Mayo Clinic Pain Rehab Center (PRC) - What’s Your Experience?

Posted by robyn @boltz7555, May 13, 2022

Hello - my Mayo neurologist recently recommended the pain rehabilitation center (PRC) to me. They have scheduled my consultation for next week. I’m interested in hearing from others who have gone through this program. What was your experience?
@rwinney Hi Rachel - I had you in mind when I came to make this post and I found the helpful feedback and information you shared in a post from April, here: https://connect.mayoclinic.org/discussion/residential-chronic-pain-treatment-programs/
Did your condition impact your ability to work? If so, were you able to return to work with no special accommodations after PRC?

Interested in more discussions like this? Go to the Chronic Pain Support Group.

@sherry26

I take a small does suboxone for opioid withdrawal Used to take pain meds but got off and went on sub to prevent withdrawal and it’s excellent . Personally get zero pain relief from it but I take a very low dose

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@jenatsky

Buprenorphine has no naloxone in it and I use 20mcg/hr patch changed 1x week. Works very well

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Yes ,I was on high dose hydromorphone ( Dilaudid) ,having been on lots of other opioids over the years. Continue to be the only things that work , sadly.
But I want to be off , so the latest plan we are trying has been a Suboxone ( Bup + nalox) micro substitution . I think it’s a relatively new concept. Gradually have been able to decrease the hydromorphone dose significantly by adding very small incremental doses of Suboxone.
Plan is to completely switch to the Subox soon.
Being a longer acting drug , it also has unique characteristics that make it easier to wean . I am currently doing this as I wait to see if I will get into the PRC. One the added benefits of being on the suboxone is that it seems to have blocked the tolerance effect and my dose of both meds have stabilized , rather than needing more opioid for the same effect. This micro-substitution method has worked better for me than the traditional switch method , when you do it all at once . This method requires a Dr with specialized knowledge and experience in this area , and is not for the standard primary care physician I would think .
Hope that explains things

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@jenatsky

Have you considered Buprenorphine? Works on different brain receptors than opiates

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Buprenorphine does have special characteristics but it is an opiate with all the same implications that opiates have . Great it’s working for you.

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@alh123

Yes ,I was on high dose hydromorphone ( Dilaudid) ,having been on lots of other opioids over the years. Continue to be the only things that work , sadly.
But I want to be off , so the latest plan we are trying has been a Suboxone ( Bup + nalox) micro substitution . I think it’s a relatively new concept. Gradually have been able to decrease the hydromorphone dose significantly by adding very small incremental doses of Suboxone.
Plan is to completely switch to the Subox soon.
Being a longer acting drug , it also has unique characteristics that make it easier to wean . I am currently doing this as I wait to see if I will get into the PRC. One the added benefits of being on the suboxone is that it seems to have blocked the tolerance effect and my dose of both meds have stabilized , rather than needing more opioid for the same effect. This micro-substitution method has worked better for me than the traditional switch method , when you do it all at once . This method requires a Dr with specialized knowledge and experience in this area , and is not for the standard primary care physician I would think .
Hope that explains things

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Sounds a bit complicated and glad your found a provider to work with to hopefully reach your goal. I’m staying put for the time being pain med wise. My back will continue to deteriorate as I age and I will not opt for more surgery at this life stage.

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@jenatsky

Sounds a bit complicated and glad your found a provider to work with to hopefully reach your goal. I’m staying put for the time being pain med wise. My back will continue to deteriorate as I age and I will not opt for more surgery at this life stage.

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Yes it is , and I realize after I posted it that’s it’s really not for everyone , so I don’t want to cause confusion . My situation is 12 yrs old , very debilitating that seems tantalizingly close to a solution . …that never comes . So I’ve gone down the rabbit hole of trying so many things that now I’ve run out . It’s good in a way that you have reached some stability and so hopefully can move forward with more positive aspects of your life .

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Why are you wanting off narcotics if they help or are the docs wanting you off? I will never stop unless I must if pain is the result of stopping. I’ve been on some form of a narcotic since I fell in 1988. I was switched to morphine in 2005 and buprenorphine in 2014. It is the easiest to use and works well for me. I’ve never abused anything other than pot and I don’t have an addictive personality so I’m not worried about addiction issues. I use mindfulness meditation to help me thru rough periods and it has also helped a great deal.

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@alh123

Yes ,I was on high dose hydromorphone ( Dilaudid) ,having been on lots of other opioids over the years. Continue to be the only things that work , sadly.
But I want to be off , so the latest plan we are trying has been a Suboxone ( Bup + nalox) micro substitution . I think it’s a relatively new concept. Gradually have been able to decrease the hydromorphone dose significantly by adding very small incremental doses of Suboxone.
Plan is to completely switch to the Subox soon.
Being a longer acting drug , it also has unique characteristics that make it easier to wean . I am currently doing this as I wait to see if I will get into the PRC. One the added benefits of being on the suboxone is that it seems to have blocked the tolerance effect and my dose of both meds have stabilized , rather than needing more opioid for the same effect. This micro-substitution method has worked better for me than the traditional switch method , when you do it all at once . This method requires a Dr with specialized knowledge and experience in this area , and is not for the standard primary care physician I would think .
Hope that explains things

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@alh123 Hi, It seems like we have all gone through some of the same drug circles. So there must be a method to our doctors madness! I got through the long Dilaudid run and it did the trick on pain. Maxed on it for 5 + years. Never was on Suboxone. I had such a doctor, just happen to be my primary. Actually made him my doctor as he said he could help me lower anxiety medication, Xanax, with a couple lower drugs. It was slow but it worked. But this was prior to my injury and all the other drugs. I was in computer operations/ data center support desk. So I was lucky to have him! Thank you for making me realize that! Through it all sometimes there is a light at the end of the tunnel.

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@donrealtesting thats very interesting and I’m glad you’ve found some help. Just to clarify , where are you at with the dilaudid ? Still on it or have managed to wean ? I think one thing that’s been lost in the opioid discussion is the fact that there are a significant number of chronic pain patients who have stabilized on long term opioids and are very functional . During my journey , I must have seen at least 7-8 pain specialists and they all said they had patients like that . It’s not ideal to be on any med long term , especially opioids , but for some people it’s a life saver ..literally. Some Drs need an open mind on this as well as the administrators of opioid regulations . As for me , I’d rather be off ..I’ve weaned off opioids three times in my journey over 11 years but have eventually and reluctantly,ended up back on , as they are the only thing that seems to work . No craving or abuse …they just work, At present , with this suboxone substitution and hopefully the PRC coming up, I’m trying to wean again , so we'll see how it goes . Thanks for your input .

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@alh123 Hi, I got off it. Yes it took me a long time. I understand your frustration, I just wanted to feel like my feet were back on the ground again, without the pain of course. I always figured that if I needed it I could go back on it. My thought was if I kept on it, at some point I may need more and maybe nothing would work. I know nothing about suboxone, but my doctor did want to put me on it. I had already came off the dilaudid with Tinctures and my Cannabis products. It was difficult. I was lucky my pain at that point was more chronic. Time may have been a healer. I know that Homeopathic methods may not work for intense pain. I wish you God speed in keeping pain in check. The worst thing I found is sitting in my chair reclined, for my back and ribs. So I swim and bike daily.

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@donrealtesting

@alh123 Hi, I got off it. Yes it took me a long time. I understand your frustration, I just wanted to feel like my feet were back on the ground again, without the pain of course. I always figured that if I needed it I could go back on it. My thought was if I kept on it, at some point I may need more and maybe nothing would work. I know nothing about suboxone, but my doctor did want to put me on it. I had already came off the dilaudid with Tinctures and my Cannabis products. It was difficult. I was lucky my pain at that point was more chronic. Time may have been a healer. I know that Homeopathic methods may not work for intense pain. I wish you God speed in keeping pain in check. The worst thing I found is sitting in my chair reclined, for my back and ribs. So I swim and bike daily.

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That’s great that you’ve found a path. I really thought cannabis type products would be my med. I tried every physical form and mixture and either nothing happened or I got a headache , brain fog a, dry mouth and felt lousy . Same stuff given to a family member as an experiment , would make them terrific! I obviously have a dif gene and metabolism ….so no help from cannabis or it forms . Very disappointing.

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