(284): Jumping off the Merry-Go-Round of Pain Medication
For years, I have been barely controlling my chronic pain using tramadol (and more recently Lyrica as well). When I was first prescribed this drug, it was (I think) a Schedule V drug; now it is a Schedule IV drug. Luckily, I could still get it refilled by the doctor over the phone. But the poor bastards who were taking hydrocodone now have a much harder time getting their refills since it was changed from a Schedule III to a Schedule II drug (same as morphine!) in 2014.
That’s the thing about treating chronic pain; it is chronic. The treatments often last for years. I witnessed the dismay and disorder in the pain clinic I was treated at when the government increased the number of hoops a patient (and the doctor) have to jump through to get access to the same medication in the same strength as they have been using to control pain on a long-term basis.
Many of these sufferers are elderly, and it is a hardship for them to sit for hours in a clinic, waiting for that magical doctor-signed chit that says they can have a month’s supply of the opioid drug that will make their severe arthritis pain less debilitating.
Now that our Commander-in-Chief and his regressive justice department under Sic ’em Sessions thinks that, if only we clamp down harder on drug dealers and traffickers and the pain doctors who dispense the legal medication, we can solve this crisis. That is the very same MO that underlay the disastrous War on Drugs.
So, long story short, I am attempting (yet again) to lower my dose of daily tramadol and hopefully wean completely off, so I can get off the pain medication merry-go-round once and for all. I am under no illusions that it will be easy. I tried it before in 2012–13. After following my doctor’s step-down schedule to the letter, I found that I could not make the ultimate jump to a completely drug-free state, because I found myself suffering severe reflux that may have been partially induced by tramadol withdrawal. Thus, I couldn’t rely on Advil, my go-to substitute over-the-counter pain reliever, as it lit a literal fire inside me.
I decided that I needed the tramadol to deal with the breakthrough pain, since I couldn’t take the stomach upsetting NSAIDs. After this debacle, I looked online for other people who had tried to wean off tramadol, and I found they had plenty of horror stories. Some sites I had seen even said that the withdrawal symptoms of tramadol could be worse than morphine, oxycodone, or even heroin. They didn’t warn me about this when they told me back in 2008 that it was mild and safe to use. Live and learn.
I have seen many instances of people who had titrated down slowly over a course of months, even going for multiple months on very small doses of tramadol to keep withdrawal symptoms at bay. They’ve said that opioids change the brain, and the longer they are taken, the more severe or persistent withdrawal can be. So it is possible that I will have to take it in tiny amounts for a year or more. Last time I only spent about 2–3 months tapering down.
There are as many different horror stories of withdrawal as there are people who pass through this stage of drug use. It is almost like standing at the top of a cliff in the total darkness, waiting to jump off, knowing there are other people out there who have survived, but also knowing that deep inside my brain there are neurons whose reactions I can’t fully predict. Maybe I should just treat it as an adventure, right?
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