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10 Ways I Balance Opioid Use for Pain Management

Editor’s note: The following is based on an individual’s experience and shouldn’t be taken as medical advice. Please consult your doctor before going on or off medication.

Like many pain patients, I have been dealing with tremendous fear in regards to my future due to the fact that pain medications are currently being taken away from pain patients. Pain patients are unfairly being penalized because there are so many struggling with addiction in our county right now. We have an epidemic of addiction in this country that needs to be dealt with. However, I do not believe taking pain medication away from chronic pain patients is not the answer.

In medicine in general, treating patients with the one-size-fits-all approach is an ongoing problem. You may have 10 individuals with the same disease with completely varying symptoms and degrees of pain. Treatment plans should generally be more individualized. Pain management is no exception to this theory.

I have dealt with severe pain my entire adult life and I have had quite a bit of experience with pain medications. Taking pain meds as prescribed (generally several times a day) may cause physical dependency. Physical dependency is not comfortable but it is also not the same as addiction. I have taken control of my pain management and I am able to utilize pain medication safely and comfortably because of that. I believe other pain patients can and probably already do the same. I believe that exploring options for better utilization of pain medications is key.

In my 20s, I was taking a pain medication prescribed by my physician about every four hours. I required this medication to deal with my severe pain but I did have concerns. I started to notice that when I didn’t take it on schedule, I would begin to feel very sick. I would get a fever and chills, become nauseous and very irritable/uncomfortable. Once I took my dose, I felt better.  The medication treated my pain and allowed me to function and be productive. However, I was concerned that my body was becoming physically dependent on this drug and I asked my physician about my concerns. His reply was that this particular drug was not even classified as a controlled substance and not to worry about it. Side note: The drug I am referencing was re-classified as a controlled substance in 2014. I no longer have this physician and haven’t for a very long time.

There have been periods in my life where my pain has been less and I have needed to come off pain meds (specifically pregnancy). I have been able to do so successfully. During pregnancy, immune system diseases, such as mine, may show improvements in pain. This is not the case for all women but for me, my pain was not quite as severe during pregnancy. I still had pain during pregnancy but the day-to-day level was more manageable. I had stopped pain medications completely prior to getting pregnant since I was utilizing fertility measures where my pregnancies were planned.

When I decided to become pregnant in my late 20s (not long after having that discussion with my physician about my concerns of physical dependency), I knew I would need to stop taking all of my medications. It was a very scary decision and I did fear that I may not be able to do it but I wanted to try. I told my rheumatologist that I had decided to stop taking my anti-inflammatory, biologic and pain medications. I told my neurologist, cardiologist and gastroenterologist that I wanted to stop taking those medications as well. I did this over the course of many months and for the most part it was pretty smooth. My heart medication was the last to go and my heart did require some close monitoring during pregnancy.

Not all of it was smooth, however. I will never forget the nightmare of coming off of my pain meds. I tapered them down over the course of a week. I remember the miserable nausea, fevers and the feeling like you want to peel your own skin off. I remember taking anti-nausea medication and Benadryl which helped only mildly. The first week was absolute misery but the uncomfortable feeling went on for a month. I experienced horrible pain as well until I became pregnant about 10 months later.

After that experience I was absolutely certain that I could never go through coming off pain medication again. Once my daughter was born, my pain levels began to slowly rise again. My other health conditions began to get worse as well and slowly medications were once again added. I tried everything to deal with pain. I changed my diet, I was prescribed a TENS device, I tried massage and acupuncture. You name it and I tried it. My doctor tried a variety of medications including low dose chemo but my pain got worse and worse. I couldn’t sleep. I had trouble doing the things I once loved, such as playing softball or teaching a class. My daily pain levels were becoming unbearable and pain began to once again rule my life. My pain had a significant negative impact on my life and my ability to function.

I finally gave in to trying pain meds again. This time I was prescribed a different pain med, one I have now taken responsibly for about 10 years. When I decided I needed to utilize pain meds again, I knew there was no way I would ever allow myself to be put in the same situation as I had in the past. I would never want to feel the discomfort of physical dependency and I would never want to go through the agony of withdrawal. I made the decision to take control of my pain management. Here are some of the ways I have accomplished this:

1. I only take pain meds when my pain is a 6 or higher on the 1-10 pain scale, or if I know it will be a particularly pain-causing day. (An example may be that I will be standing at a gathering/function for hours that day).

2. I do not take pain medication on a prescribed schedule. I take them less often. The only exception to this is when I am bedridden from illness or surgery and then I do need to take them on schedule.

3. I allow for flexibility based on my symptoms and what I need to accomplish that day. There are days where I may not even take any pain meds at all.

4. I am responsible with my medication. My medication is locked up just the same as any valuables would be. I do not share my medication or leave it where others may access it.

5. I take my medication for physical pain only. I do not take pain medication as an escape from my life.

6. I take only enough pain meds to make my pain tolerable and rarely even feel any sort of “high” from taking them.

7. I follow the rules set forth by my physician such as getting all my medication at one pharmacy and telling him when new medications are added.

8. I utilize a physician who is proactive in my pain management and knows how to prescribe responsibly. He does see me on a regular basis and makes himself available to me when I have questions or concerns.

9. I utilize other treatment options for pain as well. I currently utilize a variety of other non-narcotic medications and non-medication treatments as well. My pain medication is only part of my pain management.

10. I have learned how to balance and taper as needed. (For example, if I need to take more medication because I am bedridden, I taper slowly back down after I am able to get up and be mobile again.)

I needed to come off pain medication again briefly about three years ago (again due to infertility treatments/pregnancy) and was able to do so easily that time and without any issues. I tapered down my dose slowly over the course of about two weeks. I utilized medications such as acetaminophen and anti-nausea medication and had a very easy transition. I believe the reason this experience was so much easier than the one in the past was because I had taken control of the amount of pain medication I take. My body had adjusted to the increase and decrease balancing plan I had created.

In conclusion, I believe the key to helping individuals with pain is to remember they are individuals. We need to expand beyond the one-size-fits-all approach to medicine. We need to stop blaming chronic pain patients for the drug addiction problem in this country. Nobody should be brought to the point of considering suicide because they cannot get relief from their pain. Taking pain meds away from chronic pain patients is not the answer. Coming up with safer guidelines and providing more support and education to doctors and patients is vital. I am a patient on pain medication. I take my medication responsibly and have zero signs of addiction. Pain medication allows me to function and contribute to society. Pain medication is not going to take my life; pain medication is saving my life.

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Thinkstock photo via BananaStock.