Cancer Patient Starting Down That Dark Road

Howdy folks, I just stumbled onto this board. I am a lymphoma patient, and until very recently, had 131/2 years clean and sober. I had Oxycondone prescribed when I began immunotherapy in August, and actually began taking them in early November as I completed a round of radiation therapy. Most of my pain comes from scarring of the tissue where the tumors are being killed. Essentially, pain is good in that it represents that the cancer is dying. The smaller my tumor becomes, the more intense the pain.

My pain ratcheted up in the last couple or three weeks and my intake of pills started to increase. For a while, it was two 5mg tabs each day at 4 hr intervals, then I needed to start earlier in the day, and then to take additional pills at more frequent intervals. Just last Tuesday, the nurse at the cancer office suggested I start with two each day. Last Tuesday, I also learned that I am not in remission: I go back into immunotherapy in three weeks. We are a bout half way there in reducing my spleen to a normal size: When I was diagnosed, it was the size of a football. Now it is the size of a cantaloupe. Ideally, it should be the size of a small fist. We have a distance to go prior to achieving remission (assuming we ever get there) which means that I can expect more of the same in the upcoming three months to whenever.

Yesterday, I started at 3:00 PM with two pills and took my fifth and last pill at 11:00 PM. I began keeping a diary of my usage to keep myself honest (I have been down this road before and I know the importance of rigorous honesty). I am not sure that this is the right place for me to ask questions but it seems that now is not the right time to try to get off these pills. Though my dosages probably seem low to some of you, I am pretty sure that the sickness I often feel is related to my trying to minimize use of the pills, in that I always feel much better after I cave and take one. My pain is real but I really dont know how to handle this. My oncology office simply says do not worry about it. They want me to be comfortable while we fight the cancer. Twelve step folks generally take a pretty strict view of this and their entire program centers on abstinence. In light of the fact that I am not in remission I feel that some measured approach makes more sense, which is pretty scary for a guy who has chosen to live his life clean and sober up to this point.

My question, I suppose, it how do I know when I am crossing a line? If I follow doctors orders and stay ahead of the pain, how do I know if I am using too much? Also, when the time comes, How am I going o have to get off this stuff? I have already gone to the bottom, lost everything, gotten sober and rebuilt my life. I am not sure that I have another recovery in me. Any advice would be appreciated.
[EMAIL]suzbone @aol. com[/EMAIL

hi, wow you are in a tough situation. i can tell you that I was sober for 11 years and broke two ribs. my doctor said that one percocet would be okay. this started me back on a road of utter disaster. i do not want to scare you, because i don't believe that addicts,godwantus to be in pain where the time comes, as it has for you. you are talking to aa people which is excellent. Keep going to lots of meetings, they always remind me that indeed I may be educated and intelligent(which by the way nearly killed me) but I am an addict, full throttle, and nothing will ever change that. Surround yourself with the beauty of recovery and recovering people. Last Dec, i was drug seeking, had a surgery that I didnt need, serious complications, and took 150 percocet in 3 days. back to treatment for 3 months, drug free and fully enjoying recovery for 1 year on Jan 7th. As you know, you can do lots of things wrong but you must go to lots of meetings, and give back, tell others your story. Your honesty is wonderful. strive for that and keep yourself that way by talking lots and lots to people about how you are doing on the pills. i know someday, i will need something for pain. i will take it, but i will surround myself with the miracle of the recovering people, the winners. write back, i would love to know how you are doing. i will pray for you. suzbone
Suzie, thanks for responding. I am continuing my drug consumption diary and have discussed the issue with my oncologist as well as anyone who will listen. My spiritual life is in pretty good shape, though the painkillers have a tendency to drive me into myself and shut me off from my HP. On most days, I can still feel His presence, and that is a good thing. Three days ago, the pain was really bad, and I ratcheted up again to the highest level yet. Strangely, though, the pain has subsided in the last two days and my usage is back down to what was about three weeks ago. I take this as evidence of the existence of an active God in my life. The aspect of the program demanding rigorous honesty requires that I only take a pill in response to pain, and not in response to the fear of pain. This gets undercut by the Drs and Nurses who tell me to stay ahead of the pain. Right now, with the pain on the wane, I am going to ignore them and try to get the usage back down. I learned that I may have yet another tumor so I know I am not out of the woods, and there are likely to be rough patches ahead, but the easy thing to do is simply fold and say, hey, I am entitled, think I'll have another. I wish to avoid this line of thought, because it is the thinking of a beast inside me, which, though chained for 14 years, remains stronger than ever. I plan to take your advice and get myself to a meeting. Please stay in touch! David.
Hi Jack, Jake here. Ha! Just did that because it was funny. I am a nurse and can tell you that for many years doctors did not give patients in pain enough pain medicine. Ever since the yellow journalism of the turn of the century scared society out of thier minds that narcotic/opioid users were from satan, everyone thinks that opioids are from the devil. Since the 80's things have changed somewhat and a more level headed approach is slowly taking hold. Doctors are taught, give patients in legitimate pain adequate medicine, but keep a wary eye on the drug seeker. You are in the pain category. Cancer patients, the terminally ill, and chronic pain patients, etc all deserve to be pain free. Just as we all do. What you're doing is right, be honest and up front with yourself and those around you. It only becomes a monster when you try to hide it and make it a mystery or big secret and keep it from everyone. You have cancer, don't feel ashamed for seeking relief. When the time comes (and it will) for you to not need the pain medicine any more, tell your doctor your concerns. Chances are he's dealt with others like you oh, a thousand times or so before. He understands your worries, and fears and will help you and work with you in gradually easing you off of them. No pain, no withdrawl, no worries. If he doesn't, find another doc, because he should. Also, to allay other fears you may be having, opioids are a bit unique (with the possible exception of THC -- the main ingredient in marijuana) in that it does no harm to the systems of the body. People have been on them daily for over 30 years and have had no ill effects. Most of the risk comes from other sources. Like with heroin, the lifestyle of dirty needles, nasty substances mixed in to cut the heroin so it will go further, and just the environment in which all of that takes place. The drug itself is quite harmless to the body. In fact, i've read studies that say asprin is more harmful over all because of the damage it can do to the GI tract over time. People take asprin by the ton! Secondly, no one has ever died from withdrawl from any opioid. It just doesn't happen like coccaine or alcohol. You will feel like crap, but you won't die. Find a caring doctor who understands your concerns, who will help ease you off and keep you off if that's your wish.

You can email me if you wish at jakeman151@yahoo.com. Good luck!
Jake, thanks for your thoughts. I went through some pretty dark times with my last dance with addiction about 14 years ago. In the intervening time, I think I have built up some strength of character that will allow me to face down the pain of withdrawal. I remember the major battle for me was the emotional dependence on the drugs, and that took about one 12 step meeting per day for 7 years to get me back on solid ground. I have tried going it without pain meds and, fact is that I will lose my livelihood and relationships faster that way than rationally managing my pain. I am trying to stay "rigourously honest," as required by AA's big book by maintaining my drug use diary, and right now, I seem to be able to manage at a plateau of about 30 mg per day. I hope I do not have a need to increase this dosage anytime soon. I appreciate your thoughts. This site is great in that it reminds me quickly about the struggles that I faced and that others face to walk alway from drug dependence. It is yet another aspect of trying to stay honest in my thinking as I deal with these issues. To all those trying to get off the stuff, I will say that a meeting a day will probably not hurt your chances of getting straight. Thanks again!
JackStraw,

It's good to know that AA/NA has helped you in the past with your addictions but I don't agree with all of their hard nosed teaching re: appropriate use of certain medications such as what you are dealing with right now.

You have an illness that causes severe pain, you should not have to suffer from that because of past problems that you have had under control for years. You need to take the appropriate dosage to alleve the pain, nothing more, nothing less. Chronic pain patients should not be treated like drug addicts by any group, regardless. We should not have to suffer simply because a choice few have opted to abuse, snort, mix with alcohol, and other drugs to obtain a high, not to alleviate pain that totally leave them disabled.

I am so tired of being treated like a drug addict every time I have to get my prescription filled at the pharmacy. I have starting asking my husband to do it for me. I have been dealing with chronic pain as a result from an unsuccessful back surgery for over 10 years, I take these meds on and off, I never have problems stopping them when I don't need them, yet we only hear about the horrors of Oxycontin, not the lives it has saved. It is a miracle drug for people who for years have had to live in so much pain their quality of life is horrific and can even lead to suicide. Pain patients needed to be heard and treated.

Good luck to you Jack, I wish you the best as you deal with this illness. Don't be afraid to take pain meds, talk with your doctor, continue to keep a journal but don't suffer because of outdated hardcore opinions that the AA groups are not currently taking into their recovery process. Keep us updated.

Grace