Suggest treatment for chronic pain

Posted on Tue, 2 Jun 2015 in Pain Management
Question: I need help. I am a pain management pt. I have been throwing up for 4 days, Been to two ers don't meet criteria to be hospitalized. Pain is incredible.) In a cycle that can only be broken by hospitalization, fluids and pain control. Been on pain meds 20 yrs. Just got new Dr. Meds not working. Have several health issues. Don't know what to do. Was in medical field. Know how it works. Disabled. So much involved.XXX
Answered by Dr. Matt Wachsman 32 minutes later
Brief Answer:
cannot say in your particular case

Detailed Answer:
but the first question would be why the pain. Often the pain can be from a real condition that has worsened, or another serious condition that could even have been overlooked. So... finding what illness are present would be the first question.

Then, why it got worse. tolerance to previous medications is one of the more common causes and response to lowering the drugs the patient is on, even including suboxone for a short course (it might remove the tolerance).

Then, there's the question of treatment. Often/ usually adding a non-narcotic medicine is the way to proceed. This might include aspirin like drugs, nerve damping drugs, and/or muscle relaxants.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Matt Wachsman 16 minutes later
I'm am always in pain. Aspirin does not help. The cycle has to be stopped. I have chronic pain for 20 yrs. I knew u could not help me. Everyone is so ooh about the pain word. I have a lot of problems. Some factors too much to describe here. Need personal talk. Thanks anyway. Just as I thought no one wants to get involved personally and u r no help. Thanks anyway. I'm alone. I am very knowledgeable. I spent years in medical fields. I'm no junkie. Nor am I crazy. I won't reach out again. I need personal contact with someone who cares. I'll never use this site again. I wasted money I didn't have. Thanks a lot
Answered by Dr. Matt Wachsman 8 hours later
Brief Answer:
Ideally what would you want?

Detailed Answer:
it's pretty clear that you have frustrations that are feeding into the pain.

"nothing anyone can do" etc.
and.... lashing out emotionally rather than asking reasonable follow up questions.
indeed tricky to see how someone , anyone, under any circumstance could have personal talk wihtout appropriate background info on what one wants, what particular issues are there other than wanting more narcotics.

incidentally, while wanting more narcotics is, of course, a bit of a warning sign for drug tolerance, dependence and other issues leading into addiction, I note that your dose was decreased by at least two thirds and lowering a dose of any medication by more than half will have reliably less effect.

I might also mention the pain sensation is altered by the chronic use of the higher doses of narcotics and reliably everyone gets both an increase in the amount of pain and an extension in where it hurts going ffrom over 100 mg oxycodone equivalent chronically down to 50 or less a day.

there are well-known ways to handle this. I am doubtful you will want to hear them.

I need to give all the relevant information on a situation, detail what other features this site can provide (obviously online provision of unlimited controlled substances are from other places on the internet and NoT This One). You choose how you want to interact.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3663 Questions


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