Often chronic pain pts’ need for increased pain meds is blamed on “tolerance” … some believe that the pt’s increase needs has little/nothing to do with the concept of “tolerance”.
In all likelihood this concept came from the fact that those who have abused opiates quickly develop a “tolerance” to “getting high” and keep having to take more and more in hopes of reaching a “high”. After 1-2 yrs of an addict trying to get “high” … they can’t get high any more… they continue to use/abuse opiates to avoid withdrawal… which they call “dope sick”.
It would seems that those who have issues with substance abusers have tried to apply this tolerance to getting high to the chronic pain pt’s need for higher doses.
What they seem to ignore the fact that as everyone ages… things stop working as well as they use to… the disease state that is causing your pain has probably deteriorated or gotten worse.
Aging also tends to slow down your stamina … you may have to push harder to get the same things done as 5-10 yrs before.. which will cause activity induced pain.. trying to gets the same/similar tasks done.
There are many factors that contribute to a pt’s need for larger doses in treating their pain as times goes by… throwing the label of TOLERANCE on that need is probably more fiction than fact.
Filed under: General Problems
My pain doctor told me I’m maxed out at 15mg of Oxy’s. So does that mean my pain is maxed out? I don’t think so. I am starting to need to go to 20mg for the reason that I can’t do anything like I did a few years ago. Before, I didn’t need my cane as much, oh and I’ve gained 30lbs because I can’t do what I did. How can I be maxed out? I dream of relieving the pain again. But this doctor doesn’t care. He doesn’t care about any of the pain I’m in. In fact, he wanted to put me back on 10mg of Norcos…why? Because he thinks I built up a tolerance to what I’m on. These doctors need to quit reading pain by a book.
IMO opioid tolerance is a myth. Yes, addicts who use opioids to get high will “require” higher amounts to continue “achieving” that same high (known as “chasing the dragon”), which is one of the main reasons many of them end up overdosing.
The same can be said about abusing alcohol or any other type of substance that is chronically abused – to continue achieving that initial “high,” more of that substance must be consumed. As I’ve stated a trillion times, the abused substance is merely the symptom of something much bigger and more complex.
Pain patients are completely different, as we don’t get “high” from our medications. I’ve taken the same medication for almost 10 years while getting the same relief I had in the beginning. My dad took the same medication for over 30 years while getting the same relief he had in the beginning. I know many others who are the same way.
Many pain patients suffer from degenerative disorders and diseases (ex: MS, FM, many disorders/injuries of the spine, etc). This means the disease worsens over time. The patient will usually suffer more pain over time, which can require adjustments to their medication. This. Is. Normal. (and it’s common sense).
Not to mention, as we age, our bodies begin to break down even more. This same thing can happen with all kinds of different patients. Those with chronic depression and on an antidepressant often require adjustments to their medication because of the same issues. Same with diabetes patients, blood pressure patients, etc.
Everyone’s experience of Pain is different! When it comes to opiates, it’s simply a function of how these drugs impact our brains. I was on them 24-7 for over 5 yrs and had to switch or increase doses at about the six month marker & Was STILL in tremendous pain. Tolerance is NOT fiction, nor is it a Bad word, it’s a Medical/Scientific term. There are Many drugs & chemicals that our bodies develop tolerance to, including Sodium!
Opiate tolerance is 10000% fiction,,,,,I have been in pain management since 27 years of age,,,now 50,,,,for the last 13 years my medicine has actually decreased by 10 milligrams,,by my request,,,other then that same dosage for 10 years,,no increase ever,,and my physical pain has remained steady,,according to my physical activity,,,See,,,u if u can u gotta work w/your medicines,,,not against them,,,if your allowed,,,other wise like most folk who have to earn a living ,,then the doctor simply needs to give them enough medicine to function productively thru out the day,,,,,I think this ,”tolerance ,”lie”,, comes from doctors who refuse to initially give a patient the proper amount of medicine to lessen their pain effectively,,,,or the diagnosis is wrong,,,,,I have NEVER EVER GOTTEN THIS ,”HIGH” U SPEAK OF,,,EVER!@!!,,,,I HAVE PHYSICALLY FELT PHYSICAL RELIEF FROM THEE LESSENING OF PHYSICAL PAIN,, but never high,…I have felt less emotional stress from thee forced endurement of physical pain,,,I have actually been allowed to eat,sleep and breath with lessen physical pain which does make me emotionally happy,,,as it would anyone,,,but .”high,”’ like smoking pot at 16,,,,nope never w/opiates,,maryw