Posted by ed_uk2010 on April 17, 2010, at 17:20:26
In reply to Re: ultram, really... » ed_uk2010, posted by bulldog2 on April 17, 2010, at 13:38:28
I understand what you're saying. My point is that opioids are not generally a first-line treatment for chronic non-malignant pain.
Also, acetaminophen at recommended doses does not damage the stomach, the liver or the kidneys. Acetaminophen causes very few adverse effects. NSAIDs such as ibuprofen can be more effective than acetaminophen but they do cause more side effects, especially stomach ulcers.
> > >Hi Ed, I do have chronic pain, sad to say--not as bad as many, so I'm not complaining.
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> > Hi FB,
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> > What is the cause of the pain and what have you tried so far?
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> > Tramadol can be useful for certain types of chronic pain, at least for a few weeks to cover exacerbations. Its long term efficacy is often reduced by the development of tolerance. The extent to which tolerance develops is variable. Stopping tramadol after long term treatment can sometimes lead to significant withdrawal symptoms, which may represent a mixture of SSRI/Effexor-like withdrawal symptoms and opioid withdrawal symptoms.
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> If withdrawal is done correctly there should not be significant withdrawal symptoms. It should not be done suddenly.I don't understand people doing cold turkey. It is also a milder opiate so it should not be as bad as stronger opiates.
> I was on 60 mg on percocet for a long time and many people in the hip replacement rehab unit had also been on strong pain meds for a long time.I was on 6 10 mg pills a day. I was withdrawn 1/2 pill a week. The withdrawal went very smoothly.
> I agree that some tolerance will develope with long term use. Again I must reiterate that proper slow withdrawal should not be significant.
> I have read that benzo withdrawal is much worse.
> Times are changing in terms of opiate use. People in chronic pain may need long term use for pain and life quality maintenance. If managed carefully tolerance should be slow. Also some that are older may require opiates the rest of their lives and therefore withdrawal may not be an issue.Things are usually not simply black or white so we have to make the best decision. The nsaids and actetimoniphen while not addictive are really hard on the stomach, liver and kidneys. So life time maintenance on opiates may be appropriate for some.
poster:ed_uk2010
thread:943398
URL: http://www.dr-bob.org/babble/20100416/msgs/943733.html