Questions & Comments about tapering off morphine (Kadian)

@elsa

I'm finding that Gabapentin is starting to cause deficits in my thinking, so I started tapering off it today - talked with the pharmacist about it this morning. I was thinking that maybe one of the neuropathy meds that I tried and didn't work might pick up the residual pain after a spinal cord stimulator implant in June last year. I'm afraid that's not a reasonable consideration, which I think will mean taking a bit more morphine. I don't think I'll have to get back up to 90mg, but I'm going to ask the doctor to raise my prescription to 15mg three times a day to start with.

Jim

Jim, I wish you the best decreasing the gabapentin and increasing the morphine.
It's well-known that gabapentin can negatively impact one's memory. I can attest to it myself. I now take 900mg per day. I used to take 2700mg per day!! It made a huge difference in restoring clarity of mind. Wish I could get off it completely, but I still need it since I'm now 100% morphine and hydrocodone free!
Does your SCS help you? I considered having one but never got comfortable enough with the idea of the implant.

I am a Volunteer Mentor and not a medical professional. I posted this on another page her, but after reading your comments, I have copied my comments to this page. I hope they are helpful in some way.

As an older adult (68 yrs.old at the time) I was put on several pain medications for chronic back pain that became acute pain in October, 2016. I am already taking Citalopram (SSRI) to which my pain doctor added Gabapentin, Baclofen, and Tramadol. I was also given a prescription for Valium to take before my back surgery in December, 2016. I continued to take these medications until I was beginning to feel better as a result of a new physical therapy I was trying called Active Release Technique (ART). When I told my pain doctor I wanted to stop taking the Gabapentin (600-900 mg/day), he seemed to be mad at me and asked me why. I told him I didn't like the way I felt on it, couldn't think straight and was losing large chunks of memory. (In fact, I thought I was getting Alzheimers it was so bad.) When he said I could just stop taking it, I said I had read that you can have withdrawal symptoms if you just stop it. He laughed at me and said impossible. Then I got a lecture on what was "withdrawal" and that I could only have that from opiods, not Gabapentin. However, I had read on Mayo Connect about the problems withdrawal from Gabapentin caused people. I then called my pharmacist who gave me a withdrawal schedule and confirmed that it was difficult to withdraw from. I successfully withdrew over 2-3 months time. I also withdrew from Baclofen at the same time toward the end of the 3 months. I discovered that my pain improved as I withdrew from the Gabapentin.

I was still taking Tramadol 50mg 4x day until November, 2017. I talked to the pain doctor about withdrawing from it as well, and he encouraged me to do that. It was much harder do withdraw from, and I still have some issues that I attribute to withdrawal. It has taken me 3 months to get off the Tramadol. I found that CBD Living Water and drops helped with my anxiety during withdrawl at the beginning. CBD is from marijuana and is the part of the plant that doesn't make you high. It helped me relax and relieved anxiety. I no longer use it. My pain doctor cut the number of pills in my prescription to 3 a day, and I began cutting those in half as I was going down in dose. I just got a refill of Tramadol and asked the doctor's office to only give me 30 pills as I would only need them now if I have acute pain, which happens only occasionally if I overdo it. However, they gave me the 90 pills again. If I was still feeling addicted to Tramadol this would have been a detrimental thing for me. Fortunately, I have just put the pills away and will not take any unless I really feel pain. Even then, I will only take 1/2 a pill.

It is hard to believe that pain doctors, especially, don't want you to get off drugs. Knowing what I know about Gabapentin now after taking it, I would recommend anyone taking it to withdraw, but that is only my experience. Others may find great help with it. What I have learned is to pay attention to my body, and if I think there is a problem with what my doctor tells me, find another source to investigate the information. I have successfully withdrawn from my medications, but I wasn't taking them for many years.

I recommend that anyone withdrawing from opiods/benzos talk with your doctor, but also with your pharmacist about what they recommend as a withdrawal schedule. If you are having withdrawal symptoms that are too much, go back to your previous dose, and take it slower. None of these drugs is easy to get off,and it takes a long time to do so. Take as long as you need, many months, and cut your doses in half or by quarters to help you with the slow withdrawal. By all means I recommend from my experience, try CBD to help with the anxiety you will feel. It is not addictive and if it's legal in your state, I found it very helpful.

I agree with you that in their efforts to find a way to help relieve pain, doctors have gone to the extreme in prescribing opiods as an easy "fix". I watched my older brothers go from light use to morphine and oxycontin, and now methadone in the pain doctor world. We have genetic back disease, but just treating the pain with medications isn't where things should stop. My discovery of ART has relieved my pain almost completely. I have pain but it is bearable, and if needed I take Tylenol first (following instructions), and that usually works. My youngest brother has gotten off oxy after many years of taking all kinds of drugs for pain. He had back surgery fusing two disks 2.5 years ago and though he still has pain, it's reduced and he's living with it.

I think we've all, including doctors, been misled about opoids and benzoprines. Money is a strong driver of corporate actions, and I believe that is the case here. I know to listen to my body and be very careful what I put in it. Doctors, pharmaceutical companies, and pharmacists are human beings. As such they make mistakes. In my opinion, our mistake can be listening to their advice at the expense of our own intuition about our bodies. They do the best they can,and I must do the best for myself as well.

How have you been handling your family member's withdrawal symptoms now?
Have you spoken to any pharmacists about helping with the schedule of withdrawal?
Please let us know where things are with them and with you. Thank you for sharing your thoughts and frustrations with us. I hope my experience is helpful.

Warm regards,
Gail B
Volunteer Mentor

@elsa

The SCS implant gave me 75-80% pain reduction. It was wonderful! I don't think I can remember how much pain I was having before. I do know that the disease is progressive, so I suppose I could expect the pain to increase. My feet hurt the most when I spend the day shopping. Walking and standing on hard surfaces is painful and I pay for it when I get home, as was the case today. I sat in the recliner all evening, but my feet are burning now in bed. I'll put some Lidocaine cream on them to numb them so I can go to sleep.

The procedure was straightforward, outpatient, and not painful. There's a 6 week recovery - no lifting, bending or twisting, as the leads become one with the nerves. That was hard because I had it done in June, so my yardwork was way behind schedule.

I recommend doing the trial so you can find out if it will give you enough relief to warrant a permanent implant. They require that you have at least a 50% reduction of pain during the trial.

Gotta go.

Jim

I was seen by Dr. Mauk at Mayo in November. He said he didn't think I'd be a good candidate for a SCS. I may revisit the possibility when I'm in Rochester for pain rehab beginning March 5. The bottoms of my feet (especially the heels) hurt like the devil. I have a custom compounded salve I apply to my heels. It has 5 agents: baclofen, ketamine, gabapentin and 2 others (BA and DI). It helps some. If I'm on my feet a lot, they'll hurt lying in bed that same night. Sometimes, I have to hang both feet off the top edge of 2 pillows so they're not touching anything. Does the SCS help the pain in your feel?

I just read this article on cnn.
An outbreak of 28 salmonella infections in 20 states has been linked to kratom products, the US Centers for Disease Control and Prevention said in a statement. Though no deaths have been reported, 11 people have been hospitalized.

@elsa

Yes, the SCS has reduced the pain in my feet by around 75%. I smiled when I read you describe the process I go through many nights. I have a feather pillow for my feet, but sometimes just the contact hurts, so I also hang my feet over the edge of the bed or the pillow. I have a blanket lifter to keep the bedding off my feet.

My feet hurt, but I'm thankful that they don't hurt like they used to.

Jim

This is my first time to read and respond on this media. After about 4 hours of sleep I suddenly wake with extreme foot pain on the part of my heels that touch the bed and moderate pain on the tips of my big toes that the sheet touches. I asked my primary doctor about this and she has not heard of this. I have to get out of bed and sleep in my recliner the rest of the night. Using the term "sleep" is almost joke as I am up and down all night with back pain and a restless feeling that keeps me from sleeping. Has any one had these problems? I don't know what the initias mean that I read this morning. This is my first day. I a have psyoriatic arthritis, CÓPD, fibromyalgia, stenosis of the spine, have one stent and my bronchial tubes don't work.

I'm sorry to hear about your pain! I'm not a doctor, (nor do I play one on TV 🙂 but the pain in your feet sounds like some type of peripheral neuropathy. I would have thought that your primary care doctor, had she "never heard of" the pain in your feet, would have referred you to an appropriate specialist (i.e., a neurologist or pain medicine MD) for further testing and a diagnosis. If I were you, I'd try to get that kind of a referral! Do you live in a community where you have access to GOOD medical resources?

Yes. In fact I am being tested by a neurologist for memory problems that he thinks are caused by the pain meds I take. He is ruling out possible other causes. I never thought if telling him about foot problems. I also get pain under the ball if the right foot during the day that feels better as though my sock is waded up. I will tell him about this when I see him in a few weeks. I also have sciatic nerve pain in the same leg. What is a thing someone mentioned about that keeps the bedspread from touching the toes.