This is a bit of a strange and difficult one

[oldanddone]

I take Tramadol for my back, which I fractured almost 3 years ago. I have really been taking these ever since then. I had noticed that I had been running out of them more quickly and putting in more repeated prescriptions but didn't look into it. The doctor phoned to say that I have had far more than needed and they won't give me another prescription. I take 6 a day. I phoned the pharmacy and they say I received 168 tablets last Friday. I have just checked and I had a box that hadn't been opened together with some other tablets. On the outside of the box it says there are 68 tablets. I have just opened the sealed box and there are 20. I have phoned the pharmacy and they don't believe me. I don't have anyone who could have taken them and anyway, the box was sealed closed. What do I do. I am seeing the pharmacist tomorrow but I only have enough to do me 4 days in total.

Not everyone can take NSAIDs though - some asthmatics, this with a history of stomach ulcers or similar circumstances.

I’m currently on naproxen (as well as paracetamol, buprenorphine patches and, when the pain is bad enough that it’s needed, oromorph). I’m going to be having some surgery soon and, after that, won’t be able to have the naproxen because it is contraindicated and could cause other issues. I also have to take other medication because the NSAIDs can lead to stomach issues.

The big issue with taking NSAIDs, as an entire group of drugs, out of pain management is that there is limited access to viable alternatives that are appropriate without going down the opiate drugs direction unless your pain is neuropathic in nature in which case drugs such as prefabs lín, gabapentin or amitriptylline may be effective. I was on tramadol for a long time but then, about 15 years ago, access to it was being tailed off due to the number of people who end up with a functional addiction to it.

Is it? I've a friend who broke his back some years ago, and he has codeine and morphine prescribed. He doesn't always need it, but when it's playing up, that's what he takes. I have no idea if he's had discussions with his GP about alternatives.

Yeah. I've had years of painkillers from a neurological condition and a spinal injury when I was 10 and have always been told that anti inflammatory painkillers were the most effective and codeine was pointless to prescribe for joint pain although I have tried it and tbf the doctor was right it did nothing. It does seem to boost the effect of Diclofenac when taken together though.

For a broken back I can well imagine he'd need morphine, poor sod! I've only had morphine once and that shit is good. If it's working for him then run with it. Long term pain is horrendous to live with.

Perhaps try acupuncture for a bad back it's. Very effective.

Lidocaine patches are normally only prescribed short term use for things such as acute fractured ribs.

On hospital all controlled drugs need two nurses to sign these out of the drug cupboard and the same 2 nurses both witness the patient taking them to prevent this.

Ha Bloody Ha.

Yes I've used acupuncture, and it can help though eventually the effects get less over time. I also use a TENS machine (similar principle) sometimes, and again the effectiveness reduces after some time so no point in using it for a few months. But something like acupuncture only relieves the symptoms for a brief time - it can't cure arthritis, or pressure on the nerves, or reduce a prolapsed disc, it just reduces the impact of the associated problems.

So these are just tiny little top ups to the prescribed medications, used in addition rather than instead. Everything people with severe back pain (or TBH most types of chronic pain) do adds together with each thing reducing the pain by a certain amount. I can't remember the last time I was pain free, but you just sort of get used to it and do as much as you can to counter the worst days.

Have you tried Pregabilin ? It’s similar to Gabapentin in that it blocks nerve pain, but it’s a bit stronger. There’s also Amitriptyline and Nortriptyline which are anti depressants used off label for this type of pain. I have sciatica caused by a complicated spinal condition and l don’t think people realise just how painful it can be.

Hi Everyone. Thank you for your responses. I have tailed off the tramadol and haven't had any for over 24 hours. I'm in pain but not craving them. I phoned the doctor and I have an appointment on Friday. I absolutely will not be given any more tramadol because it was my responsibility. I have said to everyone in my house that I am going to contact the pharmacy and start and Police investigation. I'm not, but they told me I should do it because something isn't right. The only other person could be my cleaner but I really can't see it. Anyway I am not puking up, which I imagine I would be if I had been taking 2 or 3 times the recommended dose. I can't prove it though. I do take 6 Gabapentin for nerve damage - 100mg. I cut these down myself over a year ago. My Gabapentin is all there. My question is will the doctor give me something else? I'm in a lot of pain. I'm alternating between a tens machine, co-codamol off the pharmacy and copious hot water bottles. Will I get given anything else because I am pretty miserable?

You really should take this further.

If you start to get bad withdrawal please phone the GP. 24 hours is really early days.

thank you, yes I know. I feel exhausted and in a lot of pain. The fact I have been more or less accused of being an addict if really not good.

No need to be sarcastic .people are just trying to help

The g.p will not prescribe any more tramadol if you have "cannot locate 100 tablets" .Maybe keep them in a locked box if you suspect family or the cleaner is stealing them .The chronic pain clinic would recommend things such as CBT therapy, complimentary therapies,physio, exercise such as Tai chi in unison with analgesia .They use the Socrates approach to assess what type of pain it is i.e neuropathic and use the analgesic ladder to prescribe the appropriate medication.Tramadol is known as a highly addictive drug and not to be used long term .Patients are often desperate for this and display drug seeking behaviour to obtain it so the G.p is quite rightly cautious when prescribing this.

You're not an addict, withdrawal from omeprazole is hellish. No-one accuses anyone of being addicted to those.

I'm on 3 gabapentin a day, sometimes I forget the midday one which is fine when I'm having a reasonable day. I've cut back the ibuprofen to morning and bedtime if I'm in a lot of pain because my stomach really hates them.

I've increased my exercises which does seem to be working as does lying on my stomach on the sofa.

I sometimes think if I could be stretched out on a rack every day it would help my spine. 🙈

I know I know. But I'm getting to the stage where I'm sick & tired of people asking me if I've taken any painkillers - yes, I needed to so I could actually make it in to work, or the kindly suggestion that someone had found a lot of help by taking up walking; I did try telling her that I was under strict instructions from a specialist NOT to walk any more than absolutely necessary until they had the scan done & fully analysed the results, but that fell on deaf ears. And the kindly meant questions about whether my back was better - no arthritis doesn't get better over time like soft tissue injuries can, it can only ever get worse. And now I have symptoms of something else potentially more serious going on.

So far in the last couple of months I've had suggested to me:

Try OTC co-codamol (multiple times) - I'm on prescription co-codamol much stronger than you can get OTC.
How about Ibuprofen (multiple times) - well the Naproxen is supposed to be stronger than any OTC ibuprofen.
Go for long walks - see above. Plus walking more than about 30-40 metres is VERY painful. Closely related is the suggestions I go for a walk at lunchtime.
How about one of those TENS machines - you mean like the one I'm currently using as we speak?
How about a hot water bottle (multiple times) - enough said!

Most of these people also know that I'm qualified as a sports injury massage therapist, which means I needed to know what to do with many types of injuries.

I am on something called Etoricoxib for my joint pain. My consultant gave me some to try and it works very well. However, my GP won't prescribe it and the hospital says they won't prescribe any more because the GP should do it. I have used it very sparingly and only have 2 tablets left. They just constantly argue about medication. It is tedious. Maybe you could ask/mention it?
I can't take opiates at all.

Hi everyone. I was scheduled to see the doctor on Friday and was using my supply very sparingly. I did end up taking one tablet yesterday because I was in a lot of pain and felt a bit sick. I was up half the night getting ice packs, hot water bottles etc but it was pretty bad. I saw a lovely doctor and they have agreed to give me my prescription on a week to week basis. I have no idea what happened with the tablets but they could tell I hadn't over-dosed on them and had never done so in the past. Just ordered a locked box off Amazon with a combination. No one but me will know it so unless I am taking them in my sleep they will be safe. I appreciate the helpful comments. The ones saying I am an addict and took them myself, please be careful what you say to people. It's really not helpful

I have to agree with you. Unless you have chronic pain people just don't get it. Exercise, go for walks, try a bath, tens machine etc. When you are in a lot of pain the last thing you want to do is exercise or go for long walks. A tens machine works a bit but unless you were wired up to it 24 hours a day it will do nothing. I take Naproxen, Gabapentin and Tramadol and I'm still in pain so that says a lot.

I really don't understand why you wouldn't pursue this with the pharmacy, either you don't get how serious a medication error is, you don't care, or you're certain the pharmacy wasn't at fault. Either way it doesn't reflect well on you.

You are addicted to them though. 3 years of taking an opiod drug will result in a reliance on them. You say you haven't abused them only you know that. But anyone who takes tramadol for 3 years will end up addicted to them.

This.
The tablets haven't just disappeared, either something seriously wrong has happened at the chemist or someone in your house has taken them, you have obviously considered this as you've bought a secure box only you know the combination to.

Several of us have addressed this upthread and patiently tried to explain the difference between addiction and dependence.

Thanks for updating, @oldanddone. A
locked storage box is a very good idea. You must get into the habit of opening the prescription bag while you are still in the shop and counting carefully.

I am glad the doctor reviewed your medication.

If you go back again for a further review, think about asking for a patch.

My doctor put me on those as well as tablets as he said it was better to regulate pain 24 hours a day to help me sleep. They are Butran patches - also addictive and a controlled drug but they may work better for you than the tramadol.

I understood the anxiety about the review - I was expecting a consultant this week to tell me I should not be on patches and medication but instead I was told to say if I wanted to up the dose! Having read some of this thread I was expecting to be told I should come off everything .

Good luck with the locked box as well

Thanks for that. I didn't want to cause a huge drama. I also didn't want to get anyone in trouble. I have dealt with this the best way I feel comfortable with.