The Pain Med scale

[hopelessromantic]

Can anyone out there explain the pain med scale to me? My client is on Darvocet and even her doctor told her that it's not much stronger than a Tylenol . On the other end, there's Morphine? Oxycontin? Oxybutin? What's the diff there? Just thought I'd ask since I've often wondered which is stronger than which...thanks!

[etkearne]

Different opioid analgesics bind tighter to the opioid receptor. Darvocet is very weak. Next up from there is Codeine and Tramadol, which are still weak. Then are the intermediates like Hydrocodone(Vicodin) and Percocet(Oxycodone). Those pills also have acetaminophen in them and are low-dosages. If we are talking chronic pain, step up the ladder to things like OxyContin (time released, high-dose Oxycodone), Hydromorphone (Dilaudid), Oxymorphone (Opana), and Morphine. For surgery, insanely strong things like Fentanyl are used. It is also used in severe, severe chronic pain in a patch form.

Naturally, the addictiveness goes up as you go up the ladder. That is why Darvocet (which is now banned for other reasons) is Schedule 4 and Fentanyl is Schedule 2.

And I agree, Darvocet is not much more efficacious than a large amount of Tylenol. Just one of the reasons they removed it.

[isisprincess1984]

Damn.

That's all I had to say when they removed darvocet from the market. I was taking three darv a day for back pain in conjunction with anti-inflammatories. However, I do remember my heart pounding when I was taking Darvocet. I think heart palpitations was one of the reasons they removed it from the market.

Right now I take tylenol 3 in addition to the anti-inflammatories. I also have muscle relaxers for when my muscles tense up. The tylenol 3 does not erase my pain but it is somewhat manageable. That is why I'm going to see a pain management doctor because my general practitioner refuses to treat my pain. He's not a pain doc so all he gives me is tylenol 3. Which I do understand.

I know someone who takes fetanyl. It is a MAJOR heavy duty narcotic. Also when you are being treated for pain you can't EVER take more or take something in addition to what you are already taking. This person I know who took fetanyl took an extra percocet with their fetanyl and their pain doc promptly removed them from everything. This person was in bed for a month throwing up. All they were given to help with withdrawals was tramadol. I also have taken tramadol, however they put me on darvocet instead of tramadol because I had a seizure on tramadol. Tramadol lowers the seizure threshold.

You can't f*** around with narcotics, that's for dang sure.