Opiate Drug Interaction
I've seen that there are a lot of posts about opiates so I'm, sorry to start a new one, I'm just at a bit of a loss. I want to start by saying that my post will be entirely honest, I'm desperate for some sound advice so pulling the wool over anyone's eyes isn't going to do me any favours.
I have had a repeat prescription for cocodamol (30/500) and codeine (30mg) for about three years - I'm 31. I suffer really badly with terrible back pain that radiates up my back, into my neck and then causes really bad headaches. I am aware of 100 things that contribute to all of this, I have terrible posture which won't help, I seem to sleep like I'm crazed and for over a decade I was morbidly obese which can't have helped my skeleton so to speak. I underwent gastric bypass surgery 5 years ago which as a complete success but a year later I was diagnosed as a myoclonic juvenile epileptic and am prescribed Keppra every day to control seizures. Over the years my pain has moved through my body and a huge percentage of me can hurt for the majority of my day - awake and asleep. I haven't been diagnosed with any condition, much like everyone else has said pushing the pain killers in your direction seemed the knee jerk reaction. I'm at a stale mate now however. The combination of the cocodamol and supplementary codeine aren't 'working', at the very best I can reduce my 10 out of 10 pain down to about a 3 or 4, the pain never completely goes (and I honestly have a good threshold to pain). I take the cocodamols in sets of three with one or two codeine just to have some level of pain relief, my tolerance to them is now sky high, I can take these sets every couple of hours so I'm ramping through a month prescription in just over a week - even if I am trying to be well behaved. I then spend the rest of the month taking ridiculous amounts of over the counter cocodamol because I don't have any prescription ones left.
Last year, I explained this to my GP (I didn't go into exact figures but I did say I was taking far too many). He suggested tramadol and I had been prescribed this before following a surgery, I didn't think it was a great alternative and he said that from a GP perspective he was at the "ceiling" of what he has the authority to prescribe. As I am an epileptic he wanted to write to my neurologist and ask if there were any alternative meds that they could suggest because he wanted to avoid interaction. I am convinced that there was some sort of misinterpretation because the response came back and suggested amitriptyline and so he prescribed me that and told me that this will a). help the cocodamol last longer in my body and b). make me feel the effect of it more, thus negating the need to take my doses too close together.
The amitriptyline made no difference whatsoever and over a month later I asked him to remove it from my prescription. He then said that at this point, he would need to refer me to the pain clinic because only they can prescribe drugs above and beyond what I have already had. The pain clinic called me to book me in the other day and they advised that all the beginnings of this referral are group therapies which teach you mind skills to help you manage your pain?? So now I don't know if I'm going the wrong way?
To add to everything, in April of this year I went into A&E with a perforated ulcer and had to have open surgery. I was prescribed both instant and slow release oxycodone which I now hear is incredibly addictive and very hard to come off of. I had no problems with this prescription ending and at the same time, cold turkey kicked a 15 year 20 a day smoking habit, I also wans’t taking anything other than the oxycodone, all other pain relief had been replaced with this. I know people really want to believe "everyone" who has problems like this are "addicted" to opiates, but I honestly don't feel that's the case. I feel that I am drug dependent - severely, but I don't feel like I have an addiction problem with these.
I want to rediscuss all of this with both my GP and my neurologist maybe by way of an open letter to both of them, I want to know if there are any other pain relief medications that people are aware of that are effective but don't interact with Keppra? I work in an industry high stress environment and going off sick or absent isn't an option, I don't want to not be at work, but just for a little bit of the day I would really like not to hurt like this. I would really like just to be ok every once in a while.
I've tried to play every game, I've gone to every chiropractor, sports therapist, physiotherapist etc. I have the special wedge pillows for support when I sleep, I've completely bought into pilates, and so on - all of these things suggested by my GP.
I also know that excess pain relief in itself can also cause pain which is another reason I'm trying to find another solution, the vicious cycle of this is really disconcerting.
I'm sorry this is so long, any help anyone had - I would be so grateful to hear it.
Thank youReport this