using it for a longer period of time it actually begins to have the reverse affect. Meaning yes it makes the pain worse. Now I admit I have not actually read the material on this that they have referred to, only attended training and had bits of info given to me in training materials - which I cannot find at the moment. I lost my brother to an opioid addiction so i have reason to not like opioids yet I am one of the first ones to say there is a time and place for them - just under proper dr supervision and support is all (in my opinion). Problem I have personally seen and in my job is that there are doctors out there just handing some of this stuff out like candy and not properly educating people (maybe they don't know themselves) on how to take this stuff and the warning signs. Then not properly monitoring their patients. Some drs do but what their patients do after they head out the door a dr has no control over - I mean how much babysitting can be done? So who is really to blame? Good fudge bucking question.
    Anyway off topic. Obv I could go on and on. In my job, I have seen pain clinics teach relaxation exercises, mediation, massage, acupuncture, NSAID (non-steroidal anti-inflammatory meds) and listening to music etc. That may work for some but like for my Dad? Yikes I dread the though of even suggesting it to a man who has worked hard with his hands all his life. I would get banned for life typing the words he would say to me for suggesting it. I wish I knew the solution to this. I know my pain is nothing compared to a cancer patient but a severely arthritic hip and torn rotator cuff at age 45 really sucks and ya I hurt. So those who really need the meds should bloody well get them - with proper support from their dr of course. Ok I have now given my 2 bits.
    Wife to husband with squamous lung cancer stage 3 b
    dx - April 20/14
    tx started May 20/14 - radiation and chemo
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    Sept 19/14 - not infection but pneumonitis, place on dex for 4 weeks
    Oct 22/14 - now off of dex and facing even more symptoms of withdrawal
    Dec 16/14 - pretty much nothing left but a scar
    April 7/15 - ditto scan and screw you stats
    Oct 6/15 - more scarring but still cancer still gone
    Feb 2016 -scan the same
    Aug 2016 - more of the same
    Aug 2017 - and ditto

  3. #3
    Senior User Dead Man Walking's Avatar
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    Well, I appear to be on a lifetime prescription of tramadol, azacitidine, venclexta, and several anti-inflamants, plus blood pressure and sleeping aids. My pain levels and quality of life are quite acceptable, and the situation appears stable. Considering how bad the azacitidine can kick my butt sometimes, and with the venclexta having its own nasty little side effects, am I supposed to worry about the tramadol?? I don't think so.

    To provide a more substantial and useful answer, however, in my 8 years in a cancer-only hospice, I was occasionally privileged to watch the 25 year employees of the hospice dole out medications including things like methadone and other anti-addiction drugs, and the quality of life they were able to give to the patients was nothing short of amazing.

    Looking at it in a certain light, doctors and nurses have little if any training in end-of-life medications as the final days, hours, and minutes of a patient's life are ground out inside a hospice. Sometimes the passing is easy, and sometimes it can be downright nasty, and if you don't have an ingrained sense of a higher power somewhere, this job is not for you. I have no idea what kinds of training facilities they have for professional hospice workers, and based on the fact that hospice work does not lie strictly within the bounds of the Hippocratic Oath, it may be a skilled vocation like a violin maker. If you want to learn the high art of terminal caregiving, particularly the administration of palliative medications, find the most highly rated hospice in your area and bring your faith with you.
    05/6/16 pre-op physical for knee surgery show low WBC & RBC
    05/22/16 [Birthday] Results of BM biopsy: AML 25% blasts CD34 with inv t(3:3) mutation, HIGH risk
    05/30/16 Undergo 3+7 chemo regimen
    06/??/16 TSHTF!! 3+7 doesn't touch AML, knocks out immune system, infections nearly kill me. Blasts 65%
    07/04/16 Diagnosis now Refractory AML. [:tombstone:]
    Six 4 week cycles of azacitidine, 21 injections over 7 days with 1.5" long needle into gut AND below navel.
    11/05/16 Wife & I move to North Shore Lake Ponchatrain - Infusion center 4 minutes away.
    15 injections for 5 days M-F with 5/8" 25 ga. needle Huge increase in quality of life.
    12/28/16 BMB shows CD34 cells 12%
    Three 5 week cycles of azacitidine.
    04/16/17 BMB shows CD34 16%, cycles dropped to 4 weeks.
    7/20/17 Diagnosis changed to "indolent leukemia", aka MDS
    7/27/17 BMB shows CD34 17%
    8/15/17 Venclexta chemo in PILL form added
    Oncologist estimates survival time now 2 - 4 YEARS!!!

  4. #4
    Super Moderator Top User Baz10's Avatar
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    As a 6 year Tramadol veteran I can hand on heart say I’m most definitely Not addicted and that is taking as necessary 100 mg 4 times per day.
    The docs tried me on codeine and at my request did not prescribe further, not due to addiction, purely it did not agree with me.
    Latest is Amitriptyline one 25 mg early evening and as necessary topping up with Tramadol.
    So, from my aspect addiction is not even a talking point.
    For myself I can only state that I’d rather be on medication than have a permanent pain score of 7 or 8 out of 10.

    Yes of course I understand the fear of addiction, but wisely prescribed, wisely used and monitored I don’t see a problem.
    Thats my two cents worth.
    Barry
    Diagnosed stage 3 March 011
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    October -still the same pains but under semi control.
    Additional chest CT scan ordered for 11th November prior to surgery.
    Sinus surgery done and dusted.
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    Not all's rosy in the garden, but see following.
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    and dodging bullets in the meanwhile, too many bullets at moment.

 

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