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How to deal with chronic pain with h/o substance abuse

I am diagnosed with 3 herniated cervical discs and fibromyalgia. I have a history 2 years ago of substance abuse (because of these pain issues). I have been thru a year of treatment and clean for 2 years. Finally referred to pain managment MD who is reluctant to prescribe opioids to treat chronic pain. Tried duragesic patch - 25 mcg TOO strong and 12 did nothing. I've also had 4 cervical steroid epidurals which offered fair relief but can't have more at this time (also concerned about amt of steroids in body and effects). I have done P.T., yoga, chiro, heat/ice, yoga, meditation, new mattress/pillows, acupuncture.  What are my alternatives?  Have offered to sign pain contract with him. Am very frustrated because I have been to various MD's and get the same answer since I have h/o substance abuse (again, b/c of chronic pain).  Do you have any suggestions?
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535089 tn?1400673519
Hi Pennylane and welcome to the Pain Forum.

I'm sorry that you have to endure the rath of pain. It is sad when pain patients put themselves in this position. With you being a nurse, I'm sure that you knew what was coming by abusing. Putting that aside, I feel that you did not give the 25mcg Patch a fair chance. Seeing that the 12mcg patch did nothing then what would possibly make the 25mcg so strong? The side effects can be hard to deal with but if you hang in there, they do go away. The Fentanyl is the only thing that has helped me and getting past the initial month was tough.

It has been noted that a person is less likely to abuse Fentanyl and Methadone because of their properties. You do not get the euphoria that you would get using the other opiates. Like Red said, you may want to see if the Doctor won't re-issue the Fentanyl prescription and give it another try.

Also, Nick had mentioned that there might be something holding the Doctors back from prescribing....Would there be anything in your Medical Record that you did not mention here that would make a Doctor absolutely turn away??

I was also wondering if the Doctor that diagnosed the Herniated Disc as offered you Surgery to correct that? I had a few Herniations and I under went a Fusion. Have they ever mentioned that to you?

Please take care,
Mollyrae

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Avatar universal
Hi there,
I find it strange that you reject both the 12 and 25 patches. perhaps you prefer pills. I've been on both of those strength patches in the past and there isn't much difference between them side effects wise(nor strength wise). I find it highly unlikely that the 12 is useless and the 25 is too much. besides, we can't expect everything to be perfect. It just isn't realistic.
I don't think you are over your addiction. I'm sorry that my response isn't the one you're looking for. but if i were you (and really in pain) i'd make a choice between the 12 and 25 patch. it's probably the best you'll get given your history. sorry.

Nick.
Helpful - 0
765775 tn?1366024691
I read your other post. This one is a little different. You left the Fentanyl Patch out of the other one. I would think that you would have gotten some releif from that patch. As a nurse you should know that there is nothing that can be prescribed that will make you totally pain free.

I would go back on the patch if they will give it to you again and get another series of epidurals. I was also try IcePaks/Heat and get a TENS Unit and apply stimulation at the same time as ice or heat.

You must have some specific issues related to your case that are going to prevent you from being dispensed any oral opiates. These doctors won't even prescribe you (Ultram) Tramadol because of this and it is non-narcotic.

I have given you the best advice I can. That patch is he only narcotic pain medication you are going to get. If you think that 25 is too strong you can settle for 12.5, however if you had an opiate addiction I would think your tolerance is pretty high and you could adjust to the 25 mcg. quickly.

Good Luck.
Helpful - 0
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