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Suggest Treatment For Severe Back Pain Due To Opioid Abuse

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Posted on Sat, 11 Apr 2015
Question: My pain doctor was on vacation and scheduled my appointment 4 days after my script ran out. I was in horrific back pain and suffering from withdrawal and muscle spasms and in delirium by day 3. Day 4 the day before my appointment in the night the spasms were so intense I had no control over my arms and legs. I begged my husband to take me to the ER. They did nothing for me but give me a shot of Torradal. I was a mess by the time I got to my appointment in the late afternoon. I told my doctor what happened and he said he could still feel the spasms in my back. After I was done with my appointment his nurse said he ordered a drug test. I took it and went back a month later after no mention of any problems. Then I went back 6 days ago 2 months after the drug test and he told me it had had shown hydrocodone on my screen 2 months ago. No mention of it last month. I told him I really couldn't say for sure I didn't take any as I was pretty much out of my head when I was going through withdrawal. My husband was with me and told him I had been going through my dresser drawers looking to see if I had put back any medication I had saved at some point in time. I have been on oxy for over a year. But before was on both. He said it was a felony to take the hydrocodone thinking I had no script. I was so upset at the time because he said he was going to wean off my narcotics and take me off of them all together in a months time. I have degeneration of my discs and spinal stenosis. I have been on narcotics for 25 years and have been on SSI FOR 2 YEARS NOW .Also I have a spinal cord stimulater.in in my back it is so bad. My pain is unbearable. I came home and checked and I did have a legal prescription for the hydrocodone I must have taken I a desperate situation. I honestly barely remember those days period I was so sick and in pain. I informed his office manager or the prescription just so they knew I had one even if that was not what he had been prescribing me. Am I going to have to look for a new pain doctor now and will one even prescribe me narcotics for my debilitating pain now? There is no way I am going to be able to function with out them I can barely even get dressed everything day now. This is not the 1st time I have been scheduled like that and ran out of medicine before I got in to be seen. What can I do. I have been so good about going by the rug all these years. I don't even remember talking the hydrocodone.
doctor
Answered by Dr. Ajay Panwar (2 hours later)
Brief Answer:
'Opioid abuse'.Please visit a Methadone clinic.That's the solution.

Detailed Answer:
Hi XXXXXXX driver,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
If you would have presented to me as an outpatient with this medical history,I would have put up 'Opioid abuse' as your working diagnosis as you seems to fulfill the DSM(Diagnostic and statistical manual for mental disorders)criteria for the same.I can well understand that it all started due to your back pain and spinal issues.However,you must get out of it.Its the high time.

Main treatment guidelines are:
1)Opioid like hydrocodone or oxycodone will heve to be replaced by opioid agonists like methadone or buprenorphine followed by gradual taper of these medicines and finally stopping them.
2)Clonidine use to suppress the withdrawl symptoms after abruptly stopping the opioids.
3)During times of severe pain,short acting opioid analgesics have to be used along with other medicines to alleviate pain.Opioid analgesics given only during the times of pain,have been found, not to increase the chances of opioid abuse relapse in most of the research studies.
4)Cognitive-behavioural therapies
5)Psychodynamic therapy.

So,narcotics can still be given during the episodes of debilitating pain,but not on regular basis.After all,you have to get out of this hell.

Please visit a 'Methadone clinic' which are specialized centres which can help people get rid of the opioids.If you don't find one,please meet a psychiatrist as he is the person who can help you to get one.
A psychiatrist's opinion is also of value here regarding behavioural therapy and psychodynamic therapy.More than a pain specialist,a Psychiatrist can help you.

Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating can be of help to me.

Dr.Ajay Panwar,
MD,DM(Neurology)



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Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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Suggest Treatment For Severe Back Pain Due To Opioid Abuse

Brief Answer: 'Opioid abuse'.Please visit a Methadone clinic.That's the solution. Detailed Answer: Hi XXXXXXX driver, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. If you would have presented to me as an outpatient with this medical history,I would have put up 'Opioid abuse' as your working diagnosis as you seems to fulfill the DSM(Diagnostic and statistical manual for mental disorders)criteria for the same.I can well understand that it all started due to your back pain and spinal issues.However,you must get out of it.Its the high time. Main treatment guidelines are: 1)Opioid like hydrocodone or oxycodone will heve to be replaced by opioid agonists like methadone or buprenorphine followed by gradual taper of these medicines and finally stopping them. 2)Clonidine use to suppress the withdrawl symptoms after abruptly stopping the opioids. 3)During times of severe pain,short acting opioid analgesics have to be used along with other medicines to alleviate pain.Opioid analgesics given only during the times of pain,have been found, not to increase the chances of opioid abuse relapse in most of the research studies. 4)Cognitive-behavioural therapies 5)Psychodynamic therapy. So,narcotics can still be given during the episodes of debilitating pain,but not on regular basis.After all,you have to get out of this hell. Please visit a 'Methadone clinic' which are specialized centres which can help people get rid of the opioids.If you don't find one,please meet a psychiatrist as he is the person who can help you to get one. A psychiatrist's opinion is also of value here regarding behavioural therapy and psychodynamic therapy.More than a pain specialist,a Psychiatrist can help you. Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating can be of help to me. Dr.Ajay Panwar, MD,DM(Neurology)