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Narcotic Withdrawal

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

I've been on some kind of pain killer since last December with my 1st tonsillectomy. I went off briefly and right back on after my 2nd surgery in February and then third surgery less than two weeks later. I started treatment and have been on them since. Oxycododone, Oxycontin, Hydrocodone and most recently Lyrica and Tramadol. I've weaned myself down in dosage and frequency but still have been taking them daily. The Lyrica is twice daily for the nerve pain. I still hurt the vast majority of the time. Mostly it's a general body ache as if I have the flu or I'm 80 years old. My body just hurts!

Yesterday (Friday) I only took two 5mg Oxys, one in the morning and one in the evening after work. Well today I decided no matter how bad I was hurting, I wouldn't take any. What a mistake! I was absolutely miserable. OTC pain relievers didn't do a thing. It didn't help that the neuropathy I had a few weeks ago returned and has affected me from the waist down to my knees and lymphedema has my face feeling like a balloon. I finally fell asleep last night a little after 11pm and awoke an hour later with a start like I was jolted out of bed. The sheets were soaked and my legs are restless and I feel twitchy for lack of a better word. Upon consulting Dr. Google (I know I know), these are symptoms of narc withdrawal. I have a few others like anxiety, irritability and hot (sweating)and cold flashes. 

So here I sit unable to sleep. My shins feel like they want to explode and I just can't get comfortable. I took one 5mg oxy a few minutes ago and hope it quiets me down. This sucks! You think the docs would have warned me about this. I don't get a high off of these things. They just take the pain away but yet I feel like an addict and I suppose I am to some degree. I'm seeing my RO and MO the 1st week in August and will discuss it further then. I want to feel normal without pain meds. Not to mention the diet of stool softeners and M.o.M. so I don't explode from constipation!

~Sigh~

"T"

CivilMatt's picture
CivilMatt
Posts: 3067
Joined: May 2012

 

Mr. “T”,

It sounds like you have a good grasp on what is going on while you try to survive through recovery.  I would put your ordeal (treatment) up there as being susceptible to pain as many of the H&N folks I read about here; you went through a lot.

While I am glad your team was agreeable to the pain meds (there is no need to suffer), I wish there was an easy way out and off of them when the time arises.  I would tend to believe that you are physically healed, but nerve damage can be a whole other subject.  Real pain takes real pain meds.  I believe there are alternate methods of pain relief, but rarely are they as successful as are the pills.  If the pain jolts you awake I tend to think it is real pain.

I am sorry you find yourself in this quandary of pain and pain meds.  Your doctors must deal with these situations all the time, but since you aren’t scheduled to see them for a few weeks, do what helps you until better ideas are found.

Peace,

Matt

 

katenorwood
Posts: 1853
Joined: May 2012

T,

I'm glad you're connecting with what you're body is telling you.  Nerve pain simply sucks.  Don't be afraid of being an addict.....unless you had an issue with this before your DX.  I still have a script for the oxy on hand if I absolutely need it.  I like you had many issues coming off the pain meds due to surgery after surgery within a two yr. span.  My body kicked its heels at me something horrible.  I am on flexeril for the bad nerve pain the traditional (gabapentin) didn't touch it.  I heard the Lyrica is a good one for these issues.  I also started a med called celexa...which is helping ground me with all the anxiety and seems to be helping some of the issues with nerve pain.  Continue to express your concerns to your specialists.  And remember T it takes time to heal.....you've been through hell and back.  You're one tough cookie, and I hope they can find a good common ground to keep you out of pain and moving forward.  Hugs sent !  Katie

jim and i's picture
jim and i
Posts: 1666
Joined: May 2011

Just my opinion.  Don't torture yourself. My brother in law tried to take himself off pain meds and had bad withdraw. He finally went to doctor who helped him ween himself off. I say wait until you see the doctor.

Praying you feel better and get some rest.

Debbie

debbiejeanne's picture
debbiejeanne
Posts: 2590
Joined: Jan 2010

t, i don't know about the withdrawls but i wanted 2 wish u the best.  i'm sorry u have pain and the need 4 the meds.  i hope everything works out.

dj

phrannie51's picture
phrannie51
Posts: 3821
Joined: Mar 2012

to get off the narcotics, but am wondering about deciding to do it on your own without help from you Dr.'s.  When an addict is taken into treatment they give them different meds (non-narcotic) to "help" them through the withdrawal symptoms.  The brain has been using the narcotics in replacement for pain management rather than it's own management for a while, and so that part of the brain is "asleep"....and has to "re-up" and start working again (pumping out endorphins and such).  It takes a while for the brain to start working again.  Until the brain kicks in, a person feels every tiny bit of pain the body is putting out...and is why heroin and methadone addicts are so afraid to get off the dope.

Tramadol is "narcotic-like", but not a narcotic....it is not an opiate.  Lyrica is an anti-convulsant used to conteract nerve pain...it scrambles the pain messages before they get to the brain....also non-narcotic and not an opiate.  Maybe start cutting back on the opiates, but leave the Lyrica and Tramadol in place and see how that works. 

p

jcortney's picture
jcortney
Posts: 426
Joined: Sep 2012

T, as you know I'll be 6 months post treatment the beginning of August.  On Thursday I took my last Hydrocodin.  I was on Fentanyl patches, HYC and Adavan all at the same time.  The doc's took me off the patches first, a long slow process fraught with quite a few sleepless nights and then very slowly reduced my HYC ( I was on 30mg a day) until Thursday night of last week I took my last 5 mg.  I slept like crap on Friday and last night was no picnic either but I'm hoping that my body (mostly the receptors in the brain actually) will let it go tonight.

Anyway, the point is physical addiction is a common by product of our treatment and it's important to overcome the addiction by a slow supervised regimen.

Good luck buddy, as John says, you're close to abi normal now.

J.

ToBeGolden's picture
ToBeGolden
Posts: 697
Joined: Aug 2010

I also have severe insomnia, often not getting to sleep until after sunrise. I stopped both oxy and chemo about a month ago. I never considered the insomnia could be the results of withdrawl. And I really don't think they still are the culprits. But you have given me something to think and ask about.

Sorry about your sleep difficulties. The sleep difficulties have been the worst part of my C experience so far. I have no suggestions to help you out since I cannot help myself. Rick.

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

Hi Rick,

Good to see you post. Insomnia is one of the symptoms of narcotic withdrawl but you should be on the tail end if it was affecting you that way. The sunrise thing is what happened to me yesterday/today. The last dose of oxy was Friday around 5pm. Then I awoke this morning at 12:30am. I took a 5mg dose at around 2am and another around 6am after sunrise. I was able to get a few hours sleep this morning and about a 45 minute nap this afternoon. I'm staying on the narcs until I speak with my doctors in two weeks. 

With what you're dealing with it's no wonder you're having difficulty sleeping. I would definitely speak with your doctors about the insomnia. Perhaps they can give you something to help you sleep. 

Positive thoughts and prayers

"T"

tommyodavey's picture
tommyodavey
Posts: 376
Joined: Nov 2011

T, this is a subject I know a lot about.  Been down this road many times over the years and have learned a great deal about opiate pain meds.

For one, you are not an addict.  You have a physical chemical dependency to opiates.  Addicts overdue it and take more than prescribed, you don't so don't label yourself with that word.  Yes, your doctor should have warned you about withdrawal from opiates.  It does say right on the pamphlet you get from the pharmacy to not stop taking this medication w/o talking to your doctor.  But who reads that stuff?

 

Opiate withdrawal includes insomnia, diarrhea, restless leg syndrome (RLS), chills, bodyaches, and nausea, just to name a few.  The best way to taper yourself down would be to reduce your normal intake by 10% every 1-2 weeks.  You don't rush this.  You can ask for Requip.  That will help with the RLS and insomnia.  The drug makes you sleepy so two birds are hit with one script.  Time release Oxy's will need to be replaced with regular Oxycodone so you can start breaking them into smaller pieces.  Go from Oxycodone to Hydrocodone to Tramadol.  In that order.  Tramadol may be a mild non opiate drug but it does keep you from having withdrawals.

 

Keep in mind what Phrannie said.  It takes time for the brain to get used to not having the pleasure of opiates.  Exercise is the best remedy although it will be the last thing you will want to do.  Depression is another side effect but it's best to fight through it w/o going onto an anti-depressant.  

 

I took a pharmacology course in college and the one important thing I learned was that whatever a drug does while you take it, it will do the opposite when you stop.  It's called the swing effect.  Take a stimulant for too long and stop, you're tired.  Same thing with pain meds.  The pain comes back threefold in the beginning but lessens over time.  They are also a CNS depressant so it makes sense that you'll have insomnia.  Same with the bowels, etc.  That is why you taper down ever so slowly.  

 

Comfort meds from your doctor would be a mild benzodiazepine like Xanax or Valium. (go easy with those as they too are habit forming) Clonidine, which is an older blood pressure med that helps with anxiety and sleep.  And possibly some Ambien or whichever you prefer as a sleep med.  OTC stuff should be some Immodium for loose bowels, calming tea like Chamomile.  And maybe some vitamins.  That's the short list.  If you want the full one I'll have to go back and research.

 

Sorry for the book, but I hate to see anyone suffer needlessly.

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

Thanks Tommy,

It's funny... in my youth I was a party animal. A musician, on the road... nuff said! I don't have an addictive personality. With the exception of tobacco, I was able to give up the drugs and the partying (gave up tobacco last August). That being said, I still enjoyed catching a buzz. A few glasses (or more) of wine in the evening was not unusual on occasion. I hurt my back a few years ago and was prescribed Vicoden (hydro). They took the pain away and gave me a buzz as well. I won't deny it was pleasurable. Now it's not pleasure at all. There is no "buzz" involved. It's relief period! I remember thinking I'll be in lala land with all the pain drugs they're giving me but the contrary was true. They took the edge off the pain of treatment. Even now, that's what they do. They make dealing with the side effects tolerable. 

I remember going into treatment and saying to the doctors "just give me the good stuff".... and they did! I went to time released oxycontin when the pain was at it's worse but never got to the patches. I also used the herbal remedy which by far was the best pain and nausea reliever of them all but at this point, I just want to get off everything and gain a sense of normalcy. 

I'm off the oxycontin and on oxycodone. I have hydrocodone as well. I'm not taking a lot but I am taking it... two 5mg doses a day, sometimes three. Sometimes a hydrocodone which seems to work better for me when the pain gets really bad. I took the Tramadol in conjunction with the Lyrica when the nerve pain was at it's worse but I stopped taking the Tramadol when the nerve pain subsided. 

I realized that I need to continue to take pain meds for now. It all depends on side effects. I'm 12 weeks out this week and still have pain issues, nerve and otherwise. 

I appreciate the info. Like I said in another post, it was silly of me to try to go cold turkey like that. It could have caused more damage than good. I'll discuss a plan with my team and seek the help of a pain management specialist when the time comes if need be. 

Positive thoughts and prayers

"T"

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

Thanks for the replies!

After reading a bit more I realized it wasn't wise to try and go cold turkey like that. Our reaction to pain med withdrawal is no different than what a heroin addict goes through. The symptoms are identical. I finally got to sleep at 6:30 this morning after a hot shower and another 5mg of oxy. I slept a few hours and got a 45 minute nap this afternoon. I took a Benedryl and will head up to bed shortly. 

I'll be in touch with my team and request a Thyroid profile when I go in August as that may be affecting me negatively as well. In the mean time I'll continue to take the pain meds as needed. I've had two 5mg doses today and feel much better. When the time comes I'll seek the help of a pain management specialist to help wean me off.

Positive thoughts and prayers

"T"

 

 

phrannie51's picture
phrannie51
Posts: 3821
Joined: Mar 2012

withdrawal as what a heroin addict goes through....Heroin, morphine, oxy's, diladid, methadone....even codiene are all Opiates or Opioids....all pain killers and all habit forming (physically....your mind isn't looking for a high, but the body has it own cravings and needs).....

p

sin9775's picture
sin9775
Posts: 198
Joined: May 2013

"T", I wish you the very best with getting off of the pain meds. 

It is just so ironic that you should bring this up now.  Over the last couple of months I have read a few posts about the trouble with the meds.  I have been so very afraid of my brother taking them.  He had(s?) a problem with alcohol before his diagnosis/treatment.  I was afraid from the get go, that he would have a problem with the pain meds.  He has been trying very hard to avoid taking them, but just this past week, he was totally pressured into starting them by his wife and nurses.  I haven't asked them what he's taking, but I am so afraid of this happening to him.  You hear all of the time these horror stories about people, famous and otherwise, being addicted to pain medicines.  Of course I dont' want to see him or anyone else in pain, but the thought of adding pain med withdrawal to the mix makes me totally sick to my stomach.  I can't tell him what to do, but I know he has an addicting personality.  All you wonderful people have been through this.  Should I just keep quiet about my concerns and let him take the meds?  He rings the bell tomorrow.  If he has gotten this far . . .

 

~S~

 

IAmStrong2
Posts: 1
Joined: Jul 2013

Hi, reading w interest  . I SEE my primary today. I am 3 yrs out from stage 4 SVC Head and Neck. I had too much chemo and it took my kidneys out- have had horrific restless leg since-taking clonazepam for that. I can only take Tyl bc of kidney damage and I take a half of smallest dose of hydrocodone for other pain issues ie nerve, bone pain etc. So from what I am seeing restless leg can be from from the hydro? I take an avg 1 a day. Yet cisplatin can cause this too? I have hearing loss and some neuropathy. .frustrating while trying to be pro active and positive! Best to All!

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

Hi Strong,

Restless leg syndrome is a side effect of narcotic "withdrawal" too. If you're currently taking a narcotic pain releiver on a regular basis, it shouldn't cause that. I have heard that Cisplatin can cause it too. I had neuropahy "attacks" but it was nerve pain as opposed to numbness in my hands and feet and it happened a good two months out. I awoke with my skin on fire from my scalp to my chest/back/arms. Lyrica and Tramadol were prescribed and helped. Then, last week it can back from my waist to my knees! Uggg! Getting better now.

If you're still taking hydro then it shouldn't be contributing to your restless leg syndrome. My symptoms eased up after I took a dose of oxy. I'll be discussing with my team the hows and whens of going off of them. It's obvious my body has a dependency on pain meds for now. And in reality, I still need them. There are some, like yourself, who need them for much longer periods of time. It all depends on the severity of the side effects and how they affect us long term. 

Positive thoughts and prayers,

"T"

 

fishmanpa's picture
fishmanpa
Posts: 1127
Joined: Jan 2013

Hi ~S~,

 CONGRATS to your brother on ringing the bell! As you've read the other responses, the pain of treatment and the side effects afterwards warrent relief. I couldn't have gotten this far without narcotics. But I don't have an addictive personality concerning drugs. I understand your concern for your brother. Make sure his docs know of his prior addiction issues. They'll need to monitor his drug intake and help him wean off of them when the time comes. There's no need to suffer when they can provide relief. If done properly, they can be discontinued without the complications of withdrawal. 

Positive thoughts and prayers

"T"

jim and i's picture
jim and i
Posts: 1666
Joined: May 2011

T, I thought of you this morning when I signed on. I am so happy to hear you have went back on the meds until you can get assistance from the doctor. You are in my prayers.

Debbie

Roar's picture
Roar
Posts: 248
Joined: Mar 2013

getting off the pain meds was difficult for me too. i went off the oxy on my own without doctors approval about two weeks after treatment. looking back it probably was not the smartest thing i ever done. but i did it. i wanted to go back to work and could not function or remember things. at first i diidnt know what my body was telling me. i had bad neuropathy but didnt know what it was called - i couldnt sleep. what i can say now is that my neurapathy is almost completely gone, sometimes i will taks an abian to help me sleep as i still have issues sleeping and the lymphodema that once realy hung under my chin is almost gone. i still get pain once in a while but its nothing a moltrin cant handle. I think the moral of the story is stay on the meds as long as you have to and let your body heal, as you know it takes a lot of time to get better. i also notice that certain foods that i use to love cause severe irritation in my throat, so i stay away from those things. Keep fighting my fellow warrior. the months pass by quickly, and as they pass you fill take baby steps forward

Duggie88's picture
Duggie88
Posts: 557
Joined: Feb 2010

I know what your going through. Your right they never told to hang on for the joy ride. Like others said I would contact the Dr's or wait for your next appointment and let them help you. They may not want you off of them yet based on what you still have going on.

Stool softeners I remember them well also. Funny how you need drugs to conteracct the ones your already on.

Heal on

      Jeff

cureitall66's picture
cureitall66
Posts: 874
Joined: Aug 2012

"T",

Reading your post was like reliving what Kreg went through with the drug withdrawls. Yes, you do need to slowly wien yourself off of them....do NOT go cold turkey!

We were so disappointed when we called his nurse practioner about his pain and she kept say "exercise", "get on the treadmill", "walk" (as he was weining). She also mentioned to take ibruprofen. He did all of this faithfully everyday for about 5-7 days. The pain finally let up enough to be tolerable. So...we were a little skeptical about this working, but it did! 

Kreg's word of advice... "Patience".

Good luck,

~C

vermontgirl's picture
vermontgirl
Posts: 66
Joined: Nov 2012

My husband had severe withdrawal but like you was determined to get off.  He also decided to cut back too quickly.  He was on fentanyl patches and oxy.  He had flu like symptoms, severe fatigue, depression, trouble sleeping, aches, and lots and lots of sweating.  I called his team and they gave me a protocol.  Cut by half for the first week and religiously take the meds on schedule (every four hours for him), the second week, cut by a half and repeat.  We did that until I literaly could not split the meds any further.  That worked for him....slow and steady.  WHile he was on the meds, he couldnt figure out what the big deal with people abusing them....when he tried to get off, he completely understood.  He took the meds to avoid the crash.

Good luck.  You can do this.

 

Kirsten

CherieLW's picture
CherieLW
Posts: 438
Joined: May 2013

T,

I read a study awhile ago that people who are prescribed pain killers (especially the ones you mentioned) often have a hard time coming off them because something having to do with the brain makes the person feel more pain than there is actually present when they try to come off of them.  Not saying that you don't have pain, I 100 percent believe that anyone would in  your case would and would need to be prescribed pain meds. But does that first sentence make sense at all? The way the article worded it was that you would have an increased sensitivity to pain after being on pain killers for a specific period of time...

It sucks that you cannot get relief without them, but at the same time you can't be in misery all the time so it is probably best to continue taking what you need!  I hope that these problems and neuropathy (did I spell that right?) goes away... I'm not familiar with a lot regarding your recovery and I know each person is different. I'm praying for you! I know that it can't be easy having everything in your life change after going through this...

My thoughts are with you!

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