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How Can Chronic Pain For Over 18 Years Be Managed After Giving Up On Addictions To Drugs?
Question: I was on pain management since I was 20 I am 38 now I went off pain management in 2010 to try and handle it over the counter ect. Iv done nerve burn block lidocane gavapenton amitriptilene symbalta ect. Ect I waited a month to see a pain specialist today and being a bit older and an wiser I was honest and upfront with him about using substances like marijauna and drinking I quit weed in my late 20s and havent drank since 2008 I am a service plumber and its just getting worse pain wise an I know I need a career change soon but I just cant afford that switch rite now I asked for 2 break throughs a day and 1 12 time release in a proffesional manor he told me ti go to hell and only offered treatments ive already done and tried that dint help and still had to pay 206.00 dollars what the hell can I do am I to suffer the rest of my life because I was honest about foolish mistakes I made in the past. I need help/pain management to continue working im now on protonix because those 6 years I quit pain management I fried my guts with ibuprofen and naproxen
Brief Answer:
Well, you might not like this idea
Detailed Answer:
Well, you might not like this idea and, going full out onto an addiction management context would get significant pain help. These include Methadone and Suboxone. The problems with both is that they are moderate to high dose narcotics and will produce tolerance, dependence, withdrawal if you don't get them regularly, and can set up for addiction when there isn't much currently.
In the non-narcotic world, you've mentioned nearly all of the drugs used for pain that are not narcotic.
Hope I have answered your query. Let me know if I can assist you further.
Thank you.
Regards,
Dr. Matt Wachsman
Addiction Medicine Specialist
Well, you might not like this idea
Detailed Answer:
Well, you might not like this idea and, going full out onto an addiction management context would get significant pain help. These include Methadone and Suboxone. The problems with both is that they are moderate to high dose narcotics and will produce tolerance, dependence, withdrawal if you don't get them regularly, and can set up for addiction when there isn't much currently.
In the non-narcotic world, you've mentioned nearly all of the drugs used for pain that are not narcotic.
Hope I have answered your query. Let me know if I can assist you further.
Thank you.
Regards,
Dr. Matt Wachsman
Addiction Medicine Specialist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
my primary doctor is a internal medicine specialist he handles my amlodipine lysinopril for high blood pressure protonix for my stomach and mobic he was tthe one who suggested going back to pain management as it is a highly likely cause of the increase of my high blood pressure over the years and I spoke with him after wards and he will refer me to another place but I believe not just with my doctors but will all in my life honesty and full disclosure is always the right thing but should I essentially lie or leave out the fact that at one point in my younger years I smoke marijuana and used to drink
Brief Answer:
Cannot say, but I do not have to.
Detailed Answer:
Hello,
Currently, personally, I will NOT ask about Marijuana because its legal status is quite murky where I live and likely to change literally any day. Your doctor has a different opinion about Marijuana. The current statistics imply that very very few people are going to receive any pain management if any use of marijuana restricts it. It is likely that your doctor has a complex and nuanced view of previous marijuana use. I wouldn't change it. So, just not volunteering to get into a very complex discussion is NOT hiding facts. Just don't go into it. Really.
On the alcohol, which is a leading cause of death and will affect most medicines that you would take, it matters BUT there are particular features that your doctor will care the most about. I do not know them. There are many different approaches to previous alcohol use and they are all valid. You could say, that gee, if you've never been admitted for an alcohol or cirrhosis related problem then it does not affect life expectancy and that medications are going to have to be adjusted anyway, and that prior use doesn't affect anything. You could say you want an obsessive compilation of every drink and every use of any chemical legal, over the counter, and otherwise.
Follow your doctor's lead, don't lie, and don't clutter up his head with stuff he didn't even ask about (the list of that is truly infinite).
Then, it's all plumbing. You need to find what's broke. You find what can be fixed and what needs to have a large bowl placed under it. Taking methadone or Suboxone (but never both!) is a way to put a bowl under it that works (makes pain manageable without actually doing anything). Modifying work environment is another effective plan that also prevents further problems. Injections have rarely done anything. We get many many more people saying "gee, the BP med (or diabetes, or thyroid, or anti depressant or antibiotic or anything) WORKED but is there a way to not need it anymore ...than with injections where we never ever get someone saying they worked. That's a clue.
Hope I have answered your query.
Thank you.
Regards,
Dr. Matt Wachsman
Addiction Medicine Specialist
Cannot say, but I do not have to.
Detailed Answer:
Hello,
Currently, personally, I will NOT ask about Marijuana because its legal status is quite murky where I live and likely to change literally any day. Your doctor has a different opinion about Marijuana. The current statistics imply that very very few people are going to receive any pain management if any use of marijuana restricts it. It is likely that your doctor has a complex and nuanced view of previous marijuana use. I wouldn't change it. So, just not volunteering to get into a very complex discussion is NOT hiding facts. Just don't go into it. Really.
On the alcohol, which is a leading cause of death and will affect most medicines that you would take, it matters BUT there are particular features that your doctor will care the most about. I do not know them. There are many different approaches to previous alcohol use and they are all valid. You could say, that gee, if you've never been admitted for an alcohol or cirrhosis related problem then it does not affect life expectancy and that medications are going to have to be adjusted anyway, and that prior use doesn't affect anything. You could say you want an obsessive compilation of every drink and every use of any chemical legal, over the counter, and otherwise.
Follow your doctor's lead, don't lie, and don't clutter up his head with stuff he didn't even ask about (the list of that is truly infinite).
Then, it's all plumbing. You need to find what's broke. You find what can be fixed and what needs to have a large bowl placed under it. Taking methadone or Suboxone (but never both!) is a way to put a bowl under it that works (makes pain manageable without actually doing anything). Modifying work environment is another effective plan that also prevents further problems. Injections have rarely done anything. We get many many more people saying "gee, the BP med (or diabetes, or thyroid, or anti depressant or antibiotic or anything) WORKED but is there a way to not need it anymore ...than with injections where we never ever get someone saying they worked. That's a clue.
Hope I have answered your query.
Thank you.
Regards,
Dr. Matt Wachsman
Addiction Medicine Specialist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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