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high tolerance

Tolerance seems to be my biggest enemy.  Once they find a dose that works for me then a month goes by and now medicine stops working so well.  Every month to month and half my body gets use to the dose and pain breaks through and stays constant. Here lies the problem now I must convince my dr. to try and dose me far enough a head of tolerance to actually work. Most of the time the dose change falls short because my tolerance is way extreme and this is something that does not have a dosing chart.  How does a person with extreme high tolerance get a working dose of medicine that remains working?
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547368 tn?1440541785
Hi Noending,

Welcome to our Pain Management Forum. I'm sorry to hear about your situation. Your tolerance does happen. How often and to what degree it happens I'm not certain. It doesn't happen to everyone to the extent that you are talking about.

I've been on opiates for 12-13 years for increasingly horrid Chronic Pain. My condition has deteriorated during that time frame - yet I am on smaller does of opiates than I was two years ago. - significantly smaller.  

What's the answer? Sorry I don't have a good one. My heart goes out to you. We know unrelenting soul retching chronic pain. It can rip your life apart!

You may be past point have continued increasing of opiates. You may have to find complimentary (to opiates) measures to reduce your pain. Have you or your physician considered an implanted pain pump? Some ppl find this to be a good solution. I don't often suggest looking into a SCS (Spinal Cord Stimulator) but maybe in your situation it's worth considering. Look or re-look at alternatives. I've found adding Lyrica to my pain medication regime to be beneficial. I also take a medication normally used for spasms and anxiety to be helpful. I take that just a few times a month - much less than prescribed.

Rotating opiates for a few months can also help - meaning for a month or two you take completely different opiates that what you normally take - and than rotate back to your normal opiates. It's not easy - but it may help. Your body need to reset itself. Sometimes that also means drug "holidays".

I would hate to see you on higher doses of opiates. One slip and it could result in a fatal overdose - even when taken as ordered it can lead to a fatal build up of the opiate. Be cautious my friend in pain. If they up the dose than what happens next month - or in two or three months. I am concerned for you.

I live with some nasty pain - some days I barely function. I chose that over high doses of opiates. Maybe somethings that help me will help you.  It takes a lot of support from my soulmate, PMP and determination on my part to manage. I do what I have to do to get through the day - or worse yet the long nites! Baths, massage chairs, anxiety meds, Lyrica, my favorite heat product (ThermaCare)  and anything else that I think may help at the moment that's legal I do. Distraction sometimes help - though when the pain is really high distraction can be more than challenging.

I hope you'll keep in touch and share with us the outcome. I'll look forward to hearing from you again soon. I am sorry I have not better answers for you - just know that you are not alone.

Take Good Care,
~Tuck
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Avatar universal
I would not suggest taking the amount of Norco suggested it is way to much Tylenol for your body. With 5 of them it's 1625mg and I'm pretty sure your not supposed to take more than 1000mg at most at one time. But never more then 4000 in one day. But doctors like to keep it at 3200mg or something to be safe I just read this on a drug web site.  But please don't take my advice please speak to your doctor , it's just my only hope to keep you safe and healthy.  
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1 Comments
For our members. The recommended 24 hour intake of acetaminophen remains at 4,000mg. The FDA has researched and debated this issue for several years. In 2015 (November I believe) the FDA concluded that the existing 4,000 mg recommendation was adequate. The concern was education of the public on the multiple products that contain Acetaminophen. Many ppl did not realize so many products contained Acetaminophen and therefore were consuming over 4,000 mgs in a 24 hour period.  

The end of 2015 the FDA made their findings official. They also suggested terminology that should be placed on products containing Acetaminophen: "“Liver warning: This product contains acetaminophen. Severe liver damage may occur if you take • more than 4,000 mg of acetaminophen in 24 hours • with other drugs containing acetaminophen • 3 or more alcoholic drinks every day while using this product.” This quote is from the FDA website.

Note they added the alcohol concern. There are cases where ppl were well below the recommendations but consumed alcohol - and experienced liver damage - some actually died.

You're correct Grreatful, one should not consume a large dose of Acetaminophen at one time.  I didn't read Flatileman's post to say that he was taking the 5 Norco at once - but if he is that is certainly concerning. Thanks for picking that up!

Everything in moderation.

~Tuck

Avatar universal
It doesn't get any better....your tolerance will continue to build.  No matter what you do...and after a while, if not already, the pain medicine won't work any longer.  After 10 years of narcotic pain killers, I had to go cold turkey on my own, without any help.  You will have to wean yourself off ALL the pain meds for a while.  This will not be pleasant nor will your pain.  I started out on Percocet 10/325...240 of them a month.  Ten years later, I was taking 240 Oxycodone 30 mg. plus 200 mg of Demerol on a daily basis with not much relief.  Speak to your doctor.  After five years of dealing with excruciating pain, I can longer tolerate NOT having meds...but even now...I will take five Norco 10/325 to give me even a little relief.  The pills are slowly killing you.  They will start killing me as soon as I can get my doctor to prescribe more.  In the interim, I moved 5 years ago back home to Michigan.  I have a medical marijuana card...and medical marijuana has been helping to ease my pain and insomnia.   If you are able too...try something else..ANYTHING ELSE....pot is just something that was at my disposal....so I tried it...and it does help.  I hope this helps you.
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