Pain meds

[tinlizzy]

Why do I feel more alert/less tired on pain meds?

Is this real or are the meds fooling me? They're not very strong meds (hydrocodone) and don't do much for the pain but they seem to kill the fatigue pretty well. Why?

 

[Tyro]

Would you characterize it as a mild euphoria? That's a common S/E of analgesics, and is usually temporary when used long-term.

A better question might be, is your pain being adequately addressed (not necessarily totally eliminated) to allow you better functionality in day to day activities?

If not, a frank discussion with your doctor might be in order.

talk doctor pain - Google Search

Tyro

 

[obgyn65]

Lightheadedness, drowsiness are common reactions. Hydrocodone is an opioid. You may wish to consider alternatives with your provider if these reactions persist or worsen. Good luck.

Why do I feel more alert/less tired on pain meds?

Is this real or are the meds fooling me? They're not very strong meds (hydrocodone) and don't do much for the pain but they seem to kill the fatigue pretty well. Why?

 

[Richard4444]

Why do I feel more alert/less tired on pain meds?

Is this real or are the meds fooling me? They're not very strong meds (hydrocodone) and don't do much for the pain but they seem to kill the fatigue pretty well. Why?

Do not think that the pain meds are good for you even if they are making you feel more alert. And do not think that hydrocodone is not a strong pain med. Addiction can begin from this erroneous thinking. Just a piece of caution.

 

[Meadbh]

Hydrocondone is a moderately strong opioid which frequently becomes addictive after a few weeks of use. If you have been using it for a while you may be getting habituated to the drug in terms of pain control, while still feeling the euphoria. This is a very dangerous situation to be in. Please ask your doctor how you can be weaned off this drug ASAP and find a non-addictive way to manage the pain.

 

[palomalou]

Glad you posted this, everyone. I've been taking it at night (broke bone) but not every night, because I don't want to become dependent. Friday night I took it and got a VERY long night of sleep, but was a trifle dizzy yesterday. Last night I didn't take it, got no sleep at all. But I think I'll just not take any more of it.

 

[W2R]

My oral surgeon wanted to prescribe hydrocodone again, for me to use after my dental implant last Thursday. I had all but one left from the prescription he gave me after my bone graft in December, so told him I didn't need a new prescription. I haven't taken even one this time.

I don't NEED that stuff and if/since it can become addictive, I'd rather take poison. If pain is not unbearable, then to me it's not worth the risk. Like many of us, I lived through the 1960's and saw what can happen to people who become addicted. It's not pretty.

Now that I am done with the implant surgery, I plan to throw it out.

 

[Amethyst]

I was given hydrocodone (or similar opioid) when I had 4 wisdom teeth pulled. I remembered thinking, "Weird, I can still feel the pain, but I just don't care." (They also nauseated me). The next time I had oral surgery, the dentist offered stronger meds, but I opted for 800mg of ibuprofen.

I realize there are times when only an opioid will do the job, but it sounds like your meds are not doing their job very well! Please discuss w/your Dr. I hope your bone mends soon and you don't need any pills at all.


Amethyst

Why do I feel more alert/less tired on pain meds?

Is this real or are the meds fooling me? They're not very strong meds (hydrocodone) and don't do much for the pain but they seem to kill the fatigue pretty well. Why?

 

[ls99]

Many many years ago, I was put on a bus at Ft. Devans, a bit of a ways from Boston, with multiple fractures of L humerus just set in cast. And a bottle of Darvon pills. The Bus ride to Grand Central Station in Manhattan, thence to Palisades in Rockland county NY was painless.

That stuff really worked well.

The following week at West Point NY, an Ortho surgeon after viewing the Xray, had the cast cut off, with his hands puling, rotating, and gripping like molding putty, rearranged the several broken bones so my palm would be in the correct direction when the bones healed. All under the magnificent pain eliminating effects of Darvon. He also mentioned how lucky I was that no nerves were severed.

At times drugs are great.

 

[heeyy_joe]

Dang stuff puts me to sleep every time. Had some for shingles recently and couldn't stand taking them. Lyrica, however, was helpful.

 

[tinlizzy]

I appreciate all the answers and I posted on the assumption that everything else was "normal". It's not - so the meds are probably not working or maybe not being metabolized correctly?

A little background. I rarely use the hydrocodone. Dilaudid gives me the most relief and I only take that when I absolutely can't take it. A dx has been elusive so far.

For the drs. who understand this stuff (I do not expect an armchair dx - it's a Rubik's cube) I have high titers of antibodies to ds dna but nothing else supports a dx of Lupus (not even an elevated ESR) - so probable Lupus. Pos. anticardiolipid antibodies but no clots. Pos. schirmer's test (zero both eyes) for Sjogren's but neg. SSA/SSB, Raynaud's and hypothyroidism.

I take Plaquenil, Adalat, Synthroid and aspirin and I do great - until I don't, every few years. Then I feel like I've been hit by a MAC truck. My joints, muscles, tendons (not exactly sure) ache and ache and I feel as though they are softening, extra bendy, not stiff. I also get very hyperpigmented (been tested for Addison's twice), fatigued and my ears ache.

Anyway, it's back and I go see the Rheumalogist about a week and a half ago, who seems to me to be at his wit's end as to what ails me, and all he'll give me are pain meds because he doesn't feel he can justify any other med. I take them because I have no other option but have that weird reaction.

Today I get a letter that my T4 and TSH are both high - I cannot explain this, he says. No change in meds, recheck in 3 mos. I had to laugh at that blood work - craziness.

He and I are having a grudge match. He wants me to go off all my meds to see what happens and I want him to start throwing meds at me and see if one sticks, if you know what I mean.

Thanks for listening - it felt good to vent.

 

[GrayHare]

You may feel more alert because some pain meds contain caffeine.

 

[W2R]

He wants me to go off all my meds to see what happens and I want him to start throwing meds at me and see if one sticks, if you know what I mean.

Here is my suggestion, and feel free to take it or leave it!

Either:

1. Do exactly what your doctor tells you to do, and go off all your meds now, or
2. Find another doctor who you believe has more expertise.

 

[tinlizzy]

I have to find the right time to go off meds - like when I retire. I need my job more than a definitive diagnosis.

When I was unmedicated I would have vertigo so bad I'd fall down, grab the carpet so I wouldn't fly away, and lay there for hrs. I had 2 kitchen fires because my thinking was so muddled. I could barely walk or lift my legs.

 

[sheehs1]

Here is my suggestion, and feel free to take it or leave it!

Either:

1. Do exactly what your doctor tells you to do, and go off all your meds now, or
2. Find another doctor who you believe has more expertise.

+1

 

[Meadbh]

You may feel more alert because some pain meds contain caffeine.

Or you may feel alert because your T4 is high.

 

[Felix Mulier]

I have to find the right time to go off meds - like when I retire. I need my job more than a definitive diagnosis.

Please don't put your j*b before your health. TIFM, I hoped to come off all my meds once I retired, but you don't get healthy just because you retire (dang!) - less stressed? probably.

I think you need another doc's opinion. Is there a large medical center near you? Have you looked for a group like FIRE and asked about your symptoms? There are lots of conditions out there that some docs still refuse to acknowledge (such as fibromyalgia). That doesn't make them any less real to the person who's suffering. No one deserves to suffer.

 

[Tyro]

Addiction can begin from this erroneous thinking.

Hydrocondone is a moderately strong opioid which frequently becomes addictive after a few weeks of use.

Physical dependence ≠ Addiction!

Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects.

A person may have a physical dependence on a substance without having an addiction. For example, certain blood pressure medications do not cause addiction but they can cause physical dependence. Other drugs, such as cocaine, cause addiction without leading to physical dependence.

Drug dependence: MedlinePlus Medical Encyclopedia

See also: The Angry Pharmacist » Blog Archive » Addiction vs Dependence

Many non-opioid medications can cause dependence.
Physical dependence - Wikipedia, the free encyclopedia

The chances of a person taking an opioid -- under a doctors care and according to directions, who does not have a history of substance abuse or psychological problems -- becoming addicted, are very low.

A 2008 study that compiled previous research found that about 3% of people with chronic non-cancer pain using opioid drugs abused them or became addicted. The risk was less than 1% in people who had never abused drugs or been addicted.
Pain Medications: Addiction and Fear of Becoming Addicted

Tyro

 

[obgyn65]

As a prescriber, I always weigh the risk to my patient, even when the risk is low. I never prescribe narcotics at the free clinics for obvious reasons. The DEA investigated a colleague of mine a couple of years ago - I don't want to go through this.

The chances of a person taking an opioid -- under a doctors care and according to directions, who does not have a history of substance abuse or psychological problems -- becoming addicted, are very low.

Tyro

 

[Brett_Cameron]

Several years ago when preparing for a trip to India, I went to my dentist to make sure I did not have any incipient dental work that needed to be fixed before I went. He told me about an over- the counter non-opoid pain relief method that I have found to be very effective: two 500 mg tylenol (or generic) Gel Caps plus two 200 mg ibuprofen taken together. It has to be the Gel Caps, not tablets or caplets. The two ingredients work together and provide better pain relief for me than hydrocodone or the demerol+phenergan combo that my oral surgeon prescribed. I would take this every 6-8 hours for moderate pain such as wisdom teeth removal or pinched back nerve pain. The cautions to be considered are: don't take too much tylenol to avoid liver damage, and consider the impact of stomach and blood pressure issues with ibuprofen. I do not take this for more than a few days at a time. You should talk to your doctor about this before you try it. YMMV

 

[Ally]

I have an illness that comes and goes. When it flares up, it is particularly painful. I have hydrocodone for these times. I try to go as long as I can before taking one. When I do, I always feel such a relief from the pain, that its almost like drinking coffee, because I suddenly feel like cleaning, cooking, going for a walk, etc. it rarely makes me sleepy. I use them sparingly and carefully, but when I need them every 2-3 months for a few days, I am thankful to have them.

 

[Tyro]

As a prescriber, I always weigh the risk to my patient, even when the risk is low. I never prescribe narcotics at the free clinics for obvious reasons. The DEA investigated a colleague of mine a couple of years ago - I don't want to go through this.

You're referring to the DEA's War on Doctors*. Weighing risk to patients is appropriate standard of care. I wouldn't blame any doctor for being prudent, but the politics of pain* in this country (USA) have gotten so bad (from bureaucrats playing doctor, and making criminal issues out of medical ones) that everyone -- patients, doctors, and society in general -- suffers.... stupidly, IMO.

* Materials from AAPS Briefing to Congress - "Politics of Pain"

[FONT=Arial,Bold][FONT=Arial,Bold]...many innocent physicians who are dedicated to treating chronic pain [/FONT][/FONT][FONT=Arial,Bold][FONT=Arial,Bold]suffers have become targets in the DEA’s war on drugs thus [/FONT][FONT=Arial,Bold]depriving pain patients of treatment they need to live normal and [/FONT][FONT=Arial,Bold]productive lives[.][/FONT][/FONT]​

My point was/is that the uninitiated often throw around terms like "addiction" without really knowing what they mean, and unintentionally add to the fear-mongering. Opioid analgesics, when prescribed and taken appropriately, can be safe and effective (and less damaging to organs longterm than many non-opioid alternatives), and while they should be respected at all times, they need not be feared. They are not the evil bogeyman they are made out to be by bureaucrats and media attention-grabbers.

Tyro