Long Term effects of pain med

[denaqueenbee]

I am seeking help with problems no doctor can find diagnosis.  I've taken Oxycontin for 7 years now, and need to know what effects others have had from long term use?

[sandee1818]

As in?

[Worried52]

I've been on Oxycontin for 10 years. I started at 10 mg and now am up to 40mg twice a day. I have chronic back pain after 2 failed surgeries and fibromyalgia. I too wonder what this is doing to my body. I know that if I'm a little late taking a dose I start to go through withdrawal and that is scary.

[franco1470]

I've been on oxycontin for seven years. I started at 40mg x 2/day after back surgery. Went up to 160mg/day for one month then began tapering down. Did a slow taper over
a few years. The med allowed me to function and work, the pain was too intense otherwise. I now take 20mg twice a day but have been at this level for two years,
my doctor thinks this might be as low as I can go. I want to switch to 10mg with something for the breakthrough pain. For people who are responsible with their medicine it is a very helpful drug. For many others it can destroy them.
For people who drink alcohol I think it may affect their liver. For anyone who takes pain meds long term they need to have their livers checked periodically.
My biggest negative effect is that I am tied into this town because I have a great doctor,
he was my GP long before a surgeon got me dependent on this stuff, but I can't move anywhere because I would never find another doctor who trusts me the same way.

[mareke]

Your doctor won’t tell you the long term effects of what you are taking because he probably doesn’t know or is unwilling to make an educated guess. I was on 400 mg of Tramadol a day (among other drugs that I sometimes took with the Tramadol) for 5 years and monitored myself in various ways. Using a digital home BP kit to monitor my BP I worked out that it would rise to roughly 160/100 about 2 hours after taking the Tramadol and then gradually drop back to at best borderline high BP of 140/90. Using a blood glucose monitoring kit I bought my blood sugar remained normal during the 5 years even though I gained 40 lb in weight (I’ve lost 30 lb of the weight since stopping taking Tramadol). My libido pretty much disappeared while on Tramadol but has now returned to normal since going off it. Liver function tests were normal while on Tramadol except once when I took other drugs along with Tramadol.

While on Tramadol I initially suffered constipation when I started taking it but the constipation subsided somewhat as my body got used to the stuff. When I stopped taking the Tramadol I suffered from quite severe irritable bowel syndrome for some time until my bowels eventually got back to normal. Had I stayed on Tramadol I’m guessing I would have shortened my lifespan by at least say 5 years (and probably more but I’ll never know) but now while I’m physically a lot healthier having lost 30 lb in weight and become much fitter with BP, libido and bowels back to normal I’m in a lot more pain.

Many of the effects of painkillers can be self monitored apart from things like liver and kidney function which the doctor will do for you. If your BP has risen significantly as a result of taking the painkillers and you are more inactive and have gained weight then you probably won’t live as long but depending on your pain problem you may consider that you have a better quality of life and that the shortened lifespan is worth the better quality of life. In my cases the doctor I see praises me for having stopped taking the Tramadol of my own accord and is happy that I will most likely live a longer but more pain filled life as opposed to a medicated probably shorter less pain filled life. At the moment I can just cope with my pain but I hope my pain levels don’t get any worse or I might once again opt for a shorter medicated life with less pain that is if I can find a doctor that respects my choice.

[1_bamboo_lover]

Your question is a good one, yet I wonder about something.  I have been on Oxycotin 60 mg every 8 hours, methadone, flexeril, xanax for 11 yrs.  I am concerned about my over-all health like any responsible person would be.  But,  the pain is so crushing that no matter what the meds may do  to by body,  without them I have NO quality of life.  It is curious that you could consider  adjusting dosage or meds.  How much pain do you suffer with?

[AnonDH56]

I dont think they know yet but if you ever get off of opiates all together and you were like me, I had diarrhea for ten days. I think I preferred the constipation. Then I had trouble getting Lomitol since though not a narcotic, it is a Schedule 5 controlled substance and in the backwards town I live in, only one clinic in town would write for it, and I had to beg for a refill. There was no HI to it at all.

Good Luck.
DH

[lilhollywood]

Not to scare anyone but ive read in mens health and have seen on discovery that is someone taks oxycotin for more then a certain period of years, the medicine has side effects and it honestly smoothes out the brain. Not like paper but it has effects o make you have short term memory, your alot slower to do stuff... but its been a few months since i read it, i think it was more then 10-15 years for the side effects to start acting up.
im not making this up to scare anyone ive really read this stuff.

[Toomanyadvil]

Well, you have to take everything you read with a grain of salt unless its been without a doubt proven.  
I dont doubt long term opioid use has effects on your body but I havent read any information about it as of yet.  
I've been taking oxycontin for a little over 2 years and I havent noticed any side effects neurologicaly that concern me. The side effects which are a pain to me are the occasional itching and sometimes a foggy feeling if I eat sugar or a high carb meal close to my dose.  

Docs are never going to tell you what the long term effects could possibly be, and the truth is some of us are in way too much pain to actually have that be a deciding factor at the time.
.  
I know if not for opioids alot more people than already have with my condition would have ended there lives. Including myself.   Its bad enough people still are reaching that point with there pain, I say if it can save a life damn the side effects that MAY happen in a few decades.  Chronic Pain without medication is a suffering no one should have to live with on a daily basis
Thats only my two cents

[JVLB123]

I have a friend who suffers severe pain down her arm as the result of surgery to remove a piece of lung that had collapsed.  She is taking a combination of oxycotin and oxycodone (up to 10 a day) and has been on these pain killers for several years now.  She is only in her early 50s. Recently, she has been diagnosed with osteoporosis in her spine.  Coincidently, she now suffers pain in her jaw from a previous operation to fix an overbite and her teeth are sore and feel loose.  Does anyone know if long term use of these drugs leach calcium or reduce bone mineral density?  Has anyone had similar issues?

[Toomanyadvil]

Hi JVLB

     My first thoughts while reading your post was that I have never come across any research saying opioid use can cause a loss in bone density or cause denistry problems. Whether these studies do exist I myself cant say they dont. Only that I have never come across them.
The only info I have ssen on opioid use and problems with bones and teeth and due to IV use brought on by injecting bacteria from the skin or needle into the body and attacking the body and bones.

Menapause can begin to effect the body years before it actually goes into full effect. I defenitly make no assumption that that is what has happened, but as we get older bone mass lessens so may add to a pre existing problem. There area also many factors such as lifestyle that may contribute to lossing bone mass, like drinking; smoking; not getting enough exersize, calcium, vitamin D, magnisium and dother minerals.

I'm not sure its possible to nail down the exact cause of osteoperosis unless there is a difficincy found in the body. But I can be completely wrong on that.

Maybe someone will come by that knows more than I do. But I defenitly have never seen any info that links opioids to bone density loss or osteoperosis. Maybe you can make the argument that if opioids are being taken on daily long term basis, were generally unwell and may not be getting the levels of vitamins and minerals we need.  

TMA

[sandee1818]

This had been a widely known myth as there is no evidence backing it up. It could be decay is caused by dry mouth which is a common side effect of opiates and dry mouth will lead to tooth decay. Another reason opiates tend to cause sugar cravings there fore the sugar leads to tooth decay. If you were to ask anyone that has been on opiates for many years they would probably say yes the meds caused my bad teeth. Now it was originally thought that heroin addicts had bad teeth because of poor or no hygiene ( as all they care about is getting the heroin they will skip personal hygiene). But that is not the case some dentist say, they say the decay is caused by the drug use. I personally think the meds  cause tooth decay , my Dad and Uncle who had perfect teeth and have been on opiates for years have had to have extensive dental work done. As for bone density I have heard some claims but nothing to really back them up. My PM is adamant about getting the proper dental work because poor dental hygiene is unhealthy.

[mcclos10]

What is it exactly that causes the sugar cravings with the meds do you know?  I always thought it was just me.  If I have any candy within reach I will eat it until I get sick it's like I can't control myself I crave it so bad.  I have to either not keep it in the house or eat some and then throw it away.  I really always thought it was some type of sugar addcition thing with me.  I never knew the 2 could be connected.  

[Toomanyadvil]

Actually sugars have an effect on opioids. Sugar alcohol and high carb foods changing into sugar cause times release medications to release faster. Not in a way where they break the times release and cause all the medicine to rudh into your system but it has been known to release the dose quicker into the sysytem.
Thats why your body craves sugar because it knows that pain relief will happen quicker.
Its also the reason you will feel groggy and tired if you take opioids after you eat a high carb/sugary meal or snack.
There may be other reasons but this is the one i am aware of

TMA

[mcclos10]

But what if you are not taking time release meds?  Is it still the same principal?  Does the sugar affect the absorption rates do you know?  Do you crave sugar like I describe too?  So if you eat sugar you will in turn get more CNS affect from the opioids?  If so that can be a good thing in especially painful times. -m10

[Toomanyadvil]

Unfortunitly I love sugar since I;ve been on pain meds. Seriously every day I HAVE to have soemthing sweet.

I am not 100% on short acting meds like vicoden or percocet. But the way I remember it being expained is that the sugar alcohols are somehow able to carry the medication into the system faster.
Even if I take a short acting med and eat right before or an hour after I'll feel really tired. I try to space my meals out to be at least 3 or 4 hours before my medication so that I dont get so tired or I only eat protein if I eat close to my medication. But I try not to have anything heavy for a least a little while afterward.
But someone may come by who knows for sure about short acting meds

TMA

[Toomanyadvil]

But I should say again that this isnt something that breaks a time release. Just incase someone comes by and thinks that. It doesnt work like that. It just casues an annoying fatigue.  
(defenitly not refering to you mcclos, just a general thought)

[Mollyrae]

I find this thread interesting. For a while now, I have had increasing muscle and joint pain and have also been on pain meds for many yrs. While visiting many, many drs trying to find a cause for the increasing pain other than my initial diagnosis which could possibly be the culprit, my pcp mentioned that scientists are now finding that long term use in opiates can lead to muscle & joint pain that was not otherwise noted. I was rather shocked. He did not go into further detail but I'm sure I can ask. In my case, that was not the case. Anyway, I thought I would forward the interesting info. Take care, Molly

[Toomanyadvil]

Actually Ive heard of this also

I am not exactly sure how it works because there is so little research on it at this point.
As far I as I understand, as time passes your body stores something the opioids release into your system. As time goes on more and more of it gets stored and begins to cause pain.
Also As someone takes a higher and higher dose your body can actually start producing pain to tell you it wants more. It learns more pain equals more opioids. Thats why alot of DR's wont raise a dose at a certain point.
About a year ago I had complained of pain and my DR told me that pain meds can actually cause your body more pain.
I've tried to look it up but found only one or two articles and i havent been able to find them since.

So the above is only my understanding of what my DR said and what I read.

TMA

[sandee1818]

Although I realize that it is probably impossible to eliminate sugar from your diet entirely, I can help you limit your intake. Here are some tips:

•    Banish packaged products -- including those made with white flour -- and stick to food in its original form. Instead of canned fruit or juice, eat a piece of whole fruit.

•    Drink plenty of water throughout the day; you may be mistaking dehydration for hunger.  

•    Eat protein at every meal; it is digested more slowly than simple carbohydrates and will leave you feeling fuller for a longer period of time. You will therefore be more likely to resist the urge to eat dessert every night after dinner.

•    Give up your favorite sweet food for three weeks. It is likely that after three weeks, your tastes will have changed and your craving for sweets will not be as strong.

•    Resist impulse snacking. If you crave a donut, take 15 minutes to think about it or go for a walk instead. Chances are, that after this delay period, your craving will have subsided.

Sugar effects serotonin and dopamine Sugar is the a natural narcotic it acts like a narcotic pill only it is natural. Some say that the natural good feeling you get from either triggers the brain wanting more and more sugar. I have read many articles that seem to think this is this case now I have no idea of knowing for sure.
I do know it is natural human behavior to keep craving something that makes us feel good so in my opinion the meds just jump start the sugar cravings and then your brain just wants more. Now again that is just my opinion.
Simply put, sugar triggers the production of the brain’s natural opioid (a substance that has a morphine-like effect on the body, though not as strong as morphine or heroin), as a result of this, the body (or more specifically the brain) starts to get addicted to its own opioid.

[sandee1818]

This is an article from JAMA,
About loss of bone density while on opioids and other drugs. There are many studies about this you can search from an educational search engine and find quite a few. A scholar search engine will work as well.



Decreased bone mineral density defines osteoporosis according to the World Health Organization and is an important predictor of future fractures. The use of several types of central nervous system-active drugs, including benzodiazepines, anticonvulsants, antidepressants, and opioids, have all been associated with increased risk of fracture. However, it is unclear whether such an increase in risk is related to an effect of bone mineral density or to other factors, such as increased risk of falls. We sought to examine the relationship between bone mineral density and the use of benzodiazepines, anticonvulsants, antidepressants, and opioids in a representative US population-based sample.

Subjects and methods
We analyzed data on adults aged 17 years and older from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Total femoral bone mineral density of 7114 male and 7532 female participants was measured by dual-energy x-ray absorptiometry. Multivariable linear regression models were used to quantify the relation between central nervous system medication exposure and total femoral bone mineral density. Models controlled for relevant covariates, including age, sex, and body mass index.

Results
In linear regression models, significantly reduced bone mineral density was found in subjects taking anticonvulsants (0.92 g/cm2; 95% confidence interval [CI]: 0.89 to 0.94) and opioids (0.92 g/cm2; 95% CI: 0.88 to 0.95) compared with nonusers (0.95 g/cm2; 95% CI: 0.95 to 0.95) after adjusting for several potential confounders. The other central nervous system-active drugs—benzodiazepines or antidepressants—were not associated with significantly reduced bone mineral density.

Conclusion
In cross-sectional analysis of NHANES III, anticonvulsants and opioids (but not benzodiazepines or antidepressants) were associated with significantly reduced bone mineral density. These findings have implications for fracture-prevention strategies.

[ACHILDOFGOD]

HYPERALGESIA  my doctor has actually talked to me about a condition called hyperalgesia where the cns is actually over excited by the opiates instead of depressed and causes more pain where you need more opiates.  he described is as"an endless circle" of needing more and more of the opiates. this is one of the reasons he wants me to  seriously consider the pain pump, less medication and obviously more powerful going right into the spine but you also don't have the internal organ problems cuz you are using less medication.

So interesting about the sugar comments huh!   me too love that sugar along with the oxycontin.

[JVLB123]

Thank you for your comments re loss of bone density.  It helps to know that she (my friend) is likely just getting old (like the rest of us!) and her osteo is likely not caused by her meds.

JVLB123

[kobaltblue]

I find it funny that everybody is concerned with the long term use and not how do i get off the drug also the constipation is something i never had from taking narcotic medication if you eat a proper diet you wont. As to the Tramadol raising BP many medications can do that you are puuting checmicals in your body which was not designed to proccess the things you stick it in ways you would like so you have to just relax and let your body adjust and things willl be ok

[Mollyrae]

Hi, For some of us it is not an option to get off the drug. If i were to do that, I were to do that then what little enjoyment I have in being active would go right down the drain. As for constipation, well everybody processes the durgs differently. To some, it wouldn't matter what you ate, they would still be constipated from the opiates. For others, yeah, maybe a balanced diet would work. Pain is a horrible thing and pain meds allow us to function.